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Ujiie G, Murase M, Asai H, Igawa M, Okuyama A, Seo K, Ichizuka K, Ikeda H. Intrapartum prophylactic efficacy of ampicillin versus clindamycin in preventing vertical transmission of group B Streptococcus. Acta Paediatr 2024. [PMID: 38578153 DOI: 10.1111/apa.17230] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
AIM To compare the prophylactic efficacy of ampicillin and clindamycin against vertical transmission of group B Streptococcus from mothers to their infants by evaluating the rates of group B Streptococcus colonisation. METHODS We retrospectively extracted data for mothers who delivered at Showa University Northern Yokohama Hospital between 1 October 2017 and 31 March 2021 and tested positive for antepartum group B Streptococcus, and their infants. The chi-square test was used to compare the rates of group B Streptococcus colonisation, sepsis, and meningitis. We conducted a multivariate logistic regression analysis, including the time interval between membrane rupture and delivery, chorioamnionitis, and maternal intrapartum fever (≥38.0°C). RESULTS Two hundred fifty-nine mothers and their infants were eligible. Ampicillin and clindamycin were administered to 150 and 109 mothers, respectively. In the ampicillin and clindamycin groups, 12.0% (18/150) and 37.6% (41/109) infants were group B Streptococcus positive, respectively. The rate of group B Streptococcus colonisation among infants was significantly lower in the ampicillin group (p < 0.001). Multivariate regression analysis showed similar results (p < 0.001). No sepsis or meningitis cases were observed in either group. CONCLUSION Prophylactic efficacy of clindamycin against the vertical transmission of group B Streptococcus is lower than that of ampicillin.
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Affiliation(s)
- Gakuto Ujiie
- Children Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Masahiko Murase
- Children Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Hideyuki Asai
- Children Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Mio Igawa
- Children Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Ayumi Okuyama
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Kohei Seo
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Kiyotake Ichizuka
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Hirokazu Ikeda
- Children Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
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Takahashi H, Tanaka H, Osuga Y, Miura K, Saito S, Sato S, Sugawara J, Ide S, Koh I, Yamauchi K, Okuyama A, Okuno K, Kuwata T, Fujieda S, Ikeda T. Retained products of conception (RPOC) following delivery without placenta previa: Which patients with RPOC show postpartum hemorrhage? Placenta 2022; 124:12-17. [DOI: 10.1016/j.placenta.2022.05.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
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Nakamura T, Seo K, Okuyama A, Ichizuka K, Sekizawa A, Nagatsuka M. Infective endocarditis due to Streptococcus agalactiae in the puerperal period. J Obstet Gynaecol Res 2021; 47:2238-2241. [PMID: 33754408 DOI: 10.1111/jog.14757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/16/2020] [Revised: 02/21/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Abstract
Streptococcus agalactiae, also known as group B Streptococcus, is a species of bacteria occasionally detected in the vagina and/or rectum of pregnant women. This report describes the case of a 33-year-old woman who developed infective endocarditis on puerperal day 17, owing to group B Streptococcus, and required lifesaving surgery. The patient was rushed to our hospital with chief complaints of fever and fatigue. After hospitalization, antibiotics were administered; however, the symptoms did not improve. Following a detailed examination, vegetation was found in the heart, suggestive of infective endocarditis. Surgical removal of the vegetation improved the patient's condition. The development of group B Streptococcus infection and infective endocarditis in a pregnant woman with no risk factors is rare. This case confirms that this patient's life was saved by a timely diagnosis and appropriate therapeutic intervention.
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Affiliation(s)
- Takeshi Nakamura
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan
| | - Kohei Seo
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan
| | - Ayumi Okuyama
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan
| | - Kiyotake Ichizuka
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology, Showa University Hospital, Shinagawa, Japan
| | - Masaaki Nagatsuka
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan
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Yanagiya R, Suzuki T, Nakamura S, Fujita K, Oyama M, Okuyama A, Sugasawa K, Nakayama T, Suzuki Y, Ishizawa K, Saito S. TAFRO Syndrome Presenting with Retroperitoneal Panniculitis-like Computed Tomography Findings at Disease Onset. Intern Med 2020; 59:997-1000. [PMID: 31839656 PMCID: PMC7184093 DOI: 10.2169/internalmedicine.3740-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
TAFRO syndrome is rare, and its pathophysiology remains unclear. We herein report the case of a 66-year-old man who presented at our emergency department with epigastric pain. Contrast-enhanced computed tomography (CT) showed high-density retroperitoneal panniculus with contrast enhancement. He was treated initially with a protease inhibitor and hydration, to little effect. Anasarca, thrombocytopenia, and renal dysfunction developed gradually, and TAFRO syndrome was diagnosed. He was treated successfully with prednisolone and cyclophosphamide, and subsequent CT findings showed improvement. Abnormal CT findings of the retroperitoneum may indicate the early stages of TAFRO syndrome before the presentation of typical ascites.
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Affiliation(s)
- Ryo Yanagiya
- Department of Internal Medicine, Nihonkai General Hospital, Japan
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (3rd internal medicine), Yamagata University Faculty of Medicine, Japan
| | - Takuma Suzuki
- Department of Internal Medicine, Okitama Public General Hospital, Japan
| | - Shuhei Nakamura
- Department of Gastroenterology, Nihonkai General Hospital, Japan
| | - Kotaro Fujita
- Department of Internal Medicine, Nihonkai General Hospital, Japan
| | - Midori Oyama
- Department of Internal Medicine, Nihonkai General Hospital, Japan
| | - Ayumi Okuyama
- Department of Internal Medicine, Nihonkai General Hospital, Japan
| | - Kunie Sugasawa
- Department of Internal Medicine, Nihonkai General Hospital, Japan
| | | | - Yoshihiro Suzuki
- Department of Gastroenterology, Nihonkai General Hospital, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (3rd internal medicine), Yamagata University Faculty of Medicine, Japan
| | - Soichi Saito
- Department of Internal Medicine, Nihonkai General Hospital, Japan
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Saito S, Okuyama A, Okada Y, Shibata A, Sakai R, Kurasawa T, Kondo T, Takei H, Amano K. Tocilizumab monotherapy for large vessel vasculitis: results of 104-week treatment of a prospective, single-centre, open study. Rheumatology (Oxford) 2019; 59:1617-1621. [DOI: 10.1093/rheumatology/kez511] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/01/2019] [Indexed: 12/15/2022] Open
Abstract
Abstract
Objective
To evaluate the efficacy and safety of tocilizumab (TCZ) monotherapy for large vessel vasculitides (LVV), including Takayasu arteritis (TAK) and GCA.
Methods
Twelve patients with a newly diagnosed LVV (eight GCA, four TAK) were enrolled. One TAK patient withdrew consent, so 11 (eight GCA, three TAK) were analysed in a prospective, open-label study. TCZ (8 mg/kg) monotherapy, without glucocorticoids or immunosuppressants, was administered every 2 weeks for 2 months and then every 4 weeks for 10 months. Patients were followed for 1 year after the final TCZ dose. Complete and partial responses were defined as disappearance or improvement of all clinical symptoms and normalization of CRP. Relapse was defined as the worsening or recurrence of clinical symptoms, increase in CRP attributable to vasculitis, and/or the need for initiation of glucocorticoids and/or immunosuppressants. Poor clinical response described patients who did not fit the definition of complete response or partial response.
Results
Complete and partial responses rates were 75/66% and 25/0% in GCA/TAK patients, respectively, at week 24 and week 52. Five GCA patients and one TAK patient remained disease-free for 1 year after therapy. One GCA patient required TCZ discontinuation due to heart failure at week 24.
Conclusion
TCZ monotherapy showed a high response rate for newly diagnosed LVV patients, and the majority of patients did not relapse for 1 year after TCZ cessation. Result of this study could help us to understand the crucial role of IL-6 in the pathogenesis of LVV.
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Affiliation(s)
- Shuntaro Saito
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
- Division of Rheumatology, Department of Internal Medicine
| | - Ayumi Okuyama
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
| | - Yusuke Okada
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
| | - Akiko Shibata
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
| | - Ryota Sakai
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan
| | - Takahiko Kurasawa
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
| | - Tsuneo Kondo
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
| | - Hirofumi Takei
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical Centre, Saitama Medical University, Saitama
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Chino K, Kondo T, Sakai R, Saito S, Okada Y, Shibata A, Kurasawa T, Okuyama A, Takei H, Amano K. Tocilizumab monotherapy for polymyalgia rheumatica: A prospective, single‐center, open‐label study. Int J Rheum Dis 2019; 22:2151-2157. [DOI: 10.1111/1756-185x.13723] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Kentaro Chino
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
| | - Tsuneo Kondo
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
| | - Ryota Sakai
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
- Department of Microbiology and Immunology Keio University School of Medicine Tokyo Japan
| | - Shuntaro Saito
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
- Division of Rheumatology Department of Internal Medicine Keio University School of Medicine Tokyo Japan
| | - Yusuke Okada
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
| | - Akiko Shibata
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
| | - Takahiko Kurasawa
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
| | - Ayumi Okuyama
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
| | - Hirofumi Takei
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology Saitama Medical Center Saitama Medical University Saitama Japan
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Moutabarrik A, Ishibashi M, Kameoka H, Kawaguchi N, Takano Y, Kokado Y, Onishi S, Sonoda T, Takahara S, Okuyama A. In vitro FK506 kidney tubular cell toxicity. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.87] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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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Moutabarrik A, Ishibashi M, Fukunaga M, Kameoka H, Takano Y, Kokado Y, Sonoda T, Takahara S, Okuyama A. FK506 mechanism of nephrotoxicity: stimulatory effect on endothelin secretion by cultured kidney cells. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.93] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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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9
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Tokuhira M, Saito S, Okuyama A, Suzuki K, Higashi M, Momose S, Shimizu T, Mori T, Anan-Nemoto T, Amano K, Okamoto S, Takeuchi T, Tamaru JI, Kizaki M. Clinicopathologic investigation of methotrexate-induced lymphoproliferative disorders, with a focus on regression. Leuk Lymphoma 2017; 59:1143-1152. [DOI: 10.1080/10428194.2017.1369073] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Michihide Tokuhira
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
| | - Shuntaro Saito
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
- Division of Rheumatology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ayumi Okuyama
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
| | - Katsuya Suzuki
- Division of Rheumatology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Morihiro Higashi
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
| | - Shuji Momose
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
| | - Takayuki Shimizu
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tomoe Anan-Nemoto
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun-Ichi Tamaru
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe Saitama, Japan
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Kikuchi J, Kondo T, Shibata A, Sakai R, Okada Y, Chino K, Okuyama A, Kurasawa T, Takei H, Amano K. Efficacy and tolerability of six-week extended dosing interval with tocilizumab therapy in a prospective cohort as remission maintenance in patients with rheumatoid arthritis. Mod Rheumatol 2017; 28:444-451. [PMID: 28849709 DOI: 10.1080/14397595.2017.1366092] [Citation(s) in RCA: 4] [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] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To prospectively evaluate the efficacy and tolerability of a six-week extended dosing interval with tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) in sustained remission. METHODS Patients who received over six doses of intravenous TCZ in clinical remission (disease activity score [DAS] 28 - erythrocyte sedimentation rate [ESR] ≤ 2.6) maintained over 3 months between December 2013 and December 2015 were included. Flare was defined as DAS28-ESR >3.2 at two consecutive visits. RESULTS Twenty-five patients were enrolled; 87.5% achieved clinical remission at week 54 after six-week extension and 95.5% achieved a van der Heijde modified total Sharp score (ΔmTSS) ≤0.5. The Health Assessment Questionnaire Disability Index (HAQ-DI) did not increase during 54 weeks. HAQ-DI at baseline and ΔDAS28-ESR at week six positively correlated with increase in DAS28-ESR at week 54. ΔSwollen joint count at week six positively correlated with ΔmTSS at week 54. A total of 12 adverse events occurring in 10 patients did not lead to cessation of TCZ except for one case of recurrent lymphoproliferative disorder at week five. CONCLUSION A six-week extended dosing interval of TCZ for patients with RA in sustained remission is proposed as an acceptable treatment option for maintaining efficacy and tolerability.
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Affiliation(s)
- Jun Kikuchi
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan.,b Division of Rheumatology, Department of Internal Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Tsuneo Kondo
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Akiko Shibata
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Ryota Sakai
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan.,c Department of Microbiology and Immunology , Keio University School of Medicine , Tokyo , Japan
| | - Yusuke Okada
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Kentaro Chino
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Ayumi Okuyama
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Takahiko Kurasawa
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Hirofumi Takei
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Koichi Amano
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
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Sakai R, Kurasawa T, Nishi E, Kondo T, Okada Y, Shibata A, Nishimura K, Chino K, Okuyama A, Takei H, Nagasawa H, Amano K. Efficacy and safety of multitarget therapy with cyclophosphamide and tacrolimus for lupus nephritis: a prospective, single-arm, single-centre, open label pilot study in Japan. Lupus 2017; 27:273-282. [DOI: 10.1177/0961203317719148] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- R Sakai
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
- Department of Microbiology and Immunology, Keio University, Tokyo, Japan
| | - T Kurasawa
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
| | - E Nishi
- Institute of Rheumatology, Zenjinkai Shimin-no-Mori Hospital, Miyazaki, Japan
| | - T Kondo
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
| | - Y Okada
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
| | - A Shibata
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
| | - K Nishimura
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
- Division of Rheumatology, Japan Community Health Care Organization, Saitama, Japan
| | - K Chino
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
| | - A Okuyama
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
| | - H Takei
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
| | - H Nagasawa
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
- Nagasawa Clinic, Saitama, Japan
| | - K Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Saitama, Japan
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Tokuhira M, Tabayashi T, Tanaka Y, Takahashi Y, Kimura Y, Tomikawa T, Anan-Nemoto T, Momose S, Higashi M, Okuyama A, Watanabe R, Amano K, Tamaru JI, Kizaki M. The aggressive clinical courses of Hodgkin lymphoma primarily diagnosed as methotrexate-induced non-specific lymphoproliferative disorder in patients with rheumatoid arthritis. J Clin Exp Hematop 2017; 56:165-169. [PMID: 28331131 DOI: 10.3960/jslrt.56.165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Recently, attention has been focused on methotrexate-induced lymphoproliferative disease (MTX-LPD), and atypical phenotypes are occasionally documented. We encountered two patients with rheumatoid arthritis (RA) who were diagnosed with non-specific LPD (LPD-nos). Biopsy samples were not obtained during the initial examination when the LPD development was discovered, and the patients achieved a complete response after MTX cessation (case 1) or steroid pulse therapy (case 2). However, the tumors flared up 1.5 years later, and LPD-nos was determined following biopsies of the lymph node (LN, case 1) and liver (case 2). Prednisolone was subsequently administered instead of chemotherapy; however, multiple masses, including in the spine (case 1), and severe icterus with liver dysfunction (case 2) were exacerbated within a few months. Although the re-biopsy of LN proved the presence of HL and radiation followed by aggressive chemotherapy rescued the patient (case 1), the superficially accessible biopsy site was not found, and autopsy finally revealed HL (case 2). In both cases, the underlying pathogenesis along with the B symptoms and laboratory abnormalities suggested MTX-LPD, HL in particular. Therefore, even if the pathological diagnosis does not confirm the specific LPD subtype, the administration of aggressive chemotherapy should be considered if the LPD activity flares severely.
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Affiliation(s)
- Michihide Tokuhira
- Department of Hematology, Saitama Medical Center, Saitama Medical University
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Abstract
The serine protease inhibitors, aprotinin and 6-amidino-2-naphthyl-p-guanidinobenzoate (Futhan), showed striking antiviral activity in the plaque assay of the canine kidney (MDCK) cell-WSN strain system. Anti-cathepsin B IgG antibody/showed the greatest inhibitory effect on plaque formation, followed by anti-factor X antibody and then anti-plasminogen antibody. Anti-cathepsin B antibody inhibited the proteolytic cleavage of haemagglutinin (HA). These results suggest that a serine protease-like enzyme and the other protein that binds to anti-cathepsin B antibody may be involved in the process of WSN HA cleavage on the membrane surface of MDCK cells.
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Affiliation(s)
- A. Someya
- Applied Enzymology, Molecular Biology Research Laboratories, Tsukuba Research Institute, Banyu Pharmaceutical Co., Ltd, Tsukuba Techno-park Oho Okubo 3, Tsukuba 300-33 Japan
| | - N. Tanaka
- Applied Enzymology, Molecular Biology Research Laboratories, Tsukuba Research Institute, Banyu Pharmaceutical Co., Ltd, Tsukuba Techno-park Oho Okubo 3, Tsukuba 300-33 Japan
| | - A. Okuyama
- Applied Enzymology, Molecular Biology Research Laboratories, Tsukuba Research Institute, Banyu Pharmaceutical Co., Ltd, Tsukuba Techno-park Oho Okubo 3, Tsukuba 300-33 Japan
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14
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Chino K, Shibata A, Okuyama A, Kondo T, Kikuchi J, Sakai R, Takei H, Amano K. THU0576 Tocilizumab Mono-Therapy for Polymyalgia Rheumatica ∼ A Single-Center, Open, Single-Arm Trial. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1894] [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: 11/03/2022]
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15
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Sakai R, Yoshimoto K, Kondo T, Kurasawa T, Shibata A, Kikuchi J, Chino K, Okuyama A, Takei H, Suzuki K, Takeuchi T, Amano K. FRI0389 An Increase in Treg- and Th2-Associated Serum Chemokines, MDC (CCL22) and TARC (CCL17) during Tocilizumab Monotherapy in Patients with Microscopic Polyangiitis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3190] [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: 11/04/2022]
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Sakai R, Kondo T, Kikuchi J, Shibata A, Chino K, Okuyama A, Takei H, Amano K. Corticosteroid-free treatment of tocilizumab monotherapy for microscopic polyangiitis: a single-arm, single-center, clinical trial. Mod Rheumatol 2016; 26:900-907. [PMID: 26934300 DOI: 10.3109/14397595.2016.1160968] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 12/15/2022]
Abstract
OBJECTIVES To assess the efficacy of tocilizumab (TCZ) monotherapy for the remission induction of microscopic polyangiitis (MPA) in a prospective single-arm, single-center, cohort, pilot study. METHODS Eligible patients were aged between 20 and 80 years and were newly diagnosed with MPA according to Watts' classification algorithm. Seven patients received 8 mg/kg of intravenous TCZ fortnightly for the first 2 months (5 courses), and monthly for the next 10 months (10 courses). One year after TCZ monotherapy, the patients were followed-up without any treatment. The protocol did not permit the use corticosteroids or any other immunosuppressants. Complete remission (CR) was defined as the Birmingham Vasculitis Activity Score of 0 at two consecutive visits made at least a month apart. RESULTS CR was achieved in two of six patients (33.3%) at 6 months and three patients (50.0%) at 12 months. Two patients were withdrawn: one because of inefficacy at 6 weeks and the other because of flare at 6 months. One patient voluntarily withdrew after CR at 3 months. Four patients (66.7%) could be kept drug-free after 1 year of TCZ without relapse for 6-15 months at the last visit. CONCLUSION TCZ monotherapy may be an alternative treatment strategy in some patients with MPA.
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Affiliation(s)
- Ryota Sakai
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
| | - Tsuneo Kondo
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
| | - Jun Kikuchi
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
| | - Akiko Shibata
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
| | - Kentaro Chino
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
| | - Ayumi Okuyama
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
| | - Hirofumi Takei
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
| | - Koichi Amano
- a Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan
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Sakai R, Shibata A, Chino K, Kondo T, Okuyama A, Takei H, Amano K. AB0530 Efficacy and Safety of Multi-Target Therapy Using a Combination of Cyclophosphamide and Tacrolimus in Patients with Refractory Lupus Nephritis: A Prospective, Single-Arm, Open-Label Study of 13 Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3656] [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: 11/04/2022]
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18
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Sakai R, Shibata A, Chino K, Kondo T, Okuyama A, Takei H, Amano K. Corticosteroid- and cyclophosphamide-free treatment of anti-neutrophil cytoplasmic antibody-associated vasculitis using tocilizumab. Mod Rheumatol 2015; 25:810-1. [DOI: 10.3109/14397595.2015.1021138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Terai C, Tsutsumi T, Sakurai T, Moriguchi M, Azuma T, Kaneko M, Kawagoe M, Hoshi K, Yoshida H, Matsui T, Nakajima K, Okuyama A, Nishi E, Amano K, Ota M, Mimura T, Chino K, Aoki K, Handa Y, Hirose T, Kida I, Kobayashi S, Suzuki K, Matsuzaki T, Kuga Y. The efficacy of mizoribine for the treatment of rheumatoid arthritis and its correlation with renal function. Mod Rheumatol 2014; 24:892-6. [DOI: 10.3109/14397595.2014.885376] [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: 11/13/2022]
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Tokuhira M, Kimura Y, Nemoto T, Sagawa M, Tomikawa T, Sakai R, Okuyama A, Amano K, Higashi M, Tamaru JI, Mori S, Tabayashi T, Watanabe R, Kizaki M. Therapy-related myeloid neoplasm in methotrexate-associated lymphoproliferative disease in a rheumatoid arthritis patient. J Clin Exp Hematop 2014; 54:137-41. [PMID: 25318946 DOI: 10.3960/jslrt.54.137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Michihide Tokuhira
- Departments of Hematology, Saitama Medical Center, Saitama Medical University
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Sakai R, Shibata A, Chino K, Okuyama A, Kondo T, Nishi E, Takei H, Nagasawa H, Amano K. AB0497 The Euro-Lupus Protocol plus Tacrolimus for Lupus Nephritis: Potentiality of Multi-Target Therapy. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4247] [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: 11/03/2022]
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Nishi E, Kameda H, Ogawa H, Nagasawa H, Takei H, Okuyama A, Kurasawa T, Kondo T, Nishimura K, Shirai Y, Sakai R, Ito T, Takeuchi T, Amano K. Efficacy of weekly mizoribine pulse therapy in refractory lupus nephritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0645-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Eiko Nishi
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Hideto Kameda
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University,
35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Hiroe Ogawa
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Hayato Nagasawa
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Hirofumi Takei
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Ayumi Okuyama
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Takahiko Kurasawa
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University,
35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Tsuneo Kondo
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Koji Nishimura
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Yuichiro Shirai
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University,
35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Ryota Sakai
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Tatsuya Ito
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
- Department of Internal Medicine, Saitama Yorii Hospital,
395 Yodo, Yorii, Ohsato County, Saitama 369-1211, Japan
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University,
35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Koichi Amano
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University,
35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
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Nishimura K, Sakai R, Kondo T, Kurasawa T, Okuyama A, Nishi E, Shirai Y, Takei H, Nagasawa H, Amano K. AB0549 Discontinuation of methotrexate (MTX) in rheuamtoid arthritis (RA) patients receiving tocilizumab (TCZ). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.549] [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: 11/03/2022]
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24
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Okuyama A, Nagasawa H, Kondo T, Nishi E, Takei H, Sakai R, Chino K, Shibata A, Amano K. AB0209 Retrospective analysis of rheumatoid arthritis patients complicated with mtx-related lymphoproliferative diseases. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2532] [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: 11/04/2022]
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25
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Kurasawa T, Nagasawa H, Nishi E, Takei H, Okuyama A, Kondo T, Nishimura K, Sakai R, Shibata A, Chino K, Ogawa H, Ito T, Amano K, Kato H. Successful treatment of class IV+V lupus nephritis with combination therapy of high-dose corticosteroids, tacrolimus and intravenous cyclophosphamide. Intern Med 2013; 52:1125-30. [PMID: 23676603 DOI: 10.2169/internalmedicine.52.9366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 11/06/2022] Open
Abstract
A substantial number of patients with lupus nephritis (LN) are refractory to conventional glucocorticoid (GC) treatment. Although many of these patients respond to immunosuppressive drugs such as intravenous cyclophosphamide (IVCY), azathioprine (AZA), mizoribine, tacrolimus, cyclosporine A (CSA) and mycofenolate mofetil (MMF), some remain refractory to such therapies. Recent studies of multi-target therapies have reported effective outcomes for immunosuppression following renal transplantation and refractory LN when therapy consists of two or more immunosuppressive drugs with different mechanisms of action. We herein report a case of LN unresponsive to IVCY that was successfully treated with the addition of tacrolimus and discuss the usefulness of multi-target therapy for LN.
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Affiliation(s)
- Takahiko Kurasawa
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Japan
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26
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Nishi E, Kameda H, Ogawa H, Nagasawa H, Takei H, Okuyama A, Kurasawa T, Kondo T, Nishimura K, Shirai Y, Sakai R, Ito T, Takeuchi T, Amano K. Efficacy of weekly mizoribine pulse therapy in refractory lupus nephritis. Mod Rheumatol 2012; 23:97-103. [PMID: 22526831 DOI: 10.1007/s10165-012-0645-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 03/22/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We investigated the efficacy of a high-dose intermittent dosing treatment method (weekly mizoribine pulse therapy) conceived in the hope of achieving better efficacy by increasing the peak blood levels of mizoribine in patients with refractory lupus nephritis. METHODS Seventeen patients with lupus nephritis who had been resistant to corticosteroid and immunosuppressant therapy received weekly mizoribine pulse therapy. Mizoribine (350 mg) was administered three times at 12 h intervals over 2 consecutive days (700 mg for day 1 and 350 mg for day 2), followed by a washout period from day 3 to day 7. RESULTS This therapeutic strategy enabled the peak blood levels of mizoribine to be increased to more than 3 μg/mL in most of the patients. Although SLEDAI, anti-ds-DNA antibody titer, CH-50, and serum albumin level did not significantly improve, urinary protein levels decreased, and it was possible to taper the dose of concomitant steroids. Using our definition of clinical response, 10 of the 17 patients were responders and 4 of them were nonresponders. The average peak serum mizoribine concentration of the responders was as high as 3.5 μg/mL. Elevation of serum liver enzymes was seen in 1 patient, and hyperuricemia occurred in 4 cases, but none of these adverse events were serious. CONCLUSION Intermittent administration of mizoribine can increase blood levels and may be effective for refractory lupus nephritis.
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Affiliation(s)
- Eiko Nishi
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
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27
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Hasegawa J, Nakamura M, Hamada S, Okuyama A, Matsuoka R, Ichizuka K, Sekizawa A, Okai T. Gestational weight loss has adverse effects on placental development. J Matern Fetal Neonatal Med 2012; 25:1909-12. [DOI: 10.3109/14767058.2012.664666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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28
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Kuratsukuri K, Tsujimura A, Akino H, Oguchi N, Kitagawa Y, Segawa N, Tamada S, Tuji H, Watanabe A, Urashima M, Okuyama A, Uemura H, Katsuoka Y, Nakatani T, Namiki M, Fuse H, Matsuda T, Yokoyama O. 745 Randomized controlled trial of nocturia in patients with benign prostatic hyperplasia with overactive bladder using an alpha-blocker combined with a novel antichorinergic, imidafenacin; GOOD-NIGHT Study. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s1569-9056(12)60742-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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29
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Sakai R, Nagasawa H, Nishi E, Okuyama A, Takei H, Kurasawa T, Kondo T, Nishimura K, Shirai Y, Ito T, Kameda H, Takeuchi T, Amano K. Successful treatment of adult-onset Still’s disease with tocilizumab monotherapy: two case reports and literature review. Clin Rheumatol 2012; 31:569-74. [DOI: 10.1007/s10067-011-1917-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 12/15/2011] [Indexed: 10/14/2022]
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30
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Takei H, Nagasawa H, Sakai R, Nishimura K, Kurasawa T, Okuyama A, Nishi E, Shirai Y, Kondo T, Ogawa H, Ito T, Amano K. A case of multiple giant coronary aneurysms and abdominal aortic aneurysm coexisting with IgG4-related disease. Intern Med 2012; 51:963-7. [PMID: 22504260 DOI: 10.2169/internalmedicine.51.6944] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [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: 11/06/2022] Open
Abstract
IgG4-related disease (IgG4RD) is a unique systemic lymphoproliferative disorder characterized by elevated serum IgG4 levels and IgG4-producing plasma cell expansion in the affected tissues, which are accompanied by fibrotic or sclerotic changes. Vascular lesions may also be a part of IgG4RD as a number of case reports have discussed inflammatory abdominal aortic aneurysms associated with IgG4RD, but coronary artery lesions seem to be rare complications of IgG4RD. A 71-year-old man suffered from multiple giant coronary aneurysms and an abdominal aortic aneurysm with concurrent pancreatic, gall bladder, bile duct, and salivary gland lesions resulting from IgG4RD. The present observations suggest that coronary aneurysms may also develop as a consequence of this disease.
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Affiliation(s)
- Hirofumi Takei
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Japan
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31
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Takao T, Tsujimura A, Miyagawa Y, Nonomura N, Okuyama A. 54 LUTS, ED and depression among Japanese patients with late-onset hypogonadism symptoms. Journal of Men's Health 2011. [DOI: 10.1016/s1875-6867(11)60087-0] [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: 10/18/2022] Open
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32
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Toki K, Kyo M, Takahara S, Hatori M, Morozumi K, Ichimaru N, Tanaka T, Wang JD, Permpongkosol S, Miyamoto M, Oka K, Imai E, Kyakuno M, Nakamura T, Kojima Y, Inoue T, Kameoka H, Ding XQ, Kokado Y, Okuyama A. Clinocopathological evaluation in non-episode biopsies of renal transplant allograft. Transpl Int 2011. [DOI: 10.1111/j.1432-2277.2000.tb02121.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Hatano K, Nonomura N, Nishimura K, Kawashima A, Mukai M, Nagahara A, Nakai Y, Nakayama M, Takayama H, Tsujimura A, Okuyama A. Retrospective Analysis of an Oral Combination of Dexamethasone, Uracil plus Tegafur and Cyclophosphamide for Hormone-refractory Prostate Cancer. Jpn J Clin Oncol 2010; 41:253-9. [DOI: 10.1093/jjco/hyq178] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Okuyama A, Nagasawa H, Suzuki K, Kameda H, Kondo H, Amano K, Takeuchi T. Fcγ receptor IIIb polymorphism and use of glucocorticoids at baseline are associated with infusion reactions to infliximab in patients with rheumatoid arthritis. Ann Rheum Dis 2010; 70:299-304. [PMID: 20980704 PMCID: PMC3015102 DOI: 10.1136/ard.2010.136283] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective Infusion reaction is a major adverse event in patients with rheumatoid arthritis (RA) treated with infliximab. The possible factors including Fcγ receptor (FcγR) polymorphism associated with the development of infusion reactions in patients with RA receiving infliximab were prospectively examined. Methods 96 patients with RA were enrolled and scheduled to receive infliximab at a dose of 3 mg/kg at weeks 0, 2 and 6 and every 8 weeks thereafter. Genetic polymorphisms for FcγR were examined in FCGR3A 176F/V and FCGR3B NA1/2 alleles by allele-specific PCR analysis. Results An infusion reaction was observed in 17 patients (18%) during 52 weeks of treatment with infliximab. The FCGR3B NA1/NA1 genotype was found in 75% of the patients with infusion reactions and in only 37% of those without (p=0.01), whereas the FCGR3A 176F/V genotype was equally distributed in the patients with or without infusion reactions. Glucocorticoids were used in 53% of the patients who developed an infusion reaction and in 80% of those without an infusion reaction (p=0.02). A multivariable logistic regression model showed that the FCGR3B NA1/NA1 genotype and use of glucocorticoids at baseline could be used as independent predictive factors for infusion reactions (OR 6.1 (95% CI 1.9 to 24.3) and OR 0.26 (95% CI 0.08 to 0.84), respectively). The presence of anti-infliximab antibody during infliximab treatment was also associated with infusion reactions. Conclusion FCGR3B NA1/NA1 genotype, use of glucocorticoids and the presence of anti-infliximab antibody accounted for nearly all patients with RA who developed infusion reactions.
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Affiliation(s)
- Ayumi Okuyama
- Rheumatology/Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Suzuki K, Tamaru JI, Okuyama A, Kameda H, Amano K, Nagasawa H, Nishi E, Yoshimoto K, Setoyama Y, Kaneko K, Osada H, Honda N, Sasaki Y, Itoyama S, Tsuzaka K, Takeuchi T. IgG4-positive multi-organ lymphoproliferative syndrome manifesting as chronic symmetrical sclerosing dacryo-sialadenitis with subsequent secondary portal hypertension and remarkable IgG4-linked IL-4 elevation. Rheumatology (Oxford) 2010; 49:1789-91. [DOI: 10.1093/rheumatology/keq113] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Tsujimura A, Miyagawa Y, Takada S, Nagahara A, Matsuoka Y, Takao T, Nakayama J, Matsushita M, Nonomura N, Okuyama A. The relation between sexual interest and personality characteristics in men: an eye-tracking study. Int J Impot Res 2010; 22:185-9. [DOI: 10.1038/ijir.2009.61] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Nakai Y, Nonomura N, Kawashima A, Mukai M, Nagahara A, Nakayama M, Takayama H, Nishimura K, Okuyama A. Tumor Multiplicity is an Independent Prognostic Factor of Non-muscle-invasive High-grade (T1G3) Bladder Cancer. Jpn J Clin Oncol 2009; 40:252-7. [DOI: 10.1093/jjco/hyp159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tsujimura A, Matsumiya K, Takahashi T, Yamanaka M, Koga M, Miura H, Nishimura K, Takeyama M, Fujioka H, Okamoto Y, Iwamoto T, Okuyama A. EFFECT OF LIFESTYLE FACTORS ONINFERTILITY IN MEN. ACTA ACUST UNITED AC 2009; 50:15-7. [PMID: 14660165 DOI: 10.1080/01485010490250551] [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: 10/26/2022]
Abstract
Environmental factors, changes in lifestyle and occupational exposures are responsible for declining human semen quality. We investigated the effects of history of surgery and lifestyle choices on infertility of 271 infertile men and 251 healthy volunteers. The frequency of varicocelectomy was significantly higher in infertile men (2.9%) than in controls (0.4%; P < 0.05). Alcohol use was significantly more common in infertile men (92%) than in controls (80%; P < 0.01). Satisfaction with sexual life was greater in controls (85%) than in infertile men (77%; P < 0.05). Other factors had no effect.
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Affiliation(s)
- A Tsujimura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka Central Hospital, Osaka, Japan
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Nakamura T, Nonomura N, Mikami K, Shiraishi T, Takaha N, Okuyama A, Miki T. Salvage chemotherapy with irinotecan and nedaplatin for cisplatin refractory germ cell tumors. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16022] [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] [Indexed: 11/20/2022] Open
Abstract
e16022 Background: Only 20 - 30 % of patients with cisplatin (CDDP) refractory germ cell tumor (GCT) will remain continuously disease-free with salvage chemotherapy. The present study investigated the combination chemotherapy with irinotecan (Ir) and nedaplatin (CDGP), the second generation derivative of CDDP developed in Japan, as salvage chemotherapy for CDDP-refractory GCT. Methods: Between June 1998 and December 2007, 39 CDDP refractory GCT patients treated with irinotecan and CDGP (IrN therapy) were assessed retrospectively. IrN therapy consisted of Ir: 100–150 mg/m2 on day 1, 15 or 200–300 mg/m2 on day 2, CDGP: 100 mg/m2 on day 1 every four weeks with oral administration of Chinese-herb ‘Hange-shashinto’ and sodium bicarbonate for diarrhea. After tumor marker normalization, residual masses were resected and chemotherapy was continued in the case of without marker normalization. Results: The median age was 31 years old (range; 17–48). The median number of cycles of prior chemotherapy was 6 (range; 2–30). The median number of cycles of IrN therapy was 3 (range: 1–9). The response rate was 30.8% ( CR: 0%, PRm−: 15.4%, PRm+: 15.4% ) and the outcome was no evidence of disease (NED) 46.2%, alive with disease (AWD) 25.6% and dead 28.2%, respectively. Twenty-five patients with IrN therapy as 2nd (17 cases) and 3rd (8 cases) line salvage therapy showed that the response rate was 48% (CR: 0%, PRm−: 16.0%, PRm+: 16.0, NCm−: 16.0%) and the outcome was as follows; NED 64%, AWD 16% and dead 20%, respectively. On the other hand, 14 pts who had the treatment as fourth-line or more showed less response rate (PR: 28.5%) and worse outcome (NED 14.2%). Major adverse events more than grade 3 were neutropenia and thrombocytopenia. These adverse events were manageable. Grade 4 diarrhea which was major adverse event of CPT-11 was observed in only one case and there was no treatment related death. Conclusions: This study demonstrates that combination chemotherapy with CPT-11 and CDGP showed significant anticancer activity for patients with CDDP-refractory GCT without severe adverse events. These findings suggest that salvage IrN therapy may be one of the options as second- or third-line therapy. No significant financial relationships to disclose.
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Affiliation(s)
- T. Nakamura
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - N. Nonomura
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - K. Mikami
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - T. Shiraishi
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - N. Takaha
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - A. Okuyama
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - T. Miki
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
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Irie S, Tsujimura A, Miyagawa Y, Ueda T, Matsuoka Y, Matsui Y, Okuyama A, Nishimune Y, Tanaka H. Single-Nucleotide Polymorphisms of the PRDM9 (MEISETZ) Gene in Patients With Nonobstructive Azoospermia. ACTA ACUST UNITED AC 2009; 30:426-31. [DOI: 10.2164/jandrol.108.006262] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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41
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Koike H, Kouchi Z, Kinouchi T, Maeda T, Sorimachi H, Saido TC, Maruyama K, Okuyama A, Suzuki K, Ishiura S. Metabolism of amyloid precursor protein in COS cells transfected with a beta-secretase candidate. Cytotechnology 2008; 33:213-9. [PMID: 19002828 DOI: 10.1023/a:1008119512341] [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] [Indexed: 11/12/2022] Open
Abstract
Thimet oligopeptidase (TOP) is a thiol- andmetallo-dependent peptidase and has been shown to beone of the beta-secretase candidates. TOPexpressed in COS cells cleaved amyloid precursorprotein (APP) at the beta-secretase site, and wefound a proteolytic product of APP called secretedform of APP by beta-secretase (sAPPbeta) in theconditioned media. Here we demonstrate thatsAPPbeta was increased in conditioned media whenTOP was coexpressed in COS cells with APP and treatedwith an ADAM inhibitor SI-27. In addition, althoughTOP expressed in COS cell was localized at nuclei orGolgi apparatus, it exclusively colocalized at Golgiapparatus when APP was coexpressed with TOP.
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Affiliation(s)
- H Koike
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan
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42
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Ichimaru N, Kakuta Y, Abe T, Okumi M, Imamura R, Isaka Y, Nonomura N, Kojima Y, Okuyama A, Takahara S. Treatment Adherence in Renal Transplant Recipients: A Questionnaire Survey on Immunosuppressants. Transplant Proc 2008; 40:1362-5. [DOI: 10.1016/j.transproceed.2008.02.083] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 02/26/2008] [Indexed: 10/21/2022]
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43
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Nonomura N, Takayama H, Nishimura K, Oka D, Nakai Y, Shiba M, Tsujimura A, Nakayama M, Aozasa K, Okuyama A. Decreased number of mast cells infiltrating into needle biopsy specimens leads to a better prognosis of prostate cancer. Br J Cancer 2007; 97:952-6. [PMID: 17848955 PMCID: PMC2360404 DOI: 10.1038/sj.bjc.6603962] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Mast cell infiltration is often observed around human tumours. Inflammatory cells such as macrophages, neutrophils and mast cells infiltrating around tumours are known to contribute to tumour growth; however, the clinical significance of mast cell invasion in prostate cancer (PCa) has not been investigated. Mast cell infiltration was evaluated in 104 patients (age range, 45-88 years; median, 72 years), who underwent needle biopsy of the prostate and were confirmed to have PCa. Needle biopsy specimens of prostate were sliced into 5-microm-thick sections and immunostained for mast cells with monoclonal antibody against mast cell-specific tryptase. Mast cells were counted systematically under a microscope (x 400 magnification), and the relations between mast cell numbers and clinicopathologic findings were evaluated. The mast cell count was evaluated for prognostic value by multivariate analysis. Mast cells were immunostained around the cancer foci. The median number of mast cells in each case was 16. The mast cell count was higher around cancer foci in patients with higher Gleason scores than in those with low Gleason scores. The mast cell number correlated well with clinical stage (P<0.001). Prostate-specific antigen-free survival of patients with higher mast cell counts was better than that in patients with lower mast cell counts (P<0.001). Multivariate analysis revealed that mast cell count was a significant prognostic factor (P<0.005). The number of mast cells infiltrating around cancer foci in prostate biopsy specimens can be a significant prognostic factor of PCa.
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Affiliation(s)
- N Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.
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Abe T, Imao T, Ichimaru N, Takahara S, Kokado Y, Okumi M, Imamura R, Isaka Y, Nonomura N, Okuyama A. POS-03.135: Risk factors for malignancy in Japanese renal transplant recipients. Urology 2007. [DOI: 10.1016/j.urology.2007.06.684] [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: 10/22/2022]
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45
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46
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Kameda H, Okuyama A, Tamaru JI, Itoyama S, Iizuka A, Takeuchi T. Lymphomatoid granulomatosis and diffuse alveolar damage associated with methotrexate therapy in a patient with rheumatoid arthritis. Clin Rheumatol 2007; 26:1585-9. [PMID: 17200802 DOI: 10.1007/s10067-006-0480-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2006] [Accepted: 10/28/2006] [Indexed: 10/23/2022]
Abstract
We report on a patient of rheumatoid arthritis (RA) who sequentially developed an axillary mass and a fatal interstitial pneumonia during a 2-year course of methotrexate (MTX) therapy. Autopsy revealed a systemic lymph node involvement and the diagnosis of Epstein-Barr virus (EBV)-related lymphoproliferative disease (LPD) with the features of lymphomatoid granulomatosis was made. The lung tissue specimens revealed a typical diffuse alveolar damage (DAD), and small nodules consisting of atypical B lymphocytes showing positive staining for EBV were sparsely recognized only in basal lungs. This is the first report of a RA patient receiving MTX therapy sequentially developing MTX-associated lymphomatoid granulomatosis and DAD.
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Affiliation(s)
- Hideto Kameda
- Division of Rheumatology/Clinical Immunology, Department of Internal Medicine, Saitama Medical Center, Saitama Medical University, 1981 Tsujido-machi, Kamoda, Kawagoe, Saitama 350-8550, Japan.
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Tanaka H, Hirose M, Tokuhiro K, Matsuoka Y, Miyagawa Y, Tsujimura A, Okuyama A, Nishimune Y. Single nucleotide polymorphisms: discovery of the genetic causes of male infertility. Soc Reprod Fertil Suppl 2007; 65:531-4. [PMID: 17644991] [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: 05/16/2023]
Abstract
We carried out single nucleotide polymorphism (SNP) and mutation analyses of haploid germ cell-specific genes. An analysis of 13 genes associated with male infertility in approximately 300 infertile male patients and approximately 300 male volunteers with proven fertility revealed two mutations that might produce male infertility, and three SNP/mutations associated with male infertility in 13 germ cell-specific genes. These findings strongly support the hypothesis that dysfunction of germ cell-specific genes causes idiopathic human male infertility.
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Affiliation(s)
- H Tanaka
- TANAKA Project, Center for Advanced Science and Innovation, Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Miki T, Mizutani Y, Nomoto T, Nakamura T, Kawauchi A, Oka D, Nishimura K, Nonomura N, Okuyama A. Salvage chemotherapy with paclitaxel, ifosphamide and nedaplatin for cisplatin refractory germ cell tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4587] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4587 Background: Only 20–30 % of patients with cisplatin (CDDP) refractory germ cell tumor (GST) will remain continuously disease free with salvage chemotherapy. The present study investigated the chemotherapy with paclitaxel (TXL) in combination with ifosphamide (IFM) and nedaplatin (NDP), which is a derivative of CDDP, as salvage chemotherapy for CDDP refractory GCT. Methods: Between 2000 and 2005, 33 patients with CDDP refractory GCT were enrolled. All patients were male, with median age 30 (range: 17–45). Median number of previous regimens was 2 (range: 1–4). The combination chemotherapy consisted of TXL: 200 mg/m2 on day 1, NDP: 100 mg/m2 on day 2 and IFM: 1.2 g/m2 on day 2–6 every three weeks. Results: A median of 5 cycles was administered to 33 patients. Grade 3/4 toxicity were reported as follows: neutropenia: 90%, thrombocytopenia: 70%, anemia: 70%, nausea/vomiting: 90%, diarrhea: 6%, alopecia: 97%. No treatment related death was observed. Response rate was 82% (CR: 9%, PRm−: 67%, PRm+: 6%, NC: 6%, PD: 6 %). Nineteen (58%) patients achieved a no evidence of disease status with a median duration of follow-up of 18 months (7–60 months). Six patients (18%) remain alive with disease. However, 8 patients (24%) died of the disease. Conclusions: This study demonstrates that the chemotherapy with TXL in combination with IFM and NDP showed a significant anticancer activity for patients with CDDP refractory GCT. These findings suggest that the combination chemotherapy may be one of the options of salvage chemotherapy for CDDP refractory GCT. No significant financial relationships to disclose.
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Affiliation(s)
- T. Miki
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - Y. Mizutani
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - T. Nomoto
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - T. Nakamura
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - A. Kawauchi
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - D. Oka
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - K. Nishimura
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - N. Nonomura
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
| | - A. Okuyama
- Kyoto Prefectural University of Medicine, Kyoto, Japan; Osaka University, Osaka, Japan
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Tsujimura A, Matsumiya K, Takao T, Miyagawa Y, Takada S, Koga M, Iwasa A, Takeyama M, Okuyama A. Treatment with human chorionic gonadotropin for PADAM: a preliminary report. Aging Male 2005; 8:175-9. [PMID: 16390742 DOI: 10.1080/13685530500282794] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 10/23/2022] Open
Abstract
The purpose of this study was to evaluate the efficacy and safety of human chorionic gonadotropin (hCG) for patients with partial androgen deficiency of the aging male (PADAM). Twenty-one patients over 50 years of age with PADAM symptoms were included in this study. Laboratory and endocrinologic profiles were reviewed as appropriate, and PADAM symptoms were judged by means of several questionnaires such as the Aging Males' Symptoms (AMS) scale, short version of the International Index of Erectile Function (IIEF-5), and the Self-rating Depression Scale (SDS). Laboratory and endocrinologic values and symptom scores were evaluated and compared before and after treatment by hCG injection. The treatment period was 8.0 +/- 5.0 months (3.0-24.0 months). Serum concentrations of testosterone, including total testosterone, calculated free testosterone, and calculated bioavailable testosterone, increased significantly. AMS total scores and subscores decreased significantly after treatment. However, IIEF-5 and SDS scores did not improve. With respect to adverse effects, laboratory tests showed that only red blood cell count, hematocrit and hemoglobin level increased significantly after treatment, however, these values remained within the normal range. No adverse effect was identified after treatment. We conclude that hCG injection may be considered as a treatment for PADAM.
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Affiliation(s)
- A Tsujimura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
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50
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Oka K, Moriyama T, Takahara S, Naruse M, Namba Y, Ichimaru N, Kyo M, Kokado Y, Okuyama A, Ito T, Imai E, Aozasa K. Increased Expression of Renin in Chronic Allograft Nephropathy. Transplant Proc 2005; 37:2131-4. [PMID: 15964360 DOI: 10.1016/j.transproceed.2005.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/16/2022]
Abstract
BACKGROUND Chronic allograft nephropathy (CAN) is the main cause of renal transplant failure in the first decade posttransplant. The precise pathogenetic mechanism for CAN is not completely understood. A possible role of renin-angiotensin system for CAN has been suggested through clinical observations that angiotensin-converting enzyme inhibition and angiotensin II receptor blockers prevent CAN. METHODS Distribution of renin-positive cells in allograft biopsy specimens was examined immunohistochemically in 23 renal transplant recipients diagnosed with CAN Biopsy specimens obtained from seven recipients with stable renal function were examined as controls. Histologic evaluation was performed based on the Banff 97 classification. RESULTS Renin-positive cells were found in the juxtaglomerular apparatus (JGA) adjoining the afferent arterioles in both groups. When the number of renin-positive cells in JGA was defined as a renin index, it was significantly higher in the CAN than the control group (P = .007). There was no significant difference in age, interval between transplantation and biopsy, and blood pressure between groups. Only a significantly higher serum creatinine was found in the CAN group. CONCLUSIONS The increased renin-positive cells in JGA suggest a significant role of the intrarenal renin-angiotensin system activation in the development of CAN.
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Affiliation(s)
- K Oka
- Department of Pathology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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