KEIO JOURNAL OF MEDICINE最新文献_第6页

A Theory of Diagnostic Testing to Stop the Virus Spreading: Evidence-based Reasoning to Resolve the COVID-19 Crisis by Testing. 阻止病毒传播的诊断测试理论:基于证据的测试推理解决COVID-19危机。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2022-03-25 Epub Date: 2022-02-02 DOI: 10.2302/kjm.2021-0009-IR

Isao Kamae

{"title":"A Theory of Diagnostic Testing to Stop the Virus Spreading: Evidence-based Reasoning to Resolve the COVID-19 Crisis by Testing.","authors":"Isao Kamae","doi":"10.2302/kjm.2021-0009-IR","DOIUrl":"https://doi.org/10.2302/kjm.2021-0009-IR","url":null,"abstract":"In this study, the complicated reasoning and processes inherent in diagnostic testing were analyzed, and a mathematical theory was developed for effectively stopping the transmission of infection in the context of coronavirus disease 2019 (COVID-19). As a result of this work, a new formula was developed for the \"boundary condition for contagion containment,\" which, based on a horizontal transmission model, gives the lower limit of sensitivity for a diagnostic test to stop the virus spreading. Two parameters are considered in the model: the level of transmission and the effective reproduction number. In example computations, the formula indicated that a one-off polymerase chain reaction-based test with a sensitivity of 85% would not be sufficient to contain highly contagious infections such as the Delta variant of SARS-CoV-2, which would likely require a sensitivity close to 100% for its containment. Furthermore, a cascade judgment system for multiple tests was proposed and examined as a form of triplet test system. This approach can enhance the accuracy of COVID-19 testing up to the minimum level needed to stop the virus spreading. The theory developed in this study will not only contribute as an academic exercise, but also be useful for making evidence-based decisions on public policy for pandemic control.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"71 1","pages":"13-20"},"PeriodicalIF":2.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

HIF Inhibition Therapy in Ocular Diseases. 眼部疾病的HIF抑制治疗。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2022-03-25 Epub Date: 2021-04-10 DOI: 10.2302/kjm.2021-0004-IR

Deokho Lee, Yukihiro Miwa, Hiromitsu Kunimi, Mari Ibuki, Chiho Shoda, Ayaka Nakai, Toshihide Kurihara

{"title":"HIF Inhibition Therapy in Ocular Diseases.","authors":"Deokho Lee, Yukihiro Miwa, Hiromitsu Kunimi, Mari Ibuki, Chiho Shoda, Ayaka Nakai, Toshihide Kurihara","doi":"10.2302/kjm.2021-0004-IR","DOIUrl":"https://doi.org/10.2302/kjm.2021-0004-IR","url":null,"abstract":"The uncontrolled growth of blood vessels is a major pathological factor in human eye diseases that can result in blindness. This effect is termed ocular neovascularization and is seen in diabetic retinopathy, age-related macular degeneration, glaucoma and retinopathy of prematurity. Current treatments for these diseases include laser photocoagulation, topical injection of corticosteroids, intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents and vitreoretinal surgery. Although strategies to inhibit VEGF have proved to be dramatically successful in some clinical studies, there remains the possibility of significant adverse effects regarding the blockade of crucial physiological roles of VEGF and the invasive nature of the treatments. Moreover, it is evident that other pro-angiogenic factors also play important roles in the development of these diseases, as seen in cases in which anti-VEGF therapies have failed. Therefore, new types of effective treatments are required. In this review, we discuss a promising strategy for the treatment of ocular neovascular diseases, i.e., the inhibition of hypoxia-inducible factor (HIF), a master regulator of angiogenesis. We also summarize promising recently investigated HIF inhibitors as treatments for ocular diseases. This review will facilitate more comprehensive approaches to understanding the protective aspects of HIF inhibition in the prevention of ocular diseases.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"71 1","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25579582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Diagnostic Performance of Computed Tomography Imaging for COVID-19 in a Region with Low Disease Prevalence. 计算机断层成像对低患病率地区COVID-19的诊断效果

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2022-03-25 Epub Date: 2021-11-11 DOI: 10.2302/kjm.2021-0012-OA

Ho Lee, Tatsuya Suzuki, Yohei Okada, Hiromu Tanaka, Satoshi Okamori, Hirofumi Kamata, Makoto Ishii, Masahiro Jinzaki, Koichi Fukunaga

{"title":"Diagnostic Performance of Computed Tomography Imaging for COVID-19 in a Region with Low Disease Prevalence.","authors":"Ho Lee, Tatsuya Suzuki, Yohei Okada, Hiromu Tanaka, Satoshi Okamori, Hirofumi Kamata, Makoto Ishii, Masahiro Jinzaki, Koichi Fukunaga","doi":"10.2302/kjm.2021-0012-OA","DOIUrl":"https://doi.org/10.2302/kjm.2021-0012-OA","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in December 2019 as an outbreak of pneumonia of unknown origin. Previous studies have suggested the utility of chest computed tomography (CT) in the diagnosis of COVID-19 because of its high sensitivity (93%-97%), relatively simple procedure, and rapid test results. This study, performed in Japan early in the epidemic when COVID-19 prevalence was low, evaluated the diagnostic accuracy of chest CT in a population presenting with lung diseases having CT findings similar to those of COVID-19. We retrospectively included all consecutive patients (≥18 years old) presenting to the outpatient department of Keio University Hospital between March 1 and May 31, 2020, with fever and respiratory symptoms. We evaluated the performance of diagnostic CT for COVID-19 by using polymerase chain reaction (PCR) results as the reference standard. We determined the numbers of false-positive (FP) results and assessed the clinical utility using decision curve analysis. Of the 175 patients, 22 were PCR-positive. CT had a sensitivity of 68% and a specificity of 57%. Patients with FP results on CT diagnosis were mainly diagnosed with diseases mimicking COVID-19, e.g., interstitial lung disease. Decision curve analysis indicated that the clinical utility of CT imaging was limited. The diagnostic performance of CT for COVID-19 was inadequate in an area with low COVID-19 prevalence and a high prevalence of other lung diseases with chest CT findings similar to those of COVID-19. Considering this insufficient diagnostic performance, CT findings should be evaluated in the context of additional medical information to diagnose COVID-19.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"71 1","pages":"21-30"},"PeriodicalIF":2.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39608340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Food Protein-induced Enterocolitis Syndrome Due to Rice in a Japanese Infant: A Case Report. 日本婴儿食用大米引起的食物蛋白性小肠结肠炎综合征1例报告。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2022-03-05 DOI: 10.2302/kjm.2021-0016-CR

H. Hayashi, N. Kajita, Koichi Yoshida, M. Narita, H. Hataya

{"title":"Food Protein-induced Enterocolitis Syndrome Due to Rice in a Japanese Infant: A Case Report.","authors":"H. Hayashi, N. Kajita, Koichi Yoshida, M. Narita, H. Hataya","doi":"10.2302/kjm.2021-0016-CR","DOIUrl":"https://doi.org/10.2302/kjm.2021-0016-CR","url":null,"abstract":"Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food allergy characterized by repetitive vomiting within 1-4 h and/or diarrhea within 24 h after ingesting the causative food. We herein report a rare Japanese case of rice-induced FPIES. A six-month-old, female, Japanese patient presented to the emergency room (ER) with the complaint of vomiting after feeding. Postprandial vomiting had occurred occasionally since she started ingesting solid food at the age of 5 months. Rice-induced FPIES was suspected only after the fourth ER visit based on the characteristic history of recurrent vomiting occurring 1-2 h after ingesting food containing rice. Allergen-specific IgE testing and a skin prick test with an allergen scratch extract were both negative for rice. During an oral food challenge test (OFC), vomiting was observed after the patient ingested 2 g of rice porridge. Based on the OFC results and the entire clinical course, FPIES due to rice was diagnosed. A lymphocyte stimulation test with rice revealed a significantly elevated stimulation index. Rice-induced FPIES is rarely reported among Japanese infants despite rice being a staple in the Japanese diet. The prevalence of rice-induced FPIES differs greatly among populations, suggesting a multifactorial cause associated with its development. Delays in diagnosis are common in FPIES, and our case demonstrates the importance of obtaining a dietary history of food ingested prior to symptom onset in cases of infantile repetitive vomiting.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"1 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47103713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Molecular mechanisms of building blocks of life towards medicinal applications. 从分子机制构建生命的基石到医学应用。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2022-01-01 DOI: 10.2302/kjm.71-002-abst

O. Nureki

引用次数: 0

Targeting Tumor Microenvironment in Liver Cancers: Rationale, Current Progress, and Future Perspective. 肝癌靶向肿瘤微环境:基本原理、目前进展和未来展望。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2022-01-01 DOI: 10.2302/kjm.71-004-ABST

Dan G Duda

{"title":"Targeting Tumor Microenvironment in Liver Cancers: Rationale, Current Progress, and Future Perspective.","authors":"Dan G Duda","doi":"10.2302/kjm.71-004-ABST","DOIUrl":"https://doi.org/10.2302/kjm.71-004-ABST","url":null,"abstract":"Surgical treatments offer the chance for cure in primary or metastatic liver cancers. However, many patients experience disease progression after surgical interventions, or cannot undergo surgery as they present with unresectable disease at diagnosis. In such cases, available treatment options (local and systemic) have been limited in efficacy, which led to dismal survival rates in advanced hepatocellular carcinoma (HCC), intrahepatic colangiocarcinoma (ICC) or metastatic pancreatic ductal adenocarcinoma (PDAC). More recent developments in oncology have offered renewed hope for advanced liver cancer patients. Hypofractionated radiation has shown feasibility and promise in unresectable setting, and is now being tested in a randomized phase III trial in HCC (clinicaltrials.gov identifier NCT03186898). Antiangiogenic agents have strongly impacted the management of advanced HCC, with multiple drug options in first line setting (sorafenib, lenvatinib) and second line setting (regorafenib, cabozantinib, ramucirumab). Chemotherapy based regimens are standard of care in ICC and PDAC. Immunotherapy with anti-PD-1/PD-L1 or anti-CTLA4 antibodies has shown real potential to transform advanced HCC therapy, both in first line and second line settings. Finally, combinations of these new strategies are very attractive approaches, as they promise durable and profound responses in advanced HCC. But in order to achieve this promise more broadly, these concepts require greater understanding based on mechanistic preclinical studies and validation in correlative studies in clinical trials as a basis to establish optimal combinatorial strategies. The insights gained from this \"bench to the bedside and back\" approach raise the hope for a more efficient development of targeted agents in combination, and in earlier stages of the disease, with the goal of increasing survival in patients afflicted with this aggressive and deadly diseases. (Presented at the 2001st Meeting, July 4, 2022).","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"71 3","pages":"71"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33482627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing mRNA for Therapy. 开发用于治疗的 mRNA。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2022-01-01 DOI: 10.2302/kjm.71-001-ABST

Katalin Karikó

引用次数: 1

Overview of the COVID-19 Pandemic in Japan: Public Health Perspectives in the first half of 2020. 2019冠状病毒病大流行在日本的概况:2020年上半年的公共卫生展望

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2021-12-25 Epub Date: 2021-10-02 DOI: 10.2302/kjm.kjm-covid19-02

Yasuhiro Suzuki

引用次数: 1

Coagulation Assay and Stroke Severity upon Admission of Patients with Cardioembolic Cerebral Infarction during Direct Oral Anticoagulant Use. 直接口服抗凝剂治疗心栓性脑梗死患者入院时的凝血测定和卒中严重程度。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2021-12-25 Epub Date: 2021-03-16 DOI: 10.2302/kjm.2020-0019-OA

Ichiro Deguchi, Takashi Osada, Masaki Takao, Shinichi Takahashi

{"title":"Coagulation Assay and Stroke Severity upon Admission of Patients with Cardioembolic Cerebral Infarction during Direct Oral Anticoagulant Use.","authors":"Ichiro Deguchi, Takashi Osada, Masaki Takao, Shinichi Takahashi","doi":"10.2302/kjm.2020-0019-OA","DOIUrl":"https://doi.org/10.2302/kjm.2020-0019-OA","url":null,"abstract":"Although the severity of acute cerebral infarction varies in patients receiving direct oral anticoagulants (DOACs), no practical method to predict the severity has been established. We analyzed retrospectively the relationship between cardioembolic cerebral infarction severity and coagulation indicators in patients treated with DOACs. We assessed the anticoagulation effect of DOACs using the activated partial thromboplastin time (APTT), prothrombin time (PT), and prothrombin time international standardized ratio (PT-INR) in 71 patients with cardioembolic cerebral infarction admitted to our hospital between January 2015 and December 2019. The participants were divided into a prolongation group (prolonged APTT for oral thrombin inhibitors or prolonged PT for oral factor Xa inhibitors, n =37) and a normal group (no prolongation of coagulation markers, n =34). Of the 71 patients, 21 (30%) and 50 (70%) were using oral thrombin and oral factor Xa inhibitors, respectively. PT, PT-INR, and APTT were significantly higher in the prolongation group (PT: 17.4 ± 5.1 vs. 12.8 ± 1.4 s, P < 0.001; PT-INR: 1.5 ± 0.5 vs. 1.1 ± 0.1, P < 0.001; APTT: 44.8 ± 26.4 vs. 30.4 ± 4.1 s, P = 0.003). The median National Institutes of Health Stroke Scale (NIHSS) score on admission and the prevalence of large vessel occlusion were significantly lower in the prolongation group (NIHSS: 2.0 vs. 9.5, P = 0.007; large vessel occlusion: 27% vs. 53%, P = 0.031). The prevalence of large vessel occlusion was low and stroke severity was mild in patients undergoing DOAC therapy with prolongation of coagulation assay markers upon onset of cardioembolic cerebral infarction.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"70 4","pages":"93-99"},"PeriodicalIF":2.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25488365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Visualization of Lymphatic Vessels Using Photoacoustic Imaging. 利用光声成像显示淋巴管。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2021-12-25 Epub Date: 2021-01-28 DOI: 10.2302/kjm.2020-0010-OA

Hiroki Kajita, Yushi Suzuki, Hisashi Sakuma, Nobuaki Imanishi, Tetsuya Tsuji, Masahiro Jinzaki, Sadakazu Aiso, Kazuo Kishi

{"title":"Visualization of Lymphatic Vessels Using Photoacoustic Imaging.","authors":"Hiroki Kajita, Yushi Suzuki, Hisashi Sakuma, Nobuaki Imanishi, Tetsuya Tsuji, Masahiro Jinzaki, Sadakazu Aiso, Kazuo Kishi","doi":"10.2302/kjm.2020-0010-OA","DOIUrl":"https://doi.org/10.2302/kjm.2020-0010-OA","url":null,"abstract":"Lymphedema occurs when interstitial fluid and fibroadipose tissues accumulate abnormally because of decreased drainage of lymphatic fluid as a result of injury, infection, or congenital abnormalities of the lymphatic system drainage pathway. An accurate anatomical map of the lymphatic vasculature is needed not only for understanding the pathophysiology of lymphedema but also for surgical planning. However, because of their limited spatial resolution, no imaging modalities are currently able to noninvasively provide a clear visualization of the lymphatic vessels. Photoacoustic imaging is an emerging medical imaging technique that provides unique scalability of optical resolution and acoustic depth of penetration. Moreover, light-absorbing biomolecules, including oxy- and deoxyhemoglobin, lipids, water, and melanin, can be imaged. Using exogenous contrast agents that are taken up by lymphatic vessels, e.g., indocyanine green, photoacoustic lymphangiography, which has a higher spatial resolution than previous imaging modalities, is possible. Using a new prototype of a photoacoustic imaging system with a wide field of view developed by a Japanese research group, high-resolution three-dimensional structural information of the vasculatures was successfully obtained over a large area in both healthy and lymphedematous extremities. Anatomical information on the lymphatic vessels and adjacent veins provided by photoacoustic lymphangiography is helpful for the management of lymphedema. In particular, such knowledge will facilitate the planning of microsurgical lymphaticovenular anastomoses to bypass the excess fluid component by joining with the circulatory system peripherally. Although challenges remain to establish its implementation in clinical practice, photoacoustic lymphangiography may contribute to improved treatments for lymphedema patients in the near future.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"70 4","pages":"82-92"},"PeriodicalIF":2.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38801794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8