Nobuo Yaegashi

Tohoku University, Miyagi, Japan

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Publications (425)1076.04 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Uterine leiomyosarcoma (Ut-LMS) is a highly metastatic smooth muscle neoplasm. We have previously reported that low molecular mass protein2 Lmp2-deficient mice spontaneously developed Ut-LMS, which implicated this protein as an anti-oncogenic candidate. We also suggested that LMP2 may negatively regulate Ut-LMS independently of its role in the proteasome. Initially described as a transcription factor able to activate the expression of interferon-gamma (IFN-γ)-responsive genes, interferon regulatory factor-1 (IRF1) has been shown to play roles in the immune response, and tumor suppression. The aim of this study was to elucidate the molecular mechanism of sarcomagenesis of Ut-LMS using human and mouse uterine tissues. The expression of the IFN-γ signal molecules, IRF1 and -2, STAT1, and LMP2, -3, -7 and -10 were examined by western blot analysis, electrophoretic mobility shift assay and immunohistochemistry in human and mouse uterine tissues. Physiological significance of IRF1 in sarcomagenesis of Ut-LMS was demonstrated by xenograft studies. In the present study, several lines of evidence indicated that although treatment with IFN-γ strongly induced the activation of STAT1 as a transcriptional activator, its target molecule, IRF1, was not clearly produced in Lmp2-deficient uterine smooth muscle cells (Ut-SMCs). Defective expression of IRF1 in the IFN-γ-induced signaling molecules may result in the malignant transformation of Ut-SMCs. The modulation of LMP2 may lead to new therapeutic approaches in human Ut-LMS. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
    Anticancer research 09/2015; 35(9):4665-79. · 1.87 Impact Factor
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    ABSTRACT: We investigated the role of human leukocyte antigen (HLA) class II alleles in multistage cervical carcinogenesis. Cross-sectional analysis for HLA association with cervical cancer included 1253 Japanese women: normal cytology (NL, n=341), cervical intraepithelial neoplasia grade 1 (CIN1, n=505), CIN grade 2 or 3 (CIN2/3, n=96) or invasive cervical cancer (ICC, n=311). HLA class II allele frequencies were compared by Fisher's exact test or the χ2 test. The Bonferroni adjustment corrected for multiple comparisons. Among the study subjects, 454 women with low-grade squamous intraepithelial lesion (LSIL) cytology were prospectively monitored by cytology and colposcopy every 3-4 months to analyze cumulative risk of CIN3 within the next 10 years in relation to HLA Class II alleles. HLA class II DRB1*1302 allele frequency was similar between women with NL (11.7%) and CIN1 (11.9%), but significantly decreased to 5.2% for CIN2/3 and 5.8% for ICC (P=0.0003). Correction for multiple testing did not change this finding. In women with LSIL cytology, the cumulative risk of CIN3 diagnosed within 10 years was significantly reduced among DRB1*1302-positive women (3.2% vs. 23.7%, P=0.03). In conclusion, the two different types of analysis in this single study demonstrated the protective effect of the DRB1*1302 allele against progression from CIN1 to CIN2/3. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Cancer Science 08/2015; DOI:10.1111/cas.12760 · 3.53 Impact Factor
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    ABSTRACT: Analysis of the placenta can be a useful way to determine the fatty acid (FA) status of pregnant women and neonates since this large organ can be obtained easily and non-invasively. Although several studies have been conducted on using placental tissue for FA analysis, the sampling methods have not been thoroughly examined. The aim of the present study was to determine a suitable method of sampling human placentae by focusing on their heterogeneity. Twenty-four placentae were collected from healthy pregnant Japanese women in the Miyagi Prefecture of Japan. Five of them were used to compare the FA composition between the peripheral area and the central area of the placentae. The other 19 were examined to determine differences in the FA composition between the fetal and maternal side. Placental tissue crude lipid was saponified, and methyl was esterified with 14% sodium boron trifluoride methanol for gas chromatography with flame ionization detector analysis. Fifty-six peaks were detected from the methyl esters of the placental total lipid, and 33 of those were identified as FA methyl esters. There were considerable variations in the FA composition, as the variation was low in the central parts and high in the peripheral parts of the placentae. The 18:1n-9 and 18:2n-6 levels were higher in the fetal side, whereas the 20:3n-6, 20:4n-6, and 22:6n-3 levels were higher in the maternal side. These findings indicate the presence of heterogeneity in the FA composition of human placenta, and they suggest the necessity for standardizing the sampling method so that the placental tissue can be used to determine the FA status.
    Journal of oleo science 07/2015; DOI:10.5650/jos.ess15071 · 1.24 Impact Factor
  • Journal of Hypertension 07/2015; 33(7):1492-3. DOI:10.1097/HJH.0000000000000608 · 4.22 Impact Factor
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    ABSTRACT: Although most smooth muscle neoplasms detected in the human uterus are benign, uterine leiomyosarcoma (Ut-LMS) is extremely malignant with high rates of recurrence and metastasis. CAVEOLIN 1 (CAV1) levels in the epithelial cells of some carcinomas have been reported to increase during tumor progression. We herein evaluated the relationship between CAV1 expression and the pathological features of patients diagnosed with uterine mesenchymal tumors at several clinical facilities. No clinical link was observed between CAV1 expression and the malignancy of human uterine mesenchymal tumors. CAV1 expression was decreased in the normal myometrium, whereas it was strongly expressed in uterine mesenchymal tumors. However, the expression of CAV1 was not a potential biomarker to distinguish Ut-LMS from other types of uterine mesenchymal tumors. The perivascular expression of CAV1 was clearly observed in all types of uterine mesenchymal tumors and myometria. Therefore, the results of the present study suggest that CAV1 may not act as a potential biomarker of uterine malignant mesenchymal tumors. Copyright © 2015. Published by Elsevier Inc.
    Biochemical and Biophysical Research Communications 06/2015; DOI:10.1016/j.bbrc.2015.06.046 · 2.28 Impact Factor
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    ABSTRACT: Fertility-sparing treatment has been accepted as a standard treatment for epithelial ovarian cancer in stage IA non-clear cell histology grade 1/grade 2. In order to expand an indication of fertility-sparing treatment, we have started a non-randomized confirmatory trial for stage IA clear cell histology and stage IC unilateral non-clear cell histology grade 1/grade 2. The protocol-defined fertility-sparing surgery is optimal staging laparotomy including unilateral salpingo-oophorectomy, omentectomy, peritoneal cytology and pelvic and para-aortic lymph node dissection or biopsy. After fertility-sparing surgery, four to six cycles of adjuvant chemotherapy with paclitaxel and carboplatin are administered. We plan to enroll 250 patients with an indication of fertility-sparing surgery, and then the primary analysis is to be conducted for 63 operated patients with pathologically confirmed stage IA clear cell histology and stage IC unilateral non-clear cell histology grade 1/grade 2. The primary endpoint is 5-year overall survival. Secondary endpoints are other survival endpoints and factors related to reproduction. This trial has been registered at the UMIN Clinical Trials Registry as UMIN000013380. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email:
    Japanese Journal of Clinical Oncology 06/2015; 45(6):595-9. DOI:10.1093/jjco/hyv032 · 1.75 Impact Factor
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    Takashi Takeda · Kenji Tsuiji · Bin Li · Mari Tadakawa · Nobuo Yaegashi
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    ABSTRACT: Hachimijiogan (HJG), Ba-Wei-Di-Huang-Wan in Chinese, is one of the most popular herbal medicines in Japanese Kampo. HJG is often prescribed for the prevention and treatment of age-related diseases. Muscle atrophy plays an important role in aging-related disabilities such as sarcopenia. The purpose of this study was to investigate the possible beneficial effect of HJG on skeletal muscle. Cells of murine skeletal muscle myoblast cell line C2C12 were used as an in vitro model of muscle cell proliferation and differentiation. The effect of HJG on C2C12 cell proliferation and differentiation was assessed. We counted the number of myotubes morphologically to assess the degree of differentiation. HJG treatment (200 μg/mL) for 3 days significantly increased C2C12 cell number by 1.23-fold compared with that of the control. HJG promoted the proliferation of C2C12 cells through activation of the ERK1/2 signaling pathway without affecting the Akt signaling pathway. HJG did not affect the differentiation of C2C12 cells. HJG had beneficial effects on skeletal muscle myoblast proliferation. These findings may provide a useful intervention for the prevention and treatment of sarcopenia.
    Clinical Interventions in Aging 05/2015; 10(1):445-51. DOI:10.2147/CIA.S75945 · 1.82 Impact Factor
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    ABSTRACT: The Japan Environment and Children's Study (JECS) is an ongoing nationwide birth cohort study launched in January 2011. In this progress report, we present data collected in the first year to summarize selected maternal and infant characteristics. In the 15 Regional Centers located throughout Japan, the expectant mothers were recruited in early pregnancy at obstetric facilities and/or at local government offices issuing pregnancy journals. Self-administered questionnaires were distributed to the women during their first trimester and then again during the second or third trimester to obtain information on demographic factors, physical and mental health, lifestyle, occupation, environmental exposure, dwelling conditions, and socioeconomic status. Information was obtained from medical records in the first trimester and after delivery on medical history, including gravidity and related complications, parity, maternal anthropometry, and infant physical examinations. We collected data on a total of 9819 expectant mothers (mean age = 31.0 years) who gave birth during 2011. There were 9635 live births. The selected infant characteristics (singleton births, gestational age at birth, sex, birth weight) in the JECS population were similar to those in national survey data on the Japanese general population. Our final birth data will eventually be used to evaluate the national representativeness of the JECS population. We hope the JECS will provide valuable information on the impact of the environment in which our children live on their health and development.
    Journal of Epidemiology 04/2015; 25(6). DOI:10.2188/jea.JE20140186 · 2.86 Impact Factor
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    ABSTRACT: This study aimed to explore the correlation between the 2011 Great East Japan Earthquake and postpartum depression among perinatal subjects in the Miyako region of Iwate, an area damaged by earthquakes and tsunamis. We retrospectively compared the percentages of women with scores ≥9 on the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS) among 3 groups of women who gave birth prior to the disaster (before-disaster group: n=141), within 3 months after the disaster (within-3-months group: n=70), and 4-6 months after the disaster (4-6-months group: n=89) at the Iwate Prefectural Miyako Hospital. The risk factors for EPDS scores ≥9 were estimated with multivariate logistic regression analyses. Compared with the before-disaster group, a significantly greater number of women in the within-3-months group had EPDS scores ≥9 at hospital discharge (31.4% versus 9.9%, P<.0001), whereas women in the 4-6-months group did not (10.1% versus 9.9%, P=.96). In both the after-disaster groups, the destruction of their home (adjusted odds ratio [AOR], 3.68; 95% confidence interval [CI], 1.46-9.26) and dissatisfaction with their living conditions (AOR, 3.02; 95% CI, 1.20-7.59) were significantly associated with EPDS scores ≥9. An increase in postpartum depression was observed after the Great East Japan Earthquake among perinatal women. (Disaster Med Public Health Preparedness. 2015;0:1-6).
    Disaster Medicine and Public Health Preparedness 04/2015; 9(03):1-6. DOI:10.1017/dmp.2015.51 · 1.14 Impact Factor
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    ABSTRACT: Surgery is effective and useful for curative treatment of patients with early invasive cervical cancer, yet minimization of surgical procedures provides many additional advantages for patients. Because the mean age of patients diagnosed with cervical precancer and invasive cancer has been decreasing, the need for minimization of surgery to reduce disruption of fertility is increasing. Trachelectomy is an innovative procedure for young patients with invasive cancer. Minimally invasive procedures are increasingly implemented in the treatment of patients with early cervical cancer, such as laparoscopic/robotic surgery and sentinel lymph node navigation. The use of modified radical hysterectomy may not only be curative but also minimally invasive for Stage IA2-IB1 patients with a tumor size <2 cm in diameter. Here, we have summarized and discussed the minimally invasive procedures for the treatment of patients with early cervical cancer. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email:
    Japanese Journal of Clinical Oncology 04/2015; 45(7). DOI:10.1093/jjco/hyv048 · 1.75 Impact Factor
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    ABSTRACT: The second edition of the Japan Society of Gynecologic Oncology guidelines for the treatment of uterine cervical cancer was published in 2011. The guidelines comprise eight chapters and five algorithms. They were prepared by consensus among the members of the Japan Society of Gynecologic Oncology Guidelines Formulation Committee and Evaluation Committee and are based on a careful review of the evidence obtained from the literature, health insurance system, and actual clinical settings in Japan. The highlights of the 2011 revision are (1) the recommended grades have been changed to five stages-A, B, C1, C2, and D; (2) the revisions are consistent with the new International Federation of Gynecology and Obstetrics staging system; (3) the roles are shared between the 'Japanese classification of cervical cancer' and the new guidelines; (4) clinical questions related to adenocarcinoma have been revised; and (5) a clinical question regarding cervical cancer in pregnant patients has been added. Each chapter includes a clinical question, recommendations, background, objectives, explanations, and references. Each recommendation is accompanied by a classification of recommendation categories. The objective of these guidelines is to update the standard treatment strategies for cervical cancer, thus eliminating unnecessary and insufficient treatment.
    International Journal of Clinical Oncology 03/2015; 20(2). DOI:10.1007/s10147-015-0806-7 · 2.17 Impact Factor
  • Koji Matsumoto · Takashi Onda · Nobuo Yaegashi
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    ABSTRACT: Several 'lines of therapy' that utilize cytotoxic agents and are driven by platinum-free intervals are the current standard of care for patients with recurrent ovarian cancer. For patients with platinum-resistant disease, single agent chemotherapy (pegylated liposomal doxorubicin, topotecan, gemcitabine or weekly paclitaxel) is the standard of care. For patients with platinum-sensitive disease, combination chemotherapy (carboplatin plus paclitaxel, pegylated liposomal doxorubicin or gemcitabine) is the standard of care. In addition, antiangiogenic therapy using bevacizumab is an established option. Future directions could include 'lines of therapy' with biologic agents driven by specific biologic targets. Data from antiangiogenic agents (trebananib, pazopanib and cediranib), antifolate drugs (farletuzumab and vintafolide), poly(ADP-ribose) polymerase inhibitors (olaparib and veliparib), mTOR inhibitors (everolimus and temsirolimus) and immune editing agents (nivolumab) have been summarized in this review. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email:
    Japanese Journal of Clinical Oncology 03/2015; 45(5). DOI:10.1093/jjco/hyv014 · 1.75 Impact Factor
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    ABSTRACT: This multi-institutional study was conducted to clarify the clinicopathological features of squamous cell carcinomas of the vulva. The medical records of vulvar cancer patients treated between 2002 and 2012 were retrospectively reviewed following approval by the Institutional Review Board of each institution. One hundred and eleven patients with vulvar malignancies were included. Of these, 63 patients had squamous cell carcinoma (57 %). Initial treatment was surgery, radiation therapy (RT), and concurrent chemoradiotherapy (CCRT) in 34 (54 %), 15 (24 %), and 11 (17 %) patients, respectively. Nineteen, 11, 26, and 7 patients had stage I, II, III, and IV disease, respectively. Of the 34 patients who had surgical treatment, 50 % had stage I disease, while 74 % of those who received CCRT had stage III or IV disease. Complete response (CR) rates for the surgery, RT, and CCRT groups were 73, 60, and 64 %, respectively. The 5-year survival rates for stage I/II and III/IV disease were 64 and 39 %, respectively (P = 0.019). The 5-year survival rates for the surgery, RT, and CCRT groups were 53, 38, and 50 %, respectively, and the prognosis of patients treated with surgery or CCRT was significantly better than that of patients who received RT (P < 0.05). In multivariate analysis, clinical response to initial treatment was an independent prognostic factor (P < 0.001). Although many patients had advanced-stage disease in the CCRT group, the therapeutic outcome for the surgery and CCRT groups was similar. Thus, CCRT may be a promising treatment for squamous cell carcinoma of the vulva.
    International Journal of Clinical Oncology 02/2015; DOI:10.1007/s10147-015-0803-x · 2.17 Impact Factor
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    ABSTRACT: In order to determine indications for less radical surgery such as modified radical hysterectomy, the risk of pathological parametrial involvement and prognosis of FIGO stage IB1 cervical cancer patients undergoing standard radical hysterectomy with pre-operatively assessed tumor diameter ≤2cm were investigated. We conducted a retrospective multi-institutional chart review of patients with FIGO stage IB1 cervical cancer who underwent primary surgical treatment between 1998 and 2002. The eligibility criteria for the analyses were (i) histologically-proven squamous cell carcinoma, adenocarcinoma or, adenosquamous cell carcinoma, (ii) radical hysterectomy performed, (iii) clinical tumor diameter data available by MR imaging or specimens by cone biopsy, and (iv) age between 20 and 70. Based on the clinical tumor diameter, patients were stratified into those with the following tumors: i) 2cm or less (cT≤2cm) and ii) greater than 2cm (cT>2cm). We expected 5-year OS of ≥95% and parametrial involvement <2-3% for patients with cT≤2cm who underwent radical hysterectomy. Of the 1269 patients enrolled, 604 were eligible for the planned analyses. Among these, 571 underwent radical hysterectomy (323 with cT≤2cm and 248 with cT>2cm). Parametrial involvement was present in 1.9% (6/323) with cT≤2cm and 12.9% (32/248) with cT>2cm. Five-year overall survivals were 95.8% (95% CI 92.9-97.6%) in cT≤2cm and 91.9% (95% CI 87.6-94.8%) in cT>2cm patients. Patients with cT≤2cm had lower risk of parametrial involvement and more favorable 5-year overall survival. They could therefore be good candidates for receiving less radical surgery. Copyright © 2015. Published by Elsevier Inc.
    Gynecologic Oncology 02/2015; 137(1). DOI:10.1016/j.ygyno.2015.01.548 · 3.69 Impact Factor
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    ABSTRACT: Abstract Plasminogen activator inhibitor (PAI)-1 is predictive of poor outcome in several types of cancer. The present study investigated the biological role for PAI-1 in ovarian cancer and potential of targeted pharmacotherapeutics. In patients with ovarian cancer, PAI-1 mRNA expression in tumor tissues was positively correlated with poor prognosis. To determine the role of PAI-1 in cell proliferation in ovarian cancer, the effects of PAI-1 inhibition were examined in PAI-1-expressing ovarian cancer cells. PAI-1 knockdown by small interfering RNA resulted in significant suppression of cell growth accompanied with G2/M cell cycle arrest and intrinsic apoptosis. Similarly, treatment with the small molecule PAI-1 inhibitor TM5275 effectively blocked cell proliferation of ovarian cancer cells that highly express PAI-1. Together these results suggest that PAI-1 promotes cell growth in ovarian cancer. Interestingly, expression of PAI-1 was increased in ovarian clear cell carcinoma compared with that in serous tumors. Our results suggest that PAI-1 inhibition promotes cell cycle arrest and apoptosis in ovarian cancer and that PAI-1 inhibitors potentially represent a novel class of anti-tumor agents.
    Cancer biology & therapy 01/2015; DOI:10.1080/15384047.2014.1001271 · 3.63 Impact Factor
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    ABSTRACT: Aim: The aim of this study was to investigate prognostic factors, including postoperative chemotherapy regimen, for the treatment of ovarian yolk sac tumour (YST), and resulting fertility outcome. Methods: A multi-institutional retrospective investigation was undertaken to identify patients with ovarian pure or mixed YST who were treated between 1980 and 2007. Postoperative chemotherapy regimen and other variables were assessed in univariate and multivariate analyses. Additionally, the reproductive safety of the BEP (bleomycin, etoposide and cisplatin) regimen was evaluated. Results: There were 211 patients enrolled from 43 institutions. The BEP regimen and a non-BEP regimen were administered to 112 and 99 patients as postoperative chemotherapy, respectively. In univariate and multivariate analyses, age 22, alpha-fetoprotein 33,000 ng/ml, residual tumours after surgery and non-BEP regimen were independently and significantly associated with poor overall survival (OS). BEP was significantly superior to non-BEP in 5-year OS (93.6% versus 74.6%, P = 0.0004). Reduced-dose BEP (<75% standard-dose bleomycin and < 50% etoposide dose) was significantly associated with poorer 5-year OS compared with standard-dose BEP (89.4% versus 100%, P = 0.02 and 62.5% versus 96.9%, P = 0.0002). All patients who underwent fertility-sparing surgery recovered their menstrual cycles. Sixteen of 23 patients receiving BEP (70.0%) and 13 of 17 patients receiving non-BEP (76.5%) who were nulliparous at fertility-sparing surgery and married at the time of investigation gave birth to 21 and 19 healthy children, respectively. Conclusions: The results of the present study suggest that standard-dose BEP should be administered for ovarian YST. BEP is as safe as non-BEP for preserving reproductive function.
    European Journal of Cancer 01/2015; 51(3). DOI:10.1016/j.ejca.2014.12.004 · 4.82 Impact Factor
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    ABSTRACT: The Tohoku Medical Megabank Organization reports the whole-genome sequences of 1,070 healthy Japanese individuals and construction of a Japanese population reference panel (1KJPN). Here we identify through this high-coverage sequencing (32.4 × on average), 21.2 million, including 12 million novel, single-nucleotide variants (SNVs) at an estimated false discovery rate of <1.0%. This detailed analysis detected signatures for purifying selection on regulatory elements as well as coding regions. We also catalogue structural variants, including 3.4 million insertions and deletions, and 25,923 genic copy-number variants. The 1KJPN was effective for imputing genotypes of the Japanese population genome wide. These data demonstrate the value of high-coverage sequencing for constructing population-specific variant panels, which covers 99.0% SNVs of minor allele frequency ≥0.1%, and its value for identifying causal rare variants of complex human disease phenotypes in genetic association studies.
    Nature Communications 01/2015; 6:8018. DOI:10.1038/ncomms9018 · 10.74 Impact Factor
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    ABSTRACT: On March 11, 2011, the Great East Japan Earthquake hit northeast Japan. Previous letter on Hypertension by Sato et al reported that 11.6/3.9mmHg for systolic/diastolic blood pressure (BP) and 4.7bpm for heart rate (HR) elevations were observed by home BP measurement among hypertensive outpatients aged 68.1±8.8 years. In this study we observed home BP change before and after the earthquake among pregnant women. We used database from the BOSHI study which participated pregnant women from October 2006 to September 2011 at a maternity hospital In Miyagi Prefecture, Japan. The participants were asked to measure their own BPs every morning at home while they were pregnant. A linear mixed model was used for analysis of the BP course throughout pregnancy. Total 1137 pregnant woman was included into the analysis. Of those, 210 pregnant women were participated before the earthquake and gave birth after the earthquake. Of those, 133 women measured their BP in March 2011. The average number of home BP measurements was 13.8 in March 2011. Home BP and HR which are not measured in March 2011 were 105.9(105.4-106.4)/63.2(62.8-63.6)mmHg and 74.3(73.9-74.7)bpm, respectively. Home BP and HR were 105.0(103.5-106.4)/64.1(62.8-65.3)mmHg, 73.8(71.8-81.8)bpm in the morning at March 11, 2011 (just before the earthquake), and 110.7(104.8-116.6)/63.6(58.4-68.8)mmHg, 76.3(70.2-82.5)bpm in the morning at March 12, 2011 (just after the earthquake), respectively. Home BP was immediately elevated just after the earthquake and gradually decreased over a month as we previously reported among hypertensive patients. Because we only analyzed BP who could keep their equipment, the BP change just after the earthquake might be underestimated. H. Metoki: Research Support Recipient; Commercial Interest: Omron Healthcare. N. Iwama: None. Z. Watanabe: None. T. Ohkubo: None. M. Ishikuro: None. T. Obara: None. M. Kikuya: None. J. Sugawara: None. S. Kuriyama: None. K. Itoh: None. K. Hoshi: None. M. Suzuki: None. M. Satoh: None. N. Yaegashi: None. Y. Imai: None. Copyright © 2014.
    Pregnancy hypertension; 01/2015
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    ABSTRACT: Residents of areas affected by the Great East Japan Earthquake may suffer from diseases or health problems. We are conducting a cross-sectional study from 2012 to 2015 to investigate and address the health needs of schoolchildren affected by this disaster. In this paper, we describe the protocol and research perspectives of our long-term child health study, and present the results obtained immediately after the disaster. The parent-administered questionnaire includes the International Study of Asthma and Allergies in Childhood questionnaire for asthma and eczema symptoms, the Strengths and Difficulties Questionnaire (SDQ), and a questionnaire on influenza infection and vaccination status. In 2012, we distributed the questionnaire to 3,505 (2(nd), 4(th), 6(th), and 8(th) graders) in three municipalities located in southern coastal area among the 28 municipalities, and 1,277 (36.4%) returned the completed questionnaire. Mean age was 11.1 ± 2.2 years old. The number of children with symptoms of wheeze and eczema in the past 12 months was 146 (11.4%) and 199 (15.6%), respectively. The SDQ total difficulties score revealed 174 (13.6%) children with some form of difficulty in their daily lives. From May 2011 to April 2012, 195 (15.3%) and 649 (50.8%) children received the influenza vaccination once and twice, respectively, and 532 (41.7%) had suffered from influenza. The prevalence of eczema symptoms or some form of difficulty was higher than the Japanese average. However, careful interpretation was required because of potential self-selection bias from the low response rate. We will continue this study of schoolchildren to provide aggregate findings.
    The Tohoku Journal of Experimental Medicine 01/2015; 236(2):123-30. DOI:10.1620/tjem.236.123 · 1.28 Impact Factor
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    ABSTRACT: To the Editor: The global population is aging.1 Pneumonia is a leading cause of death in elderly adults, especially those with dysphasia and microaspiration.2 Because aspiration pneumonia is related to impairment of the swallowing and cough reflex,3 the development of preventive strategies is needed to improve such protective reflexes to reduce the incidence of pneumonia in older people. In Japan, pneumonia is the third leading cause of death.4 It was previously reported that acupuzncture at two points on the legs (ST36 and KI3) improved the swallowing reflex after stroke5 and reduced pharyngeal retention and aspiration.6 To investigate the effectiveness of acupuncture with press needles in improving the swallowing reflex in elderly adults with cerebrovascular disease, a three-arm randomized double-blind controlled multicenter trial was conducted by incorporating sham patches and sham points. Individuals aged 65 and older who had had a stroke and had dysphasia were recruited consecutively from two hospitals and two nursing homes in Sendai, Japan. The purpose and design of the study were explained to each individual, and informed consent was obtained. The Tohoku University ethics committee approved the study protocol. Twenty-nine individuals (10 men, 19 women; mean age � SD 82.2 � 7.1) were recruited and assigned randomly to three groups: group 1, press needles (Pyonex; Seirin Corporation, Shizuoka, Japan) on the ST36 and KI3; group 2, sham patches on the acupuncture points; and group 3, press needles on sham points. The needles were 0.2 mm in diameter and 0.6 mm long. The design of the sham patch was identical to that of the press needle except most of the needle had been cut off, so that only the head of the needle remained in the resin. Patches were applied and changed every day for 4 weeks. Latent time of swallowing reflex (LTSR), plasma substance P (SP), Barthel Index, Mini-Mental State Examination, and days of fever were measured at baseline and 4 weeks later. Table 1 shows the outcomes of this study. The primary outcome was change in LTSR. A statistically significant shortening of LTSR was evident in Group 1 (6.9 � 2.3 vs 2.5 � 0.3 seconds, P = .005), whereas no statistically significant difference was observed in the other two groups. There was a significant difference between the three groups in change in LTSR (P = .009). Change in LTSR in Group 1 was significantly different from that in Group 2 (P = .008) but not Group 3 (P > .99). There was a significant difference in LTSR at day 28 between Groups 1 and 2 (P = .001), but no significant difference between Groups 1 and 3 (P = .51). Plasma SP did not change significantly during the study in any group, and no differences in secondary outcomes were observed in any group. between baseline and Day 28. Peripheral blood tests were performed to assess inflammatory and nutritional status. No statistically significant differences were observed in white blood cell count, C-reactive protein, total protein, albumin, or total cholesterol between baseline and Day 28. There were no significant differences in any parameters. Neither press needle nor sham needle treatment caused any side effects. Attachment of press needles at the two leg acupuncture points improved the swallowing reflex of elderly adults with cerebrovascular disease. Lack of a significant difference between acupuncture points and sham points indicates that the attachment of the fine needle itself has some effect on the swallowing reflex. Even if the press needles are placed at positions that deviate from the acupoints (e.g., sham points in this study), LTSR may improve, which is clinically convenient. This type of acupuncture may become a new adjuvant method for the prevention and treatment of pneumonia in elderly adults. The limitations of the present study were the small sample size and short follow-up time. In addition, only Group 3 included participants with extremely poor LTSR at baseline, which could have been why there was no difference between Groups 1 and 3 in LTSR at Day 28. Further studies are required to investigate the effect of the press needle on swallowing function.
    Journal of the American Geriatrics Society 12/2014; 62(12):2438. DOI:10.1111/jgs.13164. · 4.22 Impact Factor

Publication Stats

6k Citations
1,076.04 Total Impact Points


  • 1989–2015
    • Tohoku University
      • • Department of Gynecology
      • • Department of Obstetrics
      • • Graduate School of Medicine
      • • Division of Reproductive and Developmental Medicine
      • • Department of Microbiology and Immunology
      • • Department of Medical Genetics
      Miyagi, Japan
  • 2003–2013
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
    • Sendai University
      Sendai, Kagoshima, Japan
    • Yamagata University
      Ямагата, Yamagata, Japan
  • 1994–2013
    • Kinki University
      • Department of Obstetrics and Gynecology
      Ōsaka, Ōsaka, Japan
  • 2011
    • University of Western Australia
      • School of Women's and Infants' Health
      Perth, Western Australia, Australia
  • 2010
    • Tottori University
      • Department of Obstetrics and Gynecology
      TTJ, Tottori, Japan
    • Keio University
      • Department of Obstetrics and Gynecology
      Tokyo, Tokyo-to, Japan
    • Iwate Prefectural Central Hospital
      Aomori, Aomori Prefecture, Japan
    • Juntendo University
      • Department of Obstetrics and Gynecology
      Edo, Tōkyō, Japan
    • Osaka City General Hospital
      Ōsaka, Ōsaka, Japan
  • 2008
    • Hirosaki University
      • Department of Obstetrics and Gynecology
      Khirosaki, Aomori Prefecture, Japan
  • 2007
    • Kurume University
      • Department of Obstetrics and Gynecology
      Куруме, Fukuoka, Japan
    • RIKEN
      Вако, Saitama, Japan
    • National Defense Medical College
      • Division of Obstetrics and Gynecology
      Tokorozawa, Saitama-ken, Japan
  • 2006
    • Fukushima Medical University
      • Department of Obstetrics and Gynecology
      Hukusima, Fukushima, Japan
  • 2001
    • Hiroshima Prefectural University
      • School of Bioresources
      Hirosima, Hiroshima, Japan
  • 1996
    • Hachinohe City Hospital
      八戸, Aomori, Japan
  • 1995
    • Maine Institute for Human Genetics and Health
      Бангор, Maine, United States
  • 1991–1993
    • Fred Hutchinson Cancer Research Center
      Seattle, Washington, United States