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Kanemaru A, Ito Y, Yamaoka M, Shirakawa Y, Yonemaru K, Miyake S, Ando M, Ota M, Masuda T, Mukasa A, Li JD, Saito H, Hide T, Jono H. Wnt/β‑catenin signaling is a novel therapeutic target for tumor suppressor CYLD‑silenced glioblastoma cells. Oncol Rep 2023; 50:201. [PMID: 37772388 DOI: 10.3892/or.2023.8638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/28/2023] [Indexed: 09/30/2023] Open
Abstract
Tumor suppressor cylindromatosis (CYLD) dysfunction by its downregulation is significantly associated with poor prognosis in patients with glioblastoma (GBM), the most aggressive and malignant type of glioma. However, no effective treatment is currently available for patients with CYLD‑downregulated GBM. The aim of the present study was to identify the crucial cell signaling pathways and novel therapeutic targets for CYLD downregulation in GBM cells. CYLD knockdown in GBM cells induced GBM malignant characteristics, such as proliferation, metastasis, and GBM stem‑like cell (GSC) formation. Comprehensive proteomic analysis and RNA sequencing data from the tissues of patients with GBM revealed that Wnt/β‑catenin signaling was significantly activated by CYLD knockdown in patients with GBM. Furthermore, a Wnt/β‑catenin signaling inhibitor suppressed all CYLD knockdown‑induced malignant characteristics of GBM. Taken together, the results of the present study revealed that Wnt/β‑catenin signaling is responsible for CYLD silencing‑induced GBM malignancy; therefore, targeting Wnt/β‑catenin may be effective for the treatment of CYLD‑negative patients with GBM with poor prognosis.
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Affiliation(s)
- Ayumi Kanemaru
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Yuki Ito
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Michiko Yamaoka
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Yuki Shirakawa
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Tokyo 113‑8421, Japan
| | - Kou Yonemaru
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Shunsuke Miyake
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Misaki Ando
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Masako Ota
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Takeshi Masuda
- Department of Pharmaceutical Microbiology, Faculty of Life Sciences, Kumamoto University, Kumamoto 862‑0973, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Jian-Dong Li
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA
| | - Hideyuki Saito
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
| | - Takuichiro Hide
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252‑0375, Japan
| | - Hirofumi Jono
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860‑8556, Japan
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Kanemaru A, Shinriki S, Kai M, Tsurekawa K, Ozeki K, Uchino S, Suenaga N, Yonemaru K, Miyake S, Masuda T, Kariya R, Okada S, Takeshita H, Seki Y, Yano H, Komohara Y, Yoshida R, Nakayama H, Li JD, Saito H, Jono H. Potential use of EGFR-targeted molecular therapies for tumor suppressor CYLD-negative and poor prognosis oral squamous cell carcinoma with chemoresistance. Cancer Cell Int 2022; 22:358. [PMCID: PMC9664721 DOI: 10.1186/s12935-022-02781-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Tumor suppressor CYLD dysfunction by loss of its expression, triggers malignant transformation, especially drug resistance and tumor invasion/metastasis. Although loss of CYLD expression is significantly associated with poor prognosis in a large variety of tumors, no clinically-effective treatment for CYLD-negative cancer patients is available.
Methods
We focused on oral squamous cell carcinoma (OSCC), and sought to develop novel therapeutic agents for CYLD-negative cancer patients with poor prognosis. CYLD-knockdown OSCC cells by using CYLD-specific siRNA, were used to elucidate and determine the efficacy of novel drug candidates by evaluating cell viability and epithelial-mesenchymal transition (EMT)-like change. Therapeutic effects of candidate drug on cell line-derived xenograft (CDX) model and usefulness of CYLD as a novel biomarker using patient-derived xenograft (PDX) model were further investigated.
Results
CYLD-knockdown OSCC cells were resistant for all currently-available cytotoxic chemotherapeutic agents for OSCC, such as, cisplatin, 5-FU, carboplatin, docetaxel, and paclitaxel. By using comprehensive proteome analysis approach, we identified epidermal growth factor receptor (EGFR), a receptor tyrosine kinase, played key roles in CYLD-knockdown OSCC cells. Indeed, cell survival rate in the cisplatin-resistant CYLD-knockdown OSCC cells was markedly inhibited by treatment with clinically available EGFR tyrosine kinase inhibitors (EGFR-TKIs), such as gefitinib. In addition, gefitinib was significantly effective for not only cell survival, but also EMT-like changes through inhibiting transforming growth factor-β (TGF-β) signaling in CYLD-knockdown OSCC cells. Thereby, overall survival of CYLD-knockdown CDX models was significantly prolonged by gefitinib treatment. Moreover, we found that CYLD expression was significantly associated with gefitinib response by using PDX models.
Conclusions
Our results first revealed that EGFR-targeted molecular therapies, such as EGFR-TKIs, could have potential to be novel therapeutic agents for the CYLD-negative OSCC patients with poor prognosis.
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Miyake S, Miwa T, Yoneda G, Kanemaru A, Saito H, Minoda R, Orita Y, Saito H, Jono H. Relationship between clinicopathological characteristics and CYLD expression in patients with cholesteatoma. PLoS One 2020; 15:e0240216. [PMID: 33031450 PMCID: PMC7544047 DOI: 10.1371/journal.pone.0240216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/23/2020] [Indexed: 11/19/2022] Open
Abstract
Middle ear cholesteatoma is a destructive disease in which inflammation plays an important role in development and progression, and there are currently no biomarkers predicting prognosis or recurrence. Cylindromatosis (CYLD), a tumor suppressor deubiquitinase, serves as a negative regulator of inflammation expressed in tissues including the middle ear. To determine the clinical significance of CYLD in acquired cholesteatoma, we evaluated CYLD expression in acquired cholesteatoma tissue by immunostaining and analyzed its correlation with clinicopathological characteristics. Our immunohistochemical analysis revealed that CYLD expression levels were varied in the tissues of acquired cholesteatoma patients. The relative expression levels of CYLD in cholesteatoma exhibited a significant correlation with the grade of otorrhea (R = 0.532, p = 0.039). Moreover, the period of epithelialization was also significantly associated with the relative expression levels of CYLD (R = 0.720, p = 0.002). In addition, CYLD expression tended to be lower in the group with recurrence. These results suggest that low CYLD expression correlates with postoperative recovery of acquired cholesteatoma, while potentially affecting the induction of recurrence. This is the first report showing that low CYLD expression correlates with accelerated disease recovery, and suggests a new aspect of CYLD as a prognostic predictor of acquired cholesteatoma.
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Affiliation(s)
- Shunsuke Miyake
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Pharmacy, Kumamoto University Hospital, Kumamoto, Japan
| | - Toru Miwa
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan
- Department of Otolaryngology-Head and Neck Surgery, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Japan
| | - Go Yoneda
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, United States of America
| | - Ayumi Kanemaru
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Haruki Saito
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Ryosei Minoda
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto General Hospital, Kumamoto, Japan
| | - Yorihisa Orita
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Hideyuki Saito
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Pharmacy, Kumamoto University Hospital, Kumamoto, Japan
| | - Hirofumi Jono
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Pharmacy, Kumamoto University Hospital, Kumamoto, Japan
- * E-mail:
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Suenaga N, Kuramitsu M, Komure K, Kanemaru A, Takano K, Ozeki K, Nishimura Y, Yoshida R, Nakayama H, Shinriki S, Saito H, Jono H. Loss of Tumor Suppressor CYLD Expression Triggers Cisplatin Resistance in Oral Squamous Cell Carcinoma. Int J Mol Sci 2019; 20:ijms20205194. [PMID: 31635163 PMCID: PMC6829433 DOI: 10.3390/ijms20205194] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 10/16/2019] [Accepted: 10/19/2019] [Indexed: 02/06/2023] Open
Abstract
Cisplatin is one of the most effective chemotherapeutic agents commonly used for several malignancies including oral squamous cell carcinoma (OSCC). Although cisplatin resistance is a major obstacle to effective treatment and is associated with poor prognosis of OSCC patients, the molecular mechanisms by which it develops are largely unknown. Cylindromatosis (CYLD), a deubiquitinating enzyme, acts as a tumor suppressor in several malignancies. Our previous studies have shown that loss of CYLD expression in OSCC tissues is significantly associated with poor prognosis of OSCC patients. Here, we focused on CYLD expression in OSCC cells and determined whether loss of CYLD expression is involved in cisplatin resistance in OSCC and elucidated its molecular mechanism. In this study, to assess the effect of CYLD down-regulation on cisplatin resistance in human OSCC cell lines (SAS), we knocked-down the CYLD expression by using CYLD-specific siRNA. In cisplatin treatment, cell survival rates in CYLD knockdown SAS cells were significantly increased, indicating that CYLD down-regulation caused cisplatin resistance to SAS cells. Our results suggested that cisplatin resistance caused by CYLD down-regulation was associated with the mechanism through which both the reduction of intracellular cisplatin accumulation and the suppression of cisplatin-induced apoptosis via the NF-κB hyperactivation. Moreover, the combination of cisplatin and bortezomib treatment exhibited significant anti-tumor effects on cisplatin resistance caused by CYLD down-regulation in SAS cells. These findings suggest the possibility that loss of CYLD expression may cause cisplatin resistance in OSCC patients through NF-κB hyperactivation and may be associated with poor prognosis in OSCC patients.
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Affiliation(s)
- Naoki Suenaga
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Mimi Kuramitsu
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Kanae Komure
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Ayumi Kanemaru
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Kanako Takano
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Kazuya Ozeki
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Yuka Nishimura
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Ryoji Yoshida
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Hideki Nakayama
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Satoru Shinriki
- Department of Molecular Laboratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Hideyuki Saito
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
- Department of Pharmacy, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
| | - Hirofumi Jono
- Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
- Department of Pharmacy, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
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Yoshihara S, Baba S, Kanemaru A, Ichikawa T. Craniofacial penetration by a wooden stick. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:393-395. [PMID: 30878510 DOI: 10.1016/j.anorl.2018.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/10/2018] [Accepted: 07/23/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Penetrating craniofacial injuries caused by stick-like foreign bodies occur as a result of accidents particularly in children, and often lead to significant morbidity. CASE SUMMARY We describe a 5-year-old boy who sustained facial trauma after falling on a wooden stick which penetrated his left cheek. At the initial visit, his vital and neurological signs were normal. However, the stick had penetrated the frontal lobe to a depth of 3cm via the orbital cavity and the anterior skull base. The stick was successfully removed while visualizing the anterior skull base in an endoscopic transethmoidal approach. A follow-up examination one year after the accident demonstrated normal visual acuity and ocular motility, with no diplopia, tearing or pain. DISCUSSION Penetrating facial injuries caused by stick-like objects carry a significantly higher risk of serious neurological involvement. Even if penetrating facial injuries sometimes appear trivial, the external injury site is often insufficient to determine the position of the object within the head. Although the cheek is a rare entry site for intracranial injuries, the extent of damage should be assessed fully before attempting removal.
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Affiliation(s)
- S Yoshihara
- Department of Otorhinolaryngology - Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-City, Tokyo 183-8561, Japan.
| | - S Baba
- Department of Otorhinolaryngology - Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-City, Tokyo 183-8561, Japan
| | - A Kanemaru
- Department of Otorhinolaryngology - Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-City, Tokyo 183-8561, Japan
| | - T Ichikawa
- Dolphin west-Funabashi ENT clinic, 2-335-1 Katsushika, Funabashi-City, Chiba 273-0032, Japan
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Kato T, Kanemaru A, Sugawara Y, Kawaji Y, Hiraoka T, Honda T, Nakajima R, Makita A, Itakura A, Yamazaki R, Ohta T. A combination intervention (cognitive training and physical exercise) could improve or maintain cognitive functioning in MCI subjects. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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7
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Kanemaru A, Kato T, Sugawara Y, Kawaji Y, Hiraoka T, Honda T, Nagajima R, Makita A, Itakura A, Yamazaki R, Ota T. The effects of the intervention using physical exercise and cognitive training on the mental status of the elderly with mild cognitive impairment or mild dementia. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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Nakayama T, Yuasa E, Kanemaru A, Saito M, Saitoh H. Construction of a mouse Aos1-Uba2 chimeric SUMO-E1 enzyme, mAU, and its expression in baculovirus-insect cells. Bioengineered 2014; 5:133-7. [PMID: 24637489 DOI: 10.4161/bioe.27544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Small ubiquitin-related modifier (SUMO) is a highly conserved protein that is covalently attached to target proteins. This posttranslational modification, designated SUMOylation, is a major protein-conjugation-driven strategy designed to regulate structure and function of cellular proteins. SUMOylation consists of an enzymatic cascade involving the E1-activating enzyme and the E2-conjugating enzyme. The SUMO-E1 enzyme consists of two subunits, a heterodimer of activation of Smt3p 1 (Aos1) and ubiquitin activating enzyme 2 (Uba2), which resembles the N- and C-terminal halves of ubiquitin E1 (Uba1). Herein, we describe the rational design of a single polypeptide version of SUMO-E1, a chimera of mouse Aos1 and Uba2 subunits, termed mAU, in which the functional domains appear to be arranged in a fashion similar to Uba1. We also describe the construction of a mAU plasmid for expression in a baculovirus-insect cell system and present an in situ SUMOylation assay using the recombinant mAU. Our results showed that mAU has SUMO-E1 activity, thereby indicating that mAU can be expressed in baculovirus-insect cells and represents a suitable source of SUMO-E1.
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Affiliation(s)
- Tomofumi Nakayama
- Department of Biological Sciences; Graduate School of Science and Technology; Kumamoto University; Kumamoto, Japan
| | - Eri Yuasa
- Department of Biological Sciences; Graduate School of Science and Technology; Kumamoto University; Kumamoto, Japan
| | - Ayumi Kanemaru
- Department of Biological Sciences; Graduate School of Science and Technology; Kumamoto University; Kumamoto, Japan
| | - Masayuki Saito
- Department of Biological Sciences; Graduate School of Science and Technology; Kumamoto University; Kumamoto, Japan
| | - Hisato Saitoh
- Department of Biological Sciences; Graduate School of Science and Technology; Kumamoto University; Kumamoto, Japan; Department of New Frontier Sciences; Graduate School of Science and Technology; Kumamoto University; Kumamoto, Japan
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Tokumaru AM, Kamakura K, Terada H, Kobayashi O, Kanemaru A, Kato T, Murayam S, Yamakawa M, Mizuno M. Asymptomatic self-limiting diffuse white matter lesions in subacute to chronic stage of herpes simplex encephalitis. Neuroradiol J 2008; 21:316-22. [PMID: 24256899 DOI: 10.1177/197140090802100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 03/13/2008] [Indexed: 11/17/2022] Open
Abstract
This study evaluated white matter changes in the subacute and chronic stages of herpes simplex encephalitis (HSE). Subjects comprised 15 patients with HSE. All patients were examined using MRI at onset, and then at seven to ten days, three to five weeks and two to three months after onset. In addition, the six patients who displayed white matter signal abnormalities were examined at six months and <one year after onset. Cell count, protein levels, polymerase chain reaction (PCR) of herpes simplex virus in cerebrospinal fluid (CSF), and exacerbation of neurological symptoms as well as dose of acyclovir were compared between patients with and without white matter abnormalities. Diffuse white matter signal changes were identified at the subacute stage (3-5 weeks after onset) of HSE in six patients (6/15, 40%). No significant relationship was observed between the presence of white matter signal abnormalities and laboratory data, acyclovir dose or clinical symptoms. These signal abnormalities disappeared or improved by two years without any clinical treatment. Diffuse white matter signal abnormalities occur frequently in the subacute stage of HSE. Although the mechanisms underlying these white matter lesions have not been elucidated, subclinical immune-mediated processes may be considered. Repeat MRI studies over a long period are necessary for evaluating the clinical process of patients with HSE.
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Affiliation(s)
- A M Tokumaru
- Department of Radiology, Tokyo Metropolitan Medical Center of Gerontology; Tokyo, Japan -
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Abstract
A 57-year-old man became unresponsive and mute with bilateral ophthalmoplegia and quadriplegia. Magnetic resonance imaging (MRI) showed bilateral infarctions at the ventral midbrain and the dorsomedial nucleus of the thalamus. Serial studies with MR and vertebral angiography disclosed hypoperfusion and spontaneous reperfusion of the bilateral posterior cerebral arteries at their origin from the basilar artery. Electroencephalographically, a posteriorly distributed alpha rhythm was clearly recorded and it was reactive in response to external stimuli. The findings seen in the present patient suggest that the ventral midbrain and medial dorsal thalamus are not necessary to produce posterior electroencephalographic alpha activity.
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Affiliation(s)
- S Yazawa
- Department of Neurology, Miyazaki Prefectural Hospital of Nobeoka
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Kanemaru K, Kanemaru A, Kuwajima I. [Antihypertensive therapy in patients with stroke]. Nihon Rinsho 2001; 59:945-8. [PMID: 11391996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Most patients with acute ischemic stroke do not need antihypertensive therapy, because the rapid lowering of blood pressure (BP) may reduce cerebral blood flow due to impaired cerebral autoregulation. In patients with severe hypertension, or associated with other complications (hemorrhagic transformation, myocardial infarction, renal failure or dissection of the aorta), antihypertensive therapy should be done cautiously. In chronic phase, the optimal BP level for the prevention of stroke recurrence remains unclear. The presence of the J-curve phenomenon is still controversial. The several large scale trials are now in progress to determine the optimal BP level for the secondary prevention in stroke patients.
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Affiliation(s)
- K Kanemaru
- Department of Neurology, Tokyo Metropolitan Geriatric Hospital
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12
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Kanemaru A, Kanemaru K, Kuwajima I. The effects of short-term blood pressure variability and nighttime blood pressure levels on cognitive function. Hypertens Res 2001; 24:19-24. [PMID: 11213025 DOI: 10.1291/hypres.24.19] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated the relationship between 24-h blood pressure (BP) and cognitive function. We performed the Hasegawa Dementia Scale Revised (HDSR), the Mini-Mental State Examination (MMSE), and the Raven's Coloured Progressive Matrices Test (RCPM) in 88 subjects (71+/-9 years) with no history of stroke. Ambulatory BP was non-invasively measured using a TM2421 for 24 h in all patients. Whereas 90% of the scores converged into a narrow range between 25 and 30 points in the HDSR and the MMSE tests, the RCPM score was widely distributed, ranging from 9 to 36 points. The subjects were therefore divided into three groups of > or =25, 26-30, and 31-36 according to their RCPM scores. Subjects with lower scores were significantly associated with increased short-term BP variability during the daytime (p<0.05) and had a tendency toward higher nighttime SBP (p=0.05) compared with those with higher scores. Increased short-term variability of daytime BP and high nighttime systolic BP were associated with cognitive impairment as assessed by the RCPM. The RCPM, which can assess the capacity for judgment through visual information processing, may detect earlier stages of cognitive impairment related to high BP. To prevent a deterioration of cognitive function, strict control of nighttime BP and suppression of short-term BP variability are thus necessary.
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Affiliation(s)
- A Kanemaru
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan
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13
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Suzuki Y, Kuwajima I, Aono T, Kanemaru A, Nishinaga M, Shibata H, Ozawa T. Prognostic value of nighttime blood pressure in the elderly: a prospective study of 24-hour blood pressure. Hypertens Res 2000; 23:323-30. [PMID: 10912768 DOI: 10.1291/hypres.23.323] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although it has been suggested in several reports that 24-h ambulatory blood pressure (BP) is a better predictor than casual BP measured in a clinician's office of the incidence of cardiovascular (CV) events, little information is available concerning the prognostic value of nighttime BP in the elderly population. Therefore, to evaluate the clinical implications of the nighttime BP in the elderly, we prospectively followed-up 324 elderly individuals (mean age, 77.2 +/- 7.0 years) who had undergone ambulatory BP monitoring at an annual health examination over a mean follow-up period of 51.5 +/- 22.0 months, and the relationship between BP and CV events was analyzed using Cox's proportional hazard model. For the analysis, 310 participants, excluding 14 subjects who were withdrawn due to non-CV events, were classed into two groups, one consisting of 134 individuals who were undergoing treatment with an anti-hypertensive drug (medicated group) and another consisting of 176 who were not medicated (nonmedicated group). New cardiovascular events developed in 43 cases in the medicated group and in 14 cases in the non-medicated group during the follow-up period. In the medicated group, a linear relationship was observed between BP and the event rates. The hazard ratio for CV events adjusted for age, sex, and other cardiovascular risks was 1.28 (95% confidence interval [CI], 1.05 to 1.54, p< 0.05) for a 10 mmHg increase of 24-h systolic BP. Corresponding values in 24-h diastolic BP, nighttime systolic BP, and nighttime diastolic BP were 1.71 (1.19 to 2.46, p< 0.01), 1.34 (1.13 to 1.58, p< 0.01), and 1.67 (1.20 to 2.31, p< 0.01), respectively. In the non-medicated group, the event rate was least in the subgroup in the second-lowest quartile for nighttime systolic BP, with a slight non-significant increase in the subgroup of the lowest quartile. It was shown that insufficient control of nighttime BP in the elderly with hypertension is associated with the development of CV complications.
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Affiliation(s)
- Y Suzuki
- Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan
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14
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Kanemaru K, Kanemaru A, Kuwajima I. [Antihypertensive treatment for acute and chronic stroke]. Nihon Rinsho 2000; 58 Suppl 2:301-4. [PMID: 11028344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- K Kanemaru
- Department of Neurology, Tokyo Metropolitan Geriatric Hospital
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15
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Kanemaru A, Kuwajima I. [Hypertension and cognitive function]. Nihon Rinsho 2000; 58 Suppl 1:707-13. [PMID: 11026364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- A Kanemaru
- Department of Rehabilitation Medicine, Tokyo Metropolitan Geriatric Hospital
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Kanemaru A, Takahashi R, Yamanaka T, Kubo A, Fujisawa A, Fujimoto T, Sakurai Y, Mochizuki N. [Relationship between cognitive function and discharge place among stroke patients after rehabilitation]. Nihon Ronen Igakkai Zasshi 1998; 35:307-12. [PMID: 9643016 DOI: 10.3143/geriatrics.35.307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
One hundred and ninety-nine elderly stroke patients, who received rehabilitation treatment, were examined, to clarify the relationship between cognitive function and discharge place. The patients who moved to long-term care facilities showed more severe disabilities of basic activities of daily living (ADL), more frequent incontinence, and lower functional impairments (Brunnstrom stage), compared with those discharged to their home. Multivariate regression analysis was done with discharge place as the dependent variable. Independent variables were age, sex, kind of stroke, rehabilitation period, level of ADL and IQ on Kohs test, or performance IQ on the Wechsler Adult Intelligence Scale. Older age, higher levels of ADLs, and higher scores on Kohs test IQ or Wechsler Adult Intelligence Scale Performance IQ were all significantly linked with home discharge. These results suggest that non-verbal cognitive dysfunction may affect discharge place in elderly stroke patients after rehabilitation therapy.
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Affiliation(s)
- A Kanemaru
- Department of Rehabilitation, Tokyo Metropolitan Geriatric Hospital
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Kanemaru A, Kuwajima I. [Antihypertensive therapy of patients with cerebrovascular disease]. Nihon Rinsho 1997; 55:2103-8. [PMID: 9284431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the acute phase of the stroke, it must be prudent to reduce blood pressure (BP) because the rapid reduction might cause the exacerbation of the perfusion pressure to the brain. The target BP level should be higher than the level of primary prevention as the blood pressure regulatory function is disturbed in acute phase. In chronic phase, BP should be reduced so slowly through the several months so as not to cause the ischemia of the brain by rapid reduction of BP. However, the optimal target BP level should be the same degree as the primary prevention level as far as the speed of reduction is taken into consideration. The several large scale trials, are now in progress to determine the optimal BP level for the secondary prevention in the patients with prion stroke.
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Motoyoshi K, Miyawaki S, Hata K, Kuriyama K, Saito K, Kanemaru A, Ono R. [Clinical application of M-CSF on AML patients]. Rinsho Ketsueki 1997; 38:375-9. [PMID: 9194378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Takahashi R, Kanemaru A, Yamanaka T, Sakurai Y, Mochizuki N, Matsukura T, Fujitomi A, Ashikawa S. [Normalization of hypercholesterolemia in a female stroke patient after switching from enteral tube feeding to oral feeding]. Nihon Ronen Igakkai Zasshi 1996; 33:116-9. [PMID: 8656578 DOI: 10.3143/geriatrics.33.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A 70-year-old female was admitted to a general hospital in a rural area due to left putamenal cerebral hemorrhage in December 1994. She had right hemiplegia and was totally aphasic. In May 1995, she was moved to Tokyo where her son lives, and she was admitted to Tokyo Metropolitan Geriatric Hospital in order to prepare a home care system. her family's support (serving her favorite dishes) allowed enteral tube feeding to be halted. After one month she could absorb enough energy to maintain her serum albumin level. The total calories ingested orally was comparable to that of enteral feeding but the fat composition was 62% of that of enteral feeding (fat was 19.6% and 31.7% of the total calories in the two diets, respectively). Her cholesterol level decreased from 286 mg/dl to 197 mg/dl. Nutrient-balanced tube feeding is useful, but may disturb lipid metabolism in patients used to having vegetable-rich diets.
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Affiliation(s)
- R Takahashi
- Geriatric Evaluation & Management Unit., Tokyo Metropolitan Geriatric Hospital, Japan
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20
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Handy DE, Zanella MT, Kanemaru A, Tavares A, Flordellis C, Gavras H. A negative regulatory element in the promoter region of the rat alpha 2A-adrenergic receptor gene overlaps an SP1 consensus binding site. Biochem J 1995; 311 ( Pt 2):541-7. [PMID: 7487893 PMCID: PMC1136033 DOI: 10.1042/bj3110541] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Three subtypes of alpha 2-adrenergic receptors (alpha 2A, alpha 2B and alpha 2C) have been described that differ in their primary sequence and tissue-specific expression and are encoded by three distinct genes. Previous work has shown that the human alpha 2A-adrenergic receptor gene promoter consists of a TATA-box (TATAAA), palindromic sequence (CCCACGTGGG) and GC-box (GGGGCGG) motif. Sequence analysis of the putative promoter region of the rat alpha 2A-adrenergic receptor gene showed that these promoter regions are conserved in their sequence and relative location. We analysed the transcriptional activity of these regions using RINm5F, a rat insulinoma cell line that expresses the endogenous alpha 2A-adrenergic receptor gene. These results showed that the region from -484 to -92 has a negative effect on transcription, as deletion of this region in alpha 2A-adrenergic receptor gene-chloramphenicol acetyltransferase reporter constructs increased reporter gene activity. This region included the GC-box sequence which is a consensus binding site for the nuclear factor SP1, which is a positive activator of transcription. Gel-mobility-shift assays and supershift assays with an antibody that recognizes SP1 showed binding of the SP1 nuclear factor as well as other nuclear factors to this GC-box region. Additional nuclear factors bind to the downstream palindromic region. We suggest that positive- and negative-acting nuclear factors contribute to the activity of the alpha 2-adrenergic receptor promoter.
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Affiliation(s)
- D E Handy
- Department of Medicine, Boston University School of Medicine, MA 02118, USA
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Kuwajima I, Suzuki Y, Kanemaru A, Matsushita S, Kuramoto K, Shibata H. [A study on 24-hour ambulatory blood pressure in normotensive elderly, living in a local home for the aged]. Nihon Ronen Igakkai Zasshi 1992; 29:774-7. [PMID: 1460782 DOI: 10.3143/geriatrics.29.774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Ambulatory blood pressure (BP) was non-invasively monitored in 124 normotensive elderly, living in an old people's home at the annual health examination. Cases were divided into 41 cases < 75 years (group A, mean age 70.6) and 83 cases > or = 75 years (group B, 82.7) for analysis of the office BP and 24-hour BP. Whole-day systolic BP in group B was significantly higher than those in the group A (p < 0.02) although no significant differences were observed in diastolic BP and pulse rate. Separated analysis of whole-day BP into daytime and nighttime revealed that the nighttime systolic BP in the group B was significantly higher than those in group A (132.2 +/- 17.4% vs. 123.8 +/- 18.6 mmHg, p < 0.02) whereas no significant difference was observed in day-time systolic BP between two groups (136.6 +/- 14.9 vs. 132.1 +/- 14.4 mmHg, n.s.). The day-night difference in systolic BP tended to be less in group B than in group A (4.5 +/- 11.6 vs. 8.2 +/- 12.2 mmHg, p < 0.10). The prevalence of non-dippers, who had a higher nighttime systolic BP than daytime systolic BP were 24.4% of the group A and 30.1% of the group B. It was concluded that systolic BP during the nighttime increased with the ageing process after age 60, although that during daytime did not change.
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Affiliation(s)
- I Kuwajima
- Division of Cardiology, Tokyo Metropolitan Geriatric Hospital
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Kuwajima I, Suzuki Y, Shimosawa T, Kanemaru A, Hoshino S, Kuramoto K. Diminished nocturnal decline in blood pressure in elderly hypertensive patients with left ventricular hypertrophy. Am Heart J 1992; 123:1307-11. [PMID: 1533487 DOI: 10.1016/0002-8703(92)91038-3] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To assess the circadian blood pressure (BP) changes in elderly hypertensive patients with left ventricular hypertrophy (LVH), the ambulatory BP was measured noninvasively every 30 minutes for 24 hours in those patients with LVH (n = 15) and without LVH (n = 23), and in normotensive elderly subjects (n = 11). Although the daytime systolic BP (SBP) was comparable in the two hypertensive groups, the nighttime SBP in patients with LVH tended to be higher than in patients without LVH (149.0 +/- 15.1 versus 138.4 +/- 20.1 mm Hg, p less than 0.10). The LV mass index correlated significantly with the nighttime SBP (r = 0.43, p less than 0.01), but not with the daytime SBP (r = 0.24, ns), with clinic SBP (r = 0.14, p = ns) or the SBP after handgrip exercise (r = 0.31, p = ns). The difference in the systolic BP between daytime and nighttime (D-N SBP) in patients with LVH (2.8 +/- 9.4 mm Hg) was significantly less than that in patients without LVH (12.8 +/- 16.0 mm Hg) (p less than 0.02). In addition, the D-N SBP correlated inversely with the left ventricular mass index (r = -0.33, p less than 0.05). It was concluded that hypertension in the elderly with LVH was associated with a diminished nocturnal decline in blood pressure.
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Affiliation(s)
- I Kuwajima
- Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan
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Suzuki Y, Kuwajima I, Kanemaru A, Shimosawa T, Hoshino S, Sakai M, Matsushita S, Ueda K, Kuramoto K. The cardiac functional reserve in elderly hypertensive patients with abnormal diurnal change in blood pressure. J Hypertens 1992; 10:173-9. [PMID: 1313481 DOI: 10.1097/00004872-199202000-00011] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the left ventricular function of hypertensive patients with abnormal diurnal change in blood pressure. DESIGN We compared left ventricular structural and functional characteristics between hypertensive patients with a normal diurnal change in blood pressure (H2 group) and those with a nocturnal blood pressure increment (H1 group) using echocardiography. METHODS The study group consisted of 36 hypertensives and 16 normotensives whose 24-h ambulatory blood pressure monitorings were measured non-invasively. The hypertensive group was subdivided into the H1 group, consisting of 11 patients (76 +/- 7 years), and the H2 group with 25 patients (73 +/- 7 years). The normotensive control group had a mean age of 73 +/- 6 years. Echocardiographic examinations were performed before and at the end of isometric exercise (handgrip for 3 min) and isoproterenol infusion (0.02 micrograms/kg per min for 5 min). RESULTS The left ventricular mass index in the H1 group was significantly greater than in the H2 or control group. Left ventricular fractional shortening (LVFS) at rest in the H1 group was also significantly greater than in the other two groups. However, the peak late: early diastolic filling ratio, which indicated diastolic function, significantly deteriorated in the H1 group compared with the H2 and control groups. Furthermore, changes in LVFS after isometric exercise in the H1 group were more suppressed than in the H2 or control group. In addition, a significantly lower increment in LVFS after isoproterenol was observed in the H1 group compared with the H2 or control group. CONCLUSION The H1 group had greater left ventricular mass and impaired left ventricular functional reserve than the H2 group.
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Affiliation(s)
- Y Suzuki
- Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan
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Konya H, Tamura S, Miyazaki E, Inoue N, Okamoto T, Takemoto Y, Kohsaki M, Kanemaru A, Kakishita E. [L-asparaginase-induced hyperlipidemia in a case of acute lymphoblastic leukemia]. Rinsho Ketsueki 1991; 32:250-4. [PMID: 2041167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 15-y-o girl who had relapsed acute lymphoblastic leukemia, followed by the two-years complete remission, was treated with a reinduction chemotherapy including methotrexate, vincristine, L-asparaginase and dexamethasone (MOAD). During the chemotherapy, a remarkable hyperlipidemia has developed. The plasma levels of triglyceride and total cholesterol reached 14,450 mg/dl and 1,750 mg/dl, respectively. The laboratory data strongly suggest that L-asparaginase could induce this hyperlipidemia of Friedrickson type V. We could successfully reduce the levels of triglyceride and total cholesterol to the normal range by LDL-apheresis, and treat the patient with the chemotherapy excluding L-asparaginase to attain the second CR.
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Affiliation(s)
- H Konya
- 2nd Department of Internal Medicine, Hyogo College of Medicine
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Kuwajima I, Suzuki Y, Hoshino S, Shimozawa T, Kanemaru A, Sakai M, Kuramoto K. Effects of aging on the cardiopulmonary receptor reflex in hypertensive patients. Jpn Heart J 1991; 32:157-66. [PMID: 2067063 DOI: 10.1536/ihj.32.157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In order to evaluate the effects of aging on cardiopulmonary receptor function in hypertensive patients, hemodynamic responses after unloading were studied in middle aged and older hypertensive patients. Twenty-one hypertensive patients were divided into 2 groups according to age. The younger group consisted of 9 patients less than 65 years old (mean age: 57.2 years) and the older group contained 12 patients more than 65 years old (77.2 years). Following 10 min rest, deactivation of cardiopulmonary receptors was obtained by reducing central venous pressure through the application of graded negative pressures of -10, -20, and -40 mmHg to the lower body. Blood pressure, pulse rate, and forearm blood flow were measured at baseline and at each level of negative pressure. Furthermore, plasma norepinephrine and plasma renin activity levels were measured at baseline and at -40 mmHg. Forearm blood flow was measured by venous occlusive plethysmography using a Silastic strain gauge applied around the forearm. Forearm peripheral vascular resistance was calculated by dividing the mean arterial pressure by the forearm blood flow. Baseline mean blood pressure, pulse rate, and peripheral vascular resistance were similar in both age groups. Following lower body negative pressure (LBNP), mean blood pressure and pulse rate did not change, suggesting the selective deactivation of cardiopulmonary receptors. The increase in peripheral vascular resistance at LBNP of -40 mmHg in the older group (20.0 +/- 6.2) was significantly lower than that in the younger group (15.5 +/- 8.9, p less than 0.05). Furthermore, the increase in peripheral vascular resistance after LBNP was inversely related to age (Y = -0.32X + 38.8, r = -0.43, p less than 0.05). Increases in plasma norepinephrine and plasma renin activity in the older group were not different from those in the younger group. It is concluded that the sensitivity of cardiopulmonary baroreceptor function in hypertensive patients deteriorates with increasing age.
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Affiliation(s)
- I Kuwajima
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan
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Suzuki Y, Kuwajima I, Hoshino S, Kanemaru A, Shimozawa T, Matsushita S, Kuramoto K. Cardiac performance in elderly hypertensive patients with left ventricular hypertrophy: responses to isometric exercise and beta-agonists. J Cardiovasc Pharmacol 1991; 17 Suppl 2:S129-32. [PMID: 1715460 DOI: 10.1097/00005344-199117002-00030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To assess the cardiac functional reserve of elderly hypertensive patients with left ventricular hypertrophy (LVH) we studied cardiac function after isometric exercise and beta-adrenergic stimulation. Forty-five elderly hypertensive and 16 normotensive patients (NC group) were recruited for the study. The hypertensive patients were divided into two groups: those with LVH (n = 17) mass index (LV mass index greater than 130 g/m2; H1 group) and those without LVH (n = 28) (H2 group). Echocardiographic studies were performed before and after isometric exercise (handgrip) and isoproterenol (ISP) administration. We measured the LV mass index, fractional shortening (FS), isovolumic relaxation time (IRT), and the ratio of late and early diastolic transmitral flow velocity (A/E). The FS at rest in the H1 group was significantly higher than those in the H2 and NC groups. In the H1 group, the IRT was elongated and A/E was greater than in the NC group, which indicated the impaired diastolic function in the H1 group. After the HG stress, the FS in the H1 group significantly decreased whereas it did not change in the H2 or NC groups. The FS increased in all three groups after the infusion of ISP, although the increment of FS was smaller in the H1 group. In conclusion, (a) diastolic function was impaired whereas systolic function was supranormal at rest in the hypertrophied heart of the elderly hypertensive patients and (b) when exercise or pharmacological stress was loaded, the systolic function deteriorated, suggesting the impairment of cardiac reserve in those patients.
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Affiliation(s)
- Y Suzuki
- Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan
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Hiraoka A, Masaoka T, Satoh T, Ota K, Oyama A, Horiuchi A, Hasegawa H, Nagai K, Kosaki M, Kanemaru A. Hematological response to the new synthetic muramyl dipeptide derivative muroctasin after chemotherapy in patients with malignant lymphoma. A randomized crossover trial. Arzneimittelforschung 1988; 38:1499-501. [PMID: 3058133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A randomized crossover trial was performed in 20 patients receiving chemotherapy for malignant lymphoma. N2-[(N-acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin) at a dose of 200 micrograms was subcutaneously administered after one of two cycles of the same protocol. The administration was started on day 4 after the start of chemotherapy and continued for 10 days. The mean length from the start of chemotherapy to nadir of white blood cell (WBC) was not significantly different between the control and muroctasin cycles. The mean WBC and neutrophil counts at nadir of the control cycle were significantly lower than those at the same point of muroctasin cycle, respectively. A positive effect of muroctasin cycle, defined as WBC count at nadir being increased by 1,000/mm3, WBC count being increased by 1,000/mm3 on two points examined after nadir, or faster reach to nadir and faster recovery to normal range of WBC than in the control cycle, was observed in 7 (35%) of 20 patients. On the other hand, only one (5%) patient showed a superiority of the control cycle over the muroctasin cycle. Toxic effects of muroctasin were observed in 34.8% of patients, but were tolerable for most patients. These results show that muroctasin has a clinical efficacy in the restoration of leukopenia after chemotherapy.
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Affiliation(s)
- A Hiraoka
- Fifth Department of Internal Medicine, Center for Adult Diseases, Osaka, Japan
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Hara H, Kanemaru A, Hamano T, Nagai K. [Studies on the erythroblast kinetics and colony stimulating activity in aplastic anemia (author's transl)]. Rinsho Ketsueki 1973; 14:1311-24. [PMID: 4807683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Yoshioka K, Tono K, Kanemaru A, Tatsuya T. [Current status of SMON in a section of Northern Settsu area in Osaka Prefecture and some etiological considerations]. Nihon Ishikai Zasshi 1971; 66:1439-46. [PMID: 5169680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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