37 results on '"Kazuki Nishida"'
Search Results
2. Influence of previous health guidance history: impact and limitations of a single health guidance session
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Ayaka Hayase, Takeshi Onoue, Kazuki Nishida, Yoshio Nakata, Fumi Hayashi, Miki Marutani, Naoki Sakane, Tomonori Okamura, Keiichi Matsuzaki, Takashi Kawamura, and Kazuyo Tsushita
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health guidance ,lifestyle intervention ,metabolic syndrome ,obesity ,weight loss ,Industrial safety. Industrial accident prevention ,T55-55.3 ,Medicine (General) ,R5-920 - Abstract
Objectives: Metabolic syndrome (MS) is a significant health concern in the working-age population. Since 2008, Japan has mandated health insurers to implement Specific Health Checkups to identify individuals with MS and preliminary groups, making Specific Health Guidance (SHG) compulsory for these groups. People receiving SHG multiple times is increasing as it is conducted as an annual public program. Therefore, we evaluated the influence of a health guidance history on the effectiveness of subsequent guidance. Methods: Using data from 10,191 participants in the 2017 Motivational Health Guidance (a type of SHG involving a single session), this longitudinal study assessed the changes in health checkup findings from 2017 to 2018. Participants were categorized based on their previous year’s (2016) SHG eligibility and participation: Group 1 (n=3,903) met the 2016 SHG criteria and participated, Group 2 (n=2,305) met the criteria but did not participate, and Group 3 (n=3,983) had no MS risk factors and did not need to participate in the 2016 SHG. Results: The entire cohort and Groups 2 and 3 exhibited significant weight loss after 1 year. Group 1 showed a significant negative association, with a 3% (odds ratio [OR] 0.64; 95% confidence interval [CI], 0.55–0.75) and 5% body weight loss (OR 0.66; 95% CI, 0.54–0.81) than Group 3. Men in Group 1 showed a significant association with new-onset MS (OR 2.56; 95% CI, 1.93–3.40). Conclusions: The findings suggest that participants with a history of health guidance in the previous year may have low rates of achieving weight loss and a high incidence of new-onset MS after 1 year.
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- 2024
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3. Comparison of Central and Peripheral Arterial Blood Pressure Gradients in Critically Ill Patients: A Systematic Review and Meta-Analysis
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Daisuke Hasegawa, MD, PhD, Ryota Sato, MD, Abhijit Duggal, MD, MS, MPH, FACP, Mary Schleicher, RN, BSN, MLIS, AHIP, Kazuki Nishida, MD, PhD, Ashish K. Khanna, MD, MS, FCCP, FCCM, FASA, and Siddharth Dugar, MD, FASE, FCCM, FCCP
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
OBJECTIVES:. Measurement of blood pressure taken from different anatomical sites, are often perceived as interchangeable, despite them representing different parts of the systemic circulation. We aimed to perform a systematic review and meta-analysis on blood pressure differences between central and peripheral arterial cannulation in critically ill patients. DATA SOURCES:. We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase from inception to December 26, 2023, using Medical Subject Headings (MeSH) terms and keywords. STUDY SELECTION:. Observation study of adult patients in ICUs and operating rooms who underwent simultaneous central (femoral, axillary, or subclavian artery) and peripheral (radial, brachial, or dorsalis pedis artery) arterial catheter placement in ICUs and operating rooms. DATA EXTRACTION:. We screened and extracted studies independently and in duplicate. We assessed risk of bias using the revised Quality Assessment for Studies of Diagnostic Accuracy tool. DATA SYNTHESIS:. Twenty-four studies that enrolled 1598 patients in total were included. Central pressures (mean arterial pressure [MAP] and systolic blood pressure [SBP]) were found to be significantly higher than their peripheral counterparts, with mean gradients of 3.5 and 8.0 mm Hg, respectively. However, there was no statistically significant difference in central or peripheral diastolic blood pressure (DBP). Subgroup analysis further highlighted a higher MAP gradient during the on-cardiopulmonary bypass stage of cardiac surgery, reperfusion stage of liver transplant, and in nonsurgical critically ill patients. SBP or DBP gradient did not demonstrate any subgroup specific changes. CONCLUSIONS:. SBP and MAP obtained by central arterial cannulation were higher than peripheral arterial cannulation; however, clinical implication of a difference of 8.0 mm Hg in SBP and 3.5 mm Hg in MAP remains unclear. Our current clinical practices preferring peripheral arterial lines need not change.
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- 2024
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4. Efficacy of intraoperative irrigation with artificial cerebrospinal fluid in chronic subdural hematoma surgery: study protocol for a multicenter randomized controlled trial
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Yoshitaka Nagashima, Yoshio Araki, Kazuki Nishida, Shunichiro Kuramitsu, Kenichi Wakabayashi, Shinji Shimato, Takeshi Kinkori, Toshihisa Nishizawa, Takahisa Kano, Toshinori Hasegawa, Atsushi Noda, Kenko Maeda, Yu Yamamoto, Osamu Suzuki, Naoki Koketsu, Takeshi Okada, Masashige Iwasaki, Kiyo Nakabayashi, Shigeru Fujitani, Hideki Maki, Yachiyo Kuwatsuka, Masahiro Nishihori, Takafumi Tanei, Tomohide Nishikawa, Yusuke Nishimura, Ryuta Saito, and Tokai Neurosurgical disorder Research Group CSDH Study investigators
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Artificial cerebrospinal fluid ,Chronic subdural hematoma ,Irrigation fluid ,Recurrence ,Surgical evacuation ,Medicine (General) ,R5-920 - Abstract
Abstract Background The surgical techniques for treatment of chronic subdural hematoma (CSDH), a common neurosurgical condition, have been discussed in a lot of clinical literature. However, the recurrence proportion after CSDH surgery remains high, ranging from 10 to 20%. The standard surgical procedure for CSDH involves a craniostomy to evacuate the hematoma, but irrigating the hematoma cavity during the procedure is debatable. The authors hypothesized that the choice of irrigation fluid might be a key factor affecting the outcomes of surgery. This multicenter randomized controlled trial aims to investigate whether intraoperative irrigation using artificial cerebrospinal fluid (ACF) followed by the placement of a subdural drain would yield superior results compared to the placement of a subdural drain alone for CSDH. Methods The study will be conducted across 19 neurosurgical departments in Japan. The 1186 eligible patients will be randomly allocated to two groups: irrigation using ACF or not. In either group, a subdural drain is to be placed for at least 12 h postoperatively. Similar to what was done in previous studies, we set the proportion of patients that meet the criteria for ipsilateral reoperation at 7% in the irrigation group and 12% in the non-irrigation group. The primary endpoint is the proportion of patients who meet the criteria for ipsilateral reoperation within 6 months of surgery (clinical worsening of symptoms and increased hematoma on imaging compared with the postoperative state). The secondary endpoints are the proportion of reoperations within 6 months, the proportion being stratified by preoperative hematoma architecture by computed tomography (CT) scan, neurological symptoms, patient condition, mortality at 6 months, complications associated with surgery, length of hospital stay from surgery to discharge, and time of the surgical procedure. Discussion We present the study protocol for a multicenter randomized controlled trial to investigate our hypothesis that intraoperative irrigation with ACF reduces the recurrence proportion after the removal of chronic subdural hematomas compared with no irrigation. Trial registration ClinicalTrials.gov jRCT1041220124. Registered on January 13, 2023.
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- 2024
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5. Association between loss of hypercoagulable phenotype, clinical features and complement pathway consumption in COVID-19
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Daisuke Kasugai, Taku Tanaka, Takako Suzuki, Yoshinori Ito, Kazuki Nishida, Masayuki Ozaki, Takeo Kutsuna, Toshiki Yokoyama, Hitoshi Kaneko, Ryo Ogata, Ryohei Matsui, Takahiro Goshima, Hiroshi Hamada, Azusa Ishii, Yusuke Kodama, Naruhiro Jingushi, Ken Ishikura, Ryo Kamidani, Masashi Tada, Hideshi Okada, Takanori Yamamoto, and Yukari Goto
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COVID-19 ,blood coagulation disorders ,rotational thromboelastometry ,alternative complement pathway ,microthrombosis ,Immunologic diseases. Allergy ,RC581-607 - Abstract
BackgroundCoronavirus disease 2019 (COVID-19) features a hypercoagulable state, but therapeutic anticoagulation effectiveness varies with disease severity. We aimed to evaluate the dynamics of the coagulation profile and its association with COVID-19 severity, outcomes, and biomarker trajectories.MethodsThis multicenter, prospective, observational study included patients with COVID-19 requiring respiratory support. Rotational thromboelastometry findings were evaluated for coagulation and fibrinolysis status. Hypercoagulable status was defined as supranormal range of maximum clot elasticity in an external pathway. Longitudinal laboratory parameters were collected to characterize the coagulation phenotype.ResultsOf 166 patients, 90 (54%) were severely ill at inclusion (invasive mechanical ventilation, 84; extracorporeal membrane oxygenation, 6). Higher maximum elasticity (P=0.02) and lower maximum lysis in the external pathway (P=0.03) were observed in severely ill patients compared with the corresponding values in patients on non-invasive oxygen supplementation. Hypercoagulability components correlated with platelet and fibrinogen levels. Hypercoagulable phenotype was associated with favorable outcomes in severely ill patients, while normocoagulable phenotype was not (median time to recovery, 15 days vs. 27 days, P=0.002), but no significant association was observed in moderately ill patients. In patients with severe COVID-19, lower initial C3, minimum C3, CH50, and greater changes in CH50 were associated with the normocoagulable phenotype. Changes in complement components correlated with dynamics of coagulation markers, hematocrit, and alveolar injury markers.ConclusionsWhile hypercoagulable states become more evident with increasing severity of respiratory disease in patients with COVID-19, normocoagulable phenotype is associated with triggered by alternative pathway activation and poor outcomes.
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- 2024
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6. Extracellular Production of Glutathione by Recombinant Escherichia coli K-12
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Hideyuki Suzuki, Kazuki Nishida, and Tatsuya Nakamura
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antioxidant ,kokumi ,desensitization ,transporter ,T5 promoter ,excretion ,Microbiology ,QR1-502 - Abstract
The goal of this study was to produce a sufficient amount of glutathione in the fermentation medium without the addition of cysteine. This would simplify and reduce the cost of its purification. In addition to reducing the cost of cysteine, it also avoids the inhibition of bacterial growth by cysteine. The gshA, gshB, and cysE genes of Escherichia coli were cloned under the control of the strong T5 promoter of the pQE-80L plasmid and introduced into an E. coli strain knocked out for the genes encoding γ-glutamyltranspeptidase and the GsiABCD glutathione transporter, which are responsible for the recycling of excreted glutathione. The overexpression of the gshA and gshB genes, genes for γ-glutamylcysteine synthetase and glutathione synthetase, and the cysEV95R D96P gene, a gene for serine acetyltransferase with the V95R D96P mutation that makes it insensitive to cysteine, were effective on glutathione production. Na2S2O3 was a good sulfur source for glutathione production, while the addition of Na2SO4 did not affect the glutathione production. With the addition of 50 mM glutamic acid and 75 mM glycine, but without the addition of cysteine, to the simplified SM1 medium, 4.6 mM and 0.56 mM of the reduced and oxidized glutathione, respectively, were accumulated in the extracellular space after 36 h of batch culture. This can eliminate the need to extract glutathione from the bacterial cells for purification.
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- 2023
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7. Impact of Ar/CF4 Mixed Gas Flow Rate on Silicon Etching Using Surface Discharge Plasma
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Toshiyuki Hamada, Kazuki Nishida, and Masafumi Yoshida
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surface discharge plasma ,etching ,Ar/CF4 mixed gas ,gas flow rate ,silicon ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
This study examines the effects of varying argon (Ar) and carbon tetrafluoride (CF4) gas flow rates on the etching of monocrystalline silicon substrates using surface discharge plasma. While previous research has primarily focused on the fundamental characteristics and applications of surface discharge plasma in silicon etching, the influence of the gas flow rate on etching efficacy remains insufficiently explored. The aim of this study is to elucidate the relationship between mixed gas flow rates and the rate and quality of silicon etching, both of which are critical for optimizing manufacturing processes in the semiconductor industry. Utilizing a setup equipped with a USB4000 spectrometer for emission spectroscopy, we varied the Ar/CF4 flow rates from 0 to 6000 sccm while maintaining a fixed discharge-sustaining voltage of 9.4 kV. We observed and analyzed the discharge power, plasma emission intensities, and resulting etch profiles of the silicon substrates. Particularly, we analyzed the emission spectra for peaks corresponding to active species such as F, F2, and CFn, indicative of the plasma’s etching capabilities. The findings revealed that higher flow rates significantly enhanced the generation of key active species, leading to increased etching rates in both depth and width directions of the silicon substrates. Importantly, an increase in flow rate also facilitated the diffusion of these species across a broader area, thereby advancing the etching process and inhibiting the deposition of etching byproducts. These results underscore the importance of optimizing gas flow rates to enhance etching efficiency and quality. In conclusion, this study confirms that adjusting the flow rates of Ar and CF4 in surface discharge plasma etching can significantly influence the effectiveness of the silicon etching process. This outcome will contribute to the realization and development of semiconductor etching technology, such as solar cell manufacturing, as well as the further advancement of atmospheric pressure non-equilibrium plasma surface treatment technology.
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- 2024
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8. Effects of KRAS, STK11, KEAP1, and TP53 mutations on the clinical outcomes of immune checkpoint inhibitors among patients with lung adenocarcinoma.
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Yao Liang, Osamu Maeda, Chiaki Kondo, Kazuki Nishida, and Yuichi Ando
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Medicine ,Science - Abstract
BackgroundThis study aimed to identify the associations between individual KRAS, STK11, KEAP1, or TP53 mutations, as well as the comutation status of these genes, and the tumor mutation burden (TMB) with clinical outcomes of lung adenocarcinoma patients treated with immune checkpoint inhibitors (ICIs).MethodsWe collected data from patients with lung adenocarcinoma treated with ICIs from the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database between June 2019 and August 2023. The main endpoints were the treatment response and overall survival (OS).ResultsAmong 343 patients with lung adenocarcinoma, 61 (18%), 69 (20%), 41 (12%), and 222 (65%) patients had KRAS, STK11, KEAP1, and TP53 mutations, respectively. An overall objective response was observed in 94 of 338 patients (28%), including 2 (1%) who achieved a complete response and 92 (27%) who achieved a partial response. Patients with STK11, KEAP1, or TP53 mutations had a significantly greater TMB (PConclusionsSTK11, KEAP1, and TP53 mutations are significantly associated with a high TMB. TP53 mutation could affect the treatment response to some degree, and both KEAP1 and TP53 mutations resulted in inferior OS in the general patient population and in those with KRAS-wild-type lung adenocarcinoma, indicating that KEAP1 and TP53 mutations might act as prognostic factors for ICI treatment in lung adenocarcinoma patients.
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- 2024
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9. Predictive factors for massive hemorrhage in women with retained products of conception: a prospective study
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Reina Sonehara, Tomoko Nakamura, Akira Iwase, Kazuki Nishida, Sachiko Takikawa, Mayuko Murakami, Sayako Yoshita, Ayako Muraoka, Natsuki Miyake, Natsuki Nakanishi, Satoko Osuka, Maki Goto, and Hiroaki Kajiyama
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Medicine ,Science - Abstract
Abstract Retained products of conception (RPOC) is a common cause of postpartum bleeding, which may be life-threatening; however, no evidence-based guidelines exist to assist in evaluating the risk of massive hemorrhage in women with RPOC. In this prospective study, we aimed to evaluate the predictive factors for massive hemorrhage in women with RPOC. The primary and secondary endpoints were to validate the usefulness of power Doppler color scoring (PDCS) in evaluating hypervascularity and to identify other predictive factors (such as maximum RPOC diameter and serum βhCG and Hb level at first visit), respectively. Among the 51 women with RPOC included in this study, 16 (31.5%) experienced massive hemorrhage during follow-up. None of the women with PDCS 1 or 2 (18) experienced massive hemorrhage, whereas 16 (48.5%) women with PDCS 3 or 4 (33) did. Multiple logistic regression analysis showed that the odds ratio [95% confidence interval] (P value) for PDCS, assisted reproductive technology (ART), and low serum hemoglobin (Hb) levels were 22.39 [2.25 − 3087.92] (P = 0.004), 5.72 [1.28 − 33.29] (P = 0.022), and 4.24 [0.97 − 22.99] (P = 0.056), respectively. Further, the decision tree method identified PDCS, ART, and low serum Hb levels as potential predictive factors for massive hemorrhage. This study identified PDCS as useful predictor of massive hemorrhage in women with RPOC. With additional inclusion of factors such as ART and low serum Hb levels, the risk of massive hemorrhage may be effectively evaluated, leading to better management of women of reproductive age.
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- 2022
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10. Fixation of intra-articular calcaneal fractures: A comparative study of the postoperative outcome between HA/PPLA screws and locking plates
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Takuya Usami, Naoya Takada, Kazuki Nishida, Hiroaki Sakai, Hidetoshi Iwata, Hiroki Yonezu, Isato Sekiya, Yuko Nagaya, Yoshino Ueki, Hideki Murakami, and Gen Kuroyanagi
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Intra-articular calcaneal fracture ,HA/PLLA screw ,Hydroxyapatite ,Bioabsorbable screw ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Background: Forged unsintered hydroxyapatite and poly l-lactic acid (F-u-HA/PLLA) screw is bioactivite, bioabsorbable, and radiopaque with high mechanical strength. Its efficacy has been previously demonstrated in the treatment of lateral humeral condylar, lateral tibial condylar, ankle, and patellar fractures. However, studies on its efficacy in treatment of calcaneal fractures is lacking. This study aimed to compare the postoperative results of F-u-HA/PLLA screw fixation and locking plate fixation for intra-articular calcaneal fractures. Methods: From January 2013 to December 2019, 47 closed intra-articular fractures treated with either F-u-HA/PLLA screws (group S, 18 feet in 17 patients) or locking plates (group P, 29 feet in 28 patients) in a single trauma center were retrospectively reviewed. The sinus tarsi approach was used in both groups. The time to bone union, step-off, varus deformity, Bohler's angle, and width and height of the calcaneus were assessed after surgery. Ankle joint range of motion (ROM) and postoperative complications were also assessed. Results: All fractures were successfully treated. The Kaplan-Meier curves of the two groups showed similar trends. The log-rank test showed no significant difference in the time to bone union between the two groups (p = 0.48). In the Cox proportional hazards model adjusted for preoperative width and Bohler's angle, the hazard ratio for bone union was not statistically significant (HR: 1.13, 95%CI: 0.50–2.56, p = 0.78). Other variables included step-off (group S: 2.0 vs group P: 2.2 mm, p = 0.84), varus deformity (2.0° vs. 3.0°, p = 0.7), Gissane's angle (103.5° vs 104.0°, p = 0.84), width (38.0 vs 34.8 mm, p = 0.12), height (42.1 vs 44.0 mm, p = 0.07), and ankle ROM degrees (dorsal flexion, 20.0° vs. 20.0°, p = 0.13; plantar flexion 40.0° vs 40.0°, p = 0.56), which were not significantly different between groups P and S. The Bohler's angle was smaller in group S than in group P (20.5° vs 27.0°, p
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- 2023
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11. The effect of environmental factors on spatial-temporal variation of heterobranch sea slug community in northern Taiwan
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Ho Yeung Chan, Yen-Wei Chang, Li-Shu Chen, Kazuki Nishida, and Yi Ta Shao
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sea slug ,monsoon ,diel period ,depth ,temperature ,Science ,General. Including nature conservation, geographical distribution ,QH1-199.5 - Abstract
Sea slug (Subclass Heterobranchia) biodiversity is an important element of marine coral reef communities. However, due to their small size and cryptic behavior, few studies have examined their spatiotemporal variation. Taiwan is in the middle of East Asia Island Arcs, where it is one of the hotspots of sea slug diversity. Meanwhile, the northeast coast of this island lies within the subtropical monsoon region, where the climate shifts from a warm southwest monsoon (SW: May to Sep) to a cold northeast monsoon (NE: Oct to Apr). Between the monsoons, distinct temperatures and currents result in different community structures. To understand how those environmental factors (i.e., monsoon season, diel period and water depth) influence sea slug species richness and assemblages, we surveyed these invertebrates monthly at both night and day by diving in a marine protection area (CJ) and at a nearby non-protected site (MR) from May 2020 to Apr 2021. We showed that the species composition in our sampling area was highly consistent with what was found in Okinawa and Pescadores island, but less similar to those in southern Taiwan or Hong Kong. On the northeast coast of Taiwan, sea slug number and abundance were both higher in CJ than MR, but biodiversity (H’) and the species evenness index J’ was lower in CJ than MR. Additionally, cluster analysis indicated that the sea slug assemblages differed between the two sites. Monsoon season significantly influenced both species richness and species assemblages, with species richness during SW being significantly higher than in the NE monsoon and species assemblages also being distinct between these two seasons. Moreover, species richness increased with water depth (within the surveyed range of 0-25 m). Diel period did not exert a strong impact on sea slug biodiversity, except for species richness at CJ, where it was higher during the day than at night. Our study suggested that changing currents between the monsoon seasons could transport individuals originating from either the north or south of these island arcs. Furthermore, temperature and food sources may differ between seasons and depths, thereby influencing sea slug assemblages in this region.
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- 2022
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12. 17O-labeled water distribution in the human inner ear: Insights into lymphatic dynamics and vestibular function
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Tadao Yoshida, Shinji Naganawa, Masumi Kobayashi, Satofumi Sugimoto, Naomi Katayama, Tsutomu Nakashima, Yutaka Kato, Kazushige Ichikawa, Hiroshi Yamaguchi, Kazuki Nishida, and Michihiko Sone
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17O-labeled water ,MRI ,perilymph ,endolymph ,vertigo ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
We evaluated the inner ear distribution of 17O-labeled saline administered to the human tympanic cavity. Magnetic resonance imaging was performed after intratympanic administration in five healthy volunteers and one patient with cochlear endolymphatic hydrops. In all volunteers, 17O-labeled water permeated the cochlear basal turn and vestibule at 30 min and disappeared gradually within 2–4 h. All participants experienced positional vertigo lasting a few hours to a few days. Visualization of 17O-labeled water distribution in the endolymphatic space of the posterior ampulla showed indistinct separation of endolymph and perilymph in the cochlea and most of the vestibule in all participants. Intralabyrinthine distribution of 17O-labeled water differed from that in previous reports of intratympanically administered gadolinium-based contrast agent. 17O-labeled water in the endolymphatic space may cause heavier endolymph and positional vertigo. These results of this study may add new insights for investigating the distribution and the effects of molecules in the inner ear after the intratympanic administration in living humans.
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- 2022
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13. Prediction of Prehospital Change of the Cardiac Rhythm From Nonshockable to Shockable in Out‐of‐Hospital Patients With Cardiac Arrest: A Post Hoc Analysis of a Nationwide, Multicenter, Prospective Registry
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Ryo Emoto, Mitsuaki Nishikimi, Muhammad Shoaib, Kei Hayashida, Kazuki Nishida, Kazuya Kikutani, Shinichiro Ohshimo, Shigeyuki Matsui, Nobuaki Shime, and Taku Iwami
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defibrillation ,nonshockable ,out‐of‐hospital cardiac arrest ,paramedics ,rhythm change ,shockable ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Predicting a spontaneous rhythm change from nonshockable to shockable before hospital arrival in patients with out‐of‐hospital cardiac arrest can help emergency medical services develop better strategies for prehospital treatment. The aim of this study was to identify predictors of spontaneous rhythm change before hospital arrival in patients with out‐of‐hospital cardiac arrest and develop a predictive scoring system. Methods and Results We retrospectively reviewed data of eligible patients with out‐of‐hospital cardiac arrest with an initial nonshockable rhythm registered in a nationwide registry between June 2014 and December 2017. We performed a multivariable analysis using a Cox proportional hazards model to identify predictors of a spontaneous rhythm change, and a ridge regression model for predicting it. The data of 25 804 patients were analyzed (derivation cohort, n=17 743; validation cohort, n=8061). The rhythm change event rate was 4.1% (724/17 743) in the derivation cohort, and 4.0% (326/8061) in the validation cohorts. Age, sex, presence of a witness, initial rhythm, chest compression by a bystander, shock with an automated external defibrillator by a bystander, and cause of the cardiac arrest were all found to be independently associated with spontaneous rhythm change before hospital arrival. Based on this finding, we developed and validated the Rhythm Change Before Hospital Arrival for Nonshockable score. The Harrell’s concordance index values of the score were 0.71 and 0.67 in the internal and external validations, respectively. Conclusions Seven factors were identified as predictors of a spontaneous rhythm change from nonshockable to shockable before hospital arrival. We developed and validated a score to predict rhythm change before hospital arrival.
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- 2022
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14. Laparoscopic Double Bypass Including Cholecystojejunal and Gastrojejunal Anastomosis for Palliative Therapy
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Ryohei Onishi, Yuhei Hamaguchi, Yuto Iwai, Ryusuke Katsura, Kazuki Nishida, Takuma Karasuyama, Kyohei Kamihata, Akio Nakajima, Akira Mori, and Seiichiro Kanaya
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Gastroenterology ,Surgery - Published
- 2023
15. Anxiety evaluated by the Hospital Anxiety and Depression Scale as a predictor of postoperative nausea and vomiting: a pilot study.
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Tatsuro Yokoyama, Takahiro Tamura, Kazuki Nishida, Ryohei Ito, and Kimitoshi Nishiwaki
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ANTICIPATORY nausea & vomiting ,SURGICAL complications ,DISEASE incidence ,DRUG administration ,RECEIVER operating characteristic curves ,THORACIC surgery - Abstract
The incidence of postoperative nausea and vomiting (PONV) remains high, and improving the accuracy of PONV prediction remains challenging. The primary aim of this study is to examine the impact of anxiety scores evaluated using the Hospital Anxiety and Depression Scale (HADS) on the PONV prediction model. We hypothesized that anxiety and depression, quantified using the HADS, could improve the accuracy of the PONV predictive model. This pilot study evaluated 100 patients. The HADS was conducted by a self-evaluation method before thoracoscopic surgery for lung tumors, and the anesthesia method was standardized. The criterion was whether the nurse in charge of the patient who complained of PONV assessed that drug administration was necessary. As the main analysis, the odds ratio of the HADS score for predicting PONV was evaluated using multivariable logistic regression models. Further, the receiver operating characteristic (ROC) curves of the model with the HADS score added to the variables of without-anxiety predictors and the model with the variables of without-anxiety predictors only were compared. The anxiety score was significantly higher in the PONV group than in the no PONV group (P = 0.021). For predictive accuracy, the model that included age, sex, smoking history, history of PONV, and anxiety score had a higher area under the ROC curve than did the model excluding the anxiety score (P = 0.021). In conclusion, the findings indicate that the HADS is worth investigating as a predictor of PONV. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Impact of Early Ambulation on the Prognosis of Coronary Artery Bypass Grafting Patients
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Yohei, Tsuchikawa, Yoshiyuki, Tokuda, Hideki, Ito, Miho, Shimizu, Shinya, Tanaka, Kazuki, Nishida, Daichi, Takagi, Akimasa, Fukuta, Natsuki, Takeda, Hiromasa, Yamamoto, Masaya, Hori, Yoshihiro, Nishida, and Masato, Mutsuga
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General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
The effect of delayed ambulation on the outcome of coronary artery bypass grafting (CABG) remains to be clarified.Methods and Results: The long-term and in-hospital outcomes of 887 patients who underwent isolated CABG (455 off-pump cases, 135 urgent cases) were evaluated, with a focus on the timing of first ambulation. In-hospital mortality cases were excluded. Early ambulation (first ambulation within 3 days after operation) was achieved in 339 (38%) patients. In the multivariable logistic regression analysis, longer operation time and urgent case, EuroSCORE II, re-thoracotomy, and respiratory time were associated with delayed (≥4 days) ambulation. Delayed ambulation was associated with a high incidence of postoperative complications, such as pneumonia, and stroke (P0.01). Following discharge, 22.2% of patients experienced major cardiac events and 13.8% died during the follow-up period (median follow-up 60 months). Cox hazards analysis revealed that delayed ambulation was associated with long-term adverse events (hazard ratio 1.04 per day, P0.001). With adjustment for preoperative factors, the estimated future risk of adverse events was found to be increased day-by-day during the delay until initial ambulation.In isolated CABG patients, delayed ambulation was associated with poor outcomes, even in the long-term period. The results support the current guideline recommending early ambulation protocol after cardiac surgery.
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- 2023
17. Diagnostic Performance of Endocytoscopy for Esophageal Eosinophilia
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Emiko Hida, Koichi Muroi, Naomi Kakushima, Satoshi Furune, Eri Ishikawa, Yasuyuki Mizutani, Tsunaki Sawada, Maeda Keiko, Takeshi Yamamura, Takuya Ishikawa, Kazuhiro Furukawa, Eizaburo Ohno, Masanao Nakamura, Kazuki Nishida, Mitsuhiro Fujishiro, and Hiroki Kawashima
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Gastroenterology - Abstract
Introduction: Eosinophils in the esophageal epithelium are unevenly distributed in eosinophilic esophagitis (EoE). Esophageal eosinophilia (EE) may be observable by endocytoscopy (EC). This study aimed to evaluate the diagnostic performance of EC for the diagnosis of EE. Methods: A total of 33 EoE patients underwent EC with methylene blue staining from March 2020 to April 2021. A total of 194 EC images with corresponding biopsies were obtained. Three findings of EC, increased squamous cells (item I), increased inflammatory cells (item II), and cells with bilobed nuclei (item III), were established. These findings were reviewed by two endoscopists to diagnose EE. Another four endoscopists reviewed the images for interobserver agreement. Results: When all three items were met by EC, the sensitivity and the accuracy for the diagnosis of EE were 88% and 76%, respectively. The integrated diagnostic odds ratios (ORs) for the diagnosis of EE of the four endoscopists were significant (OR: 3.98, 95% CI: 2.94–5.40, p < 0.001). The results were similar when only item III was met. Interobserver agreement was good for item III to diagnose EE (kappa value = 0.653). Discussion/Conclusion: The diagnostic performance of EC for EE is acceptable and has good interobserver agreement. It may be useful for targeted biopsy in EoE patients.
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- 2023
18. Premorbid angiotensin converting enzyme inhibitors or angiotensin II receptor blockers in patients with sepsis
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Daisuke Hasegawa, Young Im Lee, Narut Prasitlumkum, Lakshay Chopra, Kazuki Nishida, Robert L. Smith, and Ryota Sato
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Angiotensin Receptor Antagonists ,Cross-Sectional Studies ,Sepsis ,Emergency Medicine ,Humans ,Angiotensin-Converting Enzyme Inhibitors ,General Medicine ,Acute Kidney Injury - Abstract
The aim of this study was to conduct a systematic review and meta-analysis to investigate the effect of the premorbid use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEI/ARB) on short-term mortality in patients with sepsis.Embase, the Cochrane Central Register of Controlled Trials, and MEDLINE were searched for studies based on the below eligibility criteria. The protocol was registered at the PROSPERO (CRD42022309129).Eligibility criteria were as follows: (1) randomized controlled trials, cohort studies, cross-sectional studies, (2) patients with sepsis aged ≥16 years, and (3) received premorbid ACEI/ARB, or not.The patient and study characteristics and outcomes were extracted. All analyses were presented with the use of random-effects models. The primary outcome was short-term mortality defined as ≤30-day, in-hospital, or intensive care unit (ICU)- mortality. The secondary outcome was acute kidney injury (AKI).Fifteen studies (N = 96,159) met the eligibility criteria. Of these, eleven studies (N = 40,360) reported unadjusted short-term mortalities. The pooled odds ratio (OR) of short-term mortality with the premorbid use of ACEI/ARB was as follows: OR, 0.86; 95% confidence interval (CI), 0.67 to 1.11; P = 0.24, IIn this meta-analysis, the premorbid ACEI/ARB was associated with significantly lower short-term mortality in patients with sepsis despite the significantly higher risk of AKI.
- Published
- 2022
19. Impact of an improved driveline management for <scp>HeartMate II</scp> and <scp>HeartMate</scp> 3 left ventricular assist devices
- Author
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Masato Mutsuga, Takahiro Okumura, Ryota Morimoto, Toru Kondo, Hideki Ito, Sachie Terazawa, Yoshiyuki Tokuda, Yuji Narita, Kazuki Nishida, Toyoaki Murohara, and Akihiko Usui
- Subjects
Biomaterials ,Biomedical Engineering ,Medicine (miscellaneous) ,Bioengineering ,General Medicine - Abstract
We evaluated the impact of a standardized driveline care strategy, including a subfascial-tunneling method and dressing protocol, on the incidence of driveline infection (DLI).DLI data from all HeartMate II (HMII) and HeartMate 3 (HM3) patients (including exchange devices) were retrospectively collected between 2013 and 2021. The driveline subfascial-tunneling method was altered in three steps (A: right direct; B: left triple, C: right triple), and the shower protocol was changed in two steps (A: with/without cover, B: with cover). Disinfection was individually tailored after changing the shower protocol. Complications associated with morbidity and mortality were evaluated for each modification.During the study period, 80 devices were implanted (HMII, n = 54; HM3, n = 26). The 8-year incidence of DLI was 15% (n = 8) in HMII patients and 0% in HM3 patients (p = 0.039). DLI was not associated with hospital mortality. The modified dressing protocol and tunneling method was associated with a significantly better DLI incidence rate in comparison to the previous one: Protocol-A (n = 17), Protocol-B (n = 63), 35% vs 3% (p = 0.0009), Method-A (n = 13), Method-B (n = 42), Method-C (n = 25), 46% vs 5% vs 0% (p = 0.0001). The rete of freedom form DLI at 1, 2, and 3 years had also significant difference between groups: Protocol-A and Protocol-B, 80%, 54%, 54% vs 96%, 96%, 96%, respectively (p 0.0001), Method-A, Method-B and Method-C, 76%, 44%, 44%, vs 94%, 94%, 94% vs 100%, 100%, respectively (p 0.0001).A standardized triple driveline tunneling strategy and waterproof dressing protocol reduced driveline infection in HM3 patients to 0%.
- Published
- 2022
20. Impact of Serum Zinc Level and Oral Zinc Supplementation on Clinical Outcomes in Patients Undergoing Infrainguinal Bypass for Chronic Limb-Threatening Ischemia
- Author
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Akio Kodama, Kimihiro Komori, Akio Koyama, Tomohiro Sato, Shuta Ikeda, Takuya Tsuruoka, Yohei Kawai, Kiyoaki Niimi, Masayuki Sugimoto, Hiroshi Banno, and Kazuki Nishida
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Chronic Limb-Threatening Ischemia ,Time Factors ,General Medicine ,Limb Salvage ,Risk Assessment ,Amputation, Surgical ,Peripheral Arterial Disease ,Zinc ,Treatment Outcome ,Ischemia ,Risk Factors ,Chronic Disease ,Dietary Supplements ,Humans ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
Zinc (Zn) has been reported to play an important role in wound healing (WH). Nevertheless, the effect of Zn in chronic limb-threatening ischemia (CLTI) patients is unclear. This study investigated the effect of Zn on the clinical outcomes of CLTI patients undergoing bypass surgery.Methods and Results: This study reviewed 111 consecutive patients who underwent an infrainguinal bypass from 2012 to 2020. Patients with Zn deficiency (serum Zn level60 μg/dL) received oral Zn supplementation and maintained a normal level until WH. This study aimed to explore: (1) the effect of Zn deficiency; and (2) Zn supplementation in Zn-deficient patients on the clinical outcomes of this cohort. Patients with Zn deficiency, Zn supplementation, and no Zn supplementation despite Zn deficiency accounted for 48, 21, and 42 patients, respectively. (1) Zn deficiency was associated with WH (HR, 0.47; 95% CI, 0.29-0.78: P=0.003), major adverse limb events (MALE) (HR, 2.53; 95% CI, 1.26-5.09: P=0.009), and major amputation or death (HR, 3.17; 95% CI, 1.51-6.63: P=0.002). (2) Zn supplementation was positively related to WH (HR, 2.30; 95% CI, 1.21-4.34: P=0.011). This result was confirmed using propensity score matching (HR, 2.24; 95% CI, 1.02-4.87: P=0.043).The current study revealed that Zn level was associated with clinical outcomes in CLTI patients after bypass surgery. Oral Zn supplementation could improve WH in these patients.
- Published
- 2022
21. Hyaluronan in articular cartilage: Analysis of hip osteoarthritis and osteonecrosis of femoral head
- Author
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Jiarui Zhang, Yoshihiro Nishida, Hiroshi Koike, Kan Ito, Lisheng Zhuo, Kazuki Nishida, Koji Kimata, Kunihiro Ikuta, Tomohisa Sakai, Hiroshi Urakawa, Taisuke Seki, and Shiro Imagama
- Subjects
Orthopedics and Sports Medicine - Abstract
Hyaluronan (HA) plays crucial roles in the maintenance of high-quality cartilage extracellular matrix. Several studies have reported the HA in synovial fluid in patients with osteoarthritis (OA), but few have described the changes of HA in articular cartilage of OA or idiopathic osteonecrosis of the femoral head (ONFH). KIAA1199 was recently reported to have strong hyaluronidase activity. The aim of this study was to clarify the HA metabolism in OA and ONFH, particularly the involvement of KIAA1199. Immunohistochemical analysis of KIAA1199 and HA deposition was performed for human OA (n = 10), ONFH (n = 10), and control cartilage (n = 7). The concentration and molecular weight (MW) of HA were determined by competitive HA ELISA and Chromatography, respectively. Regarding HA metabolism-related molecules, HAS1, HAS2, HAS3, HYAL1, HYAL2, and KIAA1199 gene expression was assessed by reverse transcriptase polymerase chain reaction. Histological analysis showed the overexpression of KIAA1199 in OA cartilage, which was accompanied by decreased hyaluronic acid binding protein (HABP) staining compared with ONFH and control. Little KIAA1199 expression was observed in cartilage at the collapsed area of ONFH, which was accompanied by a slight decrease in HABP staining. The messenger RNA (mRNA) expression of HAS2 and KIAA1199 was upregulated in OA cartilage, while the mRNA expression of genes related to HA catabolism in ONFH cartilage showed mostly a downward trend. The MW of HA in OA cartilage increased while that in ONFH cartilage decreased. HA metabolism in ONFH is suggested to be generally indolent, and is activated in OA including high expression of KIAA1199. Interestingly, MW of HA in OA cartilage was not reduced.
- Published
- 2022
22. Pelvic morphologies of developmental dysplasia and primary osteoarthritis on range of motion after total hip arthroplasty
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Hiroto Funahashi, Yusuke Osawa, Taisuke Seki, Yasuhiko Takegami, Kazuki Nishida, and Shiro Imagama
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Orthopedics and Sports Medicine - Published
- 2023
23. Preoperative docetaxel, cisplatin, and fluorouracil treatment with pegfilgrastim on day 7 for patients with esophageal cancer: A phase II study
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Osamu Maeda, Masahide Fukaya, Masahiko Koike, Kazushi Miyata, Mitsuro Kanda, Kazuki Nishida, Masahiko Ando, Yasuhiro Kodera, and Yuichi Ando
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Esophageal Neoplasms ,Oncology ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Docetaxel ,Fluorouracil ,General Medicine ,Cisplatin - Abstract
The docetaxel and cisplatin plus 5-fluorouracil (5-FU) (DCF) regimen is expected to be superior to cisplatin plus 5-FU for the preoperative treatment of esophageal cancer. However, a high risk of adverse effects, including febrile neutropenia (FN), has been reported. To evaluate the effectiveness and safety of DCF with prophylactic pegfilgrastim, we conducted a phase II study.The regimen consisted of intravenous administration of docetaxel (70 mg/mThirty-seven eligible patients were enrolled and received DCF. Thirty-four patients underwent esophagectomy. Two patients received chemoradiotherapy or radiotherapy without surgery. One patient withdrew consent and ended his hospital visit. One patient received additional radiotherapy before surgery. Histopathological responses of grade 3, grade 2, grade 1b, and grade 1a were observed in two (5.4%), 14 (37.8%), 10 (27.0%), and seven (18.9%) patients, respectively, and the primary endpoint was met. Of the 37 eligible patients, 11 (29.7%) developed FN in the first cycle.Since the histopathological responses were as expected, DCF with prophylactic pegfilgrastim is considered to be effective as preoperative chemotherapy. However, the prophylactic use of pegfilgrastim on day 7 was insufficient to prevent FN.
- Published
- 2022
24. The rCAST score is useful for estimating the neurological prognosis in pediatric patients with post-cardiac arrest syndrome before ICU admission: External validation study using a nationwide prospective registry
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Mitsuaki Nishikimi, Naoyuki Matsuda, Yuma Yasuda, Shigeyuki Matsui, Ryo Emoto, Atsushi Numaguchi, Kazuki Nishida, and Kota Matsui
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Adult ,medicine.medical_specialty ,Acute medicine ,Emergency Nursing ,Return of spontaneous circulation ,Prognostic score ,Cohort Studies ,Internal medicine ,medicine ,Humans ,Post-Cardiac Arrest Syndrome ,Registries ,Post cardiac arrest ,Child ,High severity ,business.industry ,External validation ,Prognosis ,Cardiopulmonary Resuscitation ,Icu admission ,Intensive Care Units ,Emergency Medicine ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest ,Cohort study - Abstract
Introduction The objective of this cohort study was to investigate whether the revised post-Cardiac Arrest Syndrome for Therapeutic hypothermia score (rCAST), which we previously developed as a prognostic score for adult patients with post-cardiac arrest syndrome (PCAS), is also applicable to pediatric patients. Methods Pediatric PCAS patients were included from an out-of-hospital cardiac arrest (OHCA) registry of the Japanese Association for Acute Medicine (JAAM). We validated the predictive accuracy of the rCAST for the neurological outcomes at 30 and 90 days. We also evaluated the probability of a good neurological outcome in each of the three specified severity categories based on the rCAST (low severity: ≤5.5; moderate severity: 6.0–14.0; high severity: ≥14.5). Results Among the 737 pediatric patients with OHCA, the data of 179 pediatric PCAS patients in whom return of spontaneous circulation was achieved were analyzed. The areas under the curve (AUC) of the rCAST for predicting the neurological outcomes at 30 days and 90 days were 0.95 (95% CI: 0.90–0.99) and 0.96 (0.91–1.00), respectively. The proportions of patients with a good neurological outcome at 30 days were 100% (12/12) in the low severity group, 36.1% (13/36) in the moderate severity group, and 2.3% (3/131) in the high severity group. Conclusions The AUC of the rCAST for pediatric PCAS patients was found to be greater than 0.9 in the external validation, which corresponds to excellent predictive accuracy. There was no patient with good neurological outcome among the patients with more than 17.0 points (extremely high severity group).
- Published
- 2021
25. Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation
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Daisuke Hasegawa, Ryota Sato, Narut Prasitlumkum, Kazuki Nishida, Brian Keaton, Samuel O. Acquah, and Young Im Lee
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Biomaterials ,Biomedical Engineering ,Biophysics ,Bioengineering ,General Medicine - Abstract
The effect and safety of bivalirudin compared with heparin in patients undergoing extracorporeal membrane oxygenation (ECMO) remains unclear. Therefore, we conducted a systematic review and meta-analysis to compare the effectiveness and safety of heparin and bivalirudin in patients who underwent ECMO. We searched Embase, the Cochrane Central Register of Controlled Trials, and MEDLINE. Inclusion criteria included patients (1) undergoing ECMO and (2) receiving bivalirudin or heparin. We excluded studies where the majority of patients switched heparin to bivalirudin or vice versa during the clinical course. The primary outcome was short-term mortality. We presented the results of all analyses with the use of random-effects models. Eleven studies reported short-term mortality. The use of bivalirudin was associated with significantly lower short-term mortality, compared with heparin (odds ratio: 0.71, 95% confidence interval, 0.55-0.92; p = 0.01, I2 = 7%). In this meta-analysis of observational studies, the use of bivalirudin was associated with significantly lower short-term mortality, compared with heparin. Further prospective studies are warranted to clarify this finding.
- Published
- 2022
26. Scoring system for predicting the prognosis of elderly gastric cancer patients after endoscopic submucosal dissection
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Nobuhito Ito, Kohei Funasaka, Toshihisa Fujiyoshi, Kazuki Nishida, Kazuhiro Furukawa, Naomi Kakushima, Satoshi Furune, Eizaburo Ohno, Masanao Nakamura, Noriyuki Horiguchi, Tomoyuki Shibata, Ryoji Miyahara, Jun‐Ichi Haruta, Yoshiki Hirooka, Mitsuhiro Fujishiro, and Hiroki Kawashima
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Gastroenterology ,Radiology, Nuclear Medicine and imaging - Abstract
Comprehensive assessments of the long-term outcomes of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the elderly are unavailable. We aimed to create a scoring system to predict the long-term prognosis after ESD for EGC among patients aged ≥75 years.We conducted retrospective studies of two cohorts: a single-center cohort (2006-2011) for developing the scoring system, and a multicenter cohort for validating the developed system (2012-2016). In the development cohort, factors related to death after ESD were identified using multivariable Cox regression analysis, and a predictive scoring system was developed. In the validation cohort, the scoring system was validated in 295 patients.In the development cohort, Charlson comorbidity index (CCI) ≥3 (hazard ratio [HR] 3.017), high psoas muscle index (PMI) (HR 2.206), and age ≥80 years (HR 1.978) were significantly related to overall survival after ESD. Therefore, high CCI, low PMI, and age ≥80 years were assigned 1 point each. The patients were categorized into low (≤1 point) and high (≥2 points) score groups based on their total scores. In the validation cohort, 184 and 111 patients were assigned to the low- and high-score groups, respectively. In comparisons based on Kaplan-Meier curves, the 5-year survival rate was 91.5% in the low-score group and 57.8% in the high-score group (log-rank test; P 0.001).Our scoring system including high CCI, low PMI, and age ≥80 years could stratify the long-term prognosis of elderly patients aged ≥75 years after ESD for EGC.
- Published
- 2022
27. Evaluation of lower extremity gait analysis using Kinect V2
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Takuya, Usami, Kazuki, Nishida, Hirotaka, Iguchi, Taro, Okumura, Hiroaki, Sakai, Ruido, Ida, Mitsuya, Horiba, Shuuto, Kashima, Kento, Sahashi, Hayato, Asai, Yuko, Nagaya, Hideki, Murakami, Yoshino, Ueki, and Gen, Kuroyanagi
- Abstract
Microsoft Kinect V2Ten healthy volunteers walked 20 trials, and each walk was recorded by a Kinect and infrared- and marker-based-motion capture system. Pearson's correlation and overall agreement with a method of meta-analysis of Pearson's correlation coefficient were used to assess the reliability of each parameter, including gait velocity, gait cycle time, step length, hip and knee joint angle, ground contact time of foot, and max ankle velocity. Hip and knee angles in one gait cycle were calculated in Kinect and motion capture groups.The coefficients of correlation for gait velocity (r = 0.92), step length (r = 0.81) were regarded as strong reliability. Gait cycle time (r = 0.65), minimum flexion angle of hip joint (r = 0.68) were regarded as moderate reliability. The maximum flexion angle of the hip joint (r = 0.43) and maximum flexion angle of the knee joint (r = 0.54) were regarded as fair reliability. Minimum flexion angle of knee joint (r = 0.23), ground contact time of foot (r = 0.23), and maximum ankle velocity (r = 0.22) were regarded as poor reliability. The method of meta-analysis revealed that participants with small hip and knee flexion angles tended to have poor correlations in maximum flexion angle of hip and knee joints. Similar trajectories of hip and knee angles were observed in Kinect and motion capture groups.Our results strongly suggest that Kinect could be a reliable device for evaluating gait parameters, including gait velocity, gait cycle time, step length, minimum flexion angle of the hip joint, and maximum flexion angle of the knee joint.
- Published
- 2022
28. Comment on: Favourable complete remission of anti-OJ antibody-positive myositis after lung cancer resection
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Yoshinao Muro, Kazuki Nishida, Yuta Yamashita, Haruka Koizumi, Takuya Takeichi, Minoru Satoh, and Masashi Akiyama
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Lung Neoplasms ,Rheumatology ,Myositis ,Humans ,Pharmacology (medical) ,Autoantibodies ,Polymyositis - Published
- 2022
29. Effect of Premorbid Beta-Blockers on Mortality in Patients With Sepsis: A Systematic Review and Meta-Analysis
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Narut Prasitlumkum, Kazuki Nishida, Ryota Sato, and Daisuke Hasegawa
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,business.industry ,Adrenergic beta-Antagonists ,MEDLINE ,Odds ratio ,Critical Care and Intensive Care Medicine ,medicine.disease ,Intensive care unit ,Confidence interval ,law.invention ,Sepsis ,Cross-Sectional Studies ,Randomized controlled trial ,law ,Meta-analysis ,Internal medicine ,Odds Ratio ,Medicine ,Humans ,business ,Cohort study - Abstract
Objective The aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of premorbid beta-blockers on mortality in patients with sepsis. Data Sources We searched EMBASE, the Cochrane Central Register of Controlled Trials, and MEDLINE for eligible studies. The protocol was registered at the PROSPERO (CRD42021256813). Study Selection Two authors independently evaluated the following inclusion criteria: (1) randomized controlled trials, cohort studies, cross-sectional studies; (2) patients with sepsis aged ≥18 years, and (3) premorbid beta-blocker use. Data Extraction Two authors extracted the patients’ characteristics and outcomes independently. All analyses were performed using the random-effects models. The primary outcome was short-term mortality, defined as mortality within 30 days, in-hospital or intensive care unit mortality. Data Synthesis Ten studies (n = 24 748 patients) were included. The pooled odds ratio (OR) of short-term mortality associated with the premorbid use of beta-blockers was 0.85 (95% confidence interval [CI], 0.69-1.04; P = .12; I2 = 50%). Five studies reported an adjusted OR of short-term mortality. The pooled adjusted OR of short-term mortality associated with the premorbid use of beta-blockers was 0.73 (95% CI, 0.65-0.83; P < .001; I2 = 0%). Conclusion Premorbid beta-blockers were associated with a lower short-term mortality in patients with sepsis.
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- 2021
30. A Diagnostic Predictive Model of Bronchoscopy with Radial Endobronchial Ultrasound for Peripheral Pulmonary Lesions
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Takayasu Ito, Yuji Matsumoto, Shotaro Okachi, Kazuki Nishida, Midori Tanaka, Tatsuya Imabayashi, Takaaki Tsuchida, and Naozumi Hashimoto
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Pulmonary and Respiratory Medicine ,Lung Neoplasms ,Bronchoscopy ,Humans ,Tomography, X-Ray Computed ,Lung ,Retrospective Studies ,Endosonography - Abstract
Background: Several factors have been reported to affect the diagnostic yield of bronchoscopy with radial endobronchial ultrasound (R-EBUS) for peripheral pulmonary lesions (PPLs). However, it is difficult to accurately predict the diagnostic potential of bronchoscopy for each PPL in advance. Objectives: Our objective was to establish a predictive model to evaluate the diagnostic yield before the procedure. Method: We retrospectively analysed consecutive patients who underwent diagnostic bronchoscopy with R-EBUS between April 2012 and October 2015. We assessed the factors that were predictive of successful bronchoscopic diagnosis of PPLs with R-EBUS using a multivariable logistic regression model. The accuracy of the predictive model was evaluated using the receiver operator characteristic area under the curve (ROC AUC). Internal validation was analysed using 10-fold stratified cross-validation. Results: We analysed a total of 1,634 lesions; the median lesion size was 25.0 mm. Of these, 1,138 lesions (69.6%) were successfully diagnosed. In the predictive logistic model, significant factors affecting the diagnostic yield were lesion size, lesion structure, bronchus sign, and visible on chest X-ray. The predictive model consisted of seven factors: lesion size, lesion lobe, lesion location from the hilum, lesion structure, bronchus sign, visibility on chest X-ray, and background lung. The ROC AUC of the predictive model was 0.742 (95% confidence interval: 0.715–0.769). Internal validation using 10-fold stratified cross-validation revealed a mean ROC AUC of 0.734. Conclusions: The predictive model using the seven factors revealed a good performance in estimating the diagnostic yield.
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- 2021
31. Fabrication and performance evaluation of full-inkjet-printed dielectric-barrier-discharge plasma actuators
- Author
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Shintaro Sato, Kazuki Nishida, Toshimitsu Hirai, Masaki Ito, Hirofumi Teramae, Masaki Matsubara, Kiyoshi Kanie, and Naofumi Ohnishi
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Metals and Alloys ,Electrical and Electronic Engineering ,Condensed Matter Physics ,Instrumentation ,Surfaces, Coatings and Films ,Electronic, Optical and Magnetic Materials - Published
- 2022
32. 17O-labeled water distribution in the human inner ear: Insights into lymphatic dynamics and vestibular function.
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Tadao Yoshida, Shinji Naganawa, Masumi Kobayashi, Satofumi Sugimoto, Naomi Katayama, Tsutomu Nakashima, Yutaka Kato, Kazushige Ichikawa, Hiroshi Yamaguchi, Kazuki Nishida, and Michihiko Sone
- Subjects
INNER ear ,WATER distribution ,MIDDLE ear ,MAGNETIC resonance imaging ,MENIERE'S disease - Abstract
We evaluated the inner ear distribution of
17 O-labeled saline administered to the human tympanic cavity. Magnetic resonance imaging was performed after intratympanic administration in five healthy volunteers and one patient with cochlear endolymphatic hydrops. In all volunteers,17 O-labeled water permeated the cochlear basal turn and vestibule at 30 min and disappeared gradually within 2–4 h. All participants experienced positional vertigo lasting a few hours to a few days. Visualization of17 O-labeled water distribution in the endolymphatic space of the posterior ampulla showed indistinct separation of endolymph and perilymph in the cochlea and most of the vestibule in all participants. Intralabyrinthine distribution of17 O-labeled water differed from that in previous reports of intratympanically administered gadolinium-based contrast agent.17 O-labeled water in the endolymphatic space may cause heavier endolymph and positional vertigo. These results of this study may add new insights for investigating the distribution and the effects of molecules in the inner ear after the intratympanic administration in living humans. [ABSTRACT FROM AUTHOR]- Published
- 2022
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33. The finger-to-nose test improved diagnosis of cerebrovascular events in patients presenting with isolated dizziness in the emergency department.
- Author
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Kazuki Nishida, Takuya Usami, Nana Matsumoto, Mitsuaki Nishikimi, Kunihiko Takahashi, and Shigeyuki Matsui
- Subjects
DIZZINESS ,CEREBROVASCULAR disease ,EMOTIONAL trauma ,DIABETES ,NYSTAGMUS - Abstract
It is difficult to identify patients with isolated dizziness caused by cerebrovascular events. The estimated risk of cerebrovascular events in isolated dizziness patients is not completely understood. We aimed to evaluate the association of the finger-to-nose test (FNT) in diagnosing cerebrovascular events in isolated dizziness patients in emergency departments (EDs). We combined 2 datasets from a single center for consecutive isolated dizziness patients, with the same inclusion and exclusion criteria. Those who met any of the following criteria were excluded: no FNT data, age < 16 years, and psychological trauma. The primary outcome was cerebrovascular event, which was defined as cerebral stroke due to cerebral infarction, cerebral hemorrhage, vertebral artery dissection, or transient ischemic attack. In the combined dataset, there were 357 patients complaining of isolated dizziness and 31 cerebrovascular events. After adjusted by 5 previously reported risk factors for cerebrovascular event, (age, hypertension, hyperlipidemia, diabetes mellitus, nystagmus), a multivariable logistic model analysis showed that the existence of FNT abnormalities was significantly associated with cerebrovascular events (odds ratio, 25.3; 95% confidence interval, 7.3–88.2; p < 0.001). There was a significant increase in predictive accuracy, with an AUC increase of 0.116 in the in a ROC analysis (p = 0.023). The existence of FNT abnormalities is considered as a strong risk factor that could be useful for predicting cerebrovascular events in isolated dizziness patients. We recommend the FNT for screening isolated dizziness patients in EDs to judge whether they need to undergo further diagnostic evaluation. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
34. Effect of Premorbid Beta-Blockers on Mortality in Patients With Sepsis: A Systematic Review and Meta-Analysis.
- Author
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Daisuke Hasegawa, Ryota Sato, Prasitlumkum, Narut, and Kazuki Nishida
- Subjects
SEPSIS ,ADRENERGIC beta blockers ,MORTALITY ,HEALTH outcome assessment ,INTENSIVE care units - Abstract
Objective: The aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of premorbid beta-blockers on mortality in patients with sepsis. Data Sources: We searched EMBASE, the Cochrane Central Register of Controlled Trials, and MEDLINE for eligible studies. The protocol was registered at the PROSPERO (CRD42021256813). Study Selection: Two authors independently evaluated the following inclusion criteria: (1) randomized controlled trials, cohort studies, cross-sectional studies; (2) patients with sepsis aged ≥18 years, and (3) premorbid beta-blocker use. Data Extraction: Two authors extracted the patients' characteristics and outcomes independently. All analyses were performed using the random-effects models. The primary outcome was short-term mortality, defined as mortality within 30 days, in-hospital or intensive care unit mortality. Data Synthesis: Ten studies (n = 24 748 patients) were included. The pooled odds ratio (OR) of short-term mortality associated with the premorbid use of beta-blockers was 0.85 (95% confidence interval [CI], 0.69-1.04; P = .12; I² = 50%). Five studies reported an adjusted OR of short-term mortality. The pooled adjusted OR of short-term mortality associated with the premorbid use of beta-blockers was 0.73 (95% CI, 0.65-0.83; P < .001; I² = 0%). Conclusion: Premorbid beta-blockers were associated with a lower short-term mortality in patients with sepsis. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
35. Meflin-positive cancer-associated fibroblasts enhance tumor response to immune checkpoint blockade.
- Author
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Yuki Miyai, Daisuke Sugiyama, Tetsunari Hase, Naoya Asai, Tetsuro Taki, Kazuki Nishida, Takayuki Fukui, Toyofumi Fengshi Chen-Yoshikawa, Hiroki Kobayashi, Shinji Mii, Yukihiro Shiraki, Yoshinori Hasegawa, Hiroyoshi Nishikawa, Yuichi Ando, Masahide Takahashi, and Atsushi Enomoto
- Published
- 2022
- Full Text
- View/download PDF
36. STATUS OF PRE-RECONSTRUCTION EFFORTS AND ANALYSIS OF REGIONAL DIFFERENCES AMONG LOCAL GOVERNMENTS IN PREPARATION FOR THE NANKAI TROUGH EARTHQUAKE
- Author
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Kazuki NISHIDA, Junko KANAI, Hiroki OGAWA, Astuko SHIRAYAMA, and Susumu NAKANO
- Published
- 2022
37. 1466: EFFECT OF DEXMEDETOMIDINE ON MORTALITY IN SEPSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
- Author
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Daisuke Hasegawa, Ryota Sato, Narut Prasitlumkum, Kazuki Nishida, and Osamu Nishida
- Subjects
Critical Care and Intensive Care Medicine - Published
- 2021
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