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Machida, Yuichiro,Sagawa, Motoyasu,Tanaka, Makoto,Motono, Nozomu,Matsui, Takuma,Usuda, Katsuo,Uramoto, Hidetaka Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10
Background: The Glasgow Prognostic Score (GPS) is calculated from measured CRP and albumin levels. We here evaluated the significance of the GPS in patients with resected pulmonary adenocarcinoma. Materials and Methods: The present study included 156 patients with lung adenocarcinoma who underwent lobectomy at Kanazawa Medical University between 2002 and 2012. Classification was into three groups: those with normal albumin (>=3.5 g/dl) and C-reactive protein (CRP) (<=1.0 mg/dl) levels were classified as GPS 0 (n =136), those with low albumin (<3.5 g/dl) or elevated CRP (>1.0 mg/dl) levels as GPS 1 (n = 16), and those with low albumin (<3.5 g/dl) and elevated CRP (>1.0 mg/dl) levels as GPS 2 (n = 4). We retrospectively investigated relationships between the patient characteristics including the GPS, and disease-free survival and cancer-specific survival. Results: The pathological stages of the patients were as follows: IA (n=78, 50%), IB (n=31, 19.9%), IIA (n=20.0, 12.8%), IIB (n=9.0, 5.7%), and IIIA (n=18.0, 11.5%). Lobectomy was performed in all cases. The average GPS was 0.15 (0-2) and showed significant relationships with stage and tumor size. The 2-year survival rates in patients with GPS0, 1 and 2 were 81.4%, 38.4%, and 25.0%, respectively. Clear correlations were noted with both cancer-specific survival and disease-free survival. Furthermore, multivariate analysis revealed that GPS was a significant prognostic factor. Conclusions: The GPS could be a prognostic factor for patients with resected pulmonary adenocarcinoma.
( Hiroharu Kawakubo ),( Yuichiro Tanaka ),( Nanae Tsuruoka ),( Megumi Hara ),( Koji Yamamoto ),( Hidenori Hidaka ),( Yasuhisa Sakata ),( Ryo Shimoda ),( Ryuichi Iwakiri ),( Motoyasu Kusano ),( Kazuma 대한소화기기능성질환·운동학회 2016 Journal of Neurogastroenterology and Motility (JNM Vol.22 No.2
Background/Aims Upper gastrointestinal symptoms are more frequent and severe in female than in male outpatients in Japan. This study compared the upper gastrointestinal symptoms between healthy male and female young adult volunteers using a questionnaire. Methods In total, 581 third-grade medical students at Saga Medical School aged 22 to 30 years underwent upper gastrointestinal endoscopy and completed a questionnaire (frequency scale for symptoms of gastroesophageal reflux disease) from 2007 to 2013. Of these 581 students, 298 who were negative for Helicobacter pylori infection and had no particular lesions on endoscopic examination were enrolled in the present evaluation. A symptom was defined as positive when the subject evaluated the frequency of the symptom as sometimes, often, or always. Results The subjects comprised of 163 males (average age, 23.7 years) and 135 females (average age, 23.1 years). Upper gastrointestinal symptoms were more frequent in the females (75 of 135, 55.6%) than males (69 of 163, 42.3%; P < 0.05), with a high score for 4 symptoms (bloated stomach, heavy feeling in the stomach after meals, subconscious rubbing of the chest with the hand, and feeling of fullness while eating meals). Of the 144 subjects (69 males and 75 females) who complained of these symptoms, the females complained of dysmotility symptoms more often than did the males, but this was not true for reflux symptoms. Conclusions This study suggests that females develop upper gastrointestinal symptoms more frequently than do males among the young healthy Japanese population. (J Neurogastroenterol Motil 2016;22:248-253)
( Zobair M. Younossi ),( Atsushi Tanaka ),( Yuichiro Eguchi ),( Linda Henry ),( Rachel Beckerman ),( Masashi Mizokami ),( Sooji Lee ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Japanese chronic hepatitis C (CHC) patients are at greater risk for hepatocellular carcinoma (HCC). Highly effective oral Direct Acting Antiviral (DAA) regimens for CHC can lead to high SVR rates that reduce CHC complications and costs. This study estimated the economic benefit of CHC cure by reducing HCC and decompensated cirrhosis (DCC) in Japan. Methods: A hypothetical cohort of 10,000 HCV GT1b Japanese patients with a mean age of 70 was modeled with a hybrid decision tree and Markov model capturing the natural history of HCV infection over a lifetime horizon. It was assumed that 15% of the cohort had cirrhosis and 20% were treatment-experienced. Treatment compared approved all-oral DAAs vs. no treatment (NT) with efficacy based on randomized controlled trials. Transition rates and costs were obtained from Japan-specific data. DCC, HCC and quality-adjusted life years (QALYs) were projected. QALYs were monetized using a willingness to pay (WTP) threshold which varied from ¥4 to ¥6 million. The incremental savings associated with treatment were calculated by adding the projected cost of complications avoided to the monetized gains in QALYs. Results: DAA treatment avoided 1583 cases of HCC and 1162 cases of DCC, saving ¥618,076 and ¥251,329 per treated patient; respectively. Treatment leads to avoidance of 2745 cases of CHC complications and associated savings of ¥869,405 per treated patient. Additionally, DAA treatment lead to an additional 1.59 QALYs gained per patient treated. The indirect economic gains associated with treatment-related QALY improvements were estimated to be ¥6,360,000, ¥7,950,000 and ¥9,540,000 per patient at WTP thresholds of ¥4 million, ¥5 million and ¥6 million. Total economic savings of HCV GT1 treatment with DAAs (vs. NT) was ¥7,229,405, ¥8,819,405and ¥10,409,405 at these different WTP thresholds. Conclusions: Treatment of HCV GT1b with all Oral DAAs in Japan can lead to significant savings related to avoidance of HCC and DCC.
Motono, Nozomu,Ueno, Masakatsu,Tanaka, Makoto,Machida, Yuichiro,Usuda, Katsuo,Sakuma, Tsutomu,Sagawa, Motoyasu Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.23
Background: The purpose of this study was to determine the prognostic significance of the maximum standardized uptake value (SUVmax) on F-18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in patients undergoing surgical treatment for non-small cell lung cancer. Materials and Methods: Seventy-eight consecutive patients (58 with adenocarcinomas, 20 with squamous cell carcinomas) treated with potentially curative surgery were retrospectively reviewed. Results: The SUVmax was significantly higher in the patients with recurrent than with non-recurrent adenocarcinoma (p<0.01). However, among the patients with squamous cell carcinoma, there were no differences with or without recurrence (p=0.69). Multivariate analysis indicated that the SUVmax of adenocarcinoma lesions was a significant predictor of disease-free survival (p=0.04). In addition, an SUVmax of 6.19, the cut-off point based on ROC curve analysis of the patients with pathological IB or more advanced stage adenocarcinomas, was found to be a significant predictor of disease-free survival (p<0.01). Conclusions: SUVmax is a useful predictor of disease-free survival in patients with resected adenocarcinoma, but not squamous cell carcinoma. Patients with adenocarcinoma exhibiting an SUVmax above 6.19 are candidates for more intensive adjuvant therapy.
Implementation of Medical Diagnostic System Based on Epidemiological Data
Hideaki Takata,Hiroki Nogawa,Hiroshi Nagata,Yuichiro Gomi,Hiroshi Tanaka 대한의료정보학회 2007 Healthcare Informatics Research Vol.13 No.2
Objective: We implemented automatic online medical consultation software. It infers disease of patients with knowledge about symptoms and the epidemiologic data. And we compared its performance of inference with that of human doctors.Methods: This software accepts information about users' age, sex, and symptoms, lists up diseases compatible with these information, and sorts diseases by probability. We implement this software with Ruby and C. Results: We compared diseases listed up by this software with those that by two human doctors, and found that 1) 90% of confirmed diagnoses was included in the list this software inferred, and 2) more than 50% of diseases in the list this software inferred are same diseases as ones both of two human doctors inferred. Conclusion: This software can not determine final diagnosis. But this software lists up probable diseases only by interview. Then we believe this software will be useful for patients when they want to check themselves before consulting their doctor. We believe that this software will be useful for patients to check their health status. (Journal of Korean Society of Medical Informatics 13-2, 181-185, 2007)
A Systematic Review of the Extrahepatic Manifestations of Hepatitis C Infection in East Asia
( Zobair M. Younossi ),( Linda Henry ),( Janus Ong ),( Atsushi Tanaka ),( Yuichiro Eguchi ),( Masashi Mizokami ),( Young-suk Lim ),( Yock Young Dan ),( Ming-lung Yu ),( Maria Stepanova ),( Sooji Lee ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Chronic hepatitis C (CHC) infection causes a systemic infection with hepatic and extrahepatic manifestation (EHMs). Although the prevalence of EHMs in Western countries is well described, the same is not well known in East Asian countries. We performed a systematic review to quantify the prevalence of selected EHMs among CHC patients in East Asia. Methods: PubMed, Medline, and Japan databases searched (1990-Dec 2016) with “hepatitis c virus” “chronic hepatitis C”, “extrahepatic manifestations”, and respective EHM’s. Data were collected and reviewed by two per PRISMA guidelines. EHMs were by ICD-9 codes or clinically: depression:BDI-2 score>19, chronic kidney disease (CKD): eGFR of < 60 mL/ min/1.73 m2 per MDRD, diabetes (DM):fasting blood glucose level > 126 mg/dL. Pooled prevalence determined by random effects models. Results: 75 articles were identified. After applying inclusion and exclusion criteria, 23 articles remained (Japan=6; China=3, Korea= 4, Taiwan=9, Asia=1) with a total of 468,656 subjects (n= 51,160 CHC and n= 417,496 non-HCV controls). HCV patient age ranged from 44-70 (mean age 55), 50% were male (range 0%-67%), and over 80% of diagnosis was established through positive HCV anti-body. CHC subjects had higher risk of lymphoma (n=2) 4.6% vs. 2.3%, OR=1.79 (1.47-2.19), P<0.0001; DM (n=11) 16.7% vs. 9.4%, OR=1.84 (1.52-2.21), P<0.0001; SS (n=2) 9.6% vs. 3.5%, OR=9.80 (1.25-76.56), P=0.0295; LP (n=5) 8.2% vs. 4.2%, OR=2.45 (1.36-4.41), P=0.0027; depression (n=1) 51.6% vs. 27.7%, OR=2.77 (1.25-6.15), P=0.0121; CKD (n=5) 3.8% vs. 1.7%, OR=2.00 (1.09-3.70), P=0.026; RA (n=2) 0.9% vs. 0.3%, OR=2.41 (1.54-3.76), P=0.0001; CVA (n=2) 25.3% vs. 19.3%, hazard ratio 1.38 (1.24-1.53), P<0.05; IHD (n=1) 25.3% vs 11.6%, OR=1.76 (1.04-2.96), P=0. 0.034. Additionally, the prevalence of MC (symptomatic and asymptomatic; n=1) in CHC was 46.9% in CHC vs. 1.9% in general population with a risk ratio of 24.7 (17.2-32.2). Conclusions: Our review found that CHC in East Asia is associated with increased risk for EHMs.