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1.
Tohoku J Exp Med ; 248(4): 239-252, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31406089

RESUMO

Many studies have consistently reported the bidirectional relationship between problem drinking and psychological distress following a disaster, but the risk factors of problem drinking following a disaster remain unclear. In this study, we therefore aimed to explore the risk factors associated with the incidence of problem drinking among evacuees after the Great East Japan Earthquake of March 11, 2011. We used the data for evacuees of the Fukushima Daiichi nuclear power plant accident, obtained from the Mental Health and Lifestyle Survey. A total of 12,490 individuals from 13 municipalities, which included the evacuation order areas after the accident, completed surveys between 2012 and 2013. The CAGE (Cutting down, Annoyed by criticism, Guilty feeling, and Eye-opener) questionnaire was used to screen the participants for alcohol dependence, and a score ≥ 2 indicated problem drinking. Logistic regression models were applied to investigate the possible predictors of problem drinking. The results showed that insufficient sleep and heavy drinking (≥ 4 drinks per day) were significant risk factors for the incidence of problem drinking in both men and women. Additional risk factors included family financial issues due to the disaster and trauma symptoms among men and a diagnosed history of mental illness among women. Other remaining variables were not significantly associated with problem drinking. The present study is the first to identify the risk factors for problem drinking following a compound disaster. Our findings could be used to develop a primary intervention program to improve evacuees' health and lives following a disaster.


Assuntos
Alcoolismo/epidemiologia , Terremotos , Acidente Nuclear de Fukushima , Inquéritos Epidemiológicos , Adulto , Idoso , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Fatores de Risco , Inquéritos e Questionários
2.
Artigo em Inglês | MEDLINE | ID: mdl-29064443

RESUMO

This longitudinal study aimed to investigate the prevalence of newly-started drinkers and their continuing drinking behaviors after the Great East Japan earthquake. Moreover, the relationships between newly-started drinking and psychological factor, disaster-related experience, and perceived radiation risk were examined. We used data from 37,687 pre-disaster non-drinkers who participated in the 2012 and 2013 surveys conducted in Fukushima. We defined newly-started drinkers as those who did not drink before the disaster but who began drinking after the disaster, based on information collected retrospectively. In 2012, 9.6% of non-drinkers began drinking, of which the prevalence of heavy drinkers was 18.4%. The prevalence of continued drinking among newly-started drinkers in 2013 was 53.8%. Logistic regression analyses revealed post-disaster newly-started drinking was significantly associated with being male, less than 65 years old, sleep dissatisfaction and psychological distress (Kessler 6 ≤ 13) when this model was adjusted for disaster-related experience and perceived radiation risk. Moreover, psychological distress and heavy drinking were significant risk factors for continued drinking among newly-started drinkers. Newly-started drinkers might use alcohol to cope with disaster-related stress. Thus, they may be targeted for disaster-related health services. Moreover, early intervention should encourage responsible drinking, since post-disaster heavy drinkers were likely to continue heavy drinking.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Terremotos , Acidente Nuclear de Fukushima , Transtornos do Sono-Vigília/epidemiologia , Estresse Psicológico/epidemiologia , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Japão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Percepção , Fatores de Risco , Adulto Jovem
3.
Hum Pathol ; 66: 177-182, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28705706

RESUMO

We report 2 infantile cases of pulmonary tumor carrying a chimeric A2M-ALK gene. A2M-ALK is a newly identified anaplastic lymphoma kinase (ALK)-related chimeric gene from a tumor diagnosed as fetal lung interstitial tumor (FLIT). FLIT is a recently recognized infantile pulmonary lesion defined as a mass-like lesion that morphologically resembles the fetal lung. Grossly, FLIT characteristically appears as a well-circumscribed spongy mass, whereas the tumors in these patients were solid and firm. Histologically, the tumors showed intrapulmonary lesions composed of densely proliferating polygonal or spindle-shaped mesenchymal cells with diffuse and dense infiltrations of inflammatory cells forming microcystic or micropapillary structures lined by thyroid transcription factor 1-positive pneumocytes, favoring inflammatory myofibroblastic tumor rather than FLIT. The proliferating cells were immunoreactive for ALK, and A2M-ALK was identified in both tumors with reverse-transcription polymerase chain reaction. The dense infiltration of inflammatory cells, immunoreactivity for ALK, and identification of an ALK-related chimeric gene suggested a diagnosis of inflammatory myofibroblastic tumor. Histologically, most reported FLITs show sparse inflammatory infiltrates and a relatively low density of interstitial cells in the septa, although prominent infiltration of inflammatory cells and high cellularity of interstitial cells are seen in some FLITs. The present cases suggest that ALK rearrangements, including the chimeric A2M-ALK gene, may be present in these infantile pulmonary lesions, especially those with inflammatory cell infiltration. We propose that these infantile pulmonary lesions containing a chimeric A2M-ALK gene be categorized as a specific type of inflammatory myofibroblastic tumor that develops exclusively in neonates and infants.


Assuntos
Biomarcadores Tumorais/genética , Inflamação/genética , Neoplasias Pulmonares/genética , Miofibroblastos , Proteínas de Fusão Oncogênica/genética , Receptores Proteína Tirosina Quinases/genética , alfa-Macroglobulinas/genética , Biomarcadores Tumorais/análise , Biópsia , Proliferação de Células , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Lactente , Inflamação/enzimologia , Inflamação/patologia , Inflamação/cirurgia , Neoplasias Pulmonares/enzimologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Miofibroblastos/enzimologia , Miofibroblastos/patologia , Valor Preditivo dos Testes , Reação em Cadeia da Polimerase Via Transcriptase Reversa
4.
J Pediatr Surg ; 51(12): 2053-2057, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27712887

RESUMO

BACKGROUND/PURPOSE: We aimed to clarify whether surgical resectability and tumor response after preoperative chemotherapy (preCTx) represented prognostic factors for patients with hepatoblastoma (HBL) in the JPLT-2 study (1999-2012). METHODS: Patients (N=342) with HBL who underwent preCTx were eligible. PRETEXT, CHIC risk stratification (standard [SR], intermediate [IR] and high risk [HR]) at diagnosis, POST-TEXT, and tumor resectability were evaluated by imaging. Tumor response was classified into responders (CR or PR) and nonresponders (NC or PD) according to RECIST criteria. RESULTS: There were 7 PRETEXT I, 106 II, 143 III, and 86 IV, including 71 metastatic HBLs. In POST-TEXT, 12 PRETEXT II, 42 III, and 58 IV were down-staged. The 5-year EFS/OS rates of 198 SR, 73 IR, and 71 HR-HBLs were 82/94%, 49/64%, and 28/34%, respectively. In 198 SR, 154 of 160 responders and 24 of 38 nonresponders survived event-free (P<0.01). In 73 IR, 12 of 24 whose tumors remained unresectable experienced recurrence, 9 of whom were nonresponders (P<0.01). In 71 HR, chemoresponders and tumor resectability after preCTx correlated with favorable outcomes (P<0.05). CONCLUSIONS: Evaluation of response and tumor resectability after preCTx is useful for predicting prognosis in HBLs. To improve outcomes, we should reconsider surgical procedures according to resectability and chemoresponsiveness. LEVEL OF EVIDENCE: Level II.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Hepatoblastoma/tratamento farmacológico , Hepatoblastoma/cirurgia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Adolescente , Carboplatina/administração & dosagem , Criança , Pré-Escolar , Cisplatino/administração & dosagem , Protocolos Clínicos , Terapia Combinada , Doxorrubicina/administração & dosagem , Doxorrubicina/análogos & derivados , Etoposídeo/administração & dosagem , Feminino , Hepatoblastoma/diagnóstico por imagem , Humanos , Ifosfamida/administração & dosagem , Lactente , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Terapia Neoadjuvante , Prognóstico , Resultado do Tratamento
5.
J Pediatr Surg ; 51(12): 2080-2085, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27793328

RESUMO

PURPOSE: Our telomere biology study of neuroblastomas (NBLs) has revealed that unfavorable NBLs acquired telomere stabilization by telomerase activation or ALT (alternative lengthening of telomeres). Recently, genomic rearrangements in a region proximal to the telomerase reverse transcriptase (TERT) gene have been discovered in NBLs. In this study, TERT rearrangements were examined in NBLs along with their relationship to other aspects of telomere biology. METHODS: In 121 NBLs, including 67 cases detected by mass-screening whose telomere length, telomerase activity, ALT with ATRX/DAXX alterations, and MYCN amplification were already known, TERT rearrangements were examined using GeneChip SNP arrays. RESULTS: The 11 ATRX/DAXX mutated ALT cases and 29 cases with high telomerase activity showed poor prognosis. MYCN amplification and TERT rearrangements were independently detected in 16 and 13 cases, respectively, and these alterations were significantly correlated with high telomerase activity. In 81 infant cases, MYCN amplification, TERT rearrangements and ATRX mutations were detected in 3, 4, and 3 cases, respectively. Among them, 6 cases showed progression or recurrences. CONCLUSIONS: Telomere stabilization in NBLs is acquired by telomerase activation through MYCN amplification, TERT rearrangements or by ALT. Since these tumors usually show progression and recurrence, complete resection should be considered, even in infant cases. LEVEL OF EVIDENCE: Prognosis study, level III.


Assuntos
DNA de Neoplasias/genética , Mutação , Neuroblastoma/genética , Neuroblastoma/cirurgia , Telomerase/genética , Telômero/fisiologia , Criança , Pré-Escolar , DNA Helicases/genética , Análise Mutacional de DNA , Progressão da Doença , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Neuroblastoma/patologia , Prognóstico , Telomerase/metabolismo
6.
Biosci Biotechnol Biochem ; 80(9): 1737-46, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27088852

RESUMO

The mitochondrial citrate transport protein (CTP) functions as a malate-citrate shuttle catalyzing the exchange of citrate plus a proton for malate between mitochondria and cytosol across the inner mitochondrial membrane in higher eukaryotic organisms. In this study, for functional analysis, we cloned the gene encoding putative CTP (ctpA) of citric acid-producing Aspergillus niger WU-2223L. The gene ctpA encodes a polypeptide consisting 296 amino acids conserved active residues required for citrate transport function. Only in early-log phase, the ctpA disruptant DCTPA-1 showed growth delay, and the amount of citric acid produced by strain DCTPA-1 was smaller than that by parental strain WU-2223L. These results indicate that the CTPA affects growth and thereby citric acid metabolism of A. niger changes, especially in early-log phase, but not citric acid-producing period. This is the first report showing that disruption of ctpA causes changes of phenotypes in relation to citric acid production in A. niger.


Assuntos
Aspergillus niger/enzimologia , Proteínas de Transporte/genética , Citratos/biossíntese , Proteínas de Transporte/antagonistas & inibidores , Proteínas de Transporte/metabolismo , Citratos/metabolismo , Ácido Cítrico/metabolismo , Citosol/enzimologia , Malatos/metabolismo , Mitocôndrias/enzimologia , Membranas Mitocondriais/enzimologia , Fenótipo
7.
Alcohol Clin Exp Res ; 40(3): 623-30, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26895603

RESUMO

BACKGROUND: Recent evidence from alcohol and trauma studies suggests that disasters are associated with increases in the consumption of alcohol. The Great East Japan Earthquake and the associated nuclear disaster have continued to affect the mental health of evacuees from Fukushima. This study aimed to extend these findings by examining the relationship between drinking behaviors and the risk of mental illness after the compound disaster. METHODS: We conducted the Mental Health and Lifestyle Survey with 56,543 evacuees. Kessler's K6 was used to assess the risk of mental illness, and logistic regression models were applied to analyze how drinking behavior patterns influence the risk of serious mental illness after adjustment for confounding variables. RESULTS: Logistic regression analysis evidenced that beginning heavy and light drinkers had the highest and a higher risk of serious mental illness, respectively. Individuals who were nondrinkers pre- and postdisaster had the lowest proportional risk of mental illness. Abstainers also had some risk to their mental health after the compound disaster. CONCLUSIONS: The results of this study highlight that beginning drinkers have a high risk of serious mental illness. Thus, mental health professionals should pay attention to the drinking behaviors of evacuees, which might predict increased risk of serious mental illness and consequently indicate a need for psychological intervention.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/tendências , Terremotos , Acidente Nuclear de Fukushima , Inquéritos Epidemiológicos/métodos , Transtornos Mentais/epidemiologia , Adulto , Idoso , Consumo de Bebidas Alcoólicas/psicologia , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Adulto Jovem
8.
J Vasc Access ; 16 Suppl 10: S43-5, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26429126

RESUMO

OBJECTIVE: The objective of this study is to investigate and compare factors associated with pain during vascular access intervention therapy. SUBJECTS AND METHODS: Fifty patients provided informed consent to participate in a survey of pain by questionnaire after receiving dialysis treatment at our hospital. Balloons for use during the procedure were chosen at random in this prospective randomized control study. A numeric rating scale (NRS) was used for pain assessment. RESULTS: A semi-compliant balloon caused significantly worse pain as compared with the other types of balloons (NRS, 7.67 ± 1.57 vs. 6.02 ± 1.89; p<0.05). There was no correlation between maximum inflation pressure and pain, or between age and pain, and no difference between diabetic and non-diabetic patients. A comparison among vascular dilation locations, as well as a comparison of AVF with AVG also revealed no significant differences. CONCLUSIONS: The reason for severe pain with use of the semi-compliant balloon as compared with the other types might have been due to its characteristics during inflation, as increased diameter leads to an increase in pressure. Mismatching of balloon diameter to vascular diameter may also increase pain.


Assuntos
Angioplastia com Balão/efeitos adversos , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Oclusão de Enxerto Vascular/terapia , Dor/etiologia , Diálise Renal , Idoso , Angioplastia com Balão/instrumentação , Desenho de Equipamento , Feminino , Oclusão de Enxerto Vascular/diagnóstico , Oclusão de Enxerto Vascular/etiologia , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Dor/diagnóstico , Medição da Dor , Estudos Prospectivos , Diálise Renal/efeitos adversos , Inquéritos e Questionários , Resultado do Tratamento , Dispositivos de Acesso Vascular
9.
J Vasc Access ; 16 Suppl 10: S18-21, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26429128

RESUMO

PURPOSE: We investigated the characteristics of patients who received long-term hemodialysis/hemodiafiltration (HD/HDF) treatment for over 30 years at our group of hospitals and type of vascular access (VA) used. SUBJECTS AND METHODS: As of August 2014, 950 patients were receiving HD/HDF treatment at one of our hospitals. Of those, we investigated 41 (4.3%) undergoing long-term treatment in regard to their characteristics and VA type. The items subjected to analysis were sex, primary illness, age at time of dialysis initiation, present age, duration (years) of HD/HDF, type of arteriovenous fistula (AVF) and arteriovenous graft (AVG), history of surgery and AVF persistence rate. RESULTS: The subjects consisted of 22 men and 19 women, and their mean HD/HDF duration was 33.4 ± 2.8 years. For primary illness, the majority (n = 31) had chronic glomerulonephritis. The age at time of dialysis initiation was 31.7 ± 7.76 years and present age was 64.5 ± 7.65 years. They had received 3.8 VA surgeries. For present VA type, 23 patients (56.0%) had an AVF and 13 (31.7%) an AVG, while 4 AVF patients (9.7%) had a history of AVG use. One patient (2.4%) had a superficialized artery. The mean HD/HDF duration of the 13 AVG patients was 7 years and the longest was 18 years. AVF persistence rate estimated by the Kaplan-Meier method was 75% at 30 years after dialysis initiation. CONCLUSIONS: The present results suggest that the ratio of patients with AVG increased with prolonged HD/HDF treatment. AVG has a higher probability of complications and lower patency as compared to AVF, thus careful management is needed. On the other hand, AVG contributes more to a good long prognosis, as it offers efficient dialysis. In cases of vascular deterioration due to long-term hemodialysis, it is inevitable to change from AVF to AVG, thus the ratio of AVG patients is expected to increase in cases of long-term HD/HDF.


Assuntos
Derivação Arteriovenosa Cirúrgica , Implante de Prótese Vascular , Hemodiafiltração , Diálise Renal , Adulto , Idoso , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Feminino , Humanos , Japão , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
10.
J Pediatr Surg ; 50(12): 2094-7, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26388126

RESUMO

PURPOSE: Our aims are to determine circulating free DNA (cfDNA) in childhood solid tumor patients who underwent surgical intervention and to analyze any relationships with clinical parameters. METHODS: Fourty-four consenting children admitted with solid tumors between 2010 and 2014 were recruited. CfDNAs isolated from 0.5mL plasma obtained before and 1-30days after surgery were analyzed by next-generation sequencing (NGS: IonTorrent Cancer Hotspot panel) and by gene amplification analysis using a digital PCR (dPCR) platform. RESULTS: Total amounts of cfDNA were 54-825ng and were significantly associated with stage of disease. In cfDNA, 15 mutations or deletions (2 ALK, 2 TP53, 1 WT1, 3 CTNNB1, 1 APC, 1 KIT, 1 RET, 1 CDNK2AT, and 3 SMARCB1) were identified. In 10 neuroblastoma suspected cases, 2 showed high copy numbers of MYCN using dPCR. The positive rate in our cohort was 36%, and all of these aberrations were detected in the original tumors. None of the aberrations were detectable in cfDNA after surgery except for three cases whose tumors remained after surgery. CONCLUSIONS: These data demonstrate the feasibility and potential utility of mutation/deletion/amplification screening in cfDNA using NGS and dPCR for the detection of tumor biomarkers in children with solid tumors. These markers also have the potential utility to evaluate complete resection after surgery.


Assuntos
Biomarcadores Tumorais/sangue , DNA de Neoplasias/sangue , Neoplasias/diagnóstico , Criança , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Mutação , Neoplasias/genética
11.
J Pediatr Surg ; 50(12): 2098-101, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26388131

RESUMO

BACKGROUND: In the Japanese Study Group for Pediatric Liver Tumor (JPLT) protocols (JPLT-1 and 2) for evaluating the cure rate of risk-stratified hepatoblastoma, primary resection was permitted in PRETEXT I and II cases, followed by postoperative chemotherapy. METHODS: In approximately 500 enrolled cases, resection was performed as the initial treatment in 60 cases, including all 18 PRETEXT I, 30 PRETEXT II, and 12 ruptured cases. The clinical features, surgical procedures, complications, and survival rates were compared in these three groups. RESULTS: All 18 PRETEXT I cases underwent complete resection by lobectomy or segmentectomy (n=14) or nonanatomical partial hepatectomy (NPH) (n=4). The 30 PRETEXT II cases underwent primary resection by right or left lobectomy (n=16), NPH (n=10), or other procedures (n=4). Of these 30 cases, operational death occurred in 1 newborn, and recurrence occurred in 7 cases (14.6%), including 6 NPH cases and 4 older cases (aged >3years). Of the 12 ruptured cases, 7 (58.3%) showed recurrence. Event-free survival rates at 5years in the 3 groups were 88%, 70%, and 32%, respectively. CONCLUSIONS: Primary resection for PRETEXT I or II HB cases should be performed by anatomical resection according to strict surgical guidelines. More intensified chemotherapy is required for primary resected cases whose tumors have ruptured.


Assuntos
Hepatoblastoma/mortalidade , Hepatoblastoma/cirurgia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/cirurgia , Adolescente , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Hepatectomia/mortalidade , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Recidiva Local de Neoplasia , Taxa de Sobrevida , Resultado do Tratamento
12.
J Vasc Access ; 16 Suppl 10: S70-3, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26349880

RESUMO

BACKGROUND: In recent years, chlorhexidine-alcohol has been attracting increasing attention for its role in skin antisepsis. There have been few reports on the infection frequency associated with vascular access and no reports on the infection frequency associated with antiseptics. AIMS: We investigated skin disinfection during vascular access puncture in patients on chronic hemodialysis (HD). METHODS: We analyzed patients on chronic HD with arteriovenous fistula (AVF) and arteriovenous graft (AVG) between January 2006 and December 2010. RESULTS: The MEH200® (cotton pack including alcohol and chlorhexidine gluconate) was used in 97% of patients. A total of 1130 patients were analyzed, including 911 with AVF and 219 with AVG. Of these, seven with AVF had an infection attributed to the insertion site, which represented a rate of 0.008% of patients per year. Twenty patients with AVG had an infection attributed to the insertion site, which represented a rate of 9.1% of patients per year. The frequency was not higher than that previously reported. CONCLUSIONS: In HD patients, the MEH200® may be effective for the prevention of bacteremia.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Derivação Arteriovenosa Cirúrgica , Bacteriemia/prevenção & controle , Implante de Prótese Vascular , Clorexidina/análogos & derivados , Desinfecção/métodos , Etanol/administração & dosagem , Diálise Renal , Pele/microbiologia , Administração Cutânea , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Bacteriemia/microbiologia , Implante de Prótese Vascular/efeitos adversos , Clorexidina/administração & dosagem , Feminino , Humanos , Masculino , Agulhas , Punções , Diálise Renal/efeitos adversos , Resultado do Tratamento
13.
J Vasc Access ; 16 Suppl 10: S13-7, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26349888

RESUMO

BACKGROUND/AIM: The maintenance and control of vascular access in chronic hemodialysis patients are causing serious problems not only in the quality of life of patients but also in the medical economy. In this regard, we investigated the cumulative patency rate of native arteriovenous fistula (AVF) as a vascular access. METHODS: Simple surgical method for a native AVF is selected. The cumulative patency rate of AVF was compared for each parameter. More particularly, the patency rate in the AVF was investigated by primary disease, age at the time of operation, gender, condition, and site. Furthermore, the influence of factors, including primary disease, gender, age at the time of operation (1 year old), and dialysis period (1 year) on the patency rate, was investigated using Cox's proportional hazard model. RESULTS: The patency rate of AVF was 85.6, 75.0, 67.5, 52.2% for 12, 36, 60, 120 months, respectively. When the patency rate was investigated by factor, the rate was significantly higher in the males than females. When the influence of risk factors on the patency rate was investigated, the significant and independent risk factors in all the cases were 'female' sex. CONCLUSIONS: The AVF is considered as the vascular access with the highest patency rate in the chronic hemodialysis patients. However, the factor influencing this rate is gender. In conclusion, female has a higher risk than male.


Assuntos
Derivação Arteriovenosa Cirúrgica/métodos , Diálise Renal , Insuficiência Renal Crônica/terapia , Grau de Desobstrução Vascular , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Feminino , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Insuficiência Renal Crônica/diagnóstico , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento
14.
Int Heart J ; 56(1): 105-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25742947

RESUMO

Urinary albumin excretion is a predictor of cardiovascular death. Cardiac rehabilitation (CR) with exercise training (ET) has been shown to improve exercise capacity and prognosis in patients with cardiovascular disease (CVD). However, it remains unclear whether CR reduces urinary albumin excretion in CVD patients. We performed a retrospective, observational study using data obtained from 98 male CVD patients without macroalbuminuria and estimated glomerular filtration rate (eGFR) < 30 mL/minute/1.73 m(2) who participated in CR with ET during hospitalization. Twenty-three patients continued supervised ET for 6 months (supervised group) and 75 patients quit supervised ET (non-supervised group). The supervised ET program consisted of 60 minutes of supervised sessions 1-3 times a week and 30-60 minutes of home exercise at least twice a week. Urinary albumin/creatinine ratio (ACR) was significantly decreased in the supervised group at 6 months after enrollment (43 ± 71 mg/g to 17 ± 20 mg/g creatinine, P < 0.05) but not in the non-supervised group. eGFR was unchanged in the supervised group but was significantly decreased in the non-supervised group (72 ± 18 mL/minute/1.73 m(2) to 67 ± 17 mL/minute/1.73 m(2), P < 0.001). The results of multiple regression analysis showed that only supervised ET was an independent contributor to ΔACR. CR with supervised ET decreased urinary albumin excretion without deterioration of renal function. These findings suggest that continuation of a supervised ET program is associated with reduction in the development of CVD and reduction in cardiovascular morbidity and mortality in CVD patients.


Assuntos
Albuminúria , Doenças Cardiovasculares , Terapia por Exercício , Organização e Administração , Idoso , Albuminas/análise , Albuminúria/diagnóstico , Albuminúria/etiologia , Albuminúria/metabolismo , Reabilitação Cardíaca , Doenças Cardiovasculares/complicações , Creatinina/sangue , Terapia por Exercício/métodos , Terapia por Exercício/organização & administração , Tolerância ao Exercício , Feminino , Taxa de Filtração Glomerular , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estudos Retrospectivos , Resultado do Tratamento
15.
Circ J ; 78(11): 2682-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25241889

RESUMO

BACKGROUND: Oxidized low-density lipoprotein (oxLDL) levels have been found to play an important role in the progression of atherosclerosis. However, methods for effectively reducing oxLDL levels have not been established. Comprehensive cardiac rehabilitation (CR) with exercise training prevents the progression of atherosclerosis, and might reduce oxLDL levels. METHODS AND RESULTS: We measured the serum levels of malondialdehyde-modified LDL (MDA-LDL), a marker of oxLDL, in 136 patients who were enrolled in a 6-month CR program. Peak oxygen consumption (V̇O2) and MDA-LDL levels were analyzed, before and 6 months after enrolment. In total, 67 patients completed the CR program (CR group) and 69 patients failed to complete the program (non-CR group). Peak V̇O2increased significantly in the CR group (P<0.01). The levels of MDA-LDL decreased significantly in the CR group (P<0.01) but not in the non-CR group. ∆V̇O2(peak V̇O2after CR-peak V̇O2before CR) was negatively associated with ∆MDA-LDL (MDA-LDL after CR-MDA-LDL before CR) (R(2)=0.11, P=0.01). Multiple regression analysis showed that continuing CR was an independent determining factor for lowering MDA-LDL levels. CONCLUSIONS: CR decreases oxLDL levels in patients with cardiovascular diseases. Moreover, CR may prevent cardiovascular events through an antioxidative effect.


Assuntos
Reabilitação Cardíaca , Doenças Cardiovasculares/sangue , Lipoproteínas LDL/sangue , Idoso , Feminino , Seguimentos , Humanos , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade
16.
Diabetol Metab Syndr ; 6(1): 27, 2014 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-24571923

RESUMO

BACKGROUND: A high-calorie diet and physical inactivity, an imbalance between caloric intake and energy consumption, are major causes of metabolic syndrome (MetS), which manifests as accumulation of visceral fat and insulin resistance. However, the lifestyle-related factors associated with visceral fat mass in healthy men are not fully understood. METHODS: We evaluated visceral fat area (VFA), skeletal muscle mass, caloric intake, and energy expenditure in 67 healthy male participants (mean age, 36.9 ± 8.8 years; body mass index 23.4 ± 2.5 kg/m2). RESULTS: Multiple regression analysis showed that the total skeletal muscle mass (P < 0.001) were negatively and age (P < 0.001) were positively associated with VFA. Lower limb muscle mass (P < 0.001) was strongly associated with VFA. However, total caloric intake, total energy expenditure, and energy expenditure during exercise were not associated with VFA. CONCLUSIONS: Skeletal muscle mass especially lower limb muscle mass negatively contributes to visceral fat mass in healthy men. Therefore, maintaining lower limb muscular fitness through daily activity may be a useful strategy for controlling visceral obesity and metabolic syndrome.

17.
Heart Vessels ; 29(5): 653-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23979265

RESUMO

Increasing evidence indicates that inflammation contributes to the pathogenesis of atrial fibrillation (AF). Pentraxin 3 (PTX3) is produced abundantly in local inflammatory lesions while C-reactive protein (CRP) is produced mainly in the liver. In this study, we investigated whether a local level of PTX3 might be a sensitive marker for the local inflammation of AF. Blood from the periphery and left atrial appendage (LAA) was sampled from 23 patients with AF undergoing pulmonary vein isolation, and from 10 control subjects with Wolff-Parkinson-White syndrome. We measured peripheral and LAA plasma concentrations of CRP, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and PTX3. Plasma PTX3 concentrations in both locations were higher in patients with AF than in control subjects. PTX3 concentrations were significantly higher in the LAA than the periphery in patients with AF (3.7 ± 1.4 vs 3.3 ± 1.2 ng/ml, P < 0.01), but not in control subjects (2.4 ± 0.5 vs 2.4 ± 0.5 ng/ml, not significant). Patients and controls showed no significant differences in CRP, IL-6, or TNF-α concentrations between the periphery and LAA. Interestingly, there was a significant positive correlation between LAA plasma concentrations of PTX3 and left atrial volume (r = 0.55, P < 0.01). These data demonstrate that local PTX3 production in the left atrium might reflect the local inflammation of AF.


Assuntos
Apêndice Atrial/imunologia , Fibrilação Atrial/imunologia , Proteína C-Reativa/análise , Mediadores da Inflamação/análise , Componente Amiloide P Sérico/análise , Idoso , Fibrilação Atrial/sangue , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Biomarcadores/análise , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imuno-Histoquímica , Mediadores da Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Regulação para Cima
18.
J Cardiol Cases ; 10(2): 54-57, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30546505

RESUMO

Rates of morbidity and mortality from cardiovascular disease are high in patients with rheumatoid arthritis (RA); however, the mechanisms and biomarkers that reflect coronary plaque vulnerability have not yet been established. We present a case of acute coronary syndrome (ACS) presumably caused by exacerbation of chronic inflammation of RA, in which an abrupt increase in serum triglyceride was seen on the day of onset of ACS but not during effort angina. This case suggests that RA patients with an abrupt increase in triglyceride need intensive care including anti-platelet and statin therapy for the prevention of coronary plaque rupture. .

19.
Pediatr Surg Int ; 29(10): 1071-5, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24026876

RESUMO

INTRODUCTION: The Japanese Study Group for Pediatric Liver Tumor (JPLT) has conducted cooperative treatment studies on hepatoblastoma (HBL) since 1991. The JPLT2 protocol was launched in 1999 to evaluate the efficacy of cisplatin/pirarubicin (CITA) under risk stratification. European and North American groups showed the improvement of HBL patients by pre- and postoperative chemotherapeutic regimens. Therefore, we evaluated the results of JPLT study and considered the future aspect of JPLT. METHODS: A total of 389 children with malignant hepatic tumors were enrolled in JPLT-2 until 2010. Data from 331 HBL cases were analyzed. RESULTS AND DICUSSION: Of the 331 patients enrolled, their 5-year overall survival and event-free survival rates were 83.3 and 68.0%, respectively. While outcomes of standard-risk cases (tumors involving 3 or fewer sectors of the liver) were excellent, those of high-risk cases (tumors involving 4 sectors of the liver or with distant metastases) remained poor. For 26 high-risk or relapse/refractory HBL cases, high-dose chemotherapy (HDC) with stem cell transplantation (SCT) was carried out. Among them, 6 of 12 relapse or refractory cases died. Compared with other regimens, the CITA regimen achieved similar or superior rates of survival among children with standard-risk HBL, while HDC with SCT was not effective in patients with high-risk HBL. Presently, a global Children's Hepatic Tumor International Consortium (CHIC) project is ongoing, with a focus on international cooperation and risk stratification in the field of rare liver cancers in children. More promising strategies, including liver transplantation and new targeting drugs under global risk stratification, are being proposed.


Assuntos
Cisplatino/uso terapêutico , Doxorrubicina/análogos & derivados , Hepatoblastoma/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Antineoplásicos/uso terapêutico , Criança , Intervalo Livre de Doença , Doxorrubicina/uso terapêutico , Quimioterapia Combinada , Seguimentos , Hepatoblastoma/mortalidade , Humanos , Imunossupressores , Incidência , Neoplasias Hepáticas/mortalidade , Recidiva Local de Neoplasia/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Resultado do Tratamento
20.
Pediatr Surg Int ; 29(11): 1139-45, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24022278

RESUMO

PURPOSE: Amplification of neuroblastoma derived (avian)v-myc myelocytomatosis viral related oncogene (MYCN) is an important risk-stratified indicator in neuroblastoma. To evaluate the feasibility of noninvasive measurement of MYCN amplification, we analyzed MYCN amplification in stored blood plasma samples. METHODS: We used quantitative real-time PCR to determine MYCN copy numbers in plasma-derived DNA of 10 healthy volunteers and 50 neuroblastoma cases. The copy number was calculated as the ratio of copies of MYCN to those of a reference gene. Plasma samples obtained after surgery or neoadjuvant therapy were also analyzed in five cases and four cases, respectively. RESULTS: In 34 neuroblastoma cases, MYCN was nonamplified in both tumor tissue and blood plasma. In 16 neuroblastoma cases, MYCN was amplified in both tumor tissue and blood plasma; 13 of the 16 cases showed poor outcomes. MYCN amplification was undetectable in blood plasma shortly after surgery or neoadjuvant therapy. The correlation coefficient between MYCN copy numbers in tumor tissue and in blood plasma was approximately 0.9. CONCLUSION: We can detect MYCN amplification of tumor tissue noninvasively and quantitatively by measuring the MYCN copy number in blood plasma. Determination of MYCN copy number in plasma may be useful when evaluating surgery and neoadjuvant chemotherapy.


Assuntos
Biomarcadores Tumorais/sangue , DNA de Neoplasias/genética , Amplificação de Genes , Genes myc/genética , Neuroblastoma/genética , Biomarcadores Tumorais/genética , Pré-Escolar , Estudos de Viabilidade , Feminino , Dosagem de Genes , Humanos , Lactente , Recém-Nascido , Masculino , Neuroblastoma/sangue , Neuroblastoma/diagnóstico , Valor Preditivo dos Testes , Prognóstico , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos
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