Shinichi Egawa

Tohoku University | Tohokudai · International Research Institute of Disaster Science (IRIDeS)

Introduction: In Japan, evacuation at home is expected to increase in the future as a post-disaster evacuation type due to the pandemic, aging, and diverse disabilities of the population. However, more disaster-related indirect deaths occurred in homes than in evacuation centers after the 2011 Great East Japan Earthquake (GEJE). The health risks f...

The COVID-19 pandemic has been a continual challenge since 2020, and it continues to impact people and industries as a disaster caused by a biological hazard. This study examined universal health coverage (UHC) scores in relation to the performance in combating COVID-19 in the Southeast Asian region (SEAR) and the Western Pacific region (WPR), alon...

Russia’s invasion of Ukraine (February 24, 2022) has begun and there are concerns about the impact on health care supply and mental health. This study analyzed tweets in the Ukrainian language to capture the medical needs and mental health conditions in wartime Ukraine by focusing on ostensibly relevant words. The number of tweets containing the ke...

Introduction Health workforce development is essential for achieving the goals of an effective health system, as well as establishing national Health Emergency and Disaster Risk Management (Health EDRM). Study Objective The objective of this Delphi consensus study was to identify strategic recommendations for strengthening the workforce for Health...

In this study, the impact of hypothermia during tsunami disasters based on casualty data from Miyagi Prefecture during the Great East Japan Earthquake was analyzed. The spatial distribution of the locations in which the corpses of hypothermia victims were found and the effects of age group, location, environmental temperature, and tsunami exposure...

Objectives An earthquake followed by tsunami and liquefaction on September 28, 2018, in Central Sulawesi caused health system disruptions. This study aimed to know health system disruption at the primary health center (PHC) level due to the disaster in 3 districts (Palu, Sigi, Donggala) of Central Sulawesi. Methods This was a qualitative study con...

Disaster endangers the nutritional health of children with resulting effects on their mental, physical, and social well-being. Adequate infant and young child feeding (IYCF) in disaster prevents malnutrition and save lives. Although much progress has been made in nutritional support in disaster, malnutrition among children is still evident. This sc...

The 2011 Great East Japan Earthquake caused massive devastation and numerous affected people. In particular, the Ishinomaki area of the Miyagi Prefecture was one of the hardest hit areas during the event. In addition, due to tsunami inundation, several medical facilities were destroyed or inactive at the time. The Ishinomaki Red Cross Hospital serv...

To reveal gene-environment interactions underlying common diseases and estimate the risk for common diseases, the Tohoku Medical Megabank (TMM) project has conducted prospective cohort studies and genomic and multiomics analyses. To establish an integrated biobank, we developed an integrated database called “dbTMM” that incorporates both the indivi...

Sports play a functional role in human development. Regular sport participation has beneficial effects on physical, psychological and social wellbeing. It has positive effects on prevention and treatment of non-communicable diseases, physical appearance, enhance self-concept and external prestige, lower rates of suicidal ideation, reduce use of fos...

The World Health Organization (WHO) and its partners established the WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (HEALTH EDRM RN) in 2016 to respond to the increasing burden of recent health emergencies and disasters. The mission of the HEALTH EDRM RN, whose secretariat is located at the WHO Kobe Centre...

The Sendai Framework for Disaster Risk Reduction 2015–2030 placed human health at the centre of disaster risk reduction, calling for the global community to enhance local and national health emergency and disaster risk management (Health EDRM). The Health EDRM Framework, published in 2019, describes the functions required for comprehensive disaster...

The 2011 Great East Japan Earthquake (GEJE) has renewed the paradigm of disaster medicine. The Tohoku Journal of Experimental Medicine (TJEM) widened its scope to include the disaster science from the health perspectives. TJEM has been accumulating 76 articles related with “disaster” or “pandemic” out of which 69 were published after 2011. Tohoku U...

The increasing prevalence and cross-national nature of disasters means countries have much to learn from each other in terms of Disaster Risk Reduction (DRR). However, cross-nation mutual learning are often hindered by distance and language barriers. Japan and Indonesia, as countries with significant similarities and differences in terms of disaste...

Background: Surgery for patients with chronic pancreatitis (CP) is recommended when medical and endoscopic treatments fail in the Japanese practice guidelines. However, the optimal timing of surgery is not mentioned. Purpose: To investigate the optimal timing of surgery for CP. Methods: Postoperative outcomes were compared between patients undergoi...

During a disaster, all hospitals are expected to function as “social critical institutions” that protect the lives and health of people. In recent disasters, numerous hospitals were damaged, and this hampered the recovery of the affected communities. Had these hospitals business continuity plans (BCPs) to recover quickly after the disaster, most of...

In 2011, Minamisanriku Town lost all of its medical facilities during the Great East Japan Earthquake. Using 10,459 anonymized disaster medical records of affected people in Minamisanriku Town, we assessed the prevalence and risk factors of sleep disturbance, which is known to exacerbate non-communicable diseases (NCDs) and anxiety disorder. Becaus...

: Leptospirosis becomes severe, with a fatality rate of >10%, and manifests as severe lung injury accompanied by acute kidney injury. Using urine and blood samples of 112 patients with leptospirosis, osteopontin (OPN), galectin-9 (Gal-9) and other kidney-related biomarkers were measured to understand the pathological and diagnostic roles of OPN and...

Background: Total pancreatectomy is required to completely clear tumours that are locally advanced or located in the centre of the pancreas. However, reports describing clinical outcomes after total pancreatectomy are rare. The aim of this retrospective observational study was to assess clinical outcomes following total pancreatectomy using a nati...

Background We established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environmental interactions on the incidence of major diseases such as cancer and cardiovascular diseases. Methods We asked participants to join our cohort in the health check-up settings and assessm...

Background: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry-based study was to clarify the clinical implications of operative resection in patients who had positive cytology s...

The medical records of service in disaster provided at a place other than a medical facility are defined as disaster medical records (DMRs). In this epidemiological study, to clarify medical need characteristics and trends after disaster, we analyzed the all anonymized DMRs of Minamisanriku Town that lost medical facilities in 2011 Great East Japan...

Introduction Sendai Framework for Disaster Risk Reduction 2015-2030, for the first time, describes how disaster affects the health of people. Japan is prone to natural hazards, but at the same time, Japan has achieved one of the highest life expectancies (LE) in the world. After experiencing many disasters, Japan seems to have achieved resilience a...

Objective Pneumonia remains the leading cause of hospitalisations and deaths among children aged <5 years. Diverse respiratory pathogens cause acute respiratory infections, including pneumonia. Here, we analysed viral and bacterial pathogens and risk factors associated with death of hospitalised children. Design A 9-year case series study. Settin...

A healthy community is a community resilient to disaster. The Sendai Framework for Disaster Risk Reduction considers disaster impacts on health and encourages the implementation of disaster medicine and access to mental health services. Life expectancy (LE) is a basic statistic that indicates public health achievements and social development, inclu...

Purpose The Frey procedure is an effective surgery for chronic pancreatitis (CP) patients who have pancreatic head lesions with dilation of the main pancreatic duct. However, pancreatic tail lesions can cause relapsing pancreatitis after the procedure. Therefore, additional distal pancreatectomy (DP) might complement the therapeutic effect of the F...

Healthcare workers (HCWs) are often exposed to nosocomial infection when caring for patients with Ebola Virus Disease (EVD). During the 2014-2016 EVD outbreak in West Africa, more than 200 HCWs died of EVD in Sierra Leone. To determine the factors that are important for preventing infection among HCWs during EVD outbreak, we used agent-based modeli...

After the Great East Japan Earthquake (GEJE) and Tsunami in 2011, the physical and mental health of the affected people showed completely different characteristics from those of earlier disasters. Despite the lower number of injured people compared to those affected by the Great Hanshin Awaji Earthquake (GHAE) in 1995, the health needs were mainly...

We investigated the efficacy of a Wilms' tumor gene 1 (WT1) vaccine combined with gemcitabine (GEMWT1) and compared it to gemcitabine (GEM) monotherapy for advanced pancreatic ductal adenocarcinoma (PDAC) in a randomized phase II study. We randomly assigned HLA-A*02:01- or HLA-A*24:02-positive patients with advanced PDAC to receive GEMWT1 or GEM. W...

Background The prognosis for pancreatic cancer remains dismal because many patients are diagnosed with unresectable cancer at the initial diagnosis. Recently, conversion surgery was reported as an effective treatment for initially unresectable pancreatic cancer with a favorable response to non-surgical treatment lasting over 240 days. Here, we desc...

Objective Noncommunicable diseases (NCDs), including mental disorders, have become major threats to human health worldwide. People with NCDs are particularly vulnerable to disasters. We systematically reviewed reports describing studies of NCDs at the time of the Great East Japan Earthquake (GEJE) to clarify the circumstances of people with NCDs an...

The rare and deadly Ebola virus disease (EVD) is caused by Ebola virus (EBOV) infection. The 2014-2015 EVD outbreak in West Africa was unprecedented. Person-to-person transmission of EBOV by direct contact with the body or bodily fluids of an infected person through broken skin or unprotected mucous membrane caused rapid outbreak in communities. No...

In the 2011 Great East Japan Earthquake (GEJE), successful medical and public health coordination by pre-assigned disaster medical coordinators saved many affected people, though the coordination itself had difficulties. This study aims to clarify the implementation and the challenges of disaster medical coordinators in Japan. We performed question...

Damage-associated molecular patterns (DAMPs) are endogenous cellular molecules released to the extracellular environment in response to stress conditions such as virus infection. Galectins are β-galactoside-binding proteins that are widely expressed in cells and tissues of the immune system, are localized in the cell cytoplasm, and have roles in in...

Along with large-scale loss of life, infrastructural damage, and material losses, health issues have become a crucially important problem after natural disasters. Survivors must confront the threat of health risks, especially infectious diseases, as a result of limited health supplies, services, and facilities. Limited knowledge about health risks...

PurposeThe GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-ter...

Purpose: To evaluate the risk factors for peritoneal recurrence (PR) of pancreatic adenocarcinoma and to discuss the appropriate management strategies. Methods: We reviewed the medical records of 236 patients who underwent pancreatectomy for pancreatic adenocarcinoma. We then compared the clinicopathological characteristics of patients with vs....

Study/Objective The aim of this study is to create a system-dynamics model simulating the medical needs in a disaster for the assessment of medical needs and decision making. Background In the Great East Japan Earthquake (GEJE) of 2011, the medical response team faced less patients with injury than expected, but an excess of patients with non-comm...

The patient was an 85-year-old woman with poor appetite and fatigue. She was referred to us after a giant cystic tumor was observed on abdominal US. CT revealed a 15-cm cystic lesion that extended to the pelvis and scattered nodular lesions with contrast enhancement, which suggested a malignant tumor. ERCP showed communication with the pancreatic d...

Objective: This study was performed to compare health-related quality of life (HRQOL) of gemcitabine plus S-1 (GS), S-1 alone and gemcitabine alone as first-line chemotherapy for locally advanced or metastatic pancreatic cancer in the GEST (Gemcitabine and TS-1 Trial) study and to assess the impacts of adverse events and tumour response on HRQOL....

Osteopontin (OPN) is a multifunctional matricellular protein produced by a broad range of cells including osteoclasts, macrophages, T cells, endothelial cells, and vascular smooth muscle cells. OPN modulates various physiological and pathological events such as inflammation, wound healing, and bone formation and remodeling. Dengue virus (DENV) infe...

Objectives: Platelet-derived growth factor receptor beta (PDGFRβ) and hepatocyte growth factor receptor (MET) expressed on pancreatic stellate cells (PSCs) are suggested as important components modulating the interactions between pancreatic cancer cells (PCCs) and PSCs. The objective of this study is to clarify the effect of MK2461, a multikinase...

Background Galectin-9 (Gal-9) is a β-galactoside-binding lectin that interacts with sugar moieties on glycoproteins and glycolipids of cells and pathogens. Gal-9 is known as an immune modulator that induces cell death via interaction with T cell immunoglobulin and mucin domain-3 (Tim3), a co-inhibitory receptor, and it inhibits production of severa...

The Great East Japan Earthquake (GEJE) and resulting tsunami of March 11, 2011 gave rise to devastating damage on the Pacific coast of the Tohoku region. The Tohoku Medical Megabank Project (TMM), which is being conducted by Tohoku University Tohoku Medical Megabank Organization (ToMMo) and Iwate Medical University Iwate Tohoku Medical Megabank Org...

Background Lymph node dissection in Rouviere’s sulcus (RS) is essential during left-sided hepatectomy and caudate lobectomy for hilar cholangiocarcinoma. However, the small segmental or subsegmental arteries (SA/SSA) are often encountered in RS and must be preserved to prevent critical complications, such as liver infarction or liver failure. The a...

Objectives: The aim of this study was to determine the characteristics of patients with pancreatic ductal adenocarcinoma younger than 40 years. Methods: Data from the Japan Pancreas Society's nationwide Pancreatic Cancer Registry were analyzed retrospectively. Clinicopathological characteristics were compared in patients who were grouped accordi...

After disaster, the victims lose their safe lives and are even exposed to nature where they could suffer from animal bites and vectors followed by suffering from zoonosis or vector-born diseases. Because of the urgent need for rapid and cheap diagnosis for infectious diseases after disaster, anonymous questionnaire clarified that leptospirosis, den...

We report a rare surgical case of metachronous multicentric pancreatic cancer with multiple intraductal papillary mucinous neoplasms (IPMN). A 58-year-old woman with diabetes mellitus and a family history of pancreatic cancer (her father suffered from pancreatic cancer), was admitted to our hospital because of backache in November 2008. Distal panc...

In Indonesia, the Aceh earthquake and tsunami in 2004 killed 127,000 people and caused half a million injuries, while the Yogyakarta earthquake in 2006 caused 5,700 deaths and 37,000 injuries. Because disaster-affected areas are vulnerable to epidemic-prone diseases and tetanus is one such disease that is preventable, we systematically reviewed the...

Background: In the GEST study of unresectable pancreatic cancer, S-1 demonstrated non-inferiority compared to gemcitabine, but gemcitabine plus S-1 (GS) did not show superiority over gemcitabine for overall survival (OS). We performed subgroup analysis of these data focused on the efficacy and safety of these regimens as a first-line treatment for...

Background/objective: To evaluate the usefulness of genetic markers in pancreatic juice (PJ), and the combination of these markers with telomerase activity in the differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) from chronic pancreatitis. Methods: We conducted a meta-analysis for the diagnostic utility of the four major altered...

Objective: The aim of the study was to evaluate the relationship between hospital volume and outcome after pancreaticoduodenectomy (PD). Summary background data: Previous reviews for the hospital volume-outcome relationship after pancreatic resection were limited owing to clinical or methodological heterogeneity, resulting from differences in su...

Objectives: The occurrence of hepatic steatosis after pancreatectomy is known to be associated with the remnant pancreatic function. However, other risk factors for hepatic steatosis after pancreatectomy remain unknown. The aims of this study were to identify other risk factors in addition to the remnant pancreatic function and elucidate the relat...

Background: The efficacy of intramuscular islet transplantation is poor despite being technically simple, safe, and associated with reduced rates of severe complications. We evaluated the efficacy of combined treatment with extracellular matrix (ECM) and growth factors in intramuscular islet transplantation. Methods: Male BALB/C mice were used f...

IRIDeS Fact Finding Mission to Nepal - Volume 9 Issue 5 - Shinichi Egawa

The aim of the study was to clarify clinicopathological features of type 2 autoimmune pancreatitis (AIP) in Japan; a multicenter survey was carried out. The first screening collected patients with pancreatitis whose pancreatic tissue samples were available and who fulfilled at least 1 of the following 3 criteria as possible type 2 AIP: (1) histolog...

Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA Pancreatic cancer is characterized excessive desmoplasia, which occupies 80% of pancreatic cancer tissue and mainly consists of pancreatic stellate cells (PSCs). Desmoplasia has been shown to play an important role in the progression, invasion, and metastasis of pancr...

Background: Pancreatic ductal adenocarcinoma (PDAC) shows frequent genomic alterations in the 4 major genes, KRAS, CDKN2A/p16, TP53, and SMAD4/DPC4. Furthermore, a recent high-sensitivity mutational analysis discovered KRAS mutations in over 90% of pancreatic intraepithelial neoplasms. The genomic alterations of those genes in the pancreatic juice...

The canonical Wnt/β-catenin signaling pathway has been shown to promote the epithelial-mesenchymal transition (EMT), which is a crucial process in multiple embryonic developmental processes and the progression of carcinomas. We recently provided evidence that leucine-rich repeat flightless-1-interacting protein 1 (LRRFIP1) promotes cancer metastasi...

The Sendai Framework for Disaster Risk Reduction 2015–2030 (SFDRR) is the first global policy framework of the United Nations’ post-2015 agenda. It represents a step in the direction of global policy coherence with explicit reference to health, development, and climate change. To develop SFDRR, the United Nations Office for Disaster Risk Reduction...

Islet autotransplantation following total pancreatectomy differs from allograft transplantation with respect to the requirement of biliary reconstruction. Although it is known that careful consideration should be given to postoperative cholestatic liver injury after biliary reconstruction, its direct effects on transplanted islets have not been com...