著者

Chitose Ishikawa Takayoshi Tsutamoto Masanori Fujii Hiroshi Sakai Toshinari Tanaka Minoru Horie

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.70, no.7, pp.857-863, 2006 (Released:2006-06-25)

参考文献数

31

被引用文献数

36 50

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Background The prognostic role of serum C-reactive protein (CRP) in chronic heart failure (CHF) patients, especially those with nonischemic dilated cardiomyopathy (DCM), remains unknown. In the present study, whether CRP provides prognostic information in DCM patients was evaluated. Methods and Results Neurohumoral factors and hemodynamics in 84 consecutive DCM patients were measured and these patients were followed up for a mean period of 42 months. During the follow-up period, 23 patients developed cardiac events and 18 patients died of cardiac causes. Using stepwise multivariate Cox proportional hazards regression analyses, log brain natriuretic peptide (BNP) (p=0.007) and high-sensitivity CRP (hsCRP) >1 mg/L (p=0.008) were significant independent predictors of cardiac events. The patients were stratified into 4 groups based on the normal serum concentration of hsCRP (1 mg/L) and median plasma concentration of BNP (110 pg/ml). Survival rates were significantly higher in patients with hsCRP <1 mg/L and BNP <110 pg/ml. The hazard ratio of patients with BNP >110 pg/ml and hsCRP >1 mg/L was 15.8 (95% confidence interval, 1.9-127.2) compared with those with BNP <110 pg/ml and hsCRP <1 mg/L for cardiac death. Conclusions Serum hsCRP level is an independent prognostic predictor in patients with DCM and the combination of hsCRP and BNP may be useful for the management of CHF patients with DCM. (Circ J 2006; 70: 857 - 863)

著者

Hiroshi TAKASAKI Mark R. ELKINS Anne M. MOSELEY

出版者

日本理学療法士学会

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.19, no.1, pp.58-66, 2016-12-20 (Released:2016-12-20)

参考文献数

29

被引用文献数

8

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Background: The Physiotherapy Evidence Database (PEDro) may help users to overcome some obstacles to evidence-based physiotherapy. Understanding the extent to which Japanese physiotherapists access research evidence via the PEDro website may suggest strategies to enhance evidence-based physiotherapy in Japan. Objectives: To quantify usage of PEDro in Japan, to compare this to usage in other countries, and to examine variations in PEDro usage within Japan. Design: An observational study of PEDro usage with geographic analysis. Methods: Data about visits to the home-page and searches of the database were recorded for 4 years. These data were analysed by each region of the World Confederation for Physical Therapy, each country in the Asia Western Pacific region, and each prefecture in Japan. Results: From 2010 to 2013, users of PEDro made 2.27 million visits to the home-page and ran 6.28 million searches. Usage (ie, number of searches normalised by population) was highest in Europe, followed by North America Carribean, South America, Asia Western Pacific, and Africa. Within the Asia Western Pacific region, population-normalised usage was highest in Australia, then New Zealand and Singapore. Japan ranked 10 among the 26 countries in the region. Within Japan, the highest population-normalised usage was in the Nagano, Kumamoto and Aomori prefectures, which was ten-fold higher usage than in some other prefectures. Conclusions: Although Japan has higher PEDro usage than many other countries in the Asia Western Pacific region, some prefectures had very low usage, suggesting that evidence-based practice may not be being adopted uniformly across Japan.

著者

Kenichiro Yaita Hideki Ohshima Makiko Hayashi Masayuki Nakamura Shin-ichiro Ueda Yoshiro Sakai Kenji Masunaga Koichi Ohshima Hiroshi Watanabe

出版者

日本プライマリ・ケア連合学会

雑誌

Journal of General and Family Medicine (ISSN:21896577)

巻号頁・発行日

vol.17, no.2, pp.176-178, 2016-06-18 (Released:2016-06-18)

参考文献数

7

著者

Shinichi Kuriyama Nobuo Yaegashi Fuji Nagami Tomohiko Arai Yoshio Kawaguchi Noriko Osumi Masaki Sakaida Yoichi Suzuki Keiko Nakayama Hiroaki Hashizume Gen Tamiya Hiroshi Kawame Kichiya Suzuki Atsushi Hozawa Naoki Nakaya Masahiro Kikuya Hirohito Metoki Ichiro Tsuji Nobuo Fuse Hideyasu Kiyomoto Junichi Sugawara Akito Tsuboi Shinichi Egawa Kiyoshi Ito Koichi Chida Tadashi Ishii Hiroaki Tomita Yasuyuki Taki Naoko Minegishi Naoto Ishii Jun Yasuda Kazuhiko Igarashi Ritsuko Shimizu Masao Nagasaki Seizo Koshiba Kengo Kinoshita Soichi Ogishima Takako Takai-Igarashi Teiji Tominaga Osamu Tanabe Noriaki Ohuchi Toru Shimosegawa Shigeo Kure Hiroshi Tanaka Sadayoshi Ito Jiro Hitomi Kozo Tanno Motoyuki Nakamura Kuniaki Ogasawara Seiichiro Kobayashi Kiyomi Sakata Mamoru Satoh Atsushi Shimizu Makoto Sasaki Ryujin Endo Kenji Sobue the Tohoku Medical Megabank Project Study Group Masayuki Yamamoto

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20150268, (Released:2016-07-02)

参考文献数

64

被引用文献数

1 227

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The Great East Japan Earthquake (GEJE) and resulting tsunami of March 11, 2011 gave rise to devastating damage on the Pacific coast of the Tohoku region. The Tohoku Medical Megabank Project (TMM), which is being conducted by Tohoku University Tohoku Medical Megabank Organization (ToMMo) and Iwate Medical University Iwate Tohoku Medical Megabank Organization (IMM), has been launched to realize creative reconstruction and to solve medical problems in the aftermath of this disaster. We started two prospective cohort studies in Miyagi and Iwate Prefectures: a population-based adult cohort study, the TMM Community-Based Cohort Study (TMM CommCohort Study), which will recruit 80 000 participants, and a birth and three-generation cohort study, the TMM Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study), which will recruit 70 000 participants, including fetuses and their parents, siblings, grandparents, and extended family members. The TMM CommCohort Study will recruit participants from 2013 to 2016 and follow them for at least 5 years. The TMM BirThree Cohort Study will recruit participants from 2013 to 2017 and follow them for at least 4 years. For children, the ToMMo Child Health Study, which adopted a cross-sectional design, was also started in November 2012 in Miyagi Prefecture. An integrated biobank will be constructed based on the two prospective cohort studies, and ToMMo and IMM will investigate the chronic medical impacts of the GEJE. The integrated biobank of TMM consists of health and clinical information, biospecimens, and genome and omics data. The biobank aims to establish a firm basis for personalized healthcare and medicine, mainly for diseases aggravated by the GEJE in the two prefectures. Biospecimens and related information in the biobank will be distributed to the research community. TMM itself will also undertake genomic and omics research. The aims of the genomic studies are: 1) to construct an integrated biobank; 2) to return genomic research results to the participants of the cohort studies, which will lead to the implementation of personalized healthcare and medicine in the affected areas in the near future; and 3) to contribute the development of personalized healthcare and medicine worldwide. Through the activities of TMM, we will clarify how to approach prolonged healthcare problems in areas damaged by large-scale disasters and how useful genomic information is for disease prevention.

著者

Wickham Shelley F. J. Bath Jonathan Katsuda Yousuke Endo Masayuki Hidaka Kumi Sugiyama Hiroshi Turberfield Andrew J.

出版者

Nature Publishing Group

雑誌

Nature Nanotechnology (ISSN:17483387)

巻号頁・発行日

2012-01-22

被引用文献数

329

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DNA分子モーターの動きをナノスケールでコントロールする事に成功-ナノ・メゾ空間での分子ロボットの開発へ-. 京都大学プレスリリース. 2012-01-23.

著者

Katsuyuki Morishita Hiroshi Karasuno Yuka Yokoi Kazunori Morozumi Hisayoshi Ogihara Toshikazu Ito Masaaki Hanaoka Takayuki Fujiwara Tetsuya Fujimoto Koji Abe

出版者

理学療法科学学会

雑誌

Journal of Physical Therapy Science (ISSN:09155287)

巻号頁・発行日

vol.26, no.5, pp.711-715, 2014 (Released:2014-05-29)

参考文献数

23

被引用文献数

7 29

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[Purpose] This study aimed to clarify the effects of therapeutic ultrasound on range of motion and stretch pain and the relationships between the effects. [Subjects] The subjects were 15 healthy males. [Methods] Subjects performed all three interventions: (1) ultrasound (US group), (2) without powered ultrasound (placebo group), and (3) rest (control group). Ultrasound was applied at 3 MHz with an intensity of 1.0 W/cm2 and a 100% duty cycle for 10 minutes. The evaluation indices were active and passive range of motion (ROM), stretch pain (visual analog scale; VAS), and skin surface temperature (SST). The experimental protocol lasted a total of 40 minutes; this was comprised of 10 minutes before the intervention, 10 minutes during the intervention (US, placebo, and control), and 20 minutes after the intervention. [Results] ROM and SST were significantly higher in the US group than in the placebo and control groups for the 20 minutes after ultrasound, though there was no change in stretch pain. [Conclusion] The effects of ultrasound on ROM and SST were maintained for 20 minutes after the intervention. The SST increased with ultrasound and decreased afterwards. Additionally, the SST tended to return to baseline levels within 20 minutes after ultrasound exposure. Therefore, these effects were caused by a combination of thermal and mechanical effects of the ultrasound.

著者

Karthik KRISHNAN Tomoaki YAMADA Hiroko IWATSUKI Mitsuo HARA Shusaku NAGANO Kazuya OTSUBO Osami SAKATA Akihiko FUJIWARA Hiroshi KITAGAWA Yuki NAGAO

出版者

公益社団法人 電気化学会

雑誌

Electrochemistry (ISSN:13443542)

巻号頁・発行日

vol.82, no.10, pp.865-869, 2014-10-05 (Released:2014-10-05)

参考文献数

36

被引用文献数

1 11

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The organized structure and proton transport property in sulfonated polyimide (SPI) thin film have been studied, much less is known at the interfacial charge transport during confinement of such materials. The proton conductivity of SPI thin film is correlated well with the highly oriented polymer structures as determined by infrared (IR) p-polarized multiple-angle incidence resolution spectrometry (p-MAIRS) and in situ RH dependent synchrotron grazing incidence X-ray diffraction (GI-XRD). The high proton conductivity of 2.8 × 10−1 S cm−1 at 80°C and 90% RH was achieved in the highly oriented SPI thin film. In contrast, the bulk SPI showed the drop of conductivity value at high relative humidity region, which is due to the significant structural disorder accompanied by the strong interaction between the sulfonic acid side chains and water molecules.

著者

Hiroshi Inoue Hirotsugu Atarashi Ken Okumura Takeshi Yamashita Naoko Kumagai Hideki Origasa for the J-RHYTHM Registry Investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-14-0507, (Released:2014-08-06)

参考文献数

25

被引用文献数

14 39

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Background:It is disputed whether the risk of cardiogenic embolism varies with type of atrial fibrillation (AF). Although several studies have found that the risk of cardiogenic embolism was similar among paroxysmal and persistent/permanent AF, a few studies have found that patients with paroxysmal AF had a lower rate of stroke and systemic embolism than those with persistent/permanent AF. In the present study, post-hoc analysis of the J-RHYTHM Registry was done to compare the risk of thromboembolic events among 3 types of non-valvular AF (NVAF).Methods and Results:A total of 7,406 NVAF patients were followed up prospectively for 2 years. At baseline, warfarin was used for 78.6%, 90.0%, and 91.8% of patients with paroxysmal, persistent, and permanent AF, respectively. There were 126 thromboembolic events during the follow-up period. The crude event rate was 2-fold higher among the patients with permanent NVAF (2.29%) than among those with paroxysmal (1.16%) or persistent (1.20%) NVAF (P=0.001). After adjusting for warfarin use and CHA2DS2-VASc score components, however, the hazard ratio for thromboembolism did not differ between paroxysmal (reference) and permanent NVAF (1.007; 95% confidence interval: 0.955–1.061).Conclusions:The crude rate of thromboembolic events was higher in permanent NVAF than in paroxysmal NVAF, but after adjusting for warfarin use and CHA2DS2-VASc score components, paroxysmal and permanent NVAF patients had similar risk of thromboembolism.

著者

Yoichi Takaya Reon Kumasaka Tetsuo Arakawa Takahiro Ohara Michio Nakanishi Teruo Noguchi Masanobu Yanase Hiroshi Takaki Yuhei Kawano Yoichi Goto

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-13-0779, (Released:2013-11-12)

参考文献数

36

被引用文献数

6 42

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Background: Although there is a general fear that exercise training might deteriorate renal function in chronic kidney disease (CKD) patients, the effect of cardiac rehabilitation (CR) on renal function in acute myocardial infarction (AMI) patients with CKD remains unknown. We sought to determine whether CR is associated with amelioration or deterioration of renal function in such patients. Methods and Results: We enrolled 528 AMI patients who participated in a 3-month CR program. Clinical data before and after CR were compared according to participation in CR and comorbidities. In patients without CKD (estimated glomerular filtration rate [eGFR] ≥60ml·min−1·1.73m−2, n=348), peak oxygen uptake (VO2) and B-type natriuretic peptide (BNP) improved without a change in eGFR. In contrast, in patients with CKD (eGFR <60ml·min−1·1.73m−2, n=180), eGFR improved (48±12 to 53±15ml·min−1·1.73m−2, P<0.001), together with improvements in peak VO2 and BNP. When patients with CKD were divided into non-active (≤1time/week, n=70) and active participants (≥1.1time/week, n=110) according to attendance in CR, active participants showed an improvement in eGFR (50±10 to 53±13ml·min−1·1.73m−2, P<0.001), whereas eGFR did not change in non-active participants. Similar results were obtained in each subgroup of patients with hypertension, dyslipidemia, or diabetes mellitus. Conclusions: In AMI patients with CKD, active participation in CR was associated with improved peak VO2, BNP, and eGFR.

著者

Tsutomu Igarashi Yuri Nakazato Tomoyuki Kunishige Miho Fujita Yumi Yamada Chiaki Fujimoto Kimihiro Okubo Hiroshi Takahashi

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.79, no.3, pp.182-189, 2012 (Released:2012-07-05)

参考文献数

24

被引用文献数

1 7

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Background: Recent studies have examined the effects of intranasal corticosteroids (INSs) in relieving the ocular symptoms of seasonal allergic rhinoconjunctivitis (SAR) and perennial allergic rhinitis. However, because most of these studies were based on subjective assessments by patients, the associated factors and mechanism of action are unknown. Methods: A single-center, randomized, double-blind, parallel-group study was carried out in which patients with SAR were randomly assigned to an INS mometasone furoate nasal spray (MFNS) group or to a placebo group and treated once daily for 4 weeks. Substance P concentrations in tears were measured, ocular and nasal symptoms were recorded by patients in an allergy diary, and findings were recorded by an ophthalmologist. Results: There was no significant difference between treatment groups in the mean change from baseline of substance P concentration in tears after 4 weeks of treatment, but the mean change tended to increase in the placebo group and tended to decrease in the MFNS group (P = 0.089). All ocular and nasal symptom scores, except eye tearing, were significantly lower in the MFNS group than in the placebo group. Furthermore, substance P concentrations were strongly correlated with ocular and nasal symptom scores. Conclusions: In patients with SAR, INSs tend to decrease the substance P concentration in tears, which is correlated with the severity of ocular and nasal symptoms.

著者

Naoshi KONDO Makoto KURAMOTO Hiroshi SHIMIZU Yuichi OGAWA Mitsutaka KURITA Takahisa NISHIZU Vui Kiong CHONG Kazuya YAMAMOTO

出版者

Asian Agricultural and Biological Engineering Association

雑誌

Engineering in Agriculture, Environment and Food (ISSN:18818366)

巻号頁・発行日

vol.2, no.2, pp.54-59, 2009 (Released:2009-04-04)

参考文献数

14

被引用文献数

2

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As basic research to develop a machine vision system to detect rotten mandarin orange, the extraction and identification of fluorescent substances contained in rotten parts of mandarin orange were conducted, and the excitation and fluorescence wavelengths of the substance were determined. Although it has been reported that damaged orange fruit skins are often fluoresced by UV light, it was suggested that fluorescent substances exist not only in the rotten parts of skins but also the normal parts of skins from this research. The fluorescent substances were extracted from 1kg of mandarin peel, and NMR analysis and mass spectrometry were conducted. From this experiment, it was found that the fluorescent substance was quite possibly heptamethylflavone and that the excitation and fluorescent wavelengths of one of the substances were 360 to 375nm and 530 to 550nm, respectively.

著者

Kohei Kamegai Noriko Iwamoto Masahiro Ishikane Kei Yamamoto Kumi Horii Shiho Kubota Akira Hangaishi Hiroshi Shimazu Tomiteru Togano Hiroyuki Yamashita Yasuhide Yamada Norio Ohmagari

出版者

National Center for Global Health and Medicine

雑誌

Global Health & Medicine (ISSN:24349186)

巻号頁・発行日

pp.2023.01053, (Released:2023-11-15)

参考文献数

27

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Immunocompromised coronavirus disease 2019 patients are at a higher risk of prolonged viral shedding than immunocompetent patients. However, as of August 2023, there is no clear international standard for de-isolating vulnerable patients. A comprehensive assessment is advisable based on various information, such as the increase in immune escape of specific mutant strains as well as the patient's innate immunity and vaccination status; therefore, consultation with an infectious disease specialist is recommended. The patient population defined as moderately or severely immunocompromised by the Centers for Disease Control and Prevention and the European Centre for Disease Prevention and Control is significantly broad. A boundary between the two remains to be delineated, and the existing protocols allow the release of patients based on their symptoms alone. This may lead to an unnecessary extension or premature termination of isolation. In this study, we searched for studies, particularly those that used real-world data, discussed the results with experts in our hospital, and proposed new isolation criteria based on both testing and clinical symptoms. We classified patients into three groups namely severely, moderately, and mildly immunocompromised, defined by their background and the administration of immunosuppressive drugs. A separate flowchart for ending isolation is indicated for each group. This standard may be a useful support material, especially for non-specialists. Nevertheless, our criteria must be revised and added continuously; accumulating real-world data to support revision of and addition to the list is becoming increasingly important.

著者

Masayuki Ueda Marie Tsunogae Hiroshi Saito Takeya Suzuki Takahiro Ota

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.5621-20, (Released:2020-09-19)

参考文献数

14

被引用文献数

4

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A 24-year-old female patient was admitted for a right frontal intracranial hematoma with an uncal herniation due to a ruptured arteriovenous malformation and therefore underwent emergency surgery. Neuroimaging revealed left-sided midbrain notching against the tentorium, indicating Kernohan's notch phenomenon. She denied experiencing any short-term neurological deficits but right-sided delayed hemiparkinsonism developed 18 months later. Dopamine transporter tracer uptake was severely reduced in the left striatum, suggesting nigrostriatal degeneration secondary to Kernohan's notch. Uncal herniations are potentially fatal, but surgery can save the patient's life and improve the functional outcomes. Clinicians should therefore be aware of delayed hemiparkinsonism as a rare complication of Kernohan's notch phenomenon.

著者

Yuki HAMADA Fumio MIYASHITA Hideki MATSUOKA Yuki NISHINAKAMA Yusuke KAI Yusuke YAMASHITA Mei IKEDA Go TAKAGUCHI Keisuke MASUDA Fumikatsu KUBO Hiroshi TAKASHIMA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.10, pp.273-278, 2023-12-31 (Released:2023-10-14)

参考文献数

12

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Herein, we report a case of carotid artery stenting with proximal flow protection for severe stenosis of the left internal carotid artery using transbrachial and transradial artery approaches. Because an abdominal aortic aneurysm was present, we avoided the transfemoral approach. The procedure was successfully performed with a combination of an 8-Fr balloon guide catheter and microballoon catheter on separate axes. No complications such as pseudoaneurysm, thrombosis, or dissection were observed at the puncture site. The patient was discharged without complications and showed good outcomes at 3 months. This technique may offer a useful alternative for patients with severe stenosis who cannot be treated using a femoral artery approach.

著者

Kazuma Tashiro Hiroyoshi Mori Hiroshi Suzuki

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0611, (Released:2023-09-23)

参考文献数

11

著者

Akihito Yokoyama Hiroshi Okazaki Naoyuki Makita Ayako Fukui Yi Piao Yoshifumi Arita Yohji Itoh Naoki Tashiro

出版者

Japanese Society of Allergology

雑誌

Allergology International (ISSN:13238930)

巻号頁・発行日

vol.71, no.1, pp.47-54, 2022 (Released:2022-01-27)

参考文献数

18

被引用文献数

7

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Background: In Japan, regional differences in asthma mortality have been reported; however, regional differences in asthma exacerbations have not been studied extensively. Therefore, using a health insurance claims database, we investigated the regional differences in the incidence of asthma exacerbations in Japan.Methods: This study used data from Medi-Scope (Japan Medical Information Research Institute Inc., Japan)-a nationwide health insurance claims database. Patients with asthma at the index date (the latest date of an asthma-related prescription with an asthma diagnosis before October 1, 2018) were included in the analysis. The pre-index period was defined as 1 year before the index date, and the follow-up period as 1 year after the index date. The incidence of asthma exacerbation events was analyzed for each region.Results: The primary analysis population comprised 24,883 patients who were continuously prescribed ICS or ICS/LABA at least four times during the pre-index period. The incidence rate of asthma exacerbations with hospitalization was the highest in Chugoku (2.95/100 person-years [95% CI, 1.97-4.43]) and the lowest in Kanto (1.52/100 person-years [95% CI, 1.26-1.83]). The incidence rate of asthma exacerbations for the composite outcome of hospitalization, injectable corticosteroid prescription, and oral corticosteroid burst was the highest in Fukui (105.00/100 person-years [95% CI, 64.53-170.85]) and the lowest in Nagasaki (15.69/100 person-years [95% CI, 10.84-22.72]).Conclusions: Regional differences in the incidence of asthma exacerbations as well as their treatments were observed in Japan.

著者

Takashi Unuma Hiroshi Yamauchi Akihito Umehara Teruyuki Kato

出版者

公益社団法人 日本気象学会

雑誌

SOLA (ISSN:13496476)

巻号頁・発行日

pp.2023-020, (Released:2023-06-09)

被引用文献数

1

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We investigated the microphysical mechanisms for the enhancement of rainfall in a precipitating system that spawned heavy rainfall over the central part of the Kanto Plain in eastern Japan on 12 July 2022. Optical disdrometer observations confirmed the existence of an equilibrium state in the raindrop size distribution, especially when the precipitation intensity was high (e.g., 20 mm hr−1). As the raindrop size distribution approached equilibrium, raindrop sizes centered around 1.5 mm were observed initially, and then the number concentration of smaller and larger size raindrops increased simultaneously. The raindrop size distribution was closely related to the vertical profile of the parameters of raindrop size distribution that were estimated from polarimetric radar observations. These results suggest that the formation of equilibrium raindrop size distributions is important to produce substantial rainfall in the midlatitude as well as in the tropics.

著者

Teruhiko Imamura Koichiro Kinugawa Takashi Nishimura Koichi Toda Yoshikatsu Saiki Hiroshi Niinami Shinichi Nunoda Goro Matsumiya Motonobu Nishimura Hirokuni Arai Masanobu Yanase Norihide Fukushima Takeshi Nakatani Akira Shiose Ikuko Shibasaki Yasushi Sakata Minoru Ono J-MACS Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0264, (Released:2023-06-01)

参考文献数

18

被引用文献数

2

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Background: Recently, destination therapy (DT) was approved in Japan, and patients ineligible for heart transplantation may now receive durable left ventricular assist devices (LVADs). Several conventional risk scores are available, but a risk score that is best to select optimal candidates for DT in the Japanese population remains unestablished.Methods and Results: A total of 1,287 patients who underwent durable LVAD implantation and were listed for the Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) were eligible for inclusion. Finally, 494 patients were assigned to the derivation cohort and 487 patients were assigned to the validation cohort. According to the time-to-event analyses, J-MACS risk scores were newly constructed to predict 3-year mortality rate, consisting of age, history of cardiac surgery, serum creatinine level, and central venous pressure to pulmonary artery wedge pressure ratio >0.71. The J-MACS risk score had the highest predictability of 3-year death compared with other conventional scores in the validation cohort, including HeartMate II risk score and HeartMate 3 risk score.Conclusions: We constructed the J-MACS risk score to estimate 3-year mortality rate after durable LVAD implantation using large-scale multicenter Japanese data. The clinical utility of this scoring to guide the indication of DT should be validated in the next study.

著者

Masaharu Akao Hiroshi Inoue Takeshi Yamashita Hirotsugu Atarashi Takanori Ikeda Yukihiro Koretsune Ken Okumura Shinya Suzuki Hiroyuki Tsutsui Kazunori Toyoda Atsushi Hirayama Masahiro Yasaka Takenori Yamaguchi Satoshi Teramukai Tetsuya Kimura Yoshiyuki Morishima Atsushi Takita Wataru Shimizu

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0143, (Released:2023-07-21)

参考文献数

21

被引用文献数

1

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Background: This sub-analysis of the ANAFIE Registry, a prospective, observational study of >30,000 Japanese non-valvular atrial fibrillation (NVAF) patients aged ≥75 years, assessed the prevalence of direct oral anticoagulant (DOAC) under-dose prevalence, identified the factors of under-dose prescriptions, and examined the relationship between DOAC dose and clinical outcomes.Methods and Results: Patients, divided into 5 groups by DOAC dose (standard, over-, reduced, under-, and off-label), were analyzed for background factors, cumulative incidences, and clinical outcome risk. Endpoints were stroke/systemic embolic events (SEE), major bleeding, and all-cause death during the 2-year follow-up. Of 18,497 patients taking DOACs, 20.7%, 3.8%, 51.6%, 19.6%, and 4.3%, were prescribed standard, over-, reduced, under-, and off-label doses. Factors associated with under-dose use were female sex, age ≥85 years, reduced creatinine clearance, history of major bleeding, polypharmacy, antiplatelet agents, heart failure, dementia, and no history of catheter ablation or cerebrovascular disease. After confounder adjustment, under-dose vs. standard dose was not associated with the incidence of stroke/SEE or major bleeding but was associated with a higher mortality rate. Patients receiving an off-label dose showed similar tendencies to those receiving an under-dose; that is, they showed the highest mortality rates for stroke/SEE, major bleeding, and all-cause death.Conclusions: Inappropriate low DOAC doses (under- or off-label dose) were not associated with stroke/SEE or major bleeding but were associated with all-cause death.

著者

Dai MATSUI Ryoko WATABE Hiroshi ONO

出版者

The Society for Near Eastern Studies in Japan

雑誌

Orient (ISSN:04733851)

巻号頁・発行日

vol.50, pp.53-75, 2015-03-30 (Released:2018-04-01)

参考文献数

112

被引用文献数

1

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This paper presents the philological analysis of one of the Ardabīl documents: An Uigur- Turkic decree of the Timurid prince Mīrān Šāh, dated to 800 AH/1398 CE. It is the oldest of the Timurid Uigur-Turkic decrees thus far known, and the only one accompanied by a Persian summary. It attests to the patronage of the Timurid rulers for the Safavid Order in Ardabīl, and offers significant information on the administration, chancellery, taxation, and many other aspects of the early Timurid rule, and merits further investigation from the historical viewpoint.