Okayama University Medical SchoolActa Medica Okayama0386-300X6812014Impact of Comorbid Hepatic Steatosis on Treatment of Chronic Hepatitis C in Japanese Patients and the Relationship with Genetic Polymorphism of IL28B, PNPLA3 and LDL Receptor1722ENYukiMoritouFusaoIkedaYoshiakiIwasakiNobuyukiBabaKouichiTakaguchiTomonoriSenohTakuyaNaganoYasutoTakeuchiTetsuyaYasunakaHidekiOhnishiYasuhiroMiyakeAkinobuTakakiKazuhiroNousoKazuhideYamamotoOriginal Article10.18926/AMO/52139The impact of hepatic steatosis on interferon therapy for patients with chronic hepatitis C (CHC) has been associated with single-nucleotide polymorphisms (SNP) of IL28B, patatin-like phospholipase domain-containing protein 3 (PNPLA3), and low-density lipoprotein (LDL) receptor. Whether this holds true for Japanese patients, however, remains unresolved. The present study prospectively enrolled 226 Japanese patients with CHC, and investigated the impact of hepatic steatosis and its related SNPs, including rs8099917 of IL28B, rs738409 of PNPLA3, and rs14158 of LDL receptor, on outcomes of peg-interferon and ribavirin therapy. In multivariate logistic regression analysis, significant factors affecting the severity of hepatic steatosis were high body mass index and the minor alleles of IL28B SNP (p=0.020 and 0.039, respectively). The risk alleles of PNPLA3 SNP also showed weak association
(p=0.059). Severe steatosis and the minor alleles of IL28B SNP were significantly associated with null or partial virological response in patients with HCV genotype 1, as were female gender, and low LDL cholesterol (p=0.049, and <0.001, respectively). The SNP genotype of PNPLA3 and LDL receptor
did not have a significant impact on therapeutic outcomes. With respect to the SNP sites examined, the SNP of PNPLA3 has a weak association with severe hepatic steatosis, but not with the outcome of interferon therapy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6852014Nursing Support Increases the Efficacy of Interferon Therapy in Patients with Chronic Hepatitis C263268ENShihokoNambaKayokoMiyakeFusaoIkedaTomokoHazamaYuHitobeNorikoYamasakiHidenoriShirahaAkinobuTakakiKazuhiroNousoYoshiakiIwasakiKazuhideYamamotoOriginal Article10.18926/AMO/52894Nursing support might help patients with chronic hepatitis C (CHC) remain in good mental and physical condition during interferon (IFN) therapy. However, the effects of nursing support have not been studied adequately in this context. This case-control study evaluated the effects of nursing support during IFN therapy. Twenty-four CHC patients who received pegylated IFN and ribavirin were enrolled. Nurses advised patients on the maintenance of their mental and physical condition at weekly visits, based on the results of written questionnaires. An additional 24 patients who received IFN therapy without nursing support and who were matched for age, sex, platelet count, viral serogroup and IFN regimen were selected with propensity score matching as controls. The patients with nursing support during IFN therapy achieved higher sustained virological responses (79%) than those without nursing support (58%). Adherence to the IFN and ribavirin regimens at 24 weeks of therapy were slightly higher in the patients with nursing support than those without it, but these differences were not statistically significant. Adherence to ribavirin after 24 weeks of therapy was significantly higher in those with nursing support than those without it (93% and 66%, p=0.045). These results suggested that nursing support services could contribute to the virological responses of CHC patients by promoting drug-regimen adherence.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6852014Hepatitis C Virus-specific T-cell Response Correlates with Hepatitis Activity and Donor IL28B Genotype Early after Liver Transplantation291302ENRyuichiroTsuzakiAkinobuTakakiTakahitoYagiFusaoIkedaKazukoKoikeYoshiakiIwasakiHidenoriShirahaYasuhiroMiyakeHiroshiSadamoriSusumuShinouraYuzoUmedaRyuichiYoshidaDaisukeNobuokaMasashiUtsumiEiichiNakayamaToshiyoshiFujiwaraKazuhideYamamotoOriginal Article10.18926/AMO/52898It is not known how the immune system targets hepatitis C virus (HCV)-infected HLA-mismatched hepatocytes under immune-suppressed conditions after orthotopic liver transplantation (OLT). In addition, the relationship between the HCV-specific immune response and IL28B variants as predictors of HCV clearance has not been well-characterized. We determined the IL28B polymorphisms for 57 post-OLT HCV carriers, and we assessed the HCV-specific immune responses by measuring the peripheral blood mononuclear cell-derived HCV-specific interferon-gamma (IFN-γ) response using an enzyme-linked immunospot assay. At 1-3 years after OLT, patients with no active hepatitis showed higher total spots on the immunospot assay. At>3 years after OLT, patients with resolved HCV showed higher levels of core, NS3, NS5A, and total spots compared to the chronic hepatitis patients. The IL28B major genotype in the donors correlated with higher spot counts for NS5A and NS5B proteins at 1-3 years after OLT. In the post-OLT setting, the HCV-specific immune response could be strongly induced in patients with no active hepatitis with an IL28B major donor or sustained virological response. Strong immune responses in the patients with no active hepatitis could only be maintained for 3 years and diminished later. It may be beneficial to administer IFN treatment starting 3 years after OLT, to induce the maximum immunological effect.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6932015Aberrant Expression of Keratin 7 in Hepatocytes as a Predictive Marker of Rapid Progression to Hepatic Failure in Asymptomatic Primary Biliary Cirrhosis137144ENHiroyukiSekiFusaoIkedaShintaroNanbaYukiMoritouYasutoTakeuchiTetsuyaYasunakaHidekiOnishiYasuhiroMiyakeAkinobuTakakiKazuhiroNousoYoshiakiIwasakiMinoruNakamuraKazuhideYamamotoOriginal Article10.18926/AMO/53520A predictive marker of the rapid progression to hepatic failure is desired for patients with asymptomatic primary biliary cirrhosis (aPBC). We performed a systematic cohort analysis of 101 patients diagnosed as having aPBC and the rapid progression to liver failure in some, by focusing on cholestasis. Cholestasis was assessed by aberrant keratin7 (K-7) expressions in the patientsʼ hepatocytes. Intralobular expressions of K-7 were found in 9 of the 101 patients. The grades of K-7 expression were significantly associated with the levels of alanine aminotransferase, alkaline phosphatase, and total bilirubin at the time of diagnosis, but not with bile duct loss or cholestasis. Stepwise logistic regression analysis revealed that high grades of K-7 expression correlated positively with high levels of total bilirubin. During the follow-up period, 8 patients developed jaundice, and the mean period until the development of jaundice was 5.2 years. The proportional hazards models for the risk of developing jaundice identified a high grade of aberrant K-7 expression in hepatocytes as the only significant risk factor. Aberrant K-7 expression in hepatocytes can be used as an additional marker to predict rapid progression to liver failure in patients with aPBC at the time of diagnosis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6942015Effectiveness of Extending Treatment Duration in Therapy with Pegylated Interferon and Ribavirin for Genotype 2 Hepatitis C Virus Infection237244ENShintarouNanbaFusaoIkedaShin-ichiFujiokaYasuyukiArakiKouichiTakaguchiNoriakiHashimotoHiroyukiSekiAkinobuTakakiYoshiakiIwasakiKazuhideYamamotoOriginal Article10.18926/AMO/53560The effectiveness of extending treatment duration as response guided therapy was previously reported for chronic hepatitis C (CHC) genotype 1, but is still controversial for genotype 2. The present study is a retrospective cohort study to investigate the effectiveness of extending treatment duration in therapy with pegylated interferon and ribavirin for patients with CHC genotype 2 by focusing on the timing at which patients obtained undetectable HCV RNA. A total of 306 patients who obtained undetectable HCV RNA by week 24 of treatment and completed 24 weeks of treatment were enrolled. Rapid virological response (RVR) to standard therapy was achieved by 122 patients (51オ), and 89オ of them obtained sustained virological response (SVR), while 69オ of non-RVR patients achieved SVR. Non-RVR patients with undetectable HCV RNA at week 8, and insufficient adherence<80オ pegylated interferon and ribavirin during the first 24 weeks, significantly improved their SVR rate by extended therapy. Among patients receiving extended therapy, drug adherences did not differ between SVR and non-SVR patients, indicating that extending treatment duration might compensate for insufficient antiviral effects due to insufficient drug adherences. This finding might be useful in creating a guideline for extending treatment duration for patients with CHC genotype 2.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7712023Initial Two Doses of COVID-19 Vaccine mRNA-1273 for an Individual Previously Vaccinated with Two Doses of an Inactivated Vaccine CoronaVac That Has Not Been Approved in Japan105109ENYoshiakiIwasakiHealth Service Center, Okayama UniversityChigusaHiguchiHealth Service Center, Okayama UniversityCase Report10.18926/AMO/64370The inactivated coronavirus disease 2019 vaccine CoronaVac has not been approved in Japan. Little information is available on cases in Japan in which an approved mRNA vaccine was administered as the initial (first or second) dose after two doses of CoronaVac. Furthermore, the safety and efficacy of this combination are not established. We here evaluated the safety and efficacy in a patient who showed an antibody response to an approved vaccine, mRNA-1273, after a previous vaccination with CoronaVac. The adverse events consisted of only mild local and systemic common reactions and were transient. In addition, a strong and persistent antibody response was observed.No potential conflict of interest relevant to this article was reported.BioMed CentralActa Medica Okayama1471-240752005Functional promoter upstream p53 regulatory sequence of IGFBP3 that is silenced by tumor specific methylationENTadashiHanafusaToshiyukiShinjiHidenoriShirahaKazuhiroNousoYoshiakiIwasakiEichiroYumotoToshiroOnoNorioKoide<p><b>Background:</b> Insulin-like growth factor binding protein (IGFBP)-3 functions as a carrier of insulinlike
growth factors (IGF<sub>s</sub>) in circulation and a mediator of the growth suppression signal in cells. There are two reported p53 regulatory regions in the IGFBP3 gene; one upstream of the promoter and one intronic. We previously reported a hot spot of promoter hypermethylation of IGFBP-3 in
human hepatocellular carcinomas and derivative cell lines. As the hot spot locates at the putative upstream p53 consensus sequences, these p53 consensus sequences are really functional is a question to be answered.<br />
<b>Methods:</b> In this study, we examined the p53 consensus sequences upstream of the IGFBP-3 promoter for the p53 induced expression of IGFBP-3. Deletion, mutagenesis, and methylation
constructs of IGFBP-3 promoter were assessed in the human hepatoblastoma cell line HepG2 for promoter activity.<br />
Results: Deletions and mutations of these sequences completely abolished the expression of IGFBP-3 in the presence of p53 overexpression. In vitro methylation of these p53 consensus
sequences also suppressed IGFBP-3 expression. In contrast, the expression of IGFBP-3 was not affected in the absence of p53 overexpression. Further, we observed by electrophoresis mobility
shift assay that p53 binding to the promoter region was diminished when methylated.<br />
<b>Conclusion:</b> From these observations, we conclude that four out of eleven p53 consensus sequences upstream of the IGFBP-3 promoter are essential for the p53 induced expression of
IGFBP-3, and hypermethylation of these sequences selectively suppresses p53 induced IGFBP-3 expression in HepG2 cells.</p>No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1660-46011652019Awareness of Clenching and Underweight are Risk Factors for Onset of Crowding in Young Adults: A Prospective 3-Year Cohort Study690ENNaokiToyamaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyanoTaniguchi-TabataDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKotaKataokaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMayuYamane-TakeuchiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiFujimoriDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTerumasaKobayashiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaikiFukuharaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroIrieDepartment of Microbiology and Immunology, Columbia University Medical CenterTetsujiAzumaDepartment of Community Oral Health, Asahi University School of DentistryYoshiakiIwasaki Health Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Bruxism is a parafunctional activity that can seriously affect quality of life. Although bruxism induces many problems in the oral and maxillofacial area, whether it contributes to the onset of malocclusion remains unclear. The purpose of this prospective cohort study was to investigate the association between the onset of malocclusion and awareness of clenching during the daytime in young adults. Among 1,092 Okayama University students who underwent normal occlusion at baseline, we analysed 238 who had undergone a dental examination and had complete data after 3 years (2013⁻2016). We also performed subgroup analysis to focus on the association between awake bruxism and the onset of crowding (n = 216). Odds ratios (ORs) were calculated using multivariate logistic regression analyses. The incidences of malocclusion and crowding were 53.8% and 44.5%, respectively. In multivariate logistic regression, awareness of clenching was a risk factor for crowding (OR: 3.63; 95% confidence interval [CI]: 1.08⁻12.17). Moreover, underweight (body mass index < 18.5 kg/m²) was related to the onset of malocclusion (OR: 2.34; 95%CI: 1.11⁻4.92) and crowding (OR: 2.52, 95%CI: 1.25⁻5.76). These results suggest that awareness of clenching during the daytime and underweight are risk factors for the onset of crowding in young adults.No potential conflict of interest relevant to this article was reported.Nihon University School of DentistryActa Medica Okayama1343-49346112019The level of salivary lactate dehydrogenase as an indicator of the association between gingivitis and related factors in Japanese university students133139ENAyanoTaniguchi-TabataDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsujiAzumaDepartment of Community Oral Health, Asahi University School of DentistryToshikiYonedaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMayuYamane-TakeuchiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKotaKataokaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirofumiMizunoDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisatakaMiyaiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiIwasakiHealth Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe aim of this study was to investigate the association between the presence of gingivitis estimated using the salivary level of lactate dehydrogenase (LD) and related factors in young Japanese adults. Data from 1,915 participants (21.4 ± 2.5 years) were analyzed. Unstimulated saliva was collected from each participant and the salivary LD level was evaluated using a commercially available test kit with an integer scale ranging from 1 to 10. Gingivitis was defined as the LD level of ≥8. The number of permanent teeth, the simplified oral hygiene index (OHI-S), the presence of partially erupted molars and body mass index were recorded. Additionally, participants answered a questionnaire. The percentage of male participants, the number of permanent teeth, the OHI-S and the presence of partially erupted molars were higher, whereas the proportion receiving dental check-ups was lower in the gingivitis group (n = 88, 4.6%) than in the healthy group. Logistic regression analysis showed that gingivitis was significantly associated with OHI-S (OR: 2.68, 95% CI: 1.94-3.69) and receiving dental checkups (OR: 0.31, 95% CI: 0.10-0.99). The present findings indicated that the OHI-S and receiving dental checkups were significantly associated with gingivitis, as assessed by the salivary LD level, in this cohort.No potential conflict of interest relevant to this article was reported.Spandidos PublicationsActa Medica Okayama1792-10741832019Cancer stem cell induction from mouse embryonic stem cells27562762ENAkimasaSenoLaboratory of Nano-Biotechnology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityChikaeMurakamiDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityBishoyEl‑AaragLaboratory of Nano-Biotechnology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYoshiakiIwasakiHealth Service Center, Okayama UniversityToshiakiOharaDepartment of Pathology and Experimental MedicineOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasaharuSenoLaboratory of Nano-Biotechnology, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems Although cancers are often removed by surgery and treated by chemotherapy and/or radiation therapies, they often reoccur following treatment due to the presence of resistant residual cells such as cancer stem cells (CSCs). CSCs are characterized by their self-renewal, pluripotency, and tumorigenicity properties, and are promising therapeutic targets for the complete therapy of cancers; however, the number of CSCs in cancer tissue is typically too small to investigate fully. We have previously reported that CSCs could be established from induced pluripotent stem cells (iPSCs) using a conditioned medium during cancer cell culture. In the present study, mouse embryonic stem cells (mESCs) were observed to be converted to CSCs (mES-CSCs). This demonstrated that CSC induction does not exclusively occur following gene editing in somatic cells, and that conditioned medium from cancer cells may contain factors that can induce CSCs. Therefore, not only iPSCs but also mESCs, were demonstrated to be able to produce CSCs as one of the potentials of pluripotency of stem cells, suggesting that the conversion to CSCs is not specific to iPSCs. The resultant mES-CSCs would be also useful to generate tissue specific cancers and these naturally occurring cancers can contribute to drug screenings, but also undergo further investigation in order to reveal cancer mechanisms.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1660-46011752020Relationship of Salivary Microbiome with the Worsening of the Periodontal Health Status in Young Adults: A 3-Year Cohort Study1764ENMd MonirulIslamDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoki ToyamaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTerumasaKobayashiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiFujimoriDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYokoUchidaDepartment of Preventive Dentistry, Okayama University HospitalDaikiFukuharaDepartment of Preventive Dentistry, Okayama University HospitalAyanoTaniguchi-TabataDepartment of Preventive Dentistry, Okayama University HospitalKotaKataokaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiIwasakiHealth Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe purpose of this prospective cohort study was to investigate the influence of the salivary microbiome on the worsening of the periodontal health status among Japanese young adults. We assessed the data of systemically healthy and non-smoking young (18-22 years) university students (n = 457) from Okayama University at baseline (2013) and follow-up (2016). The worsening group was defined based on an increase in the percentage of bleeding on probing (%BOP) or an increase in probing pocket depth (PPD) from <4 mm to >= 4 mm. Unstimulated saliva samples were randomly collected from 69 students for microbiome analysis at follow-up. The salivary microbiome was assessed through 16S rRNA metagenomic sequencing. The type of community in the salivary microbiome clustered by statistical analysis and diversity was not significantly associated with the worsening of the periodontal health status in cases of increasing %BOP and PPD (p > 0.05). The prevalence of some species was significantly higher in the worsening group than in the non-worsening group (p < 0.05) in both cases. The worsening of the periodontal health status was associated with some species, but not the type of community and diversity in the salivary microbiome among Japanese young adults.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1660-46011792020Association between Sleep Quality and Duration and Periodontal Disease among University Students: A Cross-Sectional StudyENMd MonirulIslamDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoki ToyamaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyanoTaniguchi-TabataDepartment of Preventive Dentistry, Okayama University HospitalKotaKataokaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYokoUchida-FukuharaDepartment of Preventive Dentistry, Okayama University HospitalDaikiFukuharaDepartment of Preventive Dentistry, Okayama University HospitalHikariSahoDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNanamiSawadaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukihoNakashimaDepartment of Preventive Dentistry, Okayama University HospitalYoshiakiIwasakiHealth Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe purpose of this cross-sectional study was to investigate the association between sleep quality and duration, and periodontal disease among a group of young Japanese university students. First-year students (n = 1934) at Okayama University who voluntarily underwent oral health examinations were included in the analysis. Sleep quality and duration were assessed by the Japanese version of the Pittsburgh Sleep Quality Index. Dentists examined Oral Hygiene Index-Simplified (OHI-S), probing pocket depth (PPD), and percentage of sites with bleeding on probing (BOP). Periodontal disease was defined as presence of PPD >= 4 mm and BOP >= 30%. Overall, 283 (14.6%) students had periodontal disease. Poor sleep quality was observed among 372 (19.2%) students. Mean (+/- standard deviation) sleep duration was 7.1 +/- 1.1 (hours/night). In the logistic regression analysis, periodontal disease was significantly associated with OHI-S (odds ratio [OR]: 2.30, 95% confident interval [CI]: 1.83-2.90; p < 0.001), but not sleep quality (OR: 1.09, 95% CI: 0.79-1.53; p = 0.577) or sleep duration (OR: 0.98, CI: 0.87-1.10; p = 0.717). In conclusion, sleep quality and duration were not associated with periodontal disease among this group of young Japanese university students.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1660-460117102020Caries Increment and Salivary Microbiome during University Life: A Prospective Cohort Study3713ENYokoUchida-FukuharaDepartment of Preventive Dentistry, Okayama University HospitalDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMd MonirulIslamDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKotaKataokaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental SchoolAyanoTaniguchi-TabataDepartment of Preventive Dentistry, Okayama University HospitalDaikiFukuharaDepartment of Preventive Dentistry, Okayama University HospitalNaoki ToyamaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTerumasaKobayashiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiFujimoriDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNanamiSawadaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiIwasakiHealth Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe purpose of this 3-year prospective cohort study was to explore the relationship between an increase in dental caries and oral microbiome among Japanese university students. We analyzed 487 students who volunteered to receive oral examinations and answer baseline (2013) and follow-up (2016) questionnaires. Of these students, salivary samples were randomly collected from 55 students at follow-up and analyzed using next-generation sequencing. Students were divided into two groups: increased group (Delta decayed, missing, and filled teeth (Delta DMFT) score increased during the 3-year period) and non-increased group (Delta DMFT did not increase). Thirteen phyla, 21 classes, 32 orders, 48 families, 72 genera, and 156 species were identified. Microbial diversity in the increased group (n = 14) was similar to that in the non-increased group (n = 41). Relative abundances of the family Prevotellaceae (p = 0.007) and genera Alloprevotella (p = 0.007) and Dialister (p = 0.039) were enriched in the increased group compared with the non-increased group. Some bacterial taxonomic clades were differentially present between the two groups. These results may contribute to the development of new dental caries prevention strategies, including the development of detection kits and enlightenment activities for these bacteria.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1660-460117222020Association between Household Exposure to Secondhand Smoke and Dental Caries among Japanese Young Adults: A Cross-Sectional Study8623ENHikariSahoDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyanoTaniguchi-TabataDepartment of Preventive Dentistry, Okayama University HospitalDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyaYokoiDepartment of Preventive Dentistry, Okayama University HospitalKoutaKataokaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaikiFukuharaDepartment of Preventive Dentistry, Okayama University HospitalNaoki ToyamaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMd MonirulIslamDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNanamiSawadaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukihoNakashimaDepartment of Preventive Dentistry, Okayama University HospitalMomokoNakaharaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunyaDeguchiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYokoUchida-FukuharaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshikiYonedaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiIwasakiHealth Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe long-term effects of secondhand smoke (SHS) on dental caries among Japanese young adults remain unclear. The purpose of this cross-sectional study was to evaluate whether household exposure to SHS is associated with dental caries in permanent dentition among Japanese young adults. The study sample included 1905 first-year university students (age range: 18-19 years) who answered a questionnaire and participated in oral examinations. The degree of household exposure to SHS was categorized into four levels according to the SHS duration: no experience (-), past, current SHS < 10 years, and current SHS >= 10 years. Dental caries are expressed as the total number of decayed, missing, and filled teeth (DMFT) score. The relationships between SHS and dental caries were determined by logistic regression analysis. DMFT scores (median (25th percentile, 75th percentile)) were significantly higher in the current SHS >= 10 years (median: 1.0 (0.0, 3.0)) than in the SHS-(median: 0.0 (0.0, 2.0)); p = 0.001). DMFT >= 1 was significantly associated with SHS >= 10 years (adjusted odds ratio: 1.50, 95% confidence interval: 1.20-1.87, p < 0.001). Long-term exposure to SHS (>= 10 years) was associated with dental caries in permanent dentition among Japanese young adults.No potential conflict of interest relevant to this article was reported.Springer NatureActa Medica Okayama0007-092012292020A novel model of liver cancer stem cells developed from induced pluripotent stem cells13781390ENSaid M.AfifyDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityAnna SanchezCalleDivision of Molecular and Cellular Medicine, National Cancer Center Research InstituteGhmkinHassanLaboratory of Nano-Biotechnology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityKazukiKumonDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityHend M.NawaraDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityMaram H.ZahraLaboratory of Nano-Biotechnology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHager M.MansourDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityApriliana CahyaKhayraniDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityMd JahangirAlamDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityJuanDuDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityAkimasaSenoOkayama University Research Laboratory of Stem Cell Engineering in Detroit, IBio, Wayne State UniversityYoshiakiIwasakiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Okayama UniversityMasaharuSenoDepartment of Medical Bioengineering, Graduate School of Natural Science and Technology, Okayama UniversityBackground</br>
Liver cancer is the second most common cause of cancer-related death. Every type of tumours including liver cancer contains cancer stem cells (CSCs). To date, the molecular mechanism regulating the development of liver CSCs remains unknown.</br>
Methods</br>
In this study, we tried to generate a new model of liver CSCs by converting mouse induced pluripotent stem cells (miPSCs) with hepatocellular carcinoma (HCC) cell line Huh7 cells conditioned medium (CM). miPSCs treated with CM were injected into the liver of BALB/c nude mice. The developed tumours were then excised and analysed.</br>
Results</br>
The primary cultured cells from the malignant tumour possessed self-renewal capacity, differentiation potential and tumorigenicity in vivo, which were found rich in liver cancer-associated markers as well as CSC markers.</br>
Conclusions</br>
We established a model of liver CSCs converting from miPS and showed different stages of stemness during conversion process. Our CSC model will be important to assess the molecular mechanisms necessary to develop liver CSCs and could help in defeating liver cancer.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1660-46011812021Living with Family Is Directly Associated with Regular Dental Checkup and Indirectly Associated with Gingival Status among Japanese University Students: A 3-Year Cohort Study324ENMomokoNakaharaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKotaKataokaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyaYokoiDepartment of Preventive Dentistry, Okayama University HospitalYokoUchida-FukuharaDepartment of Preventive Dentistry, Okayama University HospitalDaikiFukuharaDepartment of Preventive Dentistry, Okayama University HospitalTerumasaKobayashiDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoki ToyamaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHikariSahoDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMd MonirulIslamDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiIwasakiHealth Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAlthough some studies showed that lifestyle was associated with oral health behavior, few studies investigated the association between household type and oral health behavior. The aim of this prospective cohort study was to investigate the association between household type, oral health behavior, and periodontal status among Japanese university students. Data were obtained from 377 students who received oral examinations and self-questionnaires in 2016 and 2019. We assessed periodontal status using the percentage of bleeding on probing (%BOP), probing pocket depth, oral hygiene status, oral health behaviors, and related factors. We used structural equation modeling to determine the association between household type, oral health behaviors, gingivitis, and periodontitis. At follow-up, 252 students did not live with their families. The mean +/- standard deviation of %BOP was 35.5 +/- 24.7 at baseline and 32.1 +/- 25.3 at follow-up. In the final model, students living with their families were significantly more likely to receive regular dental checkup than those living alone. Regular checkup affected the decrease in calculus. The decrease in calculus affected the decrease in %BOP over 3 years. Living with family was directly associated with regular dental checkups and indirectly contributed to gingival status among Japanese university students.No potential conflict of interest relevant to this article was reported.Wiley-BlackwellActa Medica Okayama1386-634643102013Serum oxidative-anti-oxidative stress balance is dysregulated in patients with hepatitis C virus-related hepatocellular carcinoma10781092ENMamoruNishimuraAkinobuTakakiNaofumiTamakiTakayukiMaruyamaHidekiOnishiSayoKobayashiKazuhiroNousoTetsuyaYasunakaKazukoKoikeHiroakiHagiharaKenjiKuwakiShinichiroNakamuraFusaoIkedaYoshiakiIwasakiTakaakiTomofujiManabuMoritaKazuhideYamamotoAim
Oxidative stress is associated with progression of chronic liver disease (CLD). This association is best established in chronic hepatitis C. However, the anti-oxidative state is not well characterized. The objective of the present study was to investigate the balance of oxidative and anti-oxidative stress in CLD patients.
Methods
We recruited a study population of 208 patients, including healthy volunteers (HV; n = 15), patients with hepatitis B virus (HBV)-related CLD without or with hepatocellular carcinoma (HBV-non-HCC, n = 25, and HBV-HCC, n = 50, respectively), and patients with hepatitis C virus (HCV)-related CLD without or with HCC (HCV-non-HCC, n = 49, and HCV-HCC, n = 69, respectively). Serum levels of reactive oxygen metabolites (ROM) and anti-oxidative markers (OXY-adsorbent test; OXY) were determined, and the balance of these values was used as the oxidative index. Correlations among ROM, OXY, oxidative index and clinical characteristics were investigated.
Results
Patients with CLD exhibited elevated ROM and oxidative index compared to HV. Among patients with CLD, HCV positive status correlated with increased ROM. In CLD, HCV-HCC patients exhibited the highest ROM levels. Among HCV-related CLD patients, lower OXY correlated with HCC positive status, but was recovered by eradication of HCC. In HCV-HCC, lower OXY correlated with high PT-INR.
Conclusion
HCV positive CLD patients displayed higher oxidative stress and HCV-HCC patients displayed lower anti-oxidative state. Anti-oxidative state depression was associated with liver reservoir-related data in HCV-HCC and could be reversed with HCC eradication.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0944-11744492009Mortality rate of patients with asymptomatic primary biliary cirrhosis diagnosed at age 55 years or older is similar to that of the general population10001006ENJunichiKubotaFusaoIkedaRyoTeradaHaruhikoKobashiShin-ichiFujiokaRyoichiOkamotoShinsukeBabaYouichiMorimotoMasaharuAndoYasuhiroMakinoHideakiTaniguchiTetsuyaYasunakaYasuhiroMiyakeYoshiakiIwasakiKazuhideYamamotoRecent routine testing for liver function and anti-mitochondrial antibodies has increased the number of newly diagnosed patients with primary biliary cirrhosis (PBC). This study investigated the prognosis of asymptomatic PBC patients, focusing on age difference, to clarify its effect on the prognosis of PBC patients.
The study was a systematic cohort analysis of 308 consecutive patients diagnosed with asymptomatic PBC. We compared prognosis between the elderly (55 years or older at the time of diagnosis) and the young patients (< 55 years). The mortality rate of the patients was also compared with that of an age- and gender-matched general population.
The elderly patients showed a higher aspartate aminotransferase-to-platelet ratio, and lower alanine aminotransferase level than the young patients (P < 0.01 and P = 0.03, respectively). The two groups showed similar values for alkaline phosphatase and immunoglobulin M. Death in the young patients was more likely to be due to liver failure (71%), while the elderly were likely to die from other causes before the occurrence of liver failure (88%; P < 0.01), especially from malignancies (35%). The mortality rate of the elderly patients was not different from that of the age- and gender-matched general population (standardized mortality ratio, 1.1; 95% confidence interval, 0.6-1.7), although this rate was significantly higher than that of the young patients (P = 0.044).
PBC often presents as more advanced disease in elderly patients than in the young. However, the mortality rate of the elderly patients is not different from that of an age- and gender-matched general population.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama1471-2407112011Hepatitis B virus core promoter mutations G1613A and C1653T are significantly associated with hepatocellular carcinoma in genotype C HBV-infected patientsENMasashiTatsukawaAkinobuTakakiHidenoriShirahaKazukoKoikeYoshiakiIwasakiHaruhikoKobashiShin-IchiFujiokaKohsakuSakaguchiKazuhideYamamotoBackground: Hepatitis B virus (HBV) is a major cause of hepatocarcinogenesis. To identify mutations relevant to hepatocellular carcinoma (HCC) development, we compared the full genome sequences of HBV from the sera of patients with and without HCC.
Methods: We compared the full genome sequences of HBV isolates from 37 HCC patients (HCC group 1) and 38 patients without HCC (non-HCC group 1). We also investigated part of the core promoter region sequences from 40 HCC patients (HCC group 2) and 68 patients without HCC. Of the 68 patients who initially did not have HCC, 52 patients remained HCC-free during the follow-up period (non-HCC group 2), and 16 patients eventually developed HCC (pre-HCC group 2). Serum samples collected from patients were subjected to PCR, and the HBV DNA was directly sequenced.
Results: All patients had genotype C. A comparison of the nucleotide sequences of the HBV genome between HCC group 1 and non-HCC group 1 revealed that the prevalence of G1613A and C1653T mutations in the core promoter region was significantly higher in the HCC group. These mutations tended to occur simultaneously in HCC patients. Multivariate analysis with group 2 revealed that the presence of HCC was associated with aging and the double mutation. Future emergence of HCC was associated with aging and the presence of a single G1613A mutation.
Conclusions: G1613A and C1653T double mutations were frequently found in patients with HCC. A single G1613A mutation was associated with future emergence of HCC. These mutations may serve as useful markers in predicting HCC development.No potential conflict of interest relevant to this article was reported.Public Library of ScienceActa Medica Okayama1932-62031572020Relationship between oral hygiene knowledge, source of oral hygiene knowledge and oral hygiene behavior in Japanese university students: A prospective cohort studye0236259ENDaikiFukuharaDepartment of Preventive Dentistry, Okayama University HospitalDaisukeEkuniDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKotaKataokaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyanoTaniguchi-TabataDepartment of Preventive Dentistry, Okayama University HospitalYokoUchida-FukuharaDepartment of Preventive Dentistry, Okayama University HospitalNaoki ToyamaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshikiYonedaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshioSugiuraDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMonirulIslamDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHikariSahoDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiIwasakiHealth Service Center, Okayama UniversityManabuMoritaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe aim of this prospective cohort study was to examine whether oral hygiene knowledge, and the source of that knowledge, affect oral hygiene behavior in university students in Japan. An oral exam and questionnaire survey developed to evaluate oral hygiene knowledge, the source of that knowledge, and oral hygiene behavior, such as the frequency of tooth brushing and regular dental checkups and the use of dental floss, was conducted on university student volunteers. In total, 310 students with poor tooth brushing behavior (frequency of tooth brushing per day [<= once]), 1,963 who did not use dental floss, and 1,882 who did not receive regular dental checkup during the past year were selected. Among these students, 50, 364, and 343 in each respective category were analyzed in over the 3-year study period (follow-up rates: 16.1%, 18.5%, and 18.2%, respectively). The odds ratios (ORs) and 95% confidence intervals (CIs) for oral hygiene behavior were calculated based on oral hygiene knowledge and the source of that knowledge using logistic regression models. The results showed that dental clinics were the most common (> 50%) source of oral hygiene knowledge, and that a more frequent use of dental floss was significantly associated with dental clinics being a source of oral hygiene knowledge (OR, 4.11; 95%CI, 1.871-9.029; p < 0.001). In addition, a significant association was seen between dental clinics being a source of oral hygiene knowledge and more frequent regular dental checkups (OR, 13.626; 95%CI, 5.971-31.095; p < 0.001). These findings suggest the existence of a relationship between dental clinics being the most common source of oral hygiene knowledge and improved oral hygiene behavior in Japanese university students.No potential conflict of interest relevant to this article was reported.Fuji Technology Press Ltd.Acta Medica Okayama1883-80301712022Questionnaire Survey on COVID-19 Vaccination at Okayama University in Japan: Factors Promoting Vaccination Among Young Adults2130ENChigusaHiguchiOkayama University Health Service CenterNaomiMatsumotoDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshiakiIwasakiOkayama University Health Service CenterTakashiYorifujiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunichiroYamazakiOkayama UniversityYasutomoNasuOkayama UniversityHirofumiMakinoOkayama UniversityCOVID-19 has been prevalent worldwide since 2019. Increasing COVID-19 vaccination coverage is an important measure to combat the disease. An online survey was conducted with university students and personnel who were vaccinated against COVID-19 at a mass vaccination event to examine the factors promoting vaccination among young adults. The online survey was conducted with persons vaccinated at Okayama University from June 5 to September 27, 2021. Although the number of those who had fever >37.5°C increased after the second vaccination compared to the first, the vaccinated persons got more satisfied after the second shot.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811322001多発性肝嚢胞の1例159164ENYutakaNakanishiKohsakuSakaguchiYoshiakiIwasakiKazuhiroNousoHiroyukiShimomuraHiroakiMatsudaTakahitoYagiNoriakiTanakaTakaoTsujiA 45-year-old female was admitted to our hospital with sever abdominal fullness, and was diagnosed as polycystic liver disease with ultrasonography, abdominal CT and abdominal angiography. Almost all part of the right lobe of the liver was replaced with a lot of cysts. The liver obviously swelled up. We thought her symptom came from oppression of the digestive tract by the liver. Liver function is good. Right lobe resection, deroofing and fenestration were performed, and after operation the volume of the liver was reduced and the symptom got better. We report a case of polycystic liver disease improved with surgical therapy, adding some study with reference.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0815-93192922014Assessment of health-related quality of life and how it predicts the outcome of pegylated interferon and ribavirin therapy for chronic hepatitis C337343ENHiroshiMatsushitaFusaoIkedaYoshiakiIwasakiHiroyukiSekiShintaroNanbaYasutoTakeuchiYukiMoritouTetsuyaYasunakaHidekiOnishiYasuhiroMiyakeAkinobuTakakiKazuhiroNousoKazuhideYamamotoBackground and Aim: Chronic infection with hepatitis C virus (HCV) decreases health-related quality of life (HRQOL). The present study was planned to investigate the impact of HRQOL of patients with chronic hepatitis C (CHC) on the outcomes of therapy with pegylated interferon and ribavirin (RBV), in addition to IL28B polymorphisms.
Methods: The present study enrolled 228 CHC patients and assessed their HRQOLs prospectively with the 36-item short-form health survey.
Results: The patients with CHC have lower physical HRQOL status than the general population (P = 0.037, the Z-test). The patients with advanced liver diseases exhibited further decreases in HRQOL (P = 0.036, Spearman's rank correlation coefficient). The score of total HRQOL was significantly lower in the group with sustained virological response (SVR) to the therapy with pegylated interferon and RBV than the non-SVR group (P = 0.031, the Mann-Whitney U-test), with significantly lower scores of mental component and its comprising subscales in the SVR group. Stepwise multivariate logistic regression analysis showed that low HRQOL score <= 400 points was significantly associated with SVR (odds ratio = 2.4, P = 0.013), independently from high platelet counts, low HCV RNA, favorable single-nucleotide polymorphism type of IL28B, and HCV serotype 2. The patients with low HRQOL score will have significantly less decrease in HRQOL score by 4 weeks of the treatment than those with high HRQOL score at baseline (P = 0.0045).
Conclusion: HRQOL is one of the significant predictor of the outcomes of therapy with pegylated interferon and RBV independently from IL28B polymorphism.No potential conflict of interest relevant to this article was reported.Wiley-BlackwellActa Medica Okayama0303-69793992012Effects of self-efficacy on oral health behaviours and gingival health in university students aged 18- or 19-years-old844849ENShinsukeMizutaniDaisukeEkuniMichikoFurutaTakaakiTomofujiKoichiroIrieTetsujiAzumaAzusaKojimaJunNagaseYoshiakiIwasakiManabuMoritaAim Although self-efficacy is known to affect various health-related practises, few studies have clearly examined how self-efficacy correlates with oral health behaviors or the oral health condition. We examined the relationship between gingivitis, oral health behaviors and self-efficacy in university students. Material & Methods A total of 2,111 students (1,197 males, 914 females) aged 18 and 19 years were examined. The degree of gingivitis was expressed as the percentage of bleeding on probing (%BOP). Additional information was collected via a questionnaire regarding oral health behaviors (daily frequency of tooth-brushing, use of dental floss and regular check-up). Self-efficacy was assessed using the Self-Efficacy Scale for Self-care (SESS). Path analysis was used to test pathways from self-efficacy to oral health behaviors and %BOP. Results In the final structural model, self-efficacies were related to each other, and they affected oral health behaviors. Good oral health behaviors reduced dental plaque and calculus, and lower levels of dental plaque and calculus resulted in lower %BOP. Conclusion Higher self-efficacy correlated with better oral health behaviours and gingival health in university students. Improving self-efficacy may be beneficial for maintaining good gingival health in university students. To prevent gingivitis, the approach of enhancing self-efficacy in university students would be useful.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0095-11375222014Necessity for Reassessment of Patients with Serogroup 2 Hepatitis C Virus (HCV) and Undetectable Serum HCV RNA544548ENYukiMoritouFusaoIkedaYasutoTakeuchiHiroyukiSekiShintaroNanbaYoshiakiIwasakiKazuhideYamamotoWe encountered a patient positive for anti-hepatitis C virus (HCV) whose serum HCV RNA was undetectable with the Roche AmpliPrep/Cobas TaqMan HCV assay (CAP/CTM) version 1 but showed a high viral load with the Abbott RealTime HCV assay (ART). Discrepancies in the detectability of serum HCV RNA were investigated among 891 consecutive patients who were positive for anti-HCV. Specific nucleotide variations causing the undetectability of HCV RNA were determined and confirmed by synthesizing RNA coding those variations. Serum samples with the discrepancies were also reassessed by CAP/CTM version 2. Among the 891 anti-HCV-positive patients, 4 patients had serum HCV RNA levels that were undetectable by CAP/CTM version 1 despite having levels of > 5 log IU/ml that were detected by ART. All four patients had HCV genotype 2a and high titers of anti-HCV. Sequencing of the HCV 5' noncoding regions revealed 2 common variations, A at nucleotide (nt) 145 and T at nt 151. Synthesized RNAs of the HCV 5' noncoding region with standard (NCR145G151C) and variant nucleotides at nt 145 and nt 151 were quantified with CAP/CTM. RNAs of NCR145G151C and NCR145G151T were quantifiable with CAP/CTM version 1, while those of NCR145A151T and NCR145A151C went undetected. The substitution from G to A at nt 145 specifically conferred this undetectability, while this undetectability was reverted in synthesized HCV RNA with correction of this variation. Reassessment of these samples by CAP/CTM version 2 resulted in similar levels of HCV RNA being detected by ART. We conclude that HCV patients with undetectable HCV RNA by CAP/CTM version 1 should be reassessed for viral quantification.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0944-11744832013The impact of patatin-like phospholipase domain-containing protein 3 polymorphism on hepatocellular carcinoma prognosis405412ENYasutoTakeuchiFusaoIkedaYukiMoritouHiroakiHagiharaTetsuyaYasunakaKenjiKuwakiYasuhiroMiyakeHidekiOhnishiShinichiroNakamuraHidenoriShirahaAkinobuTakakiYoshiakiIwasakiKazuhiroNousoKazuhideYamamotoThe single nucleotide polymorphism (SNP) rs738409 in patatin-like phospholipase domain-containing protein 3 (PNPLA3) is associated with hepatic fat accumulation and disease progression in patients with non-alcoholic fatty liver disease and alcoholic liver disease (ALD). This study was conducted to determine whether PNPLA3 rs738409 SNPs affect development and prognosis of hepatocellular carcinoma (HCC) in patients with various liver diseases.
We enrolled 638 consecutive Japanese patients newly diagnosed with HCC between 2001 and 2010: 72 patients with hepatitis B virus (HBV), 462 with hepatitis C virus (HCV), and 104 with non-B non-C (NBNC).
NBNC patients exhibited large tumors of advanced TNM stages at HCC diagnosis, and had significantly poorer prognosis than HBV or HCV patients (P < 0.001 and < 0.001, respectively; log-rank test). The G/G genotype of PNPLA3 rs738409 SNP had significantly higher distribution in NBNC patients (P < 0.001) and was significantly associated with higher body mass index (BMI) and an increased aspartate aminotransferase to platelet ratio index. No significant differences were observed in survival with differences in PNPLA3 SNP genotypes among the patients, although ALD patients with the G/G genotype of PNPLA3 SNP and low BMI had significantly poorer survival than those with high BMI (P = 0.028).
The G/G genotype of PNPLA3 rs738409 SNP was more frequently distributed, and associated with BMI and fibrosis among NBNC-HCC patients but not among HBV or HCV patients. These genotypes might affect HCC prognosis in ALD patients, but not in HBV, HCV, or NAFLD patients.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0944-117445112010Laparoscopic findings of reddish markings predict hepatocellular carcinoma in patients with hepatitis B virus-related liver disease11721182ENBonShojiFusaoIkedaShin-ichiFujiokaHaruhikoKobashiTetsuyaYasunakaYasuhiroMiyakeHidenoriShirahaAkinobuTakakiKazuhiroNousoYoshiakiIwasakiKazuhideYamamotoFor patients with chronic hepatitis due to hepatitis B virus (HBV), factors predicting hepatocellular carcinoma (HCC) other than high levels of HBV-DNA and alanine aminotransferase (ALT) are needed to prevent HCC development, as many patients with chronic HBV infection fulfill these conditions. The purpose of this study was to clarify factors predictive of HCC development for those patients.
The study was a systematic cohort analysis of 303 consecutive patients with hepatitis B e-antigen, receiving laparoscopic examination for assessment of liver disease. Laparoscopic, histological, and clinical characteristics were investigated as related to HCC development.
HCC occurred in 27 patients during a mean follow-up of 8.0 +/- A 5.0 years, at the age of 37-72 years. Significant associations with HCC development were shown for liver cirrhosis, histological activity grade, reddish markings, and older age. Multivariate analysis revealed that HCC development was strongly associated with older age and male gender (P = 0.002 and P = 0.043, respectively). HCC occurred more frequently in patients of age a parts per thousand yen30 years even with early stage than in patients of age < 30 years (P = 0.031). Severe reddish markings, a laparoscopic finding of widespread parenchymal destruction, were highly associated with HCC development in patients of age a parts per thousand yen30 years at diagnosis (odds ratio = 1.67, P = 0.034), while histological activity grade and ALT level were not (P = 0.075 and P = 0.69, respectively).
HCC development is associated with older age, male gender, and liver cirrhosis. Reddish markings, rather than histological activity or ALT level, can be useful to predict HCC for HBV patients of age a parts per thousand yen30 years.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6022006Simple surrogate index of the fibrosis stage in chronic hepatitis C patients using platelet count and serum albumin level.7784ENTakeyukiOhtaKohsakuSakaguchiAkikoFujiwaraShin-ichiFujiokaYoshiakiIwasakiYasuhiroMakinoYasuyukiArakiYasushiShiratoriArticle10.18926/AMO/30729<p>This study was conducted to develop a simple surrogate index comprised of routinely available laboratory tests to reflect the histological fibrosis stage. Clinical characteristics and laboratory data from 368 and 249 consecutive patients with chronic hepatitis C, a training cohort and a validation cohort, respectively, were retrospectively evaluated. Platelet (Plt) count and albumin (Alb) level contributed to the discrimination of the respective fibrosis stages. We derived the fi brosis index (FI), FI = 8.0-0.01 x Plt (10 multiply 3/microliter) - Alb (g/dl), from a multiple regression model. FI significantly correlated with the histological fibrosis stage in both the initial and validation cohort at p=0.691 and p=0.661, respectively (Spearman's rank correlation coefficient, p<0.0001). The sensitivity and positive predictive value of FI at a cutoff value < 2.10 for predicting fibrosis stage F0-1 were 66.8% and 78.8% in the initial cohort and 68.5% and 63.6% in the validation cohort, respectively. Corresponding values of FI at a cutoff value >- 3.30 for the prediction of F4 were 67.7% and 75.0% in the initial cohort and 70.8% and 81.0% in the validation cohort. The fibrosis index comprised of platelet count and albumin level reflected the histological fibrosis stage in patients with chronic hepatitis C.</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X4231988Ultrasonographic characteristics of small hepatocellular carcinoma.151157ENToshihiroHigashiKazuoTobeKen-ichiroAsanoHiroshiIkedaToshiyaOhsawaYoshiakiIwasakiKazuhiroNousoNoriyukiShinjiYohichiMorimotoYasumasaSatohMasaharuAndohYasuyukiArakiOsamuTomitaHirofumiMorishitaKeijiKitaTakahiroTsuchiyaShigeruMorichikaTakahiroTanabeHideoNagashimaTakaoTsujiArticle10.18926/AMO/31032<p>The ultrasonographic characteristics of hepatocellular carcinomas (HCC) were investigated. Four typical features of HCCs, "mosaic internal echo pattern", "halo", "lateral shadow" and "posterior echo enhancement", were not recognized in minute HCCs smaller than 2 cm in diameter. These characteristics developed as the tumors grew. Only hypoechoic space-occupying lesions can be considered as small HCCs. In differentiating small HCCs from hypoechoic non-malignant space-occupying lesions in the cirrhotic liver, the ratios of short to long dimensions of the lesions seemed to be important since the ratios of HCCs were significantly larger than those of non-malignant lesions. The fact that 3 hyperechoic small HCCs could not be diagnosed even by celiac arteriography has suggested to us that ultrasonically guided biopsies should be performed in order to differentiate from small hemangiomas. Serum alpha-fetoprotein (AFP) levels of 1/3 of the patients with HCCs were below 100 ng/ml, indicating that it is impossible to detect small HCCs only by measuring serum AFP.</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5642002Mutations in the hepatitis B virus preS2 region and abrogated receptor activity for polymerized human albumin.193198ENJunichiKondoHiroyukiShimomuraShin-ichiFujiokaYoshiakiIwasakiShinjiroTakagiYasuhiroOhnishiHideyukiTsujiKosakuSakaguchiKazuhideYamamotoTakaoTsujiArticle10.18926/AMO/31685<p>The preS2 region of the hepatitis B virus (HBV) has been reported to have human polymerized albumin receptor (PAR) activity, which correlates with viral replication. Here, we studied the genomic sequence of the preS region from rare patients lacking PAR activity, despite active viral replication. PAR and DNA polymerase activity was identified in 178 HBe antigen-positive HBV carriers, and a significant correlation between 2 markers was shown, except in 2 hepatitis patients lacking PAR activity. Nucleotide sequences of the preS region of HBV from both patients were examined by direct sequencing of PCR products. In one patient, a 45-base deletion was found to overlap half of the putative polymerized human albumin binding site in the preS2 region. In the other patient, a point mutation at the first nucleotide of the start codon of the preS2 region of HBV was found. There was no such genomic change in the 3 control HBV sequences. These results indicate that the preS2 region is necessary for binding of polymerized human albumin, and this is the first report of naturally existing mutant virus with no or low PAR activity.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5952005Lamivudine treatment in patients with HBV-related hepatocellular carcinoma--using an untreated, matched control cohort.217224ENCheng-YuPiaoShin-ichiFujiokaYoshiakiIwasakiKozoFujioToshihikoKaneyoshiYasuyukiArakiKuniakiHashimotoTomonoriSenohRyoTeradaTomohiroNishidaHaruhikoKobashiKohsakuSakaguchiYasushiShiratoriArticle10.18926/AMO/31969<p>Lamivudine is widely used to treat patients with hepatitis B. However, the outcomes in patients with hepatocellular carcinoma (HCC) treated with lamivudine have not been established. This study was conducted to evaluate the outcomes of lamivudine treatment for patients with HCC using an untreated, matched control group. Thirty patients with controlled HCC orally received lamivudine. As controls, 40 patients with HCC who were not treated with lamivudine and matched for clinical features were selected. The lamivudine-treated and untreated groups were compared with respect to changes in liver function, HCC recurrence, survival, and cause of death. In the lamivudine-treated group, there was significant improvement in the Child-Pugh score at 24 months after starting treatment, while no improvement was observed in the untreated group. There was no significant difference in the cumulative incidence of HCC recurrence and survival between the groups. However, there was a significant difference in the cumulative incidence of death due to liver failure (P= 0.043). A significant improvement in liver function was achieved by lamivudine treatment, even in patients with HCC. These results suggest that lamivudine treatment for patients with HCC may prevent death due to liver failure. Further prospective randomized studies using a larger number of patients are required.</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5542001Cold activation of serum complement in patients with chronic hepatitis C: study on activating pathway and involvement of IgG.229235ENYasushiIshiiHiroyukiShimomuraMamoruItoMasanobuMiyakeFusaoIkedaJiroMiyakeShin-ichiFujiokaYoshiakiIwasakiHideyukiTsujiTakaoTsujiArticle10.18926/AMO/31989<p>It has been documented that the serum complement activities measured by hemolytic assay (CH50) are decreased after storage of sera at a low temperature in some patients with chronic hepatitis C. However, the mechanism of this phenomenon has not been identified yet. Here, we tried to elucidate factors involved in the cold activation of complement (CAC). To clarify what pathway is activated in CAC, we measured complement cleavage products after cold storage of sera. C4d increased significantly after 12 h-storage at cold temperatures in 5 CAC (+) sera compared with 5 CAC (-) (P < 0.01) and 3 control sera (P < 0.05), while Bb did not increase in any of the groups. In order to determine whether IgG or IgG complex is necessary for CAC, 8 CAC (+) sera were incubated with Protein G Sepharose gel beads, and all of them retained hemolytic activities to some extent after cold storage. Column chromatography through Superose 6HR of CAC-positive serum identified the fractions containing molecules that induced CAC in normal serum, which were depleted by treatment with protein G Sepharose. In conclusion, CAC in hepatitis C seems to occur via a classical or lectin pathway, and the IgG complex produced in hepatitis C virus infection may be an important factor in inducing CAC, a common extrahepatic manifestation of hepatitis C.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5752003Anti-viral actions and viral dynamics in the early phase of three different regimens of interferon treatment for chronic hepatitis C: differences between the twice-daily administration of interferon-beta treatment and the combination therapy with interferon-alpha plus ribavirin.217225ENHirofumiNakajimaHiroyukiShimomuraYoshiakiIwasakiFusaoIkedaFumiUmeokaPiaoChengyuHideakiTaniguchiYasuhiroOhnishiShin-jiroTakagiShin-ichiFujiokaYasushiShiratoriArticle10.18926/AMO/32825<p>To improve the efficacy of interferon (IFN) treatment for chronic hepatitis C, we have proposed the twice-daily administration of IFN-beta as a promising induction therapy. In this study, we demonstrated differences between the clearance of circulating HCV-RNA and the induction of anti-viral actions during the first 2 weeks of treatment. Nine patients with a high viral load and genotype 1b were randomly assigned to 3 groups: group A received 3MU of IFN-beta twice a day at intervals of 5 and 19 h; group B received 3MU of IFN-beta twice a day at intervals of 10 and 14 h; group C received 6MU of IFN-alpha once a day with ribavirin. The expression of OAS2, PKR, and MxA in peripheral blood mononuclear cells (PBMCs) were quantified by real-time polymerase chain reaction method. The viral clearance showed a bi-phasic pattern, and those in the second phase of groups A and B were significantly steeper than that of group C. The peak level of OAS2 during the first phase was correlated with the first phase decay. The MxA expression tended to be higher in group A and B than in group C. The expression of these 3 proteins tended to decrease at day 6 in group C, but increase in groups A and B. These might make differences in the viral decay during the second phase</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6112007A homosexual japanese man with acute hepatitis due to hepatitis B virus genotype ae, concurrent with amebic colitis3539ENYasuhiroMiyakeYoshiakiIwasakiShinIshikawaMasashiTatsukawaToruNawaJunKatoAkinobuTakakiHaruhikoKobashiKohsakuSakaguchiYasushiShiratoriCase Report10.18926/AMO/32914We report herein a case with acute hepatitis due to hepatitis B virus genotype Ae, concurrent with
amebic colitis. A 39-year-old homosexual Japanese man was admitted to our hospital with jaundice.
Laboratory tests showed an elevation of transaminase and positivity for hepatitis B surface antigen and IgM-type antibody to hepatitis B core antigen. The hepatitis B virus genotype was determined to be Ae. Furthermore, a mud-like stool with blood and mucous had sometimes been noted during the
past 3 years, and amebic colitis was shown by colonofi berscopy during hospitalization. The patient was diagnosed with acute hepatitis B, concurrent with amebic colitis, and was successfully treated with lamivudine and metronidazole. In Japanese patients with acute hepatitis B virus genotype A infection, homosexual activity tends to be high. Furthermore, in Japanese homosexual men, amebiasis
has been increasing. Thus, in Japanese patients with acute hepatitis B, a determination of genotype should be performed in order to investigate the route of transmission of hepatitis B virus, and a search for amebiasis should be performed in patients with acute hepatitis due to hepatitis B virus genotype A. Furthermore, education of homosexual men regarding hepatitis B virus, hepatitis B
virus vaccination, and amebiasis is urgently required.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6512011Prognostic Model for Hepatocellular Carcinoma with Time-Dependent Factors1119ENKenjiKuwakiKazuhiroNousoYoshiyukiKobayashiShinichiroNakamuraYoichi M.ItoShoutaIwadouHiroakiHagiharaTetsuyaYasunakaJunichiToshimoriHirokazuMiyatakeKenjiMiyoshiHidekiOnishiYasuhiroMiyakeBonShojiAkinobuTakakiHidenoriShirahaYoshiakiIwasakiHaruhikoKobashiKazuhideYamamotoOriginal Article10.18926/AMO/43825The purpose of this study was to build a prognostic model of hepatocellular carcinoma (HCC) using time-dependent covariates to re-evaluate the prognosis at any stage of the disease. The subjects were consecutive HCC patients who were treated at our institute between 1995 and 2007. We constructed time-fixed and time-dependent prognostic models with a training group (n=336) and compared the prognostic abilities between conventional Cancer of the Liver Italian Program (CLIP) scores, Japan Integrated Staging (JIS) scores, an Okuda classification, and our prognostic models in the testing group (n=227) with the c-index. The time-dependent prognostic model consisted of main tumor size, tumor number, portal vein invasion, distant metastasis, alpha-fetoprotein, des-gamma-carboxy prothrombin (DCP), bilirubin, and albumin and the weighted scores were set for each factor depending on the hazard ratio for the prognosis. The prognostic index was determined by summing the scores. The c-index values for the CLIP scores, JIS scores, Okuda classification, and our time-dependent model were 0.741, 0.727, 0.609, and 0.870, respectively. These results indicate that our time-dependent model can estimate the prognosis of HCC more precisely than traditional time-fixed models and can be used to re-predict the prognosis of HCC.No potential conflict of interest relevant to this article was reported.