Publications by authors named "Kuwahara K"

Type D personality, characterized by negative affectivity and social inhibition, has been associated with both the psychophysiology of coronary artery disease (CAD) and depressive disorders. However, few reports have described the impact of coping strategies in these patients. This study aimed to analyze the characteristics of type D personality and the coping strategies adopted by patients with CAD and to explore the factors associated with depressive tendencies during follow-up.

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Karnofsky Performance Status (KPS) is a widely used scale to assess performance status. KPS ≥ 50% implies that patients can live at home. Therefore, maintaining KPS ≥ 50% is important to improve the quality of life of patients with glioblastoma, whose median survival is less than 2 years.

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In this study, we experimentally demonstrate a PPLN-based free-space to SMF (single-mode fiber) conversion system capable of efficient long-wavelength down-conversion from 518 nm, optimized for minimal loss in highly turbid water, to 1540 nm, which is ideal for low-loss transmission in standard SMF. Leveraging the nonlinear optical properties of periodically poled lithium niobate (PPLN), we achieve a wavelength conversion efficiency of 1.6% through difference frequency generation while maintaining a received optical signal-to-noise ratio of 10.

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DNA is frequently damaged by genotoxic stresses such as ionizing radiation, reactive oxygen species, and nitrogen species. DNA damage is a key contributor to cancer initiation and progression, and thus the precise and timely repair of these harmful lesions is required. Recent studies revealed transcription as a source of genome instability, and transcription-coupled DNA damage has been a focus in cancer research.

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Acute kidney injury (AKI), typically caused by ischemia, is a common clinical complication with a poor prognosis. Although proteinuria is an important prognostic indicator of AKI, the underlying causal mechanism remains unclear. In vitro studies suggest that podocytes have high ATP demands to maintain their structure and function, however, analyzing their ATP dynamics in living kidneys has been technically challenging.

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A true median cleft is an extremely rare congenital anomaly characterized by a midline vertical cleft and various deformities, also known as Tessier number 0 cleft. Here we report a case of a 5-year-old Asian boy with true median cleft associated with sinus tracts in the nasal septum, a phenomenon not previously reported in the literature. The tracts were identified as the cause of recurrent infections around the oral vestibule and upper lip.

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Introduction: Long hospital stay is associated with high costs and poor quality of life in elderly patients with heart failure (HF). This study aimed to investigate the association of early administration of tolvaptan with length of hospital stay among elderly patients with HF.

Methods: The cohort included elderly patients (age ≥ 75 years) admitted to Shinonoi General Hospital between July 2016 and December 2018 with a primary diagnosis of acute decompensated HF treated with tolvaptan.

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  • Prophylactic surgery for impending fractures in patients with long-bone metastasis is linked to better survival rates compared to those with complete fractures, especially in those deemed intermediate-to-high risk.
  • A study of 121 patients revealed lower one-year mortality rates for those with impending fractures, alongside higher rates of home discharge and improved post-operative mobility.
  • Results indicated that the type of surgical intervention (nailing vs. hemiarthroplasty) did not significantly affect survival rates among patients with impending fractures.
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Background And Objective: Inadequate response to antidepressant monotherapy is common among patients with major depressive disorder (MDD). The efficacy and safety of adjunctive brexpiprazole 2 mg/day has recently been confirmed during the 6-week, randomized, placebo-controlled phase 2/3 (BLESS) study, which evaluated brexpiprazole at 1 mg/day and 2 mg/day versus placebo as adjunctive therapy to antidepressant therapies in 740 Japanese patients with MDD and an inadequate response to antidepressant monotherapy. This study evaluated the long-term safety and efficacy of adjunctive fixed-dose brexpiprazole 2 mg/day in Japanese patients with MDD.

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  • Most heart failure patients show signs of congestion, which can impact prognosis differently based on their left ventricular ejection fraction (LVEF).
  • This study analyzed data from 3,787 patients to evaluate how varying levels of congestion affect outcomes like death and rehospitalization, revealing that severe congestion on admission is linked to worse outcomes in those with LVEF ≥ 40%.
  • The results suggest that while clinical congestion severity affects patients with higher LVEF, it does not have the same effect on those with lower LVEF, indicating a need for further research into congestion's role across different LVEF levels.
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Immune evasion is one of the mechanisms by which cancer cells acquire immunity during cancer development and progression. One of these is the increased expression of cluster of differentiation 47 (CD47), a transmembrane glycoprotein that protects cells from phagocytic elimination. The interaction between CD47 and signal regulatory protein alpha (SIRPα) on macrophages alleviates the phagocytic signal.

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Background: Optimal lesion preparation for coronary lesions has been reappraised in the interventional community, given the increasing use of drug-coated balloons for de novo lesions; however, whether multiple ballooning could achieve more favorable angiographic results compared with single ballooning remains unknown. We aimed to investigate the incremental effect of multiple ballooning on de novo coronary lesions over single ballooning as assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) among patients undergoing percutaneous coronary intervention (PCI).

Methods: Patients with chronic coronary syndrome (CCS) undergoing PCI were enrolled.

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  • Giant congenital melanocytic nevus (GCMN) is a noncancerous skin condition that raises concerns about appearance and potential malignancy, necessitating effective treatment options.
  • This report details three cases where GCMN was treated using full-thickness excision paired with cultured epidermal autograft (CEA) and split-thickness skin graft (STSG), achieving nearly complete healing without nevus recurrence.
  • The method showed better results in skin elasticity and minimizing scarring compared to traditional techniques, despite some instances of hypertrophic scars and keloids in certain patients.
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  • Heart failure is a common and serious complication following acute myocardial infarction, leading to high rates of mortality and increased healthcare costs.
  • The article discusses the established benefits of four key heart failure medications—β-blockers, mineralocorticoid receptor antagonists, angiotensin receptor-neprilysin inhibitors, and sodium-glucose cotransporter 2 inhibitors—mainly studied in patients with reduced ejection fraction.
  • It aims to provide an overview of current research on drug and device therapies that can help prevent heart failure in patients who have experienced an acute myocardial infarction.
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Most elements of filamentous fungi seen in human tissue by pathologists are hyphae, and encountering other elements may interfere with diagnosis. Sporangia and chlamydospores are such elements that have been described in only a few case reports. We present an autopsy case with the extremely rare coexistence of Mucorales sporangia and chlamydospores in the lung.

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Background: Transvenous lead extraction (TLE) for cardiovascular implantable electronic device (CIED)-related infections has increased. The incidence of TLE in nonagenarians is low, with limited reports outlining the outcomes of this procedure. Therefore, in this study, we aimed to clarify the outcomes of TLE in nonagenarians.

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Background: Clinical evidence regarding predictors of successful weaning from mechanical circulatory support (MCS) is lacking. This study aimed to create a simple risk score to predict successful weaning from MCS in patients with cardiogenic shock.

Methods And Results: This retrospective single-center cohort study included 114 consecutive patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation or IMPELLA between January 2013 and June 2023.

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  • - This study examines the connection between the hemoglobin to red blood cell distribution width (Hb/RDW) ratio and mortality in patients recovering from acute decompensated heart failure (ADHF), highlighting its potential as a predictive tool.
  • - Researchers analyzed data from 250 patients hospitalized for ADHF, finding that those with a lower Hb/RDW ratio (<0.24) had significantly worse outcomes in terms of all-cause mortality compared to those with a higher ratio (≥0.24).
  • - After adjusting for factors like demographics and heart failure severity, a lower Hb/RDW ratio was shown to nearly double the risk of mortality, suggesting its importance in identifying patients at higher risk for future cardiovascular issues.
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The prognosis of congenital heart disease (CHD) has improved, and most patients now reach adulthood. Owing to residual disease and comorbidities, it is recommended that adult CHD (ACHD) patients transition to adult care for lifelong monitoring and treatment. However, this transition period can be challenging for CHD patients owing to obstacles such as independence from their parents and establishing self-management.

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Lipid-lowering therapy plays a central role in reducing cardiovascular events. Over the past few decades, clinical trials utilizing several imaging techniques have consistently shown that lipid-lowering therapy can reduce the coronary plaque burden and improve plaque composition. Although intravascular ultrasound has been the most extensively used modality to assess plaque burden, other invasive modalities, such as optical coherence tomography and near-infrared spectroscopy, provide relevant data on plaque vulnerability, and computed tomography angiography detects both plaque volume and characteristics non-invasively.

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  • The study focused on factors influencing the effectiveness of esaxerenone in lowering blood pressure (BP) and the risk of elevated potassium levels in hypertensive patients.
  • Results showed that factors like male sex, high pulse rate, and use of calcium channel blockers were linked to a weaker BP-lowering effect, while lower urine albumin-to-creatinine ratios indicated a stronger effect.
  • Additionally, patients with higher baseline serum potassium levels were at a greater risk of experiencing elevated potassium levels after treatment with esaxerenone.
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