Selection of and Retention in Surgical Specialty during Early Career in Japan.

The number of surgeons is decreasing in Japan. We investigated the trend and factors influencing surgeons' selection of and retention in surgical specialty. In 2016, we obtained data of biennial surveys conducted by the government, and analyzed the annual data of doctors up to the latest available survey at that time (survey, 1994-2014; medical license acquisition, 1993-2014).

Clinical characteristics of hospitalized heart failure patients with preserved, mid-range, and reduced ejection fractions in Japan.

Aims: There are regional differences in the patient characteristics, management, and outcomes of hospitalized patients with heart failure (HF). The aim of this study was to evaluate the clinical characteristics and outcomes of Japanese patients who are hospitalized with HF on the basis of the left ventricular ejection fraction (LVEF) stratum.

Methods And Results: We retrospectively conducted a multicentre cohort study of 1245 hospitalized patients with decompensated HF between 2013 and 2014.

[Is Atrial Fibrillation a Pre-Thrombotic State?].

Atrial fibrillation (AF) is said to be a pre-thrombotic state. In patients with AF, the left atrium is usually dilated and blood flow is sluggish, which enables the formation of a thrombus within the left atrium. This is consistent with two of Virchow's Triad, stasis of blood flow and endothelial injury, but the last of the Triad, hypercoagulability of blood, is difficult to explain in AF.

Apixaban for the Treatment of Japanese Subjects With Acute Venous Thromboembolism (AMPLIFY-J Study).

Background: Anticoagulation is recommended as standard of care for venous thromboembolism (VTE) (pulmonary embolism [PE]/deep vein thrombosis [DVT]), for which unfractionated heparin (UFH) and warfarin are used in Japan. In the multi-regional AMPLIFY study, a fixed-dose regimen of apixaban alone was non-inferior to conventional therapy for treatment of PE/DVT and was associated with significantly fewer bleeding events.

Methods And Results: Japan phase 3 study (AMPLIFY-J), randomized, active-controlled, open-label study in Japanese subjects with acute PE/DVT, was designed based on AMPLIFY.

[Clinical evaluation of lapatinib therapy in metastatic breast cancer using the Bayes meta-analysis].

The efficacy of treatments involving lapatinib for patients with metastatic breast cancers was evaluated in a Bayesian metaanalysis of published data from randomized controlled clinical trials. Four randomized controlled trials including 2,708 patients met the inclusion criteria. Among these patients, 568 were positive for the human epidermal growth factor receptor 2(HER2).

[Study on medical economic evaluation methods for metastatic brain tumors therapy].

Introduction: Treatment design for metastatic brain tumors is required to firstly care about the life and function for which the patient hopes because it is terminal care. Therefore, to discuss the value of the therapy, a viewpoint of the QOL and the socioeconomic factors other than the survival rate is important. However, examination that applies these factors to the therapy needs to be carried out more thoroughly.

Pharmacoeconomics of antiviral therapy for influenza in a Japanese hospital setting.

Objectives: We constructed a cost-effectiveness decision model to determine a hypothetical 'best treatment' pathway for patients presenting at our institution with influenza virus infection when the choice of treatment was either oseltamivir, zanamivir or a control therapy not active against influenza.

Methods: The decision model was constructed using DATA 3.5 for evaluating the cost-effectiveness analysis of neuraminidase inhibitors from the perspective of the healthcare payer.

Pharmacoeconomic analysis of cilostazol for the secondary prevention of cerebral infarction.

Background: The antiplatelet agent, cilostazol, is known to reduce the risk of subsequent cerebral infarction. However, the cost effectiveness of such treatment in comparison to aspirin has not been studied.

Methods And Results: A Markov model was developed to calculate the health outcomes and associated costs for 65-year-old patients with cerebral infarction who were treated with 200 mg/day cilostazol or 81 mg/day aspirin.

[Introduction patient analysis from the medical institution in Shinjuku].

The number of introduction patients from July 22, 2003 to the end of December was 10,329 persons. The introduction from the medical institution in Shinjuku was 2,175 persons (21.1%).

Mutation of the phospholamban promoter associated with hypertrophic cardiomyopathy.

Phospholamban is an endogenous inhibitor of sarcoplasmic reticulum calcium ATPase and plays a prime role in cardiac contractility and relaxation. Phospholamban may be a candidate gene responsible for cardiomyopathy. We investigated genome sequence of phospholamban in patients with cardiomyopathy.