研究者総覧

阿江 竜介 (アエ リュウスケ)

  • 公衆衛生学部門 講師
Last Updated :2022/06/27

研究者情報

学位

  • 医学(2016年06月 自治医科大学)

ホームページURL

科研費研究者番号

  • 70554567

J-Global ID

プロフィール

  • 【略歴】


    2003年に自治医科大学卒業。


    兵庫県で地域医療に従事。


    2013年より自治医科大学教員(現所属)。


     


    【専門医資格】


    総合内科専門医 (日本内科学会)


    老年病専門医・指導医 (日本老年医学会)


    上級疫学専門家 (日本疫学会)


    社会医学系専門医・指導医 (社会医学系専門医協会)

研究キーワード

  • 疫学   川崎病   プリオン病   老年医学   プライマリ・ケア   へき地医療   公衆衛生学   

研究分野

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない / 疫学
  • ライフサイエンス / 胎児医学、小児成育学 / 川崎病
  • ライフサイエンス / 神経内科学 / プリオン病
  • ライフサイエンス / 内科学一般 / 老年医学
  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない / 地域医療学・へき地医療
  • ライフサイエンス / 内科学一般 / プライマリ・ケア

経歴

  • 2019年10月 - 現在  自治医科大学 地域医療学センター 公衆衛生学部門(講師)
  • 2018年09月 - 2019年09月  米国疾病管理予防センター(CDC:Centers for Disease Control and Prevention)DDID/NCEZID/DHCPP Regular Fellow
  • 2016年08月 - 2018年08月  自治医科大学 地域医療学センター 公衆衛生学部門(講師)
  • 2013年07月 - 2016年07月  自治医科大学 地域医療学センター 公衆衛生学部門(助教)
  • 2011年04月 - 2013年06月  公立浜坂病院 総合診療科(自治医科大学卒後後期へき地派遣)
  • 2009年04月 - 2011年03月  自治医科大学 地域医療学センター 総合診療部(シニアレジデント:卒後後期臨床研修)
  • 2005年04月 - 2009年03月  公立出石病院 一般内科(自治医科大学卒後前期へき地派遣)
  • 2003年05月 - 2005年03月  兵庫県立淡路病院(卒後前期臨床研修)
  • - 2003年03月  自治医科大学 医学部 医学科 卒業

所属学協会

  • 日本川崎病学会   日本静脈経腸栄養学会   日本循環器病予防学会   日本医学教育学会   日本疫学会   日本公衆衛生学会   日本プライマリ・ケア連合学会   日本老年医学会   日本内科学会   

研究活動情報

論文

  • Taiki Matsubayashi, Miho Akaza, Yuichi Hayashi, Tsuyoshi Hamaguchi, Katsuya Satoh, Koki Kosami, Ryusuke Ae, Tetsuyuki Kitamoto, Masahito Yamada, Takayoshi Shimohata, Takanori Yokota, Nobuo Sanjo
    Journal of the neurological sciences 437 120265 - 120265 2022年06月 [査読有り]
     
    Studies on the very early electroencephalography (EEG) features prior to the emergence of generalized periodic discharges (GPDs, generally known as periodic sharp-wave complexes) in Creutzfeldt-Jakob disease (CJD) are rare. Fourteen patients with sporadic CJD (sCJD) (eight with MM1/classic and six with MM2c) were included in this study. The predominant findings of the first EEG were categorized as 1) lateralized periodic discharges (LPDs), 2) central sagittal sporadic epileptiform discharges (CSSEDs) showing midline predominant generalized spike-and-wave complexes and/or sharp waves in the central sagittal regions, or 3) focal epileptiform discharges. Clinical records, magnetic resonance imaging (MRI), and changes in EEG were compared between three groups (LPD in MM1/classic, CSSED in MM1/classic, and focal epileptiform discharge in MM2c). Three (37.5%) and five (62.5%) patients with MM1/classic sCJD were classified into the LPD and CSSED groups, respectively. Patients in the LPD group were accompanied by cortical hyperintensities at the corresponding areas on MRI, while those in the CSSED group showed hyperintensities on MRI at unassociated cortical areas. Follow-up EEG of three (100%) patients in the LPD group and four (80%) in the CSSED group showed transitions to GPDs. All patients with MM1/classic sCJD showed myoclonus on initial EEG, and the symptomatic side was opposite to the hemisphere showing LPDs or higher-amplitude central sagittal epileptiform activity. The periodicity after these EEGs likely contributes to the diagnostic confidence of physicians when patients are in the very early stages of MM1/classic sCJD.
  • Ryusuke Ae, Yoshihide Shibata, Toshiki Furuno, Teppei Sasahara, Yosikazu Nakamura, Hiromichi Hamada
    International journal of environmental research and public health 19 11 2022年06月 [査読有り]
     
    The study tested the hypothesis that human mobility may be a potential factor affecting reductions in droplet-transmissible pediatric infectious diseases (PIDs) during the coronavirus disease-2019 (COVID-19) pandemic mitigation period in 2020. An ecological study was conducted using two publicly available datasets: surveillance on infectious diseases collected by the Japanese government and COVID-19 community mobility reports presented by Google. The COVID-19 community mobility reports demonstrated percentage reductions in the movement of people over time in groceries and pharmacies, parks, and transit stations. We compared the weekly trends in the number of patients with droplet-transmissible PIDs identified in 2020 with those identified in the previous years (2015-2019) and assessed the correlations between the numbers of patients and percentage decreases in human mobility during 2020. Despite experiencing their peak seasons, dramatic reductions were found in the numbers of patients with pharyngoconjunctival fever (PCF) and group A streptococcal (GAS) pharyngitis after the tenth week of 2020. Beyond the 20th week, no seasonal peaks were observed in the number of patients with all PIDs identified in 2020. Significant correlations were found between the percentage decreases in human mobility in transit stations and the number of patients with hand-foot-and-mouth disease (Pearson correlation coefficient [95% confidence interval]: 0.65 [0.44-0.79]), PCF (0.47 [0.21-0.67]), respiratory syncytial virus infection (0.45 [0.19-0.66]), and GAS pharyngitis (0.34 [0.06-0.58]). The highest correlations were found in places underlying potential human-to-human contacts among adults. These findings suggest that reductions in human mobility for adults might contribute to decreases in the number of children with droplet-transmissible PIDs by the potential prevention of adult-to-child transmission.
  • Tsuneari Takahashi, Kazutaka Sugimoto, Ryusuke Ae, Tomohiro Saito, Yuya Kimura, Tatsuya Kubo, Mikiko Handa, Katsushi Takeshita
    Technology and health care : official journal of the European Society for Engineering and Medicine 2022年05月 [査読有り]
     
    BACKGROUND: Total knee arthroplasty (TKA) is a widely performed procedure to alleviate pain and restore function of patients with end-stage knee osteoarthritis. OBJECTIVE: The study aim was to determine if tibia-first (TF) total knee arthroplasty (TKA) using a novel computer-assisted surgery (CAS) system can yield better anterior and posterior (AP) knee stability. METHODS: Patients with knee osteoarthritis with obvious varus knee who met the indication for and underwent TKA from May 2019 to November 2020 were included. Forty-one measured resection (MR)-TKAs and 32 TF-TKAs were compared. The varus-valgus ligament balance and joint tension at a joint center-gap setting equal to the tibial-baseplate thickness were measured, and appropriate polyethylene inserts with 0∘, 30∘, 45∘, 60∘, 90∘, and 120∘ of knee flexion were placed. A Kneelax 3 arthrometer was used to measure knee AP laxity in the postoperative anesthetized patients with 30∘ and 90∘ of knee flexion. RESULTS: The horizontal gap balance was significantly closer in the TF-TKA group than the MR-TKA group for 0∘, 30∘, 45∘, and 60∘ of knee flexion. In contrast, no significant differences were observed for 90∘ and 120∘ of knee flexion. No significant differences in joint-gap tensions among all knee-flexion angles were observed. Translation was significantly smaller in the TF-TKA group than the MR-TKA group for AP laxity with 30∘ of knee flexion (8.8 ± 2.9 mm vs. 10.7 ± 3.1 mm, P= 0.0079). In contrast, no significant AP laxity was observed with 90∘ of knee flexion (7.2 ± 2.8 mm vs. 7.2 ± 3.5 mm). CONCLUSION: TF-TKA using a novel CAS system provided better AP knee stability with close to horizontal gap balances.
  • Koki Kosami, Ryusuke Ae, Tsuyoshi Hamaguchi, Nobuo Sanjo, Tadashi Tsukamoto, Tetsuyuki Kitamoto, Masahito Yamada, Hidehiro Mizusawa, Yosikazu Nakamura
    Journal of neurology, neurosurgery, and psychiatry 2022年04月 [査読有り]
     
    BACKGROUND: No studies have assessed the independent association of methionine homozygosity at codon 129 with the susceptibility to prion diseases, controlling for the effects of the codon 219 polymorphisms and other potential confounders, using a large-scale population-based dataset. METHODS: We conducted a case-control study using a Japanese nationwide surveillance database for prion diseases. The main exposure was methionine homozygosity at codon 129, and the outcome was development of prion diseases. Multivariable logistic regression models were employed for specific disease subtypes (sporadic Creutzfeldt-Jakob disease (CJD), genetic CJD and Gerstmann-Sträussler-Scheinker disease (GSS)). RESULTS: Of 5461 patients registered in the database, 2440 cases and 796 controls remained for the analysis. The cases comprised 1676 patients with sporadic CJD (69%), 649 with genetic CJD (27%) and 115 with GSS (5%). For patients with methionine homozygosity, potential risk for occurring prion diseases: adjusted OR (95% CI) was 2.21 (1.46 to 3.34) in sporadic CJD, 0.47 (0.32 to 0.68) in genetic CJD and 0.3 (0.17 to 0.55) in GSS. Among patients with specific prion protein abnormalities, the potential risk was 0.27 (0.17 to 0.41) in genetic CJD with 180 Val/Ile, 1.66 (0.65 to 5.58) in genetic CJD with 200 Glu/Lys, 3.97 (1.2 to 24.62) in genetic CJD with 232 Met/Arg and 0.71 (0.34 to 1.67) in GSS with 102 Pro/Leu. CONCLUSIONS: Methionine homozygosity at codon 129 was predisposing to sporadic CJD, but protective against genetic CJD and GSS, after adjustment for codon 219 polymorphism effect. However, the impacts differed completely among patients with specific prion protein abnormalities.
  • Yuya Kimura, Tsuneari Takahashi, Ryusuke Ae, Katsushi Takeshita
    Geriatric orthopaedic surgery & rehabilitation 13 21514593221082785 - 21514593221082785 2022年 [査読有り]
     
    Introduction: Arterial injury following total knee arthroplasty (TKA) can be life-threatening. There are some anatomical variations in the popliteal artery (PA) and its branches. In most cases, the PA branches into the anterior tibial artery (ATA) and posterior tibial artery (PTA), which are usually distal to the height of tibial resection in TKA. However, some cases show that the PA branches into the ATA and PTA proximal to the height of tibial resection in TKA. This study aimed to assess the distance from the posterior cortex of the proximal tibia to the anterior wall of the PA or ATA at the height of the tibial cut line, during TKA in the distal and proximal branch groups. Methods: 129 patients (6 patients in the proximal branch group and 123 patients in the distal branch group) were enrolled for this study. For prediction of the distance from the posterior cortex of the proximal tibia to the anterior wall of the PA or ATA, preoperative sagittal and coronal magnetic resonance images and postoperative radiographs were evaluated. Results: The distance between the posterior cortex of the proximal tibia and the anterior wall of the PA or ATA at the height of the tibial cut line was 1.8 ± 1.1 mm in the proximal branch group and 6.1 ± 2.6 mm in the distal branch group, which was significantly closer in the proximal group (P < .05). Discussion: The rate of proximal branching was 4.7%. This study clarified that the proximal branching of the ATA from PA significantly decreased the distance between the posterior cortex of the proximal tibia and the anterior wall of the artery. Conclusions: The proximal branch group has a high risk for arterial injury as the artery may be close to the saw, and appropriate retraction should be performed.
  • Tsuneari Takahashi, Ryusuke Ae, Koki Kosami, Kensuke Minami, Meiwa Shibata, Tatsuya Kubo, Katsushi Takeshita
    Telemedicine reports 3 1 49 - 54 2022年 [査読有り]
     
    Background: Hospital-related coronavirus disease 2019 (COVID-19) infection is of utmost concern among patients and health care workers. Expanding the use of telemedicine may be required in daily outpatient practice; however, the acceptance of telemedicine use is still low, especially among older patients. In an orthopedic practice, no studies have investigated potential factors that can contribute to changes in the acceptance of using telemedicine. Focusing on older outpatients with knee osteoarthritis (KOA), we hypothesized that a drastic surge in the number of patients with COVID-19 could trigger changes in attitudes regarding the acceptance of telemedicine use. Methods: A baseline survey was conducted after the first wave of the COVID-19 pandemic in Japan to obtain information on the willingness to use telemedicine among patients aged ≥70 years who regularly consulted an orthopedic surgeon for KOA. A follow-up survey was subsequently conducted during the third wave of the pandemic period to assess changes in the acceptance of telemedicine use in response to the rapidly increasing number of patients with COVID-19. We compared the difference in acceptance of telemedicine use and knee pain status between the baseline and follow-up surveys. Results: In the baseline survey, 11 of 43 patients (25.6%) responded that they would be willing to use telemedicine. In the follow-up survey, patients' acceptance of telemedicine did not change, with the exact same number and percentage of patients who were willing to use telemedicine as in the baseline survey, despite that ∼20% of patients reported improvement in their knee pain status. Discussion: Our findings indicate that older outpatients with KOA did not change their willingness to accept use of telemedicine, even with a drastically increased risk of hospital-related transmission of a potentially fatal infectious disease when visiting a hospital. The acceptance of telemedicine use among older patients might not be less sensitive to external environmental factors but instead might be more sensitive to patients' personal factors, such as anxiety for information technology and resistance to changes in their lifestyle.
  • Dai Akine, Teppei Sasahara, Kotaro Kiga, Ryusuke Ae, Koki Kosami, Akio Yoshimura, Yoshinari Kubota, Kazumasa Sasaki, Yumiko Kimura, Masanori Ogawa, Shinya Watanabe, Yuji Morisawa, Longzhu Cui
    Antibiotics (Basel, Switzerland) 11 1 2021年12月 [査読有り]
     
    A high prevalence of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) may call for monitoring in geriatric long-term care facilities (g-LTCFs). We surveyed the distribution of ESBL-causative gene types and antimicrobial susceptibility in ESBL-PE strains from residents in g-LTCFs, and investigated the association between ESBL-causative gene types and antimicrobial susceptibility. First, we analyzed the types of ESBL-causative genes obtained from 141 ESBL-PE strains collected from the feces of residents in four Japanese g-LTCFs. Next, we determined the minimum inhibitory concentration values for alternative antimicrobial agents against ESBL-PE, including β-lactams and non-β-lactams. Escherichia coli accounted for 96% of the total ESBL-PE strains. Most strains (94%) contained blaCTX-M group genes. The genes most commonly underlying resistance were of the blaCTX-M-9 and blaCTX-M-1 groups. Little difference was found in the distribution of ESBL-causative genes among the facilities; however, antimicrobial susceptibility differed widely among the facilities. No specific difference was found between antimicrobial susceptibility and the number of ESBL-causative genes. Our data showed that ESBL-PEs were susceptible to some antimicrobial agents, but the susceptibility largely differed among facilities. These findings suggest that each g-LTCF may require specific treatment strategies based on their own antibiogram. Investigations into drug resistance should be performed in g-LTCFs as well as acute medical facilities.
  • Joseph Y Abrams, Ryusuke Ae, Ryan A Maddox, Lawrence B Schonberger, Yosikazu Nakamura, Ermias D Belay
    Pediatrics international : official journal of the Japan Pediatric Society 64 1 e15112  2021年12月 [査読有り]
     
    BACKGROUND: Kawasaki disease (KD) can result in severe coronary artery abnormalities (CAAs). Corticosteroids added to initial standard intravenous immunoglobulin (IVIG) treatment may decrease the risk for these complications. Different corticosteroid regimens (single-day high dose pulse vs multiple lower doses) may contribute to the discrepant results of prior studies. METHODS: Using data from the 22nd, 23rd , and 24th Japanese nationwide KD surveys (2011-2016), we identified KD patients who did not have CAAs at first presentation and who were treated with either pulse or multiple-dose corticosteroids as part of their initial treatment. Occurrence of subsequent CAAs and treatment failure were compared between the treatment regimens and adjusted odds ratios were calculated controlling for sex, age group, illness day at first treatment, survey, and recurrent KD. RESULTS: There were 782 KD patients who received pulse corticosteroid treatment and 4,817 who received multiple dose treatment. Patients receiving multiple dose treatment were less likely to develop CAAs (5.5% vs 8.3%, OR 0.64; 95% CI: 0.48-0.85) or treatment failure (21.4% vs 41.6%; OR: 0.38; 95% CI: 0.33-0.45). Adjusted analyses showed similar protective effects of multiple-dose treatment against CAAs (OR: 0.67, 95% CI: 0.51-0.90) and treatment failure (OR: 0.39, 95% CI: 0.33-0.46). CONCLUSIONS: Multiple-dose corticosteroid combination treatment resulted in substantially improved outcomes in KD patients compared to pulse treatment. For patients who may be at elevated risk of treatment failure or CAA, use of multiple-dose corticosteroids in conjunction with IVIG is likely to provide considerable clinical benefit.
  • Ryusuke Ae, Teppei Sasahara, Akio Yoshimura, Koki Kosami, Shuji Hatakeyama, Kazumasa Sasaki, Yumiko Kimura, Dai Akine, Masanori Ogawa, Kenji Hamabata, Longzhu Cui
    Scientific reports 11 1 21607 - 21607 2021年11月 
    Previous studies indicated residents in geriatric long-term care facilities (LTCFs) had much higher prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) carriage than the general population. Most ESBL-E carriers are asymptomatic. The study tested the hypothesis that residents with ESBL-E carriage may accumulate inside geriatric LTCFs through potential cross-transmission after exposure to residents with prolonged ESBL-E carriage. 260 residents from four Japanese LTCFs underwent ESBL-E testing of fecal specimens and were divided into two cohorts: Cohort 1,75 patients with ≥ 2 months residence at study onset; Cohort 2, 185 patients with < 2 months residence at study onset or new admission during the study period. Three analyses were performed: (1) ESBL-E carriage statuses in Cohort 1 and Cohort 2; (2) changes in ESBL-E carriage statuses 3-12 months after the first testing and ≥ 12 months after the second testing; and (3) lengths of positive ESBL-E carriage statuses. Compared with the residents in Cohort 1, a significantly larger proportion of residents in Cohort 2 were positive for ESBL-E carriage (28.0% in Cohort 1 vs 40.0% in Cohort 2). In the subsequent testing results, 18.3% of residents who were negative in the first testing showed positive conversion to ESBL-E carriage in the second testing, while no patients who were negative in the second testing showed positive conversion in the third testing. The maximum length of ESBL-E carriage was 17 months. The findings indicated that some residents acquired ESBL-E through potential cross-transmission inside the LTCFs after short-term residence. However, no residents showed positive conversion after long-term residence, which indicates that residents with ESBL-E carriage may not accumulate inside LTCFs. Practical infection control and prevention measures could improve the ESBL-E prevalence in geriatric LTCFs.
  • Takao Kojo, Ryusuke Ae, Koki Kosami, Shizukiyo Ishikawa, Ichiro Innami
    Preventive medicine 153 106857 - 106857 2021年10月 [査読有り]
     
    Previous studies have found the prevention paradox in the association between stroke events and a single specific risk factor, indicating that a population-based strategy may be more effective than a high-risk-based strategy for prevention. We tested the hypothesis that the prevention paradox does not apply when focusing on multiple potential risk factors simultaneously. The study cohort included 9051 individuals from Japan aged 40-89 years. The time-dependent Cox proportional-hazards models were used to identify the primary risk factor associated with stroke onset. We classified participants based on risk factors in two distinct ways: 1) classifying the high-risk group participants according to a single specific risk factor that had a large association with stroke in both sexes and all ages and 2) classifying the high-risk group participants according to 1-3 risk factor(s) including hypertension, hyperglycemia, and/or dyslipidemia. Then, we compared the proportions of the total number of participants who developed stroke in both groups to assess the prevention paradox. We found that hypertension was a primary risk factor for stroke incidence, regardless of sex and age. The percentage of patients with a single specific risk of and developed stroke was 46%-63%, while the percentage of patients with 1-3 risk factor(s) was 71-83%. This finding leads to the conclusion that the prevention paradox does not hold when multiple stroke risk factors were associated, suggesting that a high-risk-based strategy that focuses on patients with multiple risk factors may be more effective in preventing strokes.
  • Shuhei Hiyama, Tomohiro Matsumura, Tsuneari Takahashi, Ryusuke Ae, Katsushi Takeshita
    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2021年09月 [査読有り]
     
    BACKGROUND: There is a need for a novel therapeutic strategy for an earlier prediction of long bone union failure as compared to previous methodologies. This study aimed to determine whether a combination of two diagnostic tools would result in a more accurate diagnosis of delayed union. METHODS: The inclusion criteria were as follows: patients with tibial shaft fracture who underwent treatment with intramedullary nailing (IMN) as definitive internal fixation (IF). The study included a total of 114 patients with 116 tibial shaft fractures treated with IMN as definitive IF. Radiographic apparent bone gap (RABG) and nonunion risk determination score (NURDS) can be used to predict nonunion. However, this study aimed to determine whether combination of RABG and NURDS could help deduce a more accurate prediction of delayed union. RESULTS: The union rate was found to be 85% (99 fractures), the delayed union rate was found to be 15% (17 fractures), and the rate of nonunion requiring additional surgical intervention was estimated to be 4% (5 out of the 17 delayed union cases). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RABG were found to be 82.3%, 76.0%, 36.8%, and 96.2%, respectively, when an RABG cutoff value of 5.0 mm was applied to our patient cohort. The sensitivity, specificity, PPV, and NPV of NURDS were found to be 47.1%, 82.0%, 30.8%, and 90.1%, respectively, when a NURDS cutoff value of 8.0% was applied to our patient cohort. When RABG and NURDS were above their respective cutoff values, the sensitivity and PPV were estimated to be 90.0% and 56.3%, respectively. When RABG and NURDS were below their respective cutoff values, the specificity and NPV were estimated to be 90.1% and 98.5%, respectively. CONCLUSIONS: The combination of RABG and NURDS evaluation immediately after surgery helps surgeons identify patients who are at a high risk of delayed union, facilitating careful monitoring of these patients and consideration of additional treatments.
  • Masaki Iguchi, Tsuneari Takahashi, Tomohiro Matsumura, Ryusuke Ae, Shuhei Hiyama, Mitsuharu Nakashima, Katsushi Takeshita
    Injury 2021年09月 [査読有り]
     
    INTRODUCTION: The AO/OTA classification for diagnosing femoral trochanteric fractures (31A fractures) was revised in 2018. No studies have investigated whether the addition of CT to radiographic diagnosis improves the inter-rater reliability of classifying 31A fractures with the current AO/OTA criteria. The study aimed to test the hypothesis that the addition of three-dimensional CT (3D-CT) to radiographic diagnosis would improve diagnostic reliability. METHODS: A retrospective review was conducted to assess the diagnostic reliability of classification of 31A fractures with current AO/OTA criteria. Radiographs and 3D-CT images from 89 cases were assessed. Major fracture types (A1, A2, and A3) and subgroups were diagnosed by nine orthopedic surgeons who were classified into three groups (high-, intermediate-, and low-experience) according to their clinical experience. Anterior-posterior and lateral radiographs were provided to diagnose fracture type (first assessment). After a 6-week interval, radiographs and 3D-CT images of all cases were evaluated by each rater (second assessment). Fleiss's Kappa was used to determine inter-rater reliability. RESULTS: In the first assessment, the Kappa value indicated fair inter-rater reliability in all groups (high-experience group: κ = 0.296, 95% confidence interval [CI] 0.239-0.352; intermediate-experience group: κ = 0.367, 95% CI 0.305-0.428; low-experience group: κ = 0.304, 95% CI 0.246-0.362). With the addition of 3D-CT (second assessment), reliability improved from fair to moderate in the high- and intermediate-experience groups (κ = 0.483, 95% CI 0.428-0.539 and κ = 0.409, 95% CI 0.352-0.466, respectively). By contrast, reliability remained fair in the low-experience group (κ = 0.322, 95% CI 0.322-0.431). The inter-rater reliability of diagnosing subgroup fracture types improved for A2.3 and A3.1 in all three groups and for A3.2 and A3.3 in the intermediate- and low-experience groups. CONCLUSION: The current AO/OTA classification revised in 2018 provided fair reliability in diagnosing femoral trochanteric fractures in all three surgeon groups. The addition of 3D-CT to radiographic image evaluation improved reliability in high- and middle-expertise groups. The addition of 3D-CT to radiographic evaluation often improved the diagnostic reliability for unstable fractures, although there was some variation among fracture subgroups.
  • Yuji Kaneda, Yuki Kimura, Akira Saito, Hideyuki Ohzawa, Ryusuke Ae, Hiroshi Kawahira, Alan K Lefor, Naohiro Sata
    Cureus 13 9 e18238  2021年09月 [査読有り]
     
    Introduction Although new techniques and devices have been introduced, the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy remains high. To reduce the risk of POPF, we developed an innovative ligation band and conducted this pilot study to assess the possibility of reducing the incidence of POPF and pancreatic necrosis after distal pancreatectomy. Methods Distal pancreatectomy was performed in three pigs. In two animals, ligation of the pancreas was performed while maintaining arterial blood flow to the stump, and in one animal, the arterial blood flow was occluded. After ligation, the pancreas was sharply divided. Animals were sacrificed seven days later, and the remnant pancreas was assessed histologically. POPF was defined as amylase in ascites > 3x the preoperative serum amylase level. The following equation was used to quantify the extent of necrotic tissue: necrotic tissue residual rate = necrotic tissue area/ cross-sectional area. Results All animals survived, and no POPF developed. For two animals in which arterial blood flow to the stump was maintained, necrotic tissue residual rates at the ligation line were 24% and 31%. At the pancreatic stump, necrotic tissue residual rates were 37% and 50%. In the animal in which arterial blood flow to the stump was occluded, the necrotic tissue residual rate at the ligation line was 83% and that at the pancreatic stump was 78%, both higher than that in animals in which arterial blood flow was maintained. In all animals, there was no injury to pancreatic tissue at the ligation line. Conclusion The pancreas ligation band can potentially prevent POPF after distal pancreatectomy by atraumatic ligation, and the band ligates the pancreatic stump while maintaining arterial blood flow and limiting pancreatic necrosis.
  • Hiroya Masuda, Ryusuke Ae, Taka-Aki Koshimizu, Masami Matsumura, Koki Kosami, Kanako Hayashida, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yosikazu Nakamura
    Clinical rheumatology 2021年08月 [査読有り]
     
    INTRODUCTION/OBJECTIVES: Hyponatremia is a potential risk factor for the development of coronary artery lesions (CALs) identified after acute Kawasaki disease (KD). However, the serum sodium distribution corresponding to the reference intervals differs between infants (< 1 year of age) and older children. We hypothesized the association of serum sodium level with CAL complications differs between infants and older patients with KD. METHODS: We analyzed 21,610 population-based patients who developed KD throughout Japan during 2013-2014. We performed multivariable logistic regression analyses to evaluate the association between serum sodium and CAL complications. Additionally, we stratified the serum sodium distribution associated with CAL complications by infants and older patients. RESULTS: CALs were identified in 158 (3.6%) infants and 302 (1.8%) older patients. Infants were more likely to develop CALs when within the normal sodium range compared with older patients (75% vs. 29%), whereas most older patients developed CALs with a sodium level lower than the reference interval. Serum sodium ≤ 130 mEq/L indicated significantly higher risk for development of CALs in both groups (adjusted odds ratio [95% confidence intervals] = 3.21 [1.65-6.25] in infants and 1.74 [1.18-2.57] in older patients). CONCLUSIONS: Serum sodium distribution associated with CAL complications differed greatly between infants and older patients. Older patients developed CALs with sodium levels lower than the reference interval; however, among infants, hyponatremia was not necessarily a risk factor for developing coronary artery lesion. When considering risk assessments for CALs using serum sodium levels, infants with KD should be distinguished from older patients. Key Points • Hyponatremia is a potential risk factor for the development of coronary artery lesions (CALs) among patients with Kawasaki disease. • However, the serum sodium distribution corresponding to the reference intervals differs between infants (< 1 year of age) and older children. • Most infants developed CALs within the normal sodium range, whereas older patients developed at a range lower than the reference interval. • These findings highlight that when considering risk assessments for CALs using serum sodium levels, infants should be distinguished from older patients.
  • Ryusuke Ae, Yoshihide Shibata, Koki Kosami, Yosikazu Nakamura, Hiromichi Hamada
    The Journal of pediatrics 2021年07月 [査読有り]
     
    OBJECTIVE: To assess the epidemiologic association between Kawasaki disease and common pediatric infectious diseases (PIDs) identified during the coronavirus disease 2019 (COVID-19) pandemic period to confirm whether the infection-triggered theory is a plausible hypothesis for the pathogenesis of Kawasaki disease. STUDY DESIGN: A retrospective epidemiologic study was conducted using datasets obtained from Web-based surveillance of Kawasaki disease and PIDs in Japan. We compared weekly numbers of patients who developed Kawasaki disease and specific PIDs between 2020 and 2017-2019 and evaluated the association between the percent reduction in the number of patients with these diseases. RESULTS: A total of 868 patients developed Kawasaki disease in 2020. During the social distancing period in 2020, the number of patients with Kawasaki disease was approximately 35% lower than in 2017-2019. Time from the onset of Kawasaki disease until the first hospital visit did not differ significantly among the examined years. The proportion of older children with Kawasaki disease decreased more than that of infants with Kawasaki disease (age <1 year), resulting in a significant difference in the proportion of infant patients between 2020 and 2017-2019 (24% vs 19%; P < .01). The number of patients with incomplete Kawasaki disease was unchanged from that of previous years. The weekly percent reduction in patient numbers differed between Kawasaki disease and PIDs during 2020, with no strong correlation between the 2 diseases. CONCLUSIONS: Our data indicate that parents of patients with Kawasaki disease did not avoid hospital visits during the COVID-19 pandemic period. The findings indicate the possibility that triggering Kawasaki disease might be associated with presently unidentified respiratory pathogen(s) that potentially might be acquired from both within and outside the household.
  • Kanako Hayashida, Ryusuke Ae, Hiroya Masuda, Koki Kosami, Masami Matsumura, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yosikazu Nakamura
    The Pediatric infectious disease journal 40 6 531 - 536 2021年06月 [査読有り]
     
    BACKGROUND: Some patients with Kawasaki disease (KD) have siblings who developed the same disease. Using a large-scale epidemiologic dataset, the present study aimed to determine the clinical characteristics of this population. METHODS: We analyzed 89,725 patients diagnosed with KD during 2011-2018 who were registered in the nationwide Japanese KD survey database. Multivariable logistic regression analyses were performed to determine factors associated with sibling history of KD. RESULTS: Of the 89,725 patients, 1777 (2%) had sibling history of KD. Annual prevalence ranged from 1.5% to 2.3% during the study period and showed a tendency toward an increasing trend. Patients with recurrent KD and parental history of KD were significantly associated with sibling history of KD (adjusted odds ratio [95% confidence interval] = 2.15 [1.82-2.54] and 2.64 [2.02-3.47], respectively). Although patients with a sibling history of KD were significantly associated with initial intravenous immunoglobulin treatment resistance (1.14 [1.02-1.28]), no significant association was found between sibling history and coronary artery abnormality development. Among patients with a sibling history of KD, male patients were less likely to have recurrent KD than female patients (0.68 [0.49-0.96]). CONCLUSIONS: The significant association between sibling history and parental history may indicate genetic susceptibility to KD onset. Among those with a sibling history, recurrent KD was more likely to occur in female patients. Further studies focusing on this population may contribute toward identification of the cause of KD onset.
  • Ryusuke Ae, Ryan A Maddox, Joseph Y Abrams, Lawrence B Schonberger, Yosikazu Nakamura, Masanari Kuwabara, Nobuko Makino, Koki Kosami, Yuri Matsubara, Daisuke Matsubara, Teppei Sasahara, Ermias D Belay
    Journal of the American Heart Association 10 7 e019853  2021年04月 [査読有り]
     
    Background Detection of coronary artery lesions (CALs) at initial echocardiography can aid in diagnosing Kawasaki disease (KD) and inform primary adjunctive treatments. We aimed to characterize patients with KD with CALs detected at initial echocardiography. Methods and Results We analyzed data from the nationwide Japanese KD survey that contained information on 103 222 population-based patients diagnosed with KD across Japan during 2011 to 2018. Patients with CALs detected at initial echocardiography were assessed by age, day of illness, and number of principal KD signs (≥3). Multivariable logistic regression analysis was performed to evaluate factors independently associated with CAL detection. Overall, 3707 (3.6%) patients had CALs detected at initial echocardiography. Patients aged <12 and ≥60 months were associated with CAL detection (adjusted odds ratio [95% CI], 1.28 [1.18‒1.39] and 1.32 [1.20‒1.45], respectively; reference, 12‒59 months). Patients with delayed hospital visits were increasingly at higher risk for CAL detection (days 7‒8, 1.84 [1.63‒2.08]; days 9-10, 4.30 [3.58-5.15]; and days ≥11, 9.12 [7.63‒10.90]; reference, days 1-4). Patients with 3 or 4 principal KD signs were independently associated with CAL detection (1.75 [1.63‒1.88]). These patients were significantly more likely to be aged <12 months but were not associated with delayed hospital visit. Younger patients visited at earlier days of illness. Conclusions Timely diagnosis could be beneficial for patients with KD. However, even when the hospital visit occurred early in the course of illness, patients with 3 or 4 principal KD signs, especially younger patients, were at higher risk of CAL detection at initial echocardiography.
  • Hiroya Masuda, Ryusuke Ae, Taka-Aki Koshimizu, Masami Matsumura, Koki Kosami, Kanako Hayashida, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yosikazu Nakamura
    Pediatric cardiology 42 4 969 - 977 2021年04月 [査読有り]
     
    A giant coronary artery (CA) aneurysm is a potentially fatal cardiac complication resulting from Kawasaki disease (KD). We aimed to identify epidemiologic characteristics and potential risk factors associated with giant CA aneurysms identified after acute KD. We analyzed 90,252 patients diagnosed with KD from 2011 to 2018, using data obtained in nationwide KD surveys conducted in Japan. Multivariable logistic regression analyses were performed to evaluate potential risk factors associated with subsequent giant CA aneurysm complications (defined as lumen size ≥ 8 mm), adjusting for all potential factors. Giant CA aneurysms were identified in 144 patients (0.16%) after acute KD. The annual prevalence ranged from 0.07 to 0.20% during the study period. In the multivariate analyses, male sex (adjusted odds ratio 2.09 [95% confidence interval 1.41-3.11], recurrent KD (1.90 [1.09-3.33]), IVIG administration at 1-4 days of illness (1.49 [1.04-2.15]) and ≥ 8 days after KD onset (2.52 [1.38-4.60]; reference, 5-7 days), detection of CA dilatations and aneurysms at initial echocardiography (4.17 [1.85-5.41] and 46.5 [28.8-74.8], respectively), and resistance to IVIG treatment (6.09 [4.23-8.75]) were significantly associated with giant CA aneurysm complications identified after acute KD. The annual prevalence of giant CA aneurysms identified after acute KD did not increase during the study period. Patients with larger CA abnormalities detected at initial echocardiography were independently associated with progression to giant CA aneurysm complications after acute KD regardless of the number of days from onset at treatment initiation.
  • Akio Yoshimura, Teppei Sasahara, Ryusuke Ae, Koki Kosami, Dai Akine, Masanori Ogawa, Kenji Hamabata, Shuji Hatakeyama, Yuji Morisawa, Longzhu Cui
    Biocontrol science 26 4 207 - 210 2021年 
    Influenza outbreaks at geriatric long-term care facilities (g-LTCFs) can be deadly and their prevention is important. However, the factors influencing disease transmission in g-LTCFs remain controversial. In this descriptive study, we tried to identify the potential risk factors influencing influenza outbreaks that occurred in different influenza seasons within a single g-LTCF with 100 residents in Gunma Prefecture. We reviewed the detailed facility records for all influenza cases in both residents and staff between January 2012 and June 2020. Facility preventive measures were also reviewed. We found that community meals may have been a potential source of transmission leading to the outbreaks. When influenza infection is noted, implementation of strict preventive measures and restriction of meal provision to resident rooms may help to prevent disease transmission and the development of an outbreak. Such measures may also be useful to prevent the transmission of other serious droplet-borne diseases within g-LTCFs.
  • Masanori Ogawa, Ryusuke Ae, Teppei Sasahara, Dai Akine
    Sangyo eiseigaku zasshi = Journal of occupational health 63 5 154 - 161 2020年12月 [査読有り]
     
    OBJECTS: The number of workers dispatched to developing countries has increased recently. The sanitary conditions in these countries are different from those in developed countries and from what the workers are used to. Therefore, health control, especially infection control, is an important consideration for working there. In this study, we investigate workers' needs as well as the occupational physicians' skills concerning working in developing countries. We propose a more effective education system for health control. METHODS: Regarding workers who have lived in developing countries, we surveyed the company profiles, duration of stay, vaccination status, infectious education, medical assistance, and satisfaction with infection control strategies of their employer companies. Regarding occupational physicians, we surveyed their profiles, their experiences in consultation, and advice from/to the workers dispatched to developing countries as well as their suggestive advice for staying there. RESULTS: Factors that contributed to workers' satisfaction with their employment companies were prior education and health consulting services in addition to company size. Many occupational physicians believed that this kind of information should be supplied but they did not have the confidence to provide it. CONCLUSIONS: Workers who are dispatched overseas should receive prior education and access to health consulting services. It is necessary for information providers such as occupational physicians to be knowledgeable in travel medicine.
  • Teppei Sasahara, Koki Kosami, Akio Yoshimura, Ryusuke Ae, Dai Akine, Masanori Ogawa, Yuji Morisawa
    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 2 329 - 335 2020年12月 [査読有り]
     
    INTRODUCTION: Hand hygiene is crucial for infection control in long-term care facilities for elderly (LTCFEs), because it can be easily implemented in the low-resource settings of LTCFEs. This study investigated the actual status of hand hygiene adherence in LTCFEs, identified the factors inhibiting its appropriate implementation, and evaluated the effectiveness of a hand hygiene promotion program. METHODS: In this before-and-after study, participants were staff members (n = 142) at two LTCFEs in Gunma Prefecture, Japan. We modified the World Health Organization's "five moments for hand hygiene" and assessed participants' hand hygiene adherence rates in four situations: (1) Before touching around a resident's mucous membrane area; (2) Before medical practice or clean/aseptic procedures; (3) After body fluid exposure/risk or after touching around a resident's mucous membrane area; and (4) After touching a resident's contaminated environments. The study was divided into four phases. In Phase 1, participants self-assessed their hand hygiene adherence using a questionnaire. In Phase 2, we objectively assessed participants' pre-intervention adherence rates. In Phase 3, an intervention comprising various hand hygiene promotion measures, such as education and hands-on training on hand hygiene practices and timings, was implemented. In Phase 4, participants' post-intervention adherence rates were objectively measured. RESULTS: Although most participants reported high hand hygiene adherence rate in the self-assessment (93.1%), the pre-intervention evaluation revealed otherwise (16.8%). Participants' post-intervention adherence rates increased for all four situations (77.3%). CONCLUSION: The intervention program helped increase participants' hand hygiene adherence rates, indicating its effectiveness. Similar interventions in other LTCFEs may also improve adherence rates.
  • Haruki Takikawa, Ryusuke Ae, Yuri Matsubara, Daisuke Matsubara, Nobuko Makino, Koki Kosami, Masanari Kuwabara, Teppei Sasahara, Yosikazu Nakamura
    Archives of disease in childhood 106 7 669 - 673 2020年12月 [査読有り]
     
    OBJECTIVE: To investigate whether redness and crusting at the bacille Calmette-Guérin inoculation site (BCGitis), identified during acute illness owing to Kawasaki disease (KD), is an independent risk factor for development of cardiac complications. DESIGN: Retrospective cohort study using data from the nationwide KD survey in Japan. SETTING: Survey respondents included hospitals specialising in paediatrics and hospitals with ≥100 beds and a paediatric department throughout Japan. PATIENTS: We included 17 181 patients with KD across Japan during 2005-2006. MAIN OUTCOME MEASURES: BCGitis and cardiac complications resulting from KD. RESULTS: BCGitis was identified in 7549 (44%) patients with KD. Compared with patients without BCGitis, those with BCGitis were younger, more likely to be male, less likely to have recurrent status and visited a hospital and underwent initial intravenous immunoglobulin (IVIG) treatment earlier after KD onset. In the unadjusted model, patients with BCGitis were significantly less likely to have cardiac complications (crude OR 0.81, 95% CI 0.71 to 0.92). However, after including treatment factors (days of illness at initial IVIG and treatment responsiveness) in the adjusted model, the association was no longer significant (adjusted OR 0.89, 95% CI 0.77 to 1.03), indicating that BCGitis was not an independent factor associated with cardiac complication and might be confounded by treatment factors. CONCLUSIONS: BCGitis was identified in comparatively early illness stages of KD. Our findings indicated that BCGitis was not an independent factor associated with developing cardiac complications but was confounded by prompt initial IVIG administration, which might result in successful treatment and prevention of cardiac complications.
  • Teppei Sasahara, Ryusuke Ae, Akio Yoshimura, Koki Kosami, Kazumasa Sasaki, Yumiko Kimura, Dai Akine, Masanori Ogawa, Kenji Hamabata, Shuji Hatakeyama, Longzhu Cui
    BMC geriatrics 20 1 481 - 481 2020年11月 [査読有り]
     
    BACKGROUND: A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs. METHODS: We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n = 204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n = 79). RESULTS: Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p = 0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing. CONCLUSIONS: The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs might be associated with resident transfer rather than spread via cross-transmission inside LTCFs.
  • Tsuyoshi Hamaguchi, Nobuo Sanjo, Ryusuke Ae, Yosikazu Nakamura, Kenji Sakai, Masaki Takao, Shigeo Murayama, Yasushi Iwasaki, Katsuya Satoh, Hiroyuki Murai, Masafumi Harada, Tadashi Tsukamoto, Hidehiro Mizusawa, Masahito Yamada
    Journal of neurology, neurosurgery, and psychiatry 91 11 1158 - 1165 2020年11月 [査読有り]
     
    OBJECTIVE: To clinically diagnose MM2-cortical (MM2C) and MM2-thalamic (MM2T)-type sporadic Creutzfeldt-Jakob disease (sCJD) at early stage with high sensitivity and specificity. METHODS: We reviewed the results of Creutzfeldt-Jakob disease Surveillance Study in Japan between April 1999 and September 2019, which included 254 patients with pathologically confirmed prion diseases, including 9 with MM2C-type sCJD (MM2C-sCJD) and 10 with MM2T-type sCJD (MM2T-sCJD), and 607 with non-prion diseases. RESULTS: According to the conventional criteria of sCJD, 4 of 9 patients with MM2C- and 7 of 10 patients with MM2T-sCJD could not be diagnosed with probable sCJD until their death. Compared with other types of sCJD, patients with MM2C-sCJD showed slower progression of the disease and cortical distribution of hyperintensity lesions on diffusion-weighted images of brain MRI. Patients with MM2T-sCJD also showed relatively slow progression and negative results for most of currently established investigations for diagnosis of sCJD. To clinically diagnose MM2C-sCJD, we propose the new criteria; diagnostic sensitivity and specificity to distinguish 'probable' MM2C-sCJD from other subtypes of sCJD, genetic or acquired prion diseases and non-prion disease controls were 77.8% and 98.5%, respectively. As for MM2T-sCJD, clinical and laboratory features are not characterised enough to develop its diagnostic criteria. CONCLUSIONS: MM2C-sCJD can be diagnosed at earlier stage using the new criteria with high sensitivity and specificity, although it is still difficult to diagnose MM2T-sCJD clinically.
  • Google APIを用いた位置座標特定による川崎病クラスターの抽出(1989-1998)
    佐野 尭, 牧野 伸子, 阿江 竜介, 小佐見 光樹, 松原 優里, 中村 好一
    日本公衆衛生学会総会抄録集 79回 323 - 323 日本公衆衛生学会 2020年10月
  • 色素性乾皮症全国疫学調査
    石川 鎮清, 小佐見 光樹, 松原 優里, 阿江 竜介, 青山 泰子, 牧野 伸子, 錦織 千佳子, 中村 好一
    日本公衆衛生学会総会抄録集 79回 411 - 411 日本公衆衛生学会 2020年10月
  • Ryusuke Ae, Nobuko Makino, Koki Kosami, Masanari Kuwabara, Yuri Matsubara, Yosikazu Nakamura
    The Journal of pediatrics 225 23 - 29 2020年10月 [査読有り][通常論文]
     
    OBJECTIVE: To report the epidemiologic characteristics, treatments, and cardiac complications of Kawasaki disease, using data from the nationwide survey in Japan. STUDY DESIGN: The nationwide Kawasaki disease survey in Japan has been conducted biennially since 1970. The most recent survey was completed in 2019, obtaining information for patients who developed Kawasaki disease during 2017-2018. Survey respondents were hospitals specializing in pediatrics and those with ≥100 beds and a pediatric department throughout Japan, where patients with Kawasaki disease were eventually hospitalized. RESULTS: The survey identified 32 528 patients with Kawasaki disease, which consisted of 15 164 (46.6%) in 2017 and 17 364 (53.4%) in 2018. The highest annual incidence rate was recorded in 2018 (359 per 100 000 children aged 0-4 years). After 1982, patients with ≤4 principal Kawasaki disease signs gradually increased, resulting in 6847 (21.1%) patients diagnosed during 2017-2018. Among the 30 784 patients receiving initial intravenous immunoglobulin administration, 6061 (19.7%) did not respond. Within 30 days of Kawasaki disease onset, 9.0% of patients were diagnosed with cardiac complications, and 2.6% of patients developed cardiac sequelae after the acute illness. CONCLUSIONS: The annual number of patients developing Kawasaki disease in Japan increased from 1970 through 2018, whereas the proportion of patients with Kawasaki disease with cardiac complications decreased in the most recent 2 decades. Early diagnosis of Kawasaki disease as well as advances in initial treatments could explain these findings.
  • Ryusuke Ae, Joseph Y Abrams, Ryan A Maddox, Lawrence B Schonberger, Yosikazu Nakamura, Masanari Kuwabara, Nobuko Makino, Yuri Matsubara, Koki Kosami, Teppei Sasahara, Ermias D Belay
    Journal of the American Heart Association 9 17 e015308  2020年09月 [査読有り]
     
    BACKGROUND Randomized controlled trials previously provided different conclusions about the superiority of adding corticosteroids to initial intravenous immunoglobulin treatment for the prevention of coronary artery abnormalities in patients with Kawasaki disease (KD). To further assess this issue, we analyzed large-scale data from nationwide KD surveys in Japan, where combination treatment (corticosteroids added to initial standard intravenous immunoglobulin treatment) has become commonly used for patients at high risk for KD. METHODS AND RESULTS Standard intravenous immunoglobulin treatment and combination treatment were compared using data from time periods with and without combination treatment. Outcome measures were coronary artery abnormalities and initial intravenous immunoglobulin treatment failure. Hospitals where ≥20% of patients received combination treatment were identified, and treatment and control groups were selected via matching by age, sex, illness day at initial treatment, and KD recurrence. Matched group selection and subsequent analyses were conducted 1000 times to minimize sampling bias and potential confounders (bootstrapping). From 115 hospitals, 1593 patients with KD in the treatment group and 1593 controls were selected for each of the 1000 sample iterations. The median proportion of patients who developed coronary artery abnormalities among the treatment group and controls were 4.6% (95% CI, 3.8%-5.8%) and 8.8% (95% CI, 7.5%-10.0%), respectively: an estimated risk ratio of 0.53 (0.41-0.67). A median of 14.1% (95% CI, 12.4%-15.9%) of the patients in the treatment group and 21.7% (95% CI, 19.8%-23.4%) in the controls had treatment failure: an estimated risk ratio of 0.65 (0.56-0.75). CONCLUSIONS Combination treatment reduced coronary artery abnormality risk by an estimated 47% and treatment failure by 35%. Multiple-dose corticosteroids may provide benefit in selected patients at high risk for KD.
  • 松原 優里, 青山 泰子, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 石川 鎮清, 中村 好一
    日本小児科学会雑誌 124 8 1224 - 1233 (公社)日本小児科学会 2020年08月 [査読有り]
     
    栃木県の調査データを二次利用し、在宅医療的ケア児の生活状況について分析した。医療的ケア児は県内に約300人、20歳未満人口1000人対0.91みられ、年齢分布では6歳未満が50%を占め、寝たきりや座位の児が50%、歩行や走ることが可能な児が31%であった。サービスについては人工呼吸器使用者で「送迎がない」「利用できるサービスの量が不足」「費用負担が大きい」などの項目が有意に高かった。また、介護者で睡眠5時間未満の者は児に経管栄養がある場合において有意に高かった。以上、これらの結果からも、在宅医療的ケア児の運動・知的機能には個人差があり、個々に応じたサービスの提供が必要であると考えられた。
  • Ryusuke Ae, Joseph Y Abrams, Ryan A Maddox, Lawrence B Schonberger, Yosikazu Nakamura, Masanari Kuwabara, Nobuko Makino, Yuri Matsubara, Daisuke Matsubara, Koki Kosami, Teppei Sasahara, Ermias D Belay
    American heart journal 225 120 - 128 2020年07月 [査読有り][通常論文]
     
    BACKGROUND: Previous studies demonstrated that coronary artery lesions (CALs) resulting from Kawasaki disease (KD) can improve over time. However, limited information is available on sub-acute outcomes of CALs detected at admission during KD illness. METHODS: The nationwide Japanese KD survey contained substantial information on KD patients with CALs detected at admission and who received standard IVIG treatment within 10 days of disease onset. Coronary outcomes were evaluated by changes in CALs from admission to the first assessment at 30 days from disease onset in three categories: improved, unchanged, and progressed. Ordinal logistic regression analysis was performed to evaluate factors associated with the outcomes. RESULTS: Of 2024 patients with CALs detected at admission, improved, unchanged, and progressed outcomes were found in 1548 (76.5%), 390 (19.3%), and 86 (4.2%), respectively. Over 80% of patients with coronary artery (CA) dilatations had improved outcome. Independent factors associated with worse outcomes were larger-size CALs (adjusted ORs [95% CIs]: CA aneurysm = 5.13 [3.65-7.22] and giant CA aneurysms = 7.49 [3.56-15.72] compared with CA dilatation, respectively), age ≥ 60 months (1.45 [1.08-1.94] compared with 12-59 months), recurrent KD (1.57 [1.07-2.29]), parental history of KD (2.23 [1.02-4.85]), and delayed admission (8-10 days from disease onset: 1.76 [1.21-2.57] compared with 1-4 days). CONCLUSIONS: KD patients with larger CALs, ≥60 months old, and with recurrent status or parental history may require more rigorous treatment. In addition, delayed admission may result in worse coronary outcome, indicating that prompt diagnosis and treatment are required.
  • Tsuyoshi Hamaguchi, Kenji Sakai, Atsushi Kobayashi, Tetsuyuki Kitamoto, Ryusuke Ae, Yosikazu Nakamura, Nobuo Sanjo, Kimihito Arai, Mizuho Koide, Fumiaki Katada, Masafumi Harada, Hiroyuki Murai, Shigeo Murayama, Tadashi Tsukamoto, Hidehiro Mizusawa, Masahito Yamada
    Emerging infectious diseases 26 6 1140 - 1146 2020年06月 [査読有り]
     
    We previously reported a phenotype of Creutzfeldt-Jakob disease (CJD), CJD-MMiK, that could help identify iatrogenic CJD. To find cases mimicking CJD-MMiK, we investigated clinical features and pathology of 1,155 patients with diagnosed sporadic CJD or unclassified CJD with and without history of neurosurgery. Patients with history of neurosurgery more frequently had an absence of periodic sharp-wave complexes on electroencephalogram than patients without a history of neurosurgery. Among 27 patients with history of neurosurgery, 5 had no periodic sharp-wave complexes on electroencephalogram. We confirmed 1 case of CJD-MMiK and suspected another. Both had methionine homozygosity at codon 129 of the prion protein gene and hyperintensity lesions in the thalamus on magnetic resonance images of the brain, which might be a clinical marker of CJD-MMiK. A subgroup with a history of neurosurgery and clinical features mimicking dura mater graft-associated CJD might have been infected during neurosurgery and had symptoms develop after many years.
  • Masanari Kuwabara, Mehmet Kanbay, Koichiro Niwa, Ryusuke Ae, Ana Andres-Hernando, Carlos A Roncal-Jimenez, Gabriela Garcia, Laura Gabriela Sánchez-Lozada, Bernardo Rodriguez-Iturbe, Ichiro Hisatome, Miguel A Lanaspa, Richard J Johnson
    Nutrients 12 5 2020年05月 [査読有り]
     
    The potential contribution of serum osmolarity in the modulation of blood pressure has not been evaluated. This study was done to examine the relationship between hyperosmolarity and hypertension in a five-year longitudinal design. We enrolled 10,157 normotensive subjects without diabetes who developed hypertension subsequently as determined by annual medical examination in St. Luke's International Hospital, Tokyo, between 2004 and 2009. High salt intake was defined as >12 g/day by a self-answered questionnaire and hyperosmolarity was defined as >293 mOsm/L serum osmolarity, calculated using serum sodium, fasting blood glucose, and blood urea nitrogen. Statistical analyses included adjustments for age, gender, body mass index, smoking, drinking alcohol, dyslipidemia, hyperuricemia, and chronic kidney disease. In the patients with normal osmolarity, the group with high salt intake had a higher cumulative incidence of hypertension than the group with normal salt intake (8.4% versus 6.7%, p = 0.023). In contrast, in the patients with high osmolarity, the cumulative incidence of hypertension was similar in the group with high salt intake and in the group with normal salt intake (13.1% versus 12.9%, p = 0.84). The patients with hyperosmolarity had a higher incidence of hypertension over five years compared to that of the normal osmolarity group (p < 0.001). After multiple adjustments, elevated osmolarity was an independent risk for developing hypertension (OR (odds ratio), 1.025; 95% CI (confidence interval), 1.006-1.044), regardless of the amount of salt intake. When analyzed in relation to each element of calculated osmolarity, serum sodium and fasting blood glucose were independent risks for developing hypertension. Our results suggest that hyperosmolarity is a risk for developing hypertension regardless of salt intake.
  • Ryusuke Ae, Mehmet Kanbay, Masanari Kuwabara
    Hypertension research : official journal of the Japanese Society of Hypertension 43 4 354 - 356 2020年04月 [査読有り]
  • Yuri Matsubara, Daisuke Matsubara, Ryusuke Ae, Koki Kosami, Yasuko Aoyama, Mayumi Yashiro, Nobuko Makino, Shigeki Matsubara, Yosikazu Nakamura
    Pediatrics international : official journal of the Japan Pediatric Society 62 4 444 - 450 2020年04月 [査読有り][通常論文]
     
    BACKGROUND: Some patients with Kawasaki disease (KD) develop cardiac sequelae, which increase the risk of subsequent ischemic heart events. Knowing the cumulative incidence (CI) of KD with cardiac sequelae may contribute to developing health policies to prevent subsequent ischemic events in these patients. METHODS: Study participants consisted of 254 984 patients aged 0-9 years with KD who were registered in nationwide surveys in Japan from 1991-2016. We calculated the incidence probabilities by dividing the number of patients with KD aged 0-9 years by the population used in vital statistics of each calendar year. We calculated the cumulative proportion of those not affected by KD, by multiplying each probability in patients aged from age 0-9 years. The CI of KD was obtained by subtracting this value from 1. We also calculated the number of patients in each birth cohort (BC). The same was done to calculate the CI of KD-related cardiac sequelae. RESULTS: The CIBC steadily increased from 0.005067 in males and 0.003668 in females in 1991 to 0.011431 in males and 0.0088253 in females in 2007. The CIBC of KD with cardiac sequelae decreased from 0.000478 in males and 0.000213 in females in 1997 to 0.000339 in males and 0.000169 in females in 2007. CONCLUSION: The increasing CIBC of KD indicates an increased susceptibility to KD in accordance with birth year. The decreasing CIBC of cardiac sequelae suggests the efficacy of KD treatment.
  • Ryusuke Ae, Joseph Y Abrams, Ryan A Maddox, Lawrence B Schonberger, Yosikazu Nakamura, Asuka Shindo, Masanari Kuwabara, Nobuko Makino, Yuri Matsubara, Koki Kosami, Teppei Sasahara, Ermias D Belay
    The Pediatric infectious disease journal 39 3 197 - 203 2020年03月 [査読有り][通常論文]
     
    BACKGROUND: Platelet count is considered as a biomarker for the development of coronary artery abnormalities (CAAs) among Kawasaki disease (KD) patients. However, previous studies have reported inconsistent results. We addressed the controversial association of platelet count with CAAs using a large-scale dataset. METHODS: A retrospective cohort study was conducted using KD survey data from Japan (2015-2016; n = 25,448). Classifying patients by intravenous immunoglobulin (IVIG) responsiveness, we described the trends in platelet count using the lowest and highest values along with the specific illness days. Multivariate logistic regression analysis was performed to evaluate the association between platelet count and CAAs, adjusting for relevant factors. RESULTS: Platelet counts rapidly decreased from admission, reached the lowest count at 6-7 days, and peaked after 10 days. Platelet counts in IVIG non-responders decreased with a lower minimum value than IVIG responders, but subsequently rebounded toward a higher maximum. Compared with patients with normal platelet counts (150-450 × 10/L), patients with abnormally high platelet counts (>450 × 10/L) were more likely to have CAAs at admission (adjusted odds ratio: IVIG responders, 1.50 [95% confidence interval 1.20-1.87] and non-responders, 1.46 [1.01-2.12]). By contrast, IVIG non-responding patients whose counts were below normal (<150 × 10/L) after hospitalization were at higher risk for developing CAAs (2.27 [1.44-3.58]). CONCLUSIONS: Platelet count varied widely by illness day and was confounded by IVIG responsiveness, which might have contributed to previous inconsistent findings. KD patients with abnormally high platelet counts at admission or abnormally low counts after hospitalization were at higher risk for CAAs.
  • Teppei Sasahara, Masanori Ogawa, Itaru Fujimura, Ryusuke Ae, Koki Kosami, Yuji Morisawa
    Biocontrol science 25 4 223 - 230 2020年 [査読有り]
     
    Tap water contamination is a growing concern in healthcare facilities, and despite chlorination, tap water in these facilities contains several pathogenic microorganisms causing healthcare-associated waterborne infections or nosocomial outbreaks. Shower units are particularly prone to contamination as they are conducive for bacterial growth and can even produce bioaerosols containing pathogenic bacteria. Shower units coupled with point-of-use (POU) water filters are a simple and safe option; however, their efficacy has been under-reported. Therefore, we determined the efficacy of showerheads attached with a POU filter capsule in preventing infections in our hospital. We investigated the presence of pathogenic bacteria in water sampled from three shower units. After replacing the original shower units with new ones incorporated with a sterile-grade water filter capsule (0.2 µm; QPoint™), the water samples were analyzed for up to 2 months. The POU filters removed several pathogenic bacteria (Mycobacterium, Pseudomonas, Stenotrophomonas, Aeromonas, and Klebsiella spp.). Filter effectiveness depends on regional water quality and we believe that effective tap water treatment combined with the use of POU filters (introduced at a reasonable cost in healthcare facilities) can considerably minimize waterborne diseases in hospitals and improve patient care.
  • Tsuneari Takahashi, Ryusuke Ae, Kensuke Minami, Meiwa Shibata, Tatsuya Kubo, Koki Kosami, Katsushi Takeshita
    Geriatric orthopaedic surgery & rehabilitation 11 2151459320979974 - 2151459320979974 2020年 [査読有り]
     
    Background: There is no report yet on the application of telemedicine in orthopedic practice in Japan. With a focus on patients with KOA, we investigated the willingness of patients to use telemedicine by assessing factors such as the patient's age, smartphone possession, hospital visiting time, and severity of KOA. Methods: Data of patients who regularly consulted orthopedic surgeons at our institutions from April 2020 to June 2020 were retrospectively analyzed using an electronic medical database. The patients were diagnosed with KOA according to clinical and radiological findings, according to the Kellgren-Lawrence (KL) classification. included were patients with KOA with KL classification above grade 2. All patients were asked: 1) whether they were willing to use telemedicine (Yes or No), 2) the reason why they answered Yes, 3) the reason why they answered No, 4) if they possessed a smartphone, 5) their numeric rating scale for pain at their last outpatient visit after the Sars-CoV-2 epidemic emerged, and 6) the time required for visiting hospital from their house. Patients were stratified into 2 groups depending on whether they answered Yes (Group Y) or No (group N). Comparisons between the groups concerning smartphone possession, NRS pain, hospital visiting times, and distribution of KL grade were made. Results: Only 36.7% of the patients with KOA said they were willing to use telemedicine. The average age of group Y was significantly younger than that of group N (67.9 ± 9.1 vs 73.1 ± 8.0, P = 0.0026) and the cutoff age was 70.0 years. In addition, the rate of smartphone possession was significantly higher in group Y than in group N (82.5% vs 34.5%, P < 0.001). Hospital visit times and the severity of KOA did not differ between the groups. Conclusion: Age is a barrier to the adoption of telemedicine.
  • 日本国内発症進行性多巣性白質脳症患者の疫学調査と解析
    三浦 義治, 小佐見 光樹, 阿江 竜介, 中村 好一, 濱口 毅, 中道 一生, 高橋 健太, 鈴木 忠樹, 高橋 和也, 雪竹 基弘, 野村 恭一, 原田 雅史, 三條 伸夫, 船田 信顕, 岸田 修二, 西條 政幸, 水澤 英洋, 山田 正仁
    臨床神経学 59 Suppl. S254 - S254 (一社)日本神経学会 2019年11月
  • 乳幼児歯科健診データを用いた下野市のむし歯罹患に関連する要因の検討
    間中 沙織, 山崎 泰世, 佐藤 有希恵, 萩原 栞, 小川 正実, 大橋 俊子, 中山 竜司, 阿江 竜介, 松原 優里
    栃木県公衆衛生学会抄録集 57回 37 - 39 栃木県公衆衛生協会・栃木県 2019年09月 
    下野市では、1歳6ヵ月児健診時から3歳児健診時までの間における齲蝕罹患者割合の増加率が県平均に比べて高いため、この間の齲蝕予防を図る目的で平成28年度から2歳児歯科検診を導入した。今回、この対策が有効であったか調査するとともに、生活環境や養育環境の違いが齲蝕の発生とどの程度関連しているか検討した。対象は29年度に3歳児健診を受けた児のうち、1歳6ヵ月児健診と2歳児歯科検診も受けていた345名とし、健診(または検診)毎の齲蝕罹患者割合および新規罹患者割合について調査するとともに、健診(または検診)毎の齲蝕リスク要因について検討した。結果、齲蝕罹患者割合は1歳6ヵ月児健診時が0.86%、2歳児歯科検診時7.24%、3歳児健診時12.75%、新規罹患者割合は2歳児歯科検診時7%、3歳児健診時8.5%であり、2歳児歯科検診導入による明らかな効果はみられなかった。1歳6ヵ月児健診時における齲蝕リスク要因として「兄弟との同居」「間食の制限なし」などが抽出され、2歳児健診時におけるリスク要因として「出生順位(第二子以降)」「かかりつけ歯科医なし」、3歳児健診時のリスク要因として「甘い飲み物をよく飲む」が抽出された。
  • 医原性中枢神経感染症 日本国内発症PMLサーベイランス疫学調査と解析
    三浦 義治, 中道 一生, 小佐見 光樹, 阿江 竜介, 濱口 毅, 中村 好一, 西條 政幸, 山田 正仁
    NEUROINFECTION 24 2 133 - 133 日本神経感染症学会 2019年09月 [査読有り][通常論文]
  • Eric Vallabh Minikel, Sonia M Vallabh, Margaret C Orseth, Jean-Philippe Brandel, Stéphane Haïk, Jean-Louis Laplanche, Inga Zerr, Piero Parchi, Sabina Capellari, Jiri Safar, Janna Kenny, Jamie C Fong, Leonel T Takada, Claudia Ponto, Peter Hermann, Tobias Knipper, Christiane Stehmann, Tetsuyuki Kitamoto, Ryusuke Ae, Tsuyoshi Hamaguchi, Nobuo Sanjo, Tadashi Tsukamoto, Hidehiro Mizusawa, Steven J Collins, Roberto Chiesa, Ignazio Roiter, Jesús de Pedro-Cuesta, Miguel Calero, Michael D Geschwind, Masahito Yamada, Yosikazu Nakamura, Simon Mead
    Neurology 93 2 e125-e134  2019年07月 [査読有り][通常論文]
     
    OBJECTIVE: To determine whether preventive trials in genetic prion disease could be designed to follow presymptomatic mutation carriers to onset of disease. METHODS: We assembled age at onset or death data from 1,094 individuals with high penetrance mutations in the prion protein gene (PRNP) in order to generate survival and hazard curves and test for genetic modifiers of age at onset. We used formulae and simulations to estimate statistical power for clinical trials. RESULTS: Genetic prion disease age at onset varies over several decades for the most common mutations and neither sex, parent's age at onset, nor PRNP codon 129 genotype provided additional explanatory power to stratify trials. Randomized preventive trials would require hundreds or thousands of at-risk individuals in order to be statistically powered for an endpoint of clinical onset, posing prohibitive cost and delay and likely exceeding the number of individuals available for such trials. CONCLUSION: The characterization of biomarkers suitable to serve as surrogate endpoints will be essential for the prevention of genetic prion disease. Parameters such as longer trial duration, increased enrollment, and the use of historical controls in a postmarketing study could provide opportunities for subsequent determination of clinical benefit.
  • Nozomi Yokota, Ryusuke Ae, Masaki Amenomori, Koji Kitagawa, Takuya Nakamura, Tetsuro Yokota, Kato Masato, Teppei Sasahara, Yuri Matsubara, Koki Kosami, Yoshikazu Nakamura
    Journal of general and family medicine 20 4 139 - 145 2019年07月 [査読有り][通常論文]
     
    Objective: Few studies have reported the influence of clinical background factors on the outcome of Helicobacter pylori eradication therapy in primary care practice. We aimed to determine which clinical background factors influence the outcome of eradication therapy in a primary care setting. Methods: This was a retrospective study of patients who received H pylori eradication therapy at Higashiohmi City Gamo Medical Center, Shiga, Japan, from January 2012 to December 2015. We investigated clinical background factors associated with success, failure, and self-interruption of H pylori eradication therapy: patients' age, gender, first- or second-line treatment, reasons for receiving gastroenterological endoscopic examination, method of drug administration, and attending physicians' age and their specialties. Results: There were 369 patients (208 females, 161 male), with a mean age of 59 years (range 30-88 years). The middle-aged group (50-69 years) was associated with successful eradication therapy compared with the young group (30-49 years). The elderly group (>70 years) was associated with eradication therapy failure compared with the middle-aged group. The young group was associated with self-interruption of eradication therapy. There was a marginally significant association between male patients and self-interruption. Older attending physicians (>50 years) were also associated with failure compared with younger physicians. There was no difference in outcome of eradication therapy between generalists and gastroenterology specialists. Conclusion: We have identified clinical factors associated with success, failure, and self-interruption of H pylori eradication therapy in a primary care setting.
  • Shinji Kido, Ryusuke Ae, Koki Kosami, Yuri Matsubara, Nobuko Makino, Teppei Sasahara, Masanari Kuwabara, Yasuko Aoyama, Mayumi Yashiro, Hiroshi Yanagawa, Yosikazu Nakamura
    Pediatrics international : official journal of the Japan Pediatric Society 61 6 539 - 543 2019年06月 [査読有り][通常論文]
     
    BACKGROUND: Evidence suggests that seasonal variation in the onset of Kawasaki disease (KD) exists worldwide. Whether a seasonal component to successful i.v. immunoglobulin (IVIG) therapy exists in KD-positive children, however, is unknown. We addressed this question by focusing on patients with primary onset KD who were non-responsive to IVIG treatment, in the large nationwide Japanese KD survey datasets from 2009 to 2016. METHODS: In these datasets, the IVIG therapy non-responders were defined as patients whose fever persisted ≥24 h or recurred ≤24 h after the end of the initial IVIG treatment (dosage, 2,000 mg/kg). Those who successfully responded to this treatment were defined as IVIG responders. The consecutive monthly trend of the proportion of IVIG non-responders was analyzed throughout the study period to investigate seasonal periodicity on Fourier analysis, and the monthly distributions of non-responders and responders were compared. RESULTS: From a total of 113 691 KD-positive patients, 15.7% were IVIG non-responders, and 61% were male. The proportion of non-responders increased across each calendar year with fluctuation, and Fourier analysis indicated seasonal periodicity. The seasonality effect differed between responders and non-responders, with the proportion of responders tending to increase in autumn through winter, while the non-responders showed a decreasing trend in autumn. The seasonality effect tended to differ by sex. CONCLUSIONS: The results indicate that the currently unknown etiological agents of KD might differ between IVIG responders and non-responders. In addition, immune reactivity against such agents possibly differs by sex in the IVIG non-responders.
  • Nobuko Makino, Yosikazu Nakamura, Mayumi Yashiro, Koki Kosami, Yuri Matsubara, Ryusuke Ae, Yasuko Aoyama, Hiroshi Yanagawa
    Pediatrics international : official journal of the Japan Pediatric Society 61 4 397 - 403 2019年04月 [査読有り][通常論文]
     
    BACKGROUND: Approximately 50 years have passed since Kawasaki disease (KD) was first reported. The KD nationwide survey began in 1970. Although >360 000 cases have already been reported in Japan, the cause is still unknown. In Japan, the number of patients and incidence rate of KD has continued to increase. It is necessary to examine the trend of the occurrence in the surveillance of KD. METHODS: The nationwide survey of patient incidence in 2015 and 2016 was conducted in 2017, as the 24th nationwide survey of KD. A questionnaire was sent to pediatric departments in hospitals with >100 beds and specialized pediatric hospitals, and was responded to by the attending pediatricians. RESULTS: The total number of patients in 2 years was 31 595, and the sex ratio (male/female) was 1.34. The incidence rate (/100 000 children aged 0-4 years/year) was 330.2 (371.2 in boys, 287.3 in girls) in 2015, and 309.0 (343.2 in boys, 273.2 in girls) in 2016. The number of patients by month peaked in January. The age-specific incidence rate according to sex was highest in children between 9 and 11 months of age, after which the incidence rate gradually decreased with advancing age. CONCLUSIONS: We summarize the most recent nationwide survey of KD and consider the change in the epidemiologic picture.
  • Masanari Kuwabara, Mayumi Yashiro, Ryusuke Ae, Hiroshi Yanagawa, Yosikazu Nakamura
    International journal of cardiology 269 334 - 338 2018年10月 [査読有り][通常論文]
     
    BACKGROUND: Although intravenous immunoglobulin (IVIG) therapy is the standard therapy for Kawasaki disease (KD) to prevent coronary aneurysms including dilatations, it is unclear whether early IVIG therapy is more efficient in the acute stage of KD. METHODS: We conducted a cohort study using data from the 22nd nationwide survey of KD in Japan from January 2011 to December 2012. We excluded patients with recurrent KD and whose first admission day was later than seven days from the onset of symptoms. Finally, 20,933 patients with echocardiography assessment and IVIG therapy were divided into three groups according to the start of the IVIG therapy: 1) early: ≤4 days, 2) conventional: 5-7 days, and 3) late: 8-10 days. Then we investigated whether the early IVIG therapy prevented coronary dilatation or aneurysm after multiple adjustments for age, sex, total amount of IVIG, use of steroids, infliximab, other immunosuppressive agents, and plasma exchange. RESULTS: After multiple adjustments, conventional therapy had similar risks for coronary dilatation or aneurysm compared with early therapy (odds ratio [OR]:0.95; 95% confidence interval [CI], 0.78-1.16), whereas late therapy had a higher risk (OR:1.66; 95% CI, 1.03-2.68). Other risk factors for coronary dilatation or aneurysm were young male, older age, use of steroids, infliximab, other immunosuppressive agents, and a larger amount of total IVIG. CONCLUSIONS: Early IVIG therapy for KD did not reduce the risk for coronary dilatation or aneurysm compared with conventional therapy. It is recommended to start IVIG therapy within 7 days from the onset of symptoms.
  • 日本全国におけるPM2.5値と川崎病発生との関連(2011年4月-2016年3月)
    佐野 尭, 牧野 伸子, 青山 泰子, 阿江 竜介, 松原 優里, 小佐見 光樹, 中村 好一
    日本公衆衛生学会総会抄録集 77回 318 - 318 日本公衆衛生学会 2018年10月
  • 栃木県における医療的ケア児の生活状況と課題
    松原 優里, 青山 泰子, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 77回 460 - 460 日本公衆衛生学会 2018年10月
  • 栃木県における医療的ケア児及び重症心身障害児を支える資源調査結果
    青山 泰子, 松原 優里, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 77回 460 - 460 日本公衆衛生学会 2018年10月
  • Yuri Matsubara, Hitoshi Osaka, Takanori Yamagata, Ryusuke Ae, Jun Shimizu, Noriko Oguro
    Brain & development 40 9 807 - 812 2018年10月 [査読有り][通常論文]
     
    BACKGROUND: Acute encephalopathy causes various sequelae, including motor disabilities and intellectual delays. Previous studies reported that cognitive impairments can also occur after acute encephalitis. Although the incidence of acute encephalopathy is high in Japan, there have been few reports on its sequelae. OBJECTIVE: To characterize the neurological outcomes of pediatric patients who sought motor rehabilitation for motor dysfunction after acute encephalopathy. METHOD: Subjects were 26 children who were healthy before suffering from motor dysfunction following acute encephalopathy and were referred to our pediatric rehabilitation institute during a 9-year period (August 2007-April 2017). We examined subjects' neurological status and followed sequelae for at least 8 months. RESULTS: Of 26 individuals, 21 became ambulatory after several months or years during the observation period. Patients who could sit without support within 5 months after the onset of acute encephalopathy were able to walk within several months or years. Patients showing high intensity on T2-weighted sequences or "bright tree appearance" in the frontal region took an average of 7 months to develop walking, which was longer than other patients. Among ambulatory subjects, 16(76%) exhibited mild to moderate intellectual delay with a developmental quotient (DQ) under 70, and 20 (95%) exhibited cognitive impairment. There was a significant correlation between DQ scores and motor disability (p = 0.013, r = -0.481). CONCLUSIONS: Although 80% of patients who had motor dysfunction caused by acute encephalopathy and visited out motor rehabilitation outpatient clinic were eventually able to walk, the time taken to develop walking ability depended on which region exhibited magnetic resonance imaging abnormalities. DQ scores and motor disability were significantly correlated.
  • Ryusuke Ae, Yosikazu Nakamura, Hiroshi Tada, Yumi Kono, Eiko Matsui, Kazuo Itabashi, Masanori Ogawa, Teppei Sasahara, Yuri Matsubara, Takao Kojo, Kazuhiko Kotani, Nobuko Makino, Yasuko Aoyama, Takashi Sano, Koki Kosami, Maho Yamashita, Akira Oka
    Journal of epidemiology 28 6 300 - 306 2018年06月 [査読有り][通常論文]
     
    BACKGROUND: Globally, few published studies have tracked the temporal trend of dioxin levels in the human body since 2000. This study describes the annual trend of dioxin levels in human breast milk in Japanese mothers from 1998 through 2015. METHODS: An observational study was conducted from 1998 through 2015. Participants were 1,194 healthy mothers following their first delivery who were recruited annually in Japan. Breast milk samples obtained from participants were analyzed using gas chromatography and mass spectrometry for dioxins, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and coplanar polychlorinated biphenyls (PCBs). RESULTS: Mean age was 29.5 years, and 53% of participants were 20-25 years old. A declining trend in total dioxin levels was found, from a peak of 20.8 pg toxic equivalence (TEQ)/g fat in 1998 to 7.2 pg TEQ/g fat in 2014. Data from the last 5 years of the study indicated a plateau at minimal levels. In contrast, an increasing trend was found in the mean age of participants during the last 5 years. Although significantly higher dioxin levels were observed in samples from older participants, an upward trend in dioxin levels was not observed, indicating that dietary and environmental exposure to dioxins had greatly diminished in recent years. CONCLUSIONS: Dioxin levels in human breast milk may be approaching a minimum in recent years in Japan. The findings may contribute to global reference levels for environmental pollution of dioxins, which remains a problem for many developing countries.
  • Nobuko Makino, Yosikazu Nakamura, Mayumi Yashiro, Takashi Sano, Ryusuke Ae, Koki Kosami, Takao Kojo, Yasuko Aoyama, Kazuhiko Kotani, Hiroshi Yanagawa
    Pediatrics international : official journal of the Japan Pediatric Society 60 6 581 - 587 2018年06月 [査読有り][通常論文]
     
    BACKGROUND: The etiology of Kawasaki disease (KD) is unknown. In Japan, the number of patients and incidence rate of KD has increased continuously since its discovery. The aim of this report was to analyze the latest nationwide epidemiological survey of KD in Japan. METHODS: The 23rd nationwide survey of KD was conducted in 2015. To report on all patients diagnosed with KD in 2013 and 2014, a questionnaire was sent to hospitals with ≥100 beds containing pediatric departments, as well as specialized pediatric hospitals. RESULTS: The number of KD patients reported was 15 696 in 2013 and 15 979 in 2014, resulting in an annual incidence rate of 302.5 and 308.0 per 100 000 population aged 0-4 years, respectively. The number of patients and incidence rate of KD in 2014 were the highest ever recorded in Japan. The number of patients diagnosed per month peaked in January, and a gradual increase in summer was also observed. Eight patients died of KD in 2013 and 2014. CONCLUSIONS: The number of patients and incidence rate of KD in Japan continue to increase. Continued surveillance of epidemiological trends of KD is therefore required.
  • Izumi Chihara, Ryusuke Ae, Yuka Kudo, Ritei Uehara, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yasuko Aoyama, Kazuhiko Kotani, Yosikazu Nakamura
    BMC psychiatry 18 1 112 - 112 2018年04月 [査読有り][通常論文]
     
    BACKGROUND: In Japan, although many suicidal studies were previously conducted in tertiary emergency department (ED) settings, no published studies have reported on suicidal patients presenting to the secondary EDs. The aim of the study was to describe the characteristics of suicidal patients and the referral rates to a psychiatrist overall and by type of facility. METHODS: Questionnaires were sent to all secondary and tertiary EDs in Tochigi prefecture, Japan. Data were collected for cases who presented in September 2009. Chi-square, Fisher's exact, and t-tests compared the results by gender and type of ED. RESULTS: All 74 EDs responded to the survey. There were 81 patients who attempted or died by suicide (36 men and 45 women). The most common method of suicide attempt was drug overdose (57%) followed by stabbing (17%). About a half used prescription drugs to attempt or die by suicide. The majority had a history of psychiatric disorders, and 35% had previous suicide attempt. About a half were admitted to medical or surgical unit; 33% were discharged home; and 9% died. After excluding those who died, 53% were referred to a psychiatrist, but 47% were not referred to a psychiatrist. The referral rate was lower for cases seen at secondary EDs (38%) compared to tertiary EDs (67%). CONCLUSION: Although professional organizations suggest that suicidal patients are seen by a psychiatrist, many were not, especially at secondary EDs. Further research is needed to assure that suicidal patients presenting to EDs receive appropriate psychiatric assessment and follow-up after discharge.
  • 精神科病院における栄養食事指導の実態 精神科病院栄養士の役割と課題
    池内 寛子, 阿江 竜介, 江花 裕子, 荒山 麻子, 櫛田 映子, 宇賀神 裕美, 間庭 昭雄, 阿久津 里美, 中村 好一
    日本病態栄養学会誌 21 1 253 - 265 (一社)日本病態栄養学会 2018年04月 [査読有り][通常論文]
     
    緒言:昨今の精神医療の現場では、非定型抗精神病薬の普及に伴い精神症状のコントロールが安定しつつある一方で、生活習慣病を発症する患者が増加している。これが今後の課題として挙げられるが、精神科疾患患者に対して実際に行われている栄養食事指導の現状を概観した研究は見当たらない。目的:精神科疾患患者に対する栄養食事指導の実態を明らかにする。方法:栃木県内で精神科を持つ28病院を対象に自記式調査票による実態調査を行った。結果と考察:半数以上が外来患者であり、統合失調症が半数を占めた。肥満症を主とする生活習慣病の予防指導が大半を占めた。一方で、患者の認知機能や精神状態などの情報が不十分な状況のもとで栄養食事指導が実施されている現状が示された。精神医療の現場では、地域で自立した生活をめざす患者の食生活を多職種で支援できる標準的な評価指標や実態に即した効果的で継続性のある指導手法の開発が必要である。(著者抄録)
  • Ryusuke Ae, Tsuyoshi Hamaguchi, Yosikazu Nakamura, Masahito Yamada, Tadashi Tsukamoto, Hidehiro Mizusawa, Ermias D Belay, Lawrence B Schonberger
    MMWR. Morbidity and mortality weekly report 67 9 274 - 278 2018年03月 [査読有り][通常論文]
     
    Creutzfeldt-Jakob disease (CJD) is a fatal neurodegenerative disorder that, according to the most well accepted hypothesis (1), is caused by replicating, transmissible, abnormal forms of a host-encoded prion protein (prions). Most CJD cases occur spontaneously (sporadic CJD) or are inherited (genetic CJD). Iatrogenic CJD can occur after exposure to prion-contaminated instruments or products in medical/surgical settings. Cadaveric dura mater graft-associated CJD (dCJD) accounts for a common form of iatrogenic CJD. This report summarizes the epidemiologic features of 154 cases of dCJD identified in Japan during 1975-2017; these cases account for >60% of dCJD cases reported worldwide (1,2). The unusually high prevalence of dCJD in Japan was first reported in 1997 (3). In 2008, a single brand of graft (Lyodura [B. Braun Melsungen AG, Melsungen, Germany]), frequently used as a patch in neurosurgical procedures, was identified as the probable vehicle of transmission (4). No international recall of the implicated Lyodura occurred, the product had a relatively long shelf life, and the grafts were used frequently in Japanese patients with non-life-threatening conditions (4,5). Since 2008, additional cases have been ascertained, reflecting the identification of previously missed cases and the occurrence of new cases with longer latency periods (interval from exposure to symptom onset) for dCJD (up to 30 years), underscoring the importance of maintaining surveillance for dCJD.
  • 中村好一, 松原優里, 笹原鉄平, 古城隆雄, 阿江竜介, 青山泰子, 牧野伸子, 小池創一, 石川鎮清
    日本公衆衛生雑誌 65 2 72 - 82 2018年02月 [査読有り][通常論文]
  • Matsubara Y, Ae R, Ohya Y, Akiyama H, Imai T, Matsumoto K, Fukuie T, Aoyama Y, Makino N, Nakamura Y, Saito H
    Arerugi = [Allergy] 67 6 767 - 773 2018年 [査読有り][通常論文]
  • Yosikazu Nakamura, Mayumi Yashiro, Maho Yamashita, Namiko Aoyama, Ushio Otaki, Yukie Ozeki, Takashi Sano, Takao Kojo, Ryusuke Ae, Yasuko Aoyama, Nobuko Makino, Kazuhiko Kotani
    Pediatrics international : official journal of the Japan Pediatric Society 60 1 19 - 22 2018年01月 [査読有り][通常論文]
     
    BACKGROUND: Although the incidence rates of Kawasaki disease (KD) in Japan have been determined in nationwide surveys, the cumulative incidence, that is, the proportion of those with a history of KD in the general population of 10-year-olds, is currently unknown. The aim of this study was therefore to assess the cumulative incidence of KD in Japan. METHODS: Using the age- and sex-specific incidence rate of KD in Japan from the results of the nationwide surveys, incidence probabilities, that is, the age-specific number of KD patients divided by the population used in the vital statistics, and cumulative proportions of those not affected by KD up to the end of 9 years of age, were calculated. The cumulative incidence was then defined as 1 minus the cumulative proportion. The observed age classes were 0, 1, 2, 3, 4, and 5-9 years. All data were calculated by sex. RESULTS: The cumulative incidence was 0.004833 for boys and 0.003474 for girls in 1991, but was 0.015284 and 0.012145 in 2014, respectively. According to these figures, 15.284 per 1,000 boys and 12.145 per 1,000 girls have been affected by KD by the age of 10 years. The birth-cohort cumulative incidences had similar trends. CONCLUSIONS: More than 10 persons in 1,000 have a history of KD at age 10 years in Japan.
  • Yosikazu Nakamura, Yuri Matsubara, Teppei Sasahara, Takao Kojo, Ryusuke Ae, Yasuko Aoyama, Nobuko Makino, Soichi Koike, Shizukiyo Ishikawa
    [Nihon koshu eisei zasshi] Japanese journal of public health 65 2 72 - 82 2018年 [査読有り][通常論文]
     
    Objectives To reveal the features of death and subsequent funeral services, we analyzed self-reported obituaries in The Shimotsuke, a local daily newspaper in Tochigi, Japan. In addition, the usefulness and disadvantages of such a database of deaths based on the obituaries were discussed.Method For a 5-year period, from January 2011 through December 2015, all the obituary columns in The Shimotsuke were computerized as a database and analyzed. Some results were compared with the vital statistics data in the corresponding period of time. Data analyzed were: dead persons' address (municipalities), name, sex, cause of death, age at death, date of death and funeral services, the chief mourner (Moshu), and so on.Results During the observed 5-year period, 69,793 deaths appeared in the columns, which were 67.6% of the all deaths in the vital statistics. No difference was observed in the proportions between the sexes in the published deaths in comparison with the vital statistics. In both sexes, the proportion was low in 0-9 years old, then high among 10-19 years, decreasing in 20s, and after then the proportion increased according to the age. The proportion was low in city areas, such as Utsunomiya and Oyama, and high in some cities and towns in the northern or eastern parts of Tochigi prefecture. The highest was in Motegi Town (88.0%), and the lowest was Nogi Town (38.0%), which is located in the southern-most part of the prefecture and is closest to the Tokyo metropolitan area. Almost all the funeral services were conducted within a week of the death, and no delays were observed to have been caused by the short supply of cremation services, which exists in large cities in Japan. In case where the chief mourner was a child, a parent, or a spouse of a child, the male sex was dominant. Analyses of death from senile decay, suicide, and homicide indicated that the accuracy of the published cause of death was low. The date of the funeral services was strongly influenced by superstitions in this country.Conclusions Observations of the self-reported obituaries in a local daily newspaper over five years revealed the situations of the deaths in the area that could not be observed using vital statistics. Despite limitations, the information was partially useful as a database.
  • Masanori Ogawa, Ryusuke Ae, Teppei Sasahara
    Case Reports in Oncology 10 3 851 - 856 2017年11月 [査読有り][通常論文]
     
    In the current study, we report a case of a 46-year-old man who presented with sudden abdominal pain and was diagnosed with rupture of hepatic angiosarcoma (HAS). He underwent surgery, but died 13 days after the onset of the abdominal pain. Chronic exposure to carcinogens, such as thorium dioxide, arsenic, vinyl chloride, and radium, is associated with HAS. However, our patient had not been exposed to such carcinogens. He had submitted himself for annual medical checkups since he was employed. His liver was cirrhotic, and medical history data showed that he had had fatty liver for at least 10 years before HAS onset. Although liver cirrhosis may play a role in the occurrence of HAS, the connection of chronic fatty liver in the tumorigenesis remains unclear. Case reports regarding HAS with fatty liver are few. To the best of our knowledge, this is the first case of HAS occurring in a cirrhotic liver that advanced from persistent fatty stage. Given that HAS is a rare tumor, data collection is important for investigating its pathophysiology. Case presentations considering health conditions before HAS onset are limited therefore, we present a case of HAS with annual health checkup data before disease onset.
  • 三浦 義治, 中道 一生, 西條 政幸, 高橋 健太, 鈴木 忠樹, 原 由紀子, 阿江 竜介, 濱口 毅, 三條 伸夫, 雪竹 基弘, 岸田 修二, 野村 恭一, 水澤 英洋
    神経治療学 34 6 S124 - S124 (一社)日本神経治療学会 2017年11月 [査読無し][通常論文]
  • Taro Takeshima, Masanobu Okayama, Ryusuke Ae, Masanori Harada, Eiji Kajii
    BMJ open 7 7 e016322  2017年07月 [査読有り][通常論文]
     
    OBJECTIVES: It is unclear whether family medical history influences the willingness to undergo genetic testing. This study aimed to determine how family history affected the willingness to undergo genetic testing for salt-sensitive hypertension in patients with and without hypertension. DESIGN: Cross-sectional study using a self-administered questionnaire. SETTING: Six primary care clinics and hospitals in Japan. PARTICIPANTS: Consecutive 1705 outpatients aged >20 years, 578 of whom had hypertension. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome variable was the willingness to undergo genetic testing to determine the risk of salt-sensitive hypertension, and the secondary variables were age, sex, education level, family history and concerns about hypertension. Factors associated with a willingness to undergo genetic testing were evaluated in patients with and without hypertension using a logistic regression model. RESULTS: In the hypertension and non-hypertension groups, 323 (55.9%) and 509 patients (45.2%), respectively, were willing to undergo genetic testing. This willingness was related with a high level of education (adjusted OR (ad-OR): 1.81, 95% CI 1.12 to 2.93), family history of stroke (1.55, 1.04 to 2.31) and concerns about hypertension (2.04, 1.27 to 3.28) in the hypertension group, whereas in the non-hypertension group, it was influenced by education level (ad-OR: 1.45, 95% CI 1.13 to 1.86), family history of hypertension (1.52, 1.17 to 1.98) and concerns about hypertension (2.03, 1.53 to 2.68). CONCLUSIONS: The influence of family history on the willingness to undergo genetic testing for risk of salt-sensitivity hypertension differed between participants with and without hypertension. In particular, participants without hypertension wished to know their likelihood of developing hypertension, whereas those with hypertension were interested to know the risk of stroke (a complication of hypertension). Family history could help better counsel patients about genetic testing on the basis of their medical history.
  • Relationship between Self-Reported Vaccination History and Measles and Rubella Antibody Titers in Medical and Nursing Students
    Ogawa M, Ae R, Sasahara T
    Advances in Infectious Diseases 7 2 27 - 36 2017年05月 [査読有り][通常論文]
  • Takao Kojo, Ryusuke Ae, Satoshi Tsuboi, Yosikazu Nakamura, Kunio Kitamura
    The journal of obstetrics and gynaecology research 43 3 516 - 522 2017年03月 [査読有り][通常論文]
     
    AIM: This study analyzes differentials in the variables associated with the experience of artificial abortion (abortion) and use of contraception by age among women in Japan. METHODS: The 2010 National Lifestyle and Attitudes Towards Sexual Behavior Survey was distributed to 2693 men and women aged 16-49 selected from the Japanese population using a two-stage random sampling procedure. From the 1540 respondents, we selected 700 women who reported having had sexual intercourse at least once. We used logistic regression to analyze how social and demographic factors were associated with the experience of abortion and contraceptive use. RESULTS: The abortion rate according to the survey was 19.3%. Of the 700 women in the sample, 6.9% had experienced two or more abortions. Logistic regression revealed that, although significant variables depended on age, a high level of education and discussions about contraceptive use with partners were negatively associated with the experience of abortion. Self-injury, approval of abortion and first sexual intercourse between the age of 10 and 19 were positively associated with the experience of abortion. Marriage, smoking and first sexual intercourse between the age of 10 and 19 were negatively associated with contraceptive use. Higher education and discussion of contraception with partners were positively associated with contraceptive use. CONCLUSIONS: To prevent unwanted pregnancy and abortion, social support and sexual education should be age-appropriate. It is vital to educate young people of the importance of discussing contraceptive use with their partners.
  • Ryusuke Ae, Takao Kojo, Kazuhiko Kotani, Masanobu Okayama, Masanari Kuwabara, Nobuko Makino, Yasuko Aoyama, Takashi Sano, Yosikazu Nakamura
    Geriatrics & gerontology international 17 3 410 - 415 2017年03月 [査読有り][通常論文]
     
    AIM: We previously proposed the concept of caregiver daily impression (CDI) as a practical tool for emergency triage. We herein assessed how CDI varies by sex, education and career length by determining CDI scores as quantitative outcome measures. METHODS: We carried out a cross-sectional study using a self-reported questionnaire among caregivers in 20 long-term care facilities in Hyogo, Japan. A total of 10 CDI variables measured participants' previous experience of emergency transfers using a scale from 0-10. The resulting total was defined as the CDI score. We hypothetically considered that higher scores indicated greater caregiver focus. The CDI scores were compared by sex, education and career length using analysis of covariance. RESULTS: A total of 601 personal caregivers were evaluated (mean age 36.7 years; 36% men). The mean career length was 6.9 years, with the following groupings: 1-4 years (38%), 5-9 years (37%) and >10 years (24%). After adjustment for sex and education, the CDI scores for the variable, "poor eye contact," significantly differed between caregivers with ≥10 and <5 years of experience (scores of 5.0 ± 3.1 and 4.0 ± 2.7, respectively). The CDI scores for variables related to eyes tended to increase with experience, whereas other CDI scores decreased. Male caregivers focused on residents' eyes significantly more than did female caregivers. CONCLUSIONS: We found that the CDI variable, "poor eye contact," is influenced by career length. Caregivers with more experience attach more importance to their impression of residents' eyes than do those with less experience. Sex-related differences in CDI might also exist. Geriatr Gerontol Int 2016; 17: 410-415.
  • Maho Yamashita, Ryusuke Ae, Mayumi Yashiro, Yasuko Aoyama, Takashi Sano, Nobuko Makino, Yosikazu Nakamura
    Pediatric cardiology 38 2 375 - 380 2017年02月 [査読有り][通常論文]
     
    Few studies discuss the risk factors for acute cardiac lesions (within 30 days) resulting from Kawasaki disease (KD). We aimed to clarify the characteristics of patients with cardiac lesions within 30 days and determine the risk factors for acute cardiac lesion subtypes. Using the 23rd nationwide survey of KD in Japan, we analyzed data from patients with or without acute cardiac lesions resulting from KD (n = 31,380). We subdivided patients with acute cardiac lesions into three types: acute valvular lesions, coronary aneurysms, and giant coronary aneurysms (GCA), and calculated the odds ratios of potential risk factors for acute cardiac lesion subtypes. The prevalence of acute cardiac lesions was 8.6%, and these lesions were more prevalent among males than females (1.98:1). Male sex, age <1 year, and atypical definite cases predicted coronary artery lesions (CAL). The risk factors for valvular lesions differed from the risk factors for CALs, but GCA risk factors were similar to CAL risk factors: age <1 year, later presentation to hospital, atypical definite cases, and resistance to initial intravenous immunoglobulin (IVIG) therapy. Resistance to IVIG therapy was a significant risk factor for acute GCA. We found differences in cardiac lesion risk factors within 30 days of diagnosing KD between acute CAL and valvular lesions resulting from KD. In particular, pediatricians should consider atypical definite cases and resistance to initial IVIG when assessing the risk of acute-phase GCA.
  • Atsushi Satoh, Hisatomi Arima, Takayoshi Ohkubo, Nobuo Nishi, Nagako Okuda, Ryusuke Ae, Mariko Inoue, Shuji Kurita, Keiko Murakami, Aya Kadota, Akira Fujiyoshi, Kiyomi Sakata, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    Journal of hypertension 35 2 401 - 408 2017年02月 [査読有り][通常論文]
     
    OBJECTIVE: To investigate associations between socioeconomic status (SES) and prevalence, awareness, treatment, and control of hypertension in Japan's general population. METHODS: In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. The cohort included 2623 adults from 300 randomly selected areas across Japan. Using baseline data, four cross-sectional analyses were performed: association of SES with prevalent hypertension in 2623 participants; association of SES with unawareness of hypertension and with no treatment in 1282 hypertensive patients; and association of SES with uncontrolled hypertension in 720 treated hypertensive patients. SES was classified according to employment status, length of education, marital and living status, and household expenditure. RESULTS: The overall prevalence of hypertension was 48.9%. Among hypertensive participants, the proportions of unawareness and no treatment were 33.1 and 43.8%, respectively. Target blood pressure levels were not achieved among 61.2% of treated hypertensive patients. Hypertension was more prevalent in the unmarried and living alone group than in the married group (odds ratio 1.76; 95% confidence interval 1.26-2.44), after adjustment for age, sex, BMI, smoking, alcohol consumption, habitual exercise, history of cardiovascular diseases, diabetes mellitus, hypercholesterolemia, dietary sodium, and potassium intake. SES was not clearly associated with unawareness, no treatment, nor poor control of hypertension. CONCLUSION: Being unmarried and living alone was associated with increased prevalence of hypertension. There was no clear association of SES with unaware, untreated, and uncontrolled hypertension.
  • Takahiro Goto, Takashi Sano, Takao Kojo, Ryusuke Ae, Yasuko Aoyama, Nobuko Makino, Kazuhiko Kotani, Yosikazu Nakamura
    Pediatrics international : official journal of the Japan Pediatric Society 58 12 1274 - 1276 2016年12月 [査読有り][通常論文]
     
    BACKGROUND: Although Kawasaki disease (KD) cardiac lesions can be treated with i.v. immunoglobulin (IVIG) and are associated with age and sex, the time course of cardiac lesions remains unclear on the large scale. METHODS: We used the data of the 22nd nationwide survey of KD in Japan (2011-2012). We divided the time course of cardiac lesions into eight groups according to the combination of timing (first visit to hospital, acute phase, and sequelae) and presence of cardiac lesions (E, existence of cardiac lesions; N, non-existence of cardiac lesions): EEE, EEN, ENE, NEE, ENN, NEN, NNE, and NNN. For example, EEN shows that cardiac lesions existed at first visit to hospital and in the acute phase, but did not exist as sequelae. A total of 24 952 patients were analyzed. RESULTS: The majority (90.6%) of patients belonged to the NNN group, followed by the EEN (3.21%) and NEN (3.33%) groups. Male sex and ages ≤5 months and ≥5 years tended to be more prevalent. Non-response to initial IVIG therapy was the most prevalent in all groups other than NNN. CONCLUSIONS: The time course of cardiac lesions and the relationship with sex, age, and IVIG therapy have been described. KD patients who are male, aged ≤5 months or ≥5 years, and non-responders to initial IVIG tend to have cardiac lesions at some point in the time course of KD.
  • Sano Takashi, Makino Nobuko, Aoyama Yasuko, Ae Ryusuke, Kojo Takao, Kotani Kazuhiko, Nakamura Yosikazu, Yanagawa Hiroshi
    Pediatrics International 58 11 1140  Wiley Publishing Asia Pty Ltd 2016年11月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 母乳中ダイオキシン類レベルの推移 1998年〜2014年(17年間)の観察
    阿江 竜介, 牧野 伸子, 佐野 尭, 古城 隆雄, 青山 泰子, 小谷 和彦, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 661  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 川崎病の空間集積性(1989-1998年)
    佐野 尭, 牧野 伸子, 青山 泰子, 小谷 和彦, 阿江 竜介, 古城 隆雄, 山下 眞穂, 中村 好一
    日本公衆衛生学会総会抄録集 75回 566  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 栃木県下野市の小学校区別ソーシャルキャピタルと生活習慣病との関連
    山下 眞穂, 石川 鎮静, 青山 泰子, 阿江 竜介, 佐野 尭, 小谷 和彦, 古城 隆雄, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 533  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • 運動指導者対象のワールドカフェで導出した共通項 栃木県身体を動かそうプロジェクト
    青山 泰子, 牧野 伸子, 阿江 竜介, 古城 隆雄, 佐野 尭, 山下 眞穂, 小谷 和彦, 高村 寿子, 中村 好一
    日本公衆衛生学会総会抄録集 75回 400  日本公衆衛生学会 2016年10月 [査読無し][通常論文]
  • Ryusuke Ae, Koki Kosami, Shinsuke Yahata
    Ostomy/wound management 62 9 52 - 5 2016年09月 [査読有り][通常論文]
     
    Hypergranulation tissue formation around a gastrostomy tube insertion site is a common feeding tube-related complication that affects patients who receive long-term enteral nutrition. Some clinicians recommend use of a topical corticosteroid in patients with gastrostomy tube insertion site hypergranulation. However, documentation is scant regarding appropriate treatment for this condition. This case report describes a 67-year-old bedridden man with spinocerebellar degeneration who presented with hypergranulation at the site of the gastrostomy tube, inserted 1 week earlier. The tissue was raw and inflamed, with bleeding and exudation. The gastrostomy site was gently cleansed with gauze dampened with tap water, and topical 0.05% clobetasol propionate ointment was applied directly to the hypergranulation tissue twice daily. After 4 days of treatment, the hypergranulation tissue almost completely disappeared, redness markedly decreased, and bleeding and exudation ceased, with no recurrence observed during the 6 months of follow-up. This case study supports other reports that short-term corticosteroid treatment may be a safe, quick, noninvasive, and effective treatment for hypergranulation at the gastrostomy tube insertion site. Further studies are needed to evaluate the safety, effectiveness, appropriate dosage, and duration of topical corticosteroid for the treatment of hypergranulation tissue.
  • Tsogzolbaatar Enkh-Oyun, Dambadarjaa Davaalkham, Kazuhiko Kotani, Yasuko Aoyama, Satoshi Tsuboi, Ryusuke Ae, Gombojav Davaa, Dayan Angarmurun, Nanjid Khuderchuluun, Yosikazu Nakamura
    Journal of epidemiology and global health 6 3 187 - 96 2016年09月 [査読有り][通常論文]
     
    Many Mongolian people suffer from non-communicable chronic diseases. In order to plan preventive strategies against such diseases, we designed a community-based prospective cohort study of chronic diseases, called the Moncohort study, in Mongolia. This is the first nationwide large-scale cohort study of chronic diseases. This paper describes the study's rationale, design and methods with baseline data. Mongolian residents aged ⩾40years were selected nationwide from many geographic regions in 2009. Data were collected on demographics, socioeconomic status, lifestyle, and anthropometric and biochemical measurements. In total, 2280 Mongolian residents were registered in the survey. Socioeconomic, lifestyle, anthropometric and biochemical characteristics were differentiated by gender and geographical area in descriptive data. Aging, low social class, physical inactivity and infrequent fruits intake were positively associated with histories of chronic disease in men, while aging was positively associated with histories of chronic disease in women. Factors associated with chronic diseases reveal gender-oriented strategies might be needed for their prevention. Detailed prospective analyses will illustrate the impact of risk factors on chronic diseases and lead to evidence for designing programs aimed at preventing chronic diseases and related disorders in Mongolia.
  • Teppei Sasahara, Ryusuke Ae, Michiyo Watanabe, Yumiko Kimura, Chikara Yonekawa, Shunji Hayashi, Yuji Morisawa
    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 22 8 521 - 5 2016年08月 [査読有り][通常論文]
     
    Clostridium species and Bacillus spp. are spore-forming bacteria that cause hospital infections. The spores from these bacteria are transmitted from patient to patient via healthcare workers' hands. Although alcohol-based hand rubbing is an important hand hygiene practice, it is ineffective against bacterial spores. Therefore, healthcare workers should wash their hands with soap when they are contaminated with spores. However, the extent of health care worker hand contamination remains unclear. The aim of this study is to determine the level of bacterial spore contamination on healthcare workers' hands. The hands of 71 healthcare workers were evaluated for bacterial spore contamination. Spores attached to subject's hands were quantitatively examined after 9 working hours. The relationship between bacterial spore contamination and hand hygiene behaviors was also analyzed. Bacterial spores were detected on the hands of 54 subjects (76.1%). The mean number of spores detected was 468.3 CFU/hand (maximum: 3300 CFU/hand). Thirty-seven (52.1%) and 36 (50.7%) subjects were contaminated with Bacillus subtilis and Bacillus cereus, respectively. Nineteen subjects (26.8%) were contaminated with both Bacillus species. Clostridium difficile was detected on only one subject's hands. There was a significant negative correlation between the hand contamination level and the frequency of handwashing (r = -0.44, P < 0.01) and a significant positive correlation between the hand contamination level and the elapsed time since last handwashing (r = 0.34, P < 0.01). Healthcare workers' hands may be frequently contaminated with bacterial spores due to insufficient handwashing during daily patient care.
  • Ryusuke Ae, Takao Kojo, Masanobu Okayama, Satoshi Tsuboi, Nobuko Makino, Kazuhiko Kotani, Yasuko Aoyama, Yosikazu Nakamura
    Geriatrics & gerontology international 16 5 612 - 7 2016年05月 [査読有り][通常論文]
     
    AIMS: To propose a caregiver daily impression (CDI) rating instrument for personal caregivers of residents living in long-term care facilities (LTCF) to comprehensively evaluate residents' daily health condition, and to investigate whether the CDI reflects illness latency and severity in residents transferred emergently. METHODS: We carried out a retrospective review of facility care records from 20 LTCF in Hyogo, Japan. The participants were 169 LTCF residents with episodes of transfer to emergency hospitalization facilities during a 3-month period. We determined specific CDI variables by interviewing experienced LTCF caregivers, and then carried out a principal component analysis to determine the major parameter set. The generated components were incorporated into a regression model to investigate the association with hospitalization. RESULTS: The mean age was 87.9 ± 6.5 years, 68% were women and 28% of transfers resulted in hospitalization. The interview procedure identified 12 specific CDI variables, and the principal component analysis generated five distinct components: "change in feeding," "change in emotion," "disengaged or listless gaze," "decrease in eye reactivity" and "change in movement." By multivariate logistic regression, hospitalization was associated with "decrease in eye reactivity" (adjusted OR 1.78, 95% CI 1.07-2.97) and poor vital signs (adjusted OR 2.84, 95% CI 1.15-6.98), but not with body temperature (adjusted OR 1.29, 95% CI 0.52-3.21). CONCLUSIONS: The CDI might reflect underlying illness severity beyond quantitative physical findings. Once the CDI can be appropriately validated, quantified and linked to physical findings, it could be used by caregivers for daily resident assessments and as a practical triage tool in emergency situations. Geriatr Gerontol Int 2016; 16: 612-617.
  • 阿江 竜介, 中村 好一
    神経内科 84 3 212  (有)科学評論社 2016年03月 [査読無し][通常論文]
  • 阿江 竜介, 中村 好一
    神経内科 84 3 212  (有)科学評論社 2016年03月 [査読無し][通常論文]
  • Masahito Yamada, Tsuyoshi Hamaguchi, Kenji Sakai, Ichiro Nozaki, Moeko Noguchi-Shinohara, Nobuo Sanjo, Tadashi Tsukamoto, Ryusuke Ae, Yosikazu Nakamura, Tetsuyuki Kitamoto, Hidehiro Mizusawa
    PRION 10 S10 - S11 2016年 [査読有り][通常論文]
  • Ae Ryusuke, Nakamura Yosikazu, Takumi Ichiro, Sanjo Nobuo, Kitamoto Tetsuyuki, Yamada Masahito, Hamaguchi Tsuyoshi, Tsukamoto Tadashi, Mizusawa Hidehiro
    PRION 10 S103 - S104 2016年 [査読有り][通常論文]
  • Takumi Ichiro, Saito Nobuhito, Sanjo Nobuo, Takayanagi Shunsaku, Tamura Chieko, Tsukamoto Tadashi, Kuroiwa Yoshiyuki, Ae Ryusuke, Nakmamura Yoshikazu, Kitamoto Tetsuyuki, Hamaguchi Tsuyoshi, Yamada Masahito, Kawada Yumi, Mizusawa Hidehiro
    PRION 10 S124  2016年 [査読有り][通常論文]
  • Masanobu Okayama, Taro Takeshima, Masanori Harada, Ryusuke Ae, Eiji Kajii
    International journal of general medicine 9 257 - 66 2016年 [査読有り][通常論文]
     
    OBJECTIVE: Disclosing genetic testing results may contribute to the prevention and management of many common diseases. However, whether the presence of a disease influences these effects is unclear. This study aimed to clarify the difference in the effects of disclosing genetic testing results of the risk for developing salt-sensitive hypertension on the behavioral modifications with respect to salt intake in hypertensive and nonhypertensive patients. METHODS: A cross-sectional study using a self-administered questionnaire was conducted for outpatients aged >20 years (N=2,237) at six primary care clinics and hospitals in Japan. The main factors assessed were medical histories of hypertension, salt preferences, reduced salt intakes, and behavior modifications for reducing salt intake. Behavioral modifications of participants were assessed using their behavior stages before and after disclosure of the hypothetical genetic testing results. RESULTS: Of the 2,237 participants, 1,644 (73.5%) responded to the survey. Of these respondents, 558 (33.9%) patients were hypertensive and 1,086 (66.1%) were nonhypertensive. After being notified of the result "If with genetic risk", the nonhypertensive participants were more likely to make positive behavioral modifications compared to the hypertensive patients among all participants and in those aged <65 years (adjusted relative ratio [ad-RR], 1.76; 95% confidence interval, 1.12-2.76 and ad-RR, 1.99; 1.11-3.57, respectively). In contrast, no difference in negative behavioral modifications between hypertensive and nonhypertensive patients was detected after being notified of the result "If without genetic risk" (ad-RR, 1.05; 95% confidence interval, 0.70-1.57). CONCLUSION: The behavior of modifying salt intake after disclosure of the genetic testing results differed between hypertensive and nonhypertensive patients. Disclosing a genetic risk for salt-sensitive hypertension was likely to cause nonhypertensive patients, especially those aged <65 years, to improve their behavior regarding salt intake. We conclude that disclosing genetic testing results could help prevent hypertension, and that the doctor should communicate the genetic testing results to those patients with a medical history of hypertension, or those who are at risk of developing hypertension.
  • Tsogzolbaatar Enkh-Oyun, Kazuhiko Kotani, Dambadarjaa Davaalkham, Gombojav Davaa, Ulziibayar Ganchimeg, Dayan Angarmurun, Nanjid Khuderchuluun, Bayartsogt Batzorig, Satoshi Tsuboi, Ryusuke Ae, Yasuko Aoyama, Yosikazu Nakamura
    Metabolic syndrome and related disorders 13 4 179 - 86 2015年05月 [査読有り][通常論文]
     
    BACKGROUND: Although cardiovascular health is a crucial problem for Mongolian people, little information about metabolic syndrome, which is well known to be associated with the development of cardiovascular disease, is available in Mongolia. The aim of this study was to observe the epidemiological features of metabolic syndrome in a general Mongolian population. METHODS: This cross-sectional study was performed in 1911 general Mongolian subjects (717 men, 1194 women), who were ≥40 years old and free of ischemic heart disease, by using a dataset from a nationwide population-based cohort study in Mongolia. The prevalence of metabolic syndrome, as defined by International Diabetes Federation criteria, was determined. Alcohol consumption, smoking habits, and physical activity were evaluated. Education, marital status, income, and occupation were also examined as factors of socioeconomic status (SES). Their association with metabolic syndrome was determined by logistic regression models. RESULTS: The prevalence of metabolic syndrome was significantly higher in women (n=488, 40.6%) than in men (n=138, 19.4%). The prevalence of metabolic syndrome was high, especially in the Khangai region, in women. Moderate-to-high alcohol consumption was a significantly positively associated factor of metabolic syndrome in men [odds ratio (OR)=2.01; 95% confidence interval (CI) 1.15-3.51; adjusted odds ratio (AOR)=2.41; 95% CI 1.31-4.44] and widowed status was a significantly positively associated factor of metabolic syndrome in women (OR=1.61, 95% CI 1.18-2.18; AOR=1.49, 95% CI 1.07-2.08). CONCLUSIONS: Metabolic syndrome was prevalent in women compared with men among Mongolian adults. Preventive strategies aimed at men with a higher alcohol consumption and women with widowed status may help reduce metabolic syndrome, thereby improving cardiovascular health conditions in Mongolia.
  • Satoshi Tsuboi, Honami Yoshida, Ryusuke Ae, Takao Kojo, Yosikazu Nakamura, Kunio Kitamura
    Asia-Pacific journal of public health 27 2 NP2578-86 - NP2586 2015年03月 [査読有り][通常論文]
     
    A cross-sectional study was conducted with a national epidemiological survey to investigate the prevalence and demographic distribution of adult survivors of child abuse in Japan. A self-administered questionnaire was used to measure the history of child abuse and the demographic characteristics. The participants reported the following 4 types of child abuse: physical abuse (3%), sexual abuse (0.6%), neglect (0.8%), and psychological abuse (4%). Significant unequal distribution of child abuse was found to be associated with sex, living region, marital status, job status, and educational status. We determined the prevalence of adult survivors of child abuse in Japan and found that their demographic characteristics were unequally distributed. Policy makers and public health providers should take these demographic disparities into account in considering effective public health interventions for survivors of child abuse.
  • Satoshi Tsuboi, Honami Yoshida, Ryusuke Ae, Takao Kojo, Yosikazu Nakamura, Kunio Kitamura
    Asia-Pacific journal of public health 27 2 NP2390-9 - NP2399 2015年03月 [査読有り][通常論文]
     
    PURPOSE: To investigate the selection bias of an Internet panel survey organized by a commercial company. METHODS: A descriptive study was conducted. The authors compared the characteristics of the Internet panel survey with a national paper-based survey and with national governmental statistics in Japan. RESULTS: The participants in the Internet panel survey were composed of more women, were older, and resided in large cities. Regardless of age and sex, the prevalence of highly educated people in the Internet panel survey was higher than in the paper-based survey and the national statistics. In men, the prevalence of heavy drinkers among the 30- to 49-year-old population and of habitual smokers among the 20- to 49-year-old population in the Internet panel survey was lower than what was found in the national statistics. CONCLUSIONS: The estimated characteristics of commercial Internet panel surveys were quite different from the national statistical data. In a commercial Internet panel survey, selection bias should not be underestimated.
  • Yosikazu Nakamaura, Ryusuke Ae, Ichiro Takumi, Nobuo Sanjo, Tetsuyuki Kitamoto, Masahito Yamada, Hidehiro Mizusawa
    Journal of Epidemiology 25 1 8 - 14 2015年 [査読有り][通常論文]
     
    Background: Epidemiologic features of prion diseases in Japan, in particular morbidity and mortality, have not been clarified. Methods: Since 1999, the Research Committee has been conducting surveillance of prion diseases, and the surveillance data were used to assess incident cases of prion diseases. For the observation of fatal cases, vital statistics were used. Results: Both incidence and mortality rates of prion diseases increased during the 2000s in Japan. However, this increase was observed only in relatively old age groups. Conclusions: The increased number of patients among old age groups might be due to increased recognition of the diseases. If so, the number of cases should plateau in the near future.
  • Nobuko Makino, Yosikazu Nakamura, Mayumi Yashiro, Ryusuke Ae, Satoshi Tsuboi, Yasuko Aoyama, Takao Kojo, Ritei Uehara, Kazuhiko Kotani, Hiroshi Yanagawa
    Journal of epidemiology 25 3 239 - 45 2015年 [査読有り][通常論文]
     
    BACKGROUND: The number of patients and incidence rate of Kawasaki disease (KD) are increasing in Japan. We have therefore characterized the latest epidemiological information on KD. METHODS: The 22nd nationwide survey of KD, which targeted patients diagnosed with KD in 2011 and 2012, was conducted in 2013 and included a total of 1983 departments and hospitals. In order to report on all patients with KD during the 2 survey years, we targeted hospitals of 100 beds or more with pediatric departments, or specialized pediatric hospitals. RESULTS: From a total of 1420 hospitals and departments (71.6% response rate), 26,691 KD patients were reported (12,774 in 2011 and 13,917 in 2012; 15,442 males and 11,249 females). The annual incidence rates were 243.1 per 100,000 population aged 0 to 4 years in 2011 and 264.8 in 2012. The number of cases of KD recorded in 2012 was the highest ever reported in Japan. The incidence rate of complete cases was also the highest ever reported in Japan and contributed to the increase in the rate of total cases in recent years. The number of patients diagnosed per month peaked in January, and additional peaks were noted during summer months, although these peaks were lower than those seen in winter. Age-specific incidence rate showed a monomodal distribution with a peak in the latter half of the year in which patients were born. CONCLUSIONS: The number of patients and the incidence rate of KD in Japan continue to increase. A similar trend has also been seen for patients with complete KD.
  • Masanari Kuwabara, Mayumi Yashiro, Kazuhiko Kotani, Satoshi Tsuboi, Ryusuke Ae, Yosikazu Nakamura, Hiroshi Yanagawa, Tomisaku Kawasaki
    Journal of Epidemiology 25 3 189 - 193 2015年 [査読有り][通常論文]
     
    Background: Cardiac lesions, such as coronary dilatation, aneurysms, narrowing, myocardial infarction, and valvular lesions, sometimes occur in Kawasaki disease, but most studies have only evaluated cardiac lesions in the later phase of the disease. This study was undertaken to clarify the related factors between cardiac lesions and laboratory data in the initial phase of Kawasaki disease. Methods: We conducted a cross-sectional study using data for 26 691 patients from the 22nd nationwide survey of Kawasaki disease in Japan, the observation period of which was from January 2011 through December 2012. We excluded patients with recurrent Kawasaki disease and who were more than seven days from the start of symptoms at admission. We analyzed 23 155 cases (13 353 boys mean age: 923 ± 734 days) with available laboratory data for white blood cell count, platelet count, serum albumin, and C-reactive protein (CRP). Results: Cardiac lesions were detected in 984 cases (656 boys and 328 girls) lesions were classified as coronary dilatation (764 cases), coronary aneurysm (40), giant coronary aneurysm (6), coronary narrowing (3), and valvular lesions (204). The significant related factors of initial coronary dilatation were male sex (odds ratio [OR] 1.73), older age (OR per 100 days increase 1.03), higher platelet count (OR per 10 000 cells/μL increase 1.006), lower albumin (OR per 1 g/dL increase 0.66), and higher CRP (OR per 1 mg/dL increase 1.02). The factors related to coronary aneurysm were higher platelet count (OR 1.01) and lower albumin (OR 0.34). No factors were significantly related to giant coronary aneurysm. The related factors of valvular lesions were age (OR 0.98), and higher CRP (OR 1.05). Conclusions: Clinicians should consider male sex, older age, higher platelet count, lower albumin levels, and higher CRP levels when assessing risk of cardiac lesions in the initial phase of Kawasaki disease.
  • 福原円, 谷原直子, 町田真由美, 海老原美保, 若林珠江, 阿江竜介, 中村好一, 大木いずみ, 小野澤典子, 佐藤朋弓
    公衆衛生 78 11 777 - 781 2014年11月 [査読有り][通常論文]
  • Masanobu Okayama, Taro Takeshima, Ryusuke Ae, Masanori Harada, Eiji Kajii
    BMC family practice 14 149 - 149 2013年10月 [査読有り][通常論文]
     
    BACKGROUND: The current research into single nucleotide polymorphisms has extended the role of genetic testing to the identification of increased risk for common medical conditions. Advances in genetic research may soon necessitate preparation for the role of genetic testing in primary care medicine. This study attempts to determine what proportion of patients would be willing to undergo genetic testing for salt-sensitive hypertension in a primary care setting, and what factors are related to this willingness. METHODS: A cross-sectional study using a self-report questionnaire was conducted among outpatients in primary care clinics and hospitals in Japan. The main characteristics measured were education level, family medical history, personal medical history, concern about hypertension, salt preference, reducing salt intake, and willingness to undergo genetic testing for salt-sensitive hypertension. RESULTS: Of 1,932 potential participants, 1,457 (75%) responded to the survey. Of the respondents, 726 (50%) indicated a willingness to undergo genetic testing. Factors related to this willingness were being over 50 years old (adjusted odds ratio [ad-OR] = 1.42, 95% Confidence interval = 1.09 - 1.85), having a high level of education (ad-OR: 1.83, 1.38 - 2.42), having a family history of hypertension (ad-OR: 1.36, 1.09 - 1.71), and worrying about hypertension (ad-OR: 2.06, 1.59 - 2.68). CONCLUSIONS: Half of the primary care outpatients surveyed in this study wanted to know their genetic risk for salt-sensitive hypertension. Those who were worried about hypertension or had a family history of hypertension were more likely to be interested in getting tested. These findings suggest that primary care physicians should provide patients with advice on genetic testing, as well as address their anxieties and concerns related to developing hypertension.
  • 吉池理恵, 谷田和代, 高橋秀子, 陣在佳子, 河崎雄司, 原田智也, 武田賢一, 山崎章, 清水英治, 阿江竜介, 廣谷茜, 小佐見光樹, 松岡学
    月刊地域保健 44 3 50 - 56 2013年03月 [査読有り][通常論文]
  • Taro Takeshima, Masanobu Okayama, Masanori Harada, Ryusuke Ae, Eiji Kajii
    International journal of general medicine 6 361 - 8 2013年 [査読有り][通常論文]
     
    BACKGROUND: A few studies have explored the effects of disclosure of genetic testing results on chronic disease predisposition. However, these effects remain unclear in cases of hypertension. Reducing salt intake is an important nonpharmacological intervention for hypertension. We investigated the effects of genetic testing for salt sensitivity on salt restriction behavior using hypothetical genetic testing results. METHODS: We conducted a cross-sectional study using a self-completed questionnaire. We enrolled consecutive outpatients who visited primary care clinics and small hospitals between September and December 2009 in Japan. We recorded the patients' baseline characteristics and data regarding their salt restriction behavior, defined as reducing salt intake before and after disclosure of hypothetical salt sensitivity genetic test results. Behavioral stage was assessed according to the five-stage transtheoretical model. After dividing subjects into salt restriction and no salt restriction groups, we compared their behavioral changes following positive and negative test results and analyzed the association between the respondents' characteristics and their behavioral changes. RESULTS: We analyzed 1562 participants with a mean age of 58 years. In the no salt restriction group, which included patients at the precontemplation, contemplation, and preparation stages, 58.7% stated that their behavioral stage progressed after a positive test result, although 29.8% reported progression after a negative result (P < 0.001). Conversely, in the salt restriction group, which included patients at the active and maintenance stages, 9.2% stated that they would quit restricting salt intake following a negative test result, and 2.2% reported they would quit following a positive result (P < 0.001). Age < 65 years (adjusted odds ratio [OR] 1.74; 95% confidence interval [CI] 1.12-2.71), female gender (adjusted OR 1.84; CI 1.29-2.62), graduation from college or university (adjusted OR 1.66; CI 1.11-2.49), and desire for genetic testing (adjusted OR 4.53; CI 3.13-6.57) were associated with progression of behavioral stage in the no salt restriction group. Conversely, salt preference (adjusted OR 2.13; CI 1.31-3.49) was associated with quitting salt restriction in the salt restriction group. CONCLUSION: Patients in the no salt restriction group show the possibility of progression from the behavioral stage to the action stage after testing positive for salt sensitivity. Conversely, patients in the salt restriction group, particularly those with a salt preference, would quit salt restriction after testing negative.
  • 阿江 竜介, 中村 好一, 坪井 聡, 古城 隆雄, 吉田 穂波, 北村 邦夫
    日本公衆衛生雑誌 59 9 665 - 74 日本公衆衛生学会 2012年09月 [査読有り][通常論文]
     
    目的 全国的な疫学調査である「第5回 男女の生活と意識に関する調査」のデータをもとに、わが国の自傷行為についての統計解析を行い、自傷経験に関連する要因を明らかにする。方法 全国から層化二段無作為抽出法を用いて選出された2,693人に調査票を配布し、自傷経験に対する回答の解析を行った。自傷経験があると答えた群(以下、自傷群)とないと答えた群(以下、非自傷群)の2群間で比較を行った。結果 1,540人(回収率57.2%)の対象者が回答した。全体の7.1%(男の3.9%、女の9.5%)に少なくとも1回以上の自傷経験があり、男女ともに自傷経験者の約半数が反復自傷経験者であった。16-29歳における自傷経験率が9.9%と最も高く、30-39歳、40-49歳はそれぞれ5.6%、5.7%とほぼ同等であった。男女別では、年齢階級別(16-29歳、30-39歳、40-49歳)で、女はそれぞれ15.7%、7.5%、5.8%と若年ほど自傷経験率が高く、男は3.0%、3.4%、5.5%と若年ほど低かった。群間比較では、喫煙者(自傷群47.5%、非自傷群28.2%、調整オッズ比[95%信頼区間]:2.18[1.32-3.58])、虐待経験者(23.6%、3.7%、4.24[2.18-8.25])、人工妊娠中絶経験者(30.3%、12.7%、1.93[1.13-3.30])の割合が自傷群で有意に高く、中学生時代の生活が楽しかったと答えた者(41.1%、78.6%、0.45[0.25-0.79])は有意に低かった。調整後有意差は認めなかったが自傷群では、すべての性・年齢階級において、両親の離婚を経験した者、中学生時代の親とのコミュニケーションが良好ではなかったと答えた者、親への敬意・感謝の気持ちがないと答えた者の割合が高い傾向を認めた。結論 多くの先行研究と同様に、自傷経験率は16-29歳の女で高く、また、喫煙者や虐待経験者で自傷経験率が高いことが示された。自傷行為の予防には、これらに該当する者に対して重点的にケアを提供する必要がある。また、社会的な観点から言えば、これらの要因を持つ家庭環境についても、今後明らかにしていく必要があろう。(著者抄録)
  • 阿江竜介, 原田昌範, 中村好一, 岡山雅信, 古城隆雄, 林宏樹, 山田博之, 八幡晋輔, 南建輔
    総合健康推進財団研究報告書 2010 1 - 11 2012年06月 [査読無し][通常論文]
  • Harada M, Okayama M, Ae R, Kojo T, Aihara M, Kajii E
    Gen Med 13 1 25 - 29 2012年 [査読有り][通常論文]
  • Izumi Chihara, Ritei Uehara, Kazuhiko Kotani, Atsuko Sadakane, Yasuko Aoyama, Satoshi Tsuboi, Ryusuke Ae, Tsogzolbaatar Enkh-Oyun, Yosikazu Nakamura
    Archives of gynecology and obstetrics 284 5 1117 - 22 2011年11月 [査読有り][通常論文]
     
    PURPOSE: Overweight or obesity is a known risk factor for cesarean delivery although there is minimal data among Japanese women. The aim of the study was to examine the effect of prepregnancy body mass index (BMI) on singleton cesarean delivery among term nulliparous women using a national sample from the Human Milk Survey. METHODS: Data from the Human Milk Survey between 1998 and 2008 were used for the secondary analysis. Women were categorized as underweight (BMI < 18.5 kg/m(2)), normal weight (18.5 ≤ BMI < 25.0), or overweight (BMI ≥ 25.0) based on their prepregnancy BMI. The association between maternal prepregnancy BMI and cesarean delivery was assessed using logistic regression models. RESULTS: A total of 915 women were included in the analysis. The proportion of cesarean section was 10.1%. Overall, 17.1% of the women were underweight while 6.0% were overweight. After adjusting for maternal age, smoking status, pregnancy complications, and infant birthweight, overweight women were 2.7 times more likely to have a cesarean delivery compared to normal weight women (adjusted odds ratio [adjusted OR] = 2.7, 95% confidence interval [CI] = 1.4-5.4), and underweight women were half as likely to have a cesarean delivery compared to normal weight women (adjusted OR = 0.5, 95% CI = 0.2-1.1). CONCLUSIONS: Being overweight before pregnancy more than doubled the risk of cesarean delivery independent of age, smoking, pregnancy complications, and infant birthweight among term nulliparous women. Overweight Japanese women should be advised to achieve normal prepregnancy BMI in their preconception period to prevent cesarean delivery.
  • 坪井聡, 千原泉, 工藤由佳, 定金敦子, ENKH‐OYUN Tsogzolbaatar, 阿江竜介, 小谷和彦, 青山泰子, 上原里程, 中村好一
    厚生の指標 58 12 1 - 7 2011年10月 [査読無し][通常論文]
  • Sekine S, Komatsu K, Matsushima D, Takeshima T, Ae R, Fujiwara S, Matsushima E, Okayama M, Kajii E
    Gen Med 11 2 71 - 77 2011年 [査読有り][通常論文]
  • 阿江 竜介, 岡山 雅信, 関根 沙耶花, 竹島 太郎, 梶井 英治
    医学教育 = Medical education 41 6 403 - 410 日本医学教育学会 2010年12月 [査読有り][通常論文]
     
    プライマリ・ケア(PC)医の養成と充足は、わが国だけでなく諸外国でも同様に喫緊の課題として認識されている。しかし、研修医がPC医への進路を選択する意思決定に、どのような医学教育が影響を与えているかは明らかにされていない。そこで我々は、後期研修医が将来のキャリアとしてPC医を目指す進路志向に関連する要因を検討した。・無作為に選出された281の臨床研修指定施設のうち137施設(48.8%)が回答した。卒業後3年目または4年目の後期研修医724人を対象に自己記入式質問紙調査を実施し、将来のキャリアとしてPC医を志向する群(n=175、24.2%)と専門医を志向する群(n=549、75.8%)についての比較を行った。・さらに、卒前に将来のキャリアとして専門医を志向していた者(n=442、61.1%)の中で、初期研修後にPC医への進路志向に変化した群(n=33、7.5%)と変化しなかった群(n=409、92.5%)についての比較を追加した。・卒前からPC医への進路を志向していた者(調整オッズ比(95%信頼区間):9.85(6.24-15.5))、現在(後期研修中に)PC医として勤務している者(7.58(4.92-11.7))、将来へき地勤務を希望する者(2.24(1.36-3.68))が、将来のキャリアとしてPC医を有意に志向する傾向があった。・卒後にへき地での研修を体験した後期研修医は、将来の進路志向が専門医からPC医に変化する傾向があった(粗オッズ比(95%信頼区間):2.18(1.05-4.49))。卒後のへき地体験は、研修医の進路志向の変化に影響を及ぼすことが示唆された。・へき地での研修を組み入れた卒後のPC教育は、将来のPC医の養成と充足に効果的に寄与する可能性がある。(著者抄録)
  • Yosikazu Nakamura, Mayumi Yashiro, Ryusuke Ae, Izumi Chihara, Atsuko Sadakane, Yasuko Aoyama, Kazuhiko Kotani, Ritei Uehara, Shohei Harada
    Journal of epidemiology 20 6 429 - 32 2010年 [査読有り][通常論文]
     
    BACKGROUND: Although regular nationwide surveys of Kawasaki disease (KD) are conducted in Japan, there is no system for detecting the real-time epidemic status of this disease. METHODS: A web-based surveillance system for KD was developed. After consideration of the number of patients reported by prefecture to the 19th nationwide survey, 355 pediatric departments were asked to participate in the surveillance, and 225 agreed. Since January 2008, pediatricians in these 225 hospitals have reported KD patient data immediately after diagnosis. The daily numbers of patients are available to the public via the internet at http://www.kawasaki-disease.net/kawasakidata/. The validity of the data in 2008 was evaluated using the Japanese 20th nationwide survey of KD as the gold standard. RESULTS: A total of 3376 patients were reported to the web-based surveillance system from the 1st week through 52nd week of 2008. The number of patients reported to the nationwide survey during the same period was 11 680: a total of 4950 patients from the hospitals participating in the web-based surveillance and 6730 from other hospitals. The epidemic curves were similar, and the correlation coefficient between the web-based surveillance and the total numbers in the nationwide survey was 0.806 (P < 0.01). CONCLUSIONS: The web-based surveillance system for Kawasaki disease in Japan demonstrated good validity.

書籍

MISC

受賞

  • 2021年11月 自治医科大学医学部優秀論文賞
     
    受賞者: 阿江竜介
  • 2021年10月 CDC Charles C. Shepard Award (Prevention and Control category) 優秀論文賞
     Corticosteroids added to initial intravenous immunoglobulin treatment for the prevention of coronary artery abnormalities in high-risk patients with Kawasaki disease 
    受賞者: Ryusuke Ae
  • 2019年04月 CDC (Centers for Disease Control and Prevention) 米国疾病管理予防センター Spirit Awards 2019
     
    受賞者: Ryusuke Ae

共同研究・競争的資金等の研究課題

  • プリオン病のサーベイランスと感染予防に関する調査研究
    厚生労働科学研究費補助金:難治性疾患政策研究事業
    研究期間 : 2020年 -2021年 
    代表者 : 山田正仁(主任研究者), 阿江竜介(分担研究者)
  • プリオン病及び遅発性ウイルス感染症に関する調査研究
    厚生労働科学研究費補助金:難治性疾患政策研究事業
    研究期間 : 2020年 -2021年 
    代表者 : 高尾昌樹(主任研究者), 阿江竜介(分担研究者)
  • CDIと身体所見を組み合わせて高齢者施設の新たな救急受診トリアージ手法を開発する
    日本学術振興会:科学研究費助成事業 若手研究(B)
    研究期間 : 2017年04月 -2020年03月 
    代表者 : 阿江 竜介(主任研究者)
     
    本研究のテーマは、CDIを用いて高齢者の“元気さ”を定量的に把握し、それらを医療・介護の現場で活用できるかを検証することにある。本研究では、介護者による高齢者への印象をCDI(caregiver daily impression)と定義し、これらを効率的かつ的確に収集できるシステム作りを試みた。 前年度に、高齢者施設に勤務する介護スタッフから的確に(標準的に)CDIのデータを取得できるかどうかを事前に検討する必要が生じた。この課題を検証する目的で、当該年度に、鎌倉市にある特別養護老人ホーム(ささりんどう鎌倉)に本研究への協力をいただいた。2018年6月に、同施設に設置されている介護用電子媒体ソフト(医療機関で言うところの電子カルテ)にCDIのチェックリストシステムを導入した。他の施設に先駆けて同施設で試験的にシステムを導入し、実際の介護現場のスタッフからCDIに関するデータを的確に収集できるかどうかの検証を開始した。導入までの調整は比較的スムーズに進捗した。しかし導入後、日々の高齢者ケアにおける「気付き」を適切に書き留める(言語化する)習慣を持つ介護スタッフが現場にほとんどいないことがわかり、当初は想定よりも充分なデータが収集できなかった。現場の介護スタッフと会議を繰り返し、CDIに関する情報の重要性の周知を図った結果、現在ではデータが徐々に蓄積しつつある。実際の介護現場からのデータ収集は想定以上に困難であり、研究期間を1年間延長した。2019年4月末現在、CDIに関する情報は400件程度に留まっている。現在はこのデータを解析し、CDIと高齢者の健康状態との関連を検討している。
  • 長期滞在型高齢者福祉施設における効率的な感染対策プログラムの開発
    日本医療研究開発機構(AMED):疾患基礎研究プロジェクト(長寿科学研究開発事業)
    研究期間 : 2018年 -2020年 
    代表者 : 笹原鉄平(主任研究者), 阿江竜介(分担研究者)
  • 日米の大規模データベースを活用し川崎病の疫学研究における“温故創新”を具現化する
    日本川崎病研究センター:平成30年度研究助成補助金
    研究期間 : 2018年04月 -2019年03月 
    代表者 : 阿江竜介(主任研究者)
  • プリオン病及び遅発性ウイルス感染症に関する調査研究
    厚生労働科学研究費補助金:難治性疾患等政策研究事業
    研究期間 : 2018年 -2019年 
    代表者 : 山田正仁(主任研究者), 阿江竜介(分担研究者)
  • 日本学術振興会:科学研究費助成事業 若手研究(B)
    研究期間 : 2015年04月 -2018年03月 
    代表者 : 阿江 竜介(主任研究者), 古城 隆雄, カラシュ マシュウ
     
    本研究のテーマは、CDIを用いて高齢者の“元気さ”を定量的に把握し、それらを医療・介護の現場で活用できるかを検証することである。本研究では、介護者による高齢者への印象をCDIと定義した。 異なる複数の特別養護老人ホームの介護スタッフから的確に(標準的に)CDIに関するデータを得るために、紙媒体のチェックリストを用いてデータ収集を試みた。しかし、現場の介護スタッフから的確にデータを得るのは予想外に難航した。施設で使用されている介護用電子媒体ソフトにCDIのチェックリストシステムを導入する方針に転換し、2018年6月に1施設に試験的導入することが確定した。今後のデータ収集が期待できる。
  • プリオン病及び遅発性ウイルス感染症に関する調査研究
    厚生労働科学研究費補助金:難治性疾患等政策研究事業
    研究期間 : 2015年 -2017年 
    代表者 : 山田正仁(主任研究者), 阿江竜介(分担研究者)
  • 日本学術振興会:科学研究費助成事業 基盤研究(B)
    研究期間 : 2012年04月 -2015年03月 
    代表者 : 岡山 雅信(主任研究者), 梶井 英治, 中村 剛史, 竹島 太郎, 森田 喜紀, 上田 祐樹, 山本 祐, 見坂 恒明, 牧野 伸子, 神田 健史, 小松 憲一, 古城 隆雄, 藍原 雅一, 阿江 竜介, 原田 昌範
     
    地域医療に従事する医師の確保が重要な政策課題であり、その教育の充実が求められる。これに貢献するため、本研究は効果的な地域医療臨床実習プログラムを考案することを目的に実施した。地域医療臨床実習では医療のみならず介護・福祉・保健・地域活動など幅広いプログラムが求められる。本研究では、効果的な地域医療臨床実習は将来の地域医療人材確保につながることが示唆された。実習効果を高めるためには、在宅診療、保健活動、住民活動、および多職種協働作業への参加型実習を積極的に実施するのが望ましい。これらのプログラムの提供する際には、その効果を高めるために、事前にその意義を説明し、十分な実習時間の確保が必要である。
  • 高齢者福祉施設のスタッフが利用者の医療受診を決断する主要基準とその信頼性・妥当性の検証
    公益財団法人 総合健康推進財団:第27回一般研究奨励事業
    研究期間 : 2011年01月 -2011年12月 
    代表者 : 阿江 竜介(主任研究者)

委員歴

  • 2021年   日本疫学会   代議員
  • 2021年   日本公衆衛生学会   代議員
  • 2021年   日本疫学会   英文機関誌 Journal of Epidemiology 編集委員
  • 2020年   日本神経感染症学会   評議員
  • 2016年   日本循環器病予防学会   評議員

担当経験のある科目

  • 社会医学自治医科大学
  • 疫 学自治医科大学
  • 公衆衛生学自治医科大学
  • 保健統計学栃木県衛生福祉大学校


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