Podcasts about Furuta

Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Evan S. Dellon, MD, and Elizabeth T. Jensen, PhD, about a paper they published on predictors of patients receiving no medication for treatment of eosinophilic esophagitis. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:52] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:14] Holly introduces today's topic, predictors of not using medication for EoE, and today's guests, Dr. Evan Dellon and Dr. Elizabeth Jensen.   [1:29] Dr. Dellon is an Adjunct Professor of Epidemiology at the University of North Carolina School of Medicine in Chapel Hill. He is also the Director of the UNC Center for Esophageal Diseases and Swallowing.   [1:42] Dr. Dellon's main research interest is in the epidemiology, pathogenesis, diagnosis, treatment, and outcomes of eosinophilic esophagitis (EoE) and eosinophilic GI diseases (EGIDs).   [1:55] Dr. Jensen is a Professor of Epidemiology with a specific expertise in reproductive, perinatal, and pediatric epidemiology. She has appointments at both Wake Forest University School of Medicine and the University of North Carolina at Chapel Hill.   [2:07] Her research primarily focuses on etiologic factors in the development of pediatric immune-mediated chronic diseases, including understanding factors contributing to disparities in health outcomes.   [2:19] Both Dr. Dellon and Dr. Jensen also serve on the Steering Committee for EGID Partners Registry.   [2:24] Ryan thanks Dr. Dellon and Dr. Jensen for joining the podcast today.   [2:29] Dr. Dellon was the first guest on this podcast. It is wonderful to have him back for the 50th episode! Dr. Dellon is one of Ryan's GI specialists. Ryan recently went to North Carolina to get a scope with him.   [3:03] Dr. Dellon is an adult gastroenterologist at the University of North Carolina at Chapel Hill. He directs the Center for Esophageal Diseases and Swallowing. Clinically and research-wise, he is focused on EoE and other eosinophilic GI diseases.   [3:19] His research interests span the entire field, from epidemiology, diagnosis, biomarkers, risk factors, outcomes, and a lot of work, more recently, on treatments.   [3:33] Dr. Jensen has been on the podcast before, on Episode 27. Holly invites Dr. Jensen to tell the listeners more about herself and her work with eosinophilic diseases.   [3:46] Dr. Jensen has been working on eosinophilic gastrointestinal diseases for about 15 years. She started some of the early work around understanding possible risk factors for the development of disease.   [4:04] She has gone on to support lots of other research projects, including some with Dr. Dellon, where they're looking at gene-environment interactions in relation to developing EoE.   [4:15] She is also looking at reproductive factors as they relate to EoE, disparities in diagnosis, and more. It's been an exciting research trajectory, starting with what we knew very little about and building to an increasing understanding of why EoE develops.   [5:00] Dr. Dellon explains that EoE stands for eosinophilic esophagitis, a chronic allergic condition of the esophagus.   [5:08] You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have EoE, it is a long-term condition.   [5:24] Eosinophils are a type of white blood cell, specializing in allergy responses. Normally, they are not in the esophagus. When we see them there, we worry about an allergic process. When that happens, that's EoE.   [5:40] Over time, the inflammation seen in EoE and other allergic cell activity causes swelling and irritation in the esophagus. Early on, this often leads to a range of upper GI symptoms — including poor growth or failure to thrive in young children, abdominal pain, nausea, and symptoms that can mimic reflux.   [5:58] In older kids, symptoms are more about trouble swallowing. That's because the swelling that happens initially, over time, may turn into scar tissue. So the esophagus can narrow and cause swallowing symptoms like food impaction.   [6:16] Ryan speaks of living with EoE for decades and trying the full range of treatment options: food elimination, PPIs, steroids, and, more recently, biologics.   [6:36] Dr. Dellon says Ryan's history is a good overview of how EoE is treated. There are two general approaches to treating the underlying condition: using medicines and/or eliminating foods that we think may trigger EoE from the diet.   [6:57] For a lot of people, EoE is a food-triggered allergic condition.   [7:01] The other thing that has to happen in parallel is surveying for scar tissue in the esophagus. If that's present and people have trouble swallowing, sometimes stretching the esophagus is needed through esophageal dilation.   [7:14] There are three categories of medicines used for treatment. Proton pump inhibitors are reflux meds, but they also have an anti-allergy effect in the esophagus.   [7:29] Topical steroids are used to coat the esophagus and produce an anti-inflammatory effect. The FDA has approved a budesonide oral suspension for that.   [7:39] Biologics, which are generally systemic medications, often injectable, can target different allergic factors. Dupilumab is approved now, and there are other biologics that are being researched as potential treatments.   [7:51] Even though EoE is considered an allergic condition, we don't have a test to tell people what they are allergic to. If it's a food allergy, we do an empiric elimination diet because allergy tests aren't accurate enough to tell us what the EoE triggers are.   [8:10] People will eliminate foods that we know are the most common triggers, like milk protein, dairy, wheat, egg, soy, and other top allergens. You can create a diet like that and then have a response to the diet elimination.   [8:31] Dr. Jensen and Dr. Dellon recently published an abstract in the American Journal of Gastroenterology about people with EoE who are not taking any medicine for it. Dr. Jensen calls it a real-world data study, leveraging electronic health record patient data.   [8:51] It gives you an impression of what is actually happening, in terms of treatments for patients, as opposed to a randomized control trial, which is a fairly selected patient population. This is everybody who has been diagnosed, and then what happens with them.   [9:10] Because of that, it gives you a wide spectrum of patients. Some patients are going to be relatively asymptomatic. It may be that we arrived at their diagnosis while working them up for other potential diagnoses.   [9:28] Other patients are going to have rather significant impacts from the disease. We wanted to get an idea of what is actually happening out there with the full breadth of the patient population that is getting diagnosed with EoE.   [9:45] Dr. Jensen was not surprised to learn that there are patients who had no pharmacologic treatment.   [9:58] Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are early in their disease process and still exploring dietary treatment options.   [10:28] Holly sees patients from infancy to geriatrics, and if they're not having symptoms, they wonder why bother treating it.   [10:42] Dr. Jensen says it's a point of debate on the implications of somebody who has the disease and goes untreated. What does that look like long-term? Are they going to develop more of that fibrostenotic pattern in their esophagus without treatment?   [11:07] This is a question we're still trying to answer. There is some suggestion that for some patients who don't manage their disease, we very well may be looking at a food impaction in the future.   [11:19] Dr. Dellon says we know overall for the population of EoE patients, but it's hard to know for a specific patient. We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range.   [11:39] Some people get symptoms and get diagnosed right away. Others might have symptoms for 20 or 30 years that they ignore, or don't have access to healthcare, or the diagnosis is missed.   [11:51] What we see consistently is that people who may be diagnosed within a year or two may only have a 10 or 20% chance of having that stricture and scar tissue in the esophagus, whereas people who go 20 years, it might be 80% or more.   [12:06] It's not everybody who has EoE who might end up with that scar tissue, but certainly, it's suggested that it's a large majority.   [12:16] That's before diagnosis. We have data that shows that after diagnosis, if people go a long time without treatment or without being seen in care, they also have an increasing rate of developing strictures.    [12:29] In general, the idea is yes, you should treat EoE, because on average, people are going to develop scar tissue and more symptoms. For the patient in front of you with EoE but no symptoms, what are the chances it's going to get worse? You don't know.   [13:04] There are two caveats with that. The first is what we mean by symptoms. Kids may have vomiting and growth problems. Adults can eat carefully, avoiding foods that hang up in the esophagus, like breads and overcooked meats, sticky rice, and other foods.   [13:24] Adults can eat slowly, drink a lot of liquid, and not perceive they have symptoms. When someone tells Dr. Dellon they don't have symptoms, he will quiz them about that. He'll even ask about swallowing pills.    [13:40] Often, you can pick up symptoms that maybe the person didn't even realize they were having. In that case, that can give you some impetus to treat.   [13:48] If there really are no symptoms, Dr. Dellon thinks we're at a point where we don't really know what to do.   [13:54] Dr. Dellon just saw a patient who had a lot of eosinophils in their small bowel with absolutely no GI symptoms. He said, "I can't diagnose you with eosinophilic enteritis, but you may develop symptoms." People like that, he will monitor in the clinic.   [14:14] Dr. Dellon will discuss it with them each time they come back for a clinic visit.   [14:19] Holly is a speech pathologist, but also sees people for feeding and swallowing. The local gastroenterologist refers patients who choose not to treat their EoE to her. Holly teaches them things they should be looking out for.   [14:39] If your pills get stuck or if you're downing 18 ounces during a mealtime, maybe it's time to treat it. People don't see these coping mechanisms they use that are impacting their quality of life. They've normalized it.   [15:30] Dr. Dellon says, of these people who aren't treated, there's probably a subset who appropriately are being observed and don't have a medicine treatment or are on a diet elimination.   [15:43] There's also probably a subset who are inappropriately not on treatment. It especially can happen with students who were under good control with their pediatric provider, but moved away to college and didn't transfer to adult care.   [16:08] They ultimately come back with a lot of symptoms that have progressed over six to eight years.   [16:18] Ryan meets newly diagnosed adult patients at APFED's conferences, who say they have no symptoms, but chicken gets caught in their throat. They got diagnosed when they went to the ER with a food impaction.   [16:38] Ryan says you have to wonder at what point that starts to get reflected in patient charts. Are those cases documented where someone is untreated and now has EoE?   [16:49] Ryan asks in the study, "What is the target EGID Cohort and why was it selected to study EoE? What sort of patients were captured as part of that data set?"   [16:58] Dr. Jensen said they identified patients with the ICD-10 code for a diagnosis of EoE. Then they looked to see if there was evidence of symptoms or complications in relation to EoE. This was hard; some of these are relatively non-specific symptoms.   [17:23] These patients may have been seeking care and may have been experiencing some symptoms that may or may not have made it into the chart. That's one of the challenges with real-world data analyses.   [17:38] Dr. Jensen says they are using data that was collected for documenting clinical care and for billing for clinical care, not for research, so it comes with some caveats when doing research with this data.   [18:08] Research using electronic health records gives a real-world perspective on patients who are seeking care or have a diagnosis of EoE, as opposed to a study trying to enroll a patient population that potentially isn't representative of the breadth of individuals living with EoE.   [18:39] Dr. Dellon says another advantage of real-world data is the number of patients. The largest randomized controlled trials in EoE might have 400 patients, and they are incredibly expensive to do.   [18:52] A study of electronic health records (EHR) is reporting on the analysis of just under 1,000. The cohort, combined from three different centers, has more than 1,400 people, a more representative, larger population.    [19:16] Dr. Dellon says when you read the results, understand the limitations and strengths of a study of health records, to help contextualize the information.   [19:41] Dr. Dellon says it's always easier to recognize the typical presentations. Materials about EoE and studies he has done that led to medicine approvals have focused on trouble swallowing. That can be relatively easily measured.   [20:01] Patients often come to receive care with a food impaction, which can be impactful on life, and somewhat public, if in a restaurant or at work. Typical symptoms are also the ones that get you diagnosed and may be easier to treat.   [20:26] Dr. Dellon wonders if maybe people don't treat some of the atypical symptoms because it's not appreciated that they can be related to EoE.   [20:42] Holly was diagnosed as an adult. Ryan was diagnosed as a toddler. Holly asks what are some of the challenges people face in getting an EoE diagnosis.   [20:56] Dr. Jensen says symptoms can sometimes be fairly non-specific. There's some ongoing work by the CEGIR Consortium trying to understand what happens when patients come into the emergency department with a food bolus impaction.   [21:28] Dr. Jensen explains that we see there's quite a bit of variation in how that gets managed, and if they get a biopsy. You have to have a biopsy of the esophagus to get a diagnosis of EoE.   [21:45] If you think about the steps that need to happen to get a diagnosis of EoE, that can present barriers for some groups to ultimately get that diagnosis.   [21:56] There's also been some literature around a potential assumption about which patients are more likely to be at risk. Some of that is still ongoing. We know that EoE occurs more commonly in males in roughly a two-to-one ratio. Not exclusively in males, obviously, but a little more often in males.   [22:20] We don't know anything about other groups of patients that may be at higher risk. That's ongoing work that we're still trying to understand. That in itself can also be a barrier when there are assumptions about who is or isn't likely to have EoE.   [23:02] Dr. Dellon says that in adolescents and adults, the typical symptoms are trouble swallowing and food sticking, which have many causes besides EoE, some of which are more common.   [23:18] In that population, heartburn is common. Patients may report terrible reflux that, on questioning, sounds more like trouble swallowing than GERD. Sometimes, with EoE, you may have reflux that doesn't improve. Is it EoE, reflux, or both?   [24:05] Some people will have chest discomfort. There are some reports of worsening symptoms with exercise, which brings up cardiac questions that have to be ruled out first.   [24:19] Dr. Dellon mentions some more atypical symptoms. An adult having pain in the upper abdomen could have EoE. In children, the symptoms could be anything in the GI tract. Some women might have atypical symptoms with less trouble swallowing.   [24:58] Some racial minorities may have those kinds of symptoms, as well. If you're not thinking of the condition, it's hard to make the diagnosis.   [25:08] Dr. Jensen notes that there are different cultural norms around expressing symptoms and dietary patterns, which may make it difficult to parse out a diagnosis.   [25:27] Ryan cites a past episode where access to a GI specialist played a role in diagnosing patients with EoE. Do white males have more EoE, or are their concerns just listened to more seriously?   [25:57] Ryan's parents were told when he was two that he was throwing up for attention. He believes that these days, he'd have a much easier time convincing a doctor to listen to him. From speaking to physicians, Ryan believes access is a wide issue in the field.   [26:23] Dr. Dellon tells of working with researchers at Mayo in Arizona and the Children's Hospital of Phoenix. They have a large population of Hispanic children with EoE, much larger than has been reported elsewhere. They're working on characterizing that.   [26:49] Dr. Dellon describes an experience with a visiting trainee from Mexico City, where there was not a lot of EoE reported. The trainee went back and looked at the biopsies there, and it turned out they were not performing biopsies on patients with dysphagia in Mexico City.   [27:13] When he looked at the patients who ended up getting biopsies, they found EoE in 10% of patients. That's similar to what's reported out of centers in the developed world. As people are thinking about it more, we will see more detection of it.   [27:30] Dr. Dellon believes those kinds of papers will be out in the next couple of months, to a year.   [27:36] Holly has had licensure in Arizona for about 11 years. She has had nine referrals recently of children with EoE from Arizona. Normally, it's been one or two that she met at a conference.   [28:00] Ryan asks about the research on patients not having their EoE treated pharmacologically. Some treat it with food avoidance and dietary therapy. Ryan notes that he can't have applesauce, as it is a trigger for his EoE.   [28:54] Dr. Jensen says that's one of the challenges in using the EHR data. That kind of information is only available to the researchers through free text. That's a limitation of the study, assessing the use of dietary elimination approaches.   [29:11] Holly says some of her patients have things listed as allergies that are food sensitivities. Ryan says it's helpful for the patients to have their food sensitivities listed along with their food allergies, but it makes records more difficult to parse for research.   [30:14] Dr. Dellon says they identify EoE by billing code, but the codes are not always used accurately. Natural Language Processing can train a computer system to find important phrases. Their collaborators working on the real-world data are using it.   [30:59] Dr. Dellon hopes that this will be a future direction for this research to find anything in the text related to diet elimination.   [31:32] Dr. Jensen says that older patients were less likely to seek medication therapy. She says it's probably for a couple of reasons. First, older patients may have been living with the disease for a long time and have had compensatory mechanisms in place.   [32:03] The other reason may be senescence or burnout of the disease, long-term. Patients may be less symptomatic as they get older. That's a question that remains to be answered for EoE. It has been seen in some other disease processes.   [32:32] Dr. Dellon says there's not much data specifically looking at EoE in the older population. Dr. Dellon did work years ago with another doctor, and they found that older patients had a better response to some treatments, particularly topical steroids.   [32:54] It wasn't clear whether it was a milder aspect of the disease, easier to treat, or because they were older and more responsible, taking their medicines as prescribed, and having a better response rate. It's the flip side of work in the pediatric population.   [33:16] There is an increasingly aging population with EoE. Young EoE patients will someday be over 65. Dr. Dellon hopes there will be a cure by that point, but it's an expanding population now.   [33:38] Dr. Jensen says only a few sites are contributing data, so they hope to add additional sites to the study. For some of the less common outcomes, they need a pretty large patient sample to ask some of those kinds of questions.   [33:55] They will continue to follow up on some of the work that this abstract touched on and try to understand some of these issues more deeply.   [34:06] Dr. Dellon mentions other work within the cohort. Using Natural Language Processing, they are looking at characterizing endoscopy information and reporting it without a manual review of reports and codes. You can't get that from billing data.   [34:29] Similarly, they are trying to classify patient severity by the Index of Severity with EoE, and layer that on looking at treatments and outcomes based on disease severity. Those are a couple of other directions where this cohort is going.   [34:43] Holly mentions that this is one of many research projects Dr. Jensen and Dr. Dellon have collaborated on together. They also collaborate through EGID Partners. Holly asks them to share a little bit about that.   [34:53] Dr. Jensen says EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join.   [35:07] EGID Partners also needs people who don't live with an EGID to join, as controls. That gives the ability to compare those who are experiencing an EGID relative to those who aren't.   [35:22] When you join EGID Partners, they provide you with a set of questionnaires to complete. Periodically, they push out a few more questionnaires.   [35:33] EGID Partners has provided some really great information about patient experience and answered questions that patients want to know about, like joint pain and symptoms outside the GI tract.   [36:04] To date, there are close to 900 participants in the registry from all over the world. As it continues to grow, it will give the ability to look at the patient experience in different geographical areas.   [36:26] Dr. Dellon says we try to have it be interactive, because it is a collaboration with patients. The Steering Committee works with APFED and other patient advocacy groups from around the world.    [36:41] The EGID Partners website shows general patient locations anonymously. It shows the breakdown of adults with the condition and caregivers of children with the condition, the symptom distribution, and the treatment distribution.   [37:03] As papers get published and abstracts are presented, EGID Partners puts them on the website. Once someone joins, they can suggest a research idea. Many of the studies they have done have come from patient suggestions.   [37:20] If there's an interesting idea for a survey, EGID Partners can push out a survey to everybody in the group and answer questions relatively quickly.   [37:57] Dr. Dellon says a paper came out recently about telehealth. EoE care, in particular, is a good model for telehealth because it can expand access for patients who don't have providers in their area.   [38:22] EoE is a condition where care involves a lot of discussion but not a lot of need for physical exams and direct contact, so telehealth can make things very efficient.    [38:52] EGID Partners surveyed patients about telehealth. They thought it was efficient and saved time, and they had the same kind of interactions as in person. In general, in-state insurance covered it. Patients were happy to do those kinds of visits again.   [39:27] Holly says Dr. Furuta, herself, and others were published in the Gastroenterology journal in 2019 about starting to do telehealth because patients coming to the Children's Hospital of Colorado from out of state had no local access to feeding therapy.   [39:50] Holly went to the board, and they allowed her to get licensure in different states. She started with some of the most impacted patients in Texas and Florida in 2011 and 2012. They collected data. They published in 2019 about telehealth's positive impact.   [40:13] When 2020 rolled around, Holly had trained a bunch of people on how to do feeding therapy via telehealth. You have to do all kinds of things, like make yourself disappear, to keep the kids engaged and in their chairs!   [40:25] Now it is Holly's primary practice. She has licenses in nine states. She sees people all over the country. With her diagnosis, her physicians at Mass General have telehealth licensure in Maine. She gets to do telehealth with them instead of driving two hours.   [40:53] Dr. Jensen tells of two of the things they hope to do at EGID Partners. One is trying to understand more about reproductive health for patients with an EGID diagnosis. Only a few studies have looked at this question, and with very small samples.   [41:15] As more people register for EGID Partners, Dr. Jensen is hoping to be able to ask some questions related to reproductive health outcomes.   [41:27] The second goal is a survey suggested by the Student Advisory Committee, asking questions related to the burden of disease specific to the teen population.   [41:48] This diagnosis can hit that population particularly hard, at a time when they are trying to build and sustain friendships and are transitioning to adult care and moving away from home. This patient population has a unique perspective we wanted to hear.   [42:11] Dr. Jensen and Dr. Dellon work on all kinds of other projects, too.   [42:22] Dr. Dellon says they have done a lot of work on the early-life factors that may predispose to EoE. They are working on a large epidemiologic study to get some insight into early-life factors, including factors that can be measured in baby teeth.   [42:42] That's outside of EGID Partners. It's been ongoing, and they're getting close, maybe over the next couple of years, to having some results.   [43:03] Ryan says all of those projects sound so interesting. We need to have you guys back to dive into those results when you have something finalized.   [43:15] For our listeners who want to learn more about eosinophilic disorders, we encourage you to visit apfed.org and check out the links in the show notes below.   [43:22] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at apfed.org/specialist.   [43:31] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections.   [43:41] Ryan thanks Dr. Dellon and Dr. Jensen for joining us today. This was a fantastic conversation. Holly also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Evan S. Dellon, MD, MPH, Academic Gastroenterologist, University of North Carolina School of Medicine   Elizabeth T. Jensen, MPH, PhD, Epidemiologist, Wake Forest University School of Medicine, University of North Carolina at Chapel Hill   Predictors of Patients Receiving No Medication for Treatment of Eosinophilic Esophagitis in the United States: Data from the TARGET-EGIDS Cohort   Episode 15: Access to Specialty Care for Eosinophilic Esophagitis (EoE)   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   "I've been working on eosinophilic gastrointestinal diseases for about 15 years. I started some of the early work around understanding possible risk factors for the development of disease. I've gone on to support lots of other research projects." — Elizabeth T. Jensen, MPH, PhD   "You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have it, it really is a long-term condition." — Evan S. Dellon, MD, MPH   "There are two general approaches to treating the underlying condition, … using medicines and/or eliminating foods from the diet that we think may trigger EoE. I should say, for a lot of people, EoE is a food-triggered allergic condition." — Evan S. Dellon, MD, MPH   "I didn't find it that surprising [that there are patients who had no treatment]. Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are … still exploring dietary treatment options." — Elizabeth T. Jensen, MPH, PhD   "We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range. Some people get symptoms and are diagnosed right away. Other people might have symptoms for 20 or 30 years." — Evan S. Dellon, MD, MPH   "EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join. EGID Partners also needs people who don't live with an EGID to join, as controls." — Elizabeth T. Jensen, MPH, PhD

In this episode, hosts Drs. Temara Hajjat and Jenn Lee talk to Drs. Glenn Furuta and Noam Zevit about the diagnosis and management of eosinophilic GI disorders (EGIDs) beyond eosinophilic esophagitis based on the new joint ESPGHAN/NASPGHAN recommendations.Learning Objectives:Discuss the diagnosis of non-EoE EGIDs.Explain the role of pathology in diagnosis of non-EoE EGIDs.Review management of non-EoE EGIDs.References:Joint ESPGHAN/NASPGHAN Guidelines on Childhood Eosinophilic GI Disorders Beyond Eosinophilic EsophagitisSupport the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

●YouTube影片● https://voh.psee.ly/78rlkp ●FB粉專影片 ● https://voh.pse.is/78rlm2 本集主題：瓶中四季：封存最新鮮的當季滋味 訪問：劉重佐(凱恩Kyan) 內容簡介： •四季分明：按照季節挑選新鮮食材，享受當季水果的最佳風味。 •詳細步驟：詳細食譜和製作技巧，適合各種程度的廚房小白和達人。 •創意搭配：不只是一罐果醬，更是無數的創意食用方法，從早餐到下午茶，總有你喜歡的！ 果醬跟抹醬，是製作甜點以及西餐料理中，不可或缺的重要一環。但是在台灣鮮少有人會在家自製果醬，屬實是非常可惜。果醬的製作是一個非常有趣的過程，很適合大人小孩假日在家自己製作。從蔬果市場挑選新鮮蔬果開始，再到拿回家洗淨、削皮、製作。一步步看著那些新鮮蔬果被自己製作成好吃的醬，也可以吃得更加安心。 果醬的製作雖然非常有趣療癒，但也是非常講究的，對烹飪溫度的掌控尤為重要。製作一款好的果醬並沒有太多的訣竅，主要就是體現在「耐心」上。在製作果醬的過程裡，每一步驟都需要有足夠的耐心才可以。從前置作業的準備，再到後續的熬煮過程，都需要有足夠的耐心才能做好。尤其是果醬的熬煮動輒都是30分鐘以上，過程中還必須要不停地攪拌，對耐心以及耐力的考驗是極為嚴苛的。但是相對的，當你熬過這些過程，成功製作出一款「驚天地，泣鬼神」的果醬、抹醬時，那種成就感絕對會比你考試考100分還多很多。 在這本書裡作者精選了四個季節各10款的果抹醬，其中不乏很多老師的自創果抹醬，讓您在家就能做出外面都品嘗不到的果醬風味，不管是送禮還是自用都非常合適。 凱恩老師的創意食譜 本書裡很多食譜，皆是Kyan老師的原創食譜。從食材的挑選搭配，再到食譜的研究製作，都是Kyan老師長久以來的心血結晶。裡面的所有果醬、抹醬都別具特色，每一款都有其獨特的風味與口感，絕對可以帶給您驚喜！這樣獨特的果醬、抹醬，無論是要送禮還是自用，都顯得非常適合！！ 保存技巧 如何保存製作好的果醬也是一門很重要的學問。只有用正確的方式保存果醬，才能隨時隨地品嘗到濃縮果醬的美妙滋味。在本書裡，Kyan老師將會親自教您如何消毒瓶子，並將果醬裝入密封。這樣一罐自己製作、封裝的果醬，才可以讓您吃得更加安心。 四季醬風味 Kyan老師嚴選四個季節10種的果醬、抹醬，每一種都有其獨特的風味與特色，讓您一口就能品味到最純粹的濃縮季節滋味。挑選符合四季季節風味的果醬，讓您買一本書就能品嘗到四個季節不同風味的果醬，每個季節都有獨特的醬滋味。 最佳搭配方案 每一款果醬都有仔細的介紹，向您介紹該款果醬的最佳搭配食用方式。讓您可以輕鬆享用自製的美味果醬，不用擔心踩雷。Kyan老師耐心解釋每一款果醬的風味，以及其最合適的使用方法。跟著Kyan老師一起享受美好的醬醬世界吧！！ 專業器材介紹 溫度是製作好果醬的關鍵。至於如何控制好溫度，那就需要有專門的器材從旁輔助了。當然溫度可不只是唯一的關鍵，這本書向您介紹了製作果醬時的各種常用器材，提高您製作成功的機率。所謂工欲善其事必先利其器，要做好果醬，就先得瞭解製作果醬時會使用到的工具。 作者簡介：劉重佐(凱恩Kyan) 銘傳⼤學 餐旅管理學系講師 Apr.2022 – now 伊萊克斯 親⼦廚房講師 豐喜食品 特約甜點研發 Apr.2018 – 2022 MAESTRO STUDIO 主廚 麥⽥法式烘焙 特約甜點主廚 Sept.2016 – Mar. 2018 Furuta dessert house(Melbourne) 研發主廚 Foodieshow 研發經理/品牌廚師 Aug.2015 – June. 2016 FRESHONE 甜點課程講師 SOFRESH 甜點課程講師 Peace&Love CAFÉ 甜點主廚 Nov.2012 – June. 2015 La Petite Chambre ⼩房間餐酒館 特約甜點師 The Chips 美式餐廳 特約甜點師 健⾏科技⼤學 外聘講師 雙爸私廚 甜點課程講師 LALOS PARIS 實習 Mar.2012 – June. 2012 LE CORDON BLEU, PARIS, Diplôme de Pâtisserie June.2011 – Mar. 2012 法國藍帶廚藝學院 巴黎校區 甜點課程畢業 世新⼤學公共傳播系公共關係組 畢業 Sept.2000 – June. 2004 出版社粉絲頁： 出色文化 #李基銘 #李基銘主持人#fb新鮮事#生活有意思#快樂玩童軍 #廣播之神#廣播之神李基銘#漢聲廣播電台 YouTube頻道，可以收看 https://goo.gl/IQXvzd podcast平台，可以收聽 SoundOn　https://bit.ly/3oXSlmF Spotify　https://spoti.fi/2TXxH7V Apple　https://apple.co/2I7NYVc KKBOX　https://bit.ly/2JlI3wC Firstory　https://bit.ly/3lCHDPi 請支持粉絲頁 廣播之神：  / voh.god  李基銘主持人粉絲頁：  / voh.lee  李基銘的影音頻道粉絲頁：  / voh.video  -- Hosting provided by SoundOn

In November of 1988, 17 year old high school student Junko Furuta was cycling home from her part-time job when she was kicked off by a passing motorcyclist. Shortly thereafter, 18-year old teenage boy Hiroshi Miyano came across Furuta and helped her get back on her feet, even offering to walk her home as it was quite late at night. Unbeknownst to Furuta however, Miyano had actually orchestrated this seemingly chance encounter, and she would soon come to learn the true extent of his depravity. FYI we have just started a YouTube channel where you can watch these Heinous stories:https://www.youtube.com/@GrimAsia_1UpMedia Join your fellow Heinous fans and interact with the team at our website or through our socials (IG, TikTok) @heinous_1upmedia. - Love Heinous? But feel its getting too dark for you? Check out:

Description: Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Dr. Dan Atkins about Children's Hospital Colorado's multidisciplinary treatment program for eosinophilic gastrointestinal disorders (EGIDs).   In this episode, Ryan and Holly interview their friend, Dr. Dan Atkins. Ryan was a long-time patient of Dr. Atkins and Holly worked as a feeding specialist with Dr. Atkins at Children's Hospital Colorado. Together, Dr. Atkins and Dr. Glen Furuta developed the Gastrointestinal Eosinophilic Disease Program at Children's Hospital Colorado as a multidisciplinary treatment center for pediatric patients impacted by eosinophilic gastrointestinal diseases. They discuss how treatments and medicines have developed over the years. The clinic started with local patients but now also receives referrals from around the United States. Listen in for tips on identifying EGIDs and using multidisciplinary treatment. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:50] Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron, and co-host, Holly Knotowicz.   [1:19] Holly introduces today's topic, the evolution of eosinophilic gastrointestinal disorders, and the guest, Dr. Dan Atkins, a pediatric allergist at Children's Hospital Colorado.   [1:32] With more than 40 years of experience as an allergist, Dr. Atkins has seen the evolution of eosinophilic disease patient care first-hand and helped establish the Gastrointestinal Eosinophilic Disease Program at Children's Hospital Colorado.   [1:46] The Gastrointestinal Eosinophilic Disease Program is a multi-disciplinary program designed for the optimal evaluation and treatment of children with eosinophilic gastrointestinal disorders.   [2:10] Dr. Atkins thanks Holly, Ryan, and APFED for programs like this podcast to help educate the population of patients with eosinophilic gastrointestinal diseases.   [2:39] Dr. Atkins chose a pediatric residency. The last rotation was with an incredible allergist, Dr. Lenny Hoffman, in Houston. Dr. Atkins loved seeing patients with asthma, eczema, allergic rhinitis, food allergies, and anaphylaxis.   [2:59] The thing Dr. Atkins liked about it was he could take kids who had potentially life-threatening conditions, work with them, and stabilize things, and they did really well. He could see a change in their quality of life. That got him started.   [3:22] Dr. Atkins did an allergy and immunology fellowship in Buffalo, New York with Dr. Elliott Ellis and Dr. Elliott Middleton who had just written the Allergy: Principles and Practice text. They were incredible, brilliant mentors and wonderful people.   [3:55] Dr. Atkins went to the National Institutes of Health to do basic science research after learning of a double-blind, placebo-controlled food challenge by Dr. Allan Bock and Dr. May in Denver.   [4:27] Dr. Atkins did a clinical project on food allergy with Dr. Dean Metcalf, which was one of the first double-blind, placebo-controlled food challenges in adults. They published two papers on it.   [4:47] Then Dr. Atkins went to work on the faculty of National Jewish Health. He was there for 25 years.   [5:04] Dr. Atkins was invited to join the Children's Hospital of Colorado because they wanted to start an allergy program there.   [5:21] Dr. Atkins got interested in eosinophilic gastrointestinal diseases in 2006 after he saw a patient who had had difficulty eating, eosinophils in his esophagus, and food allergies. In another state, a doctor had put him on an elimination diet and he got better.   [5:42] The patient moved to Denver. Dr. Atkins saw him and found the case to be interesting. He looked in the literature and found an article on eosinophilic esophagitis by Dr. Alex Straumann.   [5:53] A gastroenterologist, Dr. Glen Furuta, came to Children's Hospital, looking to work with an allergist. Dr. Atkins met with him and they hit it off. They saw the need for a multidisciplinary program to take care of these patients.   [6:31] Dr. Atkins has always been interested in diseases that led to eosinophilia. Most of them were allergic diseases. Eosinophilic esophagitis and other eosinophilic gastrointestinal diseases came along with much more of a focus on eosinophils in the gut.   [6:45] The first case of eosinophilic esophagitis that Dr. Atkins treated was a patient in 2006. He believes he probably missed earlier cases just by not asking the right question, which is, “Does your child eat slower than everybody else?”   [7:18] Once Dr. Atkins started asking patients that question, it stunned him to find out how many patients said that was part of the issue. He followed up with testing and, sure enough, they had eosinophilic esophagitis.   [7:45] Dr. Atkins says that, in general, eosinophils are present in allergic conditions. If you look at “allergic snot,” and stain it up, it's full of eosinophils. If you have eosinophilic esophagitis and allergic rhinitis, if you swallow snot, it will impact your EoE.   [8:40] Dr. Atkins tends to be more aggressive with using a topical nasal steroid spray with patients who have allergic rhinitis because that decreases the eosinophils in the nose.   [8:50] Dr. Atkins says since eosinophils are on their way to areas that are involved in allergic inflammation, that's how Dr. Atkins got interested in eosinophils. It played out with the multidisciplinary group and eosinophilic esophagitis.    [9:07] Ryan went to see Drs. Atkins and Furuta when he was eight. Ryan is so thankful he was able to go to their clinic and is grateful that the doctors helped to create one of the first programs dedicated to treating EGIDs in the U.S.   [9:40] Dr. Atkins credits Dr. Furuta with the multidisciplinary program. They discussed who needed to be part of it. A gastroenterologist first but Dr. Atkins thought an allergist was also necessary. Treating other allergies helps the patient's eosinophilic condition.   [10:51] They decided they needed excellent nurses who loved working with kids. A lot of the kids had trouble eating, so the group needed feeding therapists and dieticians because these kids have a limited diet. They also needed a pathologist to read the slides.   [12:59] Because this is a burdensome disease, they needed psychologists for the child and the family. Learning coping mechanisms is a big part of the experience.   [14:20] As the program progressed, they saw they needed an endocrinologist to look at the children who weren't growing as expected. In clinic, they needed a child health person who could play games with the kids and keep them engaged during the long visits.   [14:44] That was how the program evolved. They had an idea but they had to show people it would be an active clinic that would grow and they had enough patients to warrant the program. It happened quickly.   [14:54] The program is fortunate to have a wonderful group of people who get along well and check their egos at the door. There are lots of conversations. Everybody's willing to listen and put their heads together. They compare notes and histories.   [15:46] Holly had been working as a feeding specialist at the hospital. Someone was on leave so Holly was put into the clinic. She had never heard of EoE; she didn't know she had it! Her first meeting was a roomful of professionals comparing notes on patients.   [16:31] Holly was in disbelief that these medical professionals met together for an hour weekly to discuss their patients with each other. Later, Holly followed a patient with Dr. Atkins, then Dr. Furuta, then a dietician, and then a nurse. [17:01] As she followed the patient, Holly listened and recognized the symptoms. She thought that she might have EoE! She introduced herself to Dr. Atkins and asked for a referral for a diagnosis. She was diagnosed that year with EoE.   [17:25] Holly sees many unique things about the program. She was impressed that they had the foresight to include a feeding specialist, not a common specialty at the time. Holly also thinks it's neat that the clinic sees patients from all over the country. [18:01] Dr. Atkins says the availability of care is improving across the country. When the program began, people had not heard of eosinophilic esophagitis, not even the local pediatricians. Allergists were just becoming aware of it. They had to be educated.   [18:29] There were people in other communities who didn't have access to multidisciplinary care. Over time the word has spread. Pediatricians are referring patients to the clinic for diagnosis. Care availability has improved.   [18:55] Not every patient needs a multidisciplinary program. If you have mild to moderate eosinophilic esophagitis and you're responding to a current therapy, are doing well, and are communicating well with your provider, that's great!   [19:10] If you need a second opinion or if you have a complicated case, there are some benefits to multidisciplinary care.   [19:33] The providers at the clinic listen to the children as well as to the parents. When a food is removed, a dietician can suggest an alternative the child might like.   [20:07] The clinic wanted to treat local patients but go beyond that, as well. They learn a lot from seeing patients from all over the country with different exposures and being treated by different doctors.   [20:17] When Ryan was young, he would go from his home in Georgia to Denver, yearly. He reflected it felt like summer camp. He got a scope one day and saw the full team of specialists the next few days. It was different from how he was treated before.   [21:06] Ryan says he was listened to and heard, and it was such a great experience for him as a patient to be seen in Dr. Atkins's clinic.   [21:46] Dr. Atkins says they are trying to teach children to be their own advocates. If the doctor does not listen to what the patients have to say, why should they be involved?   [22:50] A patient experience at the clinic starts with somebody deciding they need to go there and get a second opinion or a diagnosis. They get a referral to the clinic. Dr. Atkins mentions the need for administrative staff as part of the clinic team.   [23:40] The patient fills out forms and gives their records to be reviewed by a physician before being seen to see if the clinic is a good fit for them. If it is, the patient is scheduled with an appointment for each doctor and professional in the clinic.   [24:02] The patient records are seen by each professional on the team for how they relate to the professional's specialty. They decide what tests need to be done and if they are covered by insurance.    [24:27] The care team meets before clinic to talk about all new and follow-up patients. Then the patient comes in to see the providers, one after another. Patients don't see all the providers in the same order. The endocrinologist and psychologist are not in the clinic.   [25:39] The clinic visit takes three to four hours. It may involve skin testing for allergies or spirometry for lung function. The patient is scheduled for an endoscopy. When appropriate, they offer transnasal endoscopy, which takes only eight minutes and does not require anesthesia.   [27:11] If the patient has a stricture and the esophagus needs to be dilated, the patient is asleep for that. There is also the esophageal string test, developed by Dr. Furuta. It takes a little over an hour and tells whether there is active disease or not.   [28:02] Care has been made easier. Patients have different options for testing. Holly points out that the family is a part of the team and they are involved in every process and decision. Dr. Atkins says that shared decision-making is a cornerstone of care.   [29:31] Dr. Atkins says what happens in the room is the care provider and patient connect and the patient talks about their problems with somebody they trust. To get the patient to do what they need to do, they have to understand and feel understood.   [31:03] When Dr. Atkins started treating patients with asthma at National Jewish, patients came for a long evaluation, sometimes months. The only treatments were theophylline and steroids. There were side effects to those medications.   [31:39] Dr. Atkins says it has been wonderful to be involved while new treatments have evolved. For eosinophilic esophagitis, when diet works for people, it works. He shares the experience of a teen who is doing great on a diet eliminating milk and eggs.   [32:56] Don't discount diet. It's still up front. On the other hand, that doesn't work for some people. A metered dose inhaler with the puff swallowed may work for some. That's ideal for teenagers. There are other treatment choices like budesonide.   [34:14] Swallowed steroids go to the liver, where they are metabolized. Now biologics are revolutionizing treatment. Not everyone needs biologics but they're a great choice for some.   [35:30] A patient starting out doesn't need biologics as a first treatment. Other therapies may be effective and cheaper. If a patient doesn't respond, they can go to a biologic. More treatments are being developed.   [36:42] Dr. Atkins wishes for a way to determine the food trigger with a simple test.   [38:00] Dr. Altkins remembers Ryan as a little kid who should have gotten off of milk but he just wouldn't do it. He also recalls a patient who thrived when he was put on the right elimination diet, giving up only a couple of foods.   [38:33] Dr. Atkins doesn't want to diminish any of his patients. Every patient is an individual. It's so much fun working through the problems, the goal, and the adjustments to get there and how the patient is dealing with it, and then watching them do better!   [40:35] The hard part about eosinophilic esophagitis is that very few people outgrow it. It tends to be lifelong. But in the lifetime of patients he is seeing now, Dr. Atkins thinks we will see a cure, or at least, much easier, better treatments.   [40:56] In the population Dr. Atkins treats, they start treatment and all of a sudden, they're not having trouble swallowing. Everyone who had a dilation said they would do it again when needed. They can swallow better.   [41:44] But then, they have to maintain control of the inflammation. When people feel better, their impetus to take the medication drops off. If they stop taking their medications, a month later, they can't swallow their bagels.   [42:18] There are holidays, such as Halloween, that are challenging for kids who are on elimination diets. If they collect candy but can't eat any of it, that may be a problem.   [42:48] People who don't have EoE don't understand not being able to swallow. Dr. Atkins sees dads who have this but don't want to go get checked out. He tells them they need to be examples for their children and go get endoscopies to know if the condition is familial.   [43:53] Dr. Atkins says there are a number of other excellent programs in the country.   [44:24] Holly thanks Dr. Dan Atkins for sharing his expertise to help others and continually teaching the medical community how to recognize eosinophilic diseases and optimize care for all patients.   [44:40] Eosinophilic diseases are not going away. Allergists need to learn the ins and outs of all different eosinophilic disorders. The medications available to treat those disorders are increasing.    [45:02] Early in your career as an allergist, learn as much immunology as you can and how the biologics work and the newer medications coming out. Follow side effects so you know what to say to your patients and what to look for.   [45:20] A lot of EoE patients get picked up in the allergist's office because they have other allergic diseases. As an allergist, ask if the child or parent eats slower than everybody else.   [45:57] Ryan thanks Dr. Dan Atkins for joining today and personally, for all he has done to treat Ryan over the years. He thanks Dr. Atkins on behalf of APFED and for being instrumental in many APFED conferences and educational materials.   [46:30] Dr. Atkins's biggest hope is that people sort out the pathways that lead to eosinophilic esophagitis and that we will have an array of targeted treatments for individual patients to cure that disorder for that patient without side effects.   [47:50] Dr. Atkins thanks Ryan and Holly again for the opportunity to join them. It's been such a pleasure. He thanks APFED again. He has been a big fan for years. Giving patients a voice to share their stories is incredibly important.   [47:34] For our listeners who would like to learn more about eosinophilic disorders, please visit APFED.org and check out the links below.   [47:41] If you're looking to find a specialist who treats eosinophilic disorders, you can use APFED's Specialist Finder at APFED.org/specialist.   [47:51] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections/.   [48:07] Holly thanks Dan and also thanks APFED's Education Partner Bristol Myers Squibb, GSK, Sanofi, and Regeneron, who supported this episode.   Mentioned in This Episode: Dr. Dan Atkins, pediatric allergist Children's Hospital Colorado National Institutes of Health National Jewish Health Allergy: Principles and Practice, by Elliott Middleton Jr., Charles E. Reed, Elliot F. Ellis, N. Franklin Adkinson Jr., John W. Yunginger, and William W. Busse   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, and Regeneron.   Tweetables:   “I loved helping patients with asthma, eczema, allergic rhinitis, food allergies, and anaphylaxis. You could take these kids who had potentially life-threatening conditions, work with them, and stabilize things, and they did really well.” — Dr. Dan Atkins   “With patients who have allergic rhinitis, we tend to be more aggressive with using a topical nasal steroid spray because that decreases the eosinophils in the nose.” — Dr. Dan Atkins   “We are trying to teach children to be their own advocates. … If you don't listen to what the patients have to say, why should [the patients] be involved?” — Dr. Dan Atkins   “The hard part about eosinophilic esophagitis is that very few people outgrow it. It tends to be a lifelong phenomenon.” — Dr. Dan Atkins

Read the blog post I have been really enjoying this book, released in 2021, by Kiyoshi “Nate” Furuta, a retired Toyota executive: Welcome Problems, Find Success: Creating Toyota Cultures Around the World. I bought it a year ago and wish I had started reading it sooner! Furuta is the retired former chair and CEO of Toyota Boshoku America, Inc. — an automotive parts supplier to companies including Toyota and General Motors.  --- Support this podcast: https://podcasters.spotify.com/pod/show/lean-blog-audio/support

Description: Co-host Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist and feeding specialist living with EoE who serves on APFED's Health Sciences Advisory Council, talk with Drs. Robin Shandas and Steven Ackerman, are scientists who work together at EnteroTrack. In this episode, Ryan and Holly interview Drs. Shandas and Ackerman about the development of the esophageal string test (EST), or simply the string test. They discuss the initial concept and the work that led to the development of the string test to collect samples from the upper gastrointestinal mucosa. The test involves swallowing a capsule, similar in size to a TicTacⓇ, with a string attached. It began as an overnight test, and today is a one-hour test. During the conversation, the researchers explained the use of the string test as a monitoring device for EoE, not as a diagnostic device. They describe how the test is administered with no endoscope, no anesthesia, no recovery time, and only minor discomfort for some patients. They discuss the age range for using the device (as young as 4) and the advantages it offers over traditional endoscopy and biopsy for frequent monitoring of eosinophilic esophagitis. Finally, they advise patients on how to access the test: Ask your clinician about it!   Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:50] Co-host Ryan Piansky welcomes co-host Holly Knotowicz. Holly introduces the topic of a new unsedated diagnostic tool for EoE, the esophageal string test, or for the purposes of today's podcast episode, the string test.   [1:34] Holly introduces Drs. Robin Shandas and Steven Ackerman, are professional scientists who work together at EnteroTrack. Dr. Shandas is the Chief Executive Officer and Dr. Ackerman is the Chief Science Officer.   [1:48] Drs. Shandas and Ackerman, with a team of entrepreneurs, engineers, medical doctors, and scientists, developed the EnteroTracker®, the esophageal string test, a new method for collecting and sampling upper gastrointestinal mucosa.   [2:00] Holly thanks Drs. Shandas and Ackerman for joining us today.   [2:19] Dr. Ackerman has worked on the biology and the roles of eosinophils in the pathogenesis of allergic diseases, including asthma, eosinophilic gastrointestinal disorders, and other hypereosinophilic syndromes for the past 40 years, starting when he was a post-doctoral fellow at the Mayo Clinic in Rochester, Minnesota.   [2:44] About 18 years ago, Dr. Ackerman transitioned his lab to do more clinical translational research in eosinophilic GI diseases. His lab developed and validated the string test and the biomarkers and immunoassays that they use to evaluate the results.   [3:10] Dr. Ackerman was also interested in studying how the eosinophil participates in tissue remodeling and fibrosis of the esophagus in EoE and other eosinophil-associated diseases. Notably, this started with a small research grant from APFED in 2007 to 2008, which was followed by a more substantial APFED grant in 2011.   [3:51] Ryan was involved in APFED in 2007 and he remembers hearing about the early work that was going on for this new test. He thought it would be fantastic to have a test without anesthesia or a scope down his throat. It was exciting to hear about the development over time.   [4:23] Dr. Ackerman and Dr. Glenn Furuta, a pediatric gastroenterologist, initially conducted eosinophilic disease research together at Harvard Medical School. Dr. Ackerman eventually went to Chicago but continued to interact with Dr. Furuta. They published papers together on eosinophils and their roles in GI diseases.   [4:47] Dr. Ackerman was inspired to develop the string test when Dr. Furuta pointed out to him the tremendous need for a minimally-invasive or non-invasive test for EoE that would remove the need for children to have multiple repeat endoscopies and biopsies under sedation. [5:11] The endoscopies and biopsies were done to follow patient responses to treatment, especially food elimination diets. Dr. Ackerman's goal was to provide a way to evaluate disease activity in children with EoE in a minimally invasive or non-invasive fashion.   [5:42] Dr. Shandas is a biomedical engineer, entrepreneur, and educator. He has been a scientist for over 30 years. He is a Distinguished Professor of Bioengineering at The University of Colorado. His passion is to take ideas that he thinks can help people and go through the work. It's really, really hard work to bring those ideas to the clinic!   [6:07] Dr. Shandas has been working on the string test for some time. He started eight companies to support this type of activity. The idea of the string test, a simple, non-invasive way to collect samples from the esophagus to support frequent and granular monitoring of disease activity, was compelling when Drs. Furuta and Ackerman presented it to him.   [6:38] After Drs. Furuta and Ackerman received funding from APFED they did a lot of basic science research to develop the foundation of the string test. They approached Dr. Shandas to see if he could take the idea and figure out how they could help patients with it. That was compelling to him. He learned a lot about GI and EoE in the process.   [7:30] Dr. Ackerman and Dr. Furuta started working on the string test in 2006. It took more than 16 years from concept and pre-clinical lab studies to its marketing and adoption for routine clinical use. It was officially in the clinic at the beginning of 2023.   [8:01] Holly Knotowicz was a clinical fellow at Children's Hospital Colorado in 2010 where they were talking about this and she recognized this would be life-changing for patients in all populations not to have to participate in sedation to get updated information.   [8:32] The esophageal mucosa has biological information that may reflect the status of the disease in the esophagus. The conventional way of evaluating what is happening in the esophagus is to put a scope down the throat, pinch out a biopsy from the esophagus, and analyze that tissue for inflammatory cells and inflammatory markers.   [9:19] Dr. Shandas learned that the mucosa lining the esophagus has a lot of biological information. Because it is a barrier between the outside and your body it has a lot of biochemical reactions; it may be exposed to environmental allergens or food issues. These things interact with your body through the mucosal layer. It's a complex layer.   [10:08] Scientists are just starting to figure out the number of things that go on in the esophageal mucosal layer. The string test samples the esophageal mucosa from the throat down to the stomach, for the entire length of the esophagus. The mucosa is the repository of information on how your body interacts with EoE.   [10:39] The molecules that the body releases as a function of the reaction that's taking place are expressed in the mucosal layer. The string test collects samples of that mucosal layer. It's a simple, non-painful, non-traditional method of sampling.    [11:10] The researchers figured out there's a lot of biological information in the mucosa. Dr. Furuta and Dr. Ackerman have both done clinical studies comparing the string test against traditional biopsies to show that there are great correlations. So they set out to develop a clinically available test.   [11:30] For the past eight years, EnteroTrack has done work to answer questions such as: What is the process of swallowing the device and getting the sample? What is the process of analyzing the sample? And how do we put all of that into the framework of a clinical product that can be available to patients and clinicians?   [11:49] The string test is a phenomenally simple, easy way to sample mucosal content and analyze it for biomarkers, with no need for any sedation or anything to help you swallow the device. It's a very simple technique.   [12:32] Dr. Ackerman was a skeptic when Dr. Furuta first approached him with the idea. He agreed on the need to sample at the site of inflammation. He was surprised at how good the test was in the 16-hour overnight format, compared to endoscopy and biopsy. It was hard to tell the figures apart between the two tests.   [13:14] Dr. Ackerman learned they only needed to measure one eosinophil-specific biomarker, major basic protein-1, for a 16-hour test, but when they changed it to a one-hour test, they needed to measure two biomarkers to get enough of a sample. The second biomarker is eotaxin-3, which attracts the eosinophils into the esophagus.   [14:18] Dr. Ackerman tells of clinical validation. After multiple applications to the FDA Rare Diseases Program, they were able to get substantial funding to do a Stage 2 clinical evaluation. It was a four-year grant but it took six years to recruit all the patients. They completed and published it in 2019 as the basis for the string test and EoE score.   [15:03] Today, the string test is a one-hour test. The visit takes about 90 minutes, including the test, preparation, and removal of the string. The sample is sent to a reference lab. They analyze it and in about 10 days, send your doctor a report that describes the EoE score and the magnitude of the disease.   [16:43] There is no recommended frequency for the string test. It can be done as often as your doctor wants to keep track of changes in your disease. Until the string test, there hasn't been a real solution to monitor the disease, with samples every week, two weeks, or four weeks. The researchers encourage patients to ask their clinicians for the string test.   [18:19] After setting a baseline, the frequency of tests can be determined by the patient's progress and the clinician's findings.   [18:45] The string test is not a replacement for endoscopy. Endoscopy plays an important role in definitively diagnosing the disease and getting a comprehensive sense of what's going on with the disease. The string test is a complement to endoscopy.    [19:23] An endoscopic pinch biopsy samples a tiny fraction of the esophageal surface area. EoE is a patchy disease. It can manifest in different places in your esophagus. You may need to do multiple biopsies to make sure you're covering the esophagus nicely and identify a location where the disease manifests.   [20:01] An advantage of the string test is that in one test, you get a sample from your throat to your stomach, the entire length of the esophagus. That allows you to get a very comprehensive evaluation of your esophagus. The ease, cost, time savings, out-patient setting, no endoscopy suite, no endoscopist, and no anesthesiologist, are advantages.   [20:39] EnteroTrack is pursuing the possibility of doing point-of-care in-home use of the string test. This would be a significant advantage over the traditional way of monitoring the disease.   [21:08] A string test cannot be used instead of an endoscopy to make the initial diagnosis of EoE. It's intended as a monitoring tool. Its clinical indication is not as a diagnostic test but for monitoring the disease, in combination with a lab analysis of the assay. Endoscopy is used for the diagnosis.   [21:45] In areas where endoscopy and biopsy are not locally available, doctors might use the string test to screen patients to consider referring them to a center where they can get an endoscopy and a biopsy as an initial diagnostic tool.   [22:49] Holly is excited to have access to the string test for patients on elimination diets, to test more frequently as foods are reintroduced one at a time to the diet, without putting the patient under anesthesia for a traditional endoscopy.   [23:58] During the monitoring of EoE, if the doctor sees the data is trending in a certain way, it may be useful to get an endoscopy and biopsy to get additional information.   [24:28] Ryan has had dozens of traditional endoscopies and biopsies so he's always excited to hear about new tests. He's been putting off an endoscopy and he needs one soon. Is Ryan, an adult, a candidate for this procedure at his local hospital? Yes! He has been diagnosed with EoE, so he can be monitored by the string test.   [25:12] The youngest patient to swallow the device was a four-year-old and they did great with it; the test was very successful. EnteroTrack recommends that parents talk to their child's physician about the option to use this device. The key is if the patient, parent, and clinicians all feel that the patient can swallow the device.   [25:35] The string test device is about the size of a TicTac®. It's important for the swallowing procedure to be successful. EnteroTrack works with clinical groups to give them tips on how best to ensure that the procedure is successful.   [25:56] Holly is a feeding specialist. One of the things she helps people with eosinophilic diseases to learn is how to swallow pills. She helps them practice with different kinds of candies and capsules.    [26:40] The clinical validation study included patients aged seven and older. Now that the product is released, clinicians, parents, and patients can together make the decision if they can swallow it. EnteroTrack looks at de-identified data to evaluate how the string test is doing. They are seeing younger age groups successfully swallow it.   [27:25] There are factors that contribute to successful swallowing. One is the parental motivation of their children. Also, practice swallowing something the size of the device.   [27:39] EnteroTrack is providing training to physicians and nurses at the centers that are adopting the test. They are aware of how to make the swallowing part of this test as successful as possible with the least amount of stress.   [28:02] The EnteroTracker® is considered a minimal-risk device, and minimal-risk procedure. If you are anxious about swallowing, or you have challenges as you swallow it, you may gag a little bit.   [28:37] In the Phase 2 data, there was a small percentage who had challenges in terms of gagging, when swallowing the device. All of those issues were resolved. Even if the patient gags, the clinician has tips to help the patient get through that. Repeated gulps of water can help bring the capsule down and alleviate those issues.   [29:37] In the clinical validation studies, there were hundreds of string tests performed and there were no serious adverse reactions or problems other than the minor problem of some gagging. During the 16-hour tests, there was one patient who chewed through the string while sleeping and swallowed it. The string just passed through the GI tract.   [32:47] Dr. Shandas has personally swallowed about 50 string tests to understand the patient experience. After the swallow, when the string is in the esophagus, there is a feeling of tickling in the side of the throat in the beginning, but that resolves in a couple of minutes and it is not noticed at all. It helps if the patient has something to occupy their attention.   [34:05] The nurses and clinicians are trained to pull the device out, not fast and not slow. It should take three to five seconds. There is some discomfort as the string is coming out. It may feel like burning in the throat but it happens quickly and it resolves immediately. They have not seen big challenges with this, much less than in swallowing.   [34:50] The string has two parts. The part that goes from your mouth down your throat is like dental floss. It's connected to the collection string that goes down the esophagus to the stomach. That collection string is a thicker nylon yarn designed to optimally collect mucosal samples. It would be uncomfortable in the throat, but not in the esophagus.   [36:06] EnteroTrack has gotten a Medicare code for the assay and a Medicare reimbursement for the assay. The next step is getting private insurers to pay for the test. EnteroTrack is working on that. It will require educating insurance companies about the value of the test. Patients, clinicians, and groups like APFED can help.   [37:51] The string test is clearly less expensive than doing an endoscopy and biopsy. That should be one of the motivating factors for insurance companies. It is significantly lower cost than the test that is used as the standard of care.   [38:38] Some large centers have begun using the esophageal string test, including Denver, Phoenix, Tampa, Dallas, and Chicago. EnteroTrack has received interest from clinicians and patients around the country.   [39:04] Patients and parents, let your clinicians know if you are interested in the esophageal string test (EST). Your doctor can contact EnteroTrack and ask how to get the test to their clinic. It's a simple process and the clinical training is very straightforward.   [39:35] APFED plans to add information about the esophageal string test to its Specialist Finder at apfed.org/specialist to help patients find clinicians offering this test.   [39:53] Drs. Ackerman and Shandas anticipate that the number of centers offering this test will grow exponentially as people see that it's working for early adopters.   [40:10] Ryan and Holly thank Drs. Shandas and Ackerman for sharing their expertise to help others today in the podcast. Dr. Shandas thanks Ryan, Holly, and APFED for the opportunity to talk about the string test.   [40:35] As entrepreneurs and researchers, they are constantly innovating, including looking for other applications for the string test. They have clinical trials going on to use the string test for esophageal issues, gastric issues, and small intestinal issues, analyzing the contents for different biomarkers that have correlations with a lot of upper GI diseases.   [41:22] To learn more about eosinophilic esophagitis, visit apfed.org/eoe, to access the Specialist Finder, visit apfed.org/specialists, and to connect with patients and families living with eosinophilic disorders, visit apfed.org/eos-connections. Ryan and Holly thank Drs. Shandas and Ackerman again for an interesting conversation and thank APFED's education partners, linked below, for supporting this episode.   Mentioned in This Episode: American Partnership for Eosinophilic Disorders (APFED) APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Dr. Robin Shandas Dr. Steven Ackerman EnteroTrack, LLC Mayo Clinic Dr. Glenn Furuta The University of Colorado Real Talk: Eosinophilic Diseases Podcast   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of AstraZeneca, Bristol Myers Squibb, Sanofi, and Regeneron.   Tweetables:   “I was interested in studying how the eosinophil participates in tissue remodeling and fibrosis of the esophagus in EoE and other eosinophil-associated diseases. Notably, this started with a small research grant from APFED in 2007 to 2008.” — Dr. Steven Ackerman   “The mucosa that lines your esophagus has a lot of biological information. … The mucosa is the barrier between the outside world and your body. It is this very interesting biological fluid and … it has a lot of biochemical reactions.” — Dr. Robin Shandas   “Since we released the product earlier this year, we've had a four-year-old swallow the device; did great, very successful. And so, we recommend that patients, parents, talk to your physician.” — Dr. Robin Shandas   Featured speakers: Dr. Steven Ackerman Dr. Robin Shandas  

Dr. Furuta was among the first physician scientists I ever met and is a big reason why I decided to choose this career path. He is a dedicated mentor, exceptional clinician and researcher, and an incredible leader – most recently taking the helm of the pediatric division of gastroenterology at Colorado Children's Hospital. Dr. Furuta earned his BA at the University of Texas in Austin, His MD at Baylor College of m=Medicine, where he also did his pediatrics residency and served as chief resident, followed by a fellowship in pediatric gastroenterology at Children's Hospital/Harvard medical school program. Dr. Furuta is the director of the GI eosinophilic diseases program, the la cache endowed chair for GI allergic and immunologic diseases, the director of research in pediatric gastroenterology, hepatology, and nutrition, as well as the section head of pediatric GI and hepatology. Today, Dr. Furuta shares his passion for this varied and exciting career, and how he mentors those of us who want to follow in his footsteps.

Click on the link here to watch the video on my YouTube channel.

Hablamos sobre Los 44 horripilantes días del secuestro y asesinato de Yunko furuta Escuchanos también en la red de podcast de los sospechosos habituales

Beyond Social Services. The host for this show is Rusty Komori. The guest is Susan Furuta. We talk with Susan about why Helping Hands Hawaii is one of the most cost efficient and effective nonprofit organizations in the state of Hawaii, and fulfilling their mission to provide critical social services to improve people's quality of life and empower them on their path to a better tomorrow. The ThinkTech YouTube Playlist for this show is https://www.youtube.com/playlist?list=PLQpkwcNJny6mTzxc4G7w47Jcr_G482jrb Please visit our ThinkTech website at https://thinktechhawaii.com and see our Think Tech Advisories at https://thinktechadvisories.blogspot.com.

Becky Furuta was pregnant with her second child and racing her bike for a domestic elite team based out of Boulder, Colorado when she was diagnosed with type 1 diabetes. The then 28-year-old's family has a history of both type 1 and type 2 diabetes, so when Furuta first experienced the symptoms of the condition, she called her doctor and requested an early screening for gestational diabetes. Her midwife performed a routine glucose tolerance test. The results sent her straight to the emergency room.

Sketch and VLord have a chat with the producer of Housing Complex C Maki Terashima-Furuta. They discuss the development of the series and the many roles Maki had as the producer at Production I.G. USA Music credits: "Kurosaki wa Furiuta" as performed by Ayahi Takagaki

Aujourd'hui je rencontre Mitsuru Furuta, CTO de LexLogos, passé par Sensorit et évangéliste Microsoft. Il m'a partagé son parcours et sa vision du code. Avec ses 30 ans d'expérience, il m'a délivré beaucoup de valeur sur sa philosophie : utiliser de nouvelles technos avant tout le monde, son apprentissage constant… Bref : un passionné ! Alors dans cet épisode toujours 100% IT, il parle de son parcours : - La naissance de sa passion grâce à une calculatrice ramenée du Japon par son père. - La bulle internet en 2000. - Le lancement de .Net et son premier projet avec cette techno pour l'entreprise Printemps (paiement, interfaces de communication, développement spécifique…). - Son débauchage et son arrivée chez Microsoft avec Pierre Lagarde. - Le process d'entretiens chez Microsoft. Ces étapes permettent d'aborder beaucoup de sujets autour de l'informatique : - Comment bien recruter des développeurs ? En exposant une problématique technique ou en créant un système de mots fléchés. - Comment prendre la parole face une grande salle remplie de techos ? Il raconte son histoire de conférences internes Microsoft à Seattle. Avec plusieurs clefs : s'adapter à son public, travailler le ton, le contenu, la cadence et surtout : le lien que tu crée avec l'audience. - Comment gérer la performance pour maintenir une bonne expérience utilisateur ? Avec les enjeux de gestion du volume de trafic sur les applications / versus la puissance des serveurs et coûts de l'infrastructure (sur le cloud notamment). - Comment faire la différence entre un bon et un excellent développeur ? Enfin, il termine par un conseil pour les développeurs : “Si je devais donner un seul conseil à un développeur, ce serait de développer l'interface graphique en dernier !”. On est d'accord sur ce point. Et pas seulement ! Allez c'est parti pour ce nouvel épisode ! Bonne écoute et à dans 15 jours ! ▬▬▬▬▬▬▬▬▬▬ Soutenez le podcast gratuitement - Abonnez-vous - Laissez un avis et 5 ⭐ - Merci beaucoup ! - Inscrivez-vous sur On part en prod pour ne louper aucun épisode Les informations mentionnées dans cet épisode - MICROSOFT - LEXLOGOS / REGIE PRO - SENSORIT / YELLOW - Pierre LAGARDE - Daniel COHEN ZARDI - Cyril GIACOPINO - Casio FX 7000 - Livre “Programmation Système en Delphi 2” Dick LANTIM - BORLAND (Delphi) - Film “Shutter Island” de Martin SCORSESE : https://www.captainwatch.com/film/11324/shutter-island - Exemple de conférence Coding4Fun : https://www.youtube.com/watch?v=wfkZzkcNad0 Recommandations de Mitsuru - Dick LANTIM - Anders HEJLSBERG - Produit Yellow : https://www.getyellow.io/ Pour suivre l'actualité de Mitsuru - Son LinkedIn : https://www.linkedin.com/in/mitsurufuruta/ ▬▬▬▬▬▬▬▬▬▬ Postproduction Audio : Guillaume Lefebvre Music by MADiRFAN from Pixabay 

Junko Furuta was a 17 year old student at Yashio-Minami High School. She was a good student who had high hopes for the future as she was saving for a trip post graduation and had a job lined up. On the night of November 25, 1988, Furuta was on her way home from work when she was kicked off her bike by and unknown teenaged boy. A few seconds later, another teenaged boy appeared and helped her. He offered to walk her home. Unbeknownst to Furuta, both boys (Hiroshi Miyano and Shinji Minato) were friends who planned this out. Miyano lead Furuta to a warehouse, where she was beaten and raped. She was held captive at Misato's home for 40 days. Miyano, Minato and two of their friends, Jō Ogura and Yasushi Watanabe beat, tortured and raped Furuta. Minato's family never reported the crimes as they feared their son and his friends. Furuta succumbed to her injuries on January 4, 1989. Fearing the consequences, the boys wrapped Furuta's body in blankets and placed her in a metal drum, which was then filled with wet concrete. Over the next four months, the boys continued to commit more violent crimes. After being arrested for an unrelated crime, Miyano confessed to killing Furuta and dumping her body after thinking Ogura confessed as well. The four boys were arrested and charged with murder. They all served anywhere from 5 to 20 years in prison. Furuta's family and the public believed the sentences were too light. Once they got out, most of them continued to commit crimes.

Nos últimos dias, muitas decisões jurídicas chacoalharam o extra-campo do Paraná Clube. Ato Trabalhista, Dívida com o Bacen, Recuperação Judicial... diversas decisões foram tomadas. E o Paranautas Podcast trouxe um convidado especial, Rafael Furuta, para traduzir toda essa montanha russa jurídica para a nação paranista.Dentro de campo, o Tricolor está classificado para a segunda fase da série D e fizemos um balanço do segundo turno desta fase e pincelamos algumas expectativas prévias para o mata-mata.Para melhorar sua experiência, dividimos o episódio em blocos:0:00 a 55:25abordagens jurídicas:- Fim do Ato Trabalhista- Suspensão do Leilão da Kennedy- Recuperação Judicial do Paraná Clube é aceita- existe um prazo de entrada de recursos financeiros para a recuperação judicial?- como fica o vinculo do Paraná Clube SAF com as dividas arroladas na recuperação?- como ficam as decisões de gestão com a recuperação judicial?55:25 a 1:09 (fim)time em campo: segundo turno da primeira fase e expectativas para o mata-mata-Este podcast é uma produção da Pacundê Podcasts.A Pacundê é um selo que depende da sua ajuda pra continuar com a sua programação e estrutura.Acesse pacunde.com.br e ajude com valores a partir de R$10 mensais. Sendo apoiador você pode se inscrever em sorteios exclusivos de todos os programas da casa.* Todas as opiniões expressas neste programa não, necessariamente, refletem a opinião da Pacundê e são de responsabilidade exclusiva de seus idealizadores.

Junko Furuta was just 17 years old when she was raped, beaten, and killed by four teenage boys in 1980s Japan. . . And up until her kidnapping at age 17, she was a normal, happy and sweet girl. Furuta was known for being pretty, bright, and getting good grades at Yashio-Minami High School. Despite her “good girl” reputation — she didn't drink, smoke, or use drugs — she was quite popular at school and seemingly had a bright future ahead of her. So why was she viciously beaten, tortured, raped and made o suffer the most inhumane treatment anyone could imagine? Brought to you in part by Little Diva's Balloon Decorating Patreon subscribers received this episode on Saturday June 25th, 2022 Become a Patron! VISIT THE MOUNTAIN MYSTERIES Follow us on Facebook! Don't miss the Mountain Mysteries Gatherings on Facebook, You Tube and Twitch Thursday's at 8pm est Next week on The Mountain Mysteries, "Till Death Do Us Part". Hosted and produced by Christopher Shelby Slone for Slone Studio's Some musical scoring provided by Trevor Huff Research by Amanda Collins Additional voice work (Junko's friend at funeral) provided by Annie Hue Phung Dedicated to the enduring memory of April Pennington, Trevor Huff and Oliver Little, rest easy friends. Chris Slone studio's 2022 all rights reserved --- Send in a voice message: https://anchor.fm/chris-slone1/message Support this podcast: https://anchor.fm/chris-slone1/support

In November of 1988 a 17 year-old Japanese high school student and factory worker named Junko Furuta would leave work for home and never make it. Her brief commute would become a nightmare lasting more than a month and would become notorious around the world - not only for the monstrous brutality of the crime - but for the shocking travesty of justice that followed.Join the crew as J tells the story of Junko Furuta's 44 days of hell of Earth.*Visit us on Twitter @BentPodcast for all the creepy, crimey details*

La #historia de Junko Furuta aún resuena en Japón, especialmente entre los adolescentes. Furuta era una joven de 16 años que vivía en Tokio y llevaba la típica vida de una mujer de su edad que habita en la ciudad: estudiaba en una escuela secundaria y pasaba tiempo con sus amigos los fines de semana. Entre 1988 y 1989, fue secuestrada por otros adolescentes y, después de pasar 44 días en cautiverio, fue brutalmente #asesinada. Distribuido por Genuina Media

Feliz año amigos, estamos de vuelta y les traemos un caso perturbador proveniente de la tierra del sol naciente, Junko Furuta fue víctima de 4 de sus compañeros que la torturaron durante mas de 40 días.Les pedímos discreción en este caso ya que es fuerte.

Junko Furuta was a successful girl with a bright future, until she met Hiroshi Miyano. Her kidnapping was just the beginning of this tragic story. Let us know your thoughts on what has become the worst juvenile case in Japan to date.TW: Sexual Assault and Graphic ContentInstagram: www.instagram.com/gravedangerpodcastTikTok: https://www.tiktok.com/@gravedangerpodcast

Last week my colleague, Dr. Glenn Furuta, was named recipient of the 2021 Harry Shwachman Award by the North American Society for Pediatric GI, Hepatology and Nutrition. This is the highest honor given by NASPGHAN and is awarded to one person each year who has made outstanding lifetime achievements and contributions to the field of pediatric gastroenterology, hepatology and nutrition. Glenn's lifelong work in the field of eosinophilic and allergic GI disorders has been a game changer for all pediatric (and adult) gastroenterologists and allergists, and he continues to be a global thought and research leader in all aspects of these disorders. In recognition of this honor, we wanted to rebroadcast my discussion with Glenn about Eosinophilic Esophagitis from Season 3 of the podcast. Congratulations Glenn!!  Do you have thoughts about today's episode or suggestions for a future topic? Write to us, Chartingpediatrics@childrenscolorado.org. 

On this episode, Susan Furuta shares how her team of 75 inspires hope to thousands of local families by providing guidance, household goods and opportunities for empowerment and connection. Susan Furuta is the President & Chief Executive Officer of Helping Hands Hawaii. Born and raised in the historic Ewa plantation, Susan is a graduate of James Campbell High School and holds a bachelor's degree in Human Development from the University of Hawaii at Manoa.

Becky Furuta is on the podcast this week. This busy mother of two currently juggles being a pro athlete for Team Noro Nordisk and a diabetes ambassador. And when she's not racing her bike, Furuta is caring for her children and serving as the owner and sports vision specialist in Golden, CO, and owner and co-founder of a private label eyewear company. She holds a master's degree in Public Health Policy from the University of Colorado and works as a consultant on childhood anti-obesity and public health campaigns. In 2017, Furuta won the Colorado State Time Trial Championship, setting a new course record. In 2018, she finished sixth at the Women's Professional Criterium at Colorado Classic. She has an inspiring story on how she got to where she is today. And a huge thanks to Primalwear and Pat Mayben for connecting us while we were at the UCI World Cup in Iowa City. www.teamnoronordisk.com www.primalwear.com www.murphologypodcast.com www.Patreon.com/Murphology

Le 25 novembre 1988, Furuta Junko, une lycéenne de 17 ans, était enlevée par 4 jeunes apprentis yakuza qui lui firent vivre 39 jours de cauchemar et d'agonie avant une mort libératrice.

Als die 17-jährige Junko Furuta die Frage von Hiroshi bekommt, ob sie mit ihm ausgehen möchte, ist sie zunächst erstaunt darüber. Doch weil sie seinen Ruf kennt, lehnt sie höflich ab. Mit dieser Zurückweisung unterschreibt die Jugendliche ihr eigenes Todesurteil. Sie wird von einer Gruppe Jugendlicher entführt, gefangen gehalten und gefoltert. Obwohl einige Leute das mitbekamen, unternahm niemand etwas, um Junko zu helfen...

Furuta was born in Misato, Saitama Prefecture. She lived with her parents, her elder brother, and her younger brother.As a teenager, she attended Yashio-Minami High School and worked part-time at a plastic molding factory during after-school hours since October 1988. She did this to save up money for a graduation plan she had arranged. Furuta also accepted a job at an electronics retailer, where she planned on working after graduation. At high school, Furuta was well-liked by her classmates, with high grades and very infrequent absences. The perpetrators were four teenage boys: Hiroshi Miyano (宮野裕史, Miyano Hiroshi, 18 years old), Jō Ogura (小倉譲, Ogura Jō, 17), Shinji Minato (湊伸治, Minato Shinji, 16), and Yasushi Watanabe (渡邊恭史, Watanabe Yasushi, 17), who were respectively referred to as "A", "B", "C", and "D" in court documents. At the time of the crime, they used the second floor of Minato's house as a hangout, and had, as chimpira, previously engaged in crimes including purse snatching, extortion, and rape. On 25 November 1988, Miyano and Minato wandered around Misato with the intention of robbing and raping local women. At 8:30 p.m., they spotted Furuta riding her bike home after she had finished a shift at her job. Under Miyano's orders, Minato kicked Furuta off her bike and fled the scene. Miyano, under the pretence of witnessing the attack by coincidence, approached Furuta and offered to walk her home safely. Furuta, accepting this offer, was unaware that Miyano was leading her to a nearby warehouse, where he revealed his yakuza connections. He raped her in the warehouse and again in a nearby hotel, threatening to kill her. From the hotel, Miyano called Minato and his other friends, Jō Ogura and Yasushi Watanabe, and bragged to them about the rape. Ogura reportedly asked Miyano to keep her in captivity in order to allow numerous people to sexually assault her. The group had a history of gang rape and had recently kidnapped and raped another girl, whom they released afterward. --- Send in a voice message: https://anchor.fm/thes3podcast/message

All murders are horrible, but this one takes it to a whole new level.The details of her case are not for the faint of heart. It's the kind of crime that you think no human could commit. Junko Furuta went through hell for 44 days, and never truly got justice. Why were the perpetrators of Japan's most horrifying murder let off so easily? Let us know what you think. Email us at podcast@crimeandcompulsion.comTrailer : The Jury Room Podcast Promo: Ignorance Was Bliss & Let's Start a Cult Sources: https://web.archive.org/web/20130222041410/http://www.trutv.com/library/crime/blog/article/japanese-horror-story-the-torture-of-junko-furuta/index.htmlhttps://ripeace.wordpress.com/2012/09/14/the-murder-of-junko-furuta-44-days-of-hell/https://www.ranure content warning by Kevin Cook.ker.com/list/junko-furuta-facts/amandasedlakhevener?page=3https://www.tokyoreporter.com/japan-news/tabloid/junko-furuta-killer-arrested-for-attempted-murder-3-decades-later/https://lingualeo.com/en/jungle/junko-furuta-story-535806https://en.m.wikipedia.org/wiki/Murder_of_Junko_Furuta#:~:text=Junko%20Furuta%20(%E5%8F%A4%E7%94%B0%20%E9%A0%86%E5%AD%90%2C%20Furuta,discovered%20in%20a%20concrete%20drum.

En este podcast hablamos de la tortura y asesinato de Yunko Furuta, una joven de una escuela secundaria que es secuestrada por cuatro jóvenes que están iniciando en el grupo de los Yakusa, ellos en una casa la torturan durante 44 días hasta su muerte. BIENVENIDOS

******Disclaimer*****The murder of Furuta Junko contains graphic sexual assault and is extremely disturbing. Please listen with caution.In this episode, Erika covers the tragic abduction and murder of Furuta Junko. Furuta was held captive in a Minato, Tokyo residence for 40 days. During this time she was brutalized, raped and tortured. The group responsible also invited their friends over to participate.Erika pulled her sources from:www.news.postseven.com/archiveswww.endia.netwww.tokyoreporter.comwww.japaninsides.comThen Amber covers the tragic Tatonic Parkway accident. Suburban mom, Diane Schuler drove a minivan the wrong way down the Tatonic Parkway in upstate New York and crashed head on with an SUV, killing herself and 7 others. Diane was found to have a BAC of 1.9 at the time of the accident, but some of her family members maintain that the toxicology report can't be correct. 3 of the 8 killed were Diane's nieces 8 year old Emma Hance7 year old Alyson Hance5 year old Katie HanceYou can honor their memory through the organization founded by their parents, Warren & Jackie Hance at:www.hancefamilyfoundation.orgAmber pulled her sources from:HBO Documentary "There is Something Wrong with Aunt Diane" Directed by Liz GarbusWikipediaNewYork.CBSlocal.com

In the 8th episode of Season 3, your host JD Horror brings you two more extremely disturbing tales as we give you part 5 of our series on Sexual Sadists.WARNING: The following episode continues graphic and disturbing depictions of sexual torture and violence. This episode is definitely not for the faint of heart. Listener discretion is strongly advised. You’ve been warned.Case #1: 44 Days of Hell - Four Japanese teenagers abducted 17 year old Junko Furuta, and for 44 days she was subjected to every form of torture imaginable. Known in the Japanese media as the "Concrete Encased School Girl Murder Case", this is definitely one of the most brutal and heinous crimes in all of human history. (The Murder of Junko Furuta, Japan)Case #2: The Collector - Bob Berdella, better known as "The Kansas City Butcher" who take his inspiration from a 1963 novel as a teen. The brutality of his crimes would eclipse anything that author John Fowles could have imagined when he wrote the story. Berdella would be convicted of the rape, torture, and murder of six men... But could there have been more? (B. Berdella, Kansas City, OH, USA)If you like what you hear here on True Crime Horror Story please subscribe and give us a 5 star review. You can also think about joining our Patreon At www.patreon.com/truecrimehs and then Stay tuned after this show on Patreon for the True Crime Horror Story After Show w/ Dom & JD as well as early access to Ad free episodes and exclusive bonus content available only on Patreon.This episode features additional research by Gabriel Bulsara for Bob Berdella, music by Mechanical Ghost, Producer LB from the No One Likes Us Podcast and The Quiet Type, as well as Artwork by Nuclear Heat Graphics. Has violent crime impacted you or someone close to you? Send us your story at truecrimehorrorstory@gmail.comTrue Crime Horror Story. Sometimes Truth is more brutal than fiction.http://www.truecrimehorrorstory.com

In this episode of Bowel Sounds, hosts Drs. Peter Lu, Jennifer Lee, and Jason Silverman talk to Dr. Glenn Furuta about eosinophilic esophagitis. We discuss how our understanding of eosinophilic esophagitis has evolved over time and the key role the pediatric GI community played in studying this disease. We discuss some of the more challenging aspects of its diagnosis and treatment, including the role of proton pump inhibitors and how to encourage compliance with dietary and pharmacological treatment. We also discuss recent innovations that will address barriers our patients currently face. Finally, Dr. Furuta reflects on his career and passes along advice that has helped him become a leader in this field.As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Produced by: Peter LuSpecial requests:Thank you to everyone for listening to our podcast. If you enjoyed this content and thought it was useful, we ask you to consider doing any or all of the following three things:Tell one person that you think would like this type of content about the podcast. We want to reach more GI doctors and trainees as well as general pediatricians, pediatric residents and medical students.Leave a review on Apple Podcasts -- this helps more people discover our podcast.You can also support the show by making a donation to the NASPGHAN Foundation via the link below.Support the show (https://www.naspghan.org/content/87/en/foundation/donate)

El 18 de enero de 1971 nace en Tokio, Japón, Junko Furuta, una estudiante de 17 años que fue brutalmente asesinada por unos compañeros del colegio en noviembre de 1988.This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/4146133/advertisement Si quieres compartirnos un suceso paranormal, de fantasmas, extraterrestres, o simplemente algo aterrador que te haya sucedido, envíanos tu historia en una nota de voz a: archivosperdidos@genuinamedia.comSíguenos en:TikTok.YouTube.Instagram.Facebook.Producido y Distribuido por Genuina Media

El 18 de enero de 1971 nace en Tokio, Japón, Junko Furuta, una estudiante de 17 años que fue brutalmente asesinada por unos compañeros del colegio en noviembre de 1988.

Te contamos la historia de Junko Furuta, un crimen que superó todas las historias de terror de la pantalla grande y que quedó prácticamente impune, dejando en evidencia la poca dureza de la legislación japonesa… • CULTURIZANDO.COM/PODCAST • Podcast de Crímenes • Podcast en Español • Leer más: https://culturizando.com/junko-furuta-un-infierno-de-torturas-y-humillaciones-que-duro-44-dias/ Narrado por: Ángel David Sardi Voz Culturizando: Santiago Duarte

The case of Junko Furuta is one of the most tragic and horrifying stories of abduction and torture out there. Furuta was abducted, held captive, and killed by her Japanese gangster classmates for 44 days. During that time she suffered an incredible amount of abuse. --- Support this podcast: https://anchor.fm/conspiracies-and-mysterie/support

The Junko Furuta case is one of the most horrific in true crime history. It involves a 17yo Japanese school girl who was abducted and imprisoned by 4 teenage boys, who committed unfathomable acts of cruelty and violence against her. This is one of the most requested cases we receive, and we truly hope we did it justice. It is a very difficult case to discuss. Disclaimer: It is GRAPHIC. We will return with Lori Vallow news and updates next week, continuing our deep-dive into the cast of characters. ---------------------------------------------We would like to thank our Executive Producers:Ashley MChristy KIan MCristi RAshley BFaye SAmy SIris-Dora SKathleen HLeeAnn MShawna SYlana MTamara R...as well as all of our other Patrons! Thank you for making this possible! Check us out on Patreon.com/WeSawtheDevil if you would like to support the show!

Becky Furuta is a pro bike racer, business owner at Avenue Vision, wife, mom to 2 and community advocate. Becky has a unique story about bikes and the freedom and life change a bike gave her. Thanks Becky for being interview #1 and kicking off Bike Ride Podcast! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/bikeride/support

Subscribe to The Misery Machine on iHeartRadio - https://bit.ly/MiseryMachineSubscribe everywhere else - https://bit.ly/2U7OlSgThis week, Drewby and Yergy discuss the tragic case of Junko Furuta, a Japanese high-school student who was abducted, tortured, raped, and murdered in the late 1980's. Her murder case was named "Concrete-Encased High School Girl Murder Case," due to her body being discovered in a concrete drum.(00:00:01) Indie Drop-In Intro(00:00:21) The Misery Machine Intro/Content Warning(00:02:16) The Misery Machine Episode(00:41:30) Indie Drop-In OutroApproximately 100 people knew about Furuta's captivity, but either did nothing about it or themselves participated in the torture and murder. Most of the participants were friends of the teenage boys, who were low-ranking members of the Yakuza. We draw parallels between this case and the murder of Kitty Genovese regarding the many people who knew about what was going on and refused to act despite clear knowledge that somebody was suffering or dying.Subscribe to The Misery Machinehttps://themiserymachine.podbean.com/ - Podbeanhttps://www.youtube.com/themiserymachine - Youtubehttps://pod.link/1486604765 - All other apps. Join Our Facebook Group to Request a Topic: https://t.co/DeSZIIMgXs?amp=1Support Our Patreon For More Unreleased Content: https://www.patreon.com/themiserymachineInstagram: miserymachinepodcastTwitter: https://twitter.com/misery_podcast~~~~~~~~~~~Indie Drop-InThank you to The Misery Machine for the great episode. You can find Indie Drop-In at https://indiedropin.comTwitter: https://twitter.com/indiedropinInstagram: https://instagram.com/indiedropinAny advertising found in this episode is inserted by Indie Drop-In and not endorsed by the Creator.If you would like to have your show featured go to http://indiedropin.com/creators~~~~~~~~~~~

Subscribe to The Misery Machine on iHeartRadio - https://bit.ly/MiseryMachineSubscribe everywhere else - https://bit.ly/2U7OlSgThis week, Drewby and Yergy discuss the tragic case of Junko Furuta, a Japanese high-school student who was abducted, tortured, raped, and murdered in the late 1980's. Her murder case was named "Concrete-Encased High School Girl Murder Case," due to her body being discovered in a concrete drum.(00:00:01) Indie Drop-In Intro(00:00:21) The Misery Machine Intro/Content Warning(00:02:16) The Misery Machine Episode(00:41:30) Indie Drop-In OutroApproximately 100 people knew about Furuta's captivity, but either did nothing about it or themselves participated in the torture and murder. Most of the participants were friends of the teenage boys, who were low-ranking members of the Yakuza. We draw parallels between this case and the murder of Kitty Genovese regarding the many people who knew about what was going on and refused to act despite clear knowledge that somebody was suffering or dying.Subscribe to The Misery Machinehttps://themiserymachine.podbean.com/ - Podbeanhttps://www.youtube.com/themiserymachine - Youtubehttps://pod.link/1486604765 - All other apps. Join Our Facebook Group to Request a Topic: https://t.co/DeSZIIMgXs?amp=1Support Our Patreon For More Unreleased Content: https://www.patreon.com/themiserymachineInstagram: miserymachinepodcastTwitter: https://twitter.com/misery_podcast~~~~~~~~~~~Indie Drop-InThank you to The Misery Machine for the great episode. You can find Indie Drop-In at https://indiedropin.comTwitter: https://twitter.com/indiedropinInstagram: https://instagram.com/indiedropinAny advertising found in this episode is inserted by Indie Drop-In and not endorsed by the Creator.If you would like to have your show featured go to http://indiedropin.com/creators~~~~~~~~~~~

This week, Drewby and Yergy discuss the tragic case of Junko Furuta, a Japanese high-school student who was abducted, tortured, raped, and murdered in the late 1980s. Her murder case was named "Concrete-Encased High School Girl Murder Case," due to her body being discovered in a concrete drum.  Approximately 100 people knew about Furuta's captivity, but either did nothing about it or themselves participated in the torture and murder. Most of the participants were friends of the teenage boys, who were low-ranking members of the Yakuza. We draw parallels between this case and the murder of Kitty Genovese regarding the many people who knew about what was going on and refused to act despite clear knowledge that somebody was suffering or dying. Join Our Facebook Group to Request a Topic: https://t.co/DeSZIIMgXs?amp=1 Support Our Patreon For More Unreleased Content: https://www.patreon.com/themiserymachine Instagram: miserymachinepodcast Twitter: misery_podcast #truecrime #documentary #mystery

We ranked dragons based on how biologically and evolutionarily plausible they are. Thanks also to our Patreon patrons https://www.patreon.com/MinuteEarth and our YouTube members. ___________________________________________ To learn more, start your googling with these keywords:  Tetrapods: four-limbed (with a few exceptions, such as snakes which have vestigial limbs) animals constituting the superclass Tetrapoda. ___________________________________________ If you liked this week’s video, you might also like:  What Happened to Smaug's Other Legs? 'Hobbit' FX Expert Explains http://www.mtv.com/news/1719502/smaug-hobbit-fx-explained/ How to fly your dragon, Journal of Physics Special topics https://journals.le.ac.uk/ojs1/index.php/pst/article/view/870/802 _________________________________________ Subscribe to MinuteEarth on YouTube: Support us on Patreon: And visit our website: https://www.minuteearth.com/ Say hello on Facebook: http://goo.gl/FpAvo6 And Twitter: http://goo.gl/Y1aWVC And download our videos on itunes:  https://goo.gl/sfwS6n ___________________________________________ Credits (and Twitter handles): Script Writer, Editor and Video Narrator: Julián Gustavo Gómez (@ittakesii) Video Illustrators: Ever Salazar (@eversalazar) and Arcadi Garcia (@garirius) Video Director: Ever Salazar (@eversalazar) With Contributions From: Henry Reich, Alex Reich, Kate Yoshida, Peter Reich, David Goldenberg, Julián Gómez, Sarah Berman, Arcadi Garcia Rius  Music by: Nathaniel Schroeder: ___________________________________________ References: Tennekes, H. (2009). The simple science of flight: from insects to jumbo jets. MIT press.Azuma, A., Azuma, S., Watanabe, I., & Furuta, T. (1985). Flight mechanics of a dragonfly. Journal of experimental biology, 116(1), 79-107.Habib, M. (2013). Constraining the air giants: limits on size in flying animals as an example of constraint-based biomechanical theories of form. Biological Theory, 8(3), 245-252.

In young children, many of the symptoms of eosinophilic esophagitis resemble those of gastroesophageal reflux disease (GERD)—including feeding disorders and poor weight gain—so the child may be mistakenly diagnosed with GERD. In today’s episode we talk to Glenn Furuta, MD about the importance of a proper diagnosis of esophagitis in children, signs/symptoms to look for and effective treatment options. Dr. Furuta is the La Cache Endowed Chair for GI Allergic and Immunologic Diseases, the Director of Gastrointestinal Eosinophilic Diseases Program at Children’s Colorado and a Professor of Pediatrics in Gastroenterology at the University of Colorado School of Medicine. Do you have a suggestion for a future episode or feedback about this one? Write to us, chartingpediatrics@childrenscolorado.org 

While at Anime Expo 2019 we met up with Maki Terashima-Furuta President of Production I.G-USA and the Producer of FLCL, FLCL Progressive, FLCL Alternative, Uzumaki, Sand Whale And Me, and...

When Becky Furuta was diagnosed with type 1 diabetes, her doctor told her it was the end of her professional cycling career. But, having initially taken up cycling as a daily escape from childhood poverty, Becky wasn't about to take the news lying down. A little more than a decade later, she's an ambassador for Team Novo Nordisk – the world's first all-diabetes pro-cycling team - and can reflect on a career at the pinnacle of professional bike racing.

Happy 2019 everyone! May the coming year be full of joy and laughter and all the good stuff for you and everyone you know! Time to breakdown the events of the Junko Furuta case. not for the feint of heart, it's very immature and inappropriate, and kind of annoying... To be perfectly honest. Then, seeing as we feel we did a pretty weak job with this breakdown (it's Christmas/ New Years and we've been on other sides of the country and a bit lazy with the holidays etc etc) we recorded a "Jack and Shaun watch: The Belko Experiment" usually these are exclusive for our Patrons, but we messed this one up, so we're giving out to everyone instead! Enjoy! We'll be back to our much more organized and professional selves as of the next episode, I mean... it's the holidays yo! Patreon: Carousel Sniper Victim Shop here: www.carouselsnipervictim.com/shop -LIKE-SHARE-COMMENT-TAG-REVIEW- Find more at www.carouselsnipervictim.com Produced by Shaun Jeffery Additional production by Leigh Massoni massoni.sound.design@gmail.com ***Don't forget to check out our new addition to the Dead Glass Design line-up "Good V Evil" Follow us on all your finest social tubes: @CarouselSniperVictim @DeadGlassDesign Facebook, Instagram, Twitter

Mary Adams Urashima is a historian, former journalist and freelance writer, with thirty years in media, governmental and public affairs, and author of Historic Wintersburg in Huntington Beach (History Press). She chairs the grassroots preservation effort to save the Furuta Gold Fish Farm and Wintersburg Japanese Mission property in Huntington Beach, known as Historic Wintersburg. Mary identified and named the historic property, which was designated one of America’s 11 Most Endangered Historic Places in 2014 and one of America’s National Treasures in 2015. Mary has been researching and working to save Historic Wintersburg for almost nine years. Historic Wintersburg marks more than a century of Japanese American history and represents pioneer arrival and settlement in the American West, Orange County’s agricultural history, pioneer achievement, and the struggle for civil liberties. Everyone associated with the Furuta farm and Wintersburg Japanese Mission faced alien land laws and was forcibly removed from California and incarcerated during World War II.

The story of Junko Furuta is a tragic one to say the least. Most people assume that torturing another human being is something only a minority are capable of doing. When someone tortures just, for the sake of it... That's when we are forced to explore the darkest aspects of what we are capable of doing to one another, when we seem to lose all remnants of what it means to be a civilized member of society. Domestic Abuse- Lifeline Caring for someone with a drug problem?- Here. Patreon: Carousel Sniper Victim Shop here: www.carouselsnipervictim.com/shop -LIKE-SHARE-COMMENT-TAG-REVIEW- Find more at www.carouselsnipervictim.com Produced by Shaun Jeffery Additional production by Leigh Massoni massoni.sound.design@gmail.com ***Don't forget to check out our new addition to the Dead Glass Design line-up "Good V Evil" Tunes by: Thursday- Cross out the eyes Follow us on all your finest social tubes: @CarouselSniperVictim @DeadGlassDesign Facebook, Instagram, Twitter   Sources: https://www.thescarechamber.com/junko-furuta/ https://en.wikipedia.org/wiki/Murder_of_Junko_Furuta#cite_note-:1-2 https://allthatsinteresting.com/junko-furuta?fbclid=IwAR1he9hJzA8-2JZA4YqFe29PuJB3vM0TZTxCb8y39A8_LYjMfcNwFMzMGsg https://www.quora.com/What-do-psychopaths-think-of-the-events-that-occurred-to-Junko-Furuta https://aeon.co/essays/an-ordinary-person-becomes-a-torturer-with-surprising-ease

There are good films, bad films, and Cult films.  Well, two out of three ain't bad.  Today on GeekFest Rants Carlos will look at the  Michael Mann WWII horror film, The Keep.  Even the greatest of film makers have a skeleton in their closet and this one might be it for Michael Mann.  Even with a superb cast like Scott Glenn, Gabriel Byrne, Jürgen Prochnow, and Ian McKellen, this one misses the mark.  But is there something good about it that we might want to take a second look at?  Then we'll look at Star Trek toy ships.  From brands like Micro Machines, Furuta, Hallmark, Hot Wheels, and Eaglemoss.  So many choices, so little money.

Country: Japan Episode Thirteen Part II is a continuation of the previous episode. If you haven't tuned in to Part I, please go back and listen to that first in order for this to make sense. This episode will include some graphic details.Please proceed with caution.   Opening Song: Junko Furuta by Danilla Ending Song:Taion (体温) by the GazettE All shoutouts and podcast recommendations will resume in the next episode!  Thanks to Sudio Sweden for becoming the very first sponsor for The Asian Madness Podcast!For more information, please visit: https://goo.gl/KyoDyjUse code: ASIANMADNESS for 15% off and free shipping Thank you all for giving this a listen!Please rate, review and subscribe! We have a Patreon Page now! Please visit: https://www.patreon.com/asianmadnesspodOne-time donation on PayPal: https://www.paypal.me/asianmadnesspod Facebook/Instagram/Twitter: asianmadnesspodE-mail: asianmadnesspod@gmail.com  

Country: Japan Episode Thirteen Part I will cover the appalling case of the Japanese girl tortured for 44 days, which eventually led to her death. Her name is Furuta Junko. Part II will be out next Friday. This episode will include some graphic details.Please proceed with caution.   Ending Song: "Sei-En” by Takeda Tetsuya ”声援　ー　武田鉄矢” Podcast Promo/Recommendation: The True Crime Enthusiast Podcast & The True Crime Fan Club Podcast Thank you all for giving this a listen!Please rate, review and subscribe! We have a Patreon Page now! Please visit: https://www.patreon.com/asianmadnesspodOne-time donation on PayPal: https://www.paypal.me/asianmadnesspod Facebook/Instagram/Twitter: asianmadnesspodE-mail: asianmadnesspod@gmail.com

Our second episode of August is here, as prophecy hath foretold!  On this outing, our protagonists Anthony and Paul (and demi-antihero Jeremy) change up the formula a bit! We lead off with our "listening party" segment, and Shatter by Jeramiah "Module" Holmes gets us into a groove with the much-beloved soundtrack to the 2009 brick-breaker. We hope you like music, because we have a LOT of Shatter to share.  Our second feature is an ambivalent pick from Anthony: Square Enix' Chrono Trigger & Chrono Cross Arrangement Album, by Yasunori Mitsuda and Millennial Fair, which wobbles back and forth over that line of "good adaptations." The crew loves a good musical, but we discuss some interesting choices that leave us a bit… conflicted. In our switch-up second segment, Paul gives the grand tour of the last two weeks' news. It's not a financially-overwhelming segment (this time!) but we have a few special highlights that you won't want to miss. How will we ever fit our mandatory Vita mention into this episode? You'll see! Finally, in the third segment, the crew decides it's high time to discuss the art and science of caring for that lovingly-collected vinyl library you've been nurturing. How do we store our records? What's the best way to clean them? Does it make a difference if you change the needle on your record player? How can you make a quick buck cleaning everyone else's records? We cover it all! Join in and share us with your friends! Let us know if you prefer the new format, the old, or if it's no matter! Thanks for listening! Twitter - @vg_grooves, @ajohnagnello, @walnutsoap, @jeremy_lamont Outro: "Chrono Trigger" - Chrono Trigger: The Brink of Time, by Yasunori Mitsuda, arranged by Hiroshi Hata, Hidenori Ohtsuki, and Gizaemon de Furuta, performed by Guido [not dead to us enough that it can't be our outro! -J] Links: Earthworm Jim (Black Screen Records) Curses N Chaos (The Yetee) Wizorb (The Yetee) Night Trap 7" (Limited Run Games, sold out) Ni No Kuni 2 King's Edition (game.co.uk) Enter the Gungeon (Laced Records) Enter the Gungeon (Devolver Digital store) VA-11 HALL-A (Black Screen Records) Photos of the featured albums' art and vinyl discs are found below!

The Squad is back and with us is a very special guest, Vice President of Production IG USA @MakiTerashima. In this interview we talk about some things Production IG has...

Transformation is the theme word today as we talk about his experience from starting his path in Engineering and becoming a corporate leader and what is required to achieve it. He explains the infamous saying, “Getting an Education from MIT is like taking a drink from a Fire Hose”, and the key to a successful admission into your school of choice. Join us as we get a glimpse of MIT!