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ApoE isoforms,treatment of diabetes and the risk of coronary heart disease

World Journal of Diabetes 2012年第3期3卷 54-59页

作者： Hideki Ehara Ritsuko Yamamoto-Honda Hiroji Kitazato Yoshihiko Takahashi Shoji Kawazu Yasuo Akanuma Mitsuhiko Noda the Institute for Adult Diseases Asahi Life Foundation2-2-6Nihonbashi-bakurochoChuo-kuTokyo 103-0002Japan Ehara Medical Clinic 1-10 Shouwa-choTuyamacityOkayama 708-0886Japan Department of Diabetes and Metabolic Medicine and Diabetes Research Center National Center for Global Health and Medicine1-21-1 ToyamaShinjuku-kuTokyo 162-8655Japan Department of Diabetes and Endocrinology Oomori Red Cross Hospital 4-30-11 ChuoOota-kuTokyo 143-8527Japan

AIM:To analyze the risk of coronary heart disease in patients with type 2 diabetes mellitus(T2DM)receiving standard medical ***:We performed a retrospective chart analysis of 269 middle-aged patients(age 45-64 years,mean age,53.9±5.5 years)with T2DM and without atherosclerotic cardiovascular events who underwent typing to determine their apolipoprotein E(apoE)*** apoE isoforms were determined using isoelectric focusing,followed by *** retrospectively evaluated the charts of the 269 patients,recorded between their first visit to the hospital(the study's start point,between 1987 and 1992)and the occurrence of an atherosclerotic cardiovascular event(the study's endpoint)or January 2004,whichever came *** age-adjusted mean values and the prevalences of covariates were calculated to compare the laboratory data among the apoE *** investigate the association of risk factors with the incidence of coronary heart disease during the follow-up period,monovariate and multivariate Cox regression models were ***:At enrollment,the mean serum low density lipoprotein(LDL)cholesterol levels were lowest(2.92± 0.89 mmol/L)among the subjects with apoE2(apoE2/2 or apoE2/3)and highest(3.52±0.77 mmol/L)among the subjects with apoE4(apoE3/4 or apoE4/4).No significant differences in mean age or the percentage of smokers were observed among the three ***,no significant differences were observed in the systolic and diastolic blood pressures,body mass index,HbA1c level or serum triglyceride levels among the three *** were 47 cases of coronary heart disease over 3285 person-years of *** age-adjusted multivariate Cox proportional model identified diabetic retinopathy(hazard ratio,2.38,95% CI:1.28-4.43,P=0.006),a high systolic blood pressure(hazard ratio,1.04,95%CI:1.02-1.06,P<0.001) and high HbA1c values(hazard ratio,1.19,95%CI:1.02-1.38,P=0.0029),but not the LDL cholesterol value at enrollment(hazard ra

关键词： Type 2 diabetes Atherosclerosis Apolipoprotein E isoform

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Relationship between the Current Account Balance Ratio and Salary Ratio in Japanese Municipal hospitals

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Health 2019年第12期11卷 1591-1597页

作者： Nozomu Mandai Mayumi Watanabe Ibaraki Prefectural University of Health Sciences Ibaraki Japan Kansai University of Health Sciences Osaka Japan Faculty of Science and Engineering Chuo University Tokyo Japan

Background: While public municipal hospitals in Japan are supported by public financing and are less likely to fail than private hospitals, more than half are in financial deficit. hospitals running at a deficit may have poorer outcomes and less investment in maintenance of human or physical capital, as well as increased rates of patient adverse events. We sought to clarify the relationship between municipal hospital surpluses or deficits and salary expenditures. Methods: We extracted financial data for 253 general hospitals of 300 beds or more from financial statements for the 2013 fiscal year available in the Yearbook of Public Firms, Edition for hospital. From these data, we calculated account balance ratios and compared the average value of the ratio of labor to the output (salary ratio) for each group using analysis of variance (ANOVA). Results: The salary ratios of hospitals in the surplus group were significantly lower than the salary ratios of hospitals in the deficit group (55.5% vs. 49.4%;p p = 0.342). In the surplus group, the average value of salary ratios was different among the three-bed count groups (mean salary ratio: 53.0% vs. 48.5% vs. 47.4%;ANOVA p = 0.012). In addition, there was a significant difference in mean value between the 300-bed group and ≥500 beds group (mean salary ratio: 53.0% vs. 47.4%;p = 0.002). Conclusion: This study suggests that maintaining a favorable salary ratio to the current account balance is a useful proxy of fiscal health, and interventions to improve the salary ratio may be effective in improving municipal hospital management. Furthermore, among well-managed municipal hospitals, larger hospital size may confer some advantage in purchasing power.

关键词： hospital Finance Salary Ratio Public hospital Current Account Balance Ratio

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Relationship between urinary cadmium and mortality in habitants of a cadmium-polluted area： a 22-year follow-up study in Japan

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Chinese Medical Journal 2011年第21期000卷 3504-3509页

作者： LI Qian Muneko Nishijo Hideaki Nakagawa Yuko Morikawa Masaru Sakurai Koshi Nakarnura Teruhiko Kido Koji Nogawa DAI Min National Office of Cancer Prevention and Control Cancer Institute ＆ Hospital Cancer Institute Chinese Academy of Medical Sciences Beijing 100021 China Department of Epidemiology and Public Health Kanazawa Medical University Ishikawa 920-0293 Japan Faculty of Medicine School of Health Science Kanazawa University Kanazawa Ishikawa 920-0293 Japan Chiba Occupational Health Promotion Center Tonya Chuo-ku Chiba Japan

Background Several studies have suggested that the exposure to cadmium （Cd） increased mortalities from renal diseases, cardiovascular diseases and malignant neoplasm, including lung cancer and prostate cancer among inhabitants living in Cd-polluted areas and factory workers. This study aimed to assess the influence of environmental exposure to Cd on long term outcome of inhabitants living in an area polluted by Cd. Methods A 22-year follow-up study was conducted with 3119 inhabitants （1403 men and 1716 women） living in the Cd polluted Kakehashi River basin in Japan. The subjects were divided into 4 groups according to the amount of urinary Cd level （〈3.0 μg/g creatinine （Cr）, 3.0-4.9 μg/g Cr, 5.0-9.9 μg/g Cr, and -〉10.0 μg/g Cr）. Mortality was calculated by the person-years method. Hazards ratios （HR） and 95% confidence intervals （CI） were assessed by the Cox＇s proportional hazard model. Results Compared with urinary Cd 〈3.0 μg/g Cr group, the HR of 5.0-9.9μg/g Cr and 〉10.0 μg/g Cr groups were significantly increased after adjustment for age in both sexes： 1.24 （95% Cl 1.01-1.51） and 1.48 （95% CI 1.17-1.90） for men; 1.64 （95% CI 1.17-2.28） and 1.78 （95% Cl 1.27-2.50） for women. The most frequent cause of death was malignant neoplasm in men and cardiovascular diseases in women. The significant increase in mortality risk for cardiovascular diseases was observed in the subjects with 〉10 μg/g Cr in both sexes： 1.79 for men （95% Cl 1.02-3.12） and 2.38 for women （95% Cl 1.11-5.07）. When the subjects were divided into 2 categories （〈20μg/g Cr and 〉20 μg/g Cr）, the HR of the urinary Cd 〉20 μg/g Cr group for nephritis and nephrosis were 4.82 （95% Cl 1.07-21.61） in men and 7.92 （95% Cl 1.77-35.33） in women, respectively. The significant increase was not observed for malignant neoplasm. Conclusion These results suggest a dose-response relationship between Cd body burden and mortality for cardiovascular diseases, cerebrovascular diseases and nephritis and nephrosis.

关键词： urinary cadmium mortality special causes of death environmental exposure

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The clinical signifi cance of circulating tumor cells in gastrointestinal cancer

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Journal of Cancer Metastasis and Treatment 2015年第1期1卷 130-137页

作者： Masaaki Iwatsuki Junji Kurashige Takatsugu Ishimoto Keisuke Kosumi Yoshifumi Baba Yasuo Sakamoto Yuji Miyamoto Naoya Yoshida Masayuki Watanabe Hideo Baba Department of Gastroenterological Surgery Graduate School of Medical SciencesKumamoto University1-1-1 HonjoChuo-kuKumamoto 860-8556Japan Department of Gastroenterological Surgery Esophageal Cancer DivisionCancer Institute Hospital of Japanese Foundation for Cancer Research3-8-31 AriakeKoto-kuTokyo 135-8550Japan

Circulating tumor cells(CTCs)are originated from the primary tumor lesion into the blood *** could lead to recurrence of gastrointestinal(GI)cancers,even after a curative resection and colonizing in the distant organs to facilitate tumor distant metastasis;however,it has been challenging in clinic to detect CTCs for a long time,such as detection methodology or molecular markers for identifi cation of *** review discussed the recent technical advances and biomarkers in the detection of CTCs and the molecular mechanism of CTC in cancer progression and ***,novel concepts,such as cancer stem cells and epithelial-mesenchymal transition,could lead to CTCs and tumor progression and ***,the involvement of CTCs varies greatly among cancer types in the GI and much remains to be ***,further study will provide more insightful information from a clinical and translational viewpoint to use CTCs for cancer early diagnosis or prediction of tumor recurrence and investigation of tumor progression and metastasis as well.

关键词： Cancer stem cells circulating tumor cells epithelial-mesenchymal transition gastrointestinal cancer tumor progression and metastasis

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Bacteremia or pseudobacteremia?Review of pseudomonas fluorescens infections

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World Journal of Emergency Medicine 2017年第2期8卷 151-154页

作者： Takeshi Nishimura Kenji Hattori Akihiko Inoue Taiji Ishii Tctsuya Yumoto Kohei Tsukahara Astunori Nakao Satoshi Ishihara Shinichi Nakayama Hyogo Emergency Medical Center 1-3-1 Wakinohamakaigando-riChuo-kuKobeHyogo 651-0073Japan Department of Emergency and Critical Care Medicine Okayama University Graduate School of MedicineDentistry and Pharmaceutical Sciences2-5-1 ShikatachoKitakuOkayama CityOkayama700-8558Japan

INTRODUCTION *** is an aerobic,Gram-negative bacillus related to Pseudomonas *** other species of Pseudomonas,the organism is widespread in nature and is found in water,moist soil,and *** to its low virulence,*** is an infrequent cause of infections except for catheter-related bloodstream infections in cancer *** August 1,2003 to May 31,2016,Hyogo Emergency Medical Center and the Kobe Red Cross hospital treated three cases of bloodstream infection

关键词： Bacteremia pseudobacteremia pseudomonas fluorescens infections

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慢性丙肝患者持续干扰素治疗后患肝细胞癌的危险因素

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世界核心医学期刊文摘（胃肠病学分册） 2005年第8期1卷 56-57页

作者： Ikeda M Fujiyama S Tanaka M 杨雪娟 Hepatobiliary/Pancreatic Onco l. Div. National Cancer Center Hospital 5-1-1 Tsukiji Chuo-ku Tokyo 104- 0045 Japan

Background. Interferon(IFN) is expected to prevent the progression of hepatiti s C virus infection to cirrhosis and the development of hepatocellular carcinoma (HCC), but there have been several reports of the development of HCC after a su stained response to IFN. Our aim was to elucidate the incidence and clinical fea tures of, and risk factors for, HCC in sustained responders to IFN, taken for th e treatment of chronic hepatitis C. Methods. We designed a retrospective cohort study conducted at 16 major hospitals. The subjects were a total of 1056 patient s showing sustained responses, 29 of whom developed HCC. Results. The incidence of HCC per 100 person-years was 0.56 (95%confidence interval, 0.35-0.76) in s ustained *** the Cox proportional hazard model, we found that older ag e, higher serum aspartate aminotransferase level,and lower platelet count before IFN therapy were independent risk factors associated with the development of HC C. A risk index of HCC development, based on the coefficients of these risk fact ors, was used to classify patients into three groups, with low, intermediate, and high risk. The inciden ce rates of HCC for these three groups were 0.11, 0.44, and 1.98 per 100 person -years, respectively. The median period to the development of HCC was 4.6 years (range, 1.4-9.0 years), and there were no other specific clinical features of the HCC that developed in these patients. Conclusions. This study suggests that the risk of development of HCC is not completely eliminated in sustained respond ers to IFN. These findings may be useful in determining a follow-up strategy af ter a sustained response to IFN.

关键词：肝细胞癌丙肝患者干扰素治疗慢性丙肝回顾性队列研究丙型肝炎氨基转移酶患病风险天冬酸专科医院

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Determination of the Compound Biological Effectiveness (CBE) Factors Based on the <i>ISHIYAMA-IMAHORI</i>Deterministic Parsing Model with the Dynamic PET Technique

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Journal of Cancer Therapy 2015年第8期6卷 759-766页

作者： Shintaro Ishiyama Yoshio Imahori Jun Itami Hanna Koivunoro Quantum Beam Science Center Japan Atomic Energy Agency Tokai-mura Naka-gun Ibaraki Japan Cancer Intelligence Care Systems Inc. Koto-ku Ariake Tokyo Japan Department of Radiation Oncology National Cancer Center Tsukiji Chuo-ku Tokyo Japan Department of Oncology Helsinki University Central Hospital Helsinki Finland

Purpose: In defining the biological effects of the 10B(n, α)7Li neutron capture reaction, we have proposed a deterministic parsing model (ISHIYAMA-IMAHORI model) to determine the Compound Biological Effectiveness (CBE) factor in Borono-Phenyl-Alanine (BPA)-mediated Boron Neutron Capture Therapy (BNCT). In present paper, we demonstrate a specific method of how the application of the case of application to actual patient data, which is founded on this model for tissues and tumor. Method: To determine the CBE factor, we derived the following new calculation formula founded on the deterministic parsing model with three constants, CBE0, F, n and the eigen value Nth/Nmax.? (1), where, Nth and Nmax are the threshold value of boron concentration of N and saturation boron density and CBE0, F and n are given as 0.5, 8 and 3, respectively. In order to determine Nth and Nmax in the formula, sigmoid logistic function was employed for 10B concentration data, Db(t) obtained by dynamic PET technique. (2), where, A, a and t0 are constants. Results and Conclusion: From the application of sigmoid function to dynamic PET data, it is concluded that the Nth and Nmax for tissue and tumor are identified with the parameter constants in the sigmoid function in Equation (2) as: (3). And the calculated CBE factor values obtained from Equation (1), with Nth/Nmax.

关键词： Boron Neutron Capture Therapy Compound Biological Effectiveness Borono-Phenyl-Alanine Tumor 10B(n α)7Li Sigmoid Function

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Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan:A multicenter questionnaire study

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World Journal of Gastrointestinal Endoscopy 2016年第20期8卷 785-794页

作者： Ryota Niikura Naoyoshi Nagata Hisashi Doyama Ryosuke Ota Naoki Ishii Katsuhiro Mabe Tsutomu Nishida Takuto Hikichi Kazuki Sumiyama Jun Nishikawa Toshio Uraoka Shu Kiyotoki Mitsuhiro Fujishiro Kazuhiko Koike Department of Gastroenterology Graduate School of Medicinethe University of TokyoBunkyo-kuTokyo 113-8655Japan Department of Gastroenterology and Hepatology National Center for Global Health and MedicineShinjuku-kuTokyo 162-8655Japan Department of Gastroenterology Ishikawa Prefectural Central HospitalKanazawa-shiIshikawa 920-8201Japan Department of Gastroenterology St.Luke’s International HospitalChuo-kuTokyo 104-8560Japan Division of Endoscopy Hokkaido University HospitalKita-kuSapporo 060-0808HokkaidoJapan Department of Gastroenterology National Hospital Organization Hakodate HospitalKawaharachouHakodate-shi 041-0844HokkaidoJapan Department of Gastroenterology Toyonaka Municipal HospitalToyonaka-shiOsaka 560-0055Japan Department of Endoscopy Fukushima Medical University HospitalFukushima-shiFukushima 960-1295Japan Department of Endoscopy the Jikei University School of MedicineMinato-kuTokyo 105-8471Japan Department of Clinical Laboratory Science Yamaguchi University Graduate School of MedicineUbe-shiYamaguchi 755-0046Japan Department of Gastroenterology National Hospital Organization Tokyo Medical CenterMeguro-kuTokyo 150-0021Japan Department of Gastroenterology Shuto General HospitalYanai-shiYamaguchi 742-0032Japan Endoscopy and Endoscopic Surgery the University of Tokyo HospitalBunkyo-kuTokyo 113-8655Japan

AIMTo clarify the current state of practice for colonic diverticular bleeding(CDB)in *** conducted multicenter questionnaire surveys of the practice for CDB including clinical settings(8 questions),diagnoses(8 questions),treatments(7 questions),and outcomes(4 questions)in 37 hospitals across *** answers were compared between hospitals with high and low number of inpatient beds to investigate which factor influenced the *** at all 37 hospitals answered the questions,and the mean number of endoscopists at these hospitals was *** all the hospitals,computed tomography was performed before colonoscopy in 67%of the *** rate of bowel preparation was 46.0%.Early colonoscopy was performed within 24 h in 43.2%of the *** the hospitals,83.8%performed clipping as first-line endoscopic *** than half of the hospitals experienced less than 20%rebleeding events after endoscopic *** significant difference was observed in the annual number of patients hospitalized for CDB between high-(≥700 beds)and low-volume *** emergency visits(P=0.012)and endoscopists(P=0.015),and less frequent participation of nursing staff in early colonoscopy(P=0.045)were observed in the high-volume *** practices unique to Japan were found,such as performing computed tomography before colonoscopy,no bowel preparation,and clipping as first-line ***,the number of staff differed,the practices for CDB were common irrespective of hospital size.

关键词： Colonic diverticular hemorrhage Lower gastrointestinal bleeding Computed tomography Endoscopy Bowel preparation

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Clinicopathological features and prognosis of surgical resected cases of biliary cancer with pancreaticobiliary maljunction

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 97-100页

作者： Tsukasa Takayashiki Hideyuki Yoshitomi Katsunori Furukawa Satoshi Kuboki Masaru Miyazaki Masayuki Ohtsuka Department of General Surgery Graduate School of MedicineChiba University Department of Gastroenterological Surgery Mita HospitalInternational University of Health and Welfare

To the Editor:Pancreaticobiliary maljunction(PBM)is a congenital anomaly in which the pancreatic and bile ducts join anatomically outside of the duodenal wall away from the Oddi’s *** condition causes the reflux of pancreatic juice into the bile duct under high pressure,resulting in various pathologic *** features of PBM patients are common bile duct dilatation,long common channel,and high amylase levels in bile *** them,one of the most significant problems is the development of biliary cancer,including extrahepatic bile duct and gallbladder cancers[1].A nationwide survey in Japan reported biliary cancer in 21.6%of adult patients with PBM concomitant with congenital biliary dilatation,32.1%and 62.3%extrahepatic bile duct and gallbladder cancers,respectively[2].

关键词： biliary cancer congenital

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Vonoprazan 10 mg or 20 mg *** 15 mg as maintenance therapy in Asian patients with healed erosive esophagitis:A randomized controlled trial

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Chinese Medical Journal 2024年第8期137卷 962-971页

作者： Yinglian Xiao Jiaming Qian Shutian Zhang Ning Dai Hoon Jai Chun Chengtang Chiu Chui Fung Chong Nobuo Funao Yuuichi Sakurai Jessica D.Eisner Li Xie Minhu Chen Department of Gastroenterology The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510062China Department of Gastroenterology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100006China Department of Gastroenterology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Gastroenterology Sir Run Run Shaw HospitalSchool of Medicine Zhejiang UniversityHangzhouZhejiang 310020China Department of Internal Medicine Korea University Anam HospitalKorea University College of Medicine73 Goryeodae-roSeongbuk-guSeoul 02841Republic of Korea Department of Gastroenterology&Hepatology Linkou Medical CenterChang Gung Memorial HospitalTaoyuanTaiwan 33353China College of Medicine Chang Gung UniversityTaoyuanTaiwan 33353China Takeda Development Center Asia Singapore 018981Singapore Takeda Pharmaceutical Company Chuo-kuOsaka 540-8645Japan Takeda Pharmaceuticals International Company CambridgeMA02142 USA China Medical Team Takeda ChinaBeijing 100027China Hoffmann-La Roche Basel4070 Switzerland Abbott Laboratories Lake ForestIL 60045USA

Background:Erosive esophagitis(EE)is a gastroesophageal reflux disease characterized by mucosal breaks in the *** pump inhibitors are widely used as maintenance therapy for EE,but many patients still *** this trial,we evaluated the noninferiority of vonoprazan *** as maintenance therapy in patients with healed ***:We performed a double-blind,double-dummy,multicenter,phase 3 clinical trial among non-Japanese Asian adults with endoscopically confirmed healed EE from April 2015 to February *** from China,South Korea,and Malaysia were randomized to vonoprazan 10 mg or 20 mg once daily or lansoprazole 15 mg once daily for 24 *** primary endpoint was endoscopically confirmed EE recurrence rate over 24 weeks with a noninferiority margin of 10%using a two-sided 95%confidence interval(CI).Treatment-emergent adverse events(TEAEs)were ***:Among 703 patients,EE recurrence was observed in 24/181(13.3%)and 21/171(12.3%)patients receiving vonoprazan 10 mg or 20 mg,respectively,and 47/184(25.5%)patients receiving lansoprazole(differences:-12.3%[95%CI,-20.3%to-4.3%]and-13.3%[95%CI,-21.3%to-5.3%],respectively),meeting the primary endpoint of noninferiority to lansoprazole in preventing EE recurrence at 24 *** of superiority(upper bound of 95%CI<0%)was also *** 12 weeks,endoscopically confirmed EE recurrence was observed in 5/18,2/20,and 7/20 of patients receiving vonoprazan 10 mg,vonoprazan 20 mg,and lansoprazole,*** were experienced by 66.8%(157/235),69.0%(156/226),and 65.3%(158/242)of patients receiving vonoprazan 10 mg,vonoprazan 20 mg,and lansoprazole,*** most common TEAE was upper respiratory tract infection in 12.8%(30/235)and 12.8%(29/226)patients in vonoprazan 10 mg and 20 mg groups,respectively and 8.7%(21/242)patients in lansoprazole ***:Vonoprazan maintenance therapy was well-tolerated and noninferior to lansoprazole for preventing EE recurrence i

关键词： Erosive esophagitis Lansoprazole Maintenance therapy Potassium-competitive acid blockers Vonoprazan

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