2022/01/27 更新

写真a

アカザワ コウヘイ
赤澤 宏平
AKAZAWA Kohei
所属
医歯学総合病院 医療情報部 教授
医歯学総合研究科 地域疾病制御医学専攻 教授
職名
教授
▶ researchmapのプロフィールを表示
外部リンク

学位

  • 博士(数理学) ( 1999年3月   九州大学 )

  • 博士(医学) ( 1993年7月   九州大学 )

研究キーワード

  • 診療情報学

  • 医療情報学

  • 医療経済学

  • 病院経営

  • 生存時間解析

  • 臨床疫学

  • 臨床試験

  • 医療統計学

研究分野

  • 情報通信 / 生命、健康、医療情報学

  • ライフサイエンス / 医療管理学、医療系社会学  / 医療経済

  • 情報通信 / 統計科学

経歴(researchmap)

  • 新潟大学   医歯学総合研究科 医科学専攻   教授

    2003年10月 - 現在

      詳細を見る

  • 新潟大学   医歯学総合病院   教授

    2003年10月 - 現在

      詳細を見る

  • 新潟大学   医歯学総合研究科 地域疾病制御医学専攻   教授

    2003年10月 - 現在

      詳細を見る

経歴

  • 新潟大学   医歯学総合病院   教授

    2003年10月 - 現在

  • 新潟大学   医歯学総合研究科 地域疾病制御医学専攻   教授

    2003年10月 - 現在

  • 新潟大学   医歯学総合研究科 医科学専攻   教授

    2003年10月 - 現在

所属学協会

▶ 全件表示

委員歴

  • 日本消化器外科学会   会誌編集委員会委員(統計学)  

    2011年9月 - 現在   

      詳細を見る

    団体区分:学協会

    researchmap

  • 日本胃癌学会   胃癌登録委員  

    2006年5月 - 現在   

      詳細を見る

    団体区分:学協会

    researchmap

  • 日本外科学会   臨床研究推進委員会 臨床統計顧問、英文誌編集委員  

    2006年4月 - 現在   

      詳細を見る

    団体区分:学協会

    researchmap

  • 日本診療情報管理学会   評議員、編集委員会、  

    2005年9月 - 現在   

      詳細を見る

    団体区分:学協会

    researchmap

 

論文

  • Correction to: A novel splicing variant of ANXA11 in a patient with amyotrophic lateral sclerosis: histologic and biochemical features. 国際誌

    Makoto Sainouchi, Yuya Hatano, Mari Tada, Tomohiko Ishihara, Shoichiro Ando, Taisuke Kato, Jun Tokunaga, Gaku Ito, Hiroaki Miyahara, Yasuko Toyoshima, Akio Yokoseki, Tetsutaro Ozawa, Kohei Akazawa, Osamu Onodera, Akiyoshi Kakita

    Acta neuropathologica communications   9 ( 1 )   115 - 115   2021年6月

     詳細を見る

  • A novel splicing variant of ANXA11 in a patient with amyotrophic lateral sclerosis: histologic and biochemical features. 国際誌

    Makoto Sainouchi, Yuya Hatano, Mari Tada, Tomohiko Ishihara, Shoichiro Ando, Taisuke Kato, Jun Tokunaga, Gaku Ito, Hiroaki Miyahara, Yasuko Toyoshima, Akio Yokoseki, Tetsutaro Ozawa, Kohei Akazawa, Osamu Onodera, Akiyoshi Kakita

    Acta neuropathologica communications   9 ( 1 )   106 - 106   2021年6月

     詳細を見る

  • Surgically treated gastric cancer in Japan: 2011 annual report of the national clinical database gastric cancer registry.

    Satoshi Suzuki, Arata Takahashi, Takashi Ishikawa, Kohei Akazawa, Hitoshi Katai, Yoh Isobe, Isao Miyashiro, Hiroyuki Ono, Satoshi Tanabe, Takeo Fukagawa, Kei Muro, Souya Nunobe, Shigenori Kadowaki, Haruhisa Suzuki, Tomoyuki Irino, Shiyori Usune, Hiroaki Miyata, Yoshihiro Kakeji

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   24 ( 3 )   545 - 566   2021年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The National Clinical Database (NCD) nationwide registry program of gastric cancer started in 2018. The purpose of this study was to report the treatment results of the NCD registry in the form of treatment results of the real world in Japan. METHODS: Patients' characteristics, tumor features, treatments, and outcomes were collected using a web-based data entry system. We analyzed the initial NCD database for data on surgically treated gastric cancer patients in 2011. RESULTS: A total of 30,257 patients with malignant gastric tumors were enrolled by the NCD registry program from 501 hospitals in all 47 prefectures. Of these, the status of data entry was not approved in 8.8% of the registered data, and follow-up information was missing in 1.2% of the approved cases. Excluding 1777 cases, which were not resected for primary gastric cancer, 25,306 resected cases included 44.4% of stomach surgeries recorded in the NCD. The 5 year survival rate of the resected cases was 71.3% and the operative mortality rate was 0.41%. The stage-specific 5 year survival rates were as follows: 89.6% for stage IA, 83.8% for stage IB, 77.3% for stage IIA, 69.1% for stage IIB, 58.7% for stage IIIA, 44.1% for stage IIIB, 30.1% for stage IIIC, and 13.4% for stage IV. CONCLUSIONS: The NCD gastric cancer registry program demonstrated validity for database construction. The gastric cancer registry is expected to become a nationwide registry with the dissemination of data entry system and method in the NCD.

    DOI: 10.1007/s10120-021-01178-5

    PubMed

    researchmap

  • Accuracy of Japanese claims data in identifying diabetes‐related complications

    Kazuya Fujihara, Mayuko Yamada‐Harada, Yasuhiro Matsubayashi, Masaru Kitazawa, Masahiko Yamamoto, Yuta Yaguchi, Hiroyasu Seida, Satoru Kodama, Kohei Akazawa, Hirohito Sone

    Pharmacoepidemiology and Drug Safety   2021年3月

     詳細を見る

    掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    DOI: 10.1002/pds.5213

    researchmap

    その他リンク: https://onlinelibrary.wiley.com/doi/full-xml/10.1002/pds.5213

  • 日本人コホートJGSCAD、J-ADNI、NCGG、ToMMoにおけるバリアント解析 APOE

    宮下 哲典, 原 範和, 春日 健作, Lixin Liu, 樋口 陽, Bin Zhu, 月江 珠緒, 長谷川 舞衣, Yusran Adyfitrah, 石黒 敬信, 村上 涼太, 菊地 正隆, 中谷 明弘, 尾崎 浩一, 新飯田 俊平, 赤澤 宏平, 桑野 良三, 岩坪 威, 池内 健

    Dementia Japan   34 ( 4 )   521 - 521   2020年10月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本認知症学会  

    researchmap

  • γ-Secretase Activity Is Associated with Braak Senile Plaque Stages. 査読 国際誌

    Nobuto Kakuda, Haruyasu Yamaguchi, Kohei Akazawa, Saori Hata, Toshiharu Suzuki, Hiroyuki Hatsuta, Shigeo Murayama, Satoru Funamoto, Yasuo Ihara

    The American journal of pathology   190 ( 6 )   1323 - 1331   2020年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Amyloid β-proteins (Aβs) Aβ1-42 and Aβ1-43 are converted via two product lines of γ-secretase to Aβ1-38 and Aβ1-40. This parallel stepwise processing model of γ-secretase predicts that Aβ1-42 and Aβ1-43, and Aβ1-38 and Aβ1-40 are proportional to each other, respectively. To obtain further insight into the mechanisms of parenchymal Aβ deposition, these four Aβ species were quantified in insoluble fractions of human brains (Brodmann areas 9 to 11) at various Braak senile plaque (SP) stages, using specific enzyme-linked immunosorbent assays. With advancing SP stages, the amounts of deposited Aβ1-43 in the brain increased proportionally to those of Aβ1-42. Similarly, the amounts of deposited Aβ1-38 correlated with those of Aβ1-40. Surprisingly, the ratios of deposited Aβ1-38/Aβ1-42 and Aβ1-40/Aβ1-43 were proportional and discriminated the Braak SP stages accurately. This result indicates that the generation of Aβ1-38 and Aβ1-40 decreased and the generation of Aβ1-42 and Aβ1-43 increased with advancing SP stages. Thus, Aβs deposition might depend on γ-secretase activity, as it does in the cerebrospinal fluid. Here, the extracted γ-secretase from Alzheimer disease brains generates an amount of Aβ1-42 and Aβ1-43 compared with cognitively normal brains. This refractory γ-secretase localized in detergent-solubilized fractions from brain cortices. But activity modulated γ-secretase, which decreases Aβ1-42 and Aβ1-43 in the cerebrospinal fluid, localized in detergent-insoluble fractions. These drastic alterations reflect Aβ situation in Alzheimer disease brains.

    DOI: 10.1016/j.ajpath.2020.02.009

    PubMed

    researchmap

  • Optimal extent of lymph node dissection for remnant advanced gastric carcinoma after distal gastrectomy: a retrospective analysis of more than 3000 patients from the nationwide registry of the Japanese Gastric Cancer Association. 査読

    Hitoshi Katai, Takashi Ishikawa, Kohei Akazawa, Takeo Fukagawa, Yoh Isobe, Isao Miyashiro, Ichiro Oda, Shunichi Tsujitani, Hiroyuki Ono, Satoshi Tanabe, Souya Nunobe, Satoshi Suzuki, Yoshihiro Kakeji

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   23 ( 6 )   1091 - 1101   2020年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: No guidelines are available for defining the extent of lymph node (LN) dissection in patients with remnant gastric carcinoma (RGC). Hence, this retrospective study aimed to determine the optimal extent of LN dissection in patients with RGC. METHODS: We retrospectively evaluated the therapeutic outcomes of node dissection for RGC from a nationwide registry. When the metastatic rate or 5-year survival rate exceeded 10%, dissection was recommended. We calculated the dissection index by multiplying the incidence of metastasis at that nodal station by the 5-year survival rate of patients with metastasis at the station. A dissection index of > 1.0 was considered significant. RESULTS: We included 1133 patients with RGC (T2-T4 tumor) who had undergone distal gastrectomy as the primary surgery for the evaluation of the survival benefit of nodal dissection. Any regional node station was considered significant. When the primary surgery was for malignant disease, the index was high for Nos. 3 (10.2), 7 (9.5), 1 (7.1), and 9 (8.0) nodes. For nodes at the splenic hilum, the index value was 4.4, which was higher than that for the perigastric nodes (Nos. 4sa and 4sb). The index for No. 10 nodes was the highest (10.5) when tumors involved a greater curvature. CONCLUSIONS: The therapeutic strategy for RGC remains the same, regardless of the histology of the primary disease during the initial surgery. Total gastrectomy and dissection of the perigastric LNs (Nos. 1-4), suprapancreatic LNs (Nos. 7-9 and 11), and LNs at the splenic hilum (No. 10) are justified.

    DOI: 10.1007/s10120-020-01081-5

    PubMed

    researchmap

  • Determinant factors on differences in survival for gastric cancer between the US and Japan using nationwide databases. 査読

    Yuri Ito, Isao Miyashiro, Takashi Ishikawa, Kohei Akazawa, Keisuke Fukui, Hitoshi Katai, Souya Nunobe, Ichiro Oda, Yoh Isobe, Shunichi Tsujitani, Hiroyuki Ono, Satoshi Tanabe, Takeo Fukagawa, Satoshi Suzuki, Yoshihiro Kakeji, Mitsuru Sasako, Anton Bilchik, Manabu Fujita

    Journal of epidemiology   31 ( 4 )   241 - 248   2020年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BackgroundAlthough the incidence and mortality have decreased, gastric cancer (GC) is still a public health issue globally. An international study reported higher survival in Korea and Japan than other countries, including the US. We examined the determinant factors of the high survival in Japan, compared with the US.MethodsWe analysed data on 78,648 cases from the nationwide GC registration project, the Japanese Gastric Cancer Association (JGCA), from 2004-2007 and compared them with 16,722 cases from the Surveillance, Epidemiology, and End Results Program (SEER), a US population-based cancer registry data from 2004-2010. We estimated five-year relative survival and applied a multivariate excess hazard model to compare the two countries, considering the effect of number of lymph nodes (LNs) examined.ResultsFive-year relative survival in Japan was 81.0%, compared with 45.0% in the US. After controlling for confounding factors, we still observed significantly higher survival in Japan. Among N2 patients, a higher number of LNs examined showed better survival in both countries. Among N3 patients, the relationship between number of LNs examined and differences in survival between the two countries disappeared.ConclusionAlthough the wide differences in GC survival between Japan and US can be largely explained by differences in the stage at diagnosis, the number of LNs examined may also help to explain the gaps between two countries, which is related to stage migration.

    DOI: 10.2188/jea.JE20190351

    PubMed

    researchmap

  • Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association. 査読

    Souya Nunobe, Ichiro Oda, Takashi Ishikawa, Kohei Akazawa, Hitoshi Katai, Yoh Isobe, Isao Miyashiro, Shunichi Tsujitani, Hiroyuki Ono, Satoshi Tanabe, Takeo Fukagawa, Satoshi Suzuki, Yoshihiro Kakeji

    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association   23 ( 2 )   328 - 338   2020年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The proportion of elderly patients undergoing surgery for gastric cancer is increasing. However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage I gastric cancer. METHODS: Data from 68,353 Stage I patients who underwent gastrectomy between 2001 and 2007 were retrospectively collected. The accumulated data were reviewed and analyzed by the Japanese Gastric Cancer Association registration committee. We first classified the patients as those aged ≤ 74 years and ≥ 75 years. We further classified those patients aged ≥ 75 years into groups by 5-year increments to examine their short- and long-term postoperative outcomes. RESULTS: Patients aged ≥ 75 years accounted for 46.5%. The 30-day mortality rate was < 0.7% for any age group, but for those aged ≥ 75 years, the 60-day and 90-day mortality rates were 0.9-2.3% and 1.2-5.1%, respectively. An examination of long-term survival indicated that, as the class of age increased, the 5-year overall survival (OS) was 47.0-93.1% and disease-specific survival (DSS) was 91.4-98.2%, respectively. Although high DSS rates of ≥ 90% were found for all age groups, OS only accounted for ≤ 82% of patients aged ≥ 75 years. CONCLUSION: Among elderly patients with Stage I gastric cancer, deaths due to other diseases were frequently observed in the long term. Thus, for elderly patients, it may be appropriate to reconsider the treatment strategy with respect to the balance between the invasiveness of the treatment and the prognosis.

    DOI: 10.1007/s10120-019-01000-3

    PubMed

    researchmap

  • Novel scoring system for differentiating parechovirus-A3 and enterovirus infection in neonates and young infants. 査読 国際誌

    Ryohei Izumita, Yuta Aizawa, Rie Habuka, Kanako Watanabe, Taketo Otsuka, Nobutaka Kitamura, Kohei Akazawa, Akihiko Saitoh

    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology   124   104256 - 104256   2020年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Parechovirus-A3 (PeV-A3) and the enteroviruses (EVs) are the most common viral pathogens responsible for sepsis and meningoencephalitis in neonates and young infants; however, differences in the clinical presentations of two infections are not well described. OBJECTIVES: To describe the clinical presentations of PeV-A3- and EVs-related diseases and develop a novel scoring system to differentiate two diseases. STUDY DESIGN: This prospective study used real-time PCR and genetic sequencing to evaluate viral etiologies of febrile neonates and infants <4 months with suspected sepsis or meningoencephalitis in Niigata area, Japan, in 2014-2016. The clinical manifestations of PeV-A3- and EVs-infected patients were compared, and a novel scoring system was developed after identifying the most distinguishable clinical findings, followed by the external cohort validation. RESULTS: In 210 patients evaluated, we identified 56 PeV-A3-infected (27%) and 43 EVs-infected (20%) patients. The following clinical manifestations were significant in PeV-A3-infected patients, as compared with EVs-infected patients; a higher body temperature (38.9°C vs. 38.5°C, P < .01) and heart rate (181/min vs. 168/min, P = .01), cold extremities (72% vs. 34%, P < .01) and skin mottling (65% vs. 23%, P < .01), lower white blood cell count (5,200/μL vs. 8,900/μL, P < .01) and incidence of cerebrospinal fluid (CSF) pleocytosis (2% vs. 63%, P < .01). Using some of these significant findings, the scoring system successfully distinguished the diseases (accuracy: 86% and 83% for the derivative and external validation cohorts, respectively). CONCLUSIONS: We found significant clinical manifestations in PeV-A3-infected patients compared to EVs-infected patients. The scoring system may be helpful to distinguish two infections, especially at onset of outbreak.

    DOI: 10.1016/j.jcv.2019.104256

    PubMed

    researchmap

  • Amyotrophic Lateral Sclerosis with Pallidonigroluysian Degeneration: A Clinicopathological Study. 査読 国際誌

    Junko Ito, Hiroshi Shimizu, Kentaro Ohta, Jiro Idezuka, Hajime Tanaka, Hiroshi Kondo, Takashi Nakajima, Hitoshi Takahashi, Kohei Akazawa, Osamu Onodera, Akiyoshi Kakita

    Annals of neurology   87 ( 2 )   302 - 312   2020年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The pallidonigroluysian (PNL) system, the primary component of corticosubcortical circuits, is generally spared in amyotrophic lateral sclerosis (ALS). We evaluated the clinicopathological features of an unusual form of ALS with PNL degeneration (PNLD) and assessed whether ALS with PNLD represents a distinct ALS subtype. METHODS: From a cohort of 97 autopsied cases of sporadic ALS with phosphorylated 43kDa TAR DNA-binding protein (TDP-43) inclusions, we selected those with PNLD and analyzed their clinicopathological features. RESULTS: Eleven cases (11%) that showed PNLD were divided into 2 subtypes depending on the lesion distribution: (1) extensive type (n = 6), showing widespread TDP-43 pathology and multisystem degeneration, both involving the PNL system; and (2) limited type (n = 5), showing selective PNL and motor system involvement, thus being unclassifiable in terms of Brettschneider's staging or Nishihira's typing of ALS. The limited type showed a younger age at onset and predominant PNLD that accounted for the early development of extrapyramidal signs. The limited type exhibited the heaviest pathology in the subthalamus and external globus pallidus, suggesting that TDP-43 inclusions propagated via indirect or hyperdirect pathways, unlike ALS without PNLD, where the direct pathway is considered to convey TDP-43 aggregates from the cerebral cortex to the substantia nigra. INTERPRETATION: The PNL system can be involved in the disease process of ALS, either nonselectively as part of multisystem degeneration, or selectively. ALS with selective involvement of the PNL and motor systems exhibits unique clinicopathological features and TDP-43 propagation routes, thus representing a distinct subtype of ALS. ANN NEUROL 2020;87:302-312.

    DOI: 10.1002/ana.25652

    PubMed

    researchmap

  • Cost-effectiveness of BRCA1/2 mutation profiling to target olaparib use in patients with metastatic breast cancer. 国際誌

    Shota Saito, Kyoko Nakazawa, Masayuki Nagahashi, Takashi Ishikawa, Kouhei Akazawa

    Personalized medicine   16 ( 6 )   439 - 448   2019年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Aim: Olaparib monotherapy improves progression-free survival in patients with metastatic breast cancer and BRCA1/2 mutations. We evaluated the cost-effectiveness of BRCA1/2 mutation profiling to target olaparib use. Methods: A Markov cohort model was generated to compare the 5-year cost-effectiveness of BRCA1/2 mutation profiling to target olaparib use. Results: The incremental cost-effectiveness ratio of BRCA1/2 mutation profiling plus olaparib monotherapy was JPY14,677,259/quality-adjusted life year (QALY) (US$131,047/QALY), compared with standard chemotherapy alone. Conclusion:BRCA1/2 mutation profiling to target olaparib use is not a cost-effective strategy for metastatic breast cancer. The strategy provides minimal incremental benefit at a high incremental cost per QALY. Hence, further cost reductions in the cost of both BRCA1/2 mutation profiling and olaparib are required.

    DOI: 10.2217/pme-2018-0141

    PubMed

    researchmap

  • Risk Analysis for Chemotherapy-induced Nausea and Vomiting (CINV) in Patients Receiving FEC100 Treatment. 査読 国際誌

    Mitsuhiro Hayashi, Kyoko Nakazawa, Yoshie Hasegawa, Jun Horiguchi, Daishu Miura, Takashi Ishikawa, Shintaro Takao, Seung Jim Kim, Kazuhiko Yamagami, Masaru Miyashita, Muneharu Konishi, Yasushi Shigeoka, Masato Suzuki, Tetsuya Taguchi, Tomoyuki Kubota, Hirokazu Tanino, Kimito Yamada, Kazutaka Narui, Konomi Kimura, Kohei Akazawa, Norio Kohno

    Anticancer research   39 ( 8 )   4305 - 4314   2019年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND/AIM: Risk factors for chemotherapy-induced nausea and vomiting (CINV) with anthracycline-containing regimen for breast cancer patients remain unknown. The risk factors for CINV with FEC100 were investigated. PATIENTS AND METHODS: Data on CINV events and patient backgrounds of 180 patients were collected from the first cycle of FEC100 treatment. In this regimen, patients were administered various antiemetics (ADs). The combinations of ADs were classified into four categories, while body mass index (BMI) was stratified into three categories. Risk factors were selected based on patient characteristics and combination of ADs. Risks for CINV were analyzed by univariate and multivariate analyses. RESULTS: In the univariate analysis of nausea, BMI was a significant factor, while BMI and combination of ADs were significant in vomiting. In the multivariate analysis concerning nausea, BMI was a significant factor. In the analysis concerning vomiting, the combination of ADs and BMI were significant. CONCLUSION: BMI was the most important risk factor for nausea and vomiting, while the combination of ADs was for vomiting.

    DOI: 10.21873/anticanres.13596

    PubMed

    researchmap

  • B-Mode Ultrasonography versus Contrast-Enhanced Ultrasonography for Surveillance of Hepatocellular Carcinoma: A Prospective Multicenter Randomized Controlled Trial. 査読 国際誌

    Kudo M, Ueshima K, Osaki Y, Hirooka M, Imai Y, Aso K, Numata K, Kitano M, Kumada T, Izumi N, Sumino Y, Ogawa C, Akazawa K

    Liver cancer   8 ( 4 )   271 - 280   2019年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1159/000501082

    PubMed

    researchmap

  • Hyperbilirubinemia predicts the infectious complications after esophagectomy for esophageal cancer. 査読 国際誌

    Muneoka Y, Ichikawa H, Kosugi SI, Hanyu T, Ishikawa T, Kano Y, Shimada Y, Nagahashi M, Sakata J, Kobayashi T, Kameyama H, Akazawa K, Wakai T

    Annals of medicine and surgery (2012)   39   16 - 21   2019年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.amsu.2019.02.004

    PubMed

    researchmap

  • Prevalence, significance and reversal of abnormal P-wave indices in hypertension: A review and meta-analysis. 査読

    Aizawa Y, Sato T, Akazawa K

    Journal of electrocardiology   53   13 - 17   2019年3月

  • Phase II Trial of Trastuzumab and Docetaxel in Patients With Human Epidermal Growth Factor Receptor 2-Positive Salivary Duct Carcinoma. 査読 国際誌

    Hideaki Takahashi, Yuichiro Tada, Takashi Saotome, Kohei Akazawa, Hiroya Ojiri, Chihiro Fushimi, Tatsuo Masubuchi, Takashi Matsuki, Kaori Tani, Robert Y Osamura, Hideaki Hirai, Shuhei Yamada, Daisuke Kawakita, Kouki Miura, Shin-Etsu Kamata, Toshitaka Nagao

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology   37 ( 2 )   125 - 134   2019年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Clinical evidence demonstrating the effectiveness of systemic therapy for advanced salivary duct carcinoma (SDC) is lacking because of the disease's rarity. We assessed the efficacy and toxicity of trastuzumab plus docetaxel in patients with locally advanced and/or recurrent or metastatic human epidermal growth factor receptor 2-positive SDC. PATIENTS AND METHODS: This was a single-center, single-arm, open-label, phase II study in Japan. The patients received trastuzumab at a loading dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks. Docetaxel 70 mg/m2 was administrated every 3 weeks. The primary end point was the overall response rate; the secondary end points included the clinical benefit rate, progression-free survival, overall survival, and toxicity. This study is registered with the University Hospital Medical Information Network Clinical Trials Registry (Identification No. UMIN000009437). RESULTS: Fifty-seven eligible patients with SDC were enrolled. The overall response rate was 70.2% (95% CI, 56.6% to 81.6%), and the clinical benefit rate was 84.2% (95% CI, 72.1% to 92.5%). Median progression-free and overall survival times were 8.9 months (95% CI, 7.8 to 9.9 months) and 39.7 months (95% CI, not reached), respectively. The most frequent adverse event was anemia (52 patients [91%]), followed by a decreased WBC count (51 patients [89%]) and neutropenia (50 patients [88%]). The most frequently observed grade 4 adverse event was a decreased neutrophil count (34 patients [60%]). Grade 3 febrile neutropenia was reported in eight patients (14%). No grade 2 or greater adverse events of heart failure or left ventricular ejection fraction decline to less than 50% occurred. CONCLUSION: Our data show encouraging efficacy of trastuzumab plus docetaxel therapy in patients with human epidermal growth factor receptor 2-positive SDC, with a manageable toxicity profile.

    DOI: 10.1200/JCO.18.00545

    PubMed

    researchmap

  • Urban-rural disparity in cervical cancer in China and feasible interventions for tackling the rural excess. 査読

    Wen X, Wen D, Yang Y, Chen Y, Akazawa K, Liu Y, Shan B

    Medicine   98 ( 1 )   e13907   2019年1月

  • Professional oral care reduces carcinogenic acetaldehyde levels in mouth air of perioperative esophageal cancer patients: A prospective comparative study 査読

    Naoko Tanda, Jumpei Washio, Takashi Kamei, Kohei Akazawa, Nobuhiro Takahashi, Takeyoshi Koseki

    Tohoku Journal of Experimental Medicine   249 ( 1 )   75 - 83   2019年

     詳細を見る

    掲載種別:研究論文(学術雑誌)  

    © 2019 Tohoku University Medical Press. Acetaldehyde is a potential carcinogen for esophageal cancer, and some oral microorganisms produce acetaldehyde from ethanol or glucose. In this prospective study, we examined the influence of professional oral care on acetaldehyde levels in mouth air of esophageal cancer patients. Acetaldehyde concentrations in mouth air and breath were measured by a portable gas chromatograph, and acetaldehyde production from oral microbiota was also evaluated. Samples were taken from 21 esophageal cancer patients (median age 68 years) and 20 age-matched healthy volunteers (control group) before and after oral care. Postoperative samples were also taken from 17 patients who had undergone surgery. All samples (mouth air, breath, and saliva) were collected 2 to 3 hours after lunch. Oral microbial samples were prepared from saliva. Genotype analysis of alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) genes revealed no significant differences in the genotypes between the two groups. In the control group, acetaldehyde levels in mouth air showed no significant changes after oral care, while the amount of microbial acetaldehyde production from ethanol was significantly decreased. By contrast, among the patients, acetaldehyde levels in mouth air were significantly decreased after oral care and after operation, while the amount of microbial acetaldehyde production from ethanol showed no significant changes. Moreover, microbial acetaldehyde production from glucose was significantly decreased after operation. Overall, oral health was poorer in the patient group. In conclusion, professional oral care for esophageal cancer patients is effective for reducing acetaldehyde levels in mouth air due to the reduction of microbial count.

    DOI: 10.1620/tjem.249.75

    Scopus

    PubMed

    researchmap

  • Impact of Concurrent Genomic Alterations Detected by Comprehensive Genomic Sequencing on Clinical Outcomes in East-Asian Patients with EGFR-Mutated Lung Adenocarcinoma 査読

    Seijiro Sato, Masayuki Nagahashi, Terumoto Koike, Hiroshi Ichikawa, Yoshifumi Shimada, Satoshi Watanabe, Toshiaki Kikuchi, Kazuki Takada, Ryota Nakanishi, Eiji Oki, Tatsuro Okamoto, Kouhei Akazawa, Stephen Lyle, Yiwei Ling, Kazuaki Takabe, Shujiro Okuda, Toshifumi Wakai, Masanori Tsuchida

    Scientific Reports   8 ( 1 )   1005   2018年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nature Publishing Group  

    Next-generation sequencing (NGS) has enabled comprehensive detection of genomic alterations in lung cancer. Ethnic differences may play a critical role in the efficacy of targeted therapies. The aim of this study was to identify and compare genomic alterations of lung adenocarcinoma between Japanese patients and the Cancer Genome Atlas (TCGA), which majority of patients are from the US. We also aimed to examine prognostic impact of additional genomic alterations in patients harboring EGFR mutations. Genomic alterations were determined in Japanese patients with lung adenocarcinoma (N = 100) using NGS-based sequencing of 415 known cancer genes, and correlated with clinical outcome. EGFR active mutations, i.e., those involving exon 19 deletion or an L858R point mutation, were seen in 43% of patients. Some differences in driver gene mutation prevalence were observed between the Japanese cohort described in the present study and the TCGA. Japanese cohort had significantly more genomic alterations in cell cycle pathway, i.e., CDKN2B and RB1 than TCGA. Concurrent mutations, in genes such as CDKN2B or RB1, were associated with worse clinical outcome in patients with EGFR active mutations. Our data support the utility of comprehensive sequencing to detect concurrent genomic variations that may affect clinical outcomes in this disease.

    DOI: 10.1038/s41598-017-18560-y

    Scopus

    PubMed

    researchmap

  • 消化器外科手術患者における術後感染の早期検知をめざした機械学習と統計モデルの検討

    中澤 香子, 福島 慶子, 浅倉 宏至, 齋藤 翔太, 石川 卓, 外山 聡, 赤澤 宏平

    医療情報学連合大会論文集   38回   778 - 780   2018年11月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本医療情報学会  

    researchmap

  • Walking ability, anxiety and depression, significantly decrease EuroQol 5-Dimension 5-Level scores in older hemodialysis patients in Japan 査読

    Utako Shimizu, Hagiko Aoki, Momoe Sakagami, Kohei Akazawa

    Archives of Gerontology and Geriatrics   78   96 - 100   2018年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier Ireland Ltd  

    Background: Hemodialysis patients in Japan are aging, but the influence of lifestyle factors on EuroQoL 5-Dimension 5-Level (EQ-5D-5 L) scores in older hemodialysis patients is unclear. This study aimed to measure health-related quality of life using the EQ-5D-5 L for older hemodialysis patients and to identify the lifestyle factors affecting EQ-5D-5 L scores in Japan. Methods: Outpatients aged 65 years or older who had been receiving maintenance hemodialysis for more than 5 years were selected to determine their EQ-5D-5 L scores. Multiple linear regression analysis was applied to identify items affecting the EQ-5D-5 L scores. Results: The response rate was 59.7% (748/1251), after excluding 9 patients who did not fulfill the participation criteria, and we analyzed data from 739 patients (462 men, 277 women) aged 72.9 ± 6.5 years (mean ± standard deviation) with a mean duration of hemodialysis of 15.1 ± 8.8 years. The mean EQ-5D-5 L score was 0.738 ± 0.207. Higher Hospital Anxiety and Depression Scale scores (regression coefficient, −0.467
    P &lt
    0.001), reduced walking ability (−0.201
    P &lt
    0.001), duration of hemodialysis (−0.175
    P &lt
    0.001), age (−0.143
    P &lt
    0.001), and subjective symptoms (−0.128
    P &lt
    0.001) showed significant negative correlations with the EQ-5D-5 L score. Conclusions: Reduced walking ability, and Anxiety and Depression, were associated with lower EQ-5D-5 L score and appeared to be important factors in decreasing health for older hemodialysis patients. These results suggest that patients’ families and dialysis facility staff should be trained in early detection of depression and that patients should maintain their walking ability by exercise therapy.

    DOI: 10.1016/j.archger.2018.06.006

    Web of Science

    Scopus

    PubMed

    researchmap

  • Association of socioeconomic factors and the risk for unintentional injuries among children in Japan: a cross-sectional study. 査読 国際誌

    Nobuhiro Sato, Yusuke Hagiwara, Junta Ishikawa, Kohei Akazawa

    BMJ open   8 ( 8 )   e021621   2018年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: While Japan has socioeconomic issues, such as income inequality, little is known about the association between socioeconomic factors and the risk of unintentional childhood injuries. The purpose of the study was to evaluate the influence of socioeconomic factors on the risk for unintentional injuries among preschool children in Japan. DESIGN: Cross-sectional study using data from a web-based questionnaire survey. SETTING: Japan (January 2015). PARTICIPANTS: 1000 households with preschool children under 6 years of age. OUTCOME MEASURES: Multivariate logistic regression was performed to analyse the influence of socioeconomic factors on the incidence of unintentional injuries. RESULTS: Overall, 976 households were eligible for the analysis, with 201 households reporting unintentional injuries. The incidence rates for unintentional injury were estimated to be constant across all strata constructed using combinations of socioeconomic factors. The multivariate logistic regression analysis showed no significant differences in socioeconomic factors between households that reported unintentional injuries and those that did not. CONCLUSION: The findings of our study demonstrated that unintentional injuries among preschool children occurred at approximately fixed rates, independent of socioeconomic factors. Accordingly, prevention strategies for unintentional injuries that concern socioeconomic disadvantages should be avoided in Japan.

    DOI: 10.1136/bmjopen-2018-021621

    PubMed

    researchmap

  • Radiofrequency Ablation of Breast Cancer: A Retrospective Study. 査読

    Ito T, Oura S, Nagamine S, Takahashi M, Yamamoto N, Yamamichi N, Earashi M, Doihara H, Imoto S, Mitsuyama S, Akazawa K

    Clinical breast cancer   18 ( 4 )   e495 - e500   2018年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.clbc.2017.09.007

    PubMed

    researchmap

  • Trabecular bone microstructure and mineral density in human residual ridge at various intervals over a long period after tooth extraction 査読

    Mikako Tanaka, Emi Yamashita-Mikami, Kohei Akazawa, Michiko Yoshizawa, Yoshiaki Arai, Sadakazu Ejiri

    Clinical Implant Dentistry and Related Research   20 ( 3 )   375 - 383   2018年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing Ltd  

    Background: Long-term changes of trabecular microstructure in human tooth extraction socket have not been investigated. Purpose: To examine the trabecular microstructure of human residual ridges at various intervals following tooth extraction, and to determine whether bone remodeling activity can attain points of relative stability and when such points are reached. Materials and Methods: Forty-four bone biopsy specimens were obtained from lower molar or premolar regions of residual ridges. Postextraction times ranged from 1.6 to 360 months. Samples were analyzed using micro-computed tomography and three-dimensional bone morphometry with histological analyses. Trabecular bone parameters were plotted against postextraction times, and a stepwise piecewise linear regression analysis was performed to determine at which points of time these parameters either increased or decreased. Results: Using piecewise linear regression, “inflection points” were found in most trabecular bone parameters between 7 and 12 months postextraction. Among the residual ridge samples, woven trabecular structure became mature, consisting of thick lamellar trabeculae with sufficient bone density, under dynamic bone remodeling until the 7th to 12th month post-tooth extraction. After this period, the mature network structure remained stable with low remodeling activity. Conclusion: Bone remodeling of trabecular structure in human residual ridge after tooth extraction had a stabilization period.

    DOI: 10.1111/cid.12591

    Scopus

    PubMed

    researchmap

  • Clinical and Genetic Implications of Mutation Burden in Squamous Cell Carcinoma of the Lung 査読

    Tatsuro Okamoto, Kazuki Takada, Seijiro Sato, Gouji Toyokawa, Tetsuzo Tagawa, Fumihiro Shoji, Ryota Nakanishi, Eiji Oki, Terumoto Koike, Masayuki Nagahashi, Hiroshi Ichikawa, Yoshifumi Shimada, Satoshi Watanabe, Toshiaki Kikuchi, Kouhei Akazawa, Stephen Lyle, Kazuaki Takabe, Shujiro Okuda, Kenji Sugio, Toshifumi Wakai, Masanori Tsuchida, Yoshihiko Maehara

    Annals of Surgical Oncology   25 ( 6 )   1564 - 1571   2018年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer New York LLC  

    Background: Lung squamous cell carcinoma (LSCC) is a major histological subtype of lung cancer. In this study, we investigated genomic alterations in LSCC and evaluated the clinical implications of mutation burden (MB) in LSCC. Methods: Genomic alterations were determined in Japanese patients with LSCC (N = 67) using next-generation sequencing of 415 known cancer genes. MB was defined as the number of non-synonymous mutations per 1 Mbp. Programmed death-ligand 1 (PD-L1) protein expression in cancer cells was evaluated by immunohistochemical analysis. Results: TP53 gene mutations were the most common alteration (n = 51/67, 76.1%), followed by gene alterations in cyclin-dependent kinase inhibitor 2B (CDKN2B
    35.8%), CDKN2A (31.3%), phosphatase and tensin homolog (30.0%), and sex-determining region Y-box 2 (SOX2, 28.3%). Histological differentiation was significantly poorer in tumors with high MB (greater than or equal to the median MB) compared with that in tumors with low MB (less than the median MB
    p = 0.0446). The high MB group had more tumors located in the upper or middle lobe than tumors located in the lower lobe (p = 0.0019). Moreover, cancers in the upper or middle lobes had significantly higher MB than cancers in the lower lobes (p = 0.0005), and tended to show higher PD-L1 protein expression (p = 0.0573). SOX2 and tyrosine kinase non-receptor 2 amplifications were associated with high MB (p = 0.0065 and p = 0.0010, respectively). Conclusions: The MB level differed according to the tumor location in LSCC, suggesting that the location of cancer development may influence the genomic background of the tumor.

    DOI: 10.1245/s10434-018-6401-1

    Scopus

    PubMed

    researchmap

  • Sorafenib plus low-dose cisplatin and fluorouracil hepatic arterial infusion chemotherapy versus sorafenib alone in patients with advanced hepatocellular carcinoma (SILIUS): a randomised, open label, phase 3 trial. 査読 国際誌

    Masatoshi Kudo, Kazuomi Ueshima, Osamu Yokosuka, Sadahisa Ogasawara, Shuntaro Obi, Namiki Izumi, Hiroshi Aikata, Hiroaki Nagano, Etsuro Hatano, Yutaka Sasaki, Keisuke Hino, Takashi Kumada, Kazuhide Yamamoto, Yasuharu Imai, Shouta Iwadou, Chikara Ogawa, Takuji Okusaka, Fumihiko Kanai, Kohei Akazawa, Ken-Ichi Yoshimura, Philip Johnson, Yasuaki Arai

    The lancet. Gastroenterology & hepatology   3 ( 6 )   424 - 432   2018年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Hepatic arterial infusion chemotherapy plus sorafenib in phase 2 trials has shown favourable tumour control and a manageable safety profile in patients with advanced, unresectable hepatocellular carcinoma. However, no randomised phase 3 trial has tested the combination of sorafenib with continuous arterial infusion chemotherapy. We aimed to compare continuous hepatic arterial infusion chemotherapy plus sorafenib with sorafenib alone in patients with advanced, unresectable hepatocellular carcinoma. METHODS: We did an open-label, randomised, phase 3 trial (SILIUS) at 31 sites in Japan. Eligible patients were aged 20 years or older, with advanced hepatocellular carcinoma not suitable for resection, local ablation, or transarterial chemoembolisation; Eastern Cooperative Oncology Group (ECOG) performance status 0-1; Child-Pugh score 7 or lower; and adequate bone marrow, liver, and renal function. Patients were randomly assigned (1:1) via an interactive web response system with a computer-generated sequence to receive 400 mg sorafenib orally twice daily or 400 mg sorafenib orally twice daily plus hepatic arterial infusion chemotherapy (cisplatin 20 mg/m2 on days 1 and 8 and fluorouracil 330 mg/m2 continuously on days 1-5 and 8-12 of every 28-day cycle via an implanted catheter system). The primary endpoint was overall survival. The primary efficacy analysis comprised all randomised patients (the intention-to-treat population), and the safety analysis comprised all randomised patients who received at least one dose of study treatment. This trial is registered with ClinicalTrials.gov, number NCT01214343. FINDINGS: Between Nov 4, 2010, and June 10, 2014, 206 patients were randomly assigned (103 to the sorafenib group, 103 to the sorafenib plus hepatic arterial infusion chemotherapy group). One patient in the sorafenib plus hepatic arterial infusion chemotherapy group withdrew after randomisation. Median overall survival was similar in the sorafenib plus hepatic arterial infusion chemotherapy (n=102) and sorafenib monotherapy (n=103) groups (11·8 months [95% CI 9·1-14·5] vs 11·5 months [8·2-14·8]; hazard ratio 1·009 [95% CI 0·743-1·371]; p=0·955). Grade 3-4 adverse events that were more frequent in the sorafenib plus hepatic arterial infusion chemotherapy group than in the sorafenib monotherapy group included anaemia (15 [17%] of 88 vs six [6%] of 102), neutropenia (15 [17%] vs one [1%]), thrombocytopenia (30 [34%] vs 12 [12%]), and anorexia (12 [14%] vs six [6%]). INTERPRETATION: Addition of hepatic arterial infusion chemotherapy to sorafenib did not significantly improve overall survival in patients with advanced hepatocellular carcinoma. FUNDING: Japanese Ministry of Health, Labour and Welfare.

    DOI: 10.1016/S2468-1253(18)30078-5

    PubMed

    researchmap

  • Prediction of pathological response to neoadjuvant chemotherapy in breast cancer patients by imaging 査読

    Hiroshi Kaise, Fumika Shimizu, Kohei Akazawa, Yoshie Hasegawa, Jun Horiguchi, Daishu Miura, Norio Kohno, Takashi Ishikawa

    Journal of Surgical Research   225   175 - 180   2018年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Academic Press Inc.  

    Background: Diagnostic imaging is important for predicting the pathological response to chemotherapy during neoadjuvant chemotherapy (NAC) and for considering the surgical management with appropriate resection after NAC. This study was performed to examine the accuracy of the present radiological imaging for predicting the pathological complete response (pCR). Methods: From 188 patients in our previous JONIE1 Study, a randomized controlled trial comparing chemotherapy with and without zoledronic acid for patients with human epidermal growth factor receptor 2-negative breast cancer, we evaluated 122 patients whose tumor size was examined by magnetic resonance imaging or ultrasound at three points: before NAC
    after administering fluorouracil, epirubicin, and cyclophosphamide
    and after NAC. The maximum tumor diameter was evaluated by magnetic resonance imaging or ultrasound. Tumor reduction ratios were calculated at the same three points. The association between the radiological clinical response and the pCR was examined. Results: Among the 122 patients evaluated, there were 98 and 24 patients with luminal (Lum) and triple-negative (TN) subtypes, respectively. There were no patients who showed tumor progression after treatment. The radiological size of the tumors was finally reduced by an average of 58.4%. Clinical complete response and pCR were achieved in 22 (18.0%) and 15 (12.3%) patients, respectively. In the overall population (n = 122), the accuracy, sensitivity, and specificity for predicting pCR were 86.1%, 88.8%, and 66.7%, respectively. The negative predictive value and false-negative rate were 45.5% and 11.2%, respectively. According to subtypes, the accuracies were 83.7% and 95.8% in Lum and TN, respectively. Negative predictive value and false-negative rate were markedly different between the Lum (29.4% and 13.5%) and TN subtypes (100% and 0%), respectively. Conclusions: This randomized clinical trial demonstrated that NAC was safe for operable breast cancer patients with appropriate radiological monitoring. Radiological evaluation after NAC may be a reliable method for predicting pathological response in the TN subtype, but not in the Lum subtype.

    DOI: 10.1016/j.jss.2017.12.002

    Scopus

    PubMed

    researchmap

  • The current status of treatment-related severe hypoglycemia in Japanese patients with diabetes mellitus: A report from the committee on a survey of severe hypoglycemia in the Japan Diabetes Society 査読

    Mitsuyoshi Namba, Toshio Iwakura, Rimei Nishimura, Kohei Akazawa, Munehide Matsuhisa, Yoshihito Atsumi, Jo Satoh, Toshimasa Yamauchi, the Japan Diabetes Society (JDS) Committee for Surveys on Severe Hypoglycemia

    Journal of Diabetes Investigation   9 ( 3 )   642 - 656   2018年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing  

    Despite great strides in pharmacotherapy for diabetes, there is increasing concern over the risk of hypoglycemia in patients with diabetes receiving pharmacotherapy as they become increasingly older. This has prompted the Japan Diabetes Society (JDS) to initiate a survey on the current status of severe hypoglycemia in clinical settings. In July 2015, following approval from the JDS Scientific Survey/Research Ethics Committee, the JDS extended an invitation to executive educators, who represented a total of 631 healthcare facilities accredited by the JDS for diabetes education, to participate in the proposed survey. Of these, those who expressed their willingness to participate in the survey were sent an application form required for obtaining ethical approval at these healthcare facilities and were then asked, following approval, to enter relevant clinical data on an unlinked, anonymous basis in a web-based registry. The current survey was fully funded by the JDS Scientific Survey/Research Committee. A case registry (clinical case database) was launched after facility-specific information (healthcare facility database) was collected from all participating facilities and after informed consent was obtained from all participating patients. With severe hypoglycemia defined as the “presence of hypoglycemic symptoms requiring assistance from another person to treat and preferably venous plasma glucose levels at onset/diagnosis of disease or at presentation clearly less than 60 mg/dL (capillary whole blood glucose, less than 50 mg/dL)”, the current survey was conducted between April 1, 2014 and March 31, 2015, during which facility-specific information was collected from a total of 193 facilities with a total of 798 case reports collected from 113 facilities. Of the 193 respondent facilities, 149 reported having an emergency department as well, with the median number of patients who required emergency transportation services to reach these facilities totaling 4,962 annually, of which those with severe hypoglycemia accounted for 0.34% (17). The respondent facilities accommodated a total of 2,237 patients with severe hypoglycemia annually, with the number of patients thus accommodated being 6.5 patients per site. A total of 1,171 patients were admitted for severe hypoglycemia, with the number of patients thus admitted being 4.0 per site, who accounted for 52.3% of all patients visiting annually for severe hypoglycemia. A review of the 798 case reports collected during the survey revealed that 240, 480 and 78 patients had type 1 diabetes, type 2 diabetes, and other types of diabetes, respectively
    those with type 2 diabetes were shown to be significantly older (median [interquartile range], 77.0 [68.0–83.0]) than those with type 1 diabetes (54.0 [41.0–67.0]) (P &lt
     0.001)
    and the BMI was shown to be significantly higher for those with type 2 diabetes (22.0 [19.5–24.8] kg/m2) than for those with type 1 diabetes (21.3 [18.9–24.0] kg/m2) (P = 0.003). It was also found that the median estimated glomerular filtration rate (eGFR) was significantly lower among those with type 2 diabetes (50.6 mL [31.8–71.1]/min/1.73 m2) than among those with type 1 diabetes (73.3 [53.5–91.1] mL/min/1.73 m2) (P &lt
     0.001). Again, the median HbA1c value at onset of severe hypoglycemia was shown to be 7.0 (6.3–8.1)% among all patients examined, 7.5 (6.9–8.6)% among those with type 1 diabetes, and 6.8 (6.1–7.6)% among those with type 2 diabetes, with the HbA1c value at onset of hypoglycemia being significantly lower among those with type 2 diabetes (P &lt
     0.001). Antecedent symptoms of severe hypoglycemia were shown to be present, absent and unknown in 35.5, 35.6, and 28.9% of all patients, respectively, with the incidence of symptomatic hypoglycemia being significantly lower among those with type 1 diabetes (41.0%) than among those with type 2 diabetes (56.9%). The antidiabetic agents used in those with type 2 diabetes were insulin preparations (292 patients including 29 receiving concomitant sulfonylureas [SUs]) (60.8%), SUs (159 insulin-naïve patients) (33.1%), and no insulin preparations or SUs (29 patients) (6.0%). Of the 798 patients surveyed, 296 patients (37.2%) were shown to have required emergency transportation services for severe hypoglycemia before. Thus, the survey revealed, for the first time, the current status of treatment-related severe hypoglycemia in Japan and clearly highlights the acute need for implementing preventive measures against hypoglycemia not only through education on hypoglycemia but through optimization of antidiabetic therapy for those at high risk of severe hypoglycemia or those with a history of severe hypoglycemia.

    DOI: 10.1111/jdi.12790

    Scopus

    PubMed

    researchmap

  • Cost-effectiveness of combined serum anti-Helicobacter pylori IgG antibody and serum pepsinogen concentrations for screening for gastric cancer risk in Japan 査読

    Shota Saito, Motoi Azumi, Yusuke Muneoka, Katsuhiko Nishino, Takashi Ishikawa, Yuichi Sato, Shuji Terai, Kouhei Akazawa

    European Journal of Health Economics   19 ( 4 )   545 - 555   2018年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Verlag  

    Background: A combination of assays for the presence of serum anti-Helicobacter pylori IgG antibody (HPA) and serum pepsinogen (PG) concentrations can be used to screen for gastric cancer risk. In Japan, this “ABC method” is considered an effective means of stratifying gastric cancer risk. This study aimed to ascertain its cost-effectiveness for assessing gastric cancer risk. Methods: A Markov model was constructed to compare the cost-effectiveness of two strategies for gastric cancer-risk screening over a 30-year period: the ABC method, which uses a combination of assessing the presence of HPA and measuring serum PG concentrations and scheduling endoscopies accordingly, and annual endoscopic screening. Clinical and epidemiological data on variables in the model were obtained from published reports. Analyses were made from the perspective of the Japanese health care payer. Results: According to base-case analysis, the ABC method cost less than annual endoscopic screening (64,489 vs. 64,074 USD) and saved more lives (18.16 vs. 18.30 quality-adjusted life years). One-way analyses confirmed the robustness of the cost-effectiveness results. The probability that the ABC method is cost-effective in Japanese individuals aged 50 years was 0.997. Conclusions: A combination of HPA and serum PG assays, plus scheduling endoscopy accordingly, is a cost-effective method of screening for gastric cancer risk in Japan.

    DOI: 10.1007/s10198-017-0901-y

    Scopus

    PubMed

    researchmap

  • The current status of treatment-related severe hypoglycemia in Japanese patients with diabetes mellitus: a report from the committee on a survey of severe hypoglycemia in the Japan Diabetes Society.

    Mitsuyoshi Namba, Toshio Iwakura, Rimei Nishimura, Kohei Akazawa, Munehide Matsuhisa, Yoshihito Atsumi, Jo Satoh, Toshimasa Yamauchi

    Diabetology international   9 ( 2 )   84 - 99   2018年5月

     詳細を見る

    記述言語:英語  

    Despite great strides in pharmacotherapy for diabetes, there is increasing concern over the risk of hypoglycemia in patients with diabetes receiving pharmacotherapy as they become increasingly older. This has prompted the Japan Diabetes Society (JDS) to initiate a survey on the current status of severe hypoglycemia in clinical settings. In July 2015, following approval from the JDS Scientific Survey/Research Ethics Committee, the JDS extended an invitation to executive educators, who represented a total of 631 health-care facilities accredited by the JDS for diabetes education, to participate in the proposed survey. Of these, those who expressed their willingness to participate in the survey were sent an application form required for obtaining ethical approval at these health-care facilities and were then asked, following approval, to enter relevant clinical data on an unlinked, anonymous basis in a Web-based registry. The current survey was fully funded by the JDS Scientific Survey/Research Committee. A case registry (clinical case database) was launched after facility-specific information (healthcare facility database) was collected from all participating facilities and after informed consent was obtained from all participating patients. With severe hypoglycemia defined as the "presence of hypoglycemic symptoms requiring assistance from another person to treat and preferably venous plasma glucose levels at onset/diagnosis of disease or at presentation clearly less than 60 mg/dL (capillary whole blood glucose, less than 50 mg/dL)", the current survey was conducted between April 1, 2014 and March 31, 2015, during which facility-specific information was collected from a total of 193 facilities with a total of 798 case reports collected from 113 facilities. Of the 193 respondent facilities, 149 reported having an emergency department as well, with the median number of patients who required emergency transportation services to reach these facilities totaling 4962 annually, of which those with severe hypoglycemia accounted for 0.34% (17). The respondent facilities accommodated a total of 2237 patients with severe hypoglycemia annually, with the number of patients thus accommodated being 6.5 patients per site. A total of 1171 patients were admitted for severe hypoglycemia, with the number of patients thus admitted being 4.0 per site, who accounted for 52.3% of all patients visiting annually for severe hypoglycemia. A review of the 798 case reports collected during the survey revealed that 240, 480, and 78 patients had type 1 diabetes, type 2 diabetes, and other types of diabetes, respectively; those with type 2 diabetes were shown to be significantly older [median (interquartile range), 77.0 (68.0-83.0)] than those with type 1 diabetes [54.0 (41.0-67.0)] (P < 0.001); and the BMI was shown to be significantly higher for those with type 2 diabetes [22.0 (19.5-24.8) kg/m2] than for those with type 1 diabetes [21.3 (18.9-24.0) kg/m2] (P = 0.003). It was also found that the median estimated glomerular filtration rate (eGFR) was significantly lower among those with type 2 diabetes [50.6 mL (31.8-71.1)/min/1.73 m2] than among those with type 1 diabetes [73.3 (53.5-91.1) mL/min/1.73 m2] (P < 0.001). Again, the median HbA1c value at onset of severe hypoglycemia was shown to be 7.0 (6.3-8.1)% among all patients examined, 7.5 (6.9-8.6)% among those with type 1 diabetes, and 6.8 (6.1-7.6)% among those with type 2 diabetes, with the HbA1c value at onset of hypoglycemia being significantly lower among those with type 2 diabetes (P < 0.001). Antecedent symptoms of severe hypoglycemia were shown to be present, absent, and unknown in 35.5, 35.6, and 28.9% of all patients, respectively, with the incidence of symptomatic hypoglycemia being significantly lower among those with type 1 diabetes (41.0%) than among those with type 2 diabetes (56.9%). The antidiabetic agents used in those with type 2 diabetes were insulin preparations (292 patients including 29 receiving concomitant sulfonylureas [SUs]) (60.8%), SUs (159 insulin-naïve patients) (33.1%), and no insulin preparations or SUs (29 patients) (6.0%). Of the 798 patients surveyed, 296 patients (37.2%) were shown to have required emergency transportation services for severe hypoglycemia before. Thus, the survey revealed, for the first time, the current status of treatment-related severe hypoglycemia in Japan and clearly highlights the acute need for implementing preventive measures against hypoglycemia, not only through education on hypoglycemia but also through optimization of antidiabetic therapy for those at high risk of severe hypoglycemia or those with a history of severe hypoglycemia.

    DOI: 10.1007/s13340-018-0346-2

    PubMed

    researchmap

  • Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes. 査読 国際誌

    Michiko Imamura, Takashi Morimoto, Takashi Nomura, Shintaro Michishita, Arisa Nishimukai, Tomoko Higuchi, Yukie Fujimoto, Yoshimasa Miyagawa, Ayako Kira, Keiko Murase, Kazuhiro Araki, Yuichi Takatsuka, Koshi Oh, Yoshikazu Masai, Kouhei Akazawa, Yasuo Miyoshi

    World journal of surgical oncology   16 ( 1 )   26 - 26   2018年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Although the prognosis for operable breast cancers is reportedly worse if serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels are above normal, the usefulness of this prognosis is limited due to the low sensitivity and specificity; in addition, the optimal cutoff levels remain unknown. METHODS: A total of 1076 patients who were operated for breast cancers (test set = 608, validation set = 468) without evidence of metastasis were recruited, and their baseline and postoperative serum CEA and CA15-3 levels were analyzed. The optimal cutoff values of CEA and CA15-3 for disease-free survival (DFS) were 3.2 ng/mL and 13.3 U/mL, respectively, based on receiver operating characteristic curve and area under the curve analyses. RESULTS: The DFS of patients with high CEA levels (CEA-high: n = 191, 5-year DFS 70.6%) was significantly worse (p < 0.0001) than that of CEA-low patients (n = 885, 5-year DFS 87.2%). There was a significant difference in DFS (p < 0.0001) between CA15-3-high and CA15-3-low patients (n = 314 and n = 762, respectively; 5-year DFS 71.8 vs. 89.3%). Significant associations between DFS and CA15-3 levels were observed irrespective of the subtypes. Multivariable analysis indicated that tumor size, lymph node metastasis, tumor grade, and CEA (p = 0.0474) and CA15-3 (p < 0.0001) levels were independent prognostic factors (hazard ratio [HR] 1.520, 95% confidence interval [CI] 1.005-2.245 for CEA; HR 2.088, 95% CI 1.457-2.901 for CA15-3). CONCLUSIONS: These findings suggest that CEA and CA15-3 levels might be useful for predicting the prognosis of patients with operable early breast cancer irrespective of the subtype. Serum levels at baseline may reflect tumor characteristics for metastatic potential even when these levels are within the normal ranges.

    DOI: 10.1186/s12957-018-1325-6

    PubMed

    researchmap

  • Abundant tumor infiltrating lymphocytes after primary systemic chemotherapy predicts poor prognosis in estrogen receptor-positive/HER2-negative breast cancers 査読

    Takahiro Watanabe, Akira I. Hida, Natsuko Inoue, Michiko Imamura, Yukie Fujimoto, Kouhei Akazawa, Seiichi Hirota, Yasuo Miyoshi

    Breast Cancer Research and Treatment   168 ( 1 )   135 - 145   2018年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer New York LLC  

    Purpose: The therapeutic effect of systemic treatment for breast cancer (BC) generally depends on its intrinsic subtypes. In addition, tumor infiltrating lymphocytes (TILs) are considered to be an independent factor for tumor shrinkage and disease prognosis. High TILs at baseline or after primary systemic chemotherapy are reported to be associated with better survival in triple-negative or human epithelial growth factor receptor 2 (HER2)-positive BCs. However, the prognostic value of TILs in estrogen receptor (ER)-positive and HER2-negative (ER+/HER2−) BC is still controversial. Methods: We assessed TIL score (low, intermediate, and high) before and after primary systemic chemotherapy in every subtype of BC, and compared the clinical outcomes. Biopsy specimens of 47 triple-negative, 58 HER2+ and 91 ER+/HER2− BCs were used to assess TILs before treatment. To assess TILs after treatment, we examined residual invasive carcinoma in surgically resected samples of 28 triple-negative, 30 HER2+ and 80 ER+/HER2− BCs. Results: A high TIL score in triple-negative BC before treatment resulted in a significantly higher proportion of pathological complete response (pCR). In contrast, ER+/HER2− BC exhibited fewer instances of pCR than other subtypes. Although not statistically significant, ER+/HER2− cases with a high TIL score also tended to achieve pCR (p = 0.088). Moreover, we revealed that low TIL BCs after chemotherapy, but not at baseline, had significantly better relapse-free survival in ER+/HER2− BC (p = 0.034). Conclusion: Pathological examination of TILs after treatment may be a surrogate marker for prognosis in ER+/HER2− BC.

    DOI: 10.1007/s10549-017-4575-z

    Scopus

    PubMed

    researchmap

  • Targeting complete response with upfront bortezomib consolidation versus observation after the achievement of complete response following autologous transplantation for multiple myeloma (TUBA study) 査読

    Hideki Nakasone, Kiriko Terasako-Saito, Teiichi Hirano, Atsushi Wake, Seiichi Shimizu, Naoki Kurita, Etsuko Yamazaki, Kensuke Usuki, Kohei Akazawa, Junya Kanda, Koichiro Minauchi, Go Yamamoto, Shiori Tanimoto, Masaharu Kamoshita, Yasuhisa Yokoyama, Etsuo Miyaoka, Shuichi Ota, Shinichi Kako, Koji Izutsu, Yoshinobu Kanda

    Hematological Oncology   36 ( 1 )   202 - 209   2018年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:John Wiley and Sons Ltd  

    Complete response (CR) after treatment for multiple myeloma is associated with superior progression-free survival (PFS). Multiple myeloma patients were prospectively recruited for induction treatment with bortezomib and dexamethasone (BD) followed by autologous hematopoietic cell transplantation (auto-HCT) between 2010 and 2012. If patients did not achieve CR after auto-HCT, BD consolidation therapy was added to target CR. After the BD induction phase (n = 46), greater than or equal to CR was achieved in 4 patients (8%). After auto-HCT (n = 34), greater than or equal to CR was achieved in 9 patients (20%) and very good partial response (VGPR) was achieved in 11 (24%). Of the 24 patients who received auto-HCT and whose response was less than CR, 21 received BD consolidation therapy for a median of 4 courses. Finally, the maximum response with or without BD consolidation was greater than or equal to CR in 19 (41%), VGPR in 7 (15%), and PR in 6 (13%). Through BD consolidation, CR was achieved in 8 of 11 patients with post-HCT VGPR and in 2 of 12 patients with post-HCT PR. In total, 4 year PFS and overall survival were 43 and 80%, respectively. After adjusting for clinical factors, there was no difference in PFS between CR patients after auto-HCT and BD consolidation, while patients with less than or equal to VGPR after consolidation had a significantly lower PFS. Patients with post-HCT CR showed good PFS, and targeting CR through BD consolidation could improve the CR rate. It would be worthwhile to prospectively compare the efficacy of consolidation only for patients who failed to achieve CR to a universal consolidation strategy.

    DOI: 10.1002/hon.2452

    Scopus

    PubMed

    researchmap

  • Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001–2007) 査読

    Hitoshi Katai, Takashi Ishikawa, Kohei Akazawa, Yoh Isobe, Isao Miyashiro, Ichiro Oda, Shunichi Tsujitani, Hiroyuki Ono, Satoshi Tanabe, Takeo Fukagawa, Souya Nunobe, Yoshihiro Kakeji, Atsushi Nashimoto, Registration Committee of the Japanese Gastric Cancer Association

    Gastric Cancer   21 ( 1 )   144 - 154   2018年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Tokyo  

    Background: The aim of this retrospective study was to investigate the tumor characteristics, surgical details, and survival distribution of surgically resected cases of gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association. Methods: Data from 118,367 patients with primary gastric carcinoma who underwent resection between 2001 and 2007 were included in the survival analyses. The 5-year survival rates were calculated for various subsets of prognostic factors. Results: The median age of the patients was 67 years. The proportions of patients with pathological stage (Japanese Gastric Cancer Association) IA, IB, II, IIIA, IIIB, and IV disease were 44.0%, 14.7%, 11.7%, 9.5%, 5.0%, and 12.4% respectively. The death rate within 30 days of operation was 0.5%. The 5-year overall survival rate in the 118,367 patients who were treated by resection was 71.1%. The 5-year overall survival rates of patients with pathological stage IA, IB, II, IIIA, IIIB, and IV disease were 91.5%, 83.6%, 70.6%, 53.6%, 34.8%, and 16.4% respectively. The 5-year disease-specific survival rates in the patients with pT1 (mucosa) disease after D1+ dissection of lymph node station no. 7 (D1 + α), D1+ dissection of lymph node station nos. 7, 8, and 9 (D1+ β), and D2 lymphadenectomy were 99.4%, 99.6%, and 99.1% respectively. The 5-year disease-specific survival rates in the patients with pT1 (submucosa) disease after D1 + α, D1 + β, and D2 lymphadenectomy were 97.3%, 98.1%, and 96.9% respectively. Conclusion: Detailed analyses of the data from more than 100,000 patients show the recent trends of the outcomes of gastric cancer treatment in Japan and provide baseline information for use by medical communities around world.

    DOI: 10.1007/s10120-017-0716-7

    Scopus

    PubMed

    researchmap

  • A Hybrid Electronic Health Record System Integrating Electronic and Paper-based Records 査読

    Kenshi Terajima, Norito Negishi, Kouichi Maruyama, Hiroaki Hasegawa, Kouhei Akazawa

    European Journal for Biomedical Informatic   14 ( 1 )   58 - 66   2018年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    researchmap

  • Cost-effectiveness of Paclitaxel + Ramucirumab Combination Therapy for Advanced Gastric Cancer Progressing After First-line Chemotherapy in Japan 査読

    Shota Saito, Yusuke Muneoka, Takashi Ishikawa, Kouhei Akazawa

    Clinical Therapeutics   39 ( 12 )   2380 - 2388   2017年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Excerpta Medica Inc.  

    Purpose The combination of paclitaxel + ramucirumab is a standard second-line treatment in patients with advanced gastric cancer. This therapy has been associated with increased median overall survival and progression-free survival compared with those with paclitaxel monotherapy. We evaluated the cost-effectiveness of paclitaxel + ramucirumab combination therapy in patients with advanced gastric cancer, from the perspective of health care payers in Japan. Methods We constructed a Markov model to compare, over a time horizon of 3 years, the costs and effectiveness of the combination of paclitaxel + ramucirumab and paclitaxel alone as second-line therapies for advanced gastric cancer in Japan. Health outcomes were measured in life-years (LYs) and quality-adjusted (QA) LYs gained. Costs were calculated using year-2016 Japanese yen (\1 = US $17.79) according to the social insurance reimbursement schedule and drug tariff of the fee-for-service system in Japan. Model robustness was addressed through 1-way and probabilistic sensitivity analyses. The costs and QALYs were discounted at a rate of 2% per year. The willingness-to-pay threshold was set at the World Health Organization's criterion of \12 million, because no consensus exists regarding the threshold for acceptable cost per QALY ratios in Japan's health policy. Findings Paclitaxel + ramucirumab combination therapy was estimated to provide an additional 0.09 QALYs (0.10 LYs) at a cost of \3,870,077, resulting in an incremental cost-effectiveness ratio of \43,010,248/QALY. The incremental cost-effectiveness ratio for the combination therapy was &gt
    \12 million/QALY in all of the 1-way and probabilistic sensitivity analyses. Implications Adding ramucirumab to a regimen of paclitaxel in the second-line treatment of advanced gastric cancer is expected to provide a minimal incremental benefit at a high incremental cost per QALY. Based on our findings, adjustments in the price of ramucirumab, as well as improves in other clinical parameters such as survival time and adverse event in advanced gastric cancer therapy, are needed.

    DOI: 10.1016/j.clinthera.2017.10.017

    Scopus

    PubMed

    researchmap

  • Survival outcomes of neoadjuvant chemotherapy with zoledronic acid for HER2-negative breast cancer 査読

    Takashi Ishikawa, Kouhei Akazawa, Yoshie Hasegawa, Hirokazu Tanino, Jun Horiguchi, Daishu Miura, Mitsuhiro Hayashi, Norio Kohno

    JOURNAL OF SURGICAL RESEARCH   220   46 - 51   2017年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Background: A randomized phase 2 trial in women with HER2-negative breast cancer has shown that adding zoledronic acid (ZOL) to neoadjuvant chemotherapy (CT) has potential anticancer benefits in postmenopausal and triple-negative (TN) breast cancer patients. We report the data for the secondary end point of disease-free survival (DFS).
    Methods: Patients were randomly assigned to receive CT or CT + ZOL (CT-Z). All patients received four cycles of FEC100 followed by 12 cycles of paclitaxel weekly. ZOL (4 mg) was administered 3-4 times weekly for 7 wk to the CT-Z group patients. The primary end point was pathologic complete response (pCR). The secondary end points were the clinical response rates, rate of breast-conserving surgery, safety, and DFS.
    Results: Of the 188 patients enrolled, 95 were assigned to the CT group and 93 to the CT-Z group. DFS and overall survival were analyzed in 92 and 88 patients with the mean times of 5.15 y and 5.38 y, respectively. The 3-y DFS rate was 84.6% in the CT group and 90.8% in the CT-Z group (P = 0.188). The particular benefit from ZOL for the neoadjuvant CT seen as improvement of the pCR rate was indicated in the 3-y DFS period for TN cancer cases (CT versus CT-Z: 70.6% versus 94.1%) but not for postmenopausal cases.
    Conclusions: ZOL did not improve DFS when combined with CT. However, the improvement of the pCR rate translated to survival outcomes in TN breast cancer. The short-term application of ZOL may not be sufficient to improve the outcome in postmenopausal patients. (C) 2017 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.jss.2017.05.066

    Web of Science

    PubMed

    researchmap

  • Impact of intra-abdominal absorbable sutures on surgical site infection in gastrointestinal and hepato-biliary-pancreatic surgery: results of a multicenter, randomized, prospective, phase II clinical trial (vol 47, pg 1060, 2017) 査読

    Yoshihiko Maehara, Ken Shirabe, Shunji Kohnoe, Yasunori Emi, Eiji Oki, Yoshihiro Kakeji, Hideo Baba, Masataka Ikeda, Michiya Kobayashi, Tadatoshi Takayama, Shoji Natsugoe, Masashi Haraguchi, Kazuhiro Yoshida, Masanori Terashima, Mitsuru Sasako, Hiroki Yamaue, Norihiro Kokudo, Katsuhiko Uesaka, Shinji Uemoto, Tomoo Kosuge, Yoshiki Sawa, Mitsuo Shimada, Yuichiro Doki, Masakazu Yamamoto, Akinobu Taketomi, Masahiro Takeuchi, Kouhei Akazawa, Takeharu Yamanaka, Mototsugu Shimokawa

    SURGERY TODAY   47 ( 12 )   1539 - 1540   2017年12月

     詳細を見る

    記述言語:英語   出版者・発行元:SPRINGER  

    In the original publication, the article category was published as "Review Article". The correct category should read as "Original Article".

    DOI: 10.1007/s00595-017-1589-4

    Web of Science

    PubMed

    researchmap

  • Comprehensive genomic sequencing detects important genetic differences between right-sided and left-sided colorectal cancer 査読

    Yoshifumi Shimada, Hitoshi Kameyama, Masayuki Nagahashi, Hiroshi Ichikawa, Yusuke Muneoka, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Masato Nakano, Jun Sakata, Takashi Kobayashi, Hitoshi Nogami, Satoshi Maruyama, Yasumasa Takii, Tetsu Hayashida, Hiromasa Takaishi, Yuko Kitagawa, Eiji Oki, Tsuyoshi Konishi, Fumio Ishida, Shin-ei Kudo, Jennifer E. Ring, Alexei Protopopov, Stephen Lyle, Yiwei Ling, Shujiro Okuda, Takashi Ishikawa, Kohei Akazawa, Kazuaki Takabe, Toshifumi Wakai

    ONCOTARGET   8 ( 55 )   93567 - 93579   2017年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IMPACT JOURNALS LLC  

    Objectives: Anti-epidermal growth factor receptor (EGFR) therapy has been found to be more effective against left-sided colorectal cancer (LCRC) than right-sided colorectal cancer (RCRC). We hypothesized that RCRC is more likely to harbor genetic alterations associated with resistance to anti-EGFR therapy and tested this using comprehensive genomic sequencing.
    Materials and methods: A total of 201 patients with either primary RCRC or LCRC were analyzed. We investigated tumors for genetic alterations using a 415-gene panel, which included alterations associated with resistance to anti-EGFR therapy: TK receptors (ERBB2, MET, EGFR, FGFR1, and PDGFRA), RAS pathway (KRAS, NRAS, HRAS, BRAF, and MAPK2K1), and PI3K pathway (PTEN and PIK3CA). Patients whose tumors had no alterations in these 12 genes, theoretically considered to respond to anti-EGFR therapy, were defined as "all wild-type", while remaining patients were defined as "mutant-type".
    Results: Fifty-six patients (28%) and 145 patients (72%) had RCRC and LCRC, respectively. Regarding genetic alterations associated with anti-EGFR therapy, only 6 of 56 patients (11%) with RCRC were "all wild-type" compared with 41 of 145 patients (28%) with LCRC (P = 0.009). Among the 49 patients who received anti-EGFR therapy, RCRC showed significantly worse progression-free survival (PFS) than LCRC (P = 0.022), and "mutant-type" RCRC showed significantly worse PFS compared with "all wild-type" LCRC (P = 0.004).
    Conclusions: RCRC is more likely to harbor genetic alterations associated with resistance to anti-EGFR therapy compared with LCRC. Furthermore, our data shows primary tumor sidedness is a surrogate for the non-random distribution of genetic alterations in CRC.

    DOI: 10.18632/oncotarget.20510

    Web of Science

    PubMed

    researchmap

  • ヘリコバクター・ピロリ抗体検査と血清ペプシノゲン検査による胃がんリスク層別化検診の医療経済効果の推定

    齋藤 翔太, 石川 卓, 赤澤 宏平

    医療情報学連合大会論文集   37回   1056 - 1058   2017年11月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本医療情報学会  

    researchmap

  • Risk factors for stomatitis in patients with lymphangioleiomyomatosis during treatment with sirolimus: A multicenter investigator-initiated prospective study 査読

    Nobutaka Kitamura, Kuniaki Seyama, Yoshikazu Inoue, Katsura Nagai, Masaru Suzuki, Hiroshi Moriyama, Toshinori Takada, Ryushi Tazawa, Toyohiro Hirai, Michiaki Mishima, Mie Hayashida, Masaki Hirose, Toru Arai, Chikatoshi Sugimoto, Noboru Hattori, Kentaro Watanabe, Tsutomu Tamada, Kohei Akazawa, Takahiro Tanaka, Koh Nakata

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY   26 ( 10 )   1182 - 1189   2017年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    PurposeLymphangioleiomyomatosis is a rare lung disease caused by proliferation of abnormal smooth muscle-like cells and typically occurs in premenopausal women. Sirolimus is now the first-line drug for the treatment of lymphangioleiomyomatosis. Sirolimus-induced stomatitis is the most frequent adverse event experienced during treatment. To identify risk factors, we investigated the association of stomatitis incidence with patient background data and treatment parameters, using data from the multicenter long-term sirolimus trial.
    MethodsSubjects received sirolimus for 2years at doses adjusted to maintain a trough blood level of 5 to 15ng/mL. The incidence of stomatitis was correlated with baseline demographics, clinical characteristics, and changes in the longitudinal data. Risk factors at baseline were assessed by using univariate and multivariate analyses.
    ResultsThe most frequent adverse event was stomatitis, with the cumulative rate reaching 88.9% by 9months, higher than that reported in postrenal transplant patients. The repetition, the duration, and the severity of stomatitis events were variable among patients. We found that patients with low hemoglobin (Hb) (&lt;14.5g/dL) showed significantly higher incidence than those with high Hb (14.5g/dL, P&lt;.01). The cumulative rate for stomatitis incidence was significantly associated with a decrease in the mean corpuscular volume, while the Hb level was constant; thus, red blood cell count in patients increased during the study.
    ConclusionsBaseline Hb levels and a decrease in mean corpuscular volume during treatment were correlated with the incidence of stomatitis.

    DOI: 10.1002/pds.4259

    Web of Science

    PubMed

    researchmap

  • Actionable gene-based classification toward precision medicine in gastric cancer 査読

    Hiroshi Ichikawa, Masayuki Nagahashi, Yoshifumi Shimada, Takaaki Hanyu, Takashi Ishikawa, Hitoshi Kameyama, Takashi Kobayashi, Jun Sakata, Hiroshi Yabusaki, Satoru Nakagawa, Nobuaki Sato, Yuki Hirata, Yuko Kitagawa, Toshiyuki Tanahashi, Kazuhiro Yoshida, Ryota Nakanishi, Eiji Oki, Dana Vuzman, Stephen Lyle, Kazuaki Takabe, Yiwei Ling, Shujiro Okuda, Kohei Akazawa, Toshifumi Wakai

    GENOME MEDICINE   9 ( 1 )   93   2017年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: Intertumoral heterogeneity represents a significant hurdle to identifying optimized targeted therapies in gastric cancer (GC). To realize precision medicine for GC patients, an actionable gene alteration-based molecular classification that directly associates GCs with targeted therapies is needed.& para;& para;Methods: A total of 207 Japanese patients with GC were included in this study. Formalin-fixed, paraffin-embedded (FFPE) tum or tissues were obtained from surgical or biopsy specimens and were subjected, to DMA extraction. We generated comprehensive genomic profiling data using a 435-gene panel including 69 actionable genes paired, with US Food and Drug Administration-approved targeted therapies, and the evaluation o f Epstein-Barr virus (EBV) infection and microsatellite instability (MSI) status.& para;& para;Results: Comprehensive genomic sequencing detected at least one alteration o f 435 cancer-related genes in 194 GCs (93.7%) and o f 69 actionable genes in 141 GCs (68.1%). We classified the 207 GCs into four The Cancer Genome Atlas (TCGA) subtypes using the genomic profiling data; EBV (N = 9), MSI (N = 17), chromosomal instability (N = 119), and genomicaliy stable subtype (N = 62). Actionable gene alterations were not specific and were widely observed throughout all TCGA subtypes. To discover a novel classification which more precisely selects candidates for targeted therapies, 207 GCs were classified using hypermutated. phenotype and the mutation profile of 69 actionable genes. We identified a hypermutated group (N = 32), while the others (N = 175) were sub-divided into six dusters including five with actionable gene alterations: ERBB2 (N = 25), CDKN2A, and CDKN2B (N = 10), KRAS (N = 10), BRCA2 (N = 9), and ATM duster (N = 12). The clinical utility of this classification was demonstrated by a case of unresectable GC. with a remarkable response to anti-HER2 therapy in the ERBB2 duster.& para;& para;Conclusions: This actionable gene-based classification creates a framework for further studies for realizing precision medicine in GC.

    DOI: 10.1186/s13073-017-0484-3

    Web of Science

    PubMed

    researchmap

  • Tumor size and proliferative marker geminin rather than Ki67 expression levels significantly associated with maximum uptake of F-18-deoxyglucose levels on positron emission tomography for breast cancers 査読

    Arisa Nishimukai, Natsuko Inoue, Ayako Kira, Masashi Takeda, Koji Morimoto, Kazuhiro Araki, Kazuhiro Kitajima, Takahiro Watanabe, Seiichi Hirota, Toyomasa Katagiri, Shoji Nakamori, Kouhei Akazawa, Yasuo Miyoshi

    PLOS ONE   12 ( 9 )   e0184508   2017年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PUBLIC LIBRARY SCIENCE  

    It has been well established that maximum standardized uptake value (SUVmax) for F-18-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) is clinically useful for evaluating treatment efficacy as well as predicting prognosis of breast cancer patients. Although SUVmax reflects increased glucose uptake and metabolism possibly induced by activation of growth factor signaling or TP53 dysfunction, tumor characteristics of SUVmax-high breast cancers remain to be elucidated. For the present study, we used immunohistochemical staining to investigate expressions of phospho-ribosomal protein S6 (pS6, downstream molecule of phosphatidyl inositol 3-kinase/Akt/mammalian target of the rapamycin/S6K pathway) and phosphor-p44/42 mitogen-activated protein kinase (pMAPK). Expression levels of TP53 and proliferative marker geminin as well as Ki67 were also examined by means of immunostaining in 163 invasive breast cancers. Cutoff values were set at 10% for pS6, 20% for pMAPK and TP53, and 4% for geminin. The SUVmax levels were significantly higher in the pS6-positive (p = 0.0173), TP53-positive (p = 0.0207) and geminin-high cancers (p&lt;0.0001), but there was no significant association between pMAPK expression levels and SUVmax levels. Multivariable analysis showed that a high geminin level (odds ratio: 6.497, 95% confidence interval: 2.427-19.202, p = 0.0001) and large tumor size (6.438, 2.224-20.946, p = 0.0005) were significantly and independently associate d with SUVmax-high. Univariable but not multivariable analysis indicated that Ki67-high significantly correlated with SUVmax-high. Twenty of 23 (87.0%) breast cancers with tumor size &gt;2cm and geminin-high showed SUVmax-high, while only 6 of 49 (12.2%) breast cancers &lt;= 2cm in size and with low geminin levels were SUVmax-high. In conclusion, we could determine that breast cancers with a large tumor and a geminin-high rather than Ki67-high proliferative marker were significantly associated with high levels of SUVmax. These findings may signify that SUVmax reflects tumor characteristics with high proliferative activity but not activation of mTOR/S6K and MAPK pathways or increased glucose metabolism due to dysfunction of TP53.

    DOI: 10.1371/journal.pone.0184508

    Web of Science

    PubMed

    researchmap

  • Impact of intra-abdominal absorbable sutures on surgical site infection in gastrointestinal and hepato-biliary-pancreatic surgery: results of a multicenter, randomized, prospective, phase II clinical trial 査読

    Yoshihiko Maehara, Ken Shirabe, Shunji Kohnoe, Yasunori Emi, Eiji Oki, Yoshihiro Kakeji, Hideo Baba, Masataka Ikeda, Michiya Kobayashi, Tadatoshi Takayama, Shoji Natsugoe, Masashi Haraguchi, Kazuhiro Yoshida, Masanori Terashima, Mitsuru Sasako, Hiroki Yamaue, Norihiro Kokudo, Katsuhiko Uesaka, Shinji Uemoto, Tomoo Kosuge, Yoshiki Sawa, Mitsuo Shimada, Yuichiro Doki, Masakazu Yamamoto, Akinobu Taketomi, Masahiro Takeuchi, Kouhei Akazawa, Takeharu Yamanaka, Mototsugu Shimokawa

    SURGERY TODAY   47 ( 9 )   1060 - 1071   2017年9月

     詳細を見る

    記述言語:英語   出版者・発行元:SPRINGER  

    Background The use of absorbable sutures in wound closure has been shown to reduce the incidence of surgical site infection (SSI); however, there is no evidence that the intra-abdominal use of absorbable rather than silk sutures reduces the incidence of SSI after gastrointestinal surgery. We report the findings of a phase II trial, designed to evaluate the impact of the intra-abdominal use of absorbable sutures on the incidence of SSI.
    Methods At 19 Japanese hospitals, 1147 patients undergoing elective gastrectomy, colorectal surgery, hepatectomy, or pancreaticoduodenectomy (PD) were randomly assigned to absorbable or silk intra-abdominal suture groups. The primary efficacy endpoint was the incidence of SSI. The secondary efficacy endpoints were the locations of SSI, time to resolution of SSI, length of hospital stay, and the incidence of bile leakage in hepatectomy and pancreatic fistula.
    Results The incidence of SSI was 11.3%, 15.5%, 11.3%, and 36.9% after gastrectomy, colorectal surgery, hepatectomy, and PD, respectively. The incidence of SSI was higher in the absorbable suture group than in the silk suture group for all the surgical procedures, but the difference was not significant.
    Conclusion The intra-abdominal use of absorbable sutures did not have enough of an effect on the reduction of SSI in this phase II trial to justify the planning of a large-scale phase III trial.

    DOI: 10.1007/s00595-017-1480-3

    Web of Science

    PubMed

    researchmap

  • Predictors of cognitive function in patients with hypothalamic hamartoma following stereotactic radiofrequency thermocoagulation surgery 査読

    Masaki Sonoda, Hiroshi Masuda, Hiroshi Shirozu, Yosuke Ito, Kohei Akazawa, Eishi Asano, Shigeki Kameyama

    EPILEPSIA   58 ( 9 )   1556 - 1565   2017年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Objective: To determine the predictors of cognitive function in patients with drugresistant gelastic seizures (GS) related to hypothalamic hamartoma (HH) before and after stereotactic radiofrequency thermocoagulation surgery (SRT).
    Methods: We studied 88 patients with HH who underwent SRT between October 1997 and December 2014. Patients received neuropsychological tests preoperatively and postoperatively. Based on the preoperative measures, patients were categorized as "high-functioning" (full-scale intelligence quotient [FSIQ] &gt;= 70; n = 48) and "low-functioning" group (FSIQ &lt;70; n = 40). Univariate and multivariate linear regression analyses determined the clinical, electroencephalography (EEG), and imaging factors associated with preoperative cognitive function as well as postoperative cognitive change.
    Results: Eighty-seven patients (98.8%) were followed postoperatively for an average of 3.3 years, and 75 (85.2%) of them achieved GS remission at the last hospital visit. Neuropsychological performance was significantly improved after surgery in both groups. Multivariate linear regression analysis showed that a smaller HH size (p = 0.002) and a smaller number of antiepileptic drugs (p &lt; 0.001) were preoperatively associated with better neuropsychological performance. Multivariate linear regression analysis showed that better postoperative improvement in cognition was associated with a shorter duration of epilepsy (p = 0.03).
    Significance: Cognitive impairment related to epileptic encephalopathy may improve following SRT in substantial proportions of HH patients. Reduced improvement in postoperative cognitive function in patients with longer duration of epilepsy warrants further studies to determine if earlier SRT provides a greater chance of postoperative cognitive improvement in patients with HH.

    DOI: 10.1111/epi.13838

    Web of Science

    PubMed

    researchmap

  • Utility of comprehensive genomic sequencing for detecting HER2-positive colorectal cancer 査読

    Yoshifumi Shimada, Ryoma Yagi, Hitoshi Kameyama, Masayuki Nagahashi, Hiroshi Ichikawa, Yosuke Tajima, Takuma Okamura, Mae Nakano, Masato Nakano, Yo Sato, Takeaki Matsuzawa, Jun Sakata, Takashi Kobayashi, Hitoshi Nogami, Satoshi Maruyama, Yasumasa Takii, Takashi Kawasaki, Kei-ichi Homma, Hiroshi Izutsu, Keisuke Kodama, Jennifer E. Ring, Alexei Protopopov, Stephen Lyle, Shujiro Okuda, Kohei Akazawa, Toshifumi Wakai

    HUMAN PATHOLOGY   66   1 - 9   2017年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    HER2-targeted therapy is considered effective for KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer (CRC). In general, HER2 status is determined by the use of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Comprehensive genomic sequencing (CGS) enables the detection of gene mutations and copy number alterations including KRAS mutation and HER2 amplification; however, little is known about the utility of CGS for detecting HER2-positive CRC. To assess its utility, we retrospectively investigated 201 patients with stage I-IV CRC. The HER2 status of the primary site was assessed using IHC and FISH, and HER2 amplification of the primary site was also assessed using CGS, and the findings of these approaches were compared in each patient. CGS successfully detected alterations in 415 genes including KRAS codon 12/13 mutation and HER2 amplification. Fifty-nine (29%) patients had a KRAS codon 12/13 mutation. Ten (5%) patients were diagnosed as HER2 positive because of HER2 MC 3+, and the same 10 (5%) patients had HER2 amplification evaluated using CGS. The results of HER2 status and HER2 amplification were completely identical in all 201 patients (P &lt; .001). Nine of the 10 HER2-positive patients were KRAS 12/13 wild-type and were considered possible candidates for HER2-targeted therapy. CGS has the same utility as IHC and FISH for detecting HER2-positive patients who are candidates for HER2-targeted therapy, and facilitates precision medicine and tailor-made treatment. (C) 2017 The Authors. Published by Elsevier Inc.

    DOI: 10.1016/j.humpath.2017.02.004

    Web of Science

    PubMed

    researchmap

  • Clarifying Problems with Emergency Healthcare Systems in Japanese Long-Term Care Facilities for Older People. 査読

    Nobuhiro Sato, Kohei Akazawa, Yuji Mitadera, Tsubasa Suzuki, Nahoko Ibe, Yasuo Hirose

    Health   9 ( 8 )   1159 - 1175   2017年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4236/health.2017.98084

    researchmap

  • Body mass index and menopausal disorders during menopause affect vasomotor symptoms of postmenopausal Japanese breast cancer patients treated with anastrozole: a prospective multicenter cohort study of patient-reported outcomes 査読

    Kaori Tane, Chiyomi Egawa, Shintaro Takao, Kazuhiko Yamagami, Masaru Miyashita, Masashi Baba, Shigetoshi Ichii, Muneharu Konishi, Yuichiro Kikawa, Junya Minohata, Toshitaka Okuno, Keisuke Miyauchi, Kazuyuki Wakita, Hirofumi Suwa, Takashi Hashimoto, Masayuki Nishino, Takashi Matsumoto, Toshiharu Hidaka, Yutaka Konishi, Yoko Sakoda, Akihiro Miya, Masahiro Kishimoto, Hidefumi Nishikawa, Seishi Kono, Ikuo Kokufu, Isao Sakita, Koushiro Kitatsuji, Koushi Oh, Kouhei Akazawa, Yasuo Miyoshi

    BREAST CANCER   24 ( 4 )   528 - 534   2017年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER JAPAN KK  

    Adverse events related to endocrine therapies have a major impact not only on patients' quality of life but also on treatment discontinuation. Although vasomotor symptoms induced by aromatase inhibitors are frequently recognized, risk factors, especially for Japanese women, are not well reported. To identify risk factors for vasomotor symptoms of Japanese breast cancer patients treated with adjuvant anastrozole, we conducted a prospective cohort study based on patient-reported outcomes (PROs).
    For this prospective cohort study (SAVS-JP, UMIN000002455), 391 postmenopausal Japanese estrogen receptor-positive breast cancer patients who were treated with adjuvant anastrozole were recruited from 28 centers. The PRO assessment was obtained from a self-reported questionnaire at baseline, 3, 6, 9 and 12 months between August 2009 and April 2012. Vasomotor symptoms, comprising hot flashes, night sweats, and cold sweats, were categorized into four grades (none, Grade 1: mild, Grade 2: moderate, Grade 3: severe). Pre-existing symptoms were only included if they had become worse than at baseline.
    Hot flashes, night sweats, and cold sweats at baseline were reported by 20.5, 15.1, and 8.2 % of the patients, respectively, and new appearance or worsening of symptoms in comparison with baseline by 38.4, 29.3, and 28.7 %, respectively. About 80 % of newly occurring symptoms were Grade 1, and less than 5 % were Grade 3. Vasomotor symptoms were reported by 201 out of 362 patients (55.5 %) during the first year and the mean time to onset was 5.6 months. Patients with vasomotor symptoms were significantly younger (mean 62.8 years, range 38-86 vs 64.7 years, range 37-84; p = 0.02), had higher body mass index (BMI) (23.4 kg/m(2), range 15.8-39.9 vs 22.4 kg/m(2), range 15.8-34.9; p = 0.01), had vasomotor symptoms sooner after menopause (12.4 years, range 0-51 vs 15.1 years, range 1-37; p = 0.002), and had more menopausal disorders during menopause (63.3 vs 36.7 %; p = 0.002). Multivariate analysis showed that BMI [odds ratio (OR) 1.09 per unit of increase, 95 % confidence interval (CI) 1.02-1.16; p = 0.009] and experiencing menopausal disorders (OR 2.11, 95 % CI 1.35-3.30; p = 0.001) were significantly associated with vasomotor symptoms.
    High BMI and experiencing menopausal disorders at menopause were found to be significantly associated with the occurrence of vasomotor symptoms. These findings are expected to prove useful for the management of postmenopausal Japanese women treated with aromatase inhibitors.

    DOI: 10.1007/s12282-016-0735-y

    Web of Science

    PubMed

    researchmap

  • Serum Heparin-binding Epidermal Growth Factor-like Growth Factor (HB-EGF) as a Biomarker for Primary Ovarian Cancer 査読

    Kohei Miyata, Fusanori Yotsumoto, Satoshi Fukagawa, Chihiro Kiyoshima, Nam Sung Ouk, Daichi Urushiyama, Tomohiro Ito, Takahiro Katsuda, Masamitsu Kurakazu, Ryota Araki, Ayako Sanui, Daisuke Miyahara, Masaharu Murata, Kyoko Shirota, Hiroshi Yagi, Tadao Takono, Kiyoko Kato, Nobuo Yaegashi, Kohei Akazawa, Masahide Kuroki, ShiN'Ichiro Yasunaga, Shingo Miyamoto

    ANTICANCER RESEARCH   37 ( 7 )   3955 - 3960   2017年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:INT INST ANTICANCER RESEARCH  

    Ovarian cancer is the most lethal malignancy among gynaecological cancers. Although many anticancer agents have been developed for the treatment of ovarian cancer, it continues to have an extremely poor prognosis. Heparin-binding epidermal growth factor-like grown factor (HB-EGF) has been reported to be a rational therapeutic target for ovarian cancer. Here, we evaluated the clinical significance of serum HB-EGF by examining the association between prognosis and serum HB-EGF levels in patients with primary ovarian cancer. We found that high serum HB-EGF concentrations were significantly associated with poor prognosis in a combined cohort of patients with all stages of ovarian cancer, as well as in a subset of patients with advanced disease. In addition, serum HB-EGF levels increased as the cancer advanced. These data suggest that serum HB-EGF may be a target for the design of novel therapies for ovarian cancer.

    DOI: 10.21873/anticanres.11779

    Web of Science

    PubMed

    researchmap

  • Heterogeneity in esophageal and gastric cardia precursor progression during six-year endoscopic surveillance after population-based screening in a Chinese high-risk region 査読

    Denggui Wen, Liwei Zhang, Xiaoling Wang, Xiaoduo Wen, Yi Yang, Yuetong Chen, Guiying Wang, Kohei Akazawa, Shijie Wang, Baoen Shan

    THORACIC CANCER   8 ( 4 )   328 - 336   2017年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    BackgroundThe study was conducted to examine esophageal and gastric cardia precursor progression.
    MethodsAfter population-based baseline screening, 145 precursor and 335 chronic inflammation cases were endoscopically surveyed for sixyears.
    ResultsSurveillance of interval and baseline diagnoses for 18 severe dysplasia (SD) cases later detected were: 13, 23, 39, and 44months since a diagnosis of chronic inflammation in four cases; 6, 6, 6, 11, 13, 16, 16, and 23months since mild dysplasia (mD) diagnoses in eight; and 6, 9, 10, 13, 18, and 48months since moderate dysplasia (MD) diagnoses in six. Rates for 11 carcinoma in situ (Cis) cases later detected were: 7 and 18months since basal cell hyperplasia (Bch) diagnoses in two; and 6, 6, 9, 13, 13, 18, 35, 44, and 50months since MD diagnoses in nine. In 10 cancer cases later detected, rates were: 6, 6, 7, 18, 19, 34, 36, and 48months since SD diagnoses in eight cases with submucosal carcinoma; 46months since MD diagnosis in a T2N0M0 carcinoma case; and 52months since Bch diagnosis in another T2N0M0 case.
    ConclusionEsophageal and gastric cardia precursors are heterogeneous. Male gender, advanced age, family history of upper gastrointestinal cancer, and multifocal dysplasia are significant independent predictors for progression, and Bch/mD, MD, and SD constitute three distinctive entities regarding the risk of cancer.

    DOI: 10.1111/1759-7714.12446

    Web of Science

    PubMed

    researchmap

  • Cost-effectiveness analysis of the use of comprehensive molecular profiling before initiating monoclonal antibody therapy against metastatic colorectal cancer in Japan 査読

    Shota Saito, Hitoshi Kameyama, Yusuke Muneoka, Shujiro Okuda, Toshifumi Wakai, Kouhei Akazawa

    Journal of Cancer Policy   12   61 - 66   2017年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier Ltd  

    Introduction Comprehensive molecular profiling has become a pivotal component of precision medicine involving anti-epidermal growth factor receptor (EGFR) monoclonal antibody therapy for metastatic colorectal cancer. The objective of this study was to determine the cost-effectiveness of comprehensive molecular profiling before initiating anti-EGFR therapies for metastatic colorectal cancer. Methods A Markov model simulating the health outcomes and total costs was developed to estimate the life years and quality-adjusted life years (QALYs) gained by metastatic colorectal cancer patients treated with anti-EGFR drug. The cost-effectiveness of comprehensive screening versus RAS mutation screening was evaluated over a 5-year period using the incremental cost-effectiveness ratio (ICER). The ICER per additional QALY gained was calculated, and sensitivity analyses were performed to evaluate the robustness of the assumptions across a range of values. Analyses were made from the perspective of the Japanese healthcare payer. Results Comprehensive screening before monoclonal antibody therapy provided 0.063 additional QALYs (0.075 life years) at the cost of 268,274 Japanese Yen (JPY). The ICER was 4,260,187 JPY/QALY compared to RAS screening. The median progression-free survival obtained by sensitivity analyses for the subgroup not responding to anti-EGFR therapy showed that comprehensive screening and panitumumab prices had the strongest influence on cost-effectiveness. Conclusion The incremental cost per QALY gained indicated that comprehensive screening was more cost-effective compared to RAS screening. With a willingness-to-pay value of 6 million JPY/QALY, comprehensive screening can be considered for the genetic testing of patients before providing monoclonal antibody therapy.

    DOI: 10.1016/j.jcpo.2017.03.008

    Scopus

    researchmap

  • Updated comprehensive epidemiology, microbiology, and outcomes among patients with acute cholangitis 査読

    Harumi Gomi, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Rintaro Mori, Itaru Endo, Fumihiko Miura, Seiki Kiriyama, Naohisa Matsunaga, Takao Itoi, Masamichi Yokoe, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   24 ( 6 )   310 - 318   2017年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    BackgroundThe international practice guidelines for patients with acute cholangitis and cholecystitis were released in 2007 (TG07) and revised in 2013 (TG13). This study investigated updated epidemiology and outcomes among patients with acute cholangitis on a larger scale for the first time.
    MethodsThis is an international multi-center retrospective observational study in Japan and Taiwan. All consecutive patients older than 18years of age and given a clinical diagnosis of acute cholangitis by clinicians between 1 January 2011 and 31 December 2012 were enrolled. Those who met the diagnostic criteria of acute cholangitis by TG13 were statistically analyzed.
    ResultsA total of 7,294 patients were enrolled and 6,433 patients met the TG13 diagnostic criteria. The severity distribution was Grade I (37.5%), Grade II (36.2%), and Grade III (26.2%). The 30-day all-cause mortality was 2.4%, 4.7%, and 8.4% in Grade I, II, III severity, respectively (P&lt;0.001). The incidence of liver abscess and endocarditis as complications of acute cholangitis was 2.0% and 0.26%, respectively.
    ConclusionsThis is the first large scale study to investigate patients with acute cholangitis. This study provides the basis to define the best practices to manage patients with acute cholangitis in future studies.

    DOI: 10.1002/jhbp.452

    Web of Science

    PubMed

    researchmap

  • Descriptive review of acute cholecystitis: Japan-Taiwan collaborative epidemiological study 査読

    Masamichi Yokoe, Tadahiro Takada, Tsann-Long Hwang, Itaru Endo, Kohei Akazawa, Fumihiko Miura, Toshihiko Mayumi, Rintaro Mori, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Takao Itoi, Harumi Gomi, Seiki Kiriyama, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   24 ( 6 )   319 - 328   2017年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    BackgroundSince the publication of the Tokyo Guidelines (TG13) for the management of acute cholecystitis (AC), multidirectional studies have been published. However, epidemiological research about AC with big data was not projected. The aim of this study was to reveal the actual clinical conditions of AC.
    MethodThe study was designed as an international multicenter retrospective study of AC in Japan and Taiwan from 2011 to 2013. The factors investigated comprised data related to demographic, history, physical examinations, laboratory and imaging findings. Based on these data, we investigated the various values of AC, and real situation with respect to severity and treatment.
    ResultsA total of 5,459 patients with AC were reviewed. Thirty-day mortality rate was 1.1%. Based on the diagnostic criteria, 4,088 patients had a definite diagnosis and 291 had a suspected diagnosis. According to the severity grading, 939 patients were classified as Grade III, 2,308 as Grade II, and 2,130 as Grade I. Cholecystectomy was performed in total of 4,266 patients and 2,765 patients had laparoscopic cholecystectomy. The main etiologies were gallbladder stones in 4,623 cases.
    ConclusionThis epidemiological study with large population will undoubtedly contribute to establish the best practice for managing AC worldwide.

    DOI: 10.1002/jhbp.450

    Web of Science

    PubMed

    researchmap

  • Clinical application and verification of the TG13 diagnostic and severity grading criteria for acute cholangitis: an international multicenter observational study 査読

    Seiki Kiriyama, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Fumihiko Miura, Harumi Gomi, Rintaro Mori, Itaru Endo, Takao Itoi, Masamichi Yokoe, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   24 ( 6 )   329 - 337   2017年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    BackgroundThe Tokyo Guidelines 2007 (TG07) first presented the diagnostic and severity grading criteria for acute cholangitis. Subsequently updated in 2013, the Tokyo Guidelines (TG13) have been widely adopted throughout the world as global standard guidelines. We set out to verify the efficacy of these TG13 criteria in an international multicenter study.
    MethodsWe reviewed 6,063 patients who were clinically diagnosed with acute cholangitis in Japan and Taiwan over a 2-year period. The TG13 diagnostic and severity grading criteria were retrospectively applied, and 30-day mortality was investigated.
    ResultsA diagnosis of acute cholangitis was made in 5,454 (90.0%) patients on the basis of the TG13 criteria, and in 4,815 (79.4%) patients on the basis of the TG07 criteria. The 30-day mortality rates of patients with Grade III, Grade II, and Grade I were 5.1%, 2.6%, and 1.2%, respectively, and increased significantly along with disease severity. The mortality rate in the 1,272 Grade II cases where urgent or early biliary drainage was performed was 2.0% (n = 25), which was significantly lower than that of 3.7% (n = 28) in the other 748 cases.
    ConclusionBy using the TG13 diagnostic and severity grading criteria, more patients with possible acute cholangitis can be diagnosed, and patients whose prognosis can potentially be improved by early biliary drainage can be identified. The TG13 criteria are appropriate and useful for clinical practice.

    DOI: 10.1002/jhbp.458

    Web of Science

    PubMed

    researchmap

  • Percutaneous and endoscopic gallbladder drainage for acute cholecystitis: international multicenter comparative study using propensity score-matched analysis 査読

    Takao Itoi, Tadahiro Takada, Tsann-Long Hwang, Itaru Endo, Kohei Akazawa, Fumihiko Miura, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Harumi Gomi, Masamichi Yokoe, Seiki Kiriyama, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   24 ( 6 )   362 - 368   2017年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    BackgroundTokyo Guideline 2013 (TG13) proposed three drainage techniques for the treatment of acute cholecystitis. We evaluated the clinical efficacy and adverse events between percutaneous transhepatic intervention (PTGBI) including percutaneous transhepatic gallbladder drainage (PTGBD) and percutaneous transhepatic gallbladder aspiration (PTGBA) and endoscopic transpapillary gallbladder drainage (EGBD).
    MethodsA cohort study was performed using propensity score matching to reduce treatment selection bias. This involved the analysis of collected data for 1,764 patients who underwent PTGBI and EGBD.
    ResultsPropensity score matching extracted 330 pairs of patients. The difference in the clinical success rate within 3 days between PTGBI and EGBD were 62.5% and 69.8%, respectively (P = 0.085). The differences in the suboptimal clinical success rates within 7 days between PTGBI and EGBD were 87.6% and 89.2% (P = 0.579). The differences in the complication rate between PTGBI and EGBD were 4.8% and 8.2% (P = 0.083). The differences in the complication rate among PTGBD, PTGBA and EGBD were 5.6%, 1.6% and 8.2% (P = 0.11). Median required days of PTGBD (3.0 days) was significantly longer than those of PTGBA and EGBD (1.5 and 2.0 days, respectively) (P = 0.001).
    ConclusionThe current study showed the PTGBI showed similar clinical efficacy compared with EGBD without significant discrepancy of complication rate for the treatment of acute cholecystitis.

    DOI: 10.1002/jhbp.454

    Web of Science

    PubMed

    researchmap

  • Validation of TG13 severity grading in acute cholecystitis: Japan-Taiwan collaborative study for acute cholecystitis 査読

    Masamichi Yokoe, Tadahiro Takada, Tsann-Long Hwang, Itaru Endo, Kohei Akazawa, Fumihiko Miura, Toshihiko Mayumi, Rintaro Mori, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Takao Itoi, Harumi Gomi, Seiki Kiriyama, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   24 ( 6 )   338 - 345   2017年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    BackgroundThe collaborative multicenter retrospective study of acute cholecystitis (AC) was performed in Japan and Taiwan. The aim for this study was evaluation of the clinical value of TG13 severity grading for AC.
    MethodThe study was designed as an international multicenter retrospective study of AC from 2011 to 2013. Based on the data, we investigated the TG13 severity grading by analyzing the correlations between grade and prognosis, surgical procedures, histopathology, and organ dysfunction and prognosis.
    ResultsAn investigation revealed that 30-day overall mortality rate was 1.1% for Grade I, 0.8% for Grade II, 5.4% for Grade III. The mortality rate for Grade III was significantly higher than lower grades (P&lt;0.001). The greater the number of organ dysfunction, the higher the mortality rate (P&lt;0.001). However, the mortality rate varied depending on the number of organ dysfunction (3.1-25%). With respect to the surgical procedures, laparoscopic cholecystectomy was performed for Grade I patients (P&lt;0.001), and the higher the grade, the more likely open surgery would be selected (P&lt;0.001).
    ConclusionTG13 severity grading criteria for AC are providing great benefits in actual clinical settings. From this study, the position of each severity grade was obviously confirmed.

    DOI: 10.1002/jhbp.457

    Web of Science

    PubMed

    researchmap

  • Optimal treatment strategy for acute cholecystitis based on predictive factors: Japan-Taiwan multicenter cohort study 査読

    Itaru Endo, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Rintaro Mori, Fumihiko Miura, Masamichi Yokoe, Takao Itoi, Harumi Gomi, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Seiki Kiriyama, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   24 ( 6 )   346 - 361   2017年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    BackgroundAlthough early laparoscopic cholecystectomy is widely performed for acute cholecystitis, the optimal timing of a cholecystectomy in clinically ill patients remains controversial. This study aims to determine the best practice for the patients presenting with acute cholecystitis focused on disease severity and comorbidities.
    MethodsAn international multicentric retrospective observational study was conducted over a 2-year period. Patients were divided into four groups: Group A: primary cholecystectomy; Group B: cholecystectomy after gallbladder drainage; Group C: gallbladder drainage alone; and Group D: medical treatment alone.
    ResultsThe subjects of analyses were 5,329 patients. There were statistically significant differences in mortality rates between patients with Charlson comorbidity index (CCI) scores below and above 6 (P &lt; 0.001). The shortest operative time was observed in Group A patients who underwent surgery 0-3 days after admission (P &lt; 0.01). Multiple regression analysis revealed CCI and low body mass index &lt;20 as predictive factors of 30-day mortality in Grade I+II patients. Also, jaundice, neurological dysfunction, and respiratory dysfunction were predictive factors of 30-day mortality in Grade III patients. In Grade III patients without predictive factors, there were no difference in mortality between Group A and Group B (0% vs. 0%), whereas Group A patients had higher mortality rates than that of Group B patients (9.3% vs. 0.0%) in cases with at least one predictive factor.
    ConclusionEven patients with Grade III severity, primary cholecystectomy can be performed safely if they have no predictive factors of mortality. Gallbladder drainage may have a therapeutic role in subgroups with higher CCI or higher disease severity.

    DOI: 10.1002/jhbp.456

    Web of Science

    PubMed

    researchmap

  • Effects of an educational intervention on oral hygiene and self-care among people with mental illness in Japan: a longitudinal study 査読

    Hatsumi Yoshii, Nobutaka Kitamura, Kouhei Akazawa, Hidemitsu Saito

    BMC ORAL HEALTH   17 ( 1 )   81   2017年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: The oral hygiene of patients with a mental illness is an important concern in psychiatric care, and it is necessary to increase the level of self-care among these patients. In this study, we administered an oral care questionnaire to people with mental illness in Japan and compared their answers before (baseline) and at 1 week and 1, 3 and 6 months after they participated in an educational program.
    Methods: The questionnaire was distributed to 390 patients. It included questions about age, education, income, between-meal snacks, number of teeth, frequency of tooth brushing, and other items. The educational program was developed for the purposes of improving self-care.
    Results: Before the program, the proportion of male patients who had had a mental illness for &gt;= 10 years was significantly higher among those patients who did not brush their teeth before bed. In addition, such patients did not have primary care dentists, and a significantly higher proportion of male patients, compared with female patients, did not undergo routine dental checkups more than once per year. The educational program resulted in an improvement in the use of fluoride toothpaste from baseline to 6 months after the intervention (p = 0.001). The daily use of interdental brushes or floss was significantly different 6 months after the intervention.
    Conclusions: Male and long-term inpatients need oral hygiene instructions. Our educational program showed the effects of using oral hygiene tools. Future studies should include a control group to measure the impact of the educational program.

    DOI: 10.1186/s12903-017-0372-7

    Web of Science

    PubMed

    researchmap

  • StageII/III胃癌の根治切除後再発予後予測因子の探索(Prognostic factors for stage II/III gastric cancer patients who underwent curative gastrectomy)

    宗岡 悠介, 石川 卓, 市川 寛, 羽入 隆晃, 梨本 篤, 藪崎 裕, 田中 典生, 赤澤 宏平, 若井 俊文

    日本胃癌学会総会記事   89回   407 - 407   2017年3月

     詳細を見る

    記述言語:英語   出版者・発行元:(一社)日本胃癌学会  

    researchmap

  • Re-evaluating Cut-off Points for the Expansion of Deceased Donor Criteria for Kidney Transplantation in Japan 査読

    Y. Nakagawa, M. Ikeda, T. Ando, M. Tasaki, K. Saito, K. Takahashi, A. Aikawa, M. Kikuchi, K. Akazawa, Y. Tomita

    Transplantation Proceedings   49 ( 1 )   10 - 15   2017年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier USA  

    Background A shortage of donors poses a serious problem for organ transplantation around the world. In response, the concept of the expanded criteria donor (ECD) has been defined to include donors with traditionally less favorable characteristics. That definition has now been accepted and is being applied in kidney transplantation in the United States and Europe. However, the ECD has not yet been defined for deceased donor kidney transplantation in Japan. Patients and Methods We analyzed data on graft survival and relevant risk factors in patients who received deceased donor kidney transplants through the East Japan Branch of the Japan Organ Transplant network (n = 1051). Recipients were divided into two groups: the standard-function group (estimated glomerular filtration rate [eGFR] ≥20 mL/min/1.73 m2
    n = 906) and the poor-function group (eGFR &lt
    20 mL/min/1.73 m2
    n = 145
    Cox proportional hazards regression analysis
    P &lt
    .0001). Results The 10-year survival rate was significantly lower in the poor-function group than in the standard-function group (85.5% vs 22.5%
    P &lt
    .0001). The two groups differed significantly in recipient and donor risk for graft failure. Recipient risk factors were length of time on dialysis before renal transplantation and incidence of acute rejection after transplantation. Donor risk factors were donor category (heart death), age, history of hypertension, presence of cerebrovascular disease, mean urine output, and donor creatinine level immediately before donor nephrectomy, total ischemic time, and warm ischemic time. Conclusion Data from deceased donor transplantation should be analyzed in depth to determine which factors influence renal function after transplantation. In addition, ECD standards should be reconsidered for use in a Japanese context.

    DOI: 10.1016/j.transproceed.2016.11.016

    Scopus

    PubMed

    researchmap

  • Prognostic Impact of Indocyanine Green Plasma Disappearance Rate in Hepatocellular Carcinoma Patients after Radiofrequency Ablation: A Prognostic Nomogram Study 査読

    Motoi Azumi, Takeshi Suda, Shuji Terai, Kouhei Akazawa

    INTERNAL MEDICINE   56 ( 9 )   1001 - 1007   2017年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    Objective Radiofrequency ablation has been used widely for the local ablation of hepatocellular carcinoma, particularly in its early stages. The study aim was to identify significant prognostic factors and develop a predictive nomogram for patients with hepatocellular carcinoma who have undergone radiofrequency ablation. We also developed the formula to predict the probability of 3- and 5-year overall survival based on clinical variables.
    Methods We retrospectively studied 96 consecutive patients with hepatocellular carcinoma who had undergone radiofrequency ablation as a first-line treatment. Independent and significant factors affecting the overall survival were selected using a Cox proportional hazards model, and a prognostic nomogram was developed based on these factors. The predictive accuracy of the nomogram was determined by Harrell's concordance index and compared with the Cancer of the Liver Italian Program score and Japan Integrated Staging score.
    Results A multivariate analysis revealed that age, indocyanine green plasma disappearance rate, and log (des-gamma-carboxy prothrombin) level were independent and significant factors influencing the overall survival. The nomogram was based on these three factors. The mean concordance index of the nomogram was 0.74 +/- 0.08, which was significantly better than that of conventional staging systems using the Cancer of the Liver Italian Program score (0.54 +/- 0.03) and Japan Integrated Staging score (0.59 +/- 0.07).
    Conclusion This study suggested that the indocyanine green plasma disappearance rate and age at radiofrequency ablation (RFA) and des-gamma-carboxy-prothrombin (DCP) are good predictors of the prognosis in hepatocellular carcinoma patients after radiofrequency ablation. We successfully developed a nomogram using obtainable variables before treatment.

    DOI: 10.2169/internalmedicine.56.7278

    Web of Science

    PubMed

    researchmap

  • Analysis of Hospital Characteristics Affecting the Choice of Management Strategy Types: A Cross-Sectional Survey of Private Hospitals in Japan 査読

    Yuji Mitadera, Mayumi Watanabe, Nobuhiro Sato, Motoi Azumi, Kouhei Akazawa

    Health   9 ( 11 )   1494 - 1508   2017年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4236/health.2017.911110

    researchmap

  • Efficacy and Safety of Long-Term Sirolimus Therapy for Asian Patients with Lymphangioleiomyomatosis. 査読

    Takada T, Mikami A, Kitamura N, Seyama K, Inoue Y, Nagai K, Suzuki M, Moriyama H, Akasaka K, Tazawa R, Hirai T, Mishima M, Hayashida M, Hirose M, Sugimoto C, Arai T, Hattori N, Watanabe K, Tamada T, Yoshizawa H, Akazawa K, Tanaka T, Yagi K, Young LR, McCormack FX, Nakata K

    Annals of the American Thoracic Society   13 ( 11 )   1912 - 1922   2016年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1513/AnnalsATS.201605-335OC

    Scopus

    PubMed

    researchmap

  • Nomogram for 5-year relapse-free survival of a patient with advanced gastric cancer after surgery 査読

    Yusuke Muneoka, Kohei Akazawa, Takashi Ishikawa, Hiroshi Ichikawa, Atsushi Nashimoto, Hiroshi Yabusaki, Norio Tanaka, Shin-ichi Kosugi, Toshifumi Wakai

    INTERNATIONAL JOURNAL OF SURGERY   35   153 - 159   2016年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE BV  

    Background: Prognoses vary substantially among patients with advanced gastric cancer following curative surgery. The aim of the current study was to develop and verify the validity of a novel nomogram that predicts the probability of 5-year relapse-free survival (RFS) in patients who underwent curative resection for stage II/III gastric cancer.
    Materials and methods: A nomogram to predict 5-year RFS following surgical resection of gastric cancer was constructed based on the data of patients who underwent surgery for primary gastric carcinoma at three institutions in Japan in January 2001-December 2006. Multivariate analysis using a Cox proportional hazards regression model was performed, and the nomogram's predictive accuracy (discrimination) and the agreement between observed outcomes and predictions (calibration) were evaluated by internal validation.
    Results: Multivariate analyses revealed that age at operation, depth of tumor, tumor location, lymph node classification, and presence of combined resection were significant prognostic factors for RFS. In the internal validation, discrimination of the developed nomogram for 5-year RFS was superior to that of the American Joint Committee on Cancer TNM classification (concordance indices of 0.80 versus 0.67; P &lt; 0.001). Moreover, calibration appeared to be accurate. Based on these results, we have created free software to more easily predict 5-year RFS.
    Conclusion: We developed and validated a nomogram to predict 5-year RFS after curative surgery for stage II/III gastric cancer. This tool will be useful for the assessing a patient's individual recurrence risk when considering additional therapy in clinical practice. (C) 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.ijsu.2016.09.080

    Web of Science

    PubMed

    researchmap

  • Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer 査読

    Terumoto Koike, Teruaki Koike, Seijiro Sato, Takehisa Hashimoto, Tadashi Aoki, Katsuo Yoshiya, Yasushi Yamato, Takehiro Watanabe, Kohei Akazawa, Shin-Ichi Toyabe, Masanori Tsuchida

    JOURNAL OF THORACIC DISEASE   8 ( 11 )   3265 - 3274   2016年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PIONEER BIOSCIENCE PUBL CO  

    Background: Although lobectomy is the standard surgical procedure for non-small cell lung cancer (NSCLC), recent studies show favorable outcomes after limited resection in patients with small-sized peripheral tumors. We conducted a randomized controlled trial of such patients to estimate postoperative outcomes and pulmonary function following these surgical techniques.
    Methods: Between 2005 and 2008, eligible patients with tumors of 2 cm or less were randomly assigned 1: 1 to undergo lobectomy or limited resection; 32 and 33 NSCLC patients in each group, respectively, were analyzed. The primary end points were 5-year overall survival (OS) and disease-free survival (DFS), while the secondary end points were postoperative pulmonary function including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1).
    Results: The 5-year OS rates were 93.8% and 90.9% in the lobectomy and limited resection groups, respectively (P=0.921). The 5-year DFS rates were 93.8% and 90.9% in the lobectomy and limited resection groups, respectively (P=0.714). These rates did not differ significantly between the two resection groups. The median postoperative/preoperative FVC ratios were 84.1% and 90.0% in the lobectomy and limited resection groups, respectively, while the median postoperative/preoperative FEV1 ratios were 81.9% and 89.1%, respectively. Both ratios were significantly higher in the limited resection group (P=0.032 and P=0.005 for FVC and FEV1 ratios, respectively).
    Conclusions: A similar outcome, with more preserved postoperative pulmonary function, was observed in patients who underwent limited resection compared to those who underwent lobectomy. Ongoing large-scale multi-institutional prospective randomized trials of lobar versus sublobar resection in patients with small peripheral NSCLCs will hopefully provide definitive information about intentional limited resection of small peripheral tumors.

    DOI: 10.21037/jtd.2016.11.106

    Web of Science

    PubMed

    researchmap

  • Efficacy and Safety of Long-Term Sirolimus Therapy for Asian Patients with Lymphangioleiomyomatosis 査読

    Takada, Toshinori, Mikami, Ayako, Kitamura, Nobutaka, Seyama, Kuniaki, Inoue, Yoshikazu, Nagai, Katsura, Suzuki, Masaru, Moriyama, Hiroshi, Akasaka, Keiichi, Tazawa, Ryushi, Hirai, Toyohiro, Mishima, Michiaki, Hayashida, Mie, Hirose, Masaki, Sugimoto, Chikatoshi, Arai, Toru, Hattori, Noboru, Watanabe, Kentaro, Tamada, Tsutomu, Yoshizawa, Hirohisa, Akazawa, Kohei, Tanaka, Takahiro, Yagi, Keita, Young, Lisa R, McCormack, Francis X, Nakata, Koh

    ANNALS OF THE AMERICAN THORACIC SOCIETY   13 ( 11 )   1912 - 1922   2016年11月

     詳細を見る

    掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER THORACIC SOC  

    Rationale: Sirolimus has been shown in a randomized, controlled clinical trial to stabilize lung function in patients with lymphangioleiomyomatosis (LAM) treated for a 12-month time period; however the pretreatment decline in lung function after the drug was discontinued indicated that continued exposure is required to suppress disease progression. Objectives: To elucidate the durability and tolerability of long-term sirolimus treatment in Asian patients with LAM. Methods: We conducted a single-arm, open-label, investigator-initiated safety and efficacy study of sirolimus in 63 women with LAM at 9 sites in Japan. Subjects received sirolimus for 2 years at doses adjusted to maintain a trough blood level of 5-15 ng/ml. Measurements and Main Results: Fifty-two subjects (82.5%) completed the trial with mean drug compliance of more than 80% overall during the study. The number of adverse events was greatest during the initial 6 months of therapy, but they continued to occur with declining frequency throughout the 2-year study period. Of the 1,549 adverse events, 27 were classified as serious, including reversible sirolimus pneumonitis in 3 patients. New hypercholesterolemia occurred in

    DOI: 10.1513/AnnalsATS.201605-335OC

    Scopus

    PubMed

    researchmap

  • Therapeutic or spontaneous Helicobacter pylori eradication can obscure magnifying narrow-band imaging of gastric tumors. 査読

    Kobayashi M, Hashimoto S, Mizuno K, Takeuchi M, Sato Y, Watanabe G, Ajioka Y, Azumi M, Akazawa K, Terai S

    Endoscopy international open   4 ( 6 )   E665 - 72   2016年6月

  • Response 査読

    Shigeki Kameyama, Hiroshi Shirozu, Hiroshi Masuda, Yosuke Ito, Masaki Sonoda, Kohei Akazawa

    Journal of Neurosurgery   124 ( 5 )   1502   2016年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:American Association of Neurological Surgeons  

    DOI: 10.3171/2015.5.JNS15785

    Scopus

    researchmap

  • Hypothalamic hamartomas Response 査読

    Shigeki Kameyama, Hiroshi Shirozu, Hiroshi Masuda, Yosuke Ito, Masaki Sonoda, Kohei Akazawa

    JOURNAL OF NEUROSURGERY   124 ( 5 )   1502 - 1502   2016年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    DOI: 10.3171/2015.4.JNS1582

    Web of Science

    PubMed

    researchmap

  • Mutation burden and microsatellite instability in colorectal cancer in Japan and US 査読

    Masayuki Nagahashi, Toshifumi Wakai, Yoshifumi Shimada, Hiroshi Ichikawa, Hitoshi Kameyama, Takashi Kobayashi, Masato Nakajima, Yusuke Muneoka, Kohei Akazawa, Kazuki Moro, Junko Tsuchida, Daiki Soma, Kizuki Yuza, Takuya Ando, Hiroshi Izutsu, Julie Tse, Shujiro Okuda, Kazuaki Takabe, Alexei Protopopov, Stephen Lyle

    JOURNAL OF CLINICAL ONCOLOGY   34 ( 15 )   2016年5月

     詳細を見る

    記述言語:英語   出版者・発行元:AMER SOC CLINICAL ONCOLOGY  

    DOI: 10.1200/JCO.2016.34.15_suppl.e15103

    Web of Science

    researchmap

  • MRI-guided stereotactic radiofrequency thermocoagulation for 100 hypothalamic hamartomas 査読

    Shigeki Kameyama, Hiroshi Shirozu, Hiroshi Masuda, Yosuke Ito, Masaki Sonoda, Kohei Akazawa

    JOURNAL OF NEUROSURGERY   124 ( 5 )   1503 - 1512   2016年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    OBJECTIVE The aim of this study was to elucidate the invasiveness, effectiveness, and feasibility of MRI-guided stereotactic radiofrequency thermocoagulation (SRT) for hypothalamic hamartoma (HH).
    METHODS The authors examined the clinical records of 100 consecutive patients (66 male and 34 female) with intractable gelastic seizures (GS) caused by HH, who underwent SRT as a sole surgical treatment between 1997 and 2013. The median duration of follow-up was 3 years (range 1-17 years). Seventy cases involved pediatric patients. Ninety percent of patients also had other types of seizures (non-GS). The maximum diameter of the HHs ranged from 5 to 80 mm (median 15 mm), and 15 of the tumors were giant HHs with a diameter of 30 mm or more. Comorbidities included precocious puberty (33.0%), behavioral disorder (49.0%), and mental retardation (50.0%).
    RESULTS A total of 140 SRT procedures were performed. There was no adaptive restriction for the giant or the subtype of HH, regardless of any prior history of surgical treatment or comorbidities. Patients in this case series exhibited delayed precocious puberty (9.0%), pituitary dysfunction (2.0%), and weight gain (7.0%), besides the transient hypothalamic symptoms after SRT. Freedom from GS was achieved in 86.0% of patients, freedom from other types of seizures in 78.9%, and freedom from all seizures in 71.0%. Repeat surgeries were not effective for non-GS. Seizure freedom led to disappearance of behavioral disorders and to intellectual improvement.
    CONCLUSIONS The present SRT procedure is a minimally invasive and highly effective surgical procedure without adaptive limitations. SRT involves only a single surgical procedure appropriate for all forms of epileptogenic HH and should be considered in patients with an early history of GS.

    DOI: 10.3171/2015.4.JNS1582

    Web of Science

    researchmap

  • Clinicopathological features in anterior visual pathway in neuromyelitis optica 査読

    Mariko Hokari, Akiko Yokoseki, Musashi Arakawa, Etsuji Saji, Kaori Yanagawa, Fumihiro Yanagimura, Yasuko Toyoshima, Kouichirou Okamoto, Satoshi Ueki, Tetsuhisa Hatase, Riuko Ohashi, Takeo Fukuchi, Kohei Akazawa, Mitsunori Yamada, Akiyoshi Kakita, Hitoshi Takahashi, Masatoyo Nishizawa, Izumi Kawachi

    ANNALS OF NEUROLOGY   79 ( 4 )   605 - 624   2016年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    ObjectiveNeuromyelitis optica spectrum disorder (NMOsd) is an autoimmune disorder of the central nervous system characterized by aquaporin-4 (AQP4) autoantibodies. The aim of this study was to elucidate the characteristics of involvement of the anterior visual pathway (AVP) and neurodegeneration via glia-neuron interaction in NMOsd.
    MethodsThirty Japanese patients with serologically verified NMOsd were assessed with a neuro-ophthalmological study. Using 27 tissue blocks from 13 other cases of NMOsd, we performed neuropathological analysis of glial and neuroaxonal involvement in the AVP.
    ResultsThe AVP involvement in NMOsd was characterized by the following, compared to multiple sclerosis: (1) longitudinally extensive optic neuritis (ON); (2) more severe visual impairment and worse prognosis for ON; (3) unique AQP4 dynamics, including loss of AQP4 immunoreactivity on astrocytes with complement activation in ON lesions, loss of AQP4 immunoreactivity on Muller cells with no deposition of complement in the retinas, and densely packed AQP4 immunoreactivity on astrocytes in gliosis of secondary anterograde/retrograde degeneration in the optic nerves and retinal nerve fiber layer (RNFL); and (4) more severe neurodegeneration, including axonal accumulation of degenerative mitochondria and transient receptor potential melastatin 4 channel with complement-dependent astrocyte pathology in ON lesions, mild loss of horizontal cells, and RNFL thinning and loss of ganglion cells with abundance of AQP4(+) astrocytes, indicating secondary retrograde degeneration after ON.
    InterpretationSevere and widespread neuroaxonal damage and unique dynamics of astrocytes/Muller cells with alterations of AQP4 were prominent in the AVP and may be associated with poor visual function and prognosis in NMOsd. Ann Neurol 2016;79:605-624

    DOI: 10.1002/ana.24608

    Web of Science

    PubMed

    researchmap

  • Prognostic significance of geminin expression levels in Ki67-high subset of estrogen receptor-positive and HER2-negative breast cancers 査読

    Tomoko Yagi, Natsuko Inoue, Ayako Yanai, Keiko Murase, Michiko Imamura, Yoshimasa Miyagawa, Yukie Enomoto, Arisa Nishimukai, Yuichi Takatsuka, Seiichi Hirota, Kouhei Akazawa, Yasuo Miyoshi

    BREAST CANCER   23 ( 2 )   224 - 230   2016年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER JAPAN KK  

    Indication for chemotherapy in estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancers is determined on the basis of Ki67 expression level. However, since Ki67-high cancers are not necessarily sensitive to chemotherapy, identification of such patients who do not need chemotherapy is an important issue.
    We used immunohistochemical staining to examine the expression levels of ER, progesterone receptor (PgR), Ki67, and geminin, a marker of S to G2/M phases, in 80 ER-positive/HER2-negative breast cancers. The labeling indices of Ki67 and geminin were determined and cutoff values were set at 15 and 6 %, respectively.
    Ki67 and geminin expression levels were significantly associated with nuclear grade. In the Ki67-low subset, 26 out of 28 (92.9 %) cancers were geminin low and in the Ki67-high subset, 31 out of 52 (59.6 %) were geminin high. Distant disease-free survival (DDFS) of the geminin-high subset was significantly poorer than that of the geminin-low subset (P = 0.009). In the Ki67-low subset, only one patient showed recurrence. Metastasis was detected in eight out of 31 (25.8 %) patients in the geminin-high group of the Ki67-high subset, but no recurrence was observed in the geminin-low group of the Ki67-high subset.
    Geminin-high breast cancers are significantly associated with worse prognosis. Since poorer prognosis was recognized only in the geminin-high group in Ki67-high cancers, we speculate that geminin may be useful for identifying patients in the Ki67-high subset who can avoid unnecessary chemotherapy.

    DOI: 10.1007/s12282-014-0556-9

    Web of Science

    PubMed

    researchmap

  • Microbiological and Clinical Effects of Sitafloxacin and Azithromycin in Periodontitis Patients Receiving Supportive Periodontal Therapy 査読

    Takako Nakajima, Takafumi Okui, Harue Ito, Mayuka Nakajima, Tomoyuki Honda, Yasuko Shimada, Koichi Tabeta, Kohei Akazawa, Kazuhisa Yamazaki

    ANTIMICROBIAL AGENTS AND CHEMOTHERAPY   60 ( 3 )   1779 - 1787   2016年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER SOC MICROBIOLOGY  

    Sitafloxacin (STFX) is a newly developed quinolone that has robust antimicrobial activity against periodontopathic bacteria. We previously reported that oral administration of STFX during supportive periodontal therapy was as effective as conventional mechanical debridement under local anesthesia microbiologically and clinically for 3 months. The aim of the present study was to examine the short-term and long-term microbiological and clinical effects of systemic STFX and azithromycin (AZM) on active periodontal pockets during supportive periodontal therapy. Fifty-one patients receiving supportive periodontal therapy were randomly allocated to the STFX group (200 mg/day of STFX for 5 days) or the AZM group (500 mg/day of AZM for 3 days). The microbiological and clinical parameters were examined until 12 months after the systemic administration of each drug. The concentration of each drug in periodontal pockets and the antimicrobial susceptibility of clinical isolates were also analyzed. The proportions of red complex bacteria, i.e., Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, which are the representative periodontopathic bacteria, were significantly reduced at 1 month and remained lower at 12 months than those at baseline in both the STFX and AZM groups. Clinical parameters were significantly improved over the 12-month period in both groups. An increase in the MIC of AZM against clinical isolates was observed in the AZM group. These results indicate that monotherapy with systemic STFX and AZM might be an alternative treatment during supportive periodontal therapy in patients for whom invasive mechanical treatment is inappropriate.

    DOI: 10.1128/AAC.02575-15

    Web of Science

    PubMed

    researchmap

  • Effects of neoadjuvant chemotherapy with or without zoledronic acid on pathological response: A meta-analysis of randomised trials 査読

    J. R. Kroep, A. Charehbili, R. E. Coleman, R. L. Aft, Y. Hasegawa, M. C. Winter, K. Weilbaecher, K. Akazawa, S. Hinsley, H. Putter, G. J. Liefers, J. W.R. Nortier, N. Kohno

    European Journal of Cancer   54   57 - 63   2016年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier Ltd  

    Purpose The addition of bisphosphonates to adjuvant therapy improves survival in postmenopausal breast cancer (BC) patients. We report a meta-analysis of four randomised trials of neoadjuvant chemotherapy (CT) +/- zoledronic acid (ZA) in stage II/III BC to investigate the potential for enhancing the pathological response. Methods Individual patient data from four prospective randomised clinical trials reporting the effect of the addition of ZA on the pathological response after neoadjuvant CT were pooled. Primary outcomes were pathological complete response in the breast (PCRb) and in the breast and lymph nodes (PCR). Trial-level and individual patient data meta-analyses were done. Predefined subgroup-analyses were performed for postmenopausal women and patients with triple-negative BC. Results PCRb and PCR data were available in 735 and 552 patients respectively. In the total study population ZA addition to neoadjuvant CT did not increase PCRb or PCR rates. However, in postmenopausal patients, the addition of ZA resulted in a significant, near doubling of the PCRb rate (10.8% for CT only versus 17.7% with CT+ZA
    odds ratio [OR] 2.14, 95% confidence interval [CI] 1.01-4.55) and a non-significant benefit of the PCR rate (7.8% for CT only versus 14.6% with CT+ZA
    OR 2.62, 95% CI 0.90-7.62). In patients with triple-negative BC a trend was observed favouring CT+ZA. Conclusion This meta-analysis shows no impact from the addition of ZA to neoadjuvant CT on PCR. However, as has been seen in the adjuvant setting, the addition of ZA to neoadjuvant CT may augment the effects of CT in postmenopausal patients with BC.

    DOI: 10.1016/j.ejca.2015.10.011

    Scopus

    PubMed

    researchmap

  • Comparison of Number Versus Ratio of Positive Lymph Nodes in the Assessment of Lymph Node Status in Extrahepatic Cholangiocarcinoma 査読

    Jun Sakata, Toshifumi Wakai, Yasunobu Matsuda, Taku Ohashi, Yuki Hirose, Hiroshi Ichikawa, Takashi Kobayashi, Masahiro Minagawa, Shin-ichi Kosugi, Yu Koyama, Kouhei Akazawa, Yoichi Ajioka

    ANNALS OF SURGICAL ONCOLOGY   23 ( 1 )   225 - 234   2016年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    This study aimed to compare the utility of the number of positive lymph nodes with the lymph node ratio (LNR) in predicting survival after resection of extrahepatic cholangiocarcinoma.
    A retrospective analysis of 142 consecutive patients who underwent radical resection of extrahepatic cholangiocarcinoma was performed. A total of 3066 regional lymph nodes were resected. The median number of nodes per patient was 21. The optimal cutoff values for the number of positive nodes and the LNR were determined using the Chi square scores calculated by the Cox proportional hazards regression model.
    Nodal disease was found in 59 patients (42 %). In the subsequent analysis of the impact that nodal status has on survival, 18 patients with R1/2 resection and 6 patients with paraaortic nodal disease who did not survive for more than 5 years after resection were excluded. The optimal cutoff value for the number of positive nodes was 1, and the optimal cutoff value for the LNR was 5 %. Univariate analysis identified both the number of positive nodes (0, 1, or a parts per thousand yen2; P = 0.005) and the LNR (0, 0-5, or &gt; 5 %; P = 0.007) as significant prognostic factors. Multivariate analysis identified the number of positive nodes but not the LNR as an independent prognostic factor (P = 0.012). The 5-year survival rates were 64 % for the patients with no positive nodes, 46 % for the patients with one positive node, and 28 % for the patients with two or more positive nodes.
    The number of positive lymph nodes predicts survival better than the LNR after resection of extrahepatic cholangiocarcinoma, provided that nodal evaluation is sufficient.

    DOI: 10.1245/s10434-015-4609-x

    Web of Science

    PubMed

    researchmap

  • Randomized Controlled Trial of Zoledronic Acid plus Chemotherapy versus Chemotherapy Alone as Neoadjuvant Treatment of HER2-Negative Primary Breast Cancer (JONIE Study) 査読

    Yoshie Hasegawa, Hirokazu Tanino, Jun Horiguchi, Daishu Miura, Takashi Ishikawa, Mitsuhiro Hayashi, Shintaro Takao, Seung Jin Kim, Kazuhiko Yamagami, Masaru Miyashita, Muneharu Konishi, Yasushi Shigeoka, Masato Suzuki, Tetsuya Taguchi, Tomoyuki Kubota, Kouhei Akazawa, Norio Kohno

    PLOS ONE   10 ( 12 )   e0143643   2015年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PUBLIC LIBRARY SCIENCE  

    Purpose
    Zoledronic acid (ZOL) is a nitrogen-containing bisphosphonate that induces osteoclast apoptosis and inhibits bone resorption by inhibiting the mevalonate pathway. Its benefit for the prevention of skeletal complications due to bone metastases has been established. However, the antitumor efficacy of ZOL, although suggested by multiple preclinical and clinical studies, has not yet been clinically proven. We performed the present randomized Phase 2 trial to investigate the antitumor effect of ZOL with chemotherapy (CT).
    Methods
    Asian patients with HER2-negative invasive breast cancer were randomly assigned to either the CT or CT+ZOL (CTZ) group. One hundred and eighty-eight patients were randomized to either the CT group (n = 95) or the CTZ group (n = 93) from March 2010 to April 2012, and 180 patients were assessed. All patients received four cycles of FEC100 (fluorouracil 500 mg/m(2), epirubicin 100 mg/m(2), and cyclophosphamide 500 mg/m(2)), followed by 12 cycles of paclitaxel at 80 mg/m(2) weekly. ZOL (4 mg) was administered three to four times weekly for 7 weeks to the patients in the CTZ group. The primary endpoint was the pathological complete response (pCR) rate, which was defined as no invasive cancer in the breast tissue specimen. Safety was assessed in all patients who received at least one dose of the study drug.
    Results
    This randomized controlled trial indicated that the rates of pCR in CTZ group (14.8%) was doubled to CT group (7.7%), respectively (one-sided chi-square test, p = 0.068), though the additional efficacy of zoledronic acid was not demonstrated statistically. The pCR rate in postmenopausal patients was 18.4% and 5.1% in the CTZ and CT groups, respectively (one-sided Fisher's exact test, p = 0.071), and that in patients with triple-negative breast cancer was 35.3% and 11.8% in the CTZ and CT groups, respectively (one-sided Fisher's exact test, p = 0.112). Thus the addition of ZOL to neoadjuvant CT has potential anticancer benefits in postmenopausal patients and patients with triple-negative breast cancer. Further investigation is warranted.

    DOI: 10.1371/journal.pone.0143643

    Web of Science

    PubMed

    researchmap

  • Effects of body mass index (BMI) on surgical outcomes: a nationwide survey using a Japanese web-based database 査読

    Motonari Ri, Hiroaki Miyata, Susumu Aikou, Yasuyuki Seto, Kohei Akazawa, Masahiro Takeuchi, Yoshiro Matsui, Hiroyuki Konno, Mitsukazu Gotoh, Masaki Mori, Noboru Motomura, Shinichi Takamoto, Yoshiki Sawa, Hiroyuki Kuwano, Norihiro Kokudo

    SURGERY TODAY   45 ( 10 )   1271 - 1279   2015年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    To define the effects of body mass index (BMI) on operative outcomes for both gastroenterological and cardiovascular surgery, using the National Clinical Database (NCD) of the Japanese nationwide web-based database.
    The subjects of this study were 288,418 patients who underwent typical surgical procedures between January 2011 and December 2012. There were eight gastroenterological procedures, including esophagectomy, distal gastrectomy, total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy of &gt; 1 segment excluding the lateral segment, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis (n = 232,199); and five cardiovascular procedures, including aortic valve replacement, total arch replacement (TAR), descending thoracic aorta replacement (descending TAR), and on- or off-pump coronary artery bypass grafting (n = 56,219). The relationships of BMI with operation time and operative mortality for each procedure were investigated, using the NCD.
    Operation times were longer for patients with a higher BMI. When a BMI cut-off of 30 was used, the operation time for obese patients was significantly longer than that for non-obese patients, for all procedures except esophagectomy (P &lt; 0.01). The mortality rate based on BMI revealed a U-shaped distribution, with both underweight and obese patients having high mortality rates for almost all procedures.
    This Japanese nationwide study provides solid evidence to reinforce that both obesity and excessively low weight are factors that impact operative outcomes significantly.

    DOI: 10.1007/s00595-015-1231-2

    Web of Science

    PubMed

    researchmap

  • NKCCs in the fibrocytes of the spiral ligament are silent on the unidirectional K⁺ transport that controls the electrochemical properties in the mammalian cochlea. 査読

    Yoshida T, Nin F, Ogata G, Uetsuka S, Kitahara T, Inohara H, Akazawa K, Komune S, Kurachi Y, Hibino H

    Pflugers Archiv : European journal of physiology   467 ( 7 )   1577 - 1589   2015年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00424-014-1597-9

    Web of Science

    PubMed

    researchmap

  • Gonadotropin-releasing hormone antagonist: A real advantage? 査読

    Takahiro Kimura, Hiroshi Sasaki, Kouhei Akazawa, Shin Egawa

    UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS   33 ( 7 )   322 - 328   2015年7月

     詳細を見る

    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Degarelix is a gonadotropin-releasing hormone (GnRH) antagonist that is approved for the treatment of prostate cancer. GnRH antagonists bind directly to and block GnRH receptors, without causing the initial testosterone surge associated with GnRH agonists. A pivotal phase El study indicated that degarelix induced significantly faster reduction of testosterone and prostate-specific antigen level than GnRH agonist does. In addition, its 5-year extension trial suggested that patients could be safely switched from GnRH agonist to degarelix treatment with sustained efficacy, as measured by biochemical markers. Possible benefits of GnRH antagonists over agonists were suggested especially in patients with advanced prostate cancer with metastatic and symptomatic disease. Moreover, the recent reports including pooled data analyses on degarelix suggest improved disease control, quality of life, and lower urinary tract symptoms and decreased risk of cardiovascular diseases when compared with GnRH agonists. However, interpretation of these reports should be conducted cautiously because of the potential biases involved. This article critically reviews the results of the clinical trials and subsequent analyses and evaluates the points and counterpoints of the conclusions. (C) 2015 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.urolonc.2015.04.013

    Web of Science

    PubMed

    researchmap

  • Exploring biomarkers of response to zoledronic acid in breast cancer from clinical trial result of neoadjuvant chemotherapy with zoledronic acid: JONIE-1 study 査読

    Takafumi Sangai, Takashi Ishikawa, Norio Kohno, Daishu Miura, Eiichi Sato, Hiroshi Kaise, Masato Suzuki, Yoshie Hasegawa, Hirokazu Tanino, Jun Horiguchi, Kohei Akazawa

    CANCER RESEARCH   75   2015年5月

     詳細を見る

    記述言語:英語   出版者・発行元:AMER ASSOC CANCER RESEARCH  

    DOI: 10.1158/1538-7445.SABCS14-P6-01-02

    Web of Science

    researchmap

  • Dialysis Patients' Utilization of Health Care Services Covered by Long-Term Care Insurance in Japan 査読

    Utako Shimizu, Yuji Mitadera, Hagiko Aoki, Kouhei Akazawa

    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE   236 ( 1 )   9 - 19   2015年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TOHOKU UNIV MEDICAL PRESS  

    Hemodialysis patients in Japan are aging and thus more patients need support for attending hemodialysis facilities. This study aimed to clarify how dialysis patients utilize the services covered by Japan's public long-term care insurance (LTCI) system. This cross-sectional study was based on LTCI data of March 31, 2009, the latest available data provided by Niigata City, located on the northwest coast of Honshu. Among 30,349 LTCI users in Niigata City, there were 234 dialysis patients. To clarify the characteristics of the dialysis patients, we compared the utilization of LTCI services between the dialysis patients (234 users) and randomly selected 765 non-dialysis users. We also calculated the annual transportation service costs per patient for dialysis patients who continued home care (home care group) and those who switched to long-term hospital care at LTCI care levels 4 and 5 (hospital admission group). These care levels indicate difficulty in walking or maintaining a sitting posture without assistance. The dialysis group more frequently utilized home care and equipment services, such as renting or purchasing care-support products and support for home equipment repair, and utilized facility services and short-stay services (respite care) less frequently (both p &lt; 0.001). Cost per patient was higher in the home care group than in the hospital admission group, because the transportation services for dialysis patients at care levels 4 and 5 involve higher costs. These findings indicate that LTCI services usable for dialysis patients were limited. Therefore, instead of merely subsidizing transportation expenses, transportation services must be improved. (C) 2015 Tohoku University Medical Press

    DOI: 10.1620/tjem.236.9

    Web of Science

    PubMed

    researchmap

  • Factors predicting aggressiveness of non-hypervascular hepatic nodules detected on hepatobiliary phase of gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid magnetic resonance imaging 査読

    Tsutomu Kanefuji, Toru Takano, Takeshi Suda, Kouhei Akazawa, Takeshi Yokoo, Hiroteru Kamimura, Kenya Kamimura, Atsunori Tsuchiya, Masaaki Takamura, Hirokazu Kawai, Satoshi Yamagiwa, Hidefumi Aoyama, Minoru Nomoto, Shuji Terai

    WORLD JOURNAL OF GASTROENTEROLOGY   21 ( 15 )   4583 - 4591   2015年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BAISHIDENG PUBLISHING GROUP INC  

    AIM: To establish a prognostic formula that distinguishes non-hypervascular hepatic nodules (NHNs) with higher aggressiveness from less hazardous one.
    METHODS: Seventy-three NHNs were detected in gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid magnetic resonance imaging (Gd-EOB-DTPA-MRI) study and confirmed to change 2 mm or more in size and/or to gain hypervascularity. All images were interpreted independently by an experienced, board-certified abdominal radiologist and hepatologist; both knew that the patients were at risk for hepatocellular carcinoma development but were blinded to the clinical information. A formula predicting NHN destiny was developed using a generalized estimating equation model with thirteen explanatory variables: age, gender, background liver diseases, Child-Pugh class, NHN diameter, T1-weighted imaging/T2-weighted imaging detectability, fat deposition, lower signal intensity in arterial phase, lower signal intensity in equilibrium phase, alpha-fetoprotein, des-gamma-carboxy prothrombin, alpha-fetoprotein-L3, and coexistence of classical hepatocellular carcinoma. The accuracy of the formula was validated in bootstrap samples that were created by resampling of 1000 iterations.
    RESULTS: During a median follow-up period of 504 d, 73 NHNs with a median diameter of 9 mm (interquartile range: 8-12 mm) grew or shrank by 68.5% (fifty nodules) or 20.5% (fifteen nodules), respectively, whereas hypervascularity developed in 38.4% (twenty eight nodules). In the fifteen shrank nodules, twelve nodules disappeared, while 11.0% (eight nodules) were stable in size but acquired vascularity. A generalized estimating equation analysis selected five explanatories from the thirteen variables as significant factors to predict NHN progression. The estimated regression coefficients were 0.36 for age, 6.51 for lower signal intensity in arterial phase, 8.70 or 6.03 for positivity of hepatitis B virus or hepatitis C virus, 9.37 for des-gamma- carboxy prothrombin, and -4.05 for fat deposition. A formula incorporating the five coefficients revealed sensitivity, specificity, and accuracy of 88.0%, 86.7%, and 87.7% in the formulating cohort, whereas these of 87.2% +/- 5.7%, 83.8% +/- 13.6%, and 87.3% +/- 4.5% in the bootstrap samples.
    CONCLUSION: These data suggest that the formula helps Gd-EOB-DTPA-MRI detect a trend toward hepatocyte transformation by predicting NHN destiny.

    DOI: 10.3748/wjg.v21.i15.4583

    Web of Science

    PubMed

    researchmap

  • Body Weight Reduction Results in Favorable Changes in Blood Pressure, Serum Lipids, and Blood Sugar in Middle-Aged Japanese Persons: A 5-Year Interval Observational Study of 26,824 Cases. 査読

    Mandai N, Akazawa K, Hara N, Ide Y, Ide K, Dazai U, Chishaki A, Chishaki H

    Global journal of health science   7 ( 5 )   159 - 70   2015年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.5539/gjhs.v7n5p159

    PubMed

    researchmap

  • Statistical Properties and Power Analysis of Cox ’ s Proportional Hazards Model Regularized by Various Penalties for DNA Microarray Gene Expression Survival Data 査読

    Nobutaka Kitamura, Kouhei Akazawa, Kosuke Yoshihara

    Journal of Health & Medical Informatics   6 ( 1 )   2015年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4172/2157-7420.1000180

    researchmap

  • Report on the working environment for gastroenterological surgeons: The results of the questionnaire survey 査読

    Tetsuo Ajiki, Kohei Akazawa, Tomoko Hanashi, Nobuhiko Ueda, Kazuhisa Uchiyama, Keiji Kouda, Masanori Sugiyama, Shoji Natsugoe, Ken-ichi Mafune, Shigeru Maruhashi, Yonson Ku

    Japanese Journal of Gastroenterological Surgery   48 ( 3 )   282 - 290   2015年

     詳細を見る

    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Gastroenterological Surgery  

    DOI: 10.5833/jjgs.48.2015.sr001

    Scopus

    researchmap

  • MPO-ANCA関連肥厚性硬膜炎の臨床・免疫・病理学的特徴

    横関 明子, 河内 泉, 佐治 越爾, 荒川 武蔵, 穂苅 万李子, 豊島 靖子, 小阪 崇幸, 岡本 浩一郎, 武田 茂樹, 三瓶 一弘, 菊池 弘敏, 廣畑 俊成, 赤澤 宏平, 柿田 明美, 高橋 均, 西澤 正豊

    臨床神経学   54 ( Suppl. )   S25 - S25   2014年12月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

    researchmap

  • Prognostic Significance of Initial Recurrence Site in Hematogenous Recurrence of Esophageal Squamous Cell Carcinoma 査読

    Hiroshi Ichikawa, Shin-ichi Kosugi, Tatsuo Kanda, Takashi Ishikawa, Kazuhito Yajima, Kohei Akazawa, Tsutomu Suzuki, Toshifumi Wakai

    HEPATO-GASTROENTEROLOGY   61 ( 136 )   2241 - 2246   2014年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:H G E UPDATE MEDICAL PUBLISHING S A  

    Background/Aims: Hematogenous recurrences of esophageal squamous cell carcinoma (ESCC) have dismal prognoses, but prognostic heterogeneity exists in this disease. The objectives of this study were to clarify the prognosis in this disease with regard to the initial recurrence site and to define the prognostic factors. Methodology: We retrospectively reviewed the cases of 67 consecutive patients with hematogenous recurrence in major organs after esophagectomy for ESCC of the thoracic esophagus and the esophagogastric junction. We analyzed clinicopathological characteristics, survival probability and potential prognostic factors. Results: Lung, liver, bone, and multiple-organ metastases occurred in 24, 19, 14, and 10 patients, respectively. Twenty-seven patients simultaneously had locoregional recurrence (combined recurrence). Among all 67 patients, the median disease-free interval (DFI) was 9.7 months, and the median survival time after the initial recurrence was 4.9 months. The patients with initial lung metastasis had most favorable prognosis with the median survival time of 9.8 months. A multivariate analysis identified that initial recurrence site, DFI, combined recurrence, and anticancer therapy were independent prognostic factors. Conclusions: The initial recurrence site contributes to the prognostic heterogeneity of patients with hematogenous recurrence of ESCC. The prognostic factors identified in this study are useful to optimize the management of these patients.

    DOI: 10.5754/hge13171

    Web of Science

    PubMed

    researchmap

  • Reliability and validity of the workplace social distance scale. 査読

    Yoshii H, Mandai N, Saito H, Akazawa K

    Global journal of health science   7 ( 3 )   46 - 51   2014年10月

  • Genes associated with the progression of neurofibrillary tangles in Alzheimer's disease 査読

    A. Miyashita, H. Hatsuta, M. Kikuchi, A. Nakaya, Y. Saito, T. Tsukie, N. Hara, S. Ogishima, N. Kitamura, K. Akazawa, A. Kakita, H. Takahashi, S. Murayama, Y. Ihara, T. Ikeuchi, R. Kuwano

    TRANSLATIONAL PSYCHIATRY   4   e396   2014年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NATURE PUBLISHING GROUP  

    The spreading of neurofibrillary tangles (NFTs), intraneuronal aggregates of highly phosphorylated microtubule-associated protein tau, across the human brain is correlated with the cognitive severity of Alzheimer's disease (AD). To identify genes relevant to NFT expansion defined by the Braak stage, we conducted whole-genome exon array analysis with an exploratory sample set consisting of 213 human post-mortem brain tissue specimens from the entorinal, temporal and frontal cortices of 71 brain-donor subjects: Braak NFT stages 0 (N = 13), I-II (N = 20), III-IV (N = 19) and V-VI (N = 19). We identified eight genes, RELN, PTGS2, MYO5C, TRIL, DCHS2, GRB14, NPAS4 and PHYHD1, associated with the Braak stage. The expression levels of three genes, PHYHD1, MYO5C and GRB14, exhibited reproducible association on real-time quantitative PCR analysis. In another sample set, including control subjects (N = 30), and in patients with late-onset AD (N = 37), dementia with Lewy bodies (N = 17) and Parkinson disease (N = 36), the expression levels of two genes, PHYHD1 and MYO5C, were obviously associated with late-onset AD. Protein-protein interaction network analysis with a public database revealed that PHYHD1 interacts with MYO5C via POT1, and PHYHD1 directly interacts with amyloid beta-peptide 42. It is thus likely that functional failure of PHYHD1 and MYO5C could lead to AD development.

    DOI: 10.1038/tp.2014.35

    Web of Science

    PubMed

    researchmap

  • Development and external validation of a nomogram for overall survival after curative resection in serosa-negative, locally advanced gastric cancer 査読

    S. Hirabayashi, S. Kosugi, Y. Isobe, A. Nashimoto, I. Oda, K. Hayashi, I. Miyashiro, S. Tsujitani, Y. Kodera, Y. Seto, H. Furukawa, H. Ono, S. Tanabe, M. Kaminishi, S. Nunobe, T. Fukagawa, R. Matsuo, T. Nagai, H. Katai, T. Wakai, K. Akazawa

    ANNALS OF ONCOLOGY   25 ( 6 )   1179 - 1184   2014年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    Few nomograms can predict overall survival (OS) after curative resection of advanced gastric cancer (AGC), and these nomograms were developed using data from only a few large centers over a long time period. The aim of this study was to develop and externally validate an elaborative nomogram that predicts 5-year OS after curative resection for serosa-negative, locally AGC using a large amount of data from multiple centers in Japan over a short time period (2001-2003).
    Of 39 859 patients who underwent surgery for gastric cancer between 2001 and 2003 at multiple centers in Japan, we retrospectively analyzed 5196 patients with serosa-negative AGC who underwent Resection A according to the 13th Japanese Classification of Gastric Carcinoma. The data of 3085 patients who underwent surgery from 2001 to 2002 were used as a training set for the construction of a nomogram and Web software. The data of 2111 patients who underwent surgery in 2003 were used as an external validation set.
    Age at operation, gender, tumor size and location, macroscopic type, histological type, depth of invasion, number of positive and examined lymph nodes, and lymphovascular invasion, but not the extent of lymphadenectomy, were associated with OS. Discrimination of the developed nomogram was superior to that of the TNM classification (concordance indices of 0.68 versus 0.61; P &lt; 0.001). Moreover, calibration was accurate.
    We have developed and externally validated an elaborative nomogram that predicts the 5-year OS of postoperative serosa-negative AGC. This nomogram would be helpful in the assessment of individual risks and in the consideration of additional therapy in clinical practice, and we have created freely available Web software to more easily and quickly predict OS and to draw a survival curve for these purposes.

    DOI: 10.1093/annonc/mdu125

    Web of Science

    PubMed

    researchmap

  • Characteristics linked to the reduction of stigma towards schizophrenia: a pre-and-post study of parents of adolescents attending an educational program 査読

    Ling Y, Watanabe M, Yoshii H, Akazawa K

    BMC Public Health   14 ( 1 )   258 - 258   2014年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/1471-2458-14-258

    Web of Science

    researchmap

  • Hypertrophic pachymeningitis: significance of myeloperoxidase anti-neutrophil cytoplasmic antibody 査読

    Akiko Yokoseki, Etsuji Saji, Musashi Arakawa, Takayuki Kosaka, Mariko Hokari, Yasuko Toyoshima, Kouichirou Okamoto, Shigeki Takeda, Kazuhiro Sanpei, Hirotoshi Kikuchi, Shunsei Hirohata, Kouhei Akazawa, Akiyoshi Kakita, Hitoshi Takahashi, Masatoyo Nishizawa, Izumi Kawachi

    BRAIN   137   520 - 536   2014年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    The aim of this study was to elucidate the characteristics, pathogenesis and treatment strategy of hypertrophic pachymeningitis that is associated with myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA). We retrospectively investigated clinical, radiological, immunological and pathological profiles of 36 patients with immune-mediated or idiopathic hypertrophic pachymeningitis, including 17 patients with myeloperoxidase-ANCA, four patients with proteinase 3-ANCA, six patients with other immune-mediated disorders, and nine patients with 'idiopathic' variety. Myeloperoxidase-ANCA-positive hypertrophic pachymeningitis was characterized by: (i) an elderly female predominance; (ii) 82% of patients diagnosed with granulomatosis with polyangiitis (previously known as Wegener's granulomatosis) according to Watts' algorithm; (iii) a high frequency of patients with lesions limited to the dura mater and upper airways, developing headaches, chronic sinusitis, otitis media or mastoiditis; (iv) a low frequency of patients with the 'classical or generalized form' of granulomatosis with polyangiitis involving the entire upper and lower airways and kidney, or progressing to generalized disease, in contrast to proteinase 3-ANCA-positive hypertrophic pachymeningitis; (v) less severe neurological damage according to the modified Rankin Scale and low disease activity according to the Birmingham Vasculitis Activity Score compared with proteinase 3-ANCA-positive hypertrophic pachymeningitis; (vi) increased levels of CXCL10, CXCL8 and interleukin 6 in cerebrospinal fluids, and increased numbers of T cells, neutrophils, eosinophils, plasma cells and monocytes/macrophages in autopsied or biopsied dura mater with pachymeningitis, suggesting T(H)1-predominant granulomatous lesions in hypertrophic pachymeningitis, as previously reported in pulmonary or renal lesions of granulomatosis with polyangiitis; and (vii) greater efficacy of combination therapy with prednisolone and cyclophosphamide compared with monotherapy with prednisolone. Proteinase 3-ANCA may be considered a marker for more severe neurological damage, higher disease activity and a higher frequency of the generalized form compared with myeloperoxidase-ANCA-positive hypertrophic pachymeningitis. However, categorization into 'granulomatosis with polyangiitis' according to Watts' algorithm and immunological or pathological features were common in both proteinase 3- and myeloperoxidase-ANCA-positive hypertrophic pachymeningitis. These data indicate that most patients with myeloperoxidase-ANCA-positive hypertrophic pachymeningitis should be categorized as having the central nervous system-limited form of ANCA-associated vasculitis, consistent with the concept of ophthalmic-, pulmonary- or renal-limited vasculitis.

    DOI: 10.1093/brain/awt314

    Web of Science

    researchmap

  • A phase II study of second-line S-1/CPT-11+bev for advanced colon cancer (NCCSG04): Subset analysis by K-ras, EGFR, UGT1A1, and previous bevacizumab. 査読

    Yasumasa Takii, Kouichi Furukawa, Satoshi Maruyama, Toshiyuki Yamazaki, Atsushi Nishimura, Mikako Kawahara, Takemi Tomiyama, Kohei Akazawa, Katsuyoshi Hatakeyama

    JOURNAL OF CLINICAL ONCOLOGY   32 ( 3 )   2014年1月

     詳細を見る

    記述言語:英語   出版者・発行元:AMER SOC CLINICAL ONCOLOGY  

    DOI: 10.1200/jco.2014.32.3_suppl.564

    Web of Science

    researchmap

  • Phase I/II trial of irinotecan and S-1 combination chemotherapy as a second-line treatment for advanced colorectal cancer 査読

    Yasumasa Takii, Toshiyuki Yamazaki, Takayuki Okada, Tatsuo Tani, Kazuhiro Funakoshi, Satoshi Maruyama, Jun Hasegawa, Kouhei Akazawa, Katsuyoshi Hatakeyama

    Chemotherapy   59 ( 5 )   338 - 343   2014年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:S. Karger AG  

    Background: This study attempted to determine the therapeutic dosage of irinotecan and S-1 (IRIS) as a second-line treatment for colorectal cancer (CRC). Methods: S-1 was administered on days 1-14 of a 28-day cycle. Irinotecan was administered on days 1 and 15. The irinotecan dose was then escalated to determine the maximum-tolerated dose and the recommended dose at a fixed dosage of S-1 (80 or 65 mg·m-2·day-1). The S-1 dose was reduced to 65 mg·m-2·day-1 when dose-limiting toxicities were observed at 80 mg·m-2· day-1 and the irinotecan dose was increased. Results: The recommended dose was 65 mg/m2 for S-1 and 75 mg/m2 for irinotecan. Twenty-one patients were treated at the recommended dose. The overall response rate was 28.6%. Conclusion: This modified IRIS regimen is considered effective with acceptable toxicities for advanced CRC resistant to treatment with 5-fluorouracil/leucovorin or uracil and tegafur/leucovorin. © 2014 S. Karger AG, Basel.

    DOI: 10.1159/000358482

    Scopus

    PubMed

    researchmap

  • Simulation Program to Determine Sample Size and Power for a Multiple Logistic Regression Model with Unspecified Covariate Distributions 査読

    Naoko Kumagai, Kohei Akazawa, Hiromi Kataoka, Yutaka Hatakeyama, Yoshiyasu Okuhara

    Helth   6 ( 21 )   2973 - 2998   2014年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4236/health.2014.621336

    researchmap

  • Lack of genetic association between TREM2 and late-onset Alzheimer's disease in a Japanese population. 査読 国際誌

    Akinori Miyashita, Yanan Wen, Nobutaka Kitamura, Etsuro Matsubara, Takeshi Kawarabayashi, Mikio Shoji, Naoki Tomita, Katsutoshi Furukawa, Hiroyuki Arai, Takashi Asada, Yasuo Harigaya, Masaki Ikeda, Masakuni Amari, Haruo Hanyu, Susumu Higuchi, Masatoyo Nishizawa, Masaichi Suga, Yasuhiro Kawase, Hiroyasu Akatsu, Masaki Imagawa, Tsuyoshi Hamaguchi, Masahito Yamada, Takashi Morihara, Masatoshi Takeda, Takeo Takao, Kenji Nakata, Ken Sasaki, Ken Watanabe, Kenji Nakashima, Katsuya Urakami, Terumi Ooya, Mitsuo Takahashi, Takefumi Yuzuriha, Kayoko Serikawa, Seishi Yoshimoto, Ryuji Nakagawa, Yuko Saito, Hiroyuki Hatsuta, Shigeo Murayama, Akiyoshi Kakita, Hitoshi Takahashi, Haruyasu Yamaguchi, Kohei Akazawa, Ichiro Kanazawa, Yasuo Ihara, Takeshi Ikeuchi, Ryozo Kuwano

    Journal of Alzheimer's disease : JAD   41 ( 4 )   1031 - 8   2014年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Rare non-synonymous variants of TREM2 have recently been shown to be associated with Alzheimer's disease (AD) in Caucasians. We here conducted a replication study using a well-characterized Japanese sample set, comprising 2,190 late-onset AD (LOAD) cases and 2,498 controls. We genotyped 10 non-synonymous variants (Q33X, Y38C, R47H, T66M, N68K, D87N, T96K, R98W, H157Y, and L211P) of TREM2 reported by Guerreiro et al. (2013) by means of the TaqMan and dideoxy sequencing methods. Only three variants, R47H, H157Y, and L211P, were polymorphic (range of minor allele frequency [MAF], 0.0002-0.0059); however, no significant association with LOAD was observed in these variants. Considering low MAF of variants examined and our study sample size, further genetic analysis with a larger sample set is needed to firmly evaluate whether or not TREM2 is associated with LOAD in Japanese.

    DOI: 10.3233/JAD-140225

    PubMed

    researchmap

  • Aquaporin 8 mRNA Expression After Intestinal Resection in Rat 査読

    Koyama Y, Kameyama H, Sakata J, Kobayashi T, Minagawa M, Kosugi S, Yamamoto T, Akazawa K, Wakai T

    Open J Gastroenterol   4 ( 2 )   62 - 68   2014年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4236/ojgas.2014.42011

    researchmap

    その他リンク: http://www.scirp.org/journal/doi.aspx?DOI=10.4236/ojgas.2014.42011

  • 本邦における中枢神経系炎症性脱髄疾患の認知機能障害の特徴

    佐治 越爾, 河内 泉, 荒川 武蔵, 穂苅 万李子, 横関 明子, 豊島 靖子, 赤澤 宏平, 柿田 明美, 高橋 均, 西澤 正豊

    臨床神経学   53 ( 12 )   1627 - 1627   2013年12月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

    researchmap

  • Can the early bird catch the worm? Effects of the early rising on leukocyte subsets via modification of autonomic nervous system and the effect on glucose levels 査読

    Watanabe M, Ling Y, Tomiyama C, Adachi K, Mori H, Nishijo K, Abo T, Akazawa K

    Natural Science   5 ( 11 )   1133 - 1138   2013年11月

     詳細を見る

    記述言語:英語  

    researchmap

  • Heavy alcohol intake is a risk factor for esophageal squamous cell carcinoma among middle-aged men: A case-control and simulation study. 査読

    Kumagai N, Wakai T, Akazawa K, Ling Y, Wang S, Shan B, Okuhara Y, Hatakeyama Y, Kataoka H

    Molecular and clinical oncology   1 ( 5 )   811 - 816   2013年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3892/mco.2013.142

    PubMed

    researchmap

  • 閉経後ホルモン感受性乳癌に対する化学療法とletrozoleの同時併用術前療法

    佐藤 友威, 神林 智寿子, 佐藤 信昭, 金子 耕司, 坂田 栄子, 小山 諭, 武藤 一朗, 田邊 匡, 本間 慶一, 赤澤 宏平, 佐野 宗明

    日本癌治療学会誌   48 ( 3 )   1575 - 1575   2013年9月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本癌治療学会  

    researchmap

  • Stigma toward schizophrenia among parents of high school students. 査読

    Yoshii H, Watanabe Y, Mazumder AH, Kitamura H, Akazawa K

    Global journal of health science   5 ( 6 )   46 - 53   2013年8月

  • Growth of Japanese breastfed infants compared to national references and World Health Organization growth standards 査読

    H. Tanaka, H. Ishii, T. Yamada, K. Akazawa, S. Nagata, Y. Yamashiro

    ACTA PAEDIATRICA   102 ( 7 )   739 - 743   2013年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Aim The aim of this study was to compare the growth of Japanese infants that were exclusively breastfed to those of national references and World Health Organization (WHO) standards.
    Methods Mothers, who delivered a normal term baby and had been exclusively breastfeeding for at least 4months, were enrolled. The lengths, body weights and head circumferences of 647 children, aged 0-24months, were obtained and compared to national references and WHO standards.
    Results Comparisons of the national references for both length and body weight indicated that breastfed infants were significantly shorter and lighter almost throughout the first 24months. Conversely, head circumferences of breastfed infants were significantly larger at 1 and 6months of age in boys and 6months in girls. Compared to WHO standards, similar trends to the comparisons with national references were found.
    Conclusion There were significant differences identified between the growth of breastfed infants and existing national references and WHO standards.

    DOI: 10.1111/apa.12262

    Web of Science

    researchmap

  • Randomized phase III clinical study comparing postoperative UFT/LV, UFT plus LV/UFT and UFT plus LV plus PSK/UFT plus PSK as adjuvant therapy for curatively resected stage III colorectal cancer HGCSG-CAD study 査読

    Shichinohe Toshiaki, Komatsu Yoshito, Akazawa Kohei, Yuki Satoshi, Fukushima Hiraku, Ohno Kouichi, Nakamura Fumitaka, Kusumi Takaya, Morita Takayuki, Senmaru Naoto, Kumagai Naoko, Hirano Satoshi

    JOURNAL OF CLINICAL ONCOLOGY   31 ( 15 )   2013年5月

  • Suspected limited efficacy of γ-secretase modulators. 査読

    Kakuda N, Akazawa K, Hatsuta H, Murayama S, Ihara Y, Japanese Alzheimer's, Disease Neuroimaging Initiative

    Neurobiology of aging   34 ( 4 )   1101 - 1104   2013年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.neurobiolaging.2012.08.017

    Scopus

    PubMed

    researchmap

  • Economic impact of combination therapy with infliximab plus azathioprine for drug-refractory Crohn's disease: A cost-effectiveness analysis 査読

    Shota Saito, Utako Shimizu, Zhang Nan, Nozomu Mandai, Junji Yokoyama, Kenshi Terajima, Kouhei Akazawa

    JOURNAL OF CROHNS & COLITIS   7 ( 2 )   167 - 174   2013年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE BV  

    Background: Combination therapy with infliximab (IFX) and azathioprine (AZA) is significantly more effective for treatment of active Crohn's disease (CD) than IFX monotherapy. However, AZA is associated with an increased risk of lymphoma in patients with inflammatory bowel disease.
    Aim: To evaluate the cost-effectiveness of combination therapy with IFX plus AZA for drug-refractory CD.
    Methods: A decision analysis model is constructed to compare, over a time horizon of 1 year, the cost-effectiveness of combination therapy with IFX plus AZA and that of IFX monotherapy for CD patients refractory to conventional non-anti-TNF-alpha therapy. The treatment efficacy, adverse effects, quality-of-life scores, and treatment costs are derived from published data. One-way and probabilistic sensitivity analyses are performed to estimate the uncertainty in the results.
    Results: The incremental cost-effectiveness ratio (ICER) of combination therapy with IFX plus AZA is 24,917 GBP/QALY when compared with IFX monotherapy. The sensitivity analyses reveal that the utility score of nonresponding active disease has the strongest influence on the cost-effectiveness, with ICERs ranging from 17,147 to 45,564 GBP/QALY. Assuming that policy makers are willing to pay 30,000 GBP/QALY, the probability that combination therapy with IFX plus AZA is cost-effective is 0.750.
    Conclusions: Combination therapy with IFX plus AZA appears to be a cost-effective treatment for drug-refractory CD when compared with IFX monotherapy. Furthermore, the additional lymphoma risk of combination therapy has little significance on its cost-effectiveness. (C) 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.crohns.2012.04.007

    Web of Science

    PubMed

    researchmap

  • Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry 査読

    Atsushi Nashimoto, Kohei Akazawa, Yoh Isobe, Isao Miyashiro, Hitoshi Katai, Yasuhiro Kodera, Shunichi Tsujitani, Yasuyuki Seto, Hiroshi Furukawa, Ichiro Oda, Hiroyuki Ono, Satoshi Tanabe, Michio Kaminishi

    GASTRIC CANCER   16 ( 1 )   1 - 27   2013年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Background The Japanese Gastric Cancer Association (JGCA) started a new nationwide gastric cancer registration in 2008.
    Methods From 208 participating hospitals, 53 items including surgical procedures, pathological diagnosis, and survival outcomes of 13,626 patients with primary gastric cancer treated in 2002 were collected retrospectively. Data were entered into the JGCA database according to the JGCA classification (13th edition) and UICC TNM classification (5th edition) using an electronic data collecting system. Finally, data of 13,002 patients who underwent laparotomy were analyzed.
    Results The 5-year follow-up rate was 83.3 %. The direct death rate was 0.48 %. UICC 5-year survival rates (5YEARSs)/JGCA 5YEARSs were 92.2 %/92.3 % for stage IA, 85.3 %/84.7 % for stage IB, 72.1 %/70.0 % for stage II, 52.8 %/46.8 % for stage IIIA, 31.0 %/28.8 % for stage IIIB, and 14.9 %/15.3 % for stage IV, respectively. The proportion of patients more than 80 years old was 7.8 %, and their 5YEARS was 51.6 %. Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed.
    Conclusions Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed.

    DOI: 10.1007/s10120-012-0163-4

    Web of Science

    PubMed

    researchmap

  • Cognitive Impairment and Cortical Degeneration in Neuromyelitis Optica 査読

    Etsuji Saji, Musashi Arakawa, Kaori Yanagawa, Yasuko Toyoshima, Akiko Yokoseki, Kouichirou Okamoto, Mika Otsuki, Kohei Akazawa, Akiyoshi Kakita, Hitoshi Takahashi, Masatoyo Nishizawa, Izumi Kawachi

    ANNALS OF NEUROLOGY   73 ( 1 )   65 - 76   2013年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Objective: Neuromyelitis optica spectrum disorder (NMOsd) is an inflammatory and demyelinating syndrome characterized by optic neuritis and myelitis. Several magnetization transfer magnetic resonance imaging (MRI) studies have revealed abnormalities in normal-appearing gray matter in NMOsd. The aim of this study is to elucidate the characteristics and pathogenesis of cognitive impairment and neurodegeneration in NMOsd brains.
    Methods: Fourteen Japanese patients with serologically verified NMOsd, 17 patients with multiple sclerosis (MS), and 37 healthy controls were assessed with the Rao's Brief Repeatable Battery of Neuropsychological Tests (BRBN). Using 128 tissue blocks from 6 other cases of NMOsd, 3 cases of MS, and 4 controls without central nervous system involvement, we performed quantitative analysis of cortical neuronal loss and layer-specific changes in NMOsd.
    Results: In BRBN assessments, 57% of NMOsd patients and 47% of MS patients had impaired performance on at least 3 cognitive tests. Cognitive impairment in NMOsd was common even in the limited form of disease, indicating that NMOsd may progress insidiously from early stages of disease. Neuropathological assessments showed neuronal loss in cortical layers II, III, and IV, with nonlytic reaction of aquaporin-4 (AQP4)-negative astrocytes in layer I, massive activated microglia in layer II, and meningeal inflammation in NMOsd brains. All NMO cases showed no evidence of cortical demyelination.
    Interpretation: We demonstrate cognitive impairment and substantial cortical neuronal loss with unique AQP4 dynamics in astrocytes in NMOsd. These data indicate pathological processes consisting not only of inflammatory demyelinating events characterized by pattern-specific loss of AQP4 immunoreactivity but also cortical neurodegeneration in NMOsd brains. ANN NEUROL 2013;73:65-76

    DOI: 10.1002/ana.23721

    Web of Science

    PubMed

    researchmap

  • Cognitive impairment and cortical degeneration in neuromyelitis optica. 査読

    Saji Etsuji, Arakawa Musashi, Yanagawa Kaori, Toyoshima Yasuko, Yokoseki Akiko, Okamoto Kouichirou, Otsuki Mika, Akazawa Kohei, Kakita Akiyoshi, Takahashi Hitoshi, Nishizawa Masatoyo, Kawachi Izumi

    Ann Neurol   73 ( 1 )   65 - 76   2013年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Neuromyelitis optica spectrum disorder (NMOsd) is an inflammatory and demyelinating syndrome characterized by optic neuritis and myelitis. Several magnetization transfer magnetic resonance imaging (MRI) studies have revealed abnormalities in normal-appearing gray matter in NMOsd. The aim of this study is to elucidate the characteristics and pathogenesis of cognitive impairment and neurodegeneration in NMOsd brains. METHODS: Fourteen Japanese patients with serologically verified NMOsd, 17 patients with multiple sclerosis (MS), and 37 healthy controls were assessed with the Rao&#039;s Brief Repeatable Battery of Neuropsychological Tests (BRBN). Using 128 tissue blocks from 6 other cases of NMOsd, 3 cases of MS, and 4 controls without central nervous system involvement, we performed quantitative analysis of cortical neuronal loss and layer-specific changes in NMOsd. RESULTS: In BRBN assessments, 57% of NMOsd patients and 47% of MS patients had impaired performance on at least 3 cognitive tests. Cognitive impairment in NMOsd was common even in the limited form of disease, indicating that NMOsd may progress insidiously from early stages of disease. Neuropathological assessment

    DOI: 10.1002/ana.23721

    Web of Science

    PubMed

    researchmap

  • SORL1 is Genetically Associated with Neuropathologically Characterized Late-Onset Alzheimer's Disease 査読

    Yanan Wen, Akinori Miyashita, Nobutaka Kitamura, Tamao Tsukie, Yuko Saito, Hiroyuki Hatsuta, Shigeo Murayama, Akiyoshi Kakita, Hitoshi Takahashi, Hiroyasu Akatsu, Takayuki Yamamoto, Kenji Kosaka, Haruyasu Yamaguchi, Kohei Akazawa, Yasuo Ihara, Ryozo Kuwano

    JOURNAL OF ALZHEIMERS DISEASE   35 ( 2 )   387 - 394   2013年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IOS PRESS  

    SORL1 was shown to be genetically associated with late-onset Alzheimer's disease (LOAD) in a large-scale genome-wide association study (GWAS) involving clinically verified subjects. Here, we attempted to replicate the association of SORL1 in Japanese neuropathologically characterized brain donor subjects (LOAD, 213; control, 370) through a single-nucleotide polymorphism (SNP)-based genetic study involving 19 SNPs: 11 SNPs were selected from the initial study reported by Rogaeva et al. (2007), and the other eight were from our GWAS. Among these SNPs, five exhibited a significant association with LOAD after multiple test correction (p &lt; 2.63E-03 [=0.05/19]), which was supported by means of multiple logistic regression analysis with adjustment for age, gender, and carrier status of the APOE epsilon 4 allele. Three of these SNPs (rs985421, rs12364988 [Rogaeva's SNP 7], and rs4598682) were encompassed by a 5' linkage disequilibrium (LD) region, and the remaining two (rs3781834 and rs3781836) by a 3' LD region. Strong LD among SNPs was observed within each LD region, implying that there are two genomic regions showing association with LOAD in SORL1. Case-control haplotype analysis demonstrated that some haplotypes are associated with LOAD in both LD regions. Our replication study strongly supports the preceding evidence that SORL1 is likely one of the genes associated with LOAD.

    DOI: 10.3233/JAD-122395

    Web of Science

    PubMed

    researchmap

  • The effects of application of an ancient type of acupuncture needle on increase in urination of hospitalized oldest-old people. 査読

    Watanabe M, Takano O, Tomiyama C, Guan J, Hou G, Mori H, Nishijo K, Abo T, Akazawa K

    Health   5 ( 7 )   1092 - 1098   2013年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4236/health.2013.57147

    researchmap

  • Factors Related to Postoperative Delirium in Patients with Lower Limb Ischaemia: A Prospective Cohort Study 査読

    Y. Sasajima, T. Sasajima, N. Azuma, K. Akazawa, Y. Saito, M. Inaba, H. Uchida

    EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY   44 ( 4 )   411 - 415   2012年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO LTD  

    Objectives: To preoperatively determine candidates at definitive risk of postoperative delirium (POD), we identified relevant factors in patients with arteriosclerosis obliterans who underwent bypass surgery.
    Design: A prospective cohort study.
    Patients and methods: 299 patients (age &gt;= 60 years) who underwent bypasses in 1995-2006 were enrolled. Cognitive impairment was assessed by the Revised Hasegawa Dementia Scale, the Confusion Assessment Method was also used, and severity was graded as Grade I Ill (mild to severe) based on the Delirium Rating Scale. All patients were followed for 3 years.
    Results: POD occurred in 88 patients (29%), with a median age of 75 (10) years (IQR). Onset was 2 (1)days postoperatively, and a duration of 2 (2) days was observed. POD was hyperactive in 89% and was Grade II, and III in 11%, 68%, and 21% respectively. Multiple logistic regression analysis identified the following risk factors for POD: age &gt;= 72 years (&lt;0.0001), end-stage renal failure (0.001), multiple occlusive lesions (&lt;0.0001), cognitive impairment (0.003), and critical limb ischaemia (0.034). The 3-year survival rate was similar when comparing POD and non-POD patients (84% vs. 88%, NS).
    Conclusions: This study identified 5 risk factors for POD in patients undergoing bypasses for limb ischaemia. Long-term outcomes were similar when comparing the patients who experienced POD with those who did not. (C) 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.ejvs.2012.06.028

    Web of Science

    researchmap

  • Long-term chemotherapy may prolong survival in advanced non-small-cell lung cancer among responders to first-line chemotherapy 査読

    Tomonori Hirashima, Hidekazu Suzuki, Masashi Kobayashi, Youko Kondoh, Yoshie Tokuoka, Yuka Matsuura, Motohiro Tamiya, Naoko Morishita, Shinji Sasada, Norio Okamoto, Kohei Akazawa, Ichiro Kawase

    MEDICAL ONCOLOGY   29 ( 3 )   1629 - 1637   2012年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:HUMANA PRESS INC  

    Survival in patientswith advanced non-small-cell lung cancer (NSCLC) has substantially improved. Long-term chemotherapy with epidermal growth factor tyrosine kinase inhibitors (EGFR-TKIs) and other agents has been associated with long survival. We retrospectively examined the associations between overall survival (OS) and clinical variables in patients with advanced NSCLC who received at least one dose or course of outpatient chemotherapy in our institution. Of 360 patients who received first-line chemotherapy between January 1, 2004 and December 31, 2007, 185 subsequently received additional outpatient chemotherapy and 175 underwent inpatient chemotherapy only. Of the 185 patients, 147 (79.5%), 96 (51.9%), and 60 (32.4%) received second-line, third-line, and fourth-line chemotherapy, respectively. Patients who received outpatient chemotherapy had significantly longer median OS (22.3 months) than did those undergoing inpatient chemotherapy only (7.6 months; P &lt; 0.0001). In univariate analysis of the 185 patients, sex, performance status (PS), smoking status, stage, best response to first-line chemotherapy, use of docetaxel, and EGFR-TKIs were significantly associated with OS (P values: 0.0019, 0.0066, 0.0001, 0.0231, 0.0011, 0.0250, and 0.0023, respectively). In multivariate analysis, PS, stage, best response to first-line chemotherapy, and use of docetaxel were significantly associated with OS (P values: 0.0272, 0.0030, 0.0022, and 0.0376, respectively). Survival was significantly longer among patients who responded to docetaxel and/or EGF-RTKIs. Long-term chemotherapy did not increase cumulative hospitalization. In patients with advanced NSCLC, an effective long-termchemotherapy regimen might prolong survival in responders to first-line chemotherapy.

    DOI: 10.1007/s12032-011-0034-6

    Web of Science

    PubMed

    researchmap

  • Social Distance toward schizophrenia among parents of adolescents 査読

    Yoshii H, Watanabe Y, Kitamura H, Ling Y, Akazawa K

    Health   4 ( 7 )   386 - 391   2012年7月

     詳細を見る

    記述言語:英語  

    researchmap

  • Effects of systemic sitafloxacin on periodontal infection control in elderly patients 査読

    Takako Nakajima, Takafumi Okui, Sayuri Miyauchi, Tomoyuki Honda, Yasuko Shimada, Harue Ito, Kohei Akazawa, Kazuhisa Yamazaki

    GERODONTOLOGY   29 ( 2 )   E1024 - E1032   2012年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Effects of systemic sitafloxacin on periodontal infection control in elderly patients
    Objective: To evaluate the microbiological and clinical effects of the systemic administration of sitafloxacin (STFX) on periodontal pockets in elderly patients receiving supportive periodontal therapy (SPT).
    Background: Periodontitis is a risk factor for atherosclerosis. Better periodontal health contributes to reduce atherosclerosis-related diseases in elderly population.
    Materials and methods: Forty-four patients undergoing SPT were randomly assigned to two groups: a test group took 100 mg/day of STFX for five consecutive days, or a control group received scaling and root planing (SRP) under local anaesthesia. Microbiological and clinical parameters were examined at baseline and at 1 and 3 months after therapy.
    Results: The presence of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia was significantly reduced at 1 month after treatment in both groups. The median reductions of the bacteria between the baseline and 1 month were 3.08 and 2.54% in the STFX- and SRP-treated groups, respectively. Both treatments significantly decreased the probing depth at 1 and 3 months compared to the baseline.
    Conclusion: The systemic administration of STFX is effective at improving periodontal health during SPT and could be an alternative to SRP for elderly patients who cannot undergo anaesthesia or are at risk of tissue injury.

    DOI: 10.1111/j.1741-2358.2011.00605.x

    Web of Science

    PubMed

    researchmap

  • Cost-effectiveness achieved through changing the composition of renal replacement therapy in Japan 査読

    Utako Shimizu, Shota Saito, Yiwei Lings, Noriaki Iino, Junichirou James Kazama, Kohei Akazawa

    Journal of Medical Economics   15 ( 3 )   444 - 453   2012年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective: The cost-effectiveness of renal replacement therapy (RRT) is affected by the composition of treatment. This study aimed to estimate the costs and outcomes associated with changing the composition of RRT modality over time. Methods: By using clinical and cost data from a systematic review, a Markov model was developed to assess the costs and benefits of the four main treatments available for RRT in Japan. The model included direct health service costs and quality-adjusted life years (QALY). Sensitivity analyses were performed to assess the robustness of the results. Results: Over the 15-year period of the model, the current composition of RRT (i.e., the base composition of RRT) was $84,008/QALY. The most cost-effective treatment was when the likelihood of a living donor transplant was increased by 2.4-times ($70,581/QALY). Compared with the base composition of RRT, dominant treatments with respect to cost-effectiveness were when the likelihood of a deceased donor transplant was increased by 22-times and when the likelihood of a pre-emptive living donor transplant was increased by 2.4-times. Little difference was found between these two treatments. One-way sensitivity analysis did not change the cost effectiveness except for costs of chronic hemodialysis and a living donor transplant in subsequent years. Limitations: It is difficult to increase the rate of transplant overall in the shorter term nationally and internationally. Conclusions: Appropriate distribution of all transplant options and hemodialysis is necessary to achieve the most cost-effective solution. © 2012 Informa UK Ltd All rights reserved.

    DOI: 10.3111/13696998.2011.653512

    Scopus

    PubMed

    researchmap

  • Altered γ-secretase activity in mild cognitive impairment and Alzheimer's disease. 査読

    Kakuda N, Shoji M, Arai H, Furukawa K, Ikeuchi T, Akazawa K, Takami M, Hatsuta H, Murayama S, Hashimoto Y, Miyajima M, Arai H, Nagashima Y, Yamaguchi H, Kuwano R, Nagaike K, Ihara Y, Japanese Alzheimer's, Disease Neuroimaging Initiative

    EMBO molecular medicine   4 ( 4 )   344 - 352   2012年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1002/emmm.201200214

    Web of Science

    PubMed

    researchmap

  • High-Risk Ovarian Cancer Based on 126-Gene Expression Signature Is Uniquely Characterized by Downregulation of Antigen Presentation Pathway 査読

    Kosuke Yoshihara, Tatsuhiko Tsunoda, Daichi Shigemizu, Hiroyuki Fujiwara, Masayuki Hatae, Hisaya Fujiwara, Hideaki Masuzaki, Hidetaka Katabuchi, Yosuke Kawakami, Aikou Okamoto, Takayoshi Nogawa, Noriomi Matsumura, Yasuhiro Udagawa, Tsuyoshi Saito, Hiroaki Itamochi, Masashi Takano, Etsuko Miyagi, Tamotsu Sudo, Kimio Ushijima, Haruko Iwase, Hiroyuki Seki, Yasuhisa Terao, Takayuki Enomoto, Mikio Mikami, Kohei Akazawa, Hitoshi Tsuda, Takuya Moriya, Atsushi Tajima, Ituro Inoue, Kenichi Tanaka

    CLINICAL CANCER RESEARCH   18 ( 5 )   1374 - 1385   2012年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER ASSOC CANCER RESEARCH  

    Purpose: High-grade serous ovarian cancers are heterogeneous not only in terms of clinical outcome but also at the molecular level. Our aim was to establish a novel risk classification system based on a gene expression signature for predicting overall survival, leading to suggesting novel therapeutic strategies for high-risk patients.
    Experimental Design: In this large-scale cross-platform study of six microarray data sets consisting of 1,054 ovarian cancer patients, we developed a gene expression signature for predicting overall survival by applying elastic net and 10-fold cross-validation to a Japanese data set A (n = 260) and evaluated the signature in five other data sets. Subsequently, we investigated differences in the biological characteristics between high-and low-risk ovarian cancer groups.
    Results: An elastic net analysis identified a 126-gene expression signature for predicting overall survival in patients with ovarian cancer using the Japanese data set A (multivariate analysis, P = 4 x 10(-20)). We validated its predictive ability with five other data sets using multivariate analysis (Tothill's data set, P = 1 x 10(-5); Bonome's data set, P = 0.0033; Dressman's data set, P = 0.0016; TCGA data set, P = 0.0027; Japanese data set B, P = 0.021). Through gene ontology and pathway analyses, we identified a significant reduction in expression of immune-response-related genes, especially on the antigen presentation pathway, in high-risk ovarian cancer patients.
    Conclusions: This risk classification based on the 126-gene expression signature is an accurate predictor of clinical outcome in patients with advanced stage high-grade serous ovarian cancer and has the potential to develop new therapeutic strategies for high-grade serous ovarian cancer patients. Clin Cancer Res; 18(5); 1374-85. (C)2012 AACR.

    DOI: 10.1158/1078-0432.CCR-11-2725

    Web of Science

    PubMed

    researchmap

  • Association of Nitrogen Compounds in Drinking Water with Incidence of Esophageal Squamous Cell Carcinoma in Shexian, China 査読

    Nan Zhang, Cao Yu, Denggui Wen, Jun Chen, Yiwei Ling, Kenshi Terajima, Kohei Akazawa, Baoen Shan, Shijie Wang

    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE   226 ( 1 )   11 - 17   2012年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TOHOKU UNIV MEDICAL PRESS  

    The incidence of esophageal squamous cell carcinoma (ESCC), which is the eighth most common malignancy worldwide, is highest in China. The purpose of this study was to investigate the association between nitrogen compounds in drinking water with the incidence of ESCC by geographical spatial analysis. The incidence of ESCC is high in Shexian county, China, and environmental factors, particularly nitrogen-contaminated drinking water, are the main suspected risk factors. This study focuses on three nitrogen compounds in drinking water, namely, nitrates, nitrites, and ammonia, all of which are derived mainly from domestic garbage and agricultural fertilizer. The study surveyed 48 villages in the Shexian area with a total population of 54,716 (661 adults with ESCC and 54,055 non-cancer subjects). Hot-spot analysis was used to identify spatial clusters with a high incidence of ESCC and a high concentration of nitrogen compounds. Logistic regression analysis was used to detect risk factors for ESCC incidence. Most areas with high concentrations of nitrate nitrogen in drinking water had a high incidence of ESCC. Correlation analysis revealed a significant positive relationship between nitrate concentration and ESCC (P = 0.01). Logistic regression analysis also confirmed that nitrate nitrogen has a significantly higher odds ratio. The results indicate that nitrate nitrogen is associated with ESCC incidence in Shexian county. In conclusion, high concentrations of nitrate nitrogen in drinking water may be a significant risk factor for the incidence of ESCC.

    DOI: 10.1620/tjem.226.11

    Web of Science

    PubMed

    researchmap

  • Study on levels of nitrate nitrogen, nitrite nitrogen and ammonia in drinking water in the high-incidence area of esophageal cancer. 査読

    Liang SY, Cao Y, Akazawa K, Chen ZF, Huang SB, Song GH, Li HG, Wang SJ

    Chinese Journal of Cancer Prevention and Treatment   19 ( 9 )   649 - 651+662   2012年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    researchmap

  • Factors associated with an absence of effect of an education program for improving knowledge of schizophrenia. 査読

    Yoshii H, Watanabe Y, Kitamura H, Sakai Y, Akazawa K

    Global Journal of Health Science   4 ( 4 )   42 - 47   2012年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.5539/gjhs.v4n4p42

    researchmap

  • 災害時における医療情報・診療情報の活用に関する可能性の検討 査読

    赤澤宏平, 寺島健史, 萬代望, 凌一葦, 伊藤貞寿

    新潟大学災害・復興科学研究所年報   1   133 - 134   2012年

     詳細を見る

    記述言語:日本語  

    researchmap

  • 腎代替療法の構成の違いに基づく費用対効果の比較 査読

    清水詩子, 齋藤翔太, 凌一葦, 飯野則昭, 風間順一郎, 赤澤宏平

    医療情報学連合大会論文集   32   328 - 330   2012年

     詳細を見る

    記述言語:日本語  

    researchmap

  • Comparison of dynamic responses of cellular metabolites in Escherichia coli to pulse addition of substrates 査読

    Md. Aminul Hoque, Atefeh Taherian Fard, Mosfequr Rahman, Omar Alattas, Kohei Akazawa, Amir Feisal Merican

    BIOLOGIA   66 ( 6 )   954 - 966   2011年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:VERSITA  

    We conducted an integrated study of cell growth parameters, product formation, and the dynamics of intracellular metabolite concentrations using Escherichia coli with genes knocked out in the glycolytic and oxidative pentose phosphate pathway (PPP) for glucose catabolism. We investigated the same characteristics in the wild-type strain, using acetate or pyruvate as the sole carbon source. Dramatic effects on growth parameters and extracellular and intracellular metabolite concentrations were observed after blocking either glycolytic breakdown of glucose by inactivation of phosphoglucose isomerase (disruption of pgi gene) or pentose phosphate breakdown of glucose by inactivation of glucose-6-phosphate dehydrogenase (disruption of zwf gene). Reducing power (NADPH) was mainly produced through PPP when the pgi gene was knocked out, while NADPH was produced through the tricarboxylic acid (TCA) cycle by isocitrate dehydrogenase or NADP-linked malic enzyme when the zwf gene was knocked out. As expected, when the pgi gene was knocked out, intracellular concentrations of PPP metabolites were high and glycolytic and concentrations of TCA cycle pathway metabolites were low. In the zwf gene knockout, concentrations of PPP metabolites were low and concentrations of intracellular glycolytic and TCA cycle metabolites were high.

    DOI: 10.2478/s11756-011-0136-9

    Web of Science

    researchmap

  • 一酸化炭素中毒後遅発性脳症に対する高気圧酸素療法の治療効果の検討 査読

    寺島 健史, 五十嵐 博中, 高堂 裕平, 眞島 卓弥, 赤澤 宏平, 西澤 正豊, 中田 力

    臨床神経学   51 ( 12 )   1452 - 1452   2011年12月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

    researchmap

  • External Validation of the UCSF-CAPRA (University of California, San Francisco, Cancer of the Prostate Risk Assessment) in Japanese Patients Receiving Radical Prostatectomy 査読

    Fumio Ishizaki, Md. Aminul Hoque, Tsutomu Nishiyama, Takashi Kawasaki, Takashi Kasahara, Noboru Hara, Itsuhiro Takizawa, Toshihiro Saito, Yasuo Kitamura, Kohei Akazawa, Kota Takahashi

    JAPANESE JOURNAL OF CLINICAL ONCOLOGY   41 ( 11 )   1259 - 1264   2011年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    Objective: In 2005, the University of California, San Francisco developed the Cancer of the Prostate Risk Assessment (UCSF-CAPRA) score as a new risk stratification tool. The UCSF-CAPRA, which ranges from 0 to 10 points, consists of five clinical variables, prostate-specific antigen, Gleason score, T stage, percent of positive biopsies and age. The aim of this study was to validate the UCSF-CAPRA score for Japanese prostate cancer patients receiving radical prostatectomy using the contemporary Gleason grading.
    Methods: From 1999 to 2010, 211 men who underwent radical prostatectomy were used for validation. Biochemical progression-free survival was calculated using the Kaplan-Meier method and the UCSF-CAPRA and D&apos;Amico risk categories were compared using the log-rank method. The concordance index (c-index) for the UCSF-CAPRA and D&apos;Amico risk classification was calculated.
    Results: Using the UCSF-CAPRA score, 85 (40.3%), 106 (50.2%) and 20 (9.5%) subjects were stratified as 0-2 points (low risk), 3-5 points (intermediate risk) and 6-10 points (high risk). Using the D&apos;Amico risk criteria, 66 (31.3%), 89 (42.2%) and 56 (26.5%) were stratified as low-, intermediate- and high-risk groups, respectively. The Kaplan-Meier analysis showed that the UCSF-CAPRA divided the patients significantly into each risk category. There was no significant difference between low and intermediate in the D&apos;Amico risk classification. The c-index of the UCSF-CAPRA and D&apos;Amico classification was 0.755 and 0.713, respectively.
    Conclusion: The UCSF-CAPRA is an acceptable risk category tool comparable to that of the D&apos;Amico risk classification for Japanese prostate cancer patients receiving radical prostatectomy in the contemporary Gleason grading era.

    DOI: 10.1093/jjco/hyr136

    Web of Science

    PubMed

    researchmap

  • Gastric cancer treatment in Japan: 2008 annual report of the JGCA nationwide registry 査読

    Yoh Isobe, Atsushi Nashimoto, Kohei Akazawa, Ichiro Oda, Kenichi Hayashi, Isao Miyashiro, Hitoshi Katai, Shunichi Tsujitani, Yasuhiro Kodera, Yasuyuki Seto, Michio Kaminishi

    GASTRIC CANCER   14 ( 4 )   301 - 316   2011年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    The Japanese Gastric Cancer Association (JGCA) started a new nationwide gastric cancer registry in 2008. Approximately 50 data items, including surgical procedures, pathological diagnoses, and survival outcomes, for 12004 patients with primary gastric cancer treated in 2001 were collected retrospectively from 187 participating hospitals. Data were entered into the JGCA database according to the JGCA Classification of gastric carcinoma, 13th edition and the International Union Against Cancer (UICC) TNM Classification of malignant tumors, 5th edition by using an electronic data collecting system. Finally, data of 11261 patients with gastric resection were analyzed. The 5-year follow-up rate was 83.5%. The direct death rate was 0.6%. TNM 5-year survival rates (5YSRs)/JGCA 5YSRs were 91.8/91.9% for stage IA, 84.6/85.1% for stage IB, 70.5/73.1% for stage II, 46.6/51.0% for stage IIIA, 29.9/33.4% for stage IIIB, and 16.6/15.8% for stage IV. The proportion of patients more than 80 years old was 7.0%, and their 5YSR was 48.7%. Compared to the JGCA archived data, though the follow-up rate needs to be improved, these data suggest that the postoperative results of patients with primary gastric carcinoma have improved in those with advanced disease and in the aged population in Japan.

    DOI: 10.1007/s10120-011-0085-6

    Web of Science

    PubMed

    researchmap

  • Assessment of the Nodal Status in Ampullary Carcinoma: The Number of Positive Lymph Nodes Versus the Lymph Node Ratio 査読

    Jun Sakata, Yoshio Shirai, Toshifumi Wakai, Yoichi Ajioka, Kouhei Akazawa, Katsuyoshi Hatakeyama

    WORLD JOURNAL OF SURGERY   35 ( 9 )   2118 - 2124   2011年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    This study was intended to compare the prognostic power of the number of positive lymph nodes with that of the lymph node ratio in patients with ampullary carcinoma.
    A retrospective analysis was conducted of the medical records of 71 consecutive patients with ampullary carcinoma who underwent pancreaticoduodenectomy with regional lymph node dissection. A total of 2151 lymph nodes were dissected (median: 28 nodes per patient) and examined histologically. Cutoff points were determined for both the number of positive nodes and the lymph node ratio using chi(2) scores calculated with the Cox proportional hazards regression model.
    Lymph node metastasis was found in 34 patients. The best cutoff point for the number of positive nodes was identified as three nodes, and that for the lymph node ratio was identified as 10%. Univariate analysis revealed both the number of positive nodes (0, 1-3, or a parts per thousand yen4; P &lt; 0.0001) and the lymph node ratio (0%, 0-10%, or &gt; 10%; P &lt; 0.0001) as significant prognostic factors. Multivariate analysis identified the number of positive nodes as an independent prognostic factor (P &lt; 0.001), whereas the lymph node ratio failed to remain as an independent variable. The cumulative 5-year survival rates were 85% for patients with 0 positive nodes, 63% for patients with 1-3 positive nodes, and 0% for patients with a parts per thousand yen4 positive nodes (P &lt; 0.0001).
    The number of positive lymph nodes better predicts the outcome after resection than the lymph node ratio in patients with ampullary carcinoma.

    DOI: 10.1007/s00268-011-1175-7

    Web of Science

    researchmap

  • Relationship between Heart Rate and Optimal Reconstruction Phase in Dual-source CT Coronary Angiography 査読

    Yosuke Horii, Norihiko Yoshimura, Yoshiro Hori, Toru Takano, Shoichi Inagawa, Kohei Akazawa, Hidefumi Aoyama

    ACADEMIC RADIOLOGY   18 ( 6 )   726 - 730   2011年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Rationale and Objectives: To evaluate reconstruction image quality at the systolic and diastolic cardiac phases and determine the optimal phase for reconstruction according to heart rate when using dual-source computed tomography (CT) with 75 ms temporal resolution.
    Materials and Methods: We retrospectively reviewed the CT datasets of 35 patients with regular heartbeats who underwent coronary CT angiography. Images were reconstructed in 2% steps between 32 and 78% of the beat-to-beat interval. Two experienced radiologists determined the reconstruction interval with the fewest motion artifacts and the motion score of each vessel for the systolic and diastolic phases. Subgroup analysis was performed in patients having heart rates of &lt;70,70-80, and &gt;80 beats per minute (bpm).
    Results: In the subgroup with heart rates of &lt;70 bpm, the diastolic phase reconstruction image quality was significantly better than for the systolic phase (P &lt; .01). In the 70-80 bpm and &gt;80 bpm subgroups, no significant difference was observed. In the diastolic phase, the image quality of the &lt;70 bpm subgroup was significantly better than for the &gt;80 bpm subgroup (P &lt; .05). In all systolic phase subgroups and other diastolic phase subgroups, no significant difference was observed.
    Conclusions: Using a DSCT scanner with 75 ms temporal resolution, reconstruction at the diastolic phases should be used for patients with heart rates &lt;70 bpm. For heart rates &gt;70 bpm, larger studies are necessary to determine whether reconstruction at the systolic, diastolic, or both phases should be used.

    DOI: 10.1016/j.acra.2011.01.012

    Web of Science

    PubMed

    researchmap

  • Alcohol Consumption as a Risk Factor for Esophageal Adenocarcinoma in North China 査読

    Jun Chen, Nan Zhang, Yiwei Ling, Toshifumi Wakai, Yutong He, Lizhen Wei, Shijie Wang, Kouhei Akazawa

    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE   224 ( 1 )   21 - 27   2011年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TOHOKU UNIV MEDICAL PRESS  

    The incidence of esophageal adenocarcinoma has been rising in many countries, while esophageal squamous cell carcinoma has remained stable or even declined in the same populations over the identical periods. These differences in trends indicate that these cancer subtypes may have a different etiology, which may be caused by lifestyle factors such as alcohol consumption and cigarette smoking. Therefore, a matched case-control study to clarify the risk factors of alcohol and tobacco intake on the development of esophageal adenocarcinoma was collected in Hebei Province of China. The life expectancy of the study area was around 70 years old. In the present study, 98 patients younger than 65 years who were diagnosed with esophageal adenocarcinoma and had initial surgeries (cases) were matched with 294 healthy adults (controls) at a ratio of 1:3 according to sex and age. We found the proportions of drinkers and smokers among cases were 48.0% and 60.2%, respectively, versus 21.2% and 43.5% among controls. Univariate conditional logistic regression analyses revealed that the odds ratios (ORs) showed a nearly monotonic increase for the duration of alcohol consumption and duration of tobacco smoking. Multivariate conditional logistic regression analysis indicated that only alcohol consumption was a significant risk factor for esophageal adenocarcinoma. Additional analysis of the combination of amount and duration of alcohol consumption indicated that heavy drinkers (&gt; 30 ml/day) had significantly higher ORs, irrespective of the duration of alcohol consumption. In conclusion, heavy alcohol consumption increases the risk for esophageal adenocarcinoma independent of the duration of such consumption.

    DOI: 10.1620/tjem.224.21

    Web of Science

    researchmap

  • Effect of an education program on improving knowledge of schizophrenia among parents of junior and senior high school students in Japan 査読

    Hatsumi Yoshii, Yuichiro Watanabe, Hideaki Kitamura, Jun Chen, Kouhei Akazawa

    BMC PUBLIC HEALTH   11   323   2011年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: Early detection and intervention in schizophrenia are important in improving quality of life after treatment and are major issues in psychiatric care. Therefore, it is necessary to increase knowledge of schizophrenia among the general public. Among parents of junior and senior high school students in Japan, we compared rates of correct answers for items on knowledge of schizophrenia and ability to discriminate this psychosis from other disorders on questionnaires given before and after viewing a web-based education program.
    Methods: Questionnaires were distributed to 2,690 parents. The program was developed to help parents obtain a basic understanding of schizophrenia and to emphasize the necessity of early detection.
    Results: Before the program, the rate of correct answers was 77% for items concerning basic knowledge of schizophrenia, 47% for "discrimination of schizophrenia symptoms," and 30% for "discrimination of prodromal symptoms." The program resulted in an improvement in basic knowledge of schizophrenia, discrimination of schizophrenia symptoms, and discrimination of prodromal symptoms (P &lt; 0.001 for all).
    Conclusions: Our web-based education program was useful in helping parents acquire a basic knowledge of schizophrenia and discriminate correctly the symptoms of schizophrenia.

    DOI: 10.1186/1471-2458-11-323

    Web of Science

    researchmap

  • Associations of Age and Birth Cohort with Total and Specific IgE Antibody Levels 査読

    Kazuharu Tsukioka, Shin-Ichi Toyabe, Kohei Akazawa

    JOURNAL OF ASTHMA   48 ( 3 )   211 - 216   2011年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:INFORMA HEALTHCARE  

    Background. Total and antigen-specific IgE levels vary greatly with age; however, it is unclear whether they are more closely related to patient age or birth cohort. Objective. To determine whether birth cohort or age was more strongly correlated with total and specific IgE levels. Methods. We retrospectively examined the medical records of 5136 asthma patients who were treated at the Niigata Allergic Disease Research Institute Outpatient Clinic during the period from 1997 to 2005. The subjects were divided into four birth cohorts based on their year of birth: the first cohort was born in 1935 or earlier, the second in 1936--1955, the third in 1956--1975, and the fourth in 1976 or later. Their total IgE level and mite-, cedar-, and Candida albicans (Candida)-specific IgE levels were measured using the CAP RAST fluoroenzyme immunoassay test. Results. Univariate analysis revealed that total IgE level and mite-, cedar-, and Candida-specific IgE levels significantly decreased (p &lt; .001) with advancing age. In addition, there were significantly higher IgE levels in later birth cohorts (p &lt; .01). On multivariate analysis, there were associations of total IgE level and mite- and cedar-specific IgE levels with both age and birth cohort. However, there was no significant association between Candida-specific IgE antibody level and either age or birth cohort. Conclusions. The associations of total and specific IgE levels with age and birth cohort were different. Thus, in comparing the results of IgE antibody testing done in different years, even for patients of the same age, the possibility of a birth cohort effect on IgE levels should be considered.&lt;/.

    DOI: 10.3109/02770903.2011.558152

    Web of Science

    PubMed

    researchmap

  • Phase II Trial of Preoperative Chemotherapy for Breast Cancer: Japan Breast Cancer Research Network (JBCRN)-02 Trial 査読

    S. Iwase, D. Yamamoto, Y. Kuroda, T. Kawaguchi, K. Kitamura, H. Odagiri, S. Teramoto, K. Akazawa, Y. Nagumo

    ANTICANCER RESEARCH   31 ( 4 )   1483 - 1487   2011年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:INT INST ANTICANCER RESEARCH  

    Background: Neoadjuvant chemotherapy (NAC) is one of the main strategies for patients with locally advanced breast cancer. In our previous study, biological markers such as estrogen receptor (ER), progesterone receptor (PgR), and HER2 were essential predictors of the effectiveness of NAC to help individualize treatment. This study examined the effect of NAC on the disease-free survival (DFS) of breast cancer patients. Furthermore, the study was expanded by adding Ki-67 as a biological marker, and examined the correlation between Ki-67 and the prognosis. Patients and Methods: Between September 2005 and September 2007, 43 patients with breast cancer received NAC and surgery. Four cycles of DC (doxorubicin: 60 mg/m(2), and cyclophosphamide: 500 mg/m2) were administered intravenously (i.v.) on day 1 every 21 days, followed by 12 cycles of paclitaxel i.v. (80 mg/m2) every 7 days, prior to surgery. The primary endpoint was the pathological complete response (pCR) rate and the secondary endpoint was DFS; the pCR rate was estimated for each groups stratified by the presence or absence of different factors (PcR, ER/PgR, and Ki-67). Results: The clinical response (cCR+cPR) rate was 81.0%, and the pCR rate was 25.6%. The pCR rate was 75, 50, 9 and 0% in HER2(+)/ER(-), HER2(+)/ER(+), HER2(-)/ER(-), and HER2(-)/ER(+) patients, respectively. The 4-year DFS rate was estimated at 78% for all patients. The HER2 status was an independent predictor of pathological complete response (pCR). The DFS rate of patients with lower Ki-67 values (&lt; 15%) was higher than that of patients with higher Ki-67 values (&gt;= 15%). The treatment-related adverse events were manageable: the majority were mild, but five patients experienced grade 3 (neutropenia and sensory neuropathy) adverse events. Conclusion: DC followed by weekly paclitaxel is an active and manageable preoperative regimen for breast cancer patients. HER2 overexpression may be a good predictive marker of pCR, and the Ki-67 value after NAC may be a prognostic factor for DFS.

    Web of Science

    researchmap

  • Associations of age and birth cohort with total and specific IgE antibody levels.

    Tsukioka Kazuharu, Toyabe Shin-Ichi, Akazawa Kohei

    J Asthma   48 ( 3 )   211 - 216   2011年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Total and antigen-specific IgE levels vary greatly with age; however, it is unclear whether they are more closely related to patient age or birth cohort. OBJECTIVE: To determine whether birth cohort or age was more strongly correlated with total and specific IgE levels. METHODS: We retrospectively examined the medical records of 5136 asthma patients who were treated at the Niigata Allergic Disease Research Institute Outpatient Clinic during the period from 1997 to 2005. The subjects were divided into four birth cohorts based on their year of birth: the first cohort was born in 1935 or earlier, the second in 1936-1955, the third in 1956-1975, and the fourth in 1976 or later. Their total IgE level and mite-, cedar-, and Candida albicans (Candida)-specific IgE levels were measured using the CAP RAST fluoroenzyme immunoassay test. RESULTS: Univariate analysis revealed that total IgE level and mite-, cedar-, and Candida-specific IgE levels significantly decreased (p &lt; .001) with advancing age. In addition, there were significantly higher IgE levels in later birth cohorts (p &lt; .01). On multivariate analysis, there were associations of total IgE level and mite- and cedar-spec

    DOI: 10.3109/02770903.2011.558152

    PubMed

    researchmap

  • Intraepithelial ductal spread in colorectal carcinoma liver metastasis. 査読

    Wakai T, Korita PV, Ajioka Y, Inoue M, Takamura M, Akazawa K, Shirai Y, Hatakeyama K

    Hepato-gastroenterology   58 ( 106 )   583 - 588   2011年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Web of Science

    PubMed

    researchmap

  • Kattan postoperative nomogram for renal cell carcinoma: Predictive accuracy in a Japanese population 査読

    Kazuya Suzuki, Tsutomu Nishiyama, Noboru Hara, Kohei Akazawa, Kota Takahashi

    INTERNATIONAL JOURNAL OF UROLOGY   18 ( 3 )   194 - 199   2011年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Objectives:
    The aim of the current study was to establish the predictive accuracy of the Kattan postoperative nomogram for non-metastatic renal cell carcinoma (RCC) in a Japanese population.
    Methods:
    A total of 211 patients with stage T1-3N0M0 clear cell RCC who underwent radical nephrectomy or nephron-sparing surgery between 1991 and 2004 were included in this analysis. Median follow up was 81 months (range: 4-208). Univariate and multivariate analyses were performed, and the influence of age, sex, clinical presentation, T stage, histological tumor size, grade, and microvascular invasion on disease recurrence-free survival (RFS) was determined. For each patient, the prognostic score for 5-year RFS was calculated using the Kattan nomogram. The discriminating ability of this model was assessed by the concordance index, and bootstrapping was used to evaluate confidence intervals.
    Results:
    The 5-year RFS rate for all patients calculated using the Kaplan-Meier method was 80.6%. In multivariate analysis, the statistically significant prognostic factors for 5-year RFS were high-grade tumors (P = 0.019) and symptomatic disease (P = 0.017). The concordance index for RFS predicted by the Kattan nomogram was 0.735 (95% confidence interval: 0.734-0.736). There was a slight discrepancy between the RFS predicted by the Kattan nomogram and the likelihood of being recurrence-free at 5 years according to the Cox analysis in the current patient population.
    Conclusion:
    These findings suggest the necessity of constructing a more useful nomogram for predicting the prognosis of Japanese patients with non-metastatic RCC.

    DOI: 10.1111/j.1442-2042.2010.02693.x

    Web of Science

    PubMed

    researchmap

  • Effect of an Education Program on Improving Help-Seeking among Parents of Junior and Senior High School Students in Japan. 査読

    Yoshii H, Watanabe Y, Kitamura H, Nan Z, Akazawa K

    Global Journal of Health Science   4 ( 1 )   33 - 41   2011年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.5539/gjhs.v4n1p33

    researchmap

  • Internal environment for growth of cancer cells in mice:hypothermia, anemia and lymphocytopenia. 査読

    Watanabe M, Matsumoto H, Tomiyama C, Akazawa K, Abo T

    Health   3 ( 4 )   238 - 244   2011年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4236/health.2011.34042

    researchmap

  • Clustering and geographic variation of upper gastrointestinal cancers in a high-risk region of esophageal cancer in northern China. 査読

    Zhang N, Wen D, Shan B, Wang S, Zhang L, Wei L, Zou W, Kitsu K, Akazawa K

    Asian Pacific journal of cancer prevention : APJCP   12 ( 1 )   193 - 198   2011年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Web of Science

    PubMed

    researchmap

  • Stigma toward schizophrenia among parents of junior and senior high school students in Japan 査読

    Hatsumi Yoshii, Yuichiro Watanabe, Hideaki Kitamura, Zhang Nan, Kouhei Akazawa

    BMC Research Notes   4   558   2011年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Stigma toward schizophrenia is a substantial barrier to accessing care and adhering to treatment. Provisions to combat stigma are important, but in Japan and other developed countries there are few such provisions in place that target parents of adolescents. The attitudes of parents are important to address as first schizophrenic episodes typically occur in adolescence. In overall efforts to develop an education program and provisions against stigma, here we examined the relationship between stigma toward schizophrenia and demographic characteristics of parents of junior and senior high school students in Japan. The specific hypothesis tested was that contact and communication with a person with schizophrenia would be important to reducing stigma. A questionnaire inquiring about respondent characteristics and which included a survey on stigma toward schizophrenia was completed by 2690 parents. Results: The demographic characteristics significantly associated with the Devaluation- Discrimination Measure were family income, occupation, presence of a neighbor with schizophrenia, and participation in welfare activities for people with mental illness (p &lt
    0.05). The mean ±SD score was 32.74 ± 5.66 out of a maximum of 48 points on the Link Devaluation- Discrimination Measure. Conclusions: Stigma toward schizophrenia among parents of junior and senior high school students was in fact significantly stronger among members of the general public who had had contact with individuals with schizophrenia. In addition, stigma was associated with family income. © 2011 Yoshii et al
    licensee BioMed Central Ltd.

    DOI: 10.1186/1756-0500-4-558

    Scopus

    researchmap

  • 臨床研究における統計学的解析ー推定と検定の正しい使い方 査読

    赤澤宏平, Md. Aminul Hoque, 張楠, 凌一葦, 齋藤翔太

    脈管学   51 ( 4 )   167 - 173   2011年

     詳細を見る

    記述言語:日本語  

    researchmap

  • [Relationship between asthma severity and age at onset in Japanese adults]. 査読

    Tsukioka K, Toyabe S, Akazawa K

    Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society   48 ( 12 )   898 - 905   2010年12月

     詳細を見る

  • Effect of the interaction between the amount and duration of alcohol consumption and tobacco smoking on the risk of esophageal cancer: A case-control study 査読

    Jun Chen, Nan Zhang, Toshifumi Wakai, Lizhen Wei, Yutong He, Naoko Kumagai, Keiko Kitsu, Shijie Wang, Kohei Akazawa

    EXPERIMENTAL AND THERAPEUTIC MEDICINE   1 ( 6 )   991 - 997   2010年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPANDIDOS PUBL LTD  

    The effects of alcohol consumption and tobacco smoking on the prevalence of esophageal cancer vary considerably by country, race and lifestyle. Few data exist on the effect of the interaction between the amount and duration of alcohol consumption and tobacco smoking on the incidence of esophageal cancer. In this case-control study, the cases included patients with histologically confirmed esophageal squamous cell carcinoma (ESCC) younger than 60 years of age and recruited between January 1, 2002 and December 31, 2006. The controls had no abnormality during a medical checkup. A total of 835 pairs were created by pairing each case to a gender- and age-matched control. Conditional logistic regression analysis was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals. Univariate conditional logistic regression analyses revealed that the ORs according to both duration of alcohol consumption and tobacco smoking increased monotonically. Alcohol consumption and tobacco smoking may have a synergistic effect on the incidence of ESCC. Conditional logistic regression analysis using a forward stepwise selection procedure revealed that the incidence of ESCC was associated with the duration of tobacco smoking, the interaction between the amount and duration of alcohol consumption, and a family history of cancer. In particular, groups with a long duration of alcohol consumption and high alcohol intake had much higher ORs than those with short duration and low intake, which highlights the importance of the interaction between the amount and duration of alcohol intake. This study confirmed the significance of the interaction between alcohol consumption and tobacco smoking in esophageal cancer. This interaction between amount and duration is an accurate indicator for estimating the risk of esophageal cancer attributable to alcohol consumption and tobacco smoking. These findings suggest that decreasing the number of young and middle-aged drinkers and smokers will reduce the incidence of esophageal cancer.

    DOI: 10.3892/etm.2010.152

    Web of Science

    PubMed

    researchmap

  • A stochastic model of neuronal growth cone guidance regulated by multiple sensors 査読

    Taichiro Kobayashi, Kenshi Terajima, Motohiro Nozumi, Michihiro Igarashi, Kouhei Akazawa

    JOURNAL OF THEORETICAL BIOLOGY   266 ( 4 )   712 - 722   2010年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD  

    Neuronal growth cones migrate directionally under the control of axon guidance molecules, thereby forming synapses in the developing brain. The signal transduction system by which a growth cone detects surrounding guidance molecules, analyzes the detected signals, and then determines the overall behavior remains undetermined. In this study, we describe a novel stochastic model of this behavior that utilizes multiple sensors on filopodia to respond to guidance molecules. Overall growth cone behavior is determined by using only the concentration gradients of guidance molecules in the immediate vicinity of each sensor. The detected signal at each sensor, which is treated as a vector quantity, is sent to the growth cone center and then integrated to determine axonal growth in the next step by means of a simple vector operation. We compared the results of computer simulations of axonal growth with observations of actual axonal growth from co-culture experiments using olfactory bulb and septum. The probabilistic distributions of axonal growth generated by the computer simulation were consistent with those obtained from the culture experiments, indicating that our model accurately simulates growth cone behavior. We believe that this model will be useful for elucidating the as yet unknown mechanisms responsible for axonal growth in vivo. (c) 2010 Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.jtbi.2010.07.036

    Web of Science

    PubMed

    researchmap

  • [The relationship between the duration and severity of asthma]. 査読

    Tsukioka K, Toyabe S, Akazawa K

    Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society   48 ( 7 )   475 - 481   2010年7月

     詳細を見る

  • Single-Dose Intravenous Administration of Recombinant Human Erythropoietin Is a Promising Treatment for Patients With Acute Myocardial Infarction - Randomized Controlled Pilot Trial of EPO/AMI-1 Study 査読

    Takuya Ozawa, Ken Toba, Hiroshi Suzuki, Kiminori Kato, Yoshitaka Iso, Yasushi Akutsu, Youichi Kobayashi, Youichi Takeyama, Naohiko Kobayashi, Norihiko Yoshimura, Kohei Akazawa, Yoshifusa Aizawa

    CIRCULATION JOURNAL   74 ( 7 )   1415 - 1423   2010年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPANESE CIRCULATION SOC  

    Background: Erythropoietin (EPO) has been found to have anti-apoptotic and tissue protective effects on the myocardium. The aim of the present pilot study was to observe the safety and efficacy of EPO administration for patients with acute myocardial infarction (AMI).
    Methods and Results: Patients admitted with AMI had all undergone successful percutaneous coronary intervention (PCI). Patients were randomly assigned to 2 groups (control and EPO groups), and given 12,000 IU EPO iv or saline after PCI. The primary endpoints were the difference between the acute phase and chronic phase (6 months after the attack) regarding left ventricular function as measured on electrocardiogram-gated single-photon emission computed tomography. Thirty-six patients (control 16, EPO 20) were eligible for analysis. Left ventricular ejection fraction (LVEF) significantly increased in the EPO group (from 51.0 +/- 19.6% to 58.5 +/- 15.0%, P=0.0238), but not in the control group. Further analysis was separately undertaken in patients with occlusion in the left anterior descending artery (LAD) and others (non-LAD). LVEF was &lt;50% in most patients in the LAD subgroup, and LVEF significantly increased in the EPO group (37.5 +/- 13.0 to 52.7 +/- 15.8, P=0.0049), but not in the control group. EPO administration did not trigger any adverse clinical events.
    Conclusions: EPO administration is a promising treatment for AMI. (Circ J 2010; 74: 1415-1423)

    DOI: 10.1253/circj.CJ-10-0109

    Web of Science

    PubMed

    researchmap

  • [Total and specific IgE levels in adolescents and adults with bronchial asthma]. 査読

    Tsukioka K, Toyabe S, Akazawa K

    Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society   48 ( 6 )   409 - 418   2010年6月

     詳細を見る

  • Inhaled Granulocyte/Macrophage-Colony Stimulating Factor as Therapy for Pulmonary Alveolar Proteinosis 査読

    Ryushi Tazawa, Bruce C. Trapnell, Yoshikazu Inoue, Toru Arai, Toshinori Takada, Yasuyuki Nasuhara, Nobuyuki Hizawa, Yasunori Kasahara, Koichiro Tatsumi, Masayuki Hojo, Haruyuki Ishii, Masanori Yokoba, Naohiko Tanaka, Etsuro Yamaguchi, Ryosttke Eda, Yoshiko Tsuchihashi, Konosuke Morimoto, Masanori Akira, Masaki Terada, Junji Otsuka, Masahito Ebina, Chinatsu Kaneko, Toshihiro Nukiwa, Jeffery P. Krischer, Kohei Akazawa, Koh Nakata

    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE   181 ( 12 )   1345 - 1354   2010年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER THORACIC SOC  

    Rationale: Inhaled granulocyte/macrophage-colony stimulating factor (GM-CSF) is a promising therapy for pulmonary alveolar proteinosis (PAP) but has not been adequately studied.
    Objectives: To evaluate safety and efficacy of inhaled GM-CSF in patients with unremitting or progressive PAP.
    Methods: We conducted a national, multicenter, self-controlled, phase II trial at nine pulmonary centers throughout japan. Patients who had lung biopsy or cytology findings diagnostic of PAP, an elevated serum GM-CSF antibody level, and a Pa(O2) of less than 75 mm Hg entered a 12-week observation period. Those who improved (i.e., alveolar-arterial oxygen difference [A-aDO(2)] decreased by 10 mm Hg) during observation were excluded. The rest entered sequential periods of high-dose therapy (250 mu g Days 1-8, none Days 9-14; x six cycles; 12 wk); low-dose therapy (125 mu g Days 1-4, none Days 5-14; x six cycles; 12 wk), and follow-up (52 wk).
    Measurements and Main Results: Fifty patients with PAP were enrolled in the study. During observation, nine improved and two withdrew; all of these were excluded. Of 35 patients completing the high- and low-dose therapy, 24 improved, resulting in an overall response rate of 62% (24/39; intention-to-treat analysis) and reduction in A-aDO(2) of 12.3 mm Hg (95% confidence interval, 8.4-16.2; n = 35, P &lt; 0.001). No serious adverse events occurred, and serum GM-CSF autoantibody levels were unchanged. A treatment-emergent correlation occurred between A-aDO(2) and diffusing capacity of the lung, and high-resolution CT revealed improvement of ground-glass opacity. Twenty-nine of 35 patients remained stable without further therapy for 1 year.
    Conclusions: Inhaled GM-CSF therapy is safe, effective, and provides a sustained therapeutic effect in autoimmune PAP.

    DOI: 10.1164/rccm.200906-0978OC

    Web of Science

    PubMed

    researchmap

  • Risk factors for persistent and relapsed childhood-onset asthma 査読

    Kazuharu Tsukioka, Shin-Ichi Toyabe, Kouhei Akazawa

    Japanese Journal of Allergology   59 ( 6 )   699 - 705   2010年

     詳細を見る

    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Background: The aim of this study was to identify factors responsible for childhood-onset persistent asthma and childhood-onset asthma relapsing in adulthood. Methods: We compared a number of potential risk factors for asthma among 608 patients with childhood-onset persistent asthma (onset at 15 years of age or younger) and 286'patients with childhood-onset asthma (onset at 20 years or younger) that had relapsed "after a period of remission longer than 2 years. Results: Multiple linear regression analysis revealed that the factors associated with childhood-onset persistent asthma were a past or present history of allergic rhinitis (p = 0.001) and high serum total IgE concentration (≥300IU/ml
    p = 0.007). The factors associated, with relapse of childhood-onset asthma were female sex {p = 0.001), younger onset age (p = 0.036), and smoking (current or former: p&lt
    0.001). Conclusion: Our findings indicate that a past or present history of allergic rhinitis and high serum IgE level are significant risk factors for childhood-onset persistent asthma, and that female sex and a history of smoking are risk factors for relapse of childhood-onset asthma Fortunately, exposure to r tobacco smoke is a controllable risk factor. © 2010 Japanese Society of Allergology.

    Scopus

    PubMed

    researchmap

  • 拡散テンソルイメージングを用いた一酸化炭素中毒後遅発性白質障害の空間的分布の検討 査読

    寺島 健史, 五十嵐 博中, 高堂 裕平, 岡本 浩一郎, 赤澤 宏平, 西澤 正豊, 中田 力

    臨床神経学   49 ( 12 )   1086 - 1086   2009年12月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

    researchmap

  • Single-dose Intravenous-administration of Recombinant Human Erythropoietin Considerably Improved Cardiac Function in Patients With Acute Myocardial Infarction: A Randomized Controlled Pilot Trial of EPO/AMI-I Study 査読

    Takuya Ozawa, Ken Toba, Kiminori Kato, Hiroshi Suzuki, Yoshitaka Iso, Naohiko Kobayashi, Yasushi Akutsu, Tsugumi Takayama, Takao Yanagawa, Norihiko Yoshimura, Youichi Kobayashi, Youichi Takeyama, Kohei Akazawa, Yoshifusa Aizawa

    CIRCULATION   120 ( 18 )   S1173 - S1174   2009年11月

     詳細を見る

    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

    researchmap

  • Estimating the case fatality rate using a constant cure-death hazard ratio 査読

    Zheng Chen, Kohei Akazawa, Tsuyoshi Nakamura

    LIFETIME DATA ANALYSIS   15 ( 3 )   316 - 329   2009年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    The case fatality rate is an important indicator of the severity of a disease, and unbiased and accurate estimates of it during an outbreak are important in the study of epidemic diseases, including severe acute respiratory syndrome (SARS). In this paper, estimation methods are developed using a constant cure-death hazard ratio. A semiparametric model is presented, in which the cure-death hazard ratio is a parameter of interest, and a profile likelihood-based technique is proposed for estimating the case fatality rate. An extensive simulation was carried out to investigate the performance of this technique for small and medium sample sizes, using both summary and individual data. The results show that the performance depends on the model validity but is not heavily dependent on the sample size. The method was applied to summary SARS data obtained from Hong Kong and Singapore.

    DOI: 10.1007/s10985-009-9119-3

    Web of Science

    PubMed

    researchmap

  • Predictors of microscopic portal vein invasion by hepatocellular carcinoma: Measurement of portal perfusion defect area ratio 査読

    Ken Shirabe, Kiyoshi Kajiyama, Tomoyuki Abe, Shigeru Sakamoto, Tatsuro Fukuya, Kohei Akazawa, Kazutoyo Morita, Yoshihiko Maehara

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   24 ( 8 )   1431 - 1436   2009年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL PUBLISHING, INC  

    Objective:
    Microscopic portal vein invasion (PVI) by cancer cells is a poor prognostic factor after hepatic resection for hepatocellular carcinoma (HCC). The aim of this study is to predict PVI preoperatively in patients with HCC.
    Methods:
    We studied 46 hepatectomized patients who had HCC without any portal venous invasion detected during preoperative radiographic evaluation. We defined the portal perfusion defect area ratio (PPDAR) as the following: the quotient of the maximal portal perfusion defect area, on computed tomography during arterio-portography (CTAP) is divided by the maximal tumor area on magnetic resonance imaging (MRI) or CT.
    Results:
    The median PPDAR was 1.3 (mean 1.4 +/- 1.1; ranged from 0.7 to 5.8). The incidence of PVI was 4.5% in patients with a PPDAR &lt; 1.3, 35.7% in those with a PPDAR of 1.3-1.6, 70% in those with a PPDAR &gt;= 1.6 (P = 0.0005). When analyzing the preoperative value of different cut-off points for the PPDAR, the lowest P-value by Fisher&apos;s exact test was achieved when the PPDAR threshold was 1.6 (P = 0.0012). The sensitivity was 58%, and specificity was 91% with this cut-off value. On univariate analyses, factors that significantly correlated with PVI were PPDAR (P = 0.0012), serum levels of des-gamma-carboxy prothrombin (P = 0.033), and tumor size (P = 0.0126). On multivariate analysis, PPDAR was the only significant independent predictor of PVI.
    Conclusion:
    Our study shows that PPDAR is a new concept, which is useful in predicting PVI and that a value &gt;= 1.6 is predictive of PVI.

    DOI: 10.1111/j.1440-1746.2009.05847.x

    Web of Science

    PubMed

    researchmap

  • Tract-by-tract morphometric and diffusivity analyses in vivo of spinocerebellar degeneration 査読

    Kenshi Terajima, Hitoshi Matsuzawa, Takayoshi Shimohata, Kouhei Akazawa, Masatoyo Nishizawa, Tsutomu Nakada

    Journal of Neuroimaging   19 ( 3 )   220 - 226   2009年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND PURPOSE Three-dimensional anisotropy contrast (3DAC) based on a periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) sequence on a 3.0T system is a new magnetic resonance imaging technique capable of providing images with significantly high anatomical resolution. The purpose of this study was to confirm whether this technique can characterize the degenerative processes in the brainstem of patients with spinocerebellar degeneration (SCD). METHODS 3DAC images of 13 patients with multiple system atrophy with predominant cerebellar symptoms (MSA-C) and seven International Cooperative Ataxia Rating Scale (ICARS) score-matched patients with Machado-Joseph disease (MJD) were created using a diffusion-weighted PROPELLER sequence on a 3.0T system. The section of the middle pons was chosen for morphometric and diffusivity analyses. RESULTS The above analyses showed that atrophy and increased diffusivity of the ventral portion of the pons indicated MSA-C, whereas atrophy and increased diffusivity of the pontine tegmentum indicated MJD. Furthermore, ICARS scores significantly correlated with both the severities of the pontine atrophy and the mean diffusivity values of the ventral pontocerebellar tracts. CONCLUSIONS This study demonstrated that 3DAC PROPELLER on a 3.0T system enables in vivo "tract by tract" quantitative analysis of pontine degeneration in SCD. J Neuroimaging 2009
    19:220-226. © 2008 by the American Society of Neuroimaging.

    DOI: 10.1111/j.1552-6569.2008.00273.x

    Scopus

    PubMed

    researchmap

  • 静脈血栓塞栓症における発症率と理学的・薬物的予防効果の推定 査読

    吉田 保子, 寺島 健史, 小薬 祐子, 陳 君, 吉井 初美, 赤澤 宏平

    新潟医学会雑誌   123 ( 7 )   357 - 362   2009年7月

     詳細を見る

    記述言語:日本語   出版者・発行元:新潟医学会  

    静脈血栓塞栓症(VTE)は、発症しても臨床症状に乏しく早期診断が困難であること、また重篤な場合は死に至ることから予防が重要とされている。本研究の目的は、人工股関節置換術(THA)と人工膝関節置換術(TKA)を受けた入院患者を対象とし、予防の実施状況、VTEの発症率、および、理学的・薬物的予防効果を推定することである。本院において2005年1月から2006年3月までに、THAおよびTKAを受けた97例を対象とした。解析に用いたデータ項目は、診察所見、検査、手術に関するデータの13項目である。理学的予防、薬物的予防の実施率は、それぞれ100%、19.6%であった。97例におけるVTE発症率は23.7%であったが、VTE既往歴の有無で層別したときの発症率は、それぞれ、42.3%、16.9%であった。ロジスティック回帰分析の結果、VTE発症に関与する危険因子はVTE既往歴のみが選択された。VTEの既往歴で層別したそれぞれの層において、薬物的予防実施群と非実施群のVTE発症率を比較した。その結果、いずれの層でも実施群のVTE発症率が非実施群に比べて低かった。また合併症指標として薬物的予防実施群と非実施群でのヘモグロビン値と血小板数を比較した結果、有意な差は認められなかった(P=0.864、P=0.255)。本研究において、理学的・薬物的予防がVTEの発症率を下げることを示唆した。これらの予防効果に関する探索的な推定値を使い、確証的な予防効果を得るための臨床試験を行うことが必要である。(著者抄録)

    researchmap

  • Serum hepcidin-20 is elevated during the acute phase of myocardial infarction. 査読

    Suzuki H, Toba K, Kato K, Ozawa T, Tomosugi N, Higuchi M, Kusuyama T, Iso Y, Kobayashi N, Yokoyama S, Fukuda N, Saitoh H, Akazawa K, Aizawa Y

    The Tohoku journal of experimental medicine   218 ( 2 )   93 - 98   2009年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1620/tjem.218.93

    Web of Science

    PubMed

    researchmap

  • UNC5D, a dependence receptor for netrin-1, is down-regulated in unfavorable neuroblastomas 査読

    Yuyan Zhu, Yuanyuan Li, Miki Ohira, Atsuko Nakagawa, Kohei Akazawa, Meng Yu, Yohko Nakamura, Tadayuki Koda, Patrick Mehlen, Hirofumi Arakawa, Akira Nakagawara

    CANCER RESEARCH   69   2009年5月

     詳細を見る

    記述言語:英語   出版者・発行元:AMER ASSOC CANCER RESEARCH  

    Web of Science

    researchmap

  • GAB2 is not associated with late-onset Alzheimer&apos;s disease in Japanese 査読

    Akinori Miyashita, Hiroyuki Arai, Takashi Asada, Masaki Imagawa, Mikio Shoji, Susumu Higuchi, Katsuya Urakami, Shinichi Toyabe, Kohei Akazawa, Ichiro Kanazawa, Yasuo Ihara, Ryozo Kuwano

    EUROPEAN JOURNAL OF HUMAN GENETICS   17 ( 5 )   682 - 686   2009年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NATURE PUBLISHING GROUP  

    The epsilon 4 allele of the apolipoprotein E gene (APOE) is unequivocally recognized as a genetic risk factor for late-onset Alzheimer&apos;s disease (LOAD). Recently, single-nucleotide polymorphisms (SNPs) of the GRB2-associated binding protein 2 gene (GAB2) were shown to be associated with LOAD in Caucasians carrying the APOE-epsilon 4 allele through a genome-wide association study. Here, we attempted to replicate the finding by genotyping these SNPs in a large clinical cohort of Japanese. We observed no association of any of the SNPs with LOAD. GAB2 may not be a disease susceptibility gene for LOAD in Japanese.

    DOI: 10.1038/ejhg.2008.181

    Web of Science

    PubMed

    researchmap

  • Frontal White Matter Vulnerability to Carbon Monoxide Poisoning Demonstrated by Diffusion Tensor Imaging on 3.0T System 査読

    Kenshi Terajima, Hironaka Igarashi, Yuhei Takado, Koichiro Okamoto, Kohei Akazawa, Masatoyo Nishizawa, Tsutomu Nakada

    NEUROLOGY   72 ( 11 )   A444 - A445   2009年3月

     詳細を見る

    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

    researchmap

  • Programs for calculating the statistical powers of detecting susceptibility genes in case-control studies based on multistage designs 査読

    Nobutaka Kitamura, Kouhei Akazawa, Akinori Miyashita, Ryozo Kuwano, Shin-ichi Toyabe, Junichiro Nakamura, Norihito Nakamura, Tatsuhiko Sato, M. Aminul Hoque

    BIOINFORMATICS   25 ( 2 )   272 - 273   2009年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    Motivation: A two-stage association study is the most commonly used method among multistage designs to efficiently identify disease susceptibility genes. Recently, some SNP studies have utilized more than two stages to detect disease genes. However, there are few available programs for calculating statistical powers and positive predictive values (PPVs) of arbitrary n-stage designs.
    Results: We developed programs for a multistage case-control association study using R language. In our programs, input parameters include numbers of samples and candidate loci, genome-wide false positive rate and proportions of samples and loci to be selected at the k-th stage (k = 1,..., n). The programs output statistical powers, PPVs and numbers of typings in arbitrary n-stage designs. The programs can contribute to prior simulations under various conditions in planning a genome-wide association study.

    DOI: 10.1093/bioinformatics/btn616

    Web of Science

    PubMed

    researchmap

  • [The age of onset of adult-onset asthma is increasing in Japanese women]. 査読

    Tsukioka K, Toyabe S, Kogusuri Y, Akazawa K

    Arerugi = [Allergy]   58 ( 12 )   1599 - 1601   2009年

     詳細を見る

    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Scopus

    PubMed

    researchmap

  • Analysis of inhaled corticosteroid selection in patients with bronchial asthma using a questionnaire survey - Effects of age, gender, and disease severity 査読

    Kyuma Ota, Takashi Hasegawa, Toshiyuki Koya, Takuro Sakagami, Takashi Sekikawa, Shinichi Toyabe, Kohei Akazawa, Masaaki Arakawa, Fumitake Gejyo, Eiichi Suzuki

    Allergology International   58 ( 3 )   365 - 371   2009年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Allergology  

    Background: Inhaled corticosteroid (ICS) has played an important role in the management of asthma. Although several kinds of ICSs are currently available, there is no established strategy for ICS selection. Methods: Using the data from the 2004 questionnaire surveys by the Niigata Asthma Treatment Study Group, we analyzed relationships between each patient and the ICS employed on the basis of patient background, asthma control and treatment, and indicated characteristics of ICS selection by the physician. Results: Of 2852 cases, 2279 (79.9%) were ICS users, and 1513 (66.4% of ICS users) were classified as being in the fluticasone propionate (FP) group, 438 (19.2%) in the budesonide (BUD) group, and 240 (10.5%) in the hydrofluoroalkane-beclometasone (HFA-BDP) group, indicating that FP was a standard ICS in this study. The mean age was significantly lower in the BUD group (52.3+/-18.2 years) and was significantly higher in the HFA-BDP group (59.9+/-17.0 years) than that in the FP group (55.8+/-16.6 yaers). The proportion of female patients was significantly higher not in the HFA-BDP (46.5%) but in the BUD group (59.0%) than in the FP group (51.1%). These results indicated that BUD was frequently prescribed to young female and HFA-BDP was employed in the elderly patients irrespective of gender compared with FP. Conclusions: Our study indicates that ICS selection is reasonably adapted to each patient's background at least in the surveyed area. We need to elucidate the characteristics of ICS selection further in the future as new ICS and devices are developed. ©2009 Japanese Society of Allergology.

    DOI: 10.2332/allergolint.08-OA-0077

    Scopus

    PubMed

    researchmap

  • Influence on the suicide rate two years after a devastating disaster: A report from the 1995 Great Hanshin-Awaji Earthquake 査読

    Akihiro Nishio, Kouhei Akazawa, Futoshi Shibuya, Ryo Abe, Hideyuki Nushida, Yasuhiro Ueno, Akiyoshi Nishimura, Toshiki Shioiri

    PSYCHIATRY AND CLINICAL NEUROSCIENCES   63 ( 2 )   247 - 250   2009年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL PUBLISHING, INC  

    The relationship between suicide and disaster is an important problem but it&apos;s not clear. We conducted this study to determine whether a natural disaster affects suicide rates.
    We collected data on suicides during the 84 months before and the 60 months after the earthquake and compared the suicide rate in Kobe to that in Japan as a whole. We also examined what groups were significantly affected.
    Compared with Japan as a whole, the suicide rates in Kobe significantly decreased in the 2 years after the earthquake.
    An influence on suicide rate after the disaster clearly appeared in middle-aged men.

    DOI: 10.1111/j.1440-1819.2009.01942.x

    Web of Science

    PubMed

    researchmap

  • Expression of TSLC1, a candidate tumor suppressor gene mapped to chromosome 11q23, is downregulated in unfavorable neuroblastoma without promoter hypermethylation 査読

    Kiyohiro Ando, Miki Ohira, Toshinori Ozaki, Atsuko Nakagawa, Kohei Akazawa, Yusuke Suenaga, Yohko Nakamura, Tadayuki Koda, Takehiko Kamijo, Yoshinori Murakami, Akira Nakagawara

    INTERNATIONAL JOURNAL OF CANCER   123 ( 9 )   2087 - 2094   2008年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-LISS  

    Although it has been well documented that loss of human chromosome 11q is frequently observed in primary neuroblastomas, the smallest region of overlap (SRO) has not yet been precisely identified. Previously, we performed array-comparative genomic hybridization (array-CGH) analysis for 236 primary neuroblastomas to search for genomic aberrations with high-resolution. In our study, we have identified the SRO of deletion (10-Mb or less) at 11q23. Within this region, there exists a TSLC1/IGSF4/CADM1 gene (Tumor suppressor in lung cancer I/Immunoglobulin superfamily 4/Cell adhesion molecule 1), which has been identified as a putative tumor suppressor gene for lung and some other cancers. Consistent with previous observations, we have found that 35% of primary neuroblastomas harbor loss of heterozygosity (LOH) on TSLC1 locus. In contrast to other cancers, we could not detect the hypermethylation in its promoter region in primary neuroblastomas as well as neuroblastoma-derived cell lines. The clinicopathological analysis demonstrated that TSLC1 expression levels significantly correlate with stage, Shimada's pathological classification, MYCN amplification status, TrkA expression levels and DNA index in primary neuroblastomas. The immunohistochemical analysis showed that TSLC1 is remarkably reduced in unfavorable neuroblastomas. Furthermore, decreased expression levels of TSLC1 were significantly associated with a poor prognosis in 108 patients with neuroblastoma. Additionally, TSLC1 reduced cell proliferation in human neuroblastoma SH-SY5Y cells. Collectively, our present findings suggest that TSLC1 acts as a candidate tumor suppressor gene for neuroblastoma. (c) 2008 Wiley-Liss, Inc.

    DOI: 10.1002/ijc.23776

    Web of Science

    PubMed

    researchmap

  • Factors impacting on psychological distress and recovery after the 2004 Niigata-Chuetsu earthquake, Japan: Community-based study 査読

    Hideki Kuwabara, Toshiki Shioiri, Shin-Ichi Toyabe, Tsuyoshi Kawamura, Masataka Koizumi, Miki Ito-Sawamura, Kouhei Akazawa, Toshiyuki Someya

    PSYCHIATRY AND CLINICAL NEUROSCIENCES   62 ( 5 )   503 - 507   2008年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Aim: This study was undertaken 5 months after the 2004 Niigata-Chuetsu earthquake in Japan to assess factors that impacted on psychological distress and its recovery.
    Methods: Three thousand and twenty-six adult victims who lived in temporary shelter and in seriously damaged areas were evaluated by questionnaire. The questionnaire queried subject profile, degree of house damage, health status, and psychological distress using a 5-point scale before, immediately and 5 months after the earthquake.
    Results: Immediately after the earthquake, 59.3% of the subjects had psychological distress. At 5 months after the earthquake, however, this percentage decreased to 21.8%. The psychological distress immediately after the earthquake was significantly serious in victims who: (i) were female; (ii) felt stronger fear of the earthquake and the aftershocks; (iii) lived at home or office after the earthquake; and (iv) were injured due to the earthquake or suffered from sickness after the earthquake. In contrast, the factors impairing psychological recovery 5 months after the earthquake were as follows: (i) being with unfamiliar member(s) during the night after the earthquake; (ii) serious house damage; (iii) living in temporary shelter or at a relative&apos;s home after the earthquake; and (iv) physical illness after the earthquake.
    Conclusion: Despite differences between disasters, these results were consistent with those in some previous studies and may be useful for long-term mental care support.

    DOI: 10.1111/j.1440-1819.2008.01842.x

    Web of Science

    PubMed

    researchmap

  • 【CISA study】下肢整形外科術後静脈血栓塞栓症発症予防に関する国立大学病院での実態調査

    寺島 健史, 吉田 保子, 小薬 祐子, 吉井 初美, 赤澤 宏平

    日本血栓止血学会誌   19 ( 5 )   721 - 721   2008年10月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本血栓止血学会  

    researchmap

  • [Importance of clinical research design and statistical check point]. 査読

    Akazawa K

    Nihon Geka Gakkai zasshi   109 Suppl 3   42 - 43   2008年9月

     詳細を見る

  • Appraisal of 1 cm hepatectomy margins for intrahepatic micrometastases in patients with colorectal carcinoma liver metastasis 査読

    Toshifumi Wakai, Yoshio Shirai, Jun Sakata, Vladimir A. Valera, Pavel V. Korita, Kouhei Akazawa, Yoichi Ajioka, Katsuyoshi Hatakeyama

    ANNALS OF SURGICAL ONCOLOGY   15 ( 9 )   2472 - 2481   2008年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Background: This study sought to clarify the distribution of intrahepatic micrometastases and elucidate an adequate hepatectomy margin for colorectal carcinoma liver metastases.
    Methods: Intrahepatic micrometastases in resected specimens from 90 patients who underwent hepatectomy for colorectal carcinoma liver metastases were examined retrospectively. Intrahepatic micrometastases were defined as microscopic lesions spatially separated from the gross tumor. Distances from these lesions to the hepatic tumor borders were measured histologically, and the density of intrahepatic micrometastases (number of lesions/mm(2)) calculated relative to the advancing tumor border in a zone &lt; 1 cm from the border (close) or &gt;= 1 cm away (distant). Median follow-up time was 127 months.
    Results: A total of 294 intrahepatic micrometastases were detected in 52 (58%) patients; 95% of these occurred in the close zone. The density of intrahepatic micrometastases was significantly higher in the close zone (mean 74.8 x 10(-4) lesions/mm(2)) than in the distant zone (mean 7.4 x 10(-4) lesions/mm(2); P &lt; 0.001). Hepatectomy margin status was positive by 0 cm in 10 patients or negative by &lt; 1 cm in 51, and by &gt;= 1 cm in 29 patients. The median survival times were 18, 33, and 89 months in patients with hepatectomy margins 0 cm, &lt; 1 cm, and &gt;= 1 cm, respectively. Hepatectomy margin status independently influenced survival (P &lt; 0.001) and disease-free survival (P &lt; 0.001).
    Conclusion: The currently recommended &gt;= 1 cm hepatectomy margin should remain the goal for resections of colorectal carcinoma liver metastases, based on the distribution of intrahepatic micrometastases and survival risk.

    DOI: 10.1245/s10434-008-0023-y

    Web of Science

    PubMed

    researchmap

  • Accuracy and efficiency of computer-aided nursing diagnosis. 査読

    Kurashima S, Kobayashi K, Toyabe S, Akazawa K

    International journal of nursing terminologies and classifications : the official journal of NANDA International   19 ( 3 )   95 - 101   2008年7月

  • Combined major hepatectomy and pancreaticoduodenectomy for locally advanced biliary carcinoma: Long-term results 査読

    Toshifumi Wakai, Yoshio Shirai, Yoshiaki Tsuchiya, Tatsuya Nomura, Kouhei Akazawa, Katsuyoshi Hatakeyama

    WORLD JOURNAL OF SURGERY   32 ( 6 )   1067 - 1076   2008年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Background This study aimed to define the role of combined major hepatectomy and pancreaticoduodenectomy in the surgical management of biliary carcinoma and to identify potential candidates for this aggressive procedure.
    Methods A retrospective analysis was conducted on 28 patients who underwent a combined major hepatectomy and pancreaticoduodenectomy for extrahepatic cholangiocarcinoma (n = 17) or gallbladder carcinoma (n = 11). Major hepatectomy was defined as hemihepatectomy or more extensive hepatectomy. Altogether, 11 patients underwent a Whipple procedure, and 17 had a pylorus-preserving pancreaticoduodenectomy. The median follow-up time was 169 months.
    Results Morbidity and in-hospital mortality were 82% and 21%, respectively. Overall cumulative survival rates after resection were 32% at 2 years and 11% at 5 years (median survival time 9 months). The median survival time was 6 months with a 2-year survival rate of 0% in 11 patients with residual tumor, whereas the median survival time was 26 months with a 5-year survival rate of 18% in 17 patients with no residual tumor (P = 0.0012). Residual tumor status was the only independent prognostic factor of significance (relative risk 4.65; P = 0.003). There were three 5-year survivors (two with diffuse cholangiocarcinoma and one with gallbladder carcinoma with no bile duct involvement) among the patients with no residual tumor.
    Conclusions Combined major hepatectomy and pancreaticoduodenectomy provides survival benefit for some patients with locally advanced biliary carcinoma only if potentially curative (R0) resection is feasible. Patients with diffuse cholangiocarcinoma and gallbladder carcinoma with no bile duct involvement are potential candidates for this aggressive procedure.

    DOI: 10.1007/s00268-007-9393-8

    Web of Science

    PubMed

    researchmap

  • Cost-effectiveness of the national screening program for hepatitis C virus in the general population and the high-risk groups 査読

    Junichiro Nakamura, Kenshi Terajima, Yutaka Aoyagi, Kouhei Akazawa

    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE   215 ( 1 )   33 - 42   2008年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TOHOKU UNIV MEDICAL PRESS  

    In Japan, the national screening for the hepatitis C virus (HCV) has been started for both the general population and the high-risk groups. Our cost-effectiveness analysis was based on the result of the screening program including 99,001 people among the general population and 42,538 people among the high risk group from 2003 to 2006. The screening was performed using the three steps of the semi-quantitative HCV antibody test, the HCV core antigen test and the HCV-PCR test. A Markov model for HCV infected patients was constructed to estimate the future clinical benefits and the lifetime cost and the cost-effectiveness analysis was performed considering the recent treatment with peginterferon plus ribavirin. In the cost-effectiveness analysis, the cohort, in which the screening was implemented (= screening strategy), was compared with the similar cohort without the screening (= no-screening strategy) in both the general population and the high-risk group, stratified by age. The infection rates of the general population and the high-risk group were 0.36% and 0.81%, respectively. The incremental cost-effectiveness ratio (ICER), a measure of cost-effectiveness, of the general population and the high-risk group was calculated to be from 848 to 4,825 and - 749 to 2,297 $/life expectancy gained, respectively. The treatment effectiveness, transition probabilities and the infection rate varied in the one-way sensitivity analyses, but the superiority of the screening strategy regarding the cost-effectiveness was unchanged. In conclusion, the screening strategy in both the general population and the high-risk group therefore appears to be more cost-effective than a no-screening strategy.

    DOI: 10.1620/tjem.215.33

    Web of Science

    PubMed

    researchmap

  • Sample-size properties of a case-control association analysis of multistage SNP studies for identifying disease susceptibility genes 査読

    Nobutaka Kitamura, Kouhei Akazawa, Shin-ichi Toyabe, Akinori Miyashita, Ryozo Kuwano, Junichiro Nakamura

    JOURNAL OF HUMAN GENETICS   53 ( 5 )   390 - 400   2008年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NATURE PUBLISHING GROUP  

    A two-stage association study is the most commonly used method to efficiently identify disease susceptibility genes. However, some recent single nucleotide polymorphism (SNP) studies recently utilized three-stage designs. The purpose of this study was to investigate the practical properties of statistical powers and positive predictive values (PPVs) of replication-based analysis (RBA) and the joint analysis (JA) in multistage designs. For this purpose, a program for multistage designs was developed to calculate these performance indicators under various conditions of the number of samples, alleles of candidates, alleles remaining in the final stage, and genotypings. The results showed that the powers and PPVs of RBA and JA in three-stage designs were higher than those in two-stage designs in the range of a smaller proportion of sample size than 0.5 at the first stage. This tendency was more remarkable in JA. In conclusion, researchers who perform SNP studies for identifying disease susceptibility genes need to take account of three-stage case-control association studies, corresponding to study conditions such as the total numbers of samples, alleles, and genotypings. Furthermore, the program developed in this study is useful for estimating powers and PPVs in planning multistage association studies.

    DOI: 10.1007/s10038-008-0258-2

    Web of Science

    PubMed

    researchmap

  • Effectiveness of screening for neuroblastoma at 6 months of age: a retrospective population-based cohort study. 査読

    Hiyama E, Iehara T, Sugimoto T, Fukuzawa M, Hayashi Y, Sasaki F, Sugiyama M, Kondo S, Yoneda A, Yamaoka H, Tajiri T, Akazawa K, Ohtaki M

    Lancet (London, England)   371 ( 9619 )   1173 - 1180   2008年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/S0140-6736(08)60523-1

    Web of Science

    PubMed

    researchmap

  • Prediction of Disease-associated Single Nucleotide Polymorphisms Using Virtual Genomes Constructed from a Public Haplotype Database 査読

    S. Toyabe, A. Miyashita, N. Kitamura, R. Kuwano, K. Akazowa

    METHODS OF INFORMATION IN MEDICINE   47 ( 6 )   522 - 528   2008年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN  

    Objectives: Simultaneous dealing of hundreds of thousands of single nucleotide polymorphisms (SNPs) in genome-wide association studies is laborious. The aim of our study is to develop a method to decrease the number of candidate SNPs prior to the genotyping of study subjects.
    Methods. We created virtual genotype data on case and control subjects from data of the International HapMap Project by using haplotype-based simulation method. We repeated virtual case-control association studies and selected candidate SNPs. We applied the selected SNPs to previously published genetic case-control studies. Sensitivity to detect association with causative genes using our method was compared to the original studies and results using tag SNPs.
    Results. We found a discrete distribution pattern of SNPs, which was able to produce significant results in case-control association studies. The number of candidate SNPs that we selected was 24.7% of the number of the original set of SNPs, We applied this method to previously published genetic case-control studies and found that the use of candidate SNPs improved the sensitivity for detecting significant alleles, both compared to the original studies and to the use of tag SNPs. The results were not affected by the difference of the diseases and genes involved.
    Conclusions. Our simulation-based approach has advantages of reducing costs and improving performance to detect significant alleles. This method can be used without considering the specific disease and genes involved.

    DOI: 10.3414/ME9129

    Web of Science

    PubMed

    researchmap

  • A new scoring system for predicting survival in patients with hepatocellular carcinoma: The integration of the JIS and CLIP scoring systems. 査読

    Kuriko K, Suda T, Igarashi M, Toyabe S, Aoyagi Y, Akazawa K

    Acta medica et biologica   56 ( 2 )   73 - 84   2008年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    researchmap

  • Genetic association of CTNNA3 with late-onset Alzheimer's disease in females. 査読 国際誌

    Akinori Miyashita, Hiroyuki Arai, Takashi Asada, Masaki Imagawa, Etsuro Matsubara, Mikio Shoji, Susumu Higuchi, Katsuya Urakami, Akiyoshi Kakita, Hitoshi Takahashi, Shinichi Toyabe, Kohei Akazawa, Ichiro Kanazawa, Yasuo Ihara, Ryozo Kuwano

    Human molecular genetics   16 ( 23 )   2854 - 69   2007年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Alzheimer's disease (AD), the most common form of dementia in the elderly, was found to exhibit a trend toward a higher risk in females than in males through epidemiological studies. Therefore, we hypothesized that gender-related genetic risks could exist. To reveal the ones for late-onset AD (LOAD), we extended our previous genetic work on chromosome 10q (genomic region, 60-107 Mb), and single nucleotide polymorphism (SNP)-based genetic association analyses were performed on the same chromosomal region, where the existence of genetic risk factors for plasma Abeta42 elevation in LOAD was implied on a linkage analysis. Two-step screening of 1140 SNPs was carried out using a total of 1408 subjects with the APOE-epsilon3*3 genotype: we first genotyped an exploratory sample set (LOAD, 363; control, 337), and then genotyped some associated SNPs in a validation sample set (LOAD, 336; control, 372). Seven SNPs, spanning about 38 kb, in intron 9 of CTNNA3 were found to show multiple-hit association with LOAD in females, and exhibited more significant association on Mantel-Haenszel test (allelic P-values(MH-F) = 0.000005945-0.0007658). Multiple logistic regression analysis of a total of 2762 subjects (LOAD, 1313; controls, 1449) demonstrated that one of the seven SNPs directly interacted with the female gender, but not with the male gender. Furthermore, we found that this SNP exhibited no interaction with the APOE-epsilon4 allele. Our data suggest that CTNNA3 may affect LOAD through a female-specific mechanism independent of the APOE-epsilon4 allele.

    DOI: 10.1093/hmg/ddm244

    PubMed

    researchmap

  • 外来看護師の適正人員配置に関する定量的評価

    小薬 祐子, 吉田 保子, 中村 潤一郎, 鳥谷部 真一, 赤澤 宏平

    医療情報学連合大会論文集   27回   733 - 735   2007年11月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本医療情報学会  

    researchmap

  • Screening at 6 months of age reduced neuroblastoma incidence and mortality at elder age: Population based cohort study in Japan 査読

    Eiso Hiyama, Toru Sugimoto, Yutaka Hayashi, Masahiko Fukuzawa, Fumiaki Sasaki, Masahiko Sugiyama, Satoshi Kondo, Akihiro Yoneda, Tatsuro Tajiri, Hiroaki Yamaoka, Lehara Tomoko, Kohei Akazawa, Megu Ohtaki

    PEDIATRIC BLOOD & CANCER   49 ( 4 )   418 - 418   2007年10月

     詳細を見る

    記述言語:英語   出版者・発行元:WILEY-LISS  

    Web of Science

    researchmap

  • Comparison of the levels of accuracy of an artificial neural network model and a logistic regression model for the diagnosis of acute appendicitis 査読

    Shinya Sakai, Kuriko Kobayashi, Shin-ichi Toyabe, Nozomu Mandai, Tatsuo Kanda, Kohei Akazawa

    JOURNAL OF MEDICAL SYSTEMS   31 ( 5 )   357 - 364   2007年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    An accurate diagnosis of acute appendicitis in the early stage is often difficult, and decision support tools to improve such a diagnosis might be required. This study compared the levels of accuracy of artificial neural network models and logistic regression models for the diagnosis of acute appendicitis. Data from 169 patients presenting with acute abdomen were used for the analyses. Nine variables were used for the evaluation of the accuracy of the two models. The constructed models were validated by the ".632+ bootstrap method". The levels of accuracy of the two models for diagnosis were compared by error rate and areas under receiver operating characteristic curves. The artificial neural network models provided more accurate results than did the logistic regression models for both indices, especially when categorical variables or normalized variables were used. The most accurate diagnosis was obtained by the artificial neural network model using normalized variables.

    DOI: 10.1007/s10916-007-9077-9

    Web of Science

    PubMed

    researchmap

  • The cost-effectiveness of the new protocol reflecting rapid virologic response to peginterferon alpha-2b and ribavirin for chronic hepatitis C 査読

    Junichiro Nakamura, Kuriko Kobayashi, Shin-ichi Toyabe, Yutaka Aoyagi, Kouhei Akazawa

    EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY   19 ( 9 )   733 - 739   2007年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Objective Recent studies have reported the effectiveness of shorter courses of treatment with peginterferon alpha-2b plus ribavirin for patients with chronic hepatitis C, who achieved a rapid virologic response (RVR), defined as undetectable hepatitis C virus (HCV-) RNA at week 4. The aim of this study was to evaluate the cost-effectiveness of the new protocol for treatment, from the perspective of RVR.
    Methods A cost-effectiveness analysis based on the rate of sustained virologic response was performed. A Markov cohort model of hepatitis C was constructed to demonstrate the clinical states on the basis of the assigned transition probabilities over 30 years. The treatment strategies were classified into five subgroups taking into consideration the viral genotypes, viral load, and RVR. The lifetime costs and quality-adjusted life years (QALYs) were compared between the new and standard protocols for treatment.
    Results Genotype 1-infected patients in the new protocol for treatment compared with the standard one could prolong OALYs by 0.33 and reduce lifetime cost by (sic) 5993. Genotype 2 or 3-infected patients in the new protocol for treatment compared with the standard one could prolong QALYs by 0.02 and reduce lifetime cost by (sic)2851.
    Conclusion Treatment strategies that consider viral load and RVR for patients with a low viral load infected with genotype 1 and those infected with genotype 2 or 3 are more cost-effective compared with the standard protocol for treatment.

    DOI: 10.1097/MEG.0b013e3282748f1f

    Web of Science

    PubMed

    researchmap

  • Mortality predictors after 10 years of dialysis: A prospective study of Japanese hemodialysis patients 査読

    Junya Ajiro, Bassam Alchi, Ichiei Narita, Kentaro Omori, Daisuke Kondo, Minoru Sakatsume, Junichiro J. Kazama, Kohei Akazawa, Fumitake Gejyo

    Clinical Journal of the American Society of Nephrology   2 ( 4 )   653 - 660   2007年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: This work aimed to examine the predictive value for death of various clinical variables after long-term hemodialysis (HD). Design, s etting, participants, and measurements: A total of 947 patients (597 men and 350 women, aged 21 to 93 yr) who were undergoing maintenance HD in Niigata, Japan, were stratified into two cohorts: Those with &gt
    10 yr of prior HD at study enrollment (n = 391) and those with ≤10 yr of previous therapy (n = 556). The survival of patients was examined for up to 40 mo (1999 to 2003) with the Cox proportional hazards model. Baseline clinical and dialysis data and serum biochemistries were used as independent variables. For adjustment for bias in patient selection, patient survival in either cohort was analyzed separately. Results: In patients with &gt
    10 yr of HD, high pulse pressure, cerebrovascular disease, low serum creatinine, and low Kt/V values were the mortality risk predictors, whereas for those with ≤10 yr of HD, age and cerebrovascular disease were independent risk predictors for death. Diabetes, coronary artery disease, serum albumin, and C-reactive protein were NS predictors in those with long-term HD. Conclusions: Providing a dequate dosage of dialysis and achieving a better control of pulse pressure may further improve survival in selected patients who had undergone HD for &gt
    10 yr. Copyright © 2007 by the American Society of Nephrology.

    DOI: 10.2215/CJN.03160906

    Web of Science

    Scopus

    PubMed

    researchmap

  • Factor structure of the General Health Questionnaire (GHQ-12) in subjects who had suffered from the 2004 Niigata-Chuetsu earthquake in Japan: a community-based study 査読

    Shin-ichi Toyabe, Toshiki Shioiri, Kuriko Kobayashi, Hideki Kuwabara, Masataka Koizumi, Taro Endo, Miki Ito, Hiroko Honma, Noboru Fukushima, Toshiyuki Someya, Kouhei Akazawa

    BMC PUBLIC HEALTH   7   175   2007年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: Factor structure of the 12-item General Health Questionnaire (GHQ- 12) was studied by a survey of subjects who had experienced the 2004 Niigata-Chuetsu earthquake (6.8 on the Richter scale) in Japan.
    Methods: Psychological distress was measured at two years after the earthquake by using GHQ-12 in 2,107 subjects (99.0% response rate) who suffered the earthquake. GHQ-12 was scored by binary, chronic and Likert scoring method. Confirmatory factor analysis was used to reveal the factor structure of GHQ-12. Categorical regression analysis was performed to evaluate the relationships between various background factors and GHQ-12 scores.
    Results: Confirmatory factor analysis revealed that the model consisting of the two factors and using chronic method gave the best goodness-of-fit among the various models for factor structure. Recovery in the scale for the factor 'social dysfunction' was remarkably impaired compared with that of the factor 'dysphoria'. Categorical regression analysis revealed that various factors, including advanced age, were associated with psychological distress. Advanced age affected the impaired recovery of factor 'social dysfunction' score as well as total GHQ score.
    Conclusion: The two-factor structure of GHQ-12 was conserved between the survey at five month and that at two years after the earthquake. Impaired recovery in the ability to cope with daily problems in the subjects who had experienced the earthquake was remarkable even at two years after the earthquake.

    DOI: 10.1186/1471-2458-7-175

    Web of Science

    PubMed

    researchmap

  • 電子カルテへの「プロブレムリストエディタ」導入と使用状況

    吉田 保子, 鳥谷部 真一, 佐々木 智子, 赤澤 宏平

    診療録管理   19 ( 1 )   50 - 56   2007年5月

     詳細を見る

    記述言語:日本語   出版者・発行元:日本診療情報管理学会  

    病院情報システム更新と同時にプロブレムリストエディタを導入した。導入直後から、必要な病名が病名オーダから登録されていないという事例が多数発生した。そのため、プロブレムリストエディタの作動を止め、病院情報システム上では単なるSOAPに分けた診療録に記載を行っていた。この度、問題志向型診療録に特化したシステムとして修正して、導入し直した。以前の紙媒体での運用時の診療録記載方法を分析し検討を行った。職種や診療科によって記載方法に差異があった。また、いずれもプロブレムリストエディタの使用率が低かった。

    researchmap

  • Evaluation of magnetic resonance imaging-based prostate-specific antigen density of the prostate in the diagnosis of prostate cancer 査読

    Tatsuhiko Hoshii, Tsutomu Nishiyama, Shinichi Toyabe, Kohei Akazawa, Shuichi Komatsu, Masaaki Kaneko, Noboru Hara, Kota Takahashi

    INTERNATIONAL JOURNAL OF UROLOGY   14 ( 4 )   305 - 310   2007年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BLACKWELL PUBLISHING  

    Objectives: We evaluated prostate-specific antigen (PSA) density of the prostatic volume (PSAD) estimated using transrectal ultrasonography (TRUS; TRUS-based PSAD), magnetic resonance imaging (MRI; MRI-based PSAD), and PSA density of the transition zone (TZ) volume (PSATZD) estimated using MRI (MRI-based PSATZD) in the diagnosis of prostate cancer (PCa).
    Methods: One hundred and twenty patients, who were suspected to have PCa based on PSA, ranged between 4.1 and 20.0 ng/mL were enrolled in this study.
    Results: The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI by 11.4% in the patients with PSA levels ranging 4.1-20.0 ng/mL, 7.2% in those 4.1-10.0 ng/mL, and 15.7% in those 10.1-20.0 ng/mL, respectively. PSA levels were correlated with the prostatic volume estimated using TRUS and MRI, and TZ volume estimated using MRI in the patients without PCa; however, the level was not correlated with them in the patients with PCa. The area under the receiver operating characteristic curve of MRI-based PSAD was higher than that of TRUS-based PSAD; however, there was no statistical difference. Stepwise logistic regression analysis for the prediction of PCa by using PSA-related parameters confirmed that MRI-based PSATZD was the most significant predictor in patients with PSA levels in the range of 4.1-20.0 ng/mL (P &lt; 0.001), the range of 4.1-10.0 ng/mL (P=0.002), and the range of 10.1-20.0 ng/mL (P &lt; 0.001), respectively.
    Conclusions: The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI. MRI-based PSATZD is the most significant predictor in the four parameters.

    DOI: 10.1111/j.1442-2042.2007.01686.x

    Web of Science

    PubMed

    researchmap

  • Anatomic resection independently improves long-term survival in patients with T1-T2 hepatocellular carcinoma 査読

    Toshifumi Wakai, Yoshio Shirai, Jun Sakata, Kazuhiro Kaneko, Pauldion V. Cruz, Kouhei Akazawa, Katsuyoshi Hatakeyama

    ANNALS OF SURGICAL ONCOLOGY   14 ( 4 )   1356 - 1365   2007年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Background: This study aimed to evaluate the effect of anatomic resection on long-term outcomes in patients with pathologic T1-T2 (pT1-T2) hepatocellular carcinoma.
    Methods: A retrospective analysis of 158 consecutive patients who underwent either anatomic (n = 95) or nonanatomic (n = 63) resection for pT1-T2 hepatocellular carcinoma was conducted. Anatomic resection was defined as the complete removal of at least one Couinaud segment containing the tumor; nonanatomic resection was defined as removal of the tumor plus a rim of nonneoplastic liver parenchyma. The median follow-up time was 83 months.
    Results: Patients who underwent anatomic resection were characterized by lower prevalence of cirrhosis (P = .015), more favorable hepatic function (P = .001), larger tumor size (P = .029), and higher prevalence of vascular invasion (P = .008) compared with patients who underwent nonanatomic resection. Anatomic resection provided better survival (median survival time, 122 months) than nonanatomic resection (median survival time, 76 months; P = .0358). Patients who underwent anatomic resection had better disease-free survival (P = .0121). Anatomic resection independently improved both survival (hazard ratio, .46; P = .003) and disease-free survival (hazard ratio, .55; P = .008). When stratified for pT classification, the effectiveness of anatomic resection remained only in patients with pT2 tumors in terms of survival (P = .0012) and disease-free survival (P = .0004).
    Conclusions: Anatomic resection independently improves long-term survival in patients with T1-T2 hepatocellular carcinoma, probably because of the clearance of venous tumor thrombi within the resected domain.

    DOI: 10.1245/s10434-006-9318-z

    Web of Science

    PubMed

    researchmap

  • Second-order interactions with the treatment groups in controlled clinical trials 査読

    Shyang-Yun Pamela K. Shiao, Chul W. Ahn, Kouhei Akazawa

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   86 ( 1 )   10 - 16   2007年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER IRELAND LTD  

    The occurrence of significant second-order interactions for group characteristics was examined using real data in a randomized controlled trial (RCT). The interactions exist in all RCTs; they could be easily overlooked when using the simple randomization or stratification methods, but could become more obvious when minimization methods are used. Using real data from an RCT, the minimization method enabled balancing the distributions of the four selected stratified factors. Analyses for three-way second-order interactions including six additional potential confounding variables (for a total of 10 variables) presented 8 significant second-order interactions with the treatment groups. Interaction effects need to be evaluated when treatment effects are examined to maximize the power of the treatment effects in any RCTs. A stepwise regression method with piecewise linear functions would be useful to select the significant variables with interaction effects affecting the treatment outcomes in RCTs. Additional ways to handle interaction effects in RCTs are presented in this paper. (c) 2007 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/j.cmpb.2006.12.004

    Web of Science

    PubMed

    researchmap

  • Number of positive lymph nodes independently affects long-term survival after resection in patients with ampullary carcinoma 査読

    J. Sakata, Y. Shirai, T. Wakai, N. Yokoyama, E. Sakata, K. Akazawa, K. Hatakeyama

    EJSO   33 ( 3 )   346 - 351   2007年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI LTD  

    Aim: The nodal status is an established prognostic factor in ampullary carcinoma. The aim of this study was to compare the prognostic power of the anatomic location of positive nodes with that of the number of positive nodes.
    Methods: Of 73 consecutive patients treated for ampullary carcinoma, 62 underwent pancreaticoduodenectomy with regional lymphadenectomy. A survival analysis of these 62 patients by nodal status was conducted retrospectively. A total of 1942 lymph nodes taken from the patients were examined histologically for metastasis. The location of positive regional nodes was classified into 4 categories, according to the Japanese staging system. The number of positive regional nodes was recorded for each patient. The median follow-up period was 124 months.
    Results: Nodal disease was found in 31 patients, of whom 23 had 1-3 positive regional nodes and 8 had &gt;= 4 positive regional nodes. Univariate analysis revealed that both the location (p &lt; 0.0001) and the number (p &lt; 0.0001) of positive nodes were significant prognostic factors. Multivariate analysis revealed that the number of positive nodes was an independent prognostic factor (p = 0.007), while the location failed to remain as an independent variable. The median survival time was 59 months with a 5-year survival rate of 48% in patients with 1-3 positive nodes, whereas all patients with &gt;= 4 positive nodes died of the disease within 29 months of resection (p = 0.0001).
    Conclusion: The number, not the location, of positive regional lymph nodes independently affects long-term survival after resection in patients with ampullary carcinoma. (c) 2006 Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.ejso.2006.10.008

    Web of Science

    researchmap

  • Parental mental health affects behavioral changes in children following a devastating disaster: a community survey after the 2004 Niigata-Chuetsu earthquake 査読

    Taro Endo, Toshiki Shioiri, Toshiyuki Someya, Shinichi Toyabe, Kohei Akazawa

    GENERAL HOSPITAL PSYCHIATRY   29 ( 2 )   175 - 176   2007年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    DOI: 10.1016/j.genhosppsych.2006.09.006

    Web of Science

    PubMed

    researchmap

  • Mental development of infants with congenital hypothyroidism: A longitudinal study 査読

    Makiko Nakamizo, Shin-ichi Toyabe, Tadashi Asami, Kouhei Akazawa

    CLINICAL PEDIATRICS   46 ( 1 )   53 - 58   2007年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SAGE PUBLICATIONS INC  

    The purpose of this study was to assess the relationship between the clinical findings before starting treatment and the development quotient in children treated for congenital hypothyroidism. Patients with congenital hypothroidism (n = 129) were divided into favorable and unfavorable groups according to intellectual performance. Children with congenital hypothyroidism generally have a similar intellectual outcome to that of healthy children. However, a low birth weight, the presence of complications, and a high serum thyroid-stimulating hormone value are the risk factors for unfavorable cases, who consistently have a development quotient score of less than 100.

    DOI: 10.1177/000992280689326

    Web of Science

    PubMed

    researchmap

  • Accuracy in the diagnostic prediction of acute appendicitis based on the Bayesian network model 査読

    S. Sakai, K. Kobayashi, J. Nakamura, S. Toyabe, K. Akazawa

    METHODS OF INFORMATION IN MEDICINE   46 ( 6 )   723 - 726   2007年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN  

    Objectives: The diagnosis of acute appendicitis is difficult, and a diagnostic error will often lead to either a perforation or the removal of a normal appendix. In this study, we constructed a Bayesian network model for the diagnosis of acute appendicitis and compared the diagnostic accuracy with other diagnostic models, such as the naive Bayes model, an artificial neural network model, and a logistic regression model.
    Methods: The data from 169 patients, who suffered from acute abdominal pain and who were suspected of having an acute appendicitis, were analyzed in this study. Nine variables were used for the evaluation of the accuracy of the four models for the diagnosis of an acute appendicitis. The naive Bayes model, the Bayesian network model, an artificial neural network model, and a logistic regression model were used in this study for the diagnosis of acute appendicitis. These four models were validated by using the ".632 + bootstrap method" for resampling. The levels of accuracy of the four models for diagnosis were compared by the error rates and by the areas under the receiver operating characteristic curves.
    Results: Through the course of illness, 50.9% (86 of 169) of the patients were diagnosed as having an acute appendicitis. The error rate was the lowest in the Bayesian network model, as compared with the other diagnostic models. The area under the receiver operating characteristic curve analysis also showed that the Bayesian network model provided the most reliable results.
    Conclusion: The Bayesian network model provided the most accurate results in comparison to other models for the diagnosis of acute appendicitis.

    DOI: 10.3414/ME9066

    Web of Science

    PubMed

    researchmap

  • Analysis of perimenstrual asthma based on questionnaire surveys in Japan 査読

    Kazuo Suzuki, Takashi Hasegawa, Takuro Sakagami, Toshiyuki Koya, Shinichi Toyabe, Kohei Akazawa, Masaaki Arakawa, Fumitake Gejyo, Eiichi Suzuki

    Allergology International   56 ( 3 )   249 - 255   2007年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Allergology  

    Background: Perimenstrual asthma (PMA) has been documented in 30% to 40% of asthmatic women
    the characteristics of PMA have also been well described. However, there have been few epidemiological investigations of PMA in practice. In this study, we analyzed PMA based on a questionnaire survey carried out in Japan and compared the results with those of studies reported previously. Methods: For 8 weeks from September through October 2004, a questionnaire survey was administered to patients with bronchial asthma and their attending physicians. The questionnaire surveyed asthma control, asthma-related emergencies and satisfaction in daily life. The attending physicians were questioned about patient profiles and medications. All female patients who were menstruating during the survey period and who were known to have asthma exacerbation related to menstruation were allocated to the PMA group
    those who were not were allocated to the non-PMA group. Results: The rate of PMA in female patients who were menstruating during the survey period was 11.3% in this study. Characteristic features of the PMA group (n = 54) included more severe disease, worsened disease control and more aggressive patient management, including increased oral corticosteroid use compared with the non-PMA group. The rates of emergency episodes in the PMA group were higher than in the non-PMA group. There was a significant increase in aspirin intolerant asthma (AIA, 25.5%) in the PMA group compared with the non-PMA group (8.4%). Conclusions: Attention should be paid to the lack of knowledge regarding PMA in patients with asthma in actual clinical settings. The low rate of PMA reported in this study may be due to the study method using self-reports of PMA by patients without sufficient knowledge, and may not be an accurate representation of the actual incidence of the disease. The clinical similarity of PMA to AIA in this study may also provide a new insight into the mechanism of PMA. ©2007 Japanese Society of Allergology.

    DOI: 10.2332/allergolint.O-06-475

    Scopus

    PubMed

    researchmap

  • Distance Education Issue and Challenges Telemedicine and Distance Education in The Medical Field in Japan

    Kouhei Akazawa, Motoki Kaidu

    Nova Science Publisher, Inc.   2007年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(大学,研究機関等紀要)   出版者・発行元:Nova Science Publisher, Inc.  

    researchmap

  • A modified method of activity based costing for objectively reducing cost drivers in hospitals 査読

    Cao P, Toyabe S, Kurashima S, Okada M, Akazawa K

    Methods of Information in Medicine   45 ( 4 )   462 - 469   2006年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    researchmap

  • Impact of Sociocultural Factors on Hospital Length of Stay in Children with Nephrotic Syndrome in Japan 査読

    Toyabe S, Cao P, Abe T, Uchiyama M, Akazawa K

    Health Policy   76 ( 3 )   259 - 265   2006年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.healthpol.2005.06.008

    researchmap

  • DPC関連情報と地理情報システム(GIS)を活用した逆紹介状況の解析 査読

    鳥谷部真一, 小林久里子, 酒井伸也, 赤澤宏平

    医療情報学   26 ( 1 )   41 - 46   2006年12月

     詳細を見る

    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.14948/jami.26.41

    researchmap

  • 病院情報システムの導入による病院経費の変動 査読

    阿部寿和, 鳥谷部真一, 須藤道子, 佐々木智子, 赤澤宏平

    診療録管理   17 ( 3 )   33 - 38   2006年12月

     詳細を見る

    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    researchmap

  • Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan: a population-based study 査読

    Shin-ichi Toyabe, Toshiki Shioiri, Hideki Kuwabara, Taroh Endoh, Naohito Tanabe, Toshiyuki Someya, Kouhei Akazawa

    BMC PUBLIC HEALTH   6   230   2006年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 5.56 P. M. on the 23rd of October, 2004. The earthquake was followed by sustained occurrence of numerous aftershocks, which delayed reconstruction of community lifelines. Even one year after the earthquake, 9,160 people were living in temporary housing. Such a devastating earthquake and life after the earthquake in an unfamiliar environment should cause psychological distress, especially among the elderly.
    Methods: Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12) in 2,083 subjects (69% response rate) who were living in transient housing five months after the earthquake. GHQ-12 was scored using the original method, Likert scoring and corrected method. The subjects were asked to assess their psychological status before the earthquake, their psychological status at the most stressful time after the earthquake and their psychological status at five months after the earthquake. Exploratory and confirmatory factor analysis was used to reveal the factor structure of GHQ12. Multiple regression analysis was performed to analyze the relationship between various background factors and GHQ-12 score and its subscale.
    Results: GHQ-12 scores were significantly elevated at the most stressful time and they were significantly high even at five months after the earthquake. Factor analysis revealed that a model consisting of two factors ( social dysfunction and dysphoria) using corrected GHQ scoring showed a high level of goodness-of-fit. Multiple regression analysis revealed that age of subjects affected GHQ-12 scores. GHQ-12 score as well as its factor 'social dysfunction' scale were increased with increasing age of subjects at five months after the earthquake.
    Conclusion: Impaired psychological recovery was observed even at five months after the Niigata-Chuetsu Earthquake in the elderly. The elderly were more affected by matters relating to coping with daily problems.

    DOI: 10.1186/1471-2458-6-230

    Web of Science

    PubMed

    researchmap

  • Differences in characteristics between suicide victims who left notes or not 査読

    Hideki Kuwabara, Toshiki Shioiri, Akiyoshi Nishimura, Ryo Abe, Hideyuki Nushida, Yasuhiro Ueno, Kohel Akazawa, Toshiyuki Someya

    JOURNAL OF AFFECTIVE DISORDERS   94 ( 1-3 )   145 - 149   2006年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE BV  

    Background: Suicide notes (SN) are one of markers of the severity of a suicide attempt and are said to provide a valuable insight into the thinking of suicide victims before the fatal act [Shah, A., De, T., 1998. Suicide and the elderly. Int. J. Psychiat. Clin Pract. 2, 3-18]. To examine whether suicide victims who wrote notes (note writers: NW) differ from those who did not, we investigated the characteristics of a sample of more than 5000 Japanese suicides using multiple logistic regression analysis.
    Methods: For all suicide victims (5161 cases), we examined the following information: gender, age, suicide method, reason for suicide, marital status, residential status, history of psychiatric disorders, previous suicidal behavior, physical disease, and content of suicide notes.
    Results: Mean incidence of NW was 30.1% (male: 29.7%, female: 30.8%). NW in Japan had the following characteristics; higher proportion in female and living alone, suicide by more lethal methods such as carbon monoxide, hanging or sharp instruments. On the other hand, non-NW had tendencies to commit suicide for reasons of physical illness and psychiatric disorder, and/or history of previous psychiatric disorders.
    Limitations: This study is observational and discusses only completed, not attempted, suicide. Medical and psychiatric comorbidity are judged only by the history of diagnosis and the information about the problems in relationships is based not on valid criteria for inclusion.
    Conclusions: Although these findings show ethnic differences, it is possible that SN may be considered an indicator of a serious suicide attempt. Further studies of SN are needed to confirm this. (c) 2006 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.jad.2006.03.023

    Web of Science

    PubMed

    researchmap

  • Dynamin-binding protein gene on chromosome 10q is associated with late-onset Alzheimer's disease 査読

    R Kuwano, A Miyashita, H Arai, T Asada, M Imagawa, M Shoji, S Higuchi, K Urakami, A Kakita, H Takahashi, T Tsukie, S Toyabe, K Akazawa, Kanazawa, I, Y Ihara

    HUMAN MOLECULAR GENETICS   15 ( 13 )   2170 - 2182   2006年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    The apolipoprotein E (APOE) gene has been consistently shown to be a major genetic risk factor; however, all cases of Alzheimer's disease (AD) cannot be attributed to the epsilon 4 variant of APOE, because about half of AD patients have the APOE-epsilon 3*3 genotype. To identify an additional genetic risk factor(s), we performed large-scale single nucleotide polymorphism (SNP)-based association analysis of 1526 late-onset AD patients and 1666 control subjects in a Japanese population. We prepared two independent sets consisting of exploratory and validation samples, respectively, with only the APOE-epsilon 3*3 genotype, and first carried out genotyping for the exploratory set with 1206 SNPs in the region between 60 and 107 Mb on chromosome 10q that is implicated by linkage studies as containing an AD susceptibility locus. Thirty-five SNPs that showed significant values (P &lt; 0.01) were followed-up to detect any association with the validation samples. Finally, six SNPs exhibited replicated significant associations (P=0.000035-0.00048) on meta-analysis of both sets. These SNPs were clustered in a locus spanning 220 kb at genomic position 101 Mb, and three of the six SNPs were located in the dynamin-binding protein (DNMBP) gene. Quantitative real-time RT-PCR analysis demonstrated that neuropathologically confirmed AD brains exhibit a significant reduction of DNMBP mRNA compared with age-matched ones (P &lt; 0.0169). Thus, we confirmed the association of DNMBP with AD individuals with the APOE-epsilon 3*3 genotype or lacking the epsilon 4 allele, and DNMBP may be one of the susceptibility genes for AD.

    DOI: 10.1093/hmg/ddl142

    Web of Science

    PubMed

    researchmap

  • MYCN gene amplification is a powerful prognostic factor even in infantile neuroblastoma detected by mass screening 査読

    Iehara, T, Hosoi, H, Akazawa, K, Matsumoto, Y, Yamamoto, K, Suita, S, Tajiri, T, Kusafuka, T, Hiyama, E, Kaneko, M

    BRITISH JOURNAL OF CANCER   94 ( 10 )   1510 - 1515   2006年5月

     詳細を見る

    掲載種別:研究論文(学術雑誌)   出版者・発行元:NATURE PUBLISHING GROUP  

    MYCN is the most powerful prognostic factor in cases of older children. However, how MYCN is related to the prognosis of infantile cases is not clear. A mass screening program was carried out by measuring urinary catecholamine metabolites (VMA and HVA) from 6-month-old infants. Of 2084 cases detected by the screening program, MYCN amplification (MNA) was examined by Southern blot analyses in 1533 cases from 1987 to 2000. Of the 1533 cases examined, 1500 (97.8%) showed no MNA, 20 cases (1.3%) showed MNA from three to nine copies, and 13 (0.8%) cases showed more than 10 copies. The 4-year overall survival rates of these three groups (99, 89 and 53%, respectively) were significantly different (P &lt; 0.001), indicating that MYCN copy number correlates with the prognosis. Cases with MNA more than 10 copies were more advanced than those without amplification (stage III, IV vs I, II, IVs; P &lt; 0.001). Patients with MNA more than 10 copies had significantly higher serum levels of neuron-specific-enolase (NSE) and ferritin than non-amplified patients (P = 0.049, P = 0.025, respectively). MYCN amplification was strongly correlated with a poor prognosis in infantile neuroblastoma cases. Therefor

    DOI: 10.1038/sj.bjc.6603149

    researchmap

  • Squamous cell carcinoma-antigen messenger RNA level in peripheral blood predicts recurrence after resection in patients with esophageal squamous cell carcinoma 査読

    H Honma, T Kanda, H Ito, T Wakai, S Nakagawa, M Ohashi, Y Koyama, VA Valera, K Akazawa, K Hatakeyama

    SURGERY   139 ( 5 )   678 - 685   2006年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:MOSBY, INC  

    Background. The aim of this study was to clarify whether preoperative squamous cell carcinoma-antigen messenger RNA (SCC-Ag mRNA) level in peripheral blood can be used to predict tumor recurrence after curative resection for esophageal squamous cell carcinoma.
    Methods. A prospective analysis was conducted for 46 consecutive patients who underwent curative esophagectomy and who had no residual tumor. The SCC-Ag mRNA level in the peripheral blood of each patient was measured preoperatively by using quantitative reverse transcriptase-polymerase chain reaction. Median follow-up period was 34 months.
    Results. Receiver operating characteristic analysis demonstrated that the optimal cutoff level of SCC-Ag mRNA was 40. Patients were divided into the high SCC-Ag mRNA level group (n = 14) and the low SCC-Ag mRNA level group (n = 32). The cumulative probabilities of tumor recurrence were higher in the high SCC-Ag mRNA level group (probability of recurrence was 71% at 2 years) than in the low group (22% at 2 years; P = .0005). SCC-Ag mRNA level (relative risk, 3.00; 95% confidence interval, 1.05-8.54; P = .040) was the strongest independent predictor of recurrence by multivariate analysis.
    Conclusions. Preoperative SCC-Ag mRNA levels in the peripheral blood are the best predictive factor for recurrence in patients with esophageal squamous cell carcinoma who undergo curative resection (R0).

    DOI: 10.1016/j.surg.2005.09.022

    Web of Science

    PubMed

    researchmap

  • Etiology and prognostic significance of severe uremic pruritus in chronic hemodialysis patients 査読

    I. Narita, B. Alchi, K. Omori, F. Sato, J. Ajiro, D. Saga, D. Kondo, M. Skatsume, S. Maruyama, J. J. Kazama, K. Akazawa, F. Gejyo

    Kidney International   69 ( 9 )   1626 - 1632   2006年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Although uremia is well known as the most common cause of pruritus, the mechanisms of pruritus in chronic hemodialysis patients remain unclear. The purpose was to characterize uremic pruritus in more detail and to investigate whether severe pruritus is a marker for poor prognosis. A total of 1773 adult hemodialysis patients were studied. A questionnaire was given to each patient to assess the intensity and frequency, as well as pruritus-related sleep disturbance. We analyzed the relationship between clinical and laboratory data and the severity of pruritus in hemodialysis patients and followed them for 24 months prospectively. In total, 453 patients had severe pruritus with a visual analogue scale (VAS) score more than or equal to 7.0. Among them, more than 70% complained of sleep disturbance, whereas the majority of patients with a VAS score of less than 7.0 had no sleep disturbance. Male gender, high levels of blood urea nitrogen, β2-microglobulin (β2MG), hypercalcemia, and hyperphosphatemia were identified as independent risk factors for the development of severe pruritus, whereas a low level of calcium and intact-parathyroid hormone were associated with reduced risk. During the follow-up, 171 (9.64%) patients died. The prognosis of patients with severe pruritus was significantly worse than the others. Moreover, severe pruritus was independently associated with death even after adjusting for other clinical factors including diabetes mellitus, age, β2MG, and albumin. Severe uremic pruritus caused by multiple factors, not only affects the quality of life but may also be associated with poor outcome in chronic hemodialysis patients. © 2006 International Society of Nephrology.

    DOI: 10.1038/sj.ki.5000251

    Scopus

    PubMed

    researchmap

  • Seasonality in the incidence of biliary atresia in Japan. 査読

    Nakamizo M, Toyabe S, Kubota M, Komata O, Suzuki H, Akazawa K

    Acta paediatrica (Oslo, Norway : 1992)   95 ( 4 )   511 - 512   2006年4月

     詳細を見る

  • Development of a practical costing method for hospitals 査読

    P Cao, S Toyabe, K Akazawa

    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE   208 ( 3 )   213 - 224   2006年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TOHOKU UNIV MEDICAL PRESS  

    To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate results. The activity based costing (ABC) method introduced in the mid 1990s can prove more accurate results. With the ABC method, all events or transactions that cause costs are recognized as "activities", and a specific cost driver is prepared for each activity. Finally, the costs of activities are allocated to cost objects by the corresponding cost driver. However, it is much more complex and costly than other traditional cost accounting methods because the data collection for cost drivers is not always easy. In this study, we developed a simplified ABC (S-ABC) costing method to reduce the workload of ABC costing by reducing the number of cost drivers used in the ABC method. Using the S-ABC method, we estimated the cost of the laboratory tests, and as a result, similarly accurate results were obtained with the ABC method (largest difference was 2.64%). Simultaneously, this new method reduces the seven cost drivers used in the ABC method to four. Moreover, we performed an evaluation using other sample data from physiological laboratory department to certify the effectiveness of this new method. In conclusion, the S-ABC method provides two advantages in comparison to the VBC and ABC methods: (1) it can obtain accurate results, and (2) it is simpler to perform. Once we reduce the number of cost drivers by applying the proposed S-ABC method to the data for the ABC method, we can easily perform the cost accounting using few cost drivers after the second round of costing.

    DOI: 10.1620/tjem.208.213

    Web of Science

    PubMed

    researchmap

  • Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy. 査読

    Akazawa K, Tamaki Y, Taguchi T, Tanji Y, Miyoshi Y, Kim SJ, Ueda S, Yanagisawa T, Sato Y, Tamura S, Noguchi S

    The breast journal   12 ( 2 )   130 - 137   2006年3月

  • 術前末梢血中SCC抗原mRNA定量は食道扁平上皮癌の再発を予測する

    本間 英之, 神田 達夫, 若井 俊文, 伊藤 寛晃, 大橋 学, 小山 諭, Valera Vladimir A., 赤沢 宏平, 畠山 勝義

    日本外科学会雑誌   107 ( 臨増2 )   175 - 175   2006年3月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

    researchmap

  • Risk factors for severe coronary artery disease - a case-control study of patients who have undergone coronary artery bypass grafting. 査読

    Kosuge K, Sasaki H, Ikarashi T, Toyabe S, Akazawa K, Kobayashi C, Abe E, Suzuki A, Saito H, Eguchi S, Otsuka H, Aizawa Y

    Journal of atherosclerosis and thrombosis   13 ( 1 )   62 - 67   2006年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.5551/jat.13.62

    Web of Science

    PubMed

    researchmap

  • Referral from secondary care and to aftercare in a tertiary care university hospital in Japan 査読

    S Toyabe, A Kouhei

    BMC HEALTH SERVICES RESEARCH   6   11   2006年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: In Japan, all citizens are covered by the national insurance system in which universal free access to healthcare services is promised to everybody. There are no general physicians or gatekeepers in the Japanese healthcare system.
    Methods: We studied the pattern of referral of inpatients from secondary care hospitals to a tertiary care university hospital and the reverse referral under the situations using a geographic information system (GIS), taking paediatric inpatients as an example.
    Results: The results showed that 61.2% of the patients were directly admitted to the hospital without referral from other hospitals or clinics and that 82.8% of the inpatients were referred to the outpatient department of the hospital to which they had been admitted. GIS analysis for the inpatients service area showed the hospital functions as both a secondary care hospital and tertiary care hospital. Patients who lived near the hospital tended to be admitted directly to the hospital, and patients who lived far from the hospital tended to utilize the hospital as a tertiary care provider. There were territorial disputes with other secondary care hospitals. To estimate spatial differences in referral to aftercare, we analyzed the spatial distribution of inpatients with focus on their length of hospital stay (LOS). GIS analysis revealed apparent foci of patients with long LOS and those with low LOS.
    Conclusion: These results suggest that the function of university hospital in Japan is unspecialized and that the referral route from the university hospital to aftercare is also unequipped.

    DOI: 10.1186/1472-6963-6-11

    Web of Science

    PubMed

    researchmap

  • Profit and loss analysis for an intensive care unit (ICU) in Japan: a tool for strategic management 査読

    PY Cao, S Toyabe, T Abe, K Akazawa

    BMC HEALTH SERVICES RESEARCH   6   1   2006年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: Accurate cost estimate and a profit and loss analysis are necessary for health care practice. We performed an actual financial analysis for an intensive care unit (ICU) of a university hospital in Japan, and tried to discuss the health care policy and resource allocation decisions that have an impact on critical intensive care.
    Methods: The costs were estimated by a department level activity based costing method, and the profit and loss analysis was based on a break-even point analysis. The data used included the monthly number of patients, the revenue, and the direct and indirect costs of the ICU in 2003.
    Results: The results of this analysis showed that the total costs of US$2,678,052 of the ICU were mainly incurred due to direct costs of 88.8%. On the other hand, the actual annual total patient days in the ICU were 1,549 which resulted in revenues of US$2,295,044. However, it was determined that the ICU required at least 1,986 patient days within one fiscal year based on a break-even point analysis. As a result, an annual deficit of US$383,008 has occurred in the ICU.
    Conclusion: These methods are useful for determining the profits or losses for the ICU practice, and how to evaluate and to improve it. In this study, the results indicate that most ICUs in Japanese hospitals may not be profitable at the present time. As a result, in order to increase the income to make up for this deficit, an increase of 437 patient days in the ICU in one fiscal year is needed, and the number of patients admitted to the ICU should thus be increased without increasing the number of beds or staff members. Increasing the number of patients referred from cooperating hospitals and clinics therefore appears to be the best strategy for achieving these goals.

    DOI: 10.1186/1472-6963-6-1

    Web of Science

    PubMed

    researchmap

  • Comparison between compliance of fluticasone propionate Diskhaler and of fluticasone propionate Diskus in adult bronchial asthma patients 査読

    Takashi Hasegawa, Eiichi Suzuki, Katsuya Fujimori, Takuro Sakagami, Shinichi Toyabe, Kouhei Akazawa, Kenji Kawano, Michihiko Haraguchi, Joji Toyama, Masaaki Arakawa, Hiroshi Satoh, Fumitake Gejyo

    RESPIRATION   73 ( 5 )   680 - 684   2006年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:KARGER  

    Background and Objectives: Because inhaled corticosteroids (ICS) play a central role in the management of asthma, new drug delivery systems for fluticasone propionate, Diskhaler (FPdh) and Diskus (FPdk), were developed. However, few studies have focused on compliance with these drug delivery systems, which can influence drug efficacy. Hence, we compared compliance with FPdk versus that with FPdh. Methods: Data were obtained from a survey of pharmacists dispensing anti-asthmatic drugs to adult asthma patients who visited participating pharmacies between October 2002 and November 2003. Patients were limited to regular users of FPdh or FPdk whose medication and daily administration frequency of ICS were evaluated on the basis of pharmaceutical records. Data on asthma status and various other factors affecting ICS compliance were obtained by questionnaire. Results: Data were acquired on 337 patients. There were no significant differences in gender, age, and duration between the FPdk and FPdh groups. Although FPdk compliance was significantly higher than that of FPdh, conversely there was no significant difference in daily dose and administration frequency between the 2 groups. Furthermore, there was no significant difference in the rate of concomitant drug and in various influencing factors associated with drug compliance. Regarding compliance of concomitant drug, that of oral sustained-released theophylline was significantly lower in FPdk versus FPdh users. Conclusion: In the area of drug compliance, FPdk is superior to FPdh. Although the reason for this is unclear, it is probably due to the characteristics of FPdk itself. Copyright (C) 2006 S. Karger AG, Basel.

    DOI: 10.1159/000095313

    Web of Science

    PubMed

    researchmap

  • Development of a simulation program for estimating hospital incomes under the prospective payment system 査読

    T Abe, S Toyabe, PY Cao, S Kurashima, K Akazawa

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   80 ( 3 )   271 - 276   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER IRELAND LTD  

    A prospective payment system based on diagnosis procedure combination (DPC/PPS) was introduced to acute care hospitals in Japan in April 2003. In order to increase hospital income, hospitals must shorten the average Length of stay (ALOS) and increase the number of patients. We constructed a simulation program for evaluating the relationships among ALOS, bed occupation rate (BOR) and hospital income of hospitals in which DPC/PPS has been introduced. This program can precisely evaluate the hospital income by regulating the ALOS and the number of patients for each DPC. By using this program, it is possible to predict the optimum ALOS and optimum number of inpatients for each DPC in order to increase hospital income. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/j.cmpb.2005.09.003

    Web of Science

    researchmap

  • Analysis of asthma patients over the last 7 years (1997-2003) to determine what is necessary for patient education 査読

    Tsukioka K, Toyabe S, Akazawa K

    International Review of Asthma   7 ( 2 )   50 - 57   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    researchmap

  • Seasonality in the incidence of congenital hypothyroidism in Japan 査読

    Nakamizo M, Toyabe S, Asami T, Akazawa K

    Journal of Paediatrs and Child Health   41 ( 7 )   390 - 391   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1440-1754.2005.00644_1.x

    researchmap

  • Improvement of Asthma Management in Actual Practice Consistent with Prevalence of Anti-inflammatory Agents-Based on Questionnaire Surveys in Niigata Prefecture, Japan from 1998 to 2002 査読

    Hasegawa T, Suzuki E, Terada M, Koya T, Toyabe S, Akazawa K, Yoshizawa H, Arakawa M, Gejy F

    Allergology International   54 ( 4 )   555 - 563   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2332/allergolint.54.555

    researchmap

  • Drug Compliance in Patients with Bronchial Asthma: Relation among Compliance with Different Types of Antiasthmatic Drug and Association with Daily Administration Frequency 査読

    Hasegawa T, Suzuki E, Toyabe S, Akazawa K, Kawano K, Haraguchi M, Toyama J, Watanabe Y, Watanabe N, Arakawa M, Satoh H, Gejyo F, Niigata Inhalation Therapy, Study Group

    Allergology International   54 ( 4 )   547 - 553   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2332/allergolint.54.547

    researchmap

  • Gender differences in susceptibility of asthma to active smoking: Questionnaire based analysis in the Niigata Prefecture, Japan 査読

    Satoh H, Hasegawa T, Suzuki E, Terada M, Nakayama H, Toyabe S, Akazawa K, Kondoh A, Arakawa M, Yoshizawa H, Gejyo F

    Allergology International   54 ( 3 )   345 - 349   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2332/allergolint.54.401

    researchmap

  • Circannual variation in the onset and relapse of steroid-sensitive nephrotic syndrome 査読

    Toyabe S, Nakamizo M, Uchiyama M, Akazawa K

    Pediatric Nephrology   20 ( 4 )   470 - 473   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00467-004-1780-x

    researchmap

  • 心臓カテーテル検査における仙骨部圧迫予防効果の検討透視台マットの改良 査読

    池田由紀子, 上杉雅子, 鳥谷部真一, 吉村秀太郎, 倉島幸子, 赤澤宏平, 瀬賀裕子

    看護技術   51 ( 2 )   159 - 162   2005年12月

     詳細を見る

    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    researchmap

  • Actual and estimated costs of disposable materials used during surgical procedures 査読

    Toyabe S, Cao P, Kurashima S, Nakayama Y, Ishii Y, Hosoyama N, Akazawa K

    Health Policy   73 ( 1 )   52 - 57   2005年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.healthpol.2004.10.003

    researchmap

  • Low preoperative platelet counts predict a high mortality after partial hepatectomy in patients with hepatocellular carcinoma. 査読

    Kaneko K, Shirai Y, Wakai T, Yokoyama N, Akazawa K, Hatakeyama K

    World journal of gastroenterology   11 ( 37 )   5888 - 92   2005年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3748/wjg.v11.i37.5888

    Web of Science

    PubMed

    researchmap

  • Serotonin-2A and 2C receptor gene polymorphisms in Japanese patients with obstructive sleep apnea. 査読

    Sakai K, Takada T, Nakayama H, Kubota Y, Nakamata M, Satoh M, Suzuki E, Akazawa K, Gejyo F

    Internal medicine (Tokyo, Japan)   44 ( 9 )   928 - 933   2005年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2169/internalmedicine.44.928

    Web of Science

    PubMed

    researchmap

  • 術前末梢血中扁平上皮癌抗原メッセンジャーRNA定量値による食道癌根治切除後の再発予知

    本間 英之, 神田 達夫, 伊藤 寛晃, 若井 俊文, 中川 悟, 大橋 学, 小山 諭, 赤沢 宏平, 畠山 勝義

    日本癌治療学会誌   40 ( 2 )   331 - 331   2005年9月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本癌治療学会  

    researchmap

  • Facial axis angle as a risk factor for obstructive sleep apnea. 査読

    Kubota Y, Nakayama H, Takada T, Matsuyama N, Sakai K, Yoshizawa H, Nakamata M, Satoh M, Akazawa K, Suzuki E, Gejyo F

    Internal medicine (Tokyo, Japan)   44 ( 8 )   805 - 810   2005年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2169/internalmedicine.44.805

    Web of Science

    PubMed

    researchmap

  • CHRONIS: An animal chromosome image database 査読

    Shin-Ichi Toyabe, Kouhei Akazawa, Daisuke Fukushi, Kiichi Fukui, Tatsuo Ushiki

    Chromosome Research   13 ( 6 )   593 - 600   2005年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We have constructed a database system named CHRONIS (CHROmosome and Nano-Information System) to collect images of animal chromosomes and related nanotechnological information. CHRONIS enables rapid sharing of information on chromosome research among cell biologists and researchers in other fields via the Internet. CHRONIS is also intended to serve as a liaison tool for researchers who work in different centers. The image database contains more than 3000 color microscopic images, including karyotypic images obtained from more than 1000 species of animals. Researchers can browse the contents of the database using a usual World Wide Web interface in the following URL: http://chromosome.med.niigata-u.ac.jp/chronis/servlet/chronisservlet . The system enables users to input new images into the database, to locate images of interest by keyword searches, and to display the images with detailed information. CHRONIS has a wide range of applications, such as searching for appropriate probes for fluorescent in situ hybridization, comparing various kinds of microscopic images of a single species, and finding researchers working in the same field of interest. © Springer 2005.

    DOI: 10.1007/s10577-005-0985-6

    Scopus

    PubMed

    researchmap

  • The impact of preoperative serum C-reactive protein on the prognosis of patients with hepatocellular carcinoma 査読

    K Hashimoto, Y Ikeda, D Korenaga, K Tanoue, M Hamatake, K Kawasaki, T Yamaoka, Y Iwatani, K Akazawa, K Takenaka

    CANCER   103 ( 9 )   1856 - 1864   2005年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    BACKGROUND. The authors evaluated the significance of the preoperative serum C-reactive protein (CRP) level as a prognostic indicator in patients with hepatocellular carcinoma (HCC).
    METHODS. One hundred forty-one patients who underwent curative resection for HCC were reviewed retrospectively. Clinicopathologic variables were compared between patients with serum CRP levels &gt;= 1.0 mg/dL (n = 22 patients; the CRP-positive group) and patients with serum CRP levels &lt; 1.0 mg/dL (n = 119 patients; the CRP-negative group). Univariate and multivariate analyses were conducted to identify factors that affected survival and disease recurrence.
    RESULTS. There was a significant correlation between the preoperative serum CRP level and tumor size. Invasion to the portal vein in the CRP-positive group was significantly more frequent than that in the CRP-negative group. Even after they underwent curative resection, 75.3% of patients in the CRP-positive group experienced recurrence within 1 year. The overall survival and recurrence-free survival rates in the CRP-positive group were significantly lower compared with the rates in the CRP-negative group. On multivariate analysis, the preoperative serum CRP level was selected as one of the unfavorable indicators regarding survival and recurrence. When CRP levels, albumin levels, and platelet counts that were available before surgery were scored as a combined index, the total score demonstrated a good stratification value for survival after hepatic resection.
    CONCLUSIONS. The current results showed that the preoperative serum CRP level is an independent and significant indicator predictive of poor prognosis and early recurrence in patients with HCC. The new CRP-based scoring system offers reliable information for predicting survival. (c) 2005 American Cancer Society.

    DOI: 10.1002/cncr.20976

    Web of Science

    PubMed

    researchmap

  • Incidence of note-leaving remains constant despite increasing suicide rates. 査読

    Shioiri T, Nishimura A, Akazawa K, Abe R, Nushida H, Ueno Y, Kojika-Maruyama M, Someya T

    Psychiatry and clinical neurosciences   59 ( 2 )   226 - 228   2005年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1440-1819.2005.01364.x

    Web of Science

    PubMed

    researchmap

  • Postoperative adjuvant therapy with tamoxifen, tegafur plus uracil, or both in women with node-negative breast cancer: A pooled analysis of six randomized controlled trials 査読

    S Noguchi, H Koyama, J Uchino, R Abe, S Miura, K Sugimachi, K Akazawa, O Abe

    JOURNAL OF CLINICAL ONCOLOGY   23 ( 10 )   2172 - 2184   2005年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER SOC CLINICAL ONCOLOGY  

    Purpose This article reports the results of a pooled analysis of six randomized trials conducted to study the efficacy of uracil and tegafur (UFT) in the adjuvant treatment of node-negative breast cancer patients.
    Patients and Methods Six randomized controlled trials on node-negative breast cancer patients were conducted from 1992 through 1995 in Japan that included the three, three-arm trials (control [no adjuvant], UFT, and tamoxifen [TAM] groups) and the three, four-arm trials (control, UFT, TAM, and UFT plus TAM groups). Pooled analysis was performed on the data obtained from these six trials (involving 2,934 patients).
    Results Overall survival was compared between the UFT group (including both the UFT group and the TAM plus OFT group) and the non-UFT group (control group and TAM group). A significant difference (P = .04) was observed in 5-year survival rates between the UFT (95.9%) and the non-UFT (94.0%) groups. Overall survival was also compared between the TAM group (TAM group and TAM plus UFT group) and the non-TAM group (control group plus UFT group). The 5-year survival rate (95.2%) in the TAM group was not significantly different from that (93.9%) in the non-TAM group, but the subset analysis showed a significant (P = .01) improvement in the estrogen receptor-positive subset.
    Conclusion Adjuvant UFT improves the overall survival of node-negative breast cancer patients. Given that UFT has milder adverse effects, it is suggested that UFT can be a useful alternative to doxorubicin and cyclophosphamide, or cyclophosphamide, methotrexate, and fluorouracil in the adjuvant treatment for node-negative breast cancer. (c) 2005 by American Society of Clinical Oncology.

    DOI: 10.1200/JCO.2005.02.158

    Web of Science

    PubMed

    researchmap

  • Jaundice at presentation heralds advanced disease and poor prognosis in patients with ampullary carcinoma 査読

    N Yokoyama, Y Shirai, T Wakai, S Nagakura, K Akazawa, K Hatakeyama

    WORLD JOURNAL OF SURGERY   29 ( 4 )   519 - 523   2005年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Jaundice is a common manifestation of ampullary carcinoma. The aim of this study was to evaluate the correlation between jaundice at initial presentation and the degree of tumor spread and to determine the prognostic significance of jaundice in patients with ampullary carcinoma. Fifty-nine patients who had undergone curative resection for ampullary carcinoma were analyzed retrospectively. Jaundice was defined as a total bilirubin serum concentration of &gt;= 3 mg/dl. The median follow-up time was 106 months. Jaundice was noted at the time of initial presentation in 43 (73%) patients. Jaundice at presentation correlated with lymph node metastasis (p &lt; 0.0001), lymphatic vessel invasion (p &lt; 0.0001), invasion into the pancreas (p = 0.0007), and vascular invasion (p = 0.0487). Pancreatic invasion was absent in patients without jaundice. Superior mesenteric nodal involvement was more frequent in patients with jaundice (15143) than in those without (0/16) (p = 0.0062). The survival of patients with jaundice (median survival 48 months; cumulative 10-year survival rate 39%) was worse than for patients without jaundice (median survival time not available; cumulative 10-year survival rate 86%) (p = 0.0014). In conclusion, jaundice at presentation predicts advanced-stage ampullary carcinoma and a poor prognosis. Pancreatic invasion and superior mesenteric nodal involvement were not observed in non-jaundiced patients.

    DOI: 10.1007/s00268-004-7709-5

    Web of Science

    PubMed

    researchmap

  • Interleukin-6 (IL-6)--373 A9T11 allele is associated with reduced susceptibility to chronic periodontitis in Japanese subjects and decreased serum IL-6 level. 査読

    Komatsu Y, Tai H, Galicia JC, Shimada Y, Endo M, Akazawa K, Yamazaki K, Yoshie H

    Tissue antigens   65 ( 1 )   110 - 114   2005年1月

  • Incidence and distribution of hybrid goblet cells in complete type intestinal metaplasia of the stomach 査読

    R Aihara, Y Ajioka, H Watanabe, H Shiroshita, K Akazawa, H Kuwano

    PATHOLOGY RESEARCH AND PRACTICE   201 ( 1 )   11 - 19   2005年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:URBAN & FISCHER VERLAG  

    Previous reports suggest that hybrid goblet cells (HGCs) sharing both gastric and intestinal mucin phenotypes are rarely observed in complete intestinal metaplasia, (cIM) of the stomach. However, we have made a different observation. Thus, we compared the incidence and distribution of HGCs within the tubules of gastric cIM and the duodenum in order to define the significance of HGCs. Fifteen antral sections and 16 fundic sections from tissue with cIM and gastric cancer, as well as 19 sections from duodenal tissue with cancer of the Papilla of Vater, were stained for human gastric mucin (HGM), Con A, MUC2, CD10, and Ki-67. Multivariate analysis showed that antral location, a distance of 5 mm or less from the tumor margin, and the presence of underlying pyloric glands were significant predictive factors for tubules containing &gt; 50% HGCs as part of their goblet cell population. The incidence of tubules with HGCs differed significantly in tissue samples from the antrum, body and duodenum. HGCs did not stain for Ki-67 and were not surrounded by gastric foveolar-type epithelium within the tubules of cIM foci. These findings indicate that alterations in the proportion of HGCs may occur tinder some circumstances, and that HGCs are not precursors to gastric foveolar-type cells in the stomach and duodenum. (c) 2004 Elsevier GmbH. All rights reserved.

    DOI: 10.1016/j.prp.2004.09.014

    Web of Science

    PubMed

    researchmap

  • Analysis of Drug Compliance in Adult Patients with Bronchial Asthma 査読

    Hasegawa T, Suzuki E, Koya T, Akazawa K, Sakagami T, Toyabe S, Koyanagi K, Kawano K, Haraguchi M, Toyama J, Arakawa M, Yoshizawa H, Satoh H, Gejyo F

    General Medicine   5   7 - 11   2004年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.14442/general2000.5.7

    researchmap

  • Development and evaluation of a teleradiology and videoconferencing system. 査読

    Motoki Kaidu, Shin-ichi Toyabe, Jun-ichi Oda, Keiske Sasai, Kouhei Akazawa

    Journal of Telemedicine and Telecare   10 ( 4 )   214 - 218   2004年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We developed a teleradiology system linking a general hospital on Sado Island to tertiary care hospitals in Niigata City. The island is 40 km from Niigata City on the mainland and has only one diagnostic radiologist (for 72,000 islanders). Fibre optic cables between Sado Island and Niigata City were used for transmission. The introduction of the teleradiology system facilitated diagnostic and therapeutic consultation with specialists in Niigata City. The performance of the system was evaluated (on a scale of 0-6, with higher scores indicating better performance) by five diagnostic radiologists, who rated 32 features of the system twice, once in April 2002 and once in September 2003. The performance ratings improved from 1.38 to 2.86. While many of the initial problems with the software had been resolved, many still remained.

    DOI: 10.1258/1357633041424430

    researchmap

  • Web-based delivery of medical multimedia contents using an MPEG-4 system 査読

    T Yamakawa, SI Toyabe, PY Cao, K Akazawa

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   75 ( 3 )   259 - 264   2004年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI IRELAND LTD  

    Moving picture expert group compression standard version 4 (MPEG-4) is a standard for video coding aimed at multimedia applications. MPEG-4 was developed to enable high compression rate in a low bitrate transmission via the Internet or mobile telecommunications. Although these characteristics of MPEG-4 are suitable for tetemedicine, little is known about the possibility of using this technology in the field of telemedicine. We evaluated the quality of MPEG-4-encoded medical video streams and compared them with original analogue videos and audio-video-interleave (AVI) files. Although MPEG-4 video streams have the advantage of small file size, they were found to be inferior to original videos and AVI files in terms of smoothness of motion pictures, sharpness of images and clearness of sound. Illegibility of characters was a major probelem in MPEG-4 files. The score for total impression of MPEG-4 files was significantly lower than those for AVI files. The results of this study suggest that the quality of MPEG-4-encoded video streams is not adequate for telemedicine. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/j.cmpb.2004.03.002

    Web of Science

    researchmap

  • Polymorphisms in the IL-6 receptor (IL-6R) gene: Strong evidence that serum levels of soluble IL-6R are genetically influenced 査読

    J. C. Galicia, H. Tai, Y. Komatsu, Y. Shimada, K. Akazawa, H. Yoshie

    Genes and Immunity   5 ( 6 )   513 - 516   2004年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We have investigated the association of the recently identified IL6R polymorphisms with the serum levels of soluble IL-6 receptor (sIL-6R). sIL-6R is generated by shedding of the membrane-bound receptor (IL-6Rα) or alternative mRNA splicing. In total, 115 healthy volunteers were genotyped, with 70 of them analyzed for sIL-6R levels. Using the PCR/RFLP methods, two important polymorphic sites were selected for genotyping: the 48892A/C (D358A) in exon 9 and the - 183G/A in the promoter region. In exon 9, C allele carriers had higher sIL-6R level (P &lt
    0.0001) showing that this sequence variation, which corresponds to the proteolytic cleavage site of IL-6Rα, strongly influences the serum sIL-6R levels. In the promoter region, G allele carriers had lower sIL-6R levels (P &lt
    0.0082) compared with the A allele carriers. This could be attributed to the linkage disequilibrium (D′ = 0.54, χ2 = 51.3, P &lt
    0.0001) between the - 183G/A and the 48892A/C gene polymorphisms. © 2004 Nature Publishing Group All rights reserved.

    DOI: 10.1038/sj.gene.6364120

    Scopus

    PubMed

    researchmap

  • Association of tumor necrosis factor receptor type 2+587 gene polymorphism with severe chronic periodontitis 査読

    Y Shimada, H Tai, M Endo, T Kobayashi, K Akazawa, K Yamazaki

    JOURNAL OF CLINICAL PERIODONTOLOGY   31 ( 6 )   463 - 469   2004年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BLACKWELL MUNKSGAARD  

    Background: Genetic polymorphisms for cytokines and their receptors have been proposed as potential markers for periodontal disease. Tumor necrosis factor receptor 2 (TNFR2) is one of the cell surface receptors for TNF-alpha. Recent studies have suggested that TNFR2 gene polymorphism is involved in autoimmune and other diseases.
    Objectives: The aim of the present study is to evaluate whether TNFR2(+587T/G) gene polymorphism is associated with chronic periodontitis (CP).
    Methods: One hundred and ninety-six unrelated subjects (age 40-65 years) with different levels of CP were identified according to established criteria, including measurements of probing pocket depth (PPD), clinical attachment level (CAL), and alveolar bone loss (BL). All subjects were of Japanese descent and non-smokers. Single nucleotide polymorphism at position +587(T/G) in the TNFR2 gene was detected by a polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) method.
    Results: The frequency and the positivity of the +587G allele were significantly higher in severe CP patients than in controls (p=0.0097; odds ratio=2.61, p=0.0075; odds ratio=3.06). In addition, mean values of PPD, CAL, and BL were significantly higher in the +587G allele positive than in the negative subjects (p=0.035, 0.022, and 0.018, respectively).
    Conclusions: These findings suggest that the TNFR2(+587G) polymorphic allele could be associated with severe CP in Japanese.

    DOI: 10.1111/j.1600-051X.2004.00513.x

    Web of Science

    PubMed

    researchmap

  • Economic slump and suicide method: preliminary study in Kobe. 査読

    Abe R, Shioiri T, Nishimura A, Nushida H, Ueno Y, Kojima M, Kitamura H, Akazawa K, Someya T

    Psychiatry and clinical neurosciences   58 ( 2 )   213 - 216   2004年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1440-1819.2003.01219.x

    Web of Science

    PubMed

    researchmap

  • A method for displaying two images on a screen in distance medical education 査読

    A Motonaga, K Akazawa, S Takahashi, Y Yamamoto, H Tsukada, K Inagawa, T Yamakawa, M Hashiba

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   73 ( 3 )   183 - 188   2004年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI IRELAND LTD  

    This article describes a method for simultaneously displaying several 'REALPLAYER' ages on a screen during an online multimedia presentation. Users with software and Web browsers can view images with synchronous audio on their personal computers via the Internet. Medical researchers and physicians often find it useful to compare images after treatment with those before treatment, by displaying several arranged images simultaneously. Medical care providers can browse this type of multimedia content in their offices and universities at their convenience. There presently exist two methods for creating multimedia content with voice and images using ReaLSystem technology. Electronic lectures of otorhinolaryngology explaining new surgical procedures for patients with chronic otitis media were created with this method and made available to otorhinotaryngologists through the Internet. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/S0169-2607(03)00024-5

    Web of Science

    researchmap

  • MPEG digital compression and analogue videotape: A comparison of moving images and electroencephalogram data in epileptic patients 査読

    Kouhei Akazawa, Shigeki Kameyama, Ryuzo Mase, Tomoko Yamayaka, Masao Hashiba

    Medical Informatics and the Internet in Medicine   29 ( 1 )   57 - 63   2004年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Primary objectives: The objective of this study was to compare the clinical usefulness, in the field of epileptology, of digital moving images and electroencephalogram (EEG) waveforms by Motion Pictures Expert Group compression algorithms (MPEG-1 and MPEG-2) to that of conventional analogue recording. Research design and methods: Three epileptic seizure scenes consisting of moving images and the corresponding EEG waveforms in an epileptic patient were selected as the images to be evaluated. Each scene was recorded using MPEG-1, MPEG-2 and videotape. Ten doctors used six criteria to evaluate the quality of moving images, EEG data and audio. Main outcomes: Analysis of variance and Bonferroni tests indicated that the image quality of MPEG-2 was superior to that of MPEG-1 or videotape for all criteria. Furthermore, MPEG-2 obtained much higher scores in EEG waveform quality than did the other modalities. Conclusions: Our findings suggested that data from MPEG-2 images will lead to more precise diagnosis and treatment decision-making than data from analogue videotape recordings. © 2004 Taylor and Francis Ltd.

    DOI: 10.1080/14639230410001662110

    Scopus

    PubMed

    researchmap

  • Increased risk of cholelithiasis after esophagectomy 査読

    K Tsunoda, Y Shirai, T Wakai, N Yokoyama, K Akazawa, K Hatakeyama

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY   11 ( 5 )   319 - 323   2004年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    Background/Purpose. Truncal vagotomy enhances gallstone formation. As esophagectomy involves truncal vagotomy, it was hypothesized that esophagectomy would increase the risk of cholelithiasis. This study was intended to test this hypothesis and to elucidate factors influencing the incidence of cholelithiasis after esophagectomy.
    Methods. The study was a retrospective analysis of 136 patients with esophageal carcinoma who had survived for 5 years or longer after esophagectomy. Eight patients (5.9%) had cholelithiasis before esophagectomy. Of the remaining 128 patients, 113 underwent abdominal ultrasonographic examination for cholelithiasis twice a year after esophagectomy; the median follow-up time was 89.5 months (range, 60-1.17 months).
    Results. Gallstones developed in 26 (23%) of the 113 patients undergoing regular ultrasonographic examination. The cumulative incidence of cholelithiasis reached a plateau of 34% at 10 years after esophagectomy. Reduction of body mass index after esophagectomy was the strongest independent predictor of gallstone formation after esophagectomy (P = 0.0001, log-rank test; P = 0.0003, Cox's proportional hazards model). The prevalence of cholelithiasis at 5 years after esophagectomy (18/113; 16%) was significantly higher than that before esophagectomy (8/136: 5.9%: P = 0.012, Fisher's exact test).
    Conclusions. Esophagectomy yields an increased risk of the development of cholelithiasis. Truncal vagotomy and postsuraical malnutrition may contribute to this increased gallstone formation after esophagectomy.

    DOI: 10.1007/s00534-004-0914-7

    Web of Science

    PubMed

    researchmap

  • Efficacy of fluticasone propionate compared with beclomethasone dipropionate in bronchial asthma: improvement in compliance and symptoms by fluticasone. 査読

    Suzuki T, Hasegawa T, Suzuki E, Sasahara K, Kawada T, Koya T, Akazawa K, Satoh H, Gejyo F

    Allergy and asthma proceedings   24 ( 5 )   347 - 351   2003年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Web of Science

    PubMed

    researchmap

  • Interaction between ACE and ADD1 gene polymorphisms in the progression of IgA nephropathy in Japanese patients 査読

    Narita, I, S Goto, N Saito, J Song, J Ajiro, F Sato, D Saga, D Kondo, K Akazawa, M Sakatsume, F Gejyo

    HYPERTENSION   42 ( 3 )   304 - 309   2003年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    An interaction effect between the angiotensin-converting enzyme insertion/deletion ( ACE I/D) and alpha-adducin (ADD1) Gly460Trp polymorphisms (G460W) on blood pressure regulation has recently been suggested, although its significance in the prognosis of renal function in IgA nephropathy (IgAN) has not been fully investigated. Therefore, we evaluated the clinical manifestations and renal prognosis in 276 Japanese patients with histologically proven IgAN with respect to their ACE I/D and ADD1 G460W polymorphisms. The prognosis of renal function was analyzed by Kaplan-Meier survival curves and multivariate Cox proportional-hazards regression models. Baseline data, including blood pressures, proteinuria, renal function, and incidence of hypertension, were similar for the different genotypes of ACE and ADD1. The individual genotypes taken alone were not associated with the progression of renal dysfunction. However, renal survival of patients with the 460WW polymorphism of ADD1 was significantly worse within the group with the II genotype of ACE (Kaplan-Meier, log rank test; chi(2) = 6.062, P = 0.0138) but not for those with other ACE genotypes. In the Cox proportional-hazards regression model with adjustment for clinical risk factors, including hypertension, proteinuria, and no administration of an angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, the 460WW variant of ADD1 was a highly significant and independent risk factor only for patients with the ACE II genotype, with a hazard ratio of 3.65 ( P = 0.0016), but not for those with other ACE genotypes ( hazard ratio = 0.65, P = 0.2902). These findings suggest an interaction between ACE and ADD1 polymorphisms not only on blood pressure regulation but also on the progression of renal dysfunction in patients with IgAN.

    DOI: 10.1161/01.HYP.0000085193.25617.78

    Web of Science

    PubMed

    researchmap

  • Pepstatin A induces extracellular acidification distinct from aspartic protease inhibition in microglial cell lines 査読

    M Okada, S Irie, M Sawada, R Urae, A Urae, N Iwata, N Ozaki, K Akazawa, H Nakanishi

    GLIA   43 ( 2 )   167 - 174   2003年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-LISS  

    The extrusion of protons is considered a very general parameter of the activation of many kinds of membrane or intracellular molecules, such as receptors, ion channels, and enzymes. We found that pepstatin A caused a reproducible, concentration-related increase in the extracellular acidification rate in two microglial cell lines, Ra2 and 6-3. Washing abolished pepstatin A-induced acidification immediately. However, pepstatin A did not cause the extracellular acidification in other cell types, such as CHO, C6 glioma, and NIH3T3 cells. These observations strongly suggest that pepstatin A interacts with certain membrane proteins specific to both Ra2 and 6-3 cells from outside. N-methylmaleimide and N,N-dicyclohexylcarbodiimide, inhibitors of H+-ATPase, were found to reduce pepstatin A-induced response strongly, while bafilomycin A1, a vacuolar H+-ATPase inhibitor, vanadate, a P-type H+-ATPase inhibitor, and NaN3, an F1 ATPase inhibitor, virtually did not. 5-(N-ethyl-N-isopropyl) amiloride, an inhibitor of Na+/H+ exchanger isoform 1, greatly enhanced pepstatin-induced response, while amiloride did not. Zn2+, a voltage-dependent proton channel blocker, did not affect pepstatin-induced response neither. Staurosporine, a nonspecific inhibitor of protein kinase C, inhibited pepstatin A-induced response, while chelerythrine, more selective inhibitor of protein kinase C, greatly enhanced it. H-7 and H-8 did not affected the response. These findings suggest that pepstatin A induces extracellular acidification in microglia cell lines, Ra2 and 6-3, through an N-methylmaleimide- and NN'-dicyclohexylearbodiimide-sensitive, but bafilomycin A1-insensitive, ATPase, which seems to be distinct from protein kinase C-dependent process. (C) 2003 Wiley-Liss, Inc.

    DOI: 10.1002/glia.10237

    Web of Science

    PubMed

    researchmap

  • An integrated medical image database and retrieval system using a web application server 査読

    PY Cao, M Hashiba, K Akazawa, T Yamakawa, T Matsuto

    INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS   71 ( 1 )   51 - 55   2003年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI IRELAND LTD  

    We developed an Integrated Medical Image Database and Retrieval System (INIS) for easy access by medical staff. The INIS mainly consisted of four parts: specific servers to save medical images from mutti-vendor modalities of CT, MRI, CR, ECG and endoscopy; an integrated image database (DB) server to save various kinds of images in a DICOM format; a Web application server to connect clients to, the integrated image DB and the Web browser terminals connected to an HIS system. The INIS provided a common screen design to retrieve CT, MRI, CR,endoscopic and ECG images, and radiological reports, which would allow doctors to retrieve radiological images and corresponding reports, or ECG images of a patient simultaineously on a screen. Doctors working in internal medicine on average accessed information 492 times a month. Doctors working in cardiological and gastroenterological accessed information 308 times a month. Using the INIS, medical staff could browse all or parts of a patient's medical images and reports. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/S1386-5056(03)00088-1

    Web of Science

    PubMed

    researchmap

  • Gastrointestinal cancer and herpes zoster in adults. 査読

    Yamamoto M, Mine H, Akazawa K, Maehara Y, Sugimachi K

    Hepato-gastroenterology   50 ( 52 )   1043 - 1046   2003年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Web of Science

    PubMed

    researchmap

  • The efficacy of tonsillectomy on long-term renal survival in patients with IgA nephropathy 査読

    Yuansheng Xie, Shinichi Nishi, Mitsuhiro Ueno, Naofumi Imai, Minoru Sakatsume, Ichiei Narita, Yasushi Suzuki, Kouhei Akazawa, Hisaki Shimada, Masaaki Arakawa, Fumitake Gejyo

    Kidney International   63 ( 5 )   1861 - 1867   2003年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing Inc.  

    Background. Little information has been available until now about the clinical efficacy of tonsillectomy on long-term renal survival of patients with idiopathic immunoglobulin A nephropathy (IgAN). Methods. To investigate the effect of tonsillectomy on long-term renal survival, we reviewed the clinical course of 118 patients with idiopathic biopsy-diagnosed IgAN from 1973 to 1980. Of those, 48 patients received tonsillectomy and 70 patients did not. The starting point of observation was defined as the time of the diagnostic renal biopsy, and the end point as when requiring the first dialysis. Up to 2001, the mean observation time was 192.9 ± 74.8 months (48-326 months). Renal survival and impact of covariates were evaluated by Kaplan-Meier analysis and Cox proportional hazards regression model. Results. Age, gender, amount of urinary protein excretion, serum creatinine, serum IgA, blood pressure, and histopathologic findings at the time of renal biopsy and treatments during the observation period were not significantly different between patients with and without tonsillectomy. Five (10.4%) of the patients with tonsillectomy and 18 (25.7%) of the patients without tonsillectomy finally required dialysis therapy (chisquare test, P = 0.0393). By Kaplan-Meier analysis, renal survival rates were 89.6% and 63.7% at 240 months in the patients with and without tonsillectomy, respectively, and were significantly different (log-rank test, P = 0.0329). In the multivariate Cox regression model, tonsillectomy (hazard ratio, 0.22: 95% CI, 0.06 to 0.76
    P = 0.0164) had a significant effect on renal outcome. Conclusion. These results indicate that tonsillectomy has a favorable effect on long-term renal survival in patients with IgAN.

    DOI: 10.1046/j.1523-1755.2003.00935.x

    Scopus

    PubMed

    researchmap

  • Delivery of medical multimedia contents through the TCP/IP network using RealSystem 査読

    Suzuki, I, K Yamada, T Yamakawa, M Hashiba, K Akazawa

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   70 ( 3 )   253 - 258   2003年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI IRELAND LTD  

    We developed a low cost, user-friendly multimedia delivery system, to provide medical lectures saved as multimedia contents to persons engaged in medicine. This system was created using the RealSystem package with the TCP/IP network. Users can review lectures and medical meeting presentations with video and audio through the Internet, whenever convenient. Each medical source of video and slide has been clearly displayed on a screen. Members of medical associations or medical students can easily review the most interesting parts of these files. This system is being used efficiently in distance learning and aids the diffusion of the latest information and technology to busy physicians and medical students. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

    DOI: 10.1016/S0169-2607(02)00012-3

    Web of Science

    researchmap

  • Immunohistochemically detected micrometastasis in lymph nodes from superficial esophageal squamous cell carcinoma 査読

    T Tanabe, T Nishimaki, H Watanabe, Y Ajioka, K Akazawa, S Komukai, K Hatakeyama

    JOURNAL OF SURGICAL ONCOLOGY   82 ( 3 )   153 - 159   2003年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-LISS  

    Background and Objectives: This study was conducted to determine the incidence and clarify the patterns of nodal micrometastasis, to elucidate the histopathologic parameters of tumor extension correlating with micrometastasis, and to evaluate whether nodal micrometastasis has clinical significance in patients with superficial esophageal cancer.
    Methods: Lymph nodes resected from 78 patients with superficial esophageal squamous cell carcinoma were examined immunohistochemically using the monoclonal antibody cocktail AE1/AE3 to define histologically undetectable micrometastasis. Clinical records and pathologic features of all cases were reviewed.
    Results: Of the 78 patients, 34 had neither micro- nor overt disease in the lymph nodes, 12 had nodal micrometastasis only, and 32 had histologically overt metastasis. Nodal micrometastasis was found in carcinomas reaching the muscularis mucosae or deeper tissues of the esophagus. Multivariate analysis showed that intraesophageal multicentric cancer and venous invasion had significant correlation with nodal micrometastasis (P = 0.005 and 0.017, respectively). However, no clinical impact of nodal micrometastasis could be detected regarding patient outcome.
    Conclusions: Nodal micrometastasis is not rare in patients with superficial esophageal cancer, but it does not appear to have clinical significance in these patients. Nodal Micrometastasis correlates with intraesophageal multicentric cancer and venous invasion. (C) 2003 Wiley-Liss, Inc.

    DOI: 10.1002/jso.10207

    Web of Science

    PubMed

    researchmap

  • Attitude control using CMAC for electric wheelchairs equipped with hydraulic cylinder 査読

    S Fujisawa, K Akazawa, R Kurozumi, K Kawada, T Yamamoto, H Uenaka

    2003 IEEE INTERNATIONAL SYMPOSIUM ON COMPUTATIONAL INTELLIGENCE IN ROBOTICS AND AUTOMATION, VOLS I-III, PROCEEDINGS   1312 - 1316   2003年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(国際会議プロシーディングス)   出版者・発行元:IEEE  

    We developed a posture control system for an electric wheelchair equipped with active suspension, using CMAC which is a neural network type of control. Testing of the posture control of the wheelchair, which considers a learning result as an output to the target value inputted on-line using the learning function of CMAC (Cerebellar Model Arithmetic Controller), was performed. In this paper, testing of the learning control which holds the posture horizontally both by the simulation and in the experiment by the system, is performed, and the validity of CMAC is verified.

    DOI: 10.1109/CIRA.2003.1222186

    Web of Science

    researchmap

  • Vascular endothelial growth factor-C and vascular endothelial growth factor-D messenger RNA expression in breast cancer: Association with lymph node metastasis 査読

    Yu Koyama, Kouji Kaneko, Kohei Akazawa, Chizuko Kanbayashi, Tatsuo Kanda, Katsuyoshi Hatakeyama

    Clinical Breast Cancer   4 ( 5 )   354 - 360   2003年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier Inc.  

    Lymph node metastasis is a major prognostic factor for patients with breast cancer. Vascular endothelial growth factors (VEGF) - C and VEGF-D are capable of stimulating lymphangiogenesis, and VEGF-C enhances lymphatic metastasis. The aim of the present study was to determine whether VEGF-C and VEGF-D messenger RNA (mRNA) expression is correlated with lymphatic invasion and lymph node metastasis in patients with breast cancer. Total RNAs were isolated from 33 surgical specimens of breast cancer tissue and 7 samples of normal breast tissue. VEGF-C and VEGF-D mRNA expression was measured by quantitative reverse transcription-polymerase chain reaction analysis. There was no correlation between VEGF-C mRNA expression and lymphatic invasion or lymph node metastasis. However, VEGF-D mRNA expression was decreased in cancer tissue, and it was inversely correlated with lymphatic invasion and the number of metastatic lymph nodes. An increased VEGF-C/VEGF-D ratio was also correlated with lymph node metastasis and the number of metastatic lymph nodes. Our results suggest that a decrease in VEGF-D mRNA or an increase in the VEGF-C/VEGF-D ratio may have an association with tumorigenesis and/or lymph node metastasis in breast cancer.

    DOI: 10.3816/CBC.2003.n.041

    Scopus

    PubMed

    researchmap

  • A method to convert HDTV videos of broadcast satellite to RealSystem multimedia contents 査読

    Tomoko Yamakawa, Masao Hashiba, Tsukasa Koyama, Kouhei Akazawa

    Journal of Medical Systems   26 ( 5 )   439 - 444   2002年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recently, the Internet is widely used in the field of medicine. Daily use of e-mail for medical communication is very common. Also various information regarding hospitals can be accessed via the network. Apart from this practical use of the computer network, the mediums of telemedicine, tele-education, and telecare are also available. The Medical Information Network via Communications Satellite for University Hospital (MINCS-UH
    http://www.umin.ac.jp/mincs/) was constructed by the Ministry of Education, Culture, Sports, Science and Technology. These programs feature high quality images viewed on High Definition Television (HDTV) through the Broadcast Satellite (BS). We have compiled a video library of MINCS-UH program contents with W-VHS tapes for HDTV and VHS or S-VHS tapes for NTSC, available to medical staff in our university hospital through the Hospital local area network (Hospital intranet). We have also constructed a web-based streaming system that is a low cost, user-friendly multimedia delivery system capable of providing medical lectures. This system was constructed using the RealSystem package with the Internet Protocol (IP) network. Although the image quality of RealSystem is inferior to that of the original video, users can review lectures and medical congress presentations with video and audio through Hospital intranet, at any time that is convenient to them. This system can also be an efficient tool for distance learning and supports the diffusion of up-to-date information and technology to busy physicians via the Internet.

    DOI: 10.1023/A:1016457200802

    Scopus

    PubMed

    researchmap

  • A(-20)C polymorphism of the angiotensinogen gene and progression of IgA nephropathy. 査読

    Goto S, Narita I, Saito N, Watanabe Y, Yamazaki H, Sakatsume M, Shimada H, Nishi S, Ueno M, Akazawa K, Arakawa M, Gejyo F

    Kidney international   62 ( 3 )   980 - 985   2002年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1046/j.1523-1755.2002.00517.x

    Web of Science

    PubMed

    researchmap

  • Therapeutic value of lymph node dissection and the clinical outcome for patients with gastric cancer 査読

    Y Maehara, Y Kakeji, T Koga, Y Emi, H Baba, K Akazawa, K Sugimachi

    SURGERY   131 ( 1 )   S85 - S91   2002年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:MOSBY, INC  

    Background. While the incidence of gamic cancer differs greatly between Japan and other countries, both diagnostic and treatment modalities for patients with gastric cancer have improved in Japan. What follows is an overview of the effects of lymph node dissection for such patients.
    Methods. We analyzed data on 2152 Japanese men and women with gastric cancer who underwent surgical resection from 1965 to 1995 at Kyushu University in Fukuoka, Japan. We focused on time trends of surgical management, including lymph node dissection and postoperative outcome.
    Results. In all cases of gastric cancer, the rate of early gastric cancer increased from 18% in the first 6-year period to 57% in the last 5-year period. Extensive lymph node dissections (D2 and D3) were performed more frequently in recent years. Due to early identification of the cancer and upgraded perioperative care, both postoperative morbidity and mortality rates 30 days after surgery have decreased greatly, even in aged patients.
    Conclusions. Early tumor detection, standardized surgical treatment, including routine lymph node dissection, and improved perioperative management have led to increased survival time among patients with this malignancy.

    DOI: 10.1067/msy.2002.119309

    Web of Science

    PubMed

    researchmap

  • Peak expiratory flow in normal healthy Japanese adults: Comparisons with values reported in other races 査読

    Kazuharu Tsukioka, Sohei Makino, Terumasa Miyamoto, Naohito Tanabe, Kohei Akazawa

    Allergology International   51 ( 2 )   101 - 111   2002年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: We investigated the relationship between peak expiratory flow (PEF), age and standing height in 2785 Japanese volunteers (1047 males), aged 15-84 years, who had never smoked and who satisfied other strict criteria of normality. Many reports of regression equations for PEF by country and ethnicity are prepared using Wright or mini-Wright PEF meters, which have been calibrated by human subjects. Yet, no study has been performed in any country to determine the reference values of PEF on the American Thoracic Society (ATS) scale, which is calibrated by a computer-driven mechanical pump. Methods: Peak expiratory flow was measured with mini-Wright meters calibrated on the Wright scale. All subjects were taught how to perform a forced expiratory maneuver: the highest of three PEF values was recorded and standing height was measured. The Miles equation was used to convert mini-Wright PEF values (traditional scale) to values using the new 'mechanical' PEF, which the ATS has recommended (ATS scale). In the analysis of the data, a model based on age, age squared and age cubed was used to derive curvilinear regression equations for PEF on age and standing height for each sex. Results: There was adequate representation of subjects of each sex at all ages to 74 years. Curves plotted from the regression equations rose during adolescence and early adulthood, reached maximum values at 35 years in males and 40 years in females and then declined in an approximately linear manner. For both sexes, standing height fell progressively with increasing age. Conclusions: From the regression equations, predicted values of PEF can be derived for any Japanese adult aged 15-74 years. We were able to obtain predicted equations for PEF in normal Japanese adults using both the Wright and ATS scales. Direct comparison of our regressions with those reported in other populations was limited by differences in methodology and analysis. In comparable studies of Chinese and Indian populations, the PEF values in those studies were appreciably lower than ours. Our regressions were remarkably similar to those reported in a study of British subjects that used virtually identical entry criteria and methods.

    DOI: 10.1046/j.1440-1592.2002.00254.x

    Scopus

    researchmap

  • Loss of motility-related protein 1 (MRP1/CD9) and integrin α3 expression in endometrial cancers 査読

    Shingo Miyamoto, Akiko Maruyama, Kaoru Okugawa, Kohei Akazawa, Hideo Baba, Yoshihiko Maehara, Eisuke Mekada

    Cancer   92 ( 3 )   542 - 548   2001年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND. MRP1/CD9 and integrin α3 have played crucial roles in cell adhesion, motility, and signaling events. The loss of MRP1/CD9 and integrin α3 has been involved in tumor growth and metastasis of cancer cells. The aim of the current study was to clarify the clinical significance of MRP1/CD9 and integrin α3 in endometrial cancer. METHODS. The expression of MRP1/CD9 and integrin α3 from the same tissue sample were examined immunohistochemically in 15 patients with normal endometrium and in 56 patients with uterine endometrioid adenocarcinoma. Disease-free survival curves were estimated using the Kaplan-Meier method and analyzed by the log-rank test between the positive and reduced expression statuses of both MRP1/CD9 and integrin α3. These expressions and clinicopathologic variables were analyzed univariately and multivariately. RESULTS. In normal endometrium, MRP/CD9 was expressed at the cell membrane of cell contact sites, and the expression of integrin α3 was detected also at the cell membrane of cell contact sites and at borders of stromal tissues. In patients with endometrioid adenocarcinoma, 17 cases showed reduced expression of MRP1/ CD9, and 20 cases had reduced expression of integrin α3. Fourteen cases indicated a reduced expression of both MRP1/CD9 and integrin α3. Each reduced expression of MRP1/CD9 or integrin α3 was significantly correlated with histologic grade and metastasis. Multivariate analysis using the Cox regression model disclosed that age at surgery, metastasis, and expression status of MRP1/CD9 were significant prognostic factors for disease-free survival. CONCLUSIONS. These findings suggested that the analysis for the expression statuses of MRP1/CD9 and integrin α3 may provide important information on the clinical behavior of endometrial cancer. © 2001 American Cancer Society.

    DOI: 10.1002/1097-0142(20010801)92:3<542::AID-CNCR1353>3.0.CO;2-8

    Scopus

    PubMed

    researchmap

  • A simple computerized program for the calculation of the required sample size necessary to ensure statistical accuracy in medical experiments 査読

    H Nutahara, E Hanada, N Kinukawa, Y Kenjo, Y Antoku, K Akazawa, Y Nose

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   65 ( 2 )   133 - 139   2001年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI IRELAND LTD  

    We developed a sample size estimation program (SSEP) with which medical researchers can easily estimate the appropriate sample size for a specific significance level and statistical power using their favorite WWW browsers. SSEP can estimate the sample sizes for six statistical methods by Monte-Carlo simulation: Student's I-test, Welch's t-test, Analysis of valiance, Wilcoxon's rank sum test, Kruskal-Wallis test, and the Cochran-Armitage test for linear trends. The SSEP simulation programs were created using the SAS software macro language. Medical researchers can interactively use this program and determine reliable sample sizes when planning new prospective clinical studies and animal experiments. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

    Web of Science

    researchmap

  • Time trends of surgical treatment and the prognosis for Japanese patients with gastric cancer 査読

    Y Maehara, Y Kakeji, S Oda, Takahashi, I, K Akazawa, K Sugimachi

    BRITISH JOURNAL OF CANCER   83 ( 8 )   986 - 991   2000年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CHURCHILL LIVINGSTONE  

    The incidence of gastric cancer is much higher in Japan than in other countries even though diagnostics and treatments of such patients have improved. The objective of this study was to present an overview of the past. present and future of surgical treatment for our patients with gastric cancer. We analysed data on 2152 Japanese men and women with gastric cancer who underwent surgical resection from 1965 to 1995 at Kyushu University in Fukuoka, Japan, based on a univariate and the multivariate analysis. We focused on time trends of surgical treatment and the postoperative outcome. Over the years, there have been favourable changes in the numbers of patients with early gastric cancer, in all cases of gastric cancer; the rate of 18% in the first six year period (group 1) was 57% in the last 5 year period (group 6). Size of the tumour was smaller. well-differentiated tumour tissue was more common, and lymphatic involvement was less frequent. Lymph node metastasis, liver metastasis and peritoneal dissemination all decreased. Extensive lymph node dissection was more frequently done and the rate of curative resection (curability A and B) increased. With increases in identifying the early stage of cancer and better perioperative care, mortality rates 30 days after the surgery greatly decreased. Multivariate analysis revealed that the 10 factors of depth of invasion, lymph node metastasis, lymph node dissection, tumour size, liver metastasis, peritoneal dissemination, lymphatic invasion, Vascular invasion, lesion in the whole stomach and lesion in the middle stomach were independent factors for determining the prognosis. Detection of the tumour in an early stage, standardized surgical treatment, including routine lymph node dissection, close follow-up schedules and better perioperative management are expected to increase survival time for patients with this malignancy. (C) 2000 Cancer Research Campaign.

    Web of Science

    researchmap

  • Application of the RealAudio package to computerized medical lectures 査読

    M Hashiba, K Inagawa, T Matsuto, A Motonaga, T Yamakawa, K Akazawa

    MEDICAL INFORMATICS AND THE INTERNET IN MEDICINE   25 ( 4 )   239 - 245   2000年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TAYLOR & FRANCIS LTD  

    We created a multimedia system to computerize past lectures using RealAudio software. Physicians, medical researchers and students can browse the contents of lecture slides and handouts with synchronous audio using the Internet. The audience can easily review the most interesting parts of lectures and medical students can listen to complete medical lectures from remote sites with narration and slide depiction, whenever convenient. We have created three multimedia programs; the memorial lecture of a professor's retirement, a new method of hand washing for surgical procedures and a lecture on medical informatics. The cost of this system and the results of the evaluation by medical students are described. The ease of using this application makes it a potentially valuable tool for clinicians and researchers.

    Web of Science

    researchmap

  • The impact of covariate imbalance on the size of the logrank test in randomized clinical trials 査読

    N Kinukawa, T Nakamura, K Akazawa, Y Nose

    STATISTICS IN MEDICINE   19 ( 15 )   1955 - 1967   2000年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JOHN WILEY & SONS LTD  

    This paper examines the baseline imbalance incidental to stratified random sampling in clinical trials. We assume that patients are randomly sampled from a stratum-specific population and assigned to either treatment or control groups. Prognostic factors not used for the stratification cause within-stratum patient heterogeneity. The patient heterogeneity is investigated with an analysis of the prognostic index, or the log-relative-hazard. An index V, used to measure the degree of baseline imbalance between the groups, is defined using the prognostic index. The degree of baseline imbalance resulting from the stratified random sampling of a population of heterogeneous patients is examined. A method to estimate the exact size of the stratified logrank test is developed and applied to data obtained from a cancer clinical trial. Copyright (C) 2000 John Wiley & Sons, Ltd.

    Web of Science

    researchmap

  • An easily customized, random allocation system using the minimization method for multi-Institutional clinical trials 査読

    Y Kenjo, Y Antoku, K Akazawa, E Hanada, N Kinukawa, Y Nose

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   62 ( 1 )   45 - 49   2000年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI IRELAND LTD  

    In a randomized clinical trial, random allocation of patients to treatment groups should be done to balance in the distribution of prognostic factors. Random allocation in a multi-institutional randomized clinical trial is conducted by a coordinating center, independent of the medical institution the attending doctor uses for his/her practice. This study provides a sophisticated system for doing an exact random allocation of patients to treatment groups. The minimization method proposed by Pocock was applied to this system to balance the distribution of prognostic factors between two treatment groups, even when the number of registered patients is relatively small (S.J. Pocock, Allocation of patients to treatment in clinical trial, Biometrics 35 (1979) 183-197). Furthermore, Zelen's method is used to balance the number of patients allocated to the two groups within each institution (M. Zelen, The randomization and stratification of patients to clinical trials, J. Chron. Dis. 27 (1974) 365-375.). This system was created by the 'PERL' language for writing common gateway interface (CGI) script, and can therefore, be easily extended to include data entry function by attending doctors as well as the random allocation function. This system is being used effectively in thirteen multi-institutional randomized clinical trials for stomach, colon-rectum and breast cancers in Japan. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.

    DOI: 10.1016/S0169-2607(99)00047-4

    Web of Science

    researchmap

  • Evaluation of a new amplified enzyme immunoassay (EIA) for the detection of Chlamydia trachomatis in male urine, female endocervical swab, and patient obtained vaginal swab specimens 査読

    Masatoshi Tanaka, Hiroshi Nakayama, Kazuyuki Sagiyama, Masashi Haraoka, Hiroshi Yoshida, Toshikatsu Hagiwara, Kohei Akazawa, Seiji Naito

    Journal of Clinical Pathology   53 ( 5 )   350 - 354   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Aims - To compare the performance of a new generation dual amplified enzyme immunoassay (EIA) with a molecular method for the diagnosis of Chlamydia trachomatis, using a range of urogenital samples, and to assess the reliability of testing self collected vaginal specimens compared with clinician collected vaginal specimens. Methods - Two population groups were tested. For the first population group, first void urine samples were collected from 193 male patients with urethritis, and endocervical swabs were collected from 187 high risk commercial sex workers. All urine and endocervical specimens were tested by a conventional assay (IDEIA chlamydia), a new generation amplified immunoassay (IDEIA PCE chlamydia), and the Amplicor polymerase chain reaction (PCR). Discrepant results obtained among the three sample types were confirmed using a nested PCR test with a different plasmid target region. For the second population group, four swab specimens, including one patient obtained vaginal swab, two clinician obtained endocervical swabs, and one clinician obtained vaginal swab, were collected from 91 high risk sex workers. Self collected and clinician collected vaginal swabs were tested by IDEIA PCE chlamydia. Clinician obtained endocervical swabs were assayed by IDEIA PCE chlamydia and Amplicor PCR. Results - The performance of the IDEIA PCE chlamydia test was comparable to that of the Amplicor PCR test when male urine and female endocervical swab specimens were analysed. The relative sensitivities of IDEIA, IDEIA PCE, and Amplicor PCR on male first void urine specimens were 79.3%, 91.4%, and 100%, respectively. The relative sensitivities of the three tests on female endocervical specimens were 85.0%, 95.0%, and 100%, respectively. The positivity rates for patient collected vaginal specimens and clinician collected vaginal specimens by IDEIA PCE were 25.2% and 23.1%, respectively, whereas those for clinician collected endocervical swabs by PCR and IDEIA PCE were both 27.5%. Conclusions - IDEIA PCE chlamydia is a lower cost but sensitive alternative test to PCR for testing male urine samples and female endocervical swabs. In addition, self collected or clinician collected vaginal specimens tested by IDEIA PCE chlamydia are a reliable alternative to analysing endocervical specimens.

    DOI: 10.1136/jcp.53.5.350

    Scopus

    PubMed

    researchmap

  • Accessing endoscopic images for remote conference and diagnosis using WWW server with a secure socket layer 査読

    M. Hashiba, T. Matsuto, F. Arai, T. Yamakawa, K. Akazawa

    Journal of Medical Systems   24 ( 6 )   333 - 338   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Out of 137 hospitals in Niigata prefecture, 13 are connected to the Internet. The number of private clinics using the Internet has also increased. It is thought that an endoscopic information exchange over the Internet connection is useful for the cooperation between hospitals, clinics and organizations in related fields. A conventional World Wide Web (WWW) server of endoscopic images has been built around a compressed JPEG (Joint Panel Expert Group) format, for remote conferences and diagnoses. It has been made secure using a proxy server, a firewall server and a Secure Socket Layer (SSL). It is easy to access the server and view these endoscopic images using the usual homepage browsing method. Ordinarily, gastroenterologists would diagnose lesions with endoscopy in most cases. It is suggested that this conventional WWW server will be effective for remote conferences in some cases, even consultation will be possible.

    DOI: 10.1023/A:1005596610165

    Scopus

    PubMed

    researchmap

  • Low cell binding ability of HCV is closely related to interferon treatment especially in patients with HCV genotype 2a/2b: A large series prospective study on Japanese patients with chronic hepatitis C 査読

    Yoichi Kimura, Kazuhiro Hayashida, Yusuke Yanagi, Hiromi Ishibashi, Kouhei Akazawa, Yoshiyuki Niho

    Journal of Hepatology   33 ( 5 )   818 - 825   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Munksgaard  

    Background/Aims: We have previously shown that the quantity of antibody-free virion in the pre-treatment sera of the patients with chronic hepatitis C is a good predictive factor for the efficacy of interferon treatment. However, the biological significance of the free virion should be verified by a prospective study. Methods: We prospectively evaluated 152 consecutive patients with chronic hepatitis C who received a standardized interferon treatment, and analyzed the free virion and the binding titers, the ability of hepatitis C virus (HCV) to bind to the human lymphocytic cell line. Results: Sixty-five patients achieved a long-term sustained remission, 76 patients did not respond to the interferon therapy, and 11 patients dropped out. The sera from the patients with genotype 2a/2b had significanfly lower free virion and cell binding titers than those with genotype 1b. A multivariate analysis showed three independent variables associated with the interferon response
    cell binding titer &lt
    100.5/ml, viral load &lt
    104.5 copies/50 μl, and genotype 2a/2b with odds ratios of 14.6, 11.8, and 9.8, respectively. Conclusions: The low level of in vitro cell binding ability of HCV helped to clarify the good responsiveness to interferon observed in patients especially with a high viral load of genotype 2a/2b.

    DOI: 10.1016/S0168-8278(00)80315-3

    Scopus

    PubMed

    researchmap

  • Thymus-independent expansion of T lymphocytes in children after allogeneic bone marrow transplantation 査読

    K. Honda, H. Takada, Y. Nagatoshi, K. Akazawa, S. Ohga, E. Ishii, J. Okamura, T. Hara

    Bone Marrow Transplantation   25 ( 6 )   647 - 652   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nature Publishing Group  

    The contribution of the thymus-dependent pathway and thymus-independent pathways for T cell regeneration after BMT in children is still unclear. We analyzed the kinetics of T cell regenerative pathways after allogeneic BMT. The number of CD4+CD45RA+ T cells, a thymus-dependent population, was very low until 3 months after BMT. The numbers of CD28- T cells and CD8+ T cells expressing CD8α/α homodimer (CD8α/α+ T cells), a thymus-independent population, increased shortly after BMT, beyond the levels of healthy children in some patients. The numbers of Vγ9+Vδ2+ and Vα24+ T cells, which represent populations of extrathymic development, were less than 200/μl during the 6 months after BMT. There was a significant inverse correlation between the percentages of CD4+CD45RA+ and CD28- T-cells at 1 month, and a positive correlation between the percentages of CD28- and CD8α/α+ T cells at 2 and 3 months after BMT. The mean age at BMT was higher in patients with a high level of CD8α/α+ T cells than in those without an increase in these cells, suggesting the influence of thymic function on the regenerative pathways. These results suggest that the thymus-independent pathway is the dominant source of T cells even in children shortly after allogeneic BMT.

    DOI: 10.1038/sj.bmt.1702198

    Scopus

    PubMed

    researchmap

  • Serum vascular endothelial growth factor: A new predictive indicator for the occurrence of coronary artery lesions in Kawasaki disease 査読

    Takuro Ohno, Hisaji Igarashi, Kazuhiko Inoue, Kouhei Akazawa, Kunitaka Joh-o, Toshiro Hara

    European Journal of Pediatrics   159 ( 6 )   424 - 429   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Verlag  

    We investigated serum vascular endothelial growth factor (SVEGF) levels in Kawasaki disease and determined whether these levels had any association with the development of coronary artery lesions. We measured SVEGF levels in 66 patients with Kawasaki disease, 18 patients with active infections and 18 afebrile controls. SVEGF levels of patients in the acute phase of Kawasaki disease (0.0-2003.6 pg/ml, median 59.87 pg/ml) were significantly higher than those of patients with active infections (0.0-45.2 pg/ml, median 8.10 pg/ml
    P &lt
    0.05) or afebrile controls (0.0-49.8 pg/ml, median 7.75 pg/ml
    P &lt
    0.05) and decreased to undetectable or low levels in the recovery phase (n = 31, acute phase: 0.0-2003.6 pg/ml, median 62.50 pg/ml versus recovery phase: 0.0- 146.5 pg/ml, median 26.90 pg/ml
    P = 0.0007) of the disease. There existed a positive correlation between SVEGF levels and serum C-reactive protein concentrations in the acute phase of Kawasaki disease (r(s) = 0.347, P = 0.0051). In addition, SVEGF level and duration of fever were found to be major risk factors for the occurrence of coronary artery lesions by univariate (P = 0.012 and P = 0.003, respectively) and multivariate (P = 0.037, OR 6.16 and P = 0.0059, OR 7.59, respectively) analyses. Conclusion: Serum vascular endothelial growth factor level, in combination with persistence of fever, could be a powerful predictor for the development of coronary aneurysms.

    DOI: 10.1007/s004310051300

    Scopus

    PubMed

    researchmap

  • Properties of rat cone-mediated electroretinograms during light adaptation 査読

    Yoshinobu Goto, Shozo Tobimatsu, Junya Shigematsu, Kohei Akazawa, Motohiro Kato

    Current Eye Research   19 ( 3 )   248 - 253   1999年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Purpose. Our aim was to better understand how to isolate the cone-mediated response in rats. Therefore, we studied the difference of ERGs in the course of light adaptation between 2 and 20 Hz stimulus frequencies. Methods. A total of 90 rats divided into 18 different groups were used following overnight dark adaptation. ERGs were recorded against 3 different adapting field luminances (1.15, 1.50 or 1.75 log cd/m2) with a combination of 3 stimulus flash intensities (0.86, 1.30 or 2.03 log cd sec/m2). The responses were obtained at 2 minute intervals for 25 minutes of light adaptation. Results. The response of the rat cone ERG was large despite the small number of cones. The mean amplitude increased systematically from the dark-adapted value requiring more than 15 minutes to reach an asymptote at 2 Hz stimulation, but only 10 minutes at 20 Hz stimulation. The 2 Hz adaptation curves had biphasic pattern compared to the monophasic 20 Hz curve. This second increase in the amplitude at 2 Hz appeared at around 7-8 minutes as a function of adaptation time. This tendency was most evident when using a low adapting field luminance with a high flash intensity. Conclusions. Our results suggest that the rods intrude much more during light adaptation at 2 Hz stimulation in rodents than in humans. Therefore, 20 Hz flicker stimulation can better isolate more the cone-mediated function than 2 Hz stimulation during the course of light adaptation in rats. Furthermore, the functional characteristics of the cone in rats may be different from that in humans.

    DOI: 10.1076/ceyr.19.3.248.5313

    Scopus

    PubMed

    researchmap

  • The effect of tranilast on experimental proliferative vitreoretinopathy 査読

    Shinji Ito, Taiji Sakamoto, Yoshihisa Tahara, Yoshinobu Goto, Kouhei Akazawa, Tatsuro Ishibashi, Hajime Inomata

    Graefe's Archive for Clinical and Experimental Ophthalmology   237 ( 8 )   691 - 696   1999年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Tranilast has been clinically used for various allergic diseases. Recently, it has also been found to inhibit excessive scarring in wound healing processes. In this study, we examined the effects of tranilast on the treatment for experimental proliferative vitreoretinopathy (PVR). Methods: Cultured rabbit conjunctival fibroblasts were injected intravitreously (50,000 cells/eye) into the rabbit vitreous to induce experimental PVR. Immediately after that, tranilast (0.5-5 mg/ml, 0.1 ml/eye) was injected into the vitreous. Injection of vehicle solution was used as a negative control. PVR was clinically evaluated by masked observers using ophthalmoscopy and graded into six stages: 0 (no PVR) to 5 (severe PVR). The amount of transforming growth factor β1 (TGF-β1) in the vitreous was measured by ELISA method. Functional and morphological changes induced by 5 mg/ml tranilast were sought by electroretinography, light microscopy, and electron microscopy on day 28. Results: The average stage of PVR in the eyes treated with tranilast (1 or 5 mg/ml) was significantly lower than that in the control group on days 14 and 28. There was no difference between the eyes treated with low-dose tranilast (0.5 mg/ml) and the control group. The amount of TGF-β1 in the vitreous of tranilast-treated eyes was significantly lower than in the control group. The morphological and functional studies did not show any deleterious effect of tranilast on the retinal function and morphology. Conclusion: Tranilast effectively inhibits the progression of PVR without showing apparent toxicity of the eye. This agent has therapeutic value for PVR.

    DOI: 10.1007/s004170050298

    Scopus

    PubMed

    researchmap

  • Postoperative chemo-endocrine treatment with mitomycin C, tamoxifen, and UFT is effective for patients with premenopausal estrogen receptor-positive stage II breast cancer 査読

    K Sugimachi, Y Maehara, K Akazawa, Y Nomura, K Eida, M Ogawa, E Konaga, N Tanaka, T Toge, K Dohi, S Noda, M Maeda, Y Monden

    BREAST CANCER RESEARCH AND TREATMENT   56 ( 2 )   113 - 124   1999年7月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:KLUWER ACADEMIC PUBL  

    The effectiveness of combining mitomycin C (MMC), tamoxifen (TAM), and 1-(2-tetrahydrofuryl)-5-fluorouracil (tegafur) was evident in patients with estrogen receptor-positive (ER+) breast cancers. UFT, an oral preparation of tegafur and uracil at a molar ratio of 1:4, was reported to have higher antitumor effects than tegafur alone for patients with breast cancer. Therefore, the combined chemotherapy of MMC, TAM and UFT may possibly be effective for breast cancer.
    From 1988 to 1991, we studied the effects of postoperative adjuvant therapy for Japanese women with stage II breast cancer, all seen at 71 institutions in western areas of Japan. Five hundred and ninety four patients with stage II primary breast cancer who had undergone curative surgery, including total mastectomy and axillary lymph node dissection, were enrolled. On the day of surgery, each patient was given 13 mg/m(2) of MMC intravenously. Patients with ER+ tumors were then assigned to group A or group B. Group A received 30 mg/day of TAM given orally from postoperative 2 weeks, for 2 years. Group B was additionally given an oral dose of 300 mg/day of UFT for 2 years, given concomitantly with 30 mg/day of TAM. Patients with ER- tumors were assigned to group C or group D. Group C were prescribed 300 mg/day of UFT, orally, from postoperative 2 weeks for 2 years, and group D were additionally given an oral dose of 30 mg/day of TAM together with 300 mg/day of UFT.
    There were no differences among the groups regarding prognostic factors or doses of MMC and TAM in ER+ patients and MMC and UFT in ER- patients. Toxicity rates for leukopenia, anorexia, and nausea/vomiting were higher in group B than in group A patients. There were no statistical differences in the overall survival and disease-free survival times between groups A and B, or groups C and D, for all eligible cases. In a retrospective subgroup analysis using Bonferroni's adjustments, the additional effect of UFT on the combined treatment of MMC and TAM lengthened the disease-free survival time for patients with premenopausal ER+ cancers (corrected P value by Bonferroni's adjustments &lt; 0.05). Multivariate analysis showed that effects of the combined treatment of MMC, TAM, and UFT was significantly related to the menopausal status (P &lt; 0.01).
    Our findings show that postoperative ingestion of MMC, TAM, and UFT was effective for patients with premenopausal ER+ stage II breast cancer.

    Web of Science

    researchmap

  • Prolonged survival in hereditary nonpolyposis colorectal cancer 査読

    H Tomoda, H Baba, K Akazawa

    ONCOLOGY REPORTS   6 ( 2 )   321 - 324   1999年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PROFESSOR D A SPANDIDOS  

    We compared the survival between 46 patients with hereditary nonpolyposis colorectal cancer (HNPCC) and 1185 cases with sporadic colorectal cancer, who underwent a resection for the disease between 1972 and 1995. In a univariate analysis, the survival correlated well with stage, curability, size and the presence of HNPCC. Patients with HNPCC had a longer survival than those with sporadic colorectal cancer (P=0.0277). A multivariate analysis suggested that stage, curability, age, and HNPCC were the effective combination of factors predictive of survival. The above findings are thus expected to have a major influence on the evaluation of clinical trials in patients with colorectal cancer.

    Web of Science

    researchmap

  • Rhythmic changes in the stomach movement of the human fetus with congenital duodenal obstruction during the third trimester of pregnancy 査読

    Samia Mohamed Hussein, Toshiyuki Yoshizato, Shigehiro Fukushima, Takashi Koyanagi, Kouhei Akazawa, Hitoo Nakano

    Early Human Development   54 ( 1 )   1 - 13   1999年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In order to reveal whether or not rhythmic changes exist in fetal stomach movement (FSM), in utero FSM was assessed in three fetuses between 27 and 33 weeks' gestation with congenital duodenal obstruction. A total of four observations, one each at 27, 29, 31 and 33 weeks' gestation, was obtained. The longitudinal transection of each fetal stomach was continuously observed for 60 min using real-time ultrasound. The configuration and the area of the stomach were analyzed for each 15-s epoch. The complexity of the stomach configuration was quantified and defined as stomach complexity. For each case, the chronological changes of the stomach complexity were analyzed using the least median square of regression. The correlation between changes of the stomach complexity and the area of the stomach was analyzed using the cross-correlation method. (1) For gestational ages of 27, 29, 31 and 33 weeks, the 240 sequential measurements of the stomach complexity were significantly stratified into outlying and non-outlying points. The outlying points were 13.3% (32/240), 30.8% (74/240), 32.9% (79/240) and 36.3% (87/240) of the total observation points, respectively. (2) The percentages in which outlying points lasted 3 min (12 points) or more were 0% (0/240), 5.0% (12/240), 28.3% (68/240) and 30.4% (73/240) of the total observation points, respectively. (3) For each gestational age, no significant time series correlation was found between the stomach complexity and the area of the stomach. These findings suggest that: (1) two different conditions emerge in the FSM, at the latest at 27 weeks' gestation, and begin manifesting from 29 weeks' gestation onwards. (2) These chronological changes cluster into 'active' and 'quiet' phases from 31 weeks' gestation onwards. (3) FSMs are not related to the changes in the stomach area throughout the observation periods. The underlying mechanism of this rhythmicity may represent the development of ultradian rhythm of the stomach movement, generated by the central nervous system. Copyright (C) 1999 Elsevier Science Ireland Ltd.

    DOI: 10.1016/S0378-3782(98)00079-6

    Scopus

    PubMed

    researchmap

  • Role of transforming growth factor-beta 1 in invasion and metastasis in gastric carcinoma 査読

    Y Maehara, Y Kakeji, A Kabashima, Y Emi, A Watanabe, K Akazawa, H Baba, S Kohnoe, K Sugimachi

    JOURNAL OF CLINICAL ONCOLOGY   17 ( 2 )   607 - 614   1999年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO  

    Purpose: Transforming growth factor-beta1 (TGF-beta 1) is a major modulator of cellular proliferation and extracellular matrix formation. We determined the role of TGF-beta 1 in invasion and metastasis in gastric cancer.
    Materials and Methods: We detected TGF-beta 1 expression in primary and lymph node metastatic lesions of gastric cancer, using an antibody and in situ hybridization. The plasma TGF-beta 1 levels in the peripheral vein and in the tumor drainage vein were assayed.
    Results: In the cytoplasm of cancer cells, TGF-beta 1 was immunostained in 35.9% (78 of 217) of primary gastric carcinomas, and this expression was confirmed by in situ hybridization. Of 59 gastric carcinomas with a TGF-beta 1-negative primary tumor, metastatic lymph nodes were positive for TGF-beta 1 staining in 32 cases (54.2%). Positive staining of TGF-beta 1 in gastric cancer tissues was closely related to serosal invasion, infiltrative growth, and lymph node metastasis. Multivariate analysis showed that the expression of TGF-beta 1 was an independent risk factor for serosal invasion and infiltrative growth of the tumor. The plasma level of TGF-beta 1 did not differ between TGF-beta 1-negative and -positive groups. There were also no differences in plasma TGF-beta 1 levels among each tumor stage, between the peripheral and the tumor drainage veins, and between preoperative and postoperative testings.
    Conclusion: Transforming growth factor-beta 1 is closely related to the invasion and metastasis of gastric cancer, and production of TGF-beta 1 in the tumor does not contribute to the total amount of TGF-beta 1 in the blood circulation. We interpret our observations to mean that in a tumor microenvironment, TGF-beta 1 alters the biologic behavior of the tumor. (C) 1999 by American Society of Clinical Oncology.

    Web of Science

    researchmap

  • Quality of life after laparoscopy-assisted Billroth I gastrectomy 査読

    Yosuke Adachi, Toshihiro Suematsu, Norio Shiraishi, Takeshi Katsuta, Akio Morimoto, Seigo Kitano, Kohei Akazawa

    Annals of Surgery   229 ( 1 )   49 - 54   1999年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective: To evaluate the quality of life of patients who had undergone laparoscopy-assisted Billroth I gastrectomy (LAG) for cure of cancer. Summary Background Data: In 1994, the authors reported the first case of LAG for early gastric cancer, and this approach quickly has been adopted by Japanese surgeons. However, little is known about the subjective clinical results of this less invasive surgery. Methods: Quality of life was estimated using the 24-item questionnaire with a scoring system of 1,2, and 3 and was compared between 41 consecutive patients with LAG and 35 with conventional open gastrectomy. All patients underwent Billroth I gastrectomy for early gastric cancer from January 1993 to July 1997 and were alive without recurrence. Results: Patients who had undergone LAG were taking a normal diet (100%) with &gt
    66% of volume at each meal (90%), showed no decreased performance status (90%), and were satisfied with their surgical results (88%). Patients with LAG, when compared with open gastrectomy, showed significantly better results with regard to weight loss, difficulty in swallowing, heartburn and belch, early dumping syndrome, and total score. LAG was better accepted by the patients. Conclusions: Quality of life after Billroth I gastrectomy was significantly better in patients in whom a laparoscopic technique was used than in those who underwent a conventional method. LAG is less invasive and better accepted by patients and is the procedure of choice for the treatment of early gastric cancer.

    DOI: 10.1097/00000658-199901000-00006

    Scopus

    PubMed

    researchmap

  • The available period and kind of exercise for increasing osteo sono assessment index in women 査読

    Misuzu Tanaka, Naoko Kinukawa, Kouhei Akazawa, Shimako Abe, Kazue Itoh, Katsumi Imai, Takashi Masuda, Motoomi Nakamura

    Medicine and Science in Sports and Exercise   31 ( 12 )   1709 - 1713   1999年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:American College of Sports Medicine  

    Purpose: The purpose of this study is to determine the optimum period and kind of exercise which are more effective for increasing the calcaneus osteo sono assessment index (OSI) in adolescent women. Methods: The subjects consisted of 600 female students aged from 19 to 21 studying at the Department of Food and Nutrition at Nakamura Gakuen University. The calcaneus OSI was measured by ultrasonic bone absorptiometry. The factors associated with an increased OSI were determined using piecewise linear regression analyses. Results: Experience in performing impact-loading exercise either in junior high school or high school was found to be a significant predictive factor for increased calcaneus OSI after adjusting for age and weight. Regarding other exercise-related factors such as subjective intensity, frequency, hours at a time, and total duration of exercise, a piecewise liner regression analysis showed that a total duration of over 7 yr and a high subjective intensity of the impact-loading exercise during high school and junior high school periods caused a significant increase in the calcaneus OSI. However, the OSI decreased when the subjective intensity of the impact- loading exercise during the high school period was reported to be 'very strenuous.' Conclusions: Impact-loading exercise in junior high school and high school is important for increasing calcaneus OSI
    however, impact- loading exercise in high school with a 'very strenuous' subjective intensity was also found to possibly decrease the calcaneus OSI.

    DOI: 10.1097/00005768-199912000-00004

    Scopus

    PubMed

    researchmap

  • An analysis of risk factors for upper urinary tract deterioration in patients with myelodysplasia 査読

    N. Seki, K. Akazawa, K. Senoh, S. Kubo, T. Tsunoda, Y. Kimoto, S. Naito

    BJU International   84 ( 6 )   679 - 682   1999年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective. To identify the risk factors for upper urinary tract deterioration in a retrospective study of patients with myelodysplasia. Patients and methods. The medical history, radiographic studies and urodynamic results from 39 children with myelodysplasia who were treated at our hospital were reviewed retrospectively to obtain more accurate data in the prognosis of such patients. The upper urinary tracts were assessed by cysto-urethrography and excretory urography to determine the incidence of vesico-ureteric reflux (VUR) and hydronephrosis. The relationships between the urodynamic variables, including vesical compliance, detrusor hyper-reflexia, detrusor-sphincter dyssynergia (DSD) and the maximum urethral closing pressure (MUCP) to such upper tract deterioration were evaluated using both univariate and multiple logistic regression analysis. Results. The univariate analysis showed low vesical compliance, a high level of MUCP and the presence of DSD to be significant factors for the incidence of VUR. Low vesical compliance and a high level of MUCP also correlated with the incidence of hydronephrosis. The multivariate analysis showed a significant relationship between urodynamic values and upper urinary tract deterioration. The incidence of VUR was strongly correlated with a high MUCP and the presence of DSD. A high MUCP was also a significant factor in the incidence of hydronephrosis. Conclusion. Urodynamic results associated directly with tile abnormal function of urethral control are significantly correlated with the cause of upper tract deterioration in patients with myelodysplasia.

    DOI: 10.1046/j.1464-410x.1999.00220.x

    Scopus

    PubMed

    researchmap

  • Prediction of the clinical and histological severity of iga nephropathy by flow cytometry of urinary mononuclear cells 査読

    S. S. Deenitchina, T. Ando, K. Akazawa, H. Hirakata, R. Katafuchi, M. Fujishima

    Clinical and Experimental Nephrology   3 ( 4 )   272 - 278   1999年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Japan  

    Background. Urinary mononuclear cells (UMCs) were studied in IgA nephropathy (IgAN) in relation to clinical and histopathological parameters. Methods. A two-color flow-cytometry analysis was used to phenotype and quantitate UMCs in patients with IgAN (n = 37) and those with other kidney diseases (n = 27). Results. The IgAN patients had higher numbers of UMCs than the patients with other kidney diseases. Macrophages (CD14+
    P &lt
    0.0001) and T lymphocytes (CD3+
    P = 0.0001
    CD4+, P &lt
    0.0001) were predominantly found. In the IgAN patients, the quantities of urinary CD3+, CD14+ cells correlated with impaired renal function
    namely, 'serum creatinine, creatinine clearance, and urinary protein excretion. The UMCs were associated with histopathological changes such as glomerular segmental lesions (r = 0.511
    P &lt
    0.01 for CD3+
    r = 0.623, P &lt
    0.0001 for CD4+, and r = 0.552
    P &lt
    0.001 for CD14+) and the index of glomerular hypercellularity (r = 0.405
    P = 0.01 for CD3+ T cells and r = 0.392, P = 0.01 for CD14+ macrophages). Moreover, the UMCs reflected the severity of pathology, as estimated by the glomerular score (r = 0.424
    P &lt
    0.01 for CD3+
    r = 0.458
    P &lt
    0.01 for CD4+
    r = 0.500, P = 0.001 for CD14+ cells). UMCs were weakly correlated with tubulointerstitial changes. Conclusion. UMCs were associated with the clinical stage of IgAN and mirrored the extent of histopathology in the kidney. Flow-cytometry analysis of UMCs may help to predict the course of the disease.

    DOI: 10.1007/s101570050047

    Scopus

    researchmap

  • N-myc gene amplification in rhabdomyosarcoma detected by fluorescence in situ hybridization: Its correlation with histologic features 査読

    Yoichi Hachitanda, Satoshi Toyoshima, Kouhei Akazawa, Masazumi Tsuneyoshi

    Modern Pathology   11 ( 12 )   1222 - 1227   1998年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Fluorescence in situ hybridization (FISH) was applied to 15 alveolar rhabdomyosarcomas (A-RMSs) and 14 embryonal RMSs (E-RMSs) to detect N-myc (also called MYCN) oncogene amplification. The results were compared with histologic characteristics and clinical factors. The number of surviving patients in each subtype was 5 of 15 with A-RMS and 5 of 14 with E-RMS. N- myc amplification was detected in 9 of the 15 A-RMSs but in none of the 14 E- RMSs. Tumor cells exhibiting N-myc amplification were identified only in the alveolar area in two A-RMSs, and they demonstrated a histologic mixture of alveolar and embryonal patterns. The remaining seven cases with an amplified N-myc showed a conventional alveolar pattern. Among the 15 A-RMSs, the survival rate of patients with tumors showing nonamplified N-myc and amplified N-myc oncogene was 4 (66%) of 6 and 1 (11%) of 9, respectively (P &lt
    .05). No significant difference was observed between the other clinical findings (age, primary sites, clinical stages) of the N-myc-amplified and nonamplified tumors. Therefore, we concluded that the N-myc gene amplification, which is characteristic of a particular subtype of A-RMS, might be useful as a prognostic factor for an unfavorable outcome.

    Scopus

    PubMed

    researchmap

  • Baseline imbalance caused by stratified random sampling 査読

    T Nakamura, K Akazawa, N Kinukawa, Y Nose

    ACTA PHARMACOLOGICA SINICA   19   66 - 67   1998年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ACTA PHARMACOLOGICA SINICA  

    Web of Science

    researchmap

  • Attachment of hepatitis C virus to cultured cells: A novel predictive factor for successful interferon therapy 査読

    Yoichi Kimura, Kazuhiro Hayashida, Hiromi Ishibashi, Yoshiyuki Niho, Kouhei Akazawa, Yusuke Yanagi

    Journal of Medical Virology   56 ( 1 )   25 - 32   1998年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In order to identify reliable predictive factors for the response to interferon (IFN) therapy, we examined 52 patients with chronic hepatitis C virus (HCV) infection who underwent IFN therapy. Titers of free virions that were not complexed with antibodies were determined by immunoprecipitation of the pretreatment sera with antihuman immunoglobulin. Cell attachment titers were determined by inoculating HPB-Ma cells, a human T-cell line, with the patients' pretreatment sera. A sustained remission was achieved in 9 out of 28 patients with genotype 1b infection and in 18 out of 24 patients with genotype 2 infection, The free virion titers and the cell attachment titers correlated well with the serum HCV RNA levels in patients with genotype 1b infection (r = 0.817, P &lt
    0.001
    r = 0.802, P &lt
    0.001, respectively), but not in those with genotype 2 infection. They exhibited a high correlation with the responsiveness to IFN in all patients combined (P&lt
    0.001). A multiple logistic regression analysis was performed to identify the factor most significantly associated with the response to IFN among all confounding factors. The analysis indicated that the cell attachment is the most reliable predictive factor regarding a favorable response to IFN therapy in patients with chronic HCV infection.

    DOI: 10.1002/(SICI)1096-9071(199809)56:1<25::AID-JMV5>3.0.CO;2-P

    Scopus

    PubMed

    researchmap

  • A statistical model that takes into account patient heterogeneity in decision making 査読

    K Akazawa, T Nakamura, Y Nose

    MEDINFO '98 - 9TH WORLD CONGRESS ON MEDICAL INFORMATICS, PTS 1 AND 2   52   525 - 528   1998年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(国際会議プロシーディングス)   出版者・発行元:I O S PRESS  

    Statistical evaluation of clinical treatments or preventive medicine has profoundly contributed to decision making in medical fields such as with the acceptance of new treatment methods and health promotion policies. It is crucial in such decision making to find a correct statistical model to heat a surprisingly large variety of patients, or a heterogeneous group of patients, even with the same diagnosis. In diseases such as cancer, cardiovascular disease or diabetes, patients are often followed up to certain endpoints and these data are frequently analyzed by logrank tests or Cox-models to evaluate treatment effects. Although these methods have been widely accepted and extensively studied we are sometimes faced with problems in applying these methods when the heterogeneity of patients is large and a lot of prognostic factors affecting the endpoints have to be considered. Based on the results of the analyses of survival data from more than 6,000 gastric cancer patients, if is revealed that the stratified logrank test may suffer serious power loss, even though primary prognostic factors are used as stratified factors. A so-called 'piecewise linear Cox regression method' for properly heating the heterogeneity of patients is introduced and extensively studied. This method is shown to be appropriate for patient groups with a high degree of heterogeneity such as the gastric cancer patients. The same method is, in principle, applicable to patients of other diseases, too, using statistical software such as SAS, BMDP and etc.

    DOI: 10.3233/978-1-60750-896-0-525

    Web of Science

    researchmap

  • A NOTE ON THE CORRECTED SCORE FUNCTION ADJUSTING FOR MISCLASSIFICATION 査読

    Kouhei Akazawa, Naoko Kinukawa, Tsuyoshi Nakamura

    OURNAL OF THE JAPAN STATISTICAL SOCIETY   28 ( 1 )   115 - 123   1998年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.14490/jjss1995.28.115

    researchmap

  • Reduced chlamydial infection and gonorrhea among commercial sex workers in Fukuoka City, Japan 査読

    Masatoshi Tanaka, Hiroshi Nakayama, Misao Sakumoto, Koichi Takahashi, Tatsuo Nagafuji, Kohei Akazawa, Joichi Kumazawa

    International Journal of Urology   5 ( 5 )   471 - 475   1998年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Churchill Livingstone Japan  

    Background: Until recently, epidemiologic studies of sexually transmitted diseases (STDs), including human immunodeficiency virus type-1 (HIV-1) infection, among Japanese female commercial sex workers and their patterns of condom use have been rare. We investigated trends in STDs among female commercial sex workers and their condom use patterns in Fukuoka, Japan, from 1990 through 1995. Methods: The study group consisted of 1218 female commercial sex workers who attended an STD clinic to undergo screening for major STDs including chlamydial infection, gonorrhea and HIV-1 infection from 1990 through 1995. Endocervical smear specimens were taken from the women to detect Chlamydia trachomatis and Neisseria gonorrhoeae, and blood samples were obtained for the serologic diagnosis of HIV-1. Also, the commercial sex workers were interviewed concerning their condom use patterns. Results: The annual infection and detection rates of C. trachomatis declined significantly from 58.1% in 1990 to 46.2% in 1995 and from 16.3% in 190 to 10.0% in 1995, respectively, while the annual infection and detection rates of N. gonorrhoeae also declined significantly from 1 3.2% in 1990 to 3.5% in 1995 and from 1.5% in 1990 to 0.4% in 1995, respectively. None were found to be seropositive for HIV-1 during the 6-year period. The proportion of commercial sex workers using condoms significantly increased during 1992-1993 and 1994-1995 periods, as compared with the 1990-1991 period. Conclusion: Reductions in the prevalence of major STDs among female commercial sex workers may be related to an increase in the frequency of condom use.

    DOI: 10.1111/j.1442-2042.1998.tb00390.x

    Scopus

    PubMed

    researchmap

  • A clinical study of decreased bone density in the patients treated with long term luteinizing hormone releasing hormone analogue (LHRH-a) - The risk of iatrogenic osteoporosis due to treatment of carcinoma of prostate - 査読

    Yasuyuki Suzuki, Ken Aikawa, Yukihiko Oishi, Haruki Yamazaki, Tetsuro Onishi, Masayasu Suzuki, Toshihiko Kobari, Katsuhisa Endo, Shuichi Yanada, Nobuki Kato, Yasumasa Yoshino, Tetsuro Wada, Masatake Ueda, Satoshi Takasaka, Kouhei Akazawa

    Japanese Journal of Urology   89 ( 12 )   961 - 966   1998年

     詳細を見る

    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Urological Association  

    (Background) It is well known that androgens play an important role in bone metabolism and male hypogonadism induce osteoporosis. Luteinizing hormone-releasing hormone analogue (LHRH-a) which is essential for conservative therapy of prostatic carcinoma (CaP) ultimately reduces circulating testosterone to castration levels. The purpose of this study was to determine the risk of decrease of bone mineral density in men receiving LHRH-a for CaP. (Patients and Methods) Fifty-three man with CaP aged 63 to 95 years (mean 75.5 years) were included in this study. Seven patients received LHRH-a with estrogen drug, forty-six patients received LHRH-a with or without anti androgen drug. To estimate patient's bone density we use the second metacarpal bone density using a microdensitometry method. (Results) Blood level of sex hormone of the forty-six patients who were received LHRH-a without estrogen, was the same as that of castration. Patients who were treated more than twelve months had less bone density than patients who were treated less than eleven months. As the duration of medical castration period was prolonged, patients bone density were reduced. Whereas seven patients who received estrogen drug did not find a decrease of bone density regardless of duration of treatment period. (Conclusions) Hypogonadism induced LHRH-a also reduce bone density, so there is a risk of iatrogenic osteoporosis caused by therapy for CaP with LHRH-a. Patients with osteoporosis easily suffer from a much complicated and pernicious bone fracture, so we should measure bone density of male patients same as female treated with LHRH-a for a long term.

    DOI: 10.5980/jpnjurol1989.89.961

    Scopus

    researchmap

  • Evaluation of abdominal lymphadenopathy in children by ultrasonography 査読

    Mamie Watanabe, Eiichi Ishii, Yoshinori Hirowatari, Yutaka Hayashida, Takafumi Koga, Kouhei Akazawa, Sumio Miyazaki

    Pediatric Radiology   27 ( 11 )   860 - 864   1997年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background. There may be uncertainty as to whether enlarged abdominal lymph nodes (LNs) in children are normal or abnormal. Objective. To compare, by ultrasonography (US), enlarged abdominal LNs in healthy children with those in children with acute abdominal pain or acute gastroenteritis. Materials and methods. One hundred and twenty-two asymptomatic children were selected by questionnaire and compared with 44 children with acute abdominal pain of unknown origin and 27 children with acute gastroenteritis. The number of LNs, their location, their shape and the presence of tenderness as detected by finger compression of each LN were evaluated. The children were divided into four groups according to age: 0-2, 3-6, 7-10, and 11-15 years. Results. LNs were detected in the ileo-caecal and/or para-aortic areas in almost all of the asymptomatic children. The number of large LNs (&gt
    10 mm) in the para-aortic areas was higher in the older children (≤ 7 years of age) than in the younger children (≤ 6 years of age) (P &lt
    0.05). The number of spindle shaped LNs (ratio of long- to short-axis diameter ≤ 2.0) was increased in the older children. The number of LNs was not increased in the children with acute abdominal pain. The size of the LNs was largest in the children with acute gastroenteritis, followed by the children with acute abdominal pain and the asymptomatic children (P &lt
    0.001). Although the shape of the LNs was no different among the three groups of children, the frequency of round-shaped LNs (ratio of long- to short-axis diameter &lt
    2.0) was greater in the older children with acute abdominal pain or acute gastroenteritis than in the asymptomatic children (P &lt
    0.01). The number of LNs with tenderness detected by finger compression was significantly greater in the children with acute abdominal pain and acute gastroenteritis than in the asymptomatic children (P &lt
    0.0001). Conclusion. The number of large and round-shaped LNs with tenderness tended to be increased in the children with acute gastroenteritis and acute abdominal pain. There is no clear specificity of LN enlargement in the children with acute abdominal pain, and the main challenge is to diagnose or estimate the organic pathology by US, regardless of the presence of lymphadenopathy.

    DOI: 10.1007/s002470050256

    Scopus

    PubMed

    researchmap

  • Surgical treatment and outcome for node-negative gastric cancer 査読

    Y Maehara, M Tomoda, S Tomisaki, M Ohmori, H Baba, K Akazawa, K Sugimachi

    SURGERY   121 ( 6 )   633 - 639   1997年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:MOSBY-YEAR BOOK INC  

    Background, The clinicopathologic characteristics and prognosis for patients with node-negative gastric cancer have heretofore remained to be determined.
    Methods. We analyzed data on 730 of our patients with node-negative gastric cancer who underwent curative gastric resection in the Department of Surgery II, Kyushu University Hospital, between 1965 and 1990, with reference to prognostic factors. The presence of lymph node metastasis was determined by means of routine hematoxylin-eosin staining of excised tissues.
    Results. The 5-year survival rate was 91.7 % and the 10-year rate was 88.5 %; thus the prognosis was good for patients with node-negative gastric cancer: When the prognosis was analyzed by stratification of each clinicopathologic factor, the survival time was shorter for older patients when the size of the tumor was larger, when the tumor involved the entire stomach, and when. tissues revealed infiltrative growth, serosal invasion, and lymphatic invasion. Extensive lymph node dissection was performed for 86.6 % of the patients, and for these patients the prognosis was better, with a statistical difference. In a multivariate analysis, tumor size, serosal invasion, and extensive lymph node dissection proved to be independent prognostic factors for patients with node-negative gastric cancer.
    Conclusions, Prophylactic lymph node dissection for patients with gastric cancer will prolong the survival time.

    Web of Science

    researchmap

  • Lymph node metastasis and relation to tumour growth potential and local immune response in advanced gastric cancer 査読

    Yoshihiko Maehara, Shinichi Tomisaki, Shinya Oda, Yoshihiro Kakeji, Shunichi Tsujitani, Yuji Ichiyoshi, Kohei Akazawa, Keizo Sugimachi

    International Journal of Cancer   74 ( 2 )   224 - 228   1997年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    To evaluate the relation between the degree of lymph node metastasis and the growth potential of tumour cells and the local immune function in gastric cancer, we analyzed data on 444 patients with advanced serosally invasive gastric cancer who underwent curative gastrectomy. Tumour growth potential was evaluated based on the value proliferating cell nuclear antigen (PCNA) in the primary tumour, and dendritic cell infiltration into the tumour was determined as an indicator of local immune function. The values of PCNA labeling in the primary tumour increased and the infiltration of dendritic cells into the tumour decreased in relation to the extent of lymph node metastasis. High growth potential and low immune function were seen in cases with n3 lymph node metastasis. There was a reverse relation between the PCNA labeling index and dendritic cell infiltration. A variety of forms of recurrence was noted in patients with lymph node metastasis while the prognosis was less favorable, in relation to the degree of lymph node metastasis. Thus, the potential for nodal spread appears to be associated with the growth potential of tumour cells and with the local immune status of the tumour.

    DOI: 10.1002/(SICI)1097-0215(19970422)74:2<224::AID-IJC15>3.0.CO;2-D

    Scopus

    PubMed

    researchmap

  • Power of logrank test and Cox regression model in clinical trials with heterogeneous samples. 査読

    Akazawa K, Nakamura T, Palesch Y

    Statistics in Medicine   16 ( 5 )   583 - 597   1997年3月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1002/(SICI)1097-0258(19970315)16:5<583::AID-SIM433>3.0.CO;2-Z

    Web of Science

    PubMed

    researchmap

  • Measures of explained variation for a regression model used in survival analysis 査読

    Kouhei Akazawa

    Journal of Medical Systems   21 ( 4 )   229 - 238   1997年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    This paper describes a measure of explained variation (MEV) of survival times for a given regression model used in survival analysis. It quantifies the predictive power of a set of prognostic factors in the model, and therefore provides useful information for more precise prediction of patient prognosis, and for designing randomized clinical trials with the capability of determining treatment effects. The MEV defined in this article is asymptotically derived from the squared product-moment correlation
    it can be interpreted as an adaptation of the multiple correlation coefficient for the normal linear model to the Survival time regression model. Monte-Carlo simulations are performed to investigate the statistical behavior of the proposed MEV. The MEV is applied to estimate the predictive power of several sets of prognostic factors for gastric cancer in Japan using data from a large clinical trial.

    DOI: 10.1023/A:1022884504683

    Scopus

    PubMed

    researchmap

  • K-ras and p53 mutations are an independent unfavourable prognostic indicator in patients with non-small-cell lung cancer 査読

    Y. Fukuyama, T. Mitsudomi, K. Sugio, T. Ishida, K. Akazawa, K. Sugimachi

    British Journal of Cancer   75 ( 8 )   1125 - 1130   1997年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nature Publishing Group  

    We examined 159 consecutive cases of non-small-cell lung cancer (NSCLC) for a mutation at codon 12 of the K-ras gene and for a mutation of the p53 gene occurring in exons 5-8. Eleven (6.9%) had mutations of the K-ras (ras+) and 57 (35.8%) had mutations of the p53 (p53+). There were 95 cases (59.7%) with ras-p53-, seven cases (4.4%) with ras+/p53-, 53 cases (33.3%) with ras -/p53+ and four cases (2.5%) with ras+/p53+. The ras+ group had a worse prognosis than the ras- group in all cases and in 107 early-stage cases (stage I-II, P &lt
    0.05). The p53+ group had a worse prognosis in 107 early-stage cases (P &lt
    0.01), but there was no statistically significant difference when 52 advanced-stage cases (stage III-IV) or all patients were considered. Both ras and p53 mutations were unfavourable prognostic factors in 94 cases with adenocarcinoma, but there was no statistical significance in 57 cases with squamous cell carcinoma. According to Cox's model, the pathological stage, ras mutation and p53 mutation were found to be independent prognostic factors. Our results suggest that ras and p53 mutations were independent unfavourable prognostic markers especially in the early stage of NSCLC or in adenocarcinoma.

    DOI: 10.1038/bjc.1997.194

    Scopus

    PubMed

    researchmap

  • Remote connection to the Kyushu University Medical Center LAN using digital and analog telephone lines 査読

    Yasuaki Antoku, Eisuke Hanada, Kouhei Akazawa, Yuko Kenjo, Yoshiaki Nose

    Journal of Medical Systems   21 ( 4 )   211 - 218   1997年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    SOHO (Small Office/Home Office) has recently become popular, as it makes working at home possible. Computers or Local Area Networks(LAN) connected to the office network from home are necessary for the implementation of this concept. Kyushu University has begun a service connecting home computers to the campus LAN for researchers, staff and students of the Faculty of Medicine. We have two different telephone connection methods. One connects the campus LAN and the home computer LAN using routers through the Integrated Services Digital Network (ISDN). The other connects computers at home to the workstation in the university, using modems and the PPP (Point to Point Protocol) through a public telephone analog line. This paper outlines our university SOHO connection system and discusses the merits and demerits of using telephone line connections.

    DOI: 10.1023/A:1022880403774

    Scopus

    PubMed

    researchmap

  • Blood pressure measurement in preschool children: The Hisayama study 査読

    H. Igarashi, J. Fukushige, K. Akazawa, Y. Nose, K. Ueda

    Journal of Paediatrics and Child Health   33 ( 6 )   480 - 483   1997年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing  

    Objective: To establish the blood pressure (BP) measurement protocol for Japanese preschool children, systolic BP (K1) and diastolic BP (K4, K5) were measured along with anthropometric values. Methodology: Commercially available mercury sphygmomanometers were used. In the first group of children (group A), BP was measured in 79 boys and 85 girls using a cuff g cm wide and 23 cm long. In the second group (group B), the length and circumference of the upper right arm of 147 boys and 139 girls were measured to select cuffs appropriate for their sizes. Blood pressure measurements were performed twice on the right arm of the children in the seated position at a mean interval of 5 min. Results: There were no significant differences in the anthropometric values (height, bodyweight, body mass index [BMI], length and circumference of the upper arm) between groups A and B. The BP values at K1, K4 and K5 in the first measurement of group B were 91 ±9, 54±8, and 48±10 mmHg (boys) and 90Å, 54±8, and 48±12 mmHg (girls), respectively. There were no significant differences between the first and second measurements in both groups, however, there were significant differences in the first and second measurements of K4 between groups A and B. Multiple regression analysis by the stepwise method revealed a strong correlation between K1 and the length of the upper arm in the boys and the bodyweight in the girls: between K4 and the bodyweight in the boys and the BMI in the girls, and between K5 and the height in the boys and the upper arm circumference in the girls. Conclusions: From these results it would appear that a single measurement is sufficient under appropriate measurement conditions such as rest before measurement and the choice of the cuff size according to the upper arm circumference, and that BP is closely correlated with the anthropometric values in preschool children.

    DOI: 10.1111/j.1440-1754.1997.tb01655.x

    Scopus

    PubMed

    researchmap

  • Recurrences and related characteristics of gastric cancer 査読

    Y Maehara, Y Emi, H Baba, Y Adachi, K Akazawa, Y Ichiyoshi, K Sugimachi

    BRITISH JOURNAL OF CANCER   74 ( 6 )   975 - 979   1996年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:STOCKTON PRESS  

    We analysed data on 1117 patients with gastric cancer who were treated by curative resection. Attention was focused on invasion and a recurrence of the cancer. Based on a univariate analysis, death following a recurrence and prognosis were related to age of the patients, size of the tumour, tumour location, tumour tissue differentiation, growth pattern, depth of invasion, lymphatic and vascular invasion and lymph node metastasis. In proportion to the growth potential, determined by the level of proliferating cell nuclear antigen (PCNA) labelling, the death related to a recurrence was increased and the prognosis was poorer. Multivariate analysis showed that the three factors of serosal invasion, PCNA labelling index and lymph node dissection were independent prognostic factors. When sites of recurrence were analysed regarding each depth of invasion, haematogenous recurrence, in particular in the liver, occurred even in cases of an early invasion and many types of recurrences, including peritoneal recurrence, were noted in patients with an advanced state of invasion.

    Web of Science

    researchmap

  • Prognostic value and clinicopathological correlation of thrombomodulin in squamous cell carcinoma of the human lung. 査読

    Hamatake M, Ishida T, Mitsudomi T, Akazawa K, Sugimachi K

    Clinical cancer research : an official journal of the American Association for Cancer Research   2 ( 4 )   763 - 766   1996年4月

     詳細を見る

  • Poor prognosis of lower quadrant breast carcinoma 査読

    T Kamakura, K Akazawa, Y Nomura, K Sugimachi, Y Nose

    JOURNAL OF SURGICAL ONCOLOGY   61 ( 4 )   295 - 299   1996年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-LISS  

    Although some lymphatic plexuses exist in lower quadrants of the breast, there have been no investigations of whether or not carcinoma located in this region is a prognostic factor for breast cancer. Of 914 patients with carcinoma of the breast who underwent curative resection following chemo-endocrine therapy between 1982 and 1985, 149 patients had disease of the lower quadrants. The recurrence-free survival rate was lower in patients with the lower quadrants carcinoma than in those with carcinoma of other breast regions, Multivariate analysis showed that a lower quadrant tumor location was a significant prognostic factor for recurrence, especially soft tissue and visceral recurrence, The worse prognosis of patients with lower quadrant carcinoma of the breast suggests the possible existence of residual or occult tumor cells after surgical resection. (C) 1996 Wiley-Liss, Inc.

    Web of Science

    researchmap

  • Complications of percutaneous transhepatic catheterization of the portal venous system in patients with portal hypertension 査読

    Masayuki Ohta, Makoto Hashizume, Hirofumi Kawanaka, Kouhei Akazawa, Kiichiro Ueno, Morimasa Tomikawa, Fumiaki Kishihara, Kazuo Tanoue, Keizo Sugimachi

    Journal of Gastroenterology and Hepatology (Australia)   11 ( 7 )   630 - 634   1996年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing  

    We report here complications of percutaneous transhepatic catheterization of the portal venous system in 170 Japanese patients with portal hypertension. All patients underwent percutaneous transhepatic portography and percutaneous transhepatic obliteration of oesophagogastric varices was also performed in 29 patients. After retraction of the catheter, the puncture canal was plugged with gelatin sponge in 150 subjects and with one steel coil in 20 others. The overall complication rate was 10.5%. Intraperitoneal bleeding occurred in 10.6% of patients and 2.9% required blood transfusion. In these patients with intraperitoneal bleeding, the gelatin sponge was used for plugging after retraction of the catheter, while in the 20 patients with a steel coil plug, haemoperitoneum never occurred. Right pleural effusion was recognized in 3.5% of patients, intraperitoneal bile leakage in 1.8% and deterioration of liver function due to arteriovenous fistula in 0.6%. By univariate and multivariate analyses, female gender was the only risk factor for intraperitoneal bleeding among 150 patients investigated by percutaneous transhepatic catheterization of the portal venous system with gelatin sponge plugging. Intraperitoneal bleeding is the most important complication in patients with portal hypertension
    it is difficult to predict intraperitoneal bleeding before retraction of the catheter in patients for whom gelatin sponge is used. Thus, for patients undergoing percutaneous transhepatic catheterization of the portal venous system, close follow up is recommended.

    DOI: 10.1111/j.1440-1746.1996.tb00305.x

    Scopus

    researchmap

  • Serum cholesterol levels in school-aged Japanese children: The Hisayama study 査読

    Junichiro Fukushige, Hisaji Igarashi, Kohji Ueda, Kouhei Akazawa, Yoshiaki Nose

    Pediatrics International   38 ( 1 )   22 - 27   1996年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Hypercholesterolemia has been known to be an important factor in the development of atherosclelosis. Blood cholesterol screening and related health education in children, however, have not yet been widely practiced in Japan. From 1985 to 1990, blood samples were obtained from 5825 school children aged 6 to 14 years residing in Hisayama, Japan. The mean total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were determined. The mean TC levels ranged from 155 to 172 mg/dL for boys and from 156 to 170 mg/dL for girls, peaking at 9 years for both sexes. The TG levels also tended to increase gradually and to peak at 11 years for both sexes. The tendency for TG levels to be higher was much clearer than in US children and adolescents. The HDL-C levels were highest at 9 years of age for both sexes and the LDL-C levels also tended to peak at 9 years of age for boys and at 8 years of age for girls. Atherogenic Indices [(TC-HDL-C)/HDL-C] ranged from 1.7 to 1.9 for boys and 1.8 to 2.0 for girls. As the cholesterol level of Japanese children would be expected to rise steadily reflecting their westernized lifestyle, preventive programes on a nationwide base including health education at school environments should be emphasized. 1996 Japan Pediatric Society.

    DOI: 10.1111/j.1442-200X.1996.tb03429.x

    Scopus

    PubMed

    researchmap

  • Inverse correlation between the expression of bcl-2 and p53 proteins in primary gastric lymphoma 査読

    Shotaro Nakamura, Kouhei Akazawa, Naoko Kinukawa, Takashi Yao, Masazumi Tsuneyoshi

    Human Pathology   27 ( 3 )   225 - 233   1996年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W.B. Saunders  

    The immunohistochemical expression of bcl-2 and p53 proteins was evaluated in formalin-fixed, paraffin-embedded surgical specimens from 212 patients with primary gastric lymphoma. bcl-2 protein was found to be expressed in 145 specimens (68%). Among the 179 specimens with B-cell lymphoma of mucosa- associated lymphoid tissue (MALT), bcl-2 positivity decreased significantly as the histological grade advanced
    bcl-2 was expressed in 93% of low-grade tumors, 88% of mixed-grade (low-grade with a focal high-grade component) tumors, and 44% of high-grade tumors (Cochran's linear trend test
    P &lt
    .001). p53 protein expression was detected in 43 of 212 cases (20%). Among the B- cell MALT lymphomas, p53 positivity increased significantly as the histological grade advanced
    p53 was expressed in 6% of low-grade tumors, 12% of mixed-grade tumors, and 31% of high-grade tumors (Cochran's linear trend test
    P &lt
    .001). An inverse correlation was observed between the expression of bcl-2 and p53 in all 212 lymphomas (Γ = -0.531
    P &lt
    .05) as well as in all 179 B-cell MALT lymphomas (Γ = -0.671
    P &lt
    .01). Although the bcl-2 expression did not correlate with the patient survival, the p53 positive cases showed a significantly poorer prognosis compared with the p53 negative cases (log-rank test
    P &lt
    .05). These results suggest that the expression of bcl-2 and p53 may, therefore, be associated with the transition from low- grade to high-grade tumors in primary gastric lymphoma.

    DOI: 10.1016/S0046-8177(96)90061-1

    Scopus

    PubMed

    researchmap

  • Single oral dose of cisapride accelerates gastric antral emptying in healthy humans: An ultrasonographic study 査読

    Torahiko Takeda, Hiroyuki Konomi, Gen Naritomi, Junichi Yoshida, Hiroaki Matsunaga, Kouhei Akazawa, Masao Tanaka

    Journal of Gastroenterology   31 ( 3 )   323 - 328   1996年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    An ultrasonographic study of ten healthy volunteers was carried out to evaluate the effect of cisapride on gastric antral emptying. More than 1 week after the measurement of the baseline emptying rate, cisapride was given at a single oral dose of 5 mg 30 minutes before intake of a balanced liquid test meal (5 ml/kg body weight). To determine the time to half emptying (T1/2), an exponential curve was extrapolated for the elimination phase of the gastroantral sagittal cross-sectional area plotted against time. The T1/2 was reduced by 18.5% after cisapride, from 62.6 ± 4.3 to 51.0 ± 4.4 min (P = 0.0284). We conclude that a single oral dose of 5 mg of cisapride significantly accelerates the gastric antral emptying rate in healthy humans.

    DOI: 10.1007/BF02355019

    Scopus

    PubMed

    researchmap

  • Umbilical vein endothelial cells are an important source of c-kit and stem cell factor which regulate the proliferation of haemopoietic progenitor cells 査読

    Hideto Yamaguchi, Ehchi Ishii, Shigeru Saito, Katsuya Tashiro, Ichiro Fujita, Seiko Yoshidomi, Masamichi Ohtubo, Kouhei Akazawa, Sumio Miyazaki

    British Journal of Haematology   94 ( 4 )   606 - 611   1996年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing Ltd  

    The expression and production of c-kit and its ligand, stem cell factor (SCF), in card brood and neonates were studied. Serum SCF levels were significantly higher in cord blood, neonates aged 1-30 d, and in 4-month-old infants than in the maternal serum (P &lt
    0.01). SCF levels decreased in children from 7 months to 15 years of age (P &lt
    0.01). The serum soluble c-kit levels were significantly higher in cord (P &lt
    0.01) and neonatal blood (P &lt
    0.05) than in the maternal blood. SCF and c-kit levels in placental tissue homogenates and the culture media of decidual cells and trophoblasts were low. To determine the sites of high SCF and c-kit production in cord blood and in early neonates, SCF and c-kit mRNA expression was analysed in various tissues by polymerase chain reaction. High SCF mRNA expression was observed in human umbilical vein endothelial cells (HUVEC). Moderate c-kit mRNA expression was detected in HUVEC, the bone marrow, and cord blood. These findings suggest that endothelial cells mainly produce the SCF in cord blood and in early neonates. To confirm the role of endothelial cells in haemopoiesis, colony-forming assays were performed in the presence of HUVEC culture media, which induced the formation of high numbers of granulocyte and erythroid colonies in cord blood. IL-3, IL-6 and SCF levels were elevated in the media. Our findings suggest that endothelial cells have an important role in the maintenance and proliferation of progenitor cells in neonatal blood via the interaction of c-kit and SCF with other factors. The ex vivo expansion of cord progenitor cells in the presence of endothelial cells needs to be investigated further.

    DOI: 10.1046/j.1365-2141.1996.d01-1855.x

    Scopus

    PubMed

    researchmap

  • Trends in sexually transmitted diseases and condom use patterns among commercial sex workers in Fukuoka City, Japan 1990-93 査読

    Masatoshi Tanaka, Hiroshi Nakayama, Misao Sakumoto, Tetsuro Matsumoto, Kohei Akazawa, Joichi Kumazawa

    Genitourinary Medicine   72 ( 5 )   358 - 361   1996年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective: To investigate trends in sexually transmitted diseases (STDs) among female commercial sex workers and in their condom use patterns during the period from 1990 to 1993 in Fukuoka, Japan. Methods: The study group consisted of a total of 824 commercial sex workers who attended an STD clinic to undergo screening for STDs including chlamydia, gonorrhoea, syphilis, hepatitis B and HIV-1 infection during the period from 1990 to 1993. For detection of Chlamydia trachomatis and Neisseria gonorrhoeae, endocervical smear specimens were taken from the women. Blood samples were obtained for serological diagnosis of syphilis, hepatitis B and HIV-1. Commercial sex workers who visited the clinic during the period from November to December of 1993 were interviewed concerning past (1990 and 1991) and recent (1992 and 1993) condom use patterns. Results: The annual detection rates of C trachomatis and N gonorrhoeae declined significantly from 16.3% in 1990 to 12.2% in 1993 (P &lt
    0.0001) and from 1.5% in 1990 to 0.8% in 1993 (P = 0.0096), respectively. There was a remarkable reduction in the annual syphilis infection rate, from 7.5% in 1990 to 0.5% in 1993 (P = 0.0011). The positive rate for the hepatitis B surface antigen in the women ranged from only 0.6% to 1.9% and none were found to be positive for HIV-1 during the 4-year period. During the same period, there was a significant increase in the proportion of commercial sex workers always using condoms from 6.3% in 1990-91 to 25.3% in 1992-93 (P = 0.0023). Conclusion: The prevalences of chlamydia, gonorrhoea, and syphilis infections decreased significantly among commercial sex workers in Fukuoka from 1990 through 1993, and no commercial sex workers were HIV-1 seropositive. The reductions in the prevalence of major STDs may be related to the increased use of condoms.

    Scopus

    PubMed

    researchmap

  • The order of ward rounds influences nosocomial infection. A 2-year study in gastroenterologic surgery patients 査読

    Junichi Yoshida, Syoji Kuroki, Kohei Akazawa, Kazuo Chijiiwa, Kouichi Takemori, Motomichi Torisu, Masao Tanaka

    Journal of Gastroenterology   30 ( 6 )   718 - 724   1995年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer-Verlag  

    We studied the effect of the order of ward rounds on nosocomial infection in gastroenterologic surgery patients. The subjects were patients with gastrointestinal diseases admitted between September 1992 and August 1994. During the 1st year, the round proceeded indiscriminately among recovery rooms and rooms with stable patients and isolated patients with methicillin-resistant Staphylococcus aureus (MRSA). In the subsequent year, the round started in the recovery rooms and moved into the general rooms with stable patients and finally into the isolation rooms. Against the time course, piecewise linear regression analyses were made with the number of culture-positive patients and the quantities of antibiotics and disinfectants used. Of a total of 1894 strains from 264 patients, isolates of MRSA (n=200) decreased from 150 in the 1st year to 50 in the 2nd year. The number of MRSA-positive patients showed the point of inflexion in the analysis at the change of round order, with a later decrease. The trend was similar for Candida (n=99) and Enterococcal (n=225) species. The amount of antibiotics was unchanged while the amount of disinfectants used decreased in the 2nd year. Thus, the round re-ordering appeared to help prevent nosocomial infection. Ward rounds for patients who have had gastroenterologic surgery should proceed from compromised hosts to stable patients, and then isolated patients. © 1995 Springer-Verlag.

    DOI: 10.1007/BF02349637

    Scopus

    PubMed

    researchmap

  • Doxorubicin-heparin complex: reduction of cardiotoxicity of doxorubicin 査読

    Yumi Mizuno, Toshiro Hara, Shigeyuki Tachibana, Kohki Uragoh, Kouhei Akazawa, Kohji Ueda

    Journal of Cancer Research and Clinical Oncology   121 ( 8 )   469 - 473   1995年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer-Verlag  

    We have compared the antitumor activity and cardiotoxicity of free doxorubicin (Dox) and doxorubicinheparin complex in vivo and in vitro. Dox and Dox-heparin complex equally inhibited the DNA synthesis of leukemic cells and showed a similar anticancer activity against tumor-bearing mice. Acute toxicity of Dox at the dose of 20 mg/kg or 30 mg/kg was significantly more profound than that of the Dox-heparin complex, which was demonstrated by survival rate (P&lt
    0.01). Chronic toxicities of Dox and the Dox-heparin complex were compared by giving the respective reagent (2 mg/kg) weekly for 20 weeks. The weight gains of the mice given Dox-heparin complex were greater than those of the mice given Dox alone (P&lt
    0.01). The pathological damage to the cardiac tissue in mice treated with Dox-heparin complex was significantly less severe than that of mice treated with Dox. Thus, the present study indicates that complexing with heparin diminished the acute and chronic toxicity of Dox without reducing its antitumor activity in mice, and suggests a possible clinical application of Dox-heparin complex in humans. © 1995 Springer-Verlag.

    DOI: 10.1007/BF01218363

    Scopus

    PubMed

    researchmap

  • Penile tumescence in the human fetus at term - A preliminary report 査読

    Hiroaki Shirozu, Takashi Koyanagi, Takeshi Takashima, Naoki Horimoto, Kouhei Akazawa, Hitoo Nakano

    Early Human Development   41 ( 3 )   159 - 166   1995年4月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The aim of this study is to reveal whether the penis per se actually becomes tumescent and flaccid, in time sequence, in the human fetus at term. We observed the fetal penis with realtime ultrasonography in 50 male human fetuses at 36-39 weeks' gestation and measured the penile length once at a given time per 1-min epoch for each case during the 60-min window of examination. Thirty-eight were excluded due to a lack of continuous ultrasound visualization of the penis. Penile length changes were statistically analyzed for the remaining 12 fetuses using the 'least median of squares regression'. Penile length was seen to be significantly stratified into two groups: 22.5% at tumescence (group median = 20.8 mm) and 77.5% at flaccidity (group median = 16.0 mm). Penile tumescence was found to occur at the following frequency during the given observation period: once in 41.7%, twice in 50.0% and three times in 8.3% with durations ranging from 5 to 17 min. These findings indicate penile tumescence exists in the term fetus. The frequency and duration of penile tumescence are in good correlation with neonates. © 1995 Elsevier Science Ireland Ltd. All rights reserved.

    DOI: 10.1016/0378-3782(95)01618-D

    Scopus

    PubMed

    researchmap

  • EFFECT OF LYMPH-NODE DISSECTION ON THE PROGNOSIS IN PATIENTS WITH NODE-NEGATIVE EARLY GASTRIC-CANCER 査読

    H BABA, Y MAEHARA, H TAKEUCHI, S INUTSUKA, T OKUYAMA, Y ADACHI, K AKAZAWA, K SUGIMACHI

    SURGERY   117 ( 2 )   165 - 169   1995年2月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:MOSBY-YEAR BOOK INC  

    Background. Our objective was to evaluate the long-term benefit of R2/3 lymph node dissection compared with that of R1, even in node-negative cases.
    Methods. We analyzed clinicopathologic data on 373 surgically treated patients with early gastric cancer and without microscopic nodal involvement.
    Results. Five- and 10-year survival rates for patients treated with R2/3 gastrectomy were 97.3% and 95.4%, respectively. These values were significantly higher than the 90.1% and 81.1% noted for R1 gastrectomy (p &lt; 0.01). Although no difference was found in morbidity and mortality, the incidence of death from a recurrence of the gastric cancer was significantly higher in patients treated with R1 gastrectomy than those with R2/3. Multivariate analysis with the Cox's proportional hazard model revealed patients' age and R2/3 gastrectomy to be independent prognostic factors in patients with node-negative early gastric cancer.
    Conclusions. These data show that prophylactic lymph node dissection can potentially prolong the survival time of patients with node-negative early gastric cancer by preventing a recurrence of the gastric cancer.

    Web of Science

    researchmap

  • GASTRIC-CARCINOMA IN PATIENTS OVER 70 YEARS OF AGE 査読

    Y MAEHARA, T OSHIRO, H OIWA, S ODA, H BABA, K AKAZAWA, K SUGIMACHI

    BRITISH JOURNAL OF SURGERY   82 ( 1 )   102 - 105   1995年1月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BLACKWELL SCIENCE LTD  

    The clinicopathological features and prognosis of gastric cancer in 344 patients aged 70 years or older who underwent gastrectomy between 1965 and 1990 were determined. Over the years the mean size of the tumour decreased, differentiated tumour tissue was more common, depth of penetration was less prominent, lymphatic and vascular involvement was less frequent, and the late of lymph node metastasis and peritoneal dissemination decreased. Extensive lymph node dissection was more frequently carried out and the rate of curative resection rose. Survival rates improved with early detection of gastric cancer and there was no increase in operative morbidity and mortality rates. As age alone is not a contraindication to surgery for patients with gastric carcinoma, early detection of the lesion and surgical treatment are expected to increase the survival of elderly patients with this malignancy.

    Web of Science

    researchmap

  • Transmission of Hepatitis C Virus by Health Care Workers in a Rural Area of Japan 査読

    Jun Hayashi, Yasuhiro Kishihara, Kouzaburo Vamaji, Eriko Yoshimura, Yasunobu Kawakami, Kouhei Akazawa, Seizaburo Kashiwagi

    The American Journal of Gastroenterology   90 ( 5 )   794 - 799   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective: The prevailing route of hepatitis C virus (HCV) transmission in Japan is unclear, so we expected that a survey of routes of HCV infection in an endemic area might clarify the mode of transmission. Methods: We screened 2049 inhabitants in an isolated rural village of Fukuoka, Japan using HCV markers. All serum samples were assayed for antibody to HCV (anti‐HCV) (ELISA), and anti‐HCV‐positive samples were assayed for HCV RNA and genotype (polymerase chain reaction). Results: The prevalence of anti‐HCV was 19.7% and increased with advancing age, from zero in the under 19 yr of age group to 30.7% in the 60–69 yr of age group. HCV RNA was detected in 82.9% of the anti‐HCV‐positive inhabitants, and 88.3% of them had genotype II. Anti‐HCV was detected in 17.8% of the children of HCV‐carrier mothers, similar to the rate (15.4%) for all inhabitants in the 40–49 yr of age group, the same age group for the mean age of the anti‐HCV‐positive children. Anti‐HCV was detected in 34.8% of husbands of female HCV carriers and in 22.2% of wives of mate HCV carriers, similar to the rates (36.2% in males and 26.6% in females) for all inhabitants in 60–69 yr of age group, the same age group for the mean ages of carriers' spouses. The prevalence of anti‐HCV was the highest in inhabitants of one of three distinct areas of this village where patients had often been injected with insufficiently sterilized syringes and needles for treatment in the same clinic. Conclusion: These observations suggest that medical intervention probably played a more important role in the spread of the HCV infection in the village studied than did familial transmission. Copyright © 1995, Wiley Blackwell. All rights reserved

    DOI: 10.1111/j.1572-0241.1995.tb09321.x

    Scopus

    PubMed

    researchmap

  • Prognostic Factors of Vision in Patients with Behcet Disease 査読

    Maki Sakamoto, Kouhei Akazawa, Yuko Nishioka, Hiroki Sanui, Hajime Inomata, Yoshiaki Nose

    Ophthalmology   102 ( 2 )   317 - 321   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Behçet disease is a chronic, recurrent, inflammatory disorder characterized by the triad of oral and genital ulcers and ocular lesions. The etiology is unknown. Although many of these patients become blind, some have good vision all their life. Methods: To attain more accurate data on the prognosis of these patients, the authors studied 52 Japanese patients (101 eyes) seen at Kyushu University Hospital between 1980 and 1990. At the first visit, patients ranged in age from 21 to 61 years
    at onset, they ranged in age from 17 to 55 years
    and the disease duration at first visit was from 0 to 22 years. Thirty-five of the 101 eyes had a visual loss of more than five lines or the patients became blind. The authors divided the subjects into two groups—favorable group and unfavorable group. If an eye had more than five lines of visual loss or the patient became blind 3 years after the first visit, it was placed in the unfavorable group, and if not, it was classed in the favorable group. Thirty-two factors determined from clinical records were used to select statistically significant risk factors for visual loss, using univariate analysis and multivariate logistic regression analysis. Results: Univariate analysis showed the following four factors that were significantly different between favorable and unfavorable groups: sex, disease interval, other complications, and skin lesions (first year). Multivariate analysis showed that the following seven factors had mutually independent contributions to visual loss: skin lesions
    arthritis
    posterior attacks
    other complications (experienced), including gastrointestinal, vascular, and central nervous system lesions
    female sex
    disease interval
    and anterior attacks. The first four factors have effects of losing vision, whereas the others are related to vision retention. Conclusion: The authors find that skin lesions, arthritis, posterior attacks, and other complications are linked to loss of vision, whereas female sex, disease interval, and anterior attacks are related to retention of vision. © 1995, American Academy of Ophthalmology, Inc. All rights reserved.

    DOI: 10.1016/S0161-6420(95)31022-6

    Scopus

    PubMed

    researchmap

  • Primary gastric lymphoma. A clinicopathologic study of 233 cases with special reference to evaluation with the MIB‐1 index 査読

    Shotaro Nakamura, Kouhei Akazawa, Takashi Yao, Masazumi Tsuneyoshi

    Cancer   76 ( 8 )   1313 - 1324   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background. Few articles have analyzed the prognostic data from a large series of primary gastric lymphoma classified according to the concept of mucosa‐associated lymphoid tissue (MALT). Methods. The resected specimens from 233 patients with primary gastric lymphoma were investigated retrospectively, including immunostaining with MIB‐1 (Ki‐67). Results. Histologically, 70 (30%) of the cases were low grade B‐cell lymphoma of MALT, 27 (12%) low grade B‐cell lymphoma of MALT with a focal high grade component, 100 (43%) high grade B‐cell lymphoma of MALT, 15 (6%) other B‐cell lymphomas, 14 (6%) T‐cell lymphomas, and 7 (3%) undetermined. Macroscopically, 96 (41%) were superficial‐spreading type, 100 (43%) mass‐forming, 14 (6%) diffuse‐infiltrating, and 23 (10%) unclassified. The MIB‐1 index correlated with phenotype, histologic grade, stage, depth of invasion, and macroscopic type. A significantly better survival was noted for young patients, and those with tumors of a B‐cell phenotype, histologic low grade, macroscopic superficial‐spreading type, low stage, low depth of invasion, and low MIB‐1 index. No significantly different survival rates were found between the patients who underwent gastric resection alone and those who also received additional chemotherapy. By Cox multivariate analysis, independent prognosticators included B‐cell phenotype, low stage, and macroscopic superficial‐spreading type. Conclusions. In addition to stage, phenotype and macroscopic type are also important prognostic indicators of primary gastric lymphoma. Immunostaining with MIB‐1 had limited independent value for predicting prognosis. Copyright © 1995 American Cancer Society

    DOI: 10.1002/1097-0142(19951015)76:8<1313::AID-CNCR2820760804>3.0.CO;2-1

    Scopus

    PubMed

    researchmap

  • Prognostic Significance of Hepatic Vein Waveform by Doppler Ultrasonography in Cirrhotic Patients with Portal Hypertension 査読

    Masayuki Ohta, Makuto Hashizume, Hirofumi Kawanaka, Kouhei Akazawa, Morimasa Tomikawa, Hidefumi Higashi, Fumiaki Kishihara, Kazuo Tanoue, Keizo Sugimachi

    The American Journal of Gastroenterology   90 ( 10 )   1853 - 1857   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We prospectively evaluated the prognostic value of the flat hepatic vein waveform, measured by Doppler ultrasound, in cirrhotic patients with portal hypertension. The Doppler pattern of right and left hepatic veins in a series of 120 consecutive cirrhotic patients with portal hypertension but without hepatocellular carcinoma was examined, together with clinical and biochemical parameters. Flat waveform of the right hepatic vein was recognized in nine patients and that of the left hepatic vein was seen in 13. After a mean follow‐up of 13.6 ± 9.7 months, 17 patients died, all from liver failure. In the univariate analysis, variables significantly associated with the duration of survival were age, etiology of the liver cirrhosis, upper gastrointestinal bleeding after start of the study, Child‐Pugh score, ascites, encephalopathy, prothrombin index, bilirubin, albumin, and flat Doppler waveform in the right and left hepatic veins. Multivariate analysis showed that flat Doppler waveform in the right hepatic vein, bilirubin, and prothrombin index were independently related to survival. The prognostic accuracy in cases of cirrhosis with portal hypertension is significantly improved with acquistion of information obtained from hepatic vein waveform by Doppler ultrasound. Copyright © 1995, Wiley Blackwell. All rights reserved

    DOI: 10.1111/j.1572-0241.1995.tb08085.x

    Scopus

    PubMed

    researchmap

  • Relationship between intraocular pressure and age in the exfoliation syndrome 査読

    Kimihiko Fukisawa, Shigeru Sugaï, Hajima Inomata, Kohei Akazawa, Yoshiaki Nose

    Ophthalmologica   209 ( 4 )   199 - 202   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We examined the presence or absence of exfoliative material and measured the intraocular pressure (IOP) of 220 residents of a nursing home. The prevalence of the exfoliation syndrome increased with age and the IOP of persons with the exfoliation syndrome was higher than that of persons without the syndrome. In eyes with the exfoliation syndrome, the IOP had a tendency to decrease with increasing age. Aging had little influence on IOP in eyes without the exfoliation syndrome. There were significant differences between the two groups with regard to the effects of aging on IOP. © 1995 S. Karger AG, Basel.

    DOI: 10.1159/000310613

    Scopus

    PubMed

    researchmap

  • Endoscopic injection sclerotherapy for esophageal varices associated with concomintant portal venous thrombus of hepatocellular carcinoma 査読

    Masayuki Ohta, Makoto Hashizume, Morimasa Tomikawa, Tatsuro Kamakura, Kouhei Akazawa, Kiichiro Ueno, Hirohiko Yamaga, Seigo Kitano, Kazuo Tanoue, Takashi Matsumata, Keizo Sugimachi

    Journal of Surgical Oncology   59 ( 2 )   125 - 130   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Between 1983 and 1994, we treated 51 patients with esophageal varices and portal trunk and main branch invasion of hepatocellular carcinoma, using endoscopic injection sclerotherapy. Variceal bleeding was controlled in 28 of 29 patients (96.6%), esophageal varices were completely eradicated in 28 (54.9%), and only 2 of 28 (7.1%) bled from small, dilated, venous vessels after eradication. The cumulative nonbleeding rate at 3 years was 87.5%. Death caused by hepatocellular carcinoma accounted for 89.4% of the patients, whereas the rate of bleeding from esophageal varices was 4.3%. Variables significantly associated with the duration of survival were Okuda's clinical stage, alpha‐fetoprotein, eradication of esophageal varices by sclerotherapy, and treatment of hepatocellular carcinoma, as determined in a univariate analysis. Multivariate analysis showed that eradication of esophageal varices by sclerotherapy, Okuda's clinical stage, and age were independent factors which significantly influenced survival time. We propose that complete eradication of esophageal varices and close follow‐up using endoscopy may lead to a reduction in bleeding from esophageal varices, and hence may reduce mortality rates related to this bleeding. Copyright © 1995 Wiley‐Liss, Inc., A Wiley Company

    DOI: 10.1002/jso.2930590210

    Scopus

    PubMed

    researchmap

  • Intraoperative risk factors associated with hepatic resection 査読

    G. Tanabe, M. Sakamoto, K. Akazawa, K. Kurita, M. Hamanoue, S. Ueno, Y. Kobayashi, S. Mitue, Y. Ogura, N. Yoshidome, M. Baba, T. Aikou

    British Journal of Surgery   82 ( 9 )   1262 - 1265   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Risk factors associated with complications following hepatic resection were investigated retrospectively in 121 patients between January 1987 and April 1992. Fifty‐seven patients recovered uneventfully, but 64 suffered postoperative complications and 15 died within 3 months. All those who died had suffered from hyperbilirubinaemia or bleeding and/or coagulopathy, which were considered critical complications after hepatic resection. Risk factors following hepatic resection were investigated statistically. Stepwise logistic regression analysis showed that serum levels of cholinesterase, the histology of the remaining liver and the volume of intraoperative blood loss were significantly associated with major complications (odds ratio 0.02, 5.14 and 4.97 respectively). Coexisting liver cirrhosis, deterioration of liver protein synthesis and massive intraoperative blood loss are important risk factors following hepatic resection. Copyright © 1995 British Journal of Surgery Society Ltd.

    DOI: 10.1002/bjs.1800820935

    Scopus

    PubMed

    researchmap

  • Blood pressure levels in school-age Japanese children: The Hisayama study 査読

    R. Fukushige, H. Igarashi, K. Ueda, M. Sakamonto, K. Akazawa, Y. Nose

    Journal of Human Hypertension   9 ( 10 )   801 - 807   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Blood pressure (BP) measurements were obtained on a total of 6325 children (3294 boys and 3031 girls), aged 6-14 years, in Hisayama, Japan. All BPs were recorded in a sitting position by trained observers in a standardised manner. Standard mercury sphygmomanometers were used with commercially available cuffs, selected according to the arm circumference. Cuff size no. 3 (bladder width 9 cm, length 23 cm) was the one most commonly selected in 84% of elementary schoolers aged 6-11 years and in 35% of junior high schoolers aged 12-14 years. Mean systolic BPs (SBPs) increased from 89 mm Hg at age 6 years to 108 mm Hg at 14 years (a 21% increase) for boys and from 88 mm Hg to 102 mm Hg (a 16% increase) for girls. Diastolic BP (DBPs, Korotkoff phase IV, KIV) increased from ages 6 to 14 years to the same degree, from 58 mm Hg to 72 mm Hg (a 24% increase) for boys and from 58 mm Hg to 70 mm Hg (a 21% increase) for girls. The increase in DBP (Korotkoff phase V, KV) was greater, from 48 mm Hg to 63 mm Hg (a 30% increase) for boys and from 48 mm Hg to 61 mm Hg (a 28% increase) for girls. The increase in mean SBP for adolescent boys was greater compared with that of girls
    however, separation of age-specific values by sex was not observed for mean DBP (KIV) and DBP (KV). The cross-sectional relation between age and mean SBP levels was not linear.

    Scopus

    PubMed

    researchmap

  • Is there a critical gestational age in neutrophil superoxide production activity? 査読

    K. Ishida, K. Tsukimori, H. Nagata, T. Koyanagi, K. Akazawa, H. Nakano

    Blood   85 ( 5 )   1331 - 1333   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We studied superoxide (O2/-) production in neutrophils from 78 normal pregnant women at 7 to 39 weeks' gestation to determine whether there is a critical gestational age in O2/-production activity of maternal neutrophils. The O2/- production was measured by determining the rate of superoxide dismutase-inhibitable reduction of ferricytochrome c at 550 to 540 nm. A scattergram of neutrophil O2/- production value versus gestational age was analyzed using the least median of squares regression, leading to a statistical stratification in which the median values of O2/- production for outlying and nonoutlying points were 6.60 nmol/106 cells and 2.72 nmol/106 cells, respectively. All of the outlying points were concentrated at 19 to 22 gestational weeks. There was the significant difference in FMLP- induced O2/- production in neutrophils of nonpregnant subjects when incubated with the sera from 10 cases (selected among 60 cases with nonoutlying points) (3.86 ± 0.77 nmol/106 cells) compared with 5 cases with outlying points (5.62 ± 1.19 nmol/106 cells) (P &lt
    .05). These results suggest that during the normal course of pregnancy, the production of O2/- from the function of circulating neutrophils can be dissociated from such neutrophil functions as adherence, chemotaxis, and phagocytosis.

    Scopus

    PubMed

    researchmap

  • The prognostic significance of lymphovascular space invasion in endometrial cancer when conventional hemotoxylin and eosin staining is compared to immunohistochemical staining 査読

    N. Tsuruchi, T. Kaku, T. Kamura, N. Tsukamoto, M. Tsuneyoshi, K. Akazawa, H. Nakano

    Gynecologic Oncology   57 ( 3 )   307 - 312   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The current study was undertaken to compare the usefulness of hemotoxylin and eosin (H and E) staining and immunohistochemical staining to identify lymphovascular space invasion (LVSI) in endometrial cancer and to evaluate the presence of LVSI detected by either technique as an independent prognostic factor. Histologic sections from 92 patients with clinical stage I-II endometrial cancer were reviewed, and representative sections were stained immunohistochemically with antibodies for von Willebrand factor and blood group isoantigens. To compare the prognostic significance of LVSI detected by H and E staining with that detected by immunohistochemical staining, univariate and multivariate analyses were performed. Thirty (32.6%) of the 92 cases showed LVSI in H and E staining. In 8 of the 30 cases, LVSI was negative by immunohistochemical staining, while LVSI was positive by immunohistochemical stainings in 2 of 62 cases showing negative LVSI in H and E staining. In univariate analysis, LVSI detected by H and E and immunohistochemical staining was proved to be significant as a prognostic factor. In multivariate analysis by Cox's proportional hazards model, LVSI identified by H and E staining was selected as one of significant prognostic factors, but LVSI identified by immunohistochemical staining not selected. The results of this study indicate that LVSI is one of the independent prognostic factors in endometrial cancer, and that LVSI as detected by H and E is more prognostic of survival than immunohistochemical detection. © 1995 Academic Press, Inc.

    DOI: 10.1006/gyno.1995.1148

    Scopus

    researchmap

  • Outpatient follow-up system using a personal computer for patients with hepatocellular carcinoma after surgery 査読

    Hidetoshi Itasaka, Takashi Matsumata, Akinobu Taketomi, Kazuharu Yamamoto, Katsuhiko Yanaga, Kenji Takenaka, Kouhei Akazawa, Keizo Sugimachi

    Journal of Medical Systems   18 ( 6 )   329 - 333   1994年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Kluwer Academic Publishers-Plenum Publishers  

    A simple outpatient follow-up system was developed with a laptop personal computer to assist management of patients with hepatocellular carcinoma after hepatic resections. Since it is based on a non-relational database program and the graphical user interface of Macintosh operating system, those who are not a specialist of the computer operation can use it. It is helpful to promptly recognize current status and problems of the patients, to diagnose recurrences of the disease and to prevent lost from follow-up cases. A portability of the computer also facilitates utilization of these data everywhere, such as in clinical conferences and laboratories. © 1994 Plenum Publishing Corporation.

    DOI: 10.1007/BF00999274

    Scopus

    PubMed

    researchmap

  • PATIENT REGISTRATION AND TREATMENT ALLOCATION IN MULTICENTER CLINICAL-TRIALS USING A FAX-OCR SYSTEM 査読

    K AKAZAWA, T KAMAKURA, M SAKAMOTO, T ODAKA, Y NOSE

    METHODS OF INFORMATION IN MEDICINE   33 ( 5 )   530 - 534   1994年12月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:F K SCHATTAUER VERLAG GMBH  

    This article describes the design and results of implementation of an automated patient registration and treatment allocation system (RETAS) used in multicenter clinical trials. RETAS was developed using a FAX-OCR system by which handwritten Japanese and English characters, as well as numericals and forms with check boxes, are sent from participating institutions by Fax, processed using an optical character reader, and then transmitted to a host computer at a statistical center. Based on the facsimile data, RETAS can automatically review eligibility, collect patient identification data and provide a randomized treatment allocation. RETAS permits uninterrupted, unattended operation at a statistical center, 24 hours a day, 7 days a week. Therefore, it drastically decreases the workload of personnel at the statistical center needed to support central telephone registration coverage. Consequently, staff members are free to focus on patient registration, treatment allocation, and follow-up of patients. The treatment allocation procedure in this system is based on Pocock and Simon's minimization method combined with Zelen's method for institution balancing. By this system it was possible to balance treatment numbers for each level of various prognostic factors over an entire trial and, at the same time, balance the allocation of treatments within an institution. The system currently supports the protocol of a clinical trial for Adjuvant Chemo-Endocrine Therapy for Breast Cancer in West Japan.

    Web of Science

    researchmap

  • COMPUTER-PROGRAM FOR THE PROPORTIONAL HAZARDS MEASUREMENT ERROR MODEL 査読

    T NAKAMURA, K AKAZAWA

    COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE   45 ( 3 )   203 - 212   1994年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI PUBL IRELAND LTD  

    The Cox-regression analysis based on the partial likelihood assumes that the covariates, or independent variables, are exactly measured without error. if the covariates are subject to measurement error and the error-prone observed values are used in the analysis by simply ignoring the measurement error, the results are generally biased and misleading; the bias does not diminish as the sample size is increased. The objective of the paper is to briefly describe a method searching for asymptotically unbiased estimates of the parameters correcting for the measurement error in the Cox-regression model and to present a FORTRAN program to perform the correction method; asymptotic standard errors of the corrected estimates are also obtained, The measurement error distribution, that is the conditional distribution of the observed values given the true value, must be specified. An advantage of the method described is that it does not require any assumption on the distribution of the true values; in other words, I, values are treated as unknown fixed constants. It can accommodate tied failure times unless ties are very frequent, and any censorship or loss to follow-up are allowed as long as they are 'independent of survival',

    DOI: 10.1016/0169-2607(94)90204-6

    Web of Science

    researchmap

  • CORRECTED LIKELIHOOD FOR PROPORTIONAL HAZARDS MEASUREMENT ERROR MODEL AND ITS APPLICATION 査読

    T NAKAMURA, K AKAZAWA

    ENVIRONMENTAL HEALTH PERSPECTIVES   102 ( 8 )   21 - 24   1994年11月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NATL INST ENVIRON HEALTH SCI  

    Consider the case where the exact values of covariates in the proportional hazards model may not be observed but instead, only surrogates for them involving measurement errors are available. The maximum likelihood estimate based on the partial likelihood with the true covariate replaced by the observed surrogate is even asymptotically biased and may cause seriously misleading results in covariance analysis based on the partial likelihood. These facts are illustrated by Monte Carlo simulation. A correction to partial likelihood proposed by the first author is studied to gain insight into its merits and limitations in practical applications. The results indicate that when the ''effective magnitude oi the measurement error'' as defined in this article is smell, which is indeed the case for most applications, the method will be useful. Some other correction methods for the measurement error in censored survival models are also reviewed and discussed.

    DOI: 10.1289/ehp.94102s821

    Web of Science

    PubMed

    researchmap

  • Microsoft Excel Program for creating attractive survival curves 査読

    Maki Sakamoto, Kouhei Akazawa, Tatsuro Kamakura, Naoko Kinukawa, Yuko Nishioka, Yoshiaki Nose

    Journal of Medical Systems   18 ( 5 )   241 - 249   1994年10月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Kluwer Academic Publishers-Plenum Publishers  

    This paper describes the design of a Microsoft Excel Program which interactively creates attractive and outstanding survival curves. This program enables medical researchers to easily create quality presentation graphs of survival curves and obtain high quality slides and prints, which can be inserted in papers or used directly at medical meetings. Through the use of vertical bars, this program can display the exact points where censored cases occur on survival curves, making it possible to monitor censoring patterns between groups. Furthermore, this program can also create survival curves based on the proportional hazards model for specific patterns of covariate values, given estimated regression coefficients and baseline survival function. This program may be a most useful and effective tool in creating medical research papers containing survival analysis. © 1994 Plenum Publishing Corporation.

    DOI: 10.1007/BF00996604

    Scopus

    PubMed

    researchmap

  • Postoperative chemotherapy including intraperitoneal and intradermal administration of the streptococcal preparation OK-432 for patients with gastric cancer and peritoneal dissemination: a prospective randomized study 査読

    Keizo Sugimachi, Yoshihiko Maehara, Kouhei Akazawa, Yukifumi Kondo, Yasuo Kunii, Masatsugu Kitamura, Hiroyuki Yamaoka, Yutaka Takahashi, Tsuyoshi Kito, Michio Katou, Hiroshi Furukawa, Shigemitsu Takashima

    Cancer Chemotherapy and Pharmacology   33 ( 5 )   366 - 370   1994年9月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer-Verlag  

    We studied the effects on survival time of postoperative immuno-chemotherapy, including the streptococcal preparation OK-432, in patients with gastric cancer and synchronous peritoneal dissemination. The patients were prospectively randomized and a valid statistical assessment could be made for 109. Patients randomized to group B received therapy that is widely used in Japan to treat patients with gastric cancer: mitomycin C (MMC) and UFT, a combination of tegafur and uracil in a molar ratio of 1:4, for 1 year. Patients randomized to group A received the same drugs as were given to group B patients plus OK-432 i.p. for 7 days, beginning on postoperative day 0, and OK-432 by intradermal injection for 1 year, at 2-week intervals. There were no differences between the two groups in any known prognostic factor or in the dose of any drug administered except for OK-432. There was no difference in the toxicity rate between the groups. In this negative trial, there was no improvement in survival time with the addition of OK-432 to MMC and UFT for patients with gastric cancer and peritoneal dissemination. © 1994 Springer-Verlag.

    DOI: 10.1007/BF00686264

    Scopus

    PubMed

    researchmap

  • LYMPH-NODE METASTASIS AND MACROSCOPIC FEATURES IN EARLY GASTRIC-CANCER 査読

    H BABA, Y MAEHARA, T OKUYAMA, H ORITA, H ANAI, K AKAZAWA, K SUGIMACHI

    HEPATO-GASTROENTEROLOGY   41 ( 4 )   380 - 383   1994年8月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:H G E UPDATE MEDICAL PUBL LTD.  

    The relationship between macroscopic features and the frequency and extent of lymph node metastasis was examined retrospectively in 421 patients with early gastric cancer. Nodal involvement was evident in 48 patients (11.4 %): 7 out of 204 (3.4 %) with mucosal cancer and 41 out of 217 (19.3 %) with submucosal lesions. The incidence of metastasis to perigastric nodes and extraperigastric nodes was 2.9 % and 0.5 % for mucosal cancer, and 13.8 % and 5.1 % for submucosal cancer, respectively. There was no metastasis in lesions; less than 1 cm in diameter, but the incidence of positive nodes increased with the size of the primary lesion. There was a low incidence of lymph node metastasis associated with lesions confined to the mucosa and less than 3 cm in size, elevated types of I and IIa less than 2 cm, and the flat type of IIb, while types consisting of a depressed portion such as IIc, III, IIc + III, and IIa + IIc often had not only perigastric but also extraperigastric nodal involvement, even when the lesion was small. As early gastric cancer can be cured by surgery, this modality is the treatment of choice. Endoscopic therapy in cases with a low involvement of lymph node metastasis can be considered when the patient is in a poor clinical state of health.

    Web of Science

    researchmap

  • The organization of statistical activities at medical research institutions 査読

    Kouhei Akazawa, Maki Sakamoto, Yuko Nishioka, Naoko Kinukawa, Yoshiaki Nose

    Journal of Medical Systems   18 ( 3 )   117 - 124   1994年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Kluwer Academic Publishers-Plenum Publishers  

    In this paper, we discuss the organizational structure for the conduct of statistical activities at medical Colleges and Universities. Here, we have particularly focused on two significant statistical activities, i.e., statistical consultation and research. The consulting service for medical researchers consists of practical statistical analysis, instruction on computer manipulation and software, response to reviewer's comments and statistical design of prospective studies. From our various experiences, we describe the actual implementation of statistical consultations for medical researchers. It has played an important role in supporting medical research. In addition, we also outline some research, with respect to new ways of applying statistics in medical science. This paper concludes that it may be practical for the existing computer center or department of medical informatics, in charge of the computing service, to conduct statistical activities until formal organizations are established at the academic institution. To realize the conduct of statistical activities by Department of Medical Informatics, it needs a team of biostatisticians, data analysts and computer personnel. © 1994 Plenum Publishing Corporation.

    DOI: 10.1007/BF00997290

    Scopus

    PubMed

    researchmap

  • PREDICTIVE VALUE OF PREOPERATIVE CARCINOEMBRYONIC ANTIGEN LEVELS FOR THE PROGNOSIS OF PATIENTS WITH WELL-DIFFERENTIATED GASTRIC-CANCER - A MULTIVARIATE-ANALYSIS 査読

    Y MAEHARA, T KUSUMOTO, TAKAHASHI, I, Y KAKEJI, H BABA, K AKAZAWA, K SUGIMACHI

    ONCOLOGY   51 ( 3 )   234 - 237   1994年5月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:KARGER  

    Serum carcinoembryonic antigen (CEA) levels were determined preoperatively in 221 patients with well-differentiated gastric cancer. The mean preoperative serum CEA level was 15.9 +/- 88.5 ng/ml (1.0-1,133.0 ng/ml) for all patients, and the incidence of an elevated CEA (&gt; 5 ng/ml) was 11.8% (26/221). The CEA-positive patients had larger tumors, a more prominent serosal invasion, more frequent lymphatic and vascular involvement, less expansive tumor growth and higher rates of lymph node and hepatic metastases than did the CPA-negative patients. Thus, the CPA-positive patients had a more advanced stage of disease, and 61.5% underwent noncurative resection (vs. 11.3% in CPA-negative patients). The survival rate of the CEA-positive patients was lower than that of the CPA-negative ones (p &lt; 0.01). As the multivariate analysis revealed the preoperative CEA level to be an independent prognostic factor for survival, an assay for this antigen prior to surgery is to be recommended.

    Web of Science

    researchmap

  • Change in the three-dimensional shape of the stomach in the developing human fetus 査読

    Shin Nagata, Takashi