The BioBank Japan (BBJ) Project was launched in 2003 with the aim of providing evidence for the implementation of personalized medicine by constructing a large, patient-based biobank (BBJ). This ...report describes the study design and profile of BBJ participants who were registered during the first 5-year period of the project.
The BBJ is a registry of patients diagnosed with any of 47 target common diseases. Patients were enrolled at 12 cooperative medical institutes all over Japan from June 2003 to March 2008. Clinical information was collected annually via interviews and medical record reviews until 2013. We collected DNA from all participants at baseline and collected annual serum samples until 2013. In addition, we followed patients who reported a history of 32 of the 47 target diseases to collect survival data, including cause of death.
During the 5-year period, 200,000 participants were registered in the study. The total number of cases was 291,274 at baseline. Baseline data for 199,982 participants (53.1% male) were available for analysis. The average age at entry was 62.7 years for men and 61.5 years for women. Follow-up surveys were performed for participants with any of 32 diseases, and survival time data for 141,612 participants were available for analysis.
The BBJ Project has constructed the infrastructure for genomic research for various common diseases. This clinical information, coupled with genomic data, will provide important clues for the implementation of personalized medicine.
•The BioBank Japan Project (BBJ) enrolled 200,000 patients with 47 target diseases.•The BBJ is one of the largest patient-based biobanks in the world.•The BBJ may allow for personalized medicine in the future.
To implement personalized medicine, we established a large-scale patient cohort, BioBank Japan, in 2003. BioBank Japan contains DNA, serum, and clinical information derived from approximately 200,000 ...patients with 47 diseases. Serum and clinical information were collected annually until 2012.
We analyzed clinical information of participants at enrollment, including age, sex, body mass index, hypertension, and smoking and drinking status, across 47 diseases, and compared the results with the Japanese database on Patient Survey and National Health and Nutrition Survey. We conducted multivariate logistic regression analysis, adjusting for sex and age, to assess the association between family history and disease development.
Distribution of age at enrollment reflected the typical age of disease onset. Analysis of the clinical information revealed strong associations between smoking and chronic obstructive pulmonary disease, drinking and esophageal cancer, high body mass index and metabolic disease, and hypertension and cardiovascular disease. Logistic regression analysis showed that individuals with a family history of keloid exhibited a higher odds ratio than those without a family history, highlighting the strong impact of host genetic factor(s) on disease onset.
Cross-sectional analysis of the clinical information of participants at enrollment revealed characteristics of the present cohort. Analysis of family history revealed the impact of host genetic factors on each disease. BioBank Japan, by publicly distributing DNA, serum, and clinical information, could be a fundamental infrastructure for the implementation of personalized medicine.
•The BioBank Japan Project (BBJ) annually collected clinical information.•Analysis of the clinical information at enrollment characterized the BBJ cohort.•Analysis of family history revealed impacts of host genetic factors on the diseases.
We established a patient-oriented biobank, BioBank Japan, with information on approximately 200,000 patients, suffering from any of 47 common diseases. This follow-up survey focused on 32 diseases, ...potentially associated with poor vital prognosis, and collected patient survival information, including cause of death. We performed a survival analysis for all subjects to get an overview of BioBank Japan follow-up data.
A total of 141,612 participants were included. The survival data were last updated in 2014. Kaplan–Meier survival analysis was performed after categorizing subjects according to sex, age group, and disease status. Relative survival rates were estimated using a survival-rate table of the Japanese general population.
Of 141,612 subjects (56.48% male) with 1,087,434 person-years and a 97.0% follow-up rate, 35,482 patients died during follow-up. Mean age at enrollment was 64.24 years for male subjects and 63.98 years for female subjects. The 5-year and 10-year relative survival rates for all subjects were 0.944 and 0.911, respectively, with a median follow-up duration of 8.40 years. Patients with pancreatic cancer had the least favorable prognosis (10-year relative survival: 0.184) and patients with dyslipidemia had the most favorable prognosis (1.013). The most common cause of death was malignant neoplasms. A number of subjects died from diseases other than their registered disease(s).
This is the first report to perform follow-up survival analysis across various common diseases. Further studies should use detailed clinical and genomic information to identify predictors of mortality in patients with common diseases, contributing to the implementation of personalized medicine.
•141,612 participants with any of 32 diseases were included in the follow-up survey.•Subject characteristics at enrollment for the follow-up survey were identified.•The relative survival analysis showed the worst prognosis in pancreatic cancer.•The most common cause of death in all subjects was malignant neoplasms.
We experienced a teenage case of nonfreezing cold injury (NFCI) in a patient who spent approximately 2 weeks exposure in a cold environment. Following a bath that warmed the lower extremities, the ...patient abruptly experienced severe pain and difficulty walking, despite no frostbite in the skin or soft tissues. The sensory examination on both feet revealed no response to cold temperature and pinprick stimuli, but severe allodynic pain caused by light touch. Vasodilation and sympathetic nerve block did not change the pain. NFCI was diagnosed, and treatment with amitriptyline, pregabalin, tramadol, and continuous lumbar epidural block was started, but walking was difficult due to severe allodynia when weight was placed on the sole of the feet. After about 2 months treatment including physical rehabilitation, the neropathy were suddenly recovered, the pain disappeared and walking has also become possible.
Here, we report 77 cases where blood alternatives and surgery were performed in Jehovah's Witness patients, of whom 18 had gastric cancers, 25 had colorectal cancers, and 30 had malignant diseases in ...hepato-biliary-pancreatic areas. During pancreatoduodenectomy and lobectomy and/or more extended liver resection, the average bleeding exceeded 1,000 ml. From 57 cases of where autologous transfusion was performed, a combination of hemodilution transfusion and salvage transfusion was performed in 15 cases. Twenty-five patients with anemia were treated with preoperative blood augmentation, which enabled planned elective resection. Complications were observed in 7 cases, of which 3 involved anastomosis failure, 3 involved a pancreatic juice fistula, and 1 involved disseminated intravascular coagulation. Two patients died after surgery because of hepatic failure and intestinal perforation. Thus, multidisciplinary management involving autologous blood transfusion for surgery enabled medical treatment of Jehovah's Witness patients.
A 83-year-old man had suffered severe from postherpetic neuralgia for 8 years. He received cervical dorsal rhizotomy in C2, C3, and C4 for unbearable allodynia. Although deep hypesthesia on all the ...skin of the right C2-C4 dermatomes was noted after the dorsal rhizotomy, cramping pain and brief recurrent shooting pain on the right cervical area were persistent Various therapies including C4 root block, topical capsaicin, dextromethorphan, ketamine, lidocaine and mexiletine could not attenuate his pain. We reexamined several drugs for his pain. Intravenous morphine at 5mg reduced his pain effectively. We decided to prescribe slow-release morphine at 60mg/day and amitriptyline at 10mg/day, orally. This painful condition was relieved with morphine in his last days.
Central nervous system (CNS) complications (disturbance of consciousness, focal motor deficits, and seizures) after coronary artery bypass grafting (CABG) and cardiac valve surgery were studied ...retrospectively. The incidence of CNS complications was significantly more frequent in CABG (11%, 71/638) than in valve surgery (7%, 24/345). Major contributory factors of CNS complications were preexisting cerebrovascular disease and cardiopulmonary bypass time. In comparison to previous reports, older age, hypertension, diabetes mellitus, and cerebrovascular disease were more common in the patients undergoing CABG. The preexisting cerebrovascular disease and prolonged cardiopulmonary bypass time probably increase the risk of cerebral embolism and/or cerebral hypoperfusion. We conclude that patients undergoing CABG surgery are at greater risk for neurological damage in comparison to those undergoing valve surgery.
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