Hiroshi Ito

Okayama University, Okayama, Okayama, Japan

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Publications (554)2357.53 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Recent clinical trials have demonstrated the efficacy of short-term treatment with tolvaptan, an oral vasopressin V2 receptor antagonist, in patients with heart failure. However, the response to tolvaptan varies among patients. The aim of this study was to determine factors associated with response to tolvaptan in patients with acute decompensated heart failure (ADHF). The Tolvaptan Registry, a prospective, observational, multicenter cohort study performed in Japan, aims to determine factors affecting the responsiveness of tolvaptan in patients with ADHF. We enrolled ADHF patients treated with tolvaptan and they were divided into two groups: responders and non-responders. Responders were defined as subjects who met all of the following three conditions: (1) increasing urine volume during a 24-hour period after the start of tolvaptan treatment; (2) improvement in New York Heart Association functional class; and (3) decrease in cardiothoracic ratio assessed by chest X-ray on day 3 of tolvaptan administration. Among the 114 patients, treatment with tolvaptan improved three conditions of heart failure in more than half of all the cohorts (71 patients, 62%). As for baseline characteristics, estimated glomerular filtration rate, urine osmolality, and kidney size were significantly greater in responders than in non-responders. Multivariate logistic analysis revealed that kidney size was independently associated with responders (odds ratio: 1.083, p=0.001, 95% confidence interval 1.031-1.137). The main clinical characteristic of responders to treatment with tolvaptan is that kidney size is preserved. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
    Journal of Cardiology 06/2015; DOI:10.1016/j.jjcc.2015.04.017 · 2.57 Impact Factor
  • Nature Physics 06/2015; DOI:10.1038/nphys3359 · 20.60 Impact Factor
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    ABSTRACT: Pulmonary arterial hypertension (PAH) is characterized by elevation of pulmonary artery pressure caused by pulmonary vasoconstriction and vascular remodeling, which leads to right heart failure and death. Epoprostenol (prostaglandin I2) has a potent short-acting vasodilator property, and intravenous continuous epoprostenol is therefore used for treatment of PAH. Here we review evidence for the usefulness of intravenous continuous epoprostenol therapy in patients with PAH. Epoprostenol therapy is effective in idiopathic PAH patients and in patients with PAH associated with connective tissue disease, portal hypertension or congenital heart diseases, but it is not effective in patients with pulmonary veno-occlusive disease or pulmonary capillary hemangiomatosis. High-dose epoprostenol therapy markedly improved hemodynamics in some patients with PAH, possibly due to reverse remodeling of pulmonary arteries. This therapy has several side effects and complications such as headache, hypotension and catheter-related infections. Intravenous continuous epoprostenol is an effective treatment, but there are still some problems to be resolved.
    Acta medica Okayama 06/2015; 69(3):129-36. · 0.75 Impact Factor
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    ABSTRACT: This book highlights recent advances in beta blockers research. Beta blockers have been used for the treatment of several clinical conditions and it is of paramount importance to understand their role and applications. Chapters of the book were written by experts in the fields of vascular disease, plastic surgery, cardiovascular medicine, pharmaceutical medicine and physiology from various countries such as the United States, the United Kingdom, Brazil, Japan and New Zealand. Clinical topics on recent advances in â-blockers research covered in this book include the clinical effectiveness of â-blockers in patients with peripheral arterial disease, abdominal aortic aneurysm, heart failure, acute coronary syndrome, pulmonary hypertension, object memory recognition, portal hypertension and infantile hemangioma. These chapters were written by authors who are experts in their fields and by researchers who are most up-to-date in the recent literature on advances in â-blockers research. This book would be of great value for researchers in the field of â-blockers and adds up-to-date knowledge on the use of this class of drugs in several diseases. It will certainly contribute additional, valuable knowledge to what is already known about this very important class of drugs. This book is also a valuable source of information for residents and medical students to help enable them to keep abreast with recent evidence concerning beta blockers.
    1 edited by Yousef Shahin, 06/2015; Nova Science Publishers, New York, USA., ISBN: 978-1-63482-423-1
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    ABSTRACT: Although the volume overload of pulmonary circulation improves after atrial septal defect (ASD) closure, the increasing left ventricular preload may contribute to mitral regurgitation (MR) deterioration. We aimed to evaluate the impact of MR after transcatheter ASD closure on clinical outcomes in adults. A total of 288 consecutive patients who underwent transcatheter ASD closure were enrolled. Changes in MR were assessed at 1 month after the procedure. The end point was defined as cardiovascular events. After the procedure, MR ameliorated in 3 patients and unchanged in 253, whereas MR deteriorated in 32. During a median follow-up of 24 months, patients with MR deterioration had no cardiovascular events, and the event-free survival rate was not different between patients with MR deterioration and those with MR amelioration or no-change (p = 0.355). Even in patients with MR deterioration, the New York Heart Association functional class improved after the procedure, with no cases of worsening functional class. Multivariate logistic regression analysis showed that MR deterioration was independently related to advanced age and female gender. The degree of enlargement of mitral valve annulus diameter after the procedure was greater in patients with MR deterioration than in those with MR amelioration or no-change, and it was correlated with the degree of MR deterioration. In conclusion, MR deterioration occurs in a minority of adult patients after transcatheter ASD closure; however, it is not linked with adverse outcomes. MR deterioration may be provoked by geometric changes in mitral valve annulus, especially in women with advanced age. Copyright © 2015 Elsevier Inc. All rights reserved.
    The American journal of cardiology 05/2015; DOI:10.1016/j.amjcard.2015.04.042 · 3.43 Impact Factor
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    ABSTRACT: Cardiac CT is an excellent tool for evaluating the anatomy of a secundum atrial septal defect (ASD). However, a comprehensive assessment of its usefulness, including measurement of the pulmonary to systemic blood flow ratio in secundum ASD patients, has not been performed. Therefore, this study was designed to evaluate the usefulness of CT for assessing the hemodynamics of secundum ASD in adults compared with transesophageal echocardiography (TEE), transthoracic echocardiography, and invasive catheterization. Fifty adult patients with secundum ASD were enrolled. Cardiac CT scans (128-slice multidetector CT instrument) were acquired. These were followed by 2-dimensional reconstruction of the secundum ASDs to determine the defect size, the rim length between the outer edge of the defect, and the pulmonary to systemic blood flow (Qp/Qs) ratio. The maximum sizes of the secundum ASDs derived from CT and TEE studies were comparable (21.2 ± 8.0 vs 20.0 ± 7.3 mm; P = .41; r = 0.960; P < .001). The rim lengths for the aortic, mitral, and tricuspid valves; the inferior vena cava; and posterior atrium were also comparable between CT and TEE measurements. The mean Qp/Qs ratio that was derived from CT measurements was comparable with that found by invasive catheterization (2.3 ± 0.7 vs 2.3 ± 0.8; P = .73; r = 0.786; P < .001). Cardiac CT is feasible for assessing pathology and the severity of secundum ASD in adults. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
    Journal of Cardiovascular Computed Tomography 05/2015; 9(4). DOI:10.1016/j.jcct.2015.04.007 · 4.51 Impact Factor
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    ABSTRACT: Cystatin C is an endogenous marker of kidney function that overcomes the limitations of serum creatinine. High serum cystatin C levels have been associated with increased cardiovascular mortality and morbidity. In this cross-sectional study, we aimed to determine the associations between serum cystatin C levels and structural and functional cardiac changes in patients with stage 2 or 3 chronic kidney disease (CKD). We enrolled 429 consecutive patients (aged 24-97years) with CKD stage 2 or 3 and left ventricular (LV) ejection fraction (LVEF)>40%. Echocardiographic parameters, including LV mass index (LVMI), early diastolic mitral annulus velocity (e' velocity), left atrial volume index (LAVI), and N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) were measured. Patients were categorized into quartiles according to serum cystatin C levels. Cystatin C was associated with LAVI (p=0.0055), LVEF (p=0.0432), LVMI (p=0.0409), e' (p=0.0051), E/e' (p=0.0027), and log-transformed NT-proBNP (p<0.0001) according to multivariate linear regression analysis, after adjustment for confounding factors including creatinine-based estimated glomerular filtration rate (eGFRcreat) and urinary albumin to creatinine ratio. Incidence of eccentric and concentric hypertrophy increased with increasing cystatin C (Q1, 38%; Q2 49%; Q3, 51%; Q4, 66%, p=0.0008), mainly because of increasing concentric hypertrophy (Q1, 30%; Q2, 39%; Q3, 39%; Q4, 51%, p=0.0187). A high serum cystatin C is strongly associated with structural cardiac abnormalities such as LVH and left atrial enlargement, impaired LV relaxation, and an increased NT-proBNP, independently of eGFRcreat in patients with stage 2 or 3 CKD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    International journal of cardiology 04/2015; 190:287-292. DOI:10.1016/j.ijcard.2015.04.189 · 6.18 Impact Factor
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    ABSTRACT: Platelet-derived growth factor (PDGF) is implicated in the pathogenesis of pulmonary arterial hypertension (PAH). Imatinib, a PDGF-receptor tyrosine kinase inhibitor, improved hemodynamics, but serious side effects and drug discontinuation are common when treating PAH. A drug delivery system using nanoparticles (NPs) enables the reduction of side effects while maintaining the effects of the drug. We examined the efficacy of imatinib-incorporated NPs (Ima-NPs) in a rat model and in human PAH-pulmonary arterial smooth muscle cells (PASMCs). Rats received a single intratracheal administration of PBS, FITC-NPs, or Ima-NPs immediately after monocrotaline injection. Three weeks after monocrotaline injection, intratracheal administration of Ima-NPs suppressed the development of pulmonary hypertension, small pulmonary artery remodeling, and right ventricular hypertrophy in the rat model of monocrotaline-induced PAH. We also examined the effects of imatinib and Ima-NPs on PDGF-induced proliferation of human PAH-PASMCs by (3)H-thymidine incorporation. Imatinib and Ima-NPs significantly inhibited proliferation after 24 hours of treatment. Ima-NPs significantly inhibited proliferation compared with imatinib at 24 hours after removal of these drugs. Delivery of Ima-NPs into lungs suppressed the development of MCT-induced PAH by sustained antiproliferative effects on PAS-MCs.
    International Heart Journal 04/2015; 56(3). DOI:10.1536/ihj.14-338 · 1.13 Impact Factor
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    ABSTRACT: The increase in proprotein convertase subtilisin/kexin type 9 (PCSK9) leads to low-density lipoprotein (LDL) receptor degradation. Statins significantly reduce LDL-cholesterol levels, but upregulate PCSK9. This study evaluated the effect of ezetimibe monotherapy or ezetimibe in combination with a statin on serum levels of PCSK9 in patients with type 2 diabetes and hypercholesterolemia. Ezetimibe treatment was given to ten patients with diabetes without statin therapy and ten patients with statin therapy. Plasma levels of PCSK9 were examined at baseline and 24 weeks after treatment. At baseline, PCSK9 concentrations in patients with statin therapy were significantly higher than those in patients without statin use and in control subjects [median (25th-75th percentile) 411 (272-467) and 382 (356-453) ng/mL, respectively, p < 0.01]. After ezetimibe treatment for 24 weeks, LDL-cholesterol, triglyceride and remnant-like lipoprotein cholesterol were significantly decreased in both groups. However, PCSK9 concentration did not change compared with baseline measurements in both groups. The percentage change in LDL-cholesterol after ezetimibe therapy for 24 weeks was not correlated with the percentage change in PCSK9 concentration. Ezetimibe may reduce LDL-cholesterol levels without affecting PCSK9 in patients with type 2 diabetes and hypercholesterolemia.
    American Journal of Cardiovascular Drugs 04/2015; 15(3). DOI:10.1007/s40256-015-0119-2 · 2.20 Impact Factor
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    ABSTRACT: This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age. The clinical benefits of transcatheter ASD closure in this aged population are controversial. A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed. During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    JACC. Cardiovascular Interventions 04/2015; 8(4):600-6. DOI:10.1016/j.jcin.2015.02.002 · 7.44 Impact Factor
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    ABSTRACT: Ambulatory measurement of intrathoracic impedance (ITI) with an implanted device may detect increases in pulmonary fluid retention early, but the clinical utility of this method is not well established. The goal of this study was to test whether conventional ITI-derived parameters can diagnose fluid retention that may cause early stage heart failure (HF).Methods and Results:HF patients implanted with high-energy devices with OptiVol (Medtronic) monitoring were enrolled in this study. Patients were monitored remotely. At both baseline and OptiVol alert, patients were assessed on standard examinations, including analysis of serum brain natriuretic peptide (BNP). From April 2010 to August 2011, 195 patients from 12 institutes were enrolled. There were 154 primary OptiVol alert events. BNP level at the alerts was not significantly different from that at baseline. Given that ITI was inversely correlated with log BNP, we added a criterion specifying that the OptiVol alert is triggered only when ITI decreases by ≥4% from baseline. This change improved the diagnostic potential of increase in BNP at OptiVol alert (sensitivity, 75%; specificity, 88%). BNP increase could not be identified based on OptiVol alert. Decrease in ITI ≥4% compared with baseline, in addition to the alert, however, may be a useful marker for the likelihood of HF (Clinical trial info: UMIN000003351).
    Circulation Journal 03/2015; 79(6). DOI:10.1253/circj.CJ-15-0076 · 3.69 Impact Factor
  • Journal of the American College of Cardiology 03/2015; 65(10):A1728. DOI:10.1016/S0735-1097(15)61728-4 · 15.34 Impact Factor
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    European Heart Journal – Cardiovascular Imaging 02/2015; DOI:10.1093/ehjci/jev038 · 2.65 Impact Factor
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    ABSTRACT: Physical examination as an initial screening tool to diagnose abdominal aortic aneurysm (AAA) has lost favor over the past 20 years. This multicenter cohort study aimed to determine the prevalence of AAA in elderly Japanese patients with hypertension (HT) and to clarify the diagnostic accuracy of physical examination using a pocket-sized ultrasound imaging device (the "pocket-echo").Methods and Results:A total of 1,731 patients with HT aged >60 years from 20 collaborating institutions were enrolled in this study. Abdominal palpation was performed on physical examination, and the pocket-echo was used to confirm the diagnosis of AAA. The abdominal aorta was well visualized in 1,692 patients (98%). AAA was discovered in 69 patients (4.1%), with advanced age and male sex identified as independent risk factors. The prevalence of AAA increased according to age regardless of sex, and reached 9.2% and 5.7%, respectively, in males and females ≥80 years. Overall, 33 cases of AAA were missed on abdominal palpation (sensitivity, 52%), whereas for AAAs >40 mm, the sensitivity was 75%. We assessed the utility of the pocket-echo and physical examination for diagnosing AAA in Japanese patients with HT aged over 60 years. Our findings highlight the importance of AAA screening programs in high-risk Japanese populations, and confirm the ability of physical examination to detect large, but not small, AAAs. (Circ J 2015; 79: 524-529).
    Circulation Journal 02/2015; 79(3). DOI:10.1253/circj.CJ-14-0972 · 3.69 Impact Factor
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    ABSTRACT: Patients with probable cardiac sarcoidosis (CS) who satisfy only clinical cardiac findings for CS are not uncommon. The aim of this study was to compare outcomes between patients with probable CS and those with definite CS treated with steroids. The study population consisted of 101 consecutive patients who satisfied clinical cardiac findings for CS. Patients with definite CS were defined as having histologic or clinical confirmation of CS according to the guidelines and were treated with steroids. Patients with probable CS were defined as having only clinical cardiac findings but not definite CS because of no histologic confirmation or extracardiac sarcoidosis and were not treated with steroids. The end point was major adverse cardiac events. Forty-seven patients had definite CS, and the other 54 had probable CS. Except for serum angiotensin-converting enzyme levels and left ventricular dysfunction, clinical characteristics were similar between the 2 groups. Over a median follow-up period of 15 months, major adverse cardiac events occurred more frequently in patients with probable CS than in those with definite CS (74% vs 53%, p = 0.029). The event-free survival rate was worse in patients with probable CS than in those with definite CS (log-rank test, p = 0.006). Cox proportional-hazards analysis showed that probable CS was an independent predictor of major adverse cardiac events. In conclusion, outcomes were worse in patients with probable CS than in those with definite CS treated with steroids. The initiation of steroid treatment may be considered for patients who satisfy only clinical cardiac findings for CS. Copyright © 2015 Elsevier Inc. All rights reserved.
    The American Journal of Cardiology 02/2015; 115(9). DOI:10.1016/j.amjcard.2015.01.562 · 3.43 Impact Factor
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    ABSTRACT: Coronary artery calcification (CAC) is associated with the incidence of congestive heart failure. We evaluated the association between CAC and left ventricular diastolic dysfunction (LVDD) in elderly patients without coronary artery disease. Coronary computed tomography was performed in 1,021 consecutive patients >55 years of age who were suspected of having coronary artery disease. A total of 530 patients (age, 70 ± 8 years; 56 % men) with a LV ejection fraction >50 % and without obstructive coronary artery disease and a history of coronary artery disease were included in the analysis. LVDD was defined according to a standard algorithm by echocardiography (septal e' <8, lateral e' <10, and left atrial volume index ≥34 mL/m(2)). A total of 224 of 530 patients had LVDD. CAC scores in patients with LVDD were higher than those in patients without LVDD (p < 0.01). The prevalence of LVDD in patients with CAC scores ≥400 was greater than that in patients with CAC scores of 0-9 (58 vs. 34 %, p < 0.01). After adjustment for confounding factors, the CAC score was associated with LVDD, with an odds ratio of 1.96 (95 % confidence interval: 1.11-3.43, p = 0.02) for a CAC score ≥400 compared with a CAC score of 0-9. A CAC score ≥400 was associated with LVDD in elderly patients without CAD in this population. Further prospective studies are needed to evaluate the clinical relevance of CAC as a risk of heart failure with preserved ejection fraction.
    Heart and Vessels 02/2015; DOI:10.1007/s00380-015-0645-5 · 2.11 Impact Factor
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    ABSTRACT: Critical behaviors indicating an insulator-metal (IM) transition are observed in poly(2,5-bis(3-hexadecylthiophene-2-yl)thieno[3,2-b]thiophene) [PBTTT] in ionic-liquid-gated transistors. At room temperature, a maximum channel conductivity of 300 S cm−1 is achieved at the doping concentration of 1021 cm−3. The conductivity shows a very weak temperature dependence; the conductivity at 5 K is only 1.6 times lower than that at 250 K. The signature of the IM transition at low temperatures is evidenced by the results of Zabrodskii plot analysis. The IM transition is benefitted by the semicrystalline lamellar structure of PBTTT enhanced by the substrate treatment with a self-assembled monolayer.
    Applied Physics Express 02/2015; 8(2):021601. DOI:10.7567/APEX.8.021601 · 2.57 Impact Factor
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    ABSTRACT: RIPC reduced acute kidney injury after emergency percutaneous coronary intervention.•RIPC was safe and was an easy strategy in real clinical settings.•RIPC is a promising strategy in patients with ST-elevation myocardial infarction.
    International Journal of Cardiology 01/2015; 178. DOI:10.1016/j.ijcard.2014.10.135 · 6.18 Impact Factor
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    ABSTRACT: A simplified diagnostic/monitoring instrument for use in primary screening for sleep-disordered breathing (SDB) has been desired. This study was designed to assess the validity of a newly developed piezoelectric sensor as a simple and noninvasive tool for primary screening for sleep-disordered breathing. Forty-three consecutive patients suspected of having sleep-disordered breathing and 10 healthy volunteers were enrolled. Breathing movement was detected with the piezoelectric sensor (180 × 30 × 1 mm), which was placed under a bed sheet under patients, and simultaneous polysomnographic recordings were obtained. We counted the number of apneas of >10 s, irrespective of central or obstructive, that appeared during Cheyne-Stokes-like breathing with a waxing and waning pattern with an amplitude ratio of >10 in the piezoelectric sensor signal. The correlation coefficient between the number of apneas and apnea–hypopnea index (AHI) was 0.74 (P < 0.0001). The sensitivity/specificity of the number of apneas for distinguishing non-SDB patients from mild SDB patients (AHI ≥ 5) were 92.1/60.0% and those for separating moderate to severe (AHI ≥ 15) and severe (AHI ≥ 30) SDB patients from the other patients were 96.9/100% and 93.8/86.5%, respectively. There were no complaints from patients about the use of the piezoelectric sensor. The results indicate that the number of apneas detected by this piezoelectric sensor during Cheyne-Stokes-like breathing is a potential new index for primary screening for SDB at least for cardiac patients. Thus, the piezoelectric-sensor system might be useful for simple, noninvasive and comfortable SDB screening at home, hospitals and health care facilities.
    Sleep and Biological Rhythms 01/2015; 13(1). DOI:10.1111/sbr.12097 · 0.76 Impact Factor
  • Vascular Health and Risk Management 01/2015; DOI:10.2147/VHRM.S50368

Publication Stats

7k Citations
2,357.53 Total Impact Points


  • 2009–2015
    • Okayama University
      • • Department of Radiology
      • • Department of Cardiovascular Medicine
      Okayama, Okayama, Japan
  • 2005–2015
    • Akita University
      • • Department of Cardiovascular and Respiratory Medicine
      • • Faculty of Medicine
      Akita, Akita, Japan
    • University of Hyogo
      • Department of Material Science
      Kōbe, Hyōgo, Japan
    • Osaka Rosai Hospital
      Ōsaka, Ōsaka, Japan
    • Osaka Police Hospital
      Ōsaka, Ōsaka, Japan
  • 2005–2014
    • Akita University Hospital
      Akita, Akita, Japan
  • 2004–2014
    • Nagoya University
      • • Graduate School of Engineering
      • • Research Center for Materials Science
      Nagoya, Aichi, Japan
  • 2013
    • Saitama Medical University
      • Center for Maternal, Fetal and Neonatal Medicine
      Saitama, Saitama, Japan
  • 2011
    • Fukaya Red Cross Hospital
      Fukaya, Saitama, Japan
  • 1992–2011
    • Sakurabashi Watanabe Hospital
      Ōsaka, Ōsaka, Japan
  • 1991–2011
    • Tokyo Medical and Dental University
      • • Department of Cardiovascular Medicine
      • • Department of Internal Medicine
      Tokyo, Tokyo-to, Japan
  • 2010
    • Minami Okayama Medical Center
      Okayama, Okayama, Japan
  • 2008
    • Juntendo University
      Edo, Tōkyō, Japan
  • 1996–2008
    • Chiba University
      • • Graduate School of Medicine
      • • Department of Oral Surgery
      Tiba, Chiba, Japan
  • 1995–2007
    • Yamaguchi University
      • • Graduate School of Medicine
      • • Department of Medical Bioregulation
      • • Department of Stress and Bio-response Medicine
      • • Yamaguchi University Hospital
      Yamaguti, Yamaguchi, Japan
    • Himeji Institute of Technology
      • Department of Material Science
      Himezi, Hyōgo, Japan
  • 2006
    • Tohoku University
      • Department of Chemistry
      Sendai-shi, Miyagi-ken, Japan
    • Tokyo Metropolitan University
      • Department of Chemistry
      Edo, Tōkyō, Japan
  • 2004–2006
    • Massachusetts General Hospital
      • Transplantation Biology Research Center
      Boston, MA, United States
  • 1999–2004
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2003
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
    • Musashino Red Cross Hospital
      Edo, Tōkyō, Japan
  • 1998–2001
    • Chiba University Hospital
      Tiba, Chiba, Japan
  • 1992–1997
    • Kyoto University
      • • Division of Chemistry
      • • Department of Physics II
      Kioto, Kyōto, Japan
  • 1994
    • Université Paris-Sud 11
      • Laboratoire de Physique des Solides
      Orsay, Île-de-France, France