1.Preparation of Motion Pictures to Visualize the Geographical Propagation Pattern of Influenza Infection Using Pharmacy Big Data
Mitsuo Saito ; Yuzuru Hayashi ; Takehiko Yajima
Japanese Journal of Drug Informatics 2015;17(2):94-99
Objective: The aim of this study was to propose a method for preparing motion pictures to visualize the geometrical propagation of influenza infection. The Greater Tokyo area (Kanto region) of Japan, which has a population of 43 million, was considered as a typical epidemic area for the 2012/2013 flu season. Therefore, we collected data regarding the daily variations in the number of flu patients from 285 pharmacies located in the Kanto region during that time period.
Design and Methods: To visualize the information mined from these big data, a motion picture consisting of 90 frames ranging from December 12, 2012 to March 21, 2013 was created. Each frame depicted the daily image of infection as a circle centered at the pharmacy location on the background map, and its radius was proportioned to patient number. The time variations of the flu patients at the pharmacies appeared to be noisy, which would cause the flickering on a display screen. We adopted data smoothing and a model time series of the Gaussian distribution curve to circumvent the above problem.
Result: The created motion picture indicated that the 2012/2013 flu season began near the central part of Toyo in December, 2012, spread towards the suburbs, and ended in March, 2013.
Conclusion: The method proposed in this study can be considered an efficient and intuitive way to communicate essential epidemiological information.
2.Effect of exercise at intensities around ventilatory threshold on plasma protein-bound sulfhydryl groups.
MAKOTO SAITO ; TAKAYO INAYAMA ; SEIJI MAEDA ; MITSUO MATSUDA
Japanese Journal of Physical Fitness and Sports Medicine 1997;46(4):365-373
Although it has been established that exercise is useful for health promotion, physical exercise may induce oxidative stress in humans. Our previous study showed that the concentration of plasma protein-bound sulfhydryl groups (p-SHs) was significantly decreased after strenuous exercise, i. e. full-marathon running and participation in an athletic training camp. Reactive oxygen species may cause oxidation of plasma proteins in vitro. To study whether moderate exercise for health promotion, e. g. jogging or walking, induces oxidative stress in human circulating blood, the authors examined the change in plasma p-SHs concentration following ergometric exercise at moderate intensity and of relatively short duration {Exercise 1: 80% ventilatory threshold (VT), 100% VT, and 110% VT; 30 min, Exercise 2 : 90% VT; 120 min} in 8 (23-28 yr; Exercise 1) and 6 males (23-28 yr; Exercise 2) respectively. The plasma p-SHs concentration did not changed significantly after Exercise 1 or 2. The data indicated that the exercise did not cause significant modification of plasma proteins, suggesting that it did not induce significant oxidative stress in the circulating blood.
3.Long-term Results of Direct Surgical Approach to Left Main Coronary Artery.
Hisanaga MORO ; Fumiaki OGUMA ; Osamu NAMURA ; Mitsuo UENO ; Akira SAITO ; Junichi HAYASHI ; Haruo MIYAMURA ; Shoji EGUCHI
Japanese Journal of Cardiovascular Surgery 1993;22(4):334-338
Five patients with isolated stenosis of the left main coronary artery or stenotic ostial lesions underwent direct coronary artery surgery. These surgical approaches included vein patch angioplasty in 2 cases, punch out endarterectomy in 1 case, and resection of the thickened aortic wall and transaortic endarterectomy in 2 cases. Early results were satisfactory, except for one case who died due to severe LOS and MOF. In the late postoperative period, one case of vein patch angioplasty died due to cerebral bleeding, and in the other case, stenosis existed in position of distal patch anastomosis. Since direct coronary artery surgery was successful in both early and late postoperative fidings, it is believed to be useful and safe technique if the candidates are selected properly.
4.Perception of Physicians, Pharmacists and Pharmaceutical Industries about Information in Package Inserts in Japan
Mitsuo Saito ; Lucia S. Yoshida ; Yuzuru Hayashi ; Kimie Sai ; Hiromi Takano-Ohmuro ; Takehiko Yajima ; Yasufumi Sawada ; Ryuichi Hasegawa
Japanese Journal of Drug Informatics 2012;14(1):2-13
Objective: A perception survey of healthcare providers and pharmaceutical industries about the current package insert (PI) was conducted to evaluate whether its layout and issues such as the contents concerning drug-drug interactions are found appropriate.
Methods: A questionnaire was sent via the Internet to physicians of various subspecialties, or via the postal service to pharmacy-employed pharmacists and pharmaceutical industries. It consisted of questions regarding the PI layout, the information contents on drug-drug interactions and other matters about PI revision.
Results: The survey showed that the PI is a major source of drug information for physicians (82.4%) and pharmacists (98.7%). The layout (order of appearance of headings and information about drug interactions in a tabular format) of the current PI is widely accepted by physicians, pharmacists, and pharmaceutical industries. There was, however, some degree of disagreement within these three groups in the perceptions about the presentation/contents of the several drug interactions, as well as about the timing for its updating. Around 24% of physicians and 35% of pharmacists view that the content of drug interactions is insufficient, and that information about adverse drug reactions and drug interactions is not enough updated in the PIs. On the other hand, near 86% of pharmaceutical industries were prone to wait for accumulation of enough data until revising the information in PIs.
Conclusions: Differences of perception were found between healthcare providers (i.e., PI users) and industries. Our survey revealed that the basic layout of the current PI should be preserved, but there are issues such as the contents and updating of information regarding drug interactions and adverse drug interactions that may require modifications according to the healthcare providers’ point of view.
5.Recent refinements and advances for pancreatoduodenectomy
Yuji Morine ; Mitsuo Shimada ; Satoru Imura ; Tetsuya Ikemoto ; Yusuke Arakawa ; Syuichi Iwahashi ; Yu Saito ; Shinichiro Yamada ; Daichi Ishikawa
Innovation 2014;8(4):136-137
Background: The technique of pancreatoduodenectomy (PD) has evolved, and
artery first’ approach was considered for the intraoperative early determination
of resectability for borderline resectable cases before the ‘point of no return’
and avoidance of blood congestion resulted in the reduction of blood loss. Also,
active application of energy device was useful for the reduced operative time and
blood loss. Recently, 3D simulation for hepatobiliary pancreatic surgery has been
useful and mandatory. In this presentation, we introduced our recent refinements
and advances for PD.
‘Artery first’ approach and vessel sealing system for PD: ‘Artery first’ approach
were considered as six different methods as follows; 1) Superior approach, 2)
Anterior approach, 3) Posterior approach, 4) Left posterior approach, 5) Right/
medial uncinate approach and 6) Mesenteric approach. A while ago, we
preferably applied the mesenteric approach to PD, and also the combination of
this approach with vessel sealing system (VSS) significantly reduced intraoperative
blood loss (Mesenteric approach with VSS, n=21 vs. non-‘Artery first’ approach
without VSS, n=78; 320±174ml vs. 486±263ml, p<0.01).
Modified de-rotation method as complete ‘Artery first’ approach: Most recently,
for further refinement of operative procedure, we refined a right/medial uncinate
and posterior approach as modified de-rotation method. Point of view in this
method was the complete clockwise rotation of small intestinal mesentery
including ascending colon, in order to linearize from duodenum to jejunum
and look at the direct front of superior mesenteric artery (SMA), vein (SMV) and
some branched jejunal vessels originated from SMA and SMV (Fig.). Thereby, in
the posterior view, the easy dissection of all pancreatic branch originated from
SMA can be done. This modified de-rotation method was possible to achieve the
complete ‘Artery first’ approach.
Preoperative 3D simulation of arterial and venous anatomy:
Until now, we applied 3D volumetery software (SYNAPSE VINCENT®) as
preoperative simulation for hepatic resection. And recently, for evaluation of the
position relationship between arteries and veins surround pancreas head, we
adopted this software before PD. As first step, arteries and veins are automatically
identified, and small vessels are manually traced on the axial CT view. After
that, 3D arterial and venous simulations are combined. Grasp of detailed vessel
anatomy and its relationship using preoperative 3D simulation enable to safely
perform PD, even in young surgeons (operative time; young 512±49 vs. senior
445±41 min, p<0.01), (blood loss; young 353±203 vs. senior 246±109 ml,
p=0.16).
Conclusion: Those refinements and advances are possible to safely and easily
perform pancreatoduodenectomy.
6. Recent refinements and advances for pancreatoduodenectomy
Yuji MORINE ; Mitsuo SHIMADA ; Satoru IMURA ; Tetsuya IKEMOTO ; Yusuke ARAKAWA ; Syuichi IWAHASHI ; Yu SAITO ; Shinichiro YAMADA ; Daichi ISHIKAWA
Innovation 2014;8(4):136-137
Background: The technique of pancreatoduodenectomy (PD) has evolved, andartery first’ approach was considered for the intraoperative early determinationof resectability for borderline resectable cases before the ‘point of no return’and avoidance of blood congestion resulted in the reduction of blood loss. Also,active application of energy device was useful for the reduced operative time andblood loss. Recently, 3D simulation for hepatobiliary pancreatic surgery has beenuseful and mandatory. In this presentation, we introduced our recent refinementsand advances for PD.‘Artery first’ approach and vessel sealing system for PD: ‘Artery first’ approachwere considered as six different methods as follows; 1) Superior approach, 2)Anterior approach, 3) Posterior approach, 4) Left posterior approach, 5) Right/medial uncinate approach and 6) Mesenteric approach. A while ago, wepreferably applied the mesenteric approach to PD, and also the combination ofthis approach with vessel sealing system (VSS) significantly reduced intraoperativeblood loss (Mesenteric approach with VSS, n=21 vs. non-‘Artery first’ approachwithout VSS, n=78; 320±174ml vs. 486±263ml, p<0.01).Modified de-rotation method as complete ‘Artery first’ approach: Most recently,for further refinement of operative procedure, we refined a right/medial uncinateand posterior approach as modified de-rotation method. Point of view in thismethod was the complete clockwise rotation of small intestinal mesenteryincluding ascending colon, in order to linearize from duodenum to jejunumand look at the direct front of superior mesenteric artery (SMA), vein (SMV) andsome branched jejunal vessels originated from SMA and SMV (Fig.). Thereby, inthe posterior view, the easy dissection of all pancreatic branch originated fromSMA can be done. This modified de-rotation method was possible to achieve thecomplete ‘Artery first’ approach.Preoperative 3D simulation of arterial and venous anatomy:Until now, we applied 3D volumetery software (SYNAPSE VINCENT®) aspreoperative simulation for hepatic resection. And recently, for evaluation of theposition relationship between arteries and veins surround pancreas head, weadopted this software before PD. As first step, arteries and veins are automaticallyidentified, and small vessels are manually traced on the axial CT view. Afterthat, 3D arterial and venous simulations are combined. Grasp of detailed vesselanatomy and its relationship using preoperative 3D simulation enable to safelyperform PD, even in young surgeons (operative time; young 512±49 vs. senior445±41 min, p<0.01), (blood loss; young 353±203 vs. senior 246±109 ml,p=0.16).Conclusion: Those refinements and advances are possible to safely and easilyperform pancreatoduodenectomy.
7.Элэгний мэс засалд гарсан сүүлийн үеийн ололт амжилтууд: Элэгний үйл ажиллагааны нөөцийг үнэлэх, загварчлах болон чиглүүлэх
Satoru Imura ; Mitsuo Shimada ; Tohru Utsunomiya ; Yuji Morine ; Tetsuya Ikemoto ; Yusuke Arakawa ; Mami Kanamoto ; Shuichi Iwahashi, ; Yu Saito ; Daichi Ishikawa, ; Batsaikhan Bat-Erdene.
Innovation 2013;7(3):8-12
INTRODUCTION:
Recent technical innovation in liver surgery is remarkable. Now, for example, a preoperative 3D-simulation of the liver is a routine modality, and indispensable (or essential) for liver surgery. The aim of this presentation is to clarify various kinds of progresses and future perspective in liver surgery.
PREOPERATIVE MODALITIES
1) One-stop shopping of 3D-simulation of the liver: We newly developed 3D-simulation using a software of SYNAPSE VINCENT Ver. 3.1 (Fujifilm Medical, Tokyo, Japan), in which biliary system is simultaneously reconstructed in one dynamic MD-CT. This technique avoids position error which occurred in 3D fusion image using another modality such as DIC–CT or MRCP, as well as unnecessary radiation exposure.
2) Assessment of partial functional reserve: We have reported new methods to astimate regional hepatic functional reserve using hepatocyte-phase of EOB-MRI (J Gastroenterol 2012), and fusion image of 3D-CT and asialoscintigraphy using 99m-Tc galactosyl human albumin. The method of EOB-MRI utilized character of hepatocyte-uptake of EOB through membrane transporters on hepatocytes. The other used fusion of both asialoscintigram of hepatic functional reserve and 3D-simulation by the above-mentioned software. Those techniques provided accurate estimation of partial functional volume, and help surgeons’ decision making of resection volume.
INTRAOPERATIVE MODALITIES:
1) Navigation using iPad: navigation using iPad in which preoperative 3D-image data are uploaded in advance, tumor location, accurate and anatomical orientation can confirm in the operative field during operation. This technique enable not only operators also assistants or students to better understand precise anatomy.
2) Indocyanine green (ICG) fluorescent image-guided navigation: this technique using HyperEye Medical System (MIZUHO IKAKOGYO Co., Ltd. Tokyo, Japan) help us to confirm tattooing of target segment and parenchymal intersegmental plane, and detect hepatic tumors (metastatic and HCC) near liver surface as well as invisible tumor inside the liver.
CONCLUSIONS:
Various advancements such as preoperative 3D-simulation including partial functional reserve estimation and intraoperative navigation techniques enabled surgeons to easily and safely perform hepatic resection.
8.The ideal focus of the study in the drug information sciences
Yasuhiko Yamada ; Yasufumi Sawada ; Koujirou Yamamoto ; Takashi Iikubo ; Hisakazu Ohtani ; Naoki Kamimura ; Yoshihiro Abe ; Keiko Uehara ; Takafumi Ohta ; Takao ORII ; Toshiko Kishimoto ; Mitsuo Saito ; Keiko Butatsu ; Hiroyuki Taruno ; Youhei Chikazawa ; Hiromitsu Nakasa ; Masayuki Hashiguchi ; Satoko HORI ; Toshinori Yamamoto
Japanese Journal of Drug Informatics 2009;11(2):76-87
In 2008, Japanese Society of Drug Informatics (JASDI) organized the Future Vision Committee (the Committee) to propose the essential focus of drug informatics. To explore a future vision about the drug information sciences, it was necessary to collect a variety of opinions widely from researchers. Therefore, at the 11th annual meeting of JASDI in July 5-6, 2008, the Committee convened a workshop to extract problems in the researches of drug informatics by using KJ method and evaluated the contents. The major problems raised were “the field of drug informatics is too broad” and “there is no definition and/or no system of the drug informatics”. Related problems raised are the shortness of the history and lack of originality in the study. From different viewpoints, it was also pointed out that the methodology of the research is not well established and no systematic education is provided. Taken together, major problems in drug informatics are concluded to be the lack of definition and the lack of systematizations, and will be solved to a certain extent by defining the outcome of the researches in drug informatics.
9.Recent refinements of glissonean pedicle approach for liver resection
Yu Saito M.D. ; Mitsuo Shimada M.D ; Satoru Imura M.D ; Yuji Morine M.D ; Tetsuya Ikemoto M.D. ; Yusuke Arakawa M.D. ; Shuichi Iwahashi M.D. ; Shinichiro Yamada M.D ; Daichi Ichikawa M.D ; Masato Yoshikawa M.D. ; Hiroki Teraoku M.D.
Innovation 2014;8(4):142-143
Background: The glissonean pedicle approach was introduced by Couinaud
and Takasaki in the early 1980s. The key of the glissonean pedicle approach is
clamping the pedicle first, secondly confirming the territory, and finally dissecting
the liver parenchyma. In this presentation, we introduced our recent refinements
of glissonean pedicle approach for liver resection.
“Approach to the glissonean pedicles at the hepatic hilus” Couinaud described
three approaches to the hepatic hilus. 1) Intra-fascial access (Control method):
The conventional dissection at the hilus or within the sheath is referred to as intrafascial
access However, dissection performed under the hilar plate is dangerous
and surgeons have to consider any variations of the hepatic artery and bile ducts.
2) Extra-fascial access (Glissonean pedicle approach): The glissonean pedicle is
dissected from the liver parenchyma at the hepatic hilus before dissecting the
liver parenchyma. This procedure prevents intrahepatic metastasis of HCC, which
spreads along the portal vein and improves the overall survival after surgery.
3) Extra-fascial and transfissural access: If the main portal fissure or the left
suprahepatic fissure is opened after dissecting the liver parenchyma, the surgeon
can confirm the pedicles that arise from the hilar plate or the umbilical plate.
“Operative techniques” 1) Preoperative 3D simulation of the precise anatomy
of portal vein, hepatic artery and bile duct at hepatic hilus should be performed.
2) Right glissonean pedicle: The hilar plate is detached from the quadrate lobe.
The assistant pulls the liver parenchyma cranially and the operator conversely
pulls the hepatoduodenal ligament caudally. Mayo scissors are inserted along the
liver parenchyma between the liver parenchyma and glissonean capsule (Fig.1).
Then forceps are inserted in the same way and the right main pedicle is taped
(Fig.2). The right anterior and posterior glissonean pedicles are taped as well. 3)
Left glissonean pedicle: The hilar plate is detached from the liver parenchyma.
Then, the Arantius duct is confirmed and the left pedicle is dissected along the left
pedicle at the ventral side of the Arantius duct.
“Pitfall of glissonean pedicle approach” The right pedicle should be dissected
in the liver side as much as possible to prevent the injury of left hepatic duct.
If possible, the right pedicle is recommended to be dissected at the level of the
second branches separately (Fig.3). The right posterior hepatic duct sometimes
branches from the left hepatic duct and the Arantius duct is confirmed and the left
pedicle should be dissected along the left pedicle at the ventral side of the Arantius
duct because the right posterior hepatic duct branches from the left hepatic duct
at the dorsal side of Arantius’ duct. In addition, the intraoperative cholangiogram
should be used in the case with the abnormal anatomy of bile duct.
Conclusions: Any anatomical hepatectomy can be performed using “glissonean
pedicle approach” which allows simple, safe and easy liver resection.
10.Optimization and validation of a highly sensitive method for determining glyphosate in human urine by solid-phase extraction and liquid chromatography with tandem mass spectrometry: a methodological study.
Hiroshi NOMURA ; Risa HAMADA ; Isao SAITO ; Kunihiko NAKANE ; Ritsuko SAWA ; Miwa UKAI ; Eiji SHIBATA ; Mitsuo SATO ; Michihiro KAMIJIMA ; Jun UEYAMA
Environmental Health and Preventive Medicine 2020;25(1):83-83
BACKGROUND:
Glyphosate and its salt formulations are nonselective herbicides that have been extensively used worldwide, both for residential and agricultural purposes. The possible carcinogenicity and teratogenicity of glyphosate remain to be elucidated. We developed a sensitive and high-throughput analytical method for urinary glyphosate using liquid chromatography-tandem mass spectrometry with the aim of contributing to glyphosate exposure assessment in epidemiological studies.
METHODS:
After urine dilution (creatinine matching dilution to 0.05 g creatinine/L), glyphosate was extracted using two types of solid phase extraction columns (SCX and NH2) with automated sample preparation instruments. The eluate was dried and dissolved in the mobile phase, followed by liquid chromatography-tandem mass spectrometry analysis. The optimized method was applied to urine samples obtained from 54 Japanese adults and children.
RESULTS:
The results from the validation study demonstrated good recoveries (91.0-99.6%), within- and between-run precisions (< 15%), low detection limits (0.1 μg/L), and lower limit of quantification (0.3 μg/L). The detection frequency and median concentration of the urinary glyphosate in Japanese subjects were 59% and 0.25 μg/L (0.34 μg/g creatinine).
CONCLUSIONS
Our reliable determination method was successful in measuring urinary glyphosate concentration. Moreover, this is the first biomonitoring report of urinary glyphosate levels in the Japanese general population.
Adult
;
Aged
;
Chromatography, Liquid/methods*
;
Female
;
Glycine/urine*
;
Humans
;
Male
;
Middle Aged
;
Solid Phase Extraction/methods*
;
Tandem Mass Spectrometry/methods*