Tokyo National Research Articles

A case of Mycobacterium tuberculosis laboratory cross-contamination

SettingA laboratory cross-contamination event was suspected because Mycobacterium tuberculosis was unexpectedly detected at a high incidence in the cultures of several clinical specimens at the National Hospital Organization, Tokyo National Hospital, Japan. ObjectiveTo describe a case of Mycobacterium tuberculosis laboratory cross-contamination. DesignWe reviewed the medical records of 20 patients whose clinical specimens were suspected to have been contaminated by Mycobacterium tuberculosis. Variable number of tandem repeat analysis with 15 loci, the Japan Anti-Tuberculosis Association-12, and three additional hyper-variable loci, was performed to identify the cross-contamination event. ResultsThe clinical, laboratory, and variable number of tandem repeat data revealed that the cross-contamination had possibly originated from one strongly positive specimen, resulting in false-positive results in 11 other specimens, including a case treated with anti-tuberculosis drugs. ConclusionClinical and laboratory data must be re-evaluated when cross-contamination is suspected and variable number of tandem repeat analysis should be used to confirm cross-contamination. Furthermore, original isolates should be stored appropriately, without sub-culturing and genotyping should be performed at the earliest possible for better utilization of variable number of tandem repeat for the identification of cross-contamination.

Exacerbation of chronic pulmonary aspergillosis was associated with a high rebleeding rate after bronchial artery embolization.

Hemoptysis is a common symptom associated with chronic pulmonary aspergillosis (CPA). While surgery is the primary choice to manage hemoptysis, it is often avoided because patients with CPA are more likely to have complications such as respiratory insufficiency and low pulmonary function. Bronchial artery embolization (BAE) may be considered one of the treatments of massive and persistent hemoptysis for such patients. We retrospectively reviewed medical records of 41 patients, admitted to National Hospital Organization Tokyo National Hospital, Tokyo, Japan with hemoptysis arising from CPA between January 2011 to December 2016, who were considered inoperable and had undergone BAE. Out of the 41 cases analyzed in this study, 21 (51.2%) developed rebleeding after BAE within the mean follow-up duration of 24 months. The non-rebleeding rate of patients after BAE was 92.7% within a month and 65.8% within a year. Patients who developed rebleeding had significantly more non-bronchial systemic arteries responsible for the bleeding compared with patients who did not develop rebleeding (mean of 2.55 vs. 4.86, respectively, P = 0.011). Patients with stable or improved radiological findings demonstrated significantly lower rebleeding rates than those with radiological deterioration (P < 0.001). The non-rebleeding patients had significantly better survival than those with rebleeding (79.7% vs. 39.9% over 5 years, P = 0.046). Bronchial artery embolization was effective in controlling hemoptysis in patients with CPA, especially those who could not undergo surgical resection. However, disease control of CPA was important to prevent rebleeding over the long term and to improve survival after BAE.

東京高専体育科の20年間の活動を振り返る - セレンディピティ的体験を求めて(その2)-

東京高専体育科の20年間の活動を振り返る - セレンディピティ的体験を求めて(その2)-

도쿄국립박물관 소장 〈車爭圖屛風〉의 도상에 관한 일고찰

도쿄국립박물관 소장 〈車爭圖屛風〉은 기존의 다른 車爭圖와는 차별되는 새로운 도상의 車爭圖이다. 본고에서는 작품이 제작된 ‘당대의 풍속’을 표현한 점과 ‘행렬’, 그리고 ‘난투’라는 〈車爭圖屛風〉만의 독특한 도상적 특징에 대해 살펴보고 그러한 도상이 채택된 배경에 대해 다각적으로 고찰해 보았다. 〈車爭圖屛風〉이 전달하고자 한 메시지는 작품의 주문자와 그 설치공간과 관련된 사회 · 정치적 상황을 함께 고려해야 제대로 파악할 수 있다. 시공간적으로 별개인 두 사건을 하나로 연결시켜 새롭게 창조한 ‘행렬’과 다른 車爭圖에서는 그려지지 않았던 격렬한 ‘난투’ 도상은 〈車爭圖屛風〉의 賀茂祭 제례도적 성격을 강화시키는 역할을 한다. 또한 〈車爭圖屛風〉에 묘사된 작품이 제작된 ‘당대의 풍속’ 표현은 〈車爭圖屛風〉의 화면에 ‘새롭게 창조된 賀茂祭 행렬’이 마치 당대 거행된 賀茂祭인 것과 같은 느낌을 준다. 이러한 〈車爭圖屛風〉의 독특한 도상들은 이 작품이 원래 건물의 내부에 설치되는 미닫이문에 그려진 襖繪였다는 점과 관련 있다. 〈車爭圖屛風〉에서 4월의 봄을 대표하는 연중행사인 賀茂祭의 제례도적 성격이 두드러진 것은 『源氏物語』에서 사계절별 화제를 선택해 구성한 襖繪로서 기능하기 위한 것이었을 가능성이 크다.BR 한편 〈車爭圖屛風〉의 당대 풍속묘사는 源氏繪라는 장르의 작화 특성상 작품의 주문자인 九條家의 개입 없이는 불가능한 일이다. 〈車爭圖屛風〉이 제작될 당시 九條家의 수장이었던 九條幸家(1586~1665)는 당대의 권력자인 江戶幕府의 德川將軍家와 혼인관계를 맺으며 매우 친밀한 관계를 유지한 인물이었다. 九條幸家는 1619년에 발생한 정치적 사건인 ‘およつ御寮人 사건’에서 關白이라는 조정 최고의 관직에 복귀해 분쟁의 당사자였던 江戶幕府와 교토 궁정 사이를 중재하며 사건의 해결을 꾀했다. 새로 입궁할 德川將軍家 출신 중궁을 위해 천황의 총애를 받던 측실을 쫓아낸 사건인 およつ 御寮人 사건은 격렬한 난투로 묘사된 〈車爭圖屛風〉의 六條御息所와 葵上의 車爭 장면을 연상시킨다. 〈車爭圖屛風〉의 화면 곳곳에 그려진 德川將軍家의 문장이 그려진 옷을 입은 무사들은 이 작품과 江戶幕府와의 관련성을 시사한다. 또한 賀茂祭를 주관하는 賀茂神社의 문장인 葵이 德川將軍家의 문장과 동일하다는 점도 賀茂祭를 배경으로 하는 車爭 장면이 작품의 화제로 선택된 이유가 德川將軍家와 관련 있음을 암시한다.『源氏物語』연구를 가학(家學)으로 삼을 만큼 『源氏物語』에 조예가 깊었던 九條家가 가문의 저택 내부에 설치할 源氏繪 襖繪의 화제로 およつ御寮人 사건을 연상시키는 車爭 장면을 선택한 것은 분명 의도적이었다. 九條家는 당대의 권력자인 江戶幕府와 교토 궁정과의 분쟁에서 막부의 이익을 대변한 가문의 공적을 〈車爭圖屛風〉을 통해 공공연하게 드러내고자 했던 것으로 보인다.

Validation and Recalibration of Seattle Heart Failure Model in Japanese Acute Heart Failure Patients

BackgroundPrecise risk stratification in heart failure (HF) patients enables clinicians to tailor the intensity of their management. The Seattle Heart Failure Model (SHFM), which uses conventional clinical variables for its prediction, is widely used. We aimed to externally validate SHFM in Japanese HF patients with a recent episode of acute decompensation requiring hospital admission. Methods and ResultsSHFM was applied to 2470 HF patients registered in the West Tokyo Heart Failure and National Cerebral And Cardiovascular Center Acute Decompensated Heart Failure databases from 2006 to 2016. Discrimination and calibration were assessed with the use of the c-statistic and calibration plots, respectively, in HF patients with reduced ejection fraction (HFrEF; <40%) and preserved ejection fraction (HFpEF; ≥40%). In a perfectly calibrated model, the slope and intercept would be 1.0 and 0.0, respectively. The method of intercept recalibration was used to update the model. The registered patients (mean age 74 ± 13 y) were predominantly men (62%). Overall, 572 patients (23.2%) died during a mean follow-up of 2.1 years. Among HFrEF patients, SHFM showed good discrimination (c-statistic = 0.75) but miscalibration, tending to overestimate 1-year survival (slope = 0.78; intercept = −0.22). Among HFpEF patients, SHFM showed modest discrimination (c-statistic = 0.69) and calibration, tending to underestimate 1-year survival (slope = 1.18; intercept = 0.16). Intercept recalibration (replacing the baseline survival function) successfully updated the model for HFrEF (slope = 1.03; intercept = −0.04) but not for HFpEF patients. ConclusionsIn Japanese acute HF patients, SHFM showed adequate performance after recalibration among HFrEF patients. Using prediction models to tailor the care for HF patients may improve the allocation of medical resources.

Rediscovering Japan through Duchamp. Marcel Duchamp and Japanese Art. Collaborative Exhibition Project between the Tokyo National Museum and the Philadelphia Museum of Art.

Rediscovering Japan through Duchamp. Marcel Duchamp and Japanese Art. Collaborative Exhibition Project between the Tokyo National Museum and the Philadelphia Museum of Art.

Basic design and cost study of the FRP roof of the Tokyo National Stadium

Basic design and cost study of the FRP roof of the Tokyo National Stadium

International Relations of the Chinese Yogācāra School in the 8th Century: Focusing on Chongjun and Faqing (Faxiang)

According to his stūpa inscription (Tang Chanzhisi gu dade fashi Chongjun ta ming bing xu唐禅智寺故大徳法師崇俊塔銘并序; Based on the glass dry plates of Tokyo National Research Institute for Cultural Properties), Chongjun (696–760) of the Chanzhisi temple in Yang province learned Yogācāra, Buddhist logic, the Lotus sūtra and Nirvāna sūtra from Zhizhou 智周,and traveled to Tufan 吐蕃 or Tibet. Faqing (or Faxiang), his immediate disciple, a Buddhist layman, responded to a Tōketsu 唐決 (Questions to the Chinese Buddhists) brought by Japanese monk Tokushō 徳清,according to Zōshun’s 蔵俊 Inmyō daisho shō 因明大疏抄 and Gen’ei’s 玄叡 Daijō sanron daigishō 大乗三論大義鈔.Although it is said that there was no doctrinal development of Chinese Yogācāra after Zhizhou, we can see the international interactions between the Chinese Yogācāra school and the surrounding areas in the 8th century.

東京国立博物館本館[日本ギャラリー]リニューアル

東京国立博物館本館[日本ギャラリー]リニューアル

池大雅筆『銭塘観潮図屏風』の主題再考察 : 図様と文学的典拠を探る(第五十五回美学会全国大会発表要旨)

池大雅筆『銭塘観潮図屏風』の主題再考察 : 図様と文学的典拠を探る(第五十五回美学会全国大会発表要旨)

東京国立博物館・特集展示「伊能忠敬の日本図」とミュージアムシアターを活用したサービスデザインプラクティス( デジタルミュージアムの展開)

東京国立博物館・特集展示「伊能忠敬の日本図」とミュージアムシアターを活用したサービスデザインプラクティス( デジタルミュージアムの展開)

일본 도쿄(東京)박물관 소장 금산사 은입사 향완의 특징과 중요성

일본 도쿄(東京)박물관 소장 금산사 은입사 향완의 특징과 중요성

Staging the Silk Road Journey Abroad: The Case of Dunhuang Performative Arts

Staging the Silk Road Journey Abroad: The Case of Dunhuang Performative Arts

Organization of collection information in museums: Information standards and practices in Tokyo National Museum

Organization of collection information in museums: Information standards and practices in Tokyo National Museum

QOL-24VALIDATION STUDY OF THE JAPANESE VERSION OF M.D. ANDERSON SYMPTOM INVENTORY BRAIN TUMOR MODULE (MDASI-BT)

BACKGROUND: It has been recognized that symptom burden reported as a patient-reported outcome is valuable in assessment of both disease and treatment-related symptoms and should be incorporated into evaluation of clinical benefit of novel therapies. MDASI-BT is a widely-used instrument for measuring symptom burden in brain tumor patients, and its Japanese version (MDASI-BT-J) has recently been validated linguistically. The purpose of this study is to psychometrically validate MDASI-BT-J. METHODS: Patients with brain tumors who were undergoing oncologic treatments in The University of Tokyo Hospital or National Cancer Center Hospital between 2014 and 2015 were asked to fill out MDASI-BT-J and the Japanese version of European Quality of Life-5 Dimensions (EQ-5D-J). Feasibility, reliability, and validity of MDASI-BT-J were assessed. RESULTS: One-hundred-and-forty patients (72 men) including 63 patients with gliomas participated in the study. The median age was 54 years, and the median Karnofsky Performance Status (KPS) score was 90. The mean symptom severity score (MSS) and mean interference score (MIS) were 1.9 ± 1.7 and 2.8 ± 2.7, respectively. The median amount of time required to complete the form was 4 minutes (range, 0-30), and missing values were seen in 1%. Internal consistency using Cronbach's coefficient alpha was 0.94 and 0.92 for symptom severity and interference, respectively. Test-retest reliability was assessed in 30 patients with acceptable intra-class correlation coefficient (mean, 0.74). Known-group validity confirmed a significant difference in MSS (1.6 versus 2.3, P = 0.007) and MIS (2.0 versus 3.9, P = 0.007) between patients with KPS score >= 90 and those with KPS score <90. As evidence of concurrent validity, EQ-5D-J correlated with MDASI-BT-J in the hypothesized magnitude and direction. CONCLUSIONS: The current study endorses reliability of the newly-developed MDASI-BT-J in evaluation of clinical benefit in brain tumor patients in Japan. It is being used as one of the secondary endpoints in a multi-center prospective study for newly-diagnosed glioblastoma.

Present and future issues to be solved regarding nasal high flow at National Hospital Organization Tokyo National Hospital

Present and future issues to be solved regarding nasal high flow at National Hospital Organization Tokyo National Hospital

Remaking tradition: modern art of Japan from the Tokyo National Museum

This catalogue presents over fifty works in different media--most notably sculpture, painting, and ceramics--assembled together for the first time to convey the impressive variety of Japanese art from the late 19th and early 20th centuries. These works, all masterpieces from the collection of the Tokyo National Museum, introduce the museum's astounding holdings of modern Japanese art to an American audience and help illustrate where modern works fit within the rich history of Japanese visual tradition. Engaging essays by noted scholars explore the diverse sources of influence for Japanese artists around the turn of the 20th century, such as Western oil painting, Buddhist portraiture, European porcelain, traditional Japanese landscape and figure imagery, and Chinese painting. This publication offers a compelling and innovative conception of modern Japanese art, framing artists as creators of traditions for the modern age who maintained a sense of continuity with the past while also integrating wide-ranging cultural inspirations.

The teaching of music history in Japanese music education

One of the leading institutions in the field of musicology in Japan is the one hosted by “Tokyo University of the Arts” (previously Tokyo National University of Fine Arts and Music). The musicology course, started in 1949, was, and still is, the main promoter of music history teaching in the Japanese university system. A reflection on the over 60 years of its existence, which has been characterized by the fortunate coexistence of musicology students and students of ‘practical’ musical courses, might contribute to raise awareness among European musicologists about the pedagogic-didactic task that is expected of them in the current situation of Western musical culture.

Recurrence of chronic pulmonary aspergillosis after discontinuation of maintenance treatment by antifungal triazoles

To assess the prevalence and risk factors of recurrence of chronic pulmonary aspergillosis (CPA) after discontinuation of antifungal triazoles. We reviewed the medical records of CPA patients who achieved resolution of clinical and radiographic manifestations and stopped taking antifungal triazoles between June 2006 and June 2012 at Tokyo National Hospital. We evaluated whether there was CPA recurrence within 1 year after treatment cessation and investigated risk factors for relapse. The association of anti-Aspergillus antibody conversion with CPA recurrence was also reviewed. A total of 39 patients were included in this study and there was CPA recurrence in 14 patients. Compared with the Non-recurrence group, the Recurrence group exhibited 1) younger age (p = 0.017), 2) more than one lung lobe affected by CPA more frequently (p = 0.008), 3) longer duration needed to remit manifestations of chest radiograph (p = 0.031), 4) longer antifungal treatment duration (p = 0.042). The present study did not reveal an association between negative conversion of serum anti-Aspergillus antibody and recurrence risk. Multivariate logistic regression analysis revealed that patients with CPA with affected area of more than one lung lobe had increased risk (odds ratio, 10.20; 95% confidence interval, 1.49-69.77; p = 0.018). CPA recurrence can be seen in about one-third of cases after discontinuing azole treatment. We should make decisions about treatment duration and follow up depending on the severity of each case, particularly on the expansion of CPA-affected area.

Tezuka's &lt;em&gt;Buddha&lt;/em&gt; at the Tokyo National Museum: An Interview with Matsumoto Nobuyuki

Tezuka's &lt;em&gt;Buddha&lt;/em&gt; at the Tokyo National Museum: An Interview with Matsumoto Nobuyuki