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Arakane N, Yoshida K, Murata S, Mizuno R, Furuta K, Tojo M, Tamagawa H, Miyanaga R, Watanabe K, Fukuhara S. Large submucosal hematoma after cold snare polypectomy for colorectal adenoma. DEN Open 2022; 3:e199. [PMID: 36545292 PMCID: PMC9763534 DOI: 10.1002/deo2.199] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Cold snare polypectomy (CSP), for the treatment of colorectal polyps, has become widespread due to its low incidence of adverse events compared to that of endoscopic procedures such as endoscopic mucosal resection. However, we experienced a case of large hematoma development shortly after CSP for a colorectal adenoma despite no bleeding during the procedure. The patient underwent CSP for a 7-mm type Isp lesion in the ascending colon. She returned the following day because of hematochezia. Computed tomography showed a 70-mm, high-intensity mass in the ascending colon, consistent with the large hematoma that was detected by colonoscopy. Although the patient initially had right-sided abdominal pain, it gradually improved with conservative treatment. The hematoma decreased in size, and she was discharged 20 days after emergency admission. Although CSP can be a favorable alternative to more invasive procedures and is expected to be performed more frequently, adverse events, such as that described in this case, should be anticipated.
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Affiliation(s)
- Naomi Arakane
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Kosuke Yoshida
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Shoma Murata
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Rika Mizuno
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Koichi Furuta
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Masaya Tojo
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Hiroki Tamagawa
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Ryoichi Miyanaga
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Kazuyo Watanabe
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
| | - Seiichiro Fukuhara
- Department of Gastroenterology and HepatologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
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Tamagawa H, Sugimoto N, Watanabe T, Satake H, Kataoka K, Kamei K, Kobayashi M, Munakata K, Fukunaga M, Kotaka M, Satoh T, Kanazawa A, Kurata T, Tomita N. P-78 A phase II study of resection followed by capecitabine plus oxaliplatin for liver metastasis of colorectal cancer (REX study): Final analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.168] [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: 11/29/2022] Open
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Sugimoto N, Nakata K, Miyo M, Yoshioka S, Kagawa Y, Naito A, Tei M, Tamagawa H, Konishi K, Osawa H, Shingai T, Danno K, Nishida N, Sato G, Shimokawa T, Miyoshi N, Takahashi H, Uemura M, Yamamoto H, Murata K, Doki Y, Eguchi H. P-76 Phase II study of FOLFIRI plus ramucirumab with recurrent colorectal cancer refractory to adjuvant chemotherapy with oxaliplatin/fluoropyrimidine (RAINCLOUD). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.166] [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: 11/01/2022] Open
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Fukuhara S, Iwasaki E, Kayashima A, Machida Y, Tamagawa H, Kawasaki S, Horibe M, Hori S, Abe Y, Kitago M, Ogata H, Kanai T. Endoscopic Diagnosis of Biliary Stricture Combined with Digital Cholangioscope: A Case Series. Healthcare (Basel) 2021; 10:healthcare10010012. [PMID: 35052176 PMCID: PMC8775675 DOI: 10.3390/healthcare10010012] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022] Open
Abstract
The endoscopic diagnosis of biliary tract lesions is applied as a non-invasive method; however, its diagnostic accuracy is not yet high. Moreover, digital cholangioscopy is used for directly visualizing the inside of the bile duct, resulting in a more precise biopsy. We present the case series of the outcomes of diagnosis using digital cholangioscopy in patients who underwent cholangioscopy for the evaluation of biliary stenosis in our department between January 2014 and March 2021. The controls were those who underwent a biopsy for biliary stenosis with conventional endoscopic retrograde cholangiopancreatography (ERCP). Background data for each case were collected, and the clinical outcomes by biopsy were evaluated, focusing on the accuracy of the diagnosis. Cholangioscopy was performed in 15 cases, while a conventional biopsy by ERCP was performed in 172 cases. Nine of 15 cases (60.0%) were diagnosed with cholangiocarcinoma. The number of specimens obtained through conventional ERCP and cholangioscopy was 2.5 ± 1.3 and 3.3 ± 1.5, respectively (p = 0.043). The diagnostic accuracy of conventional ERCP and cholangioscopy were 65.7% (113 of 172 cases) and 100%, respectively, which was significantly higher in the group with cholangioscopy. Digital cholangioscopy is useful when the diagnosis of the biliary stricture using the conventional ERCP method is difficult.
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Affiliation(s)
- Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan; (S.F.); (H.O.)
- National Hospital Organization Tokyo Medical Center, Division of Gastroenterology and Hepatology, Tokyo 152-8902, Japan;
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.K.); (Y.M.); (S.K.); (M.H.); (T.K.)
- Correspondence: ; Tel.: +81-3-5363-3790
| | - Atsuto Kayashima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.K.); (Y.M.); (S.K.); (M.H.); (T.K.)
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.K.); (Y.M.); (S.K.); (M.H.); (T.K.)
| | - Hiroki Tamagawa
- National Hospital Organization Tokyo Medical Center, Division of Gastroenterology and Hepatology, Tokyo 152-8902, Japan;
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.K.); (Y.M.); (S.K.); (M.H.); (T.K.)
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.K.); (Y.M.); (S.K.); (M.H.); (T.K.)
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.K.); (Y.M.); (S.K.); (M.H.); (T.K.)
| | - Shutaro Hori
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (S.H.); (Y.A.); (M.K.)
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (S.H.); (Y.A.); (M.K.)
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (S.H.); (Y.A.); (M.K.)
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan; (S.F.); (H.O.)
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.K.); (Y.M.); (S.K.); (M.H.); (T.K.)
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Fukuhara S, Kato M, Iwasaki E, Machida Y, Tamagawa H, Kawasaki S, Sasaki M, Kiguchi Y, Takatori Y, Matsuura N, Nakayama A, Ogata H, Kanai T, Yahagi N. External drainage of bile and pancreatic juice after endoscopic submucosal dissection for duodenal neoplasm: Feasibility study (with video). Dig Endosc 2021; 33:977-984. [PMID: 33258135 DOI: 10.1111/den.13907] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 10/11/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Endoscopic submucosal dissection (ESD) for superficial duodenal epithelial tumors (SDETs) is technically difficult and has a high risk of adverse events. Endoscopic nasobiliary and nasopancreatic duct drainage (ENBPD) may reduce the risk of delayed adverse events by preventing exposure of the post-ESD mucosal defect to bile and pancreatic juice. This study was performed to evaluate the safety and feasibility of ENBPD after duodenal ESD. METHODS Patients who underwent ESD for SDETs from July 2010 to March 2020 were included. We collected data on the success rate of ENBPD, adverse events due to insertion of a side-viewing endoscope, and pancreatitis after ENBPD. We also collected the clinical outcomes of duodenal ESD, including the incidence rate of delayed adverse events (defined as bleeding or perforation found after the endoscopic procedure). RESULTS Among 70 patients without complete closure of the post-ESD mucosal defect, ENBPD was successfully performed in all 25 patients including 21 cases inserted immediately after ESD and four cases inserted later. There were no adverse events associated with ENBPD procedure intraoperatively, while pancreatitis after ENBPD occurred in four patients (16.0%). No patients who underwent immediate ENBPD required intervention for an intra-abdominal abscess or delayed perforation, whereas 3 of 49 patients (6.1%) who did not undergo immediate ENBPD required surgery or drainage of an abscess. CONCLUSIONS Endoscopic nasobiliary and nasopancreatic duct drainage is technically feasible and might provide effective prophylaxis for delayed adverse events, even if a large mucosal defect is present after ESD.
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Affiliation(s)
- Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Motohiko Kato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Motoki Sasaki
- Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiyuki Kiguchi
- Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Yusaku Takatori
- Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Noriko Matsuura
- Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Atsushi Nakayama
- Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Naohisa Yahagi
- Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
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Fukuhara S, Iwasaki E, Iwano T, Machida Y, Tamagawa H, Kawasaki S, Seino T, Yokose T, Endo Y, Yoshimura K, Kashiwagi K, Kitago M, Ogata H, Takeda S, Kanai T. New strategy for evaluating pancreatic tissue specimens from endoscopic ultrasound-guided fine needle aspiration and surgery. JGH Open 2021; 5:953-958. [PMID: 34386605 PMCID: PMC8341188 DOI: 10.1002/jgh3.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/03/2021] [Accepted: 07/07/2021] [Indexed: 01/07/2023]
Abstract
Background and Aim Preoperative histological evaluation of pancreatic neoplasms is important for guiding the resection strategy and preventing postoperative adverse events. However, conventional endoscopic methods have technical limitations that reduce the accuracy of the histopathological examination. Probe electrospray ionization mass spectrometry (PESI‐MS) may be a useful technique for rapidly evaluating small specimens. Methods This single‐center prospective study included patients with pancreatic neoplasms between October 2018 and December 2019. Pancreatic ductal adenocarcinoma (PDAC) specimens were obtained via endoscopic ultrasound‐guided fine needle aspiration (EUS‐FNA) and non‐neoplastic tissue was obtained via surgery. Specimens were subjected to PESI‐MS and the mass spectra were analyzed using partial least squares regression‐discriminant analysis. Results The study included 40 patients with 20 nonneoplastic specimens and 19 PDAC specimens (1 case of neuroendocrine carcinoma was omitted). All nonneoplastic specimens were sufficient for PESI‐MS analysis, although only 7 of 19 PDAC specimens were sufficient for PESI‐MS analysis because of poor sample quality or insufficient quantity (<1 mg). Among the 27 analyzed cases, the mass spectra clearly differentiated between the PDAC and nonneoplastic specimens. Conclusions This study revealed that PESI‐MS could differentiate between PDAC and nonneoplastic specimens, even in cases where EUS‐FNA produced very small specimens.
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Affiliation(s)
- Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine Tokyo Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan
| | - Tomohiko Iwano
- Department of Anatomy and Cell Biology University of Yamanashi Faculty of Medicine Yamanashi Japan
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan
| | - Takashi Seino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan
| | - Takahiro Yokose
- Department of Surgery Keio University School of Medicine Tokyo Japan
| | - Yutaka Endo
- Department of Surgery Keio University School of Medicine Tokyo Japan
| | - Kentaro Yoshimura
- Department of Anatomy and Cell Biology University of Yamanashi Faculty of Medicine Yamanashi Japan
| | - Kazuhiro Kashiwagi
- Center for Preventive Medicine Keio University School of Medicine Tokyo Japan
| | - Minoru Kitago
- Department of Surgery Keio University School of Medicine Tokyo Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine Tokyo Japan
| | - Sen Takeda
- Department of Anatomy and Cell Biology University of Yamanashi Faculty of Medicine Yamanashi Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan
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Iwasaki E, Fukuhara S, Horibe M, Kawasaki S, Seino T, Takimoto Y, Tamagawa H, Machida Y, Kayashima A, Noda M, Hayashi H, Kanai T. Endoscopic Ultrasound-Guided Sampling for Personalized Pancreatic Cancer Treatment. Diagnostics (Basel) 2021; 11:469. [PMID: 33800161 PMCID: PMC8000964 DOI: 10.3390/diagnostics11030469] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/27/2021] [Accepted: 02/27/2021] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cancer is the most lethal solid malignancy, and the number of patients with pancreatic cancer is increasing. Systemic chemotherapies are often ineffective for such patients, and there is an urgent need for personalized medicine. Unlike other types of cancer, personalized treatments for pancreatic cancer are still in development. Consequently, pancreatic cancer is less sensitive to anticancer drugs and is often refractory to common treatments. Therefore, advances in personalized medicine for pancreatic cancer are necessary. This review examined advances in personalized medicine for pancreatic cancer, including the use of endoscopic ultrasound (EUS)-guided sampling. EUS-guided sampling is widely used for diagnosing pancreatic tumors and is expected to be applied to sampled tissues. Additionally, there has been an increase in clinical research using EUS-guided sampling. The combination of precision medicine using genomic testing and pharmacological profiles based on high-throughput drug sensitivity testing using patient-derived organoids is expected to revolutionize pancreatic cancer treatment.
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Affiliation(s)
- Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan;
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Takashi Seino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Yoichi Takimoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Atsuto Kayashima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Marin Noda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
| | - Hideyuki Hayashi
- Keio Cancer Center, Genomic Units, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan;
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (M.H.); (S.K.); (T.S.); (Y.T.); (H.T.); (Y.M.); (A.K.); (M.N.); (T.K.)
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Iguchi K, Mushiake H, Hasegawa S, Fukushima T, Numata M, Tamagawa H, Shiozawa M, Yukawa N, Rino Y, Masuda M. Evaluation of vascular anatomy for colon cancer located in the splenic flexure using the preoperative three-dimensional computed tomography angiography with colonography. Int J Colorectal Dis 2021; 36:405-411. [PMID: 33047209 DOI: 10.1007/s00384-020-03773-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Accepted: 10/07/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this study is to reveal the vascular branching variation in SFC (splenic flexure cancer) patients using the preoperative three-dimensional computed tomography angiography with colonography (3D-CTAC). METHODS We retrospectively analyzed patients with SFC who underwent preoperative 3D-CTAC between January 2014 and December 2019. RESULTS Among 1256 colorectal cancer (CRC) patients, 96 (7.6%) manifested SFC. The arterial branching from the superior mesenteric artery (SMA) was classified into five patterns, as follows: (type 1A) the left branch of middle colic artery (LMCA) diverged from middle colic artery (MCA) (N = 47, 49.0%); (2A) the LMCA diverged from the MCA and the accessory middle colic artery (AMCA) (N = 26, 27.1%); (3A) the LMCA independently diverged from the SMA (N = 16, 16.7%); (4A) the LMCA independently diverged from the SMA and AMCA (N = 3, 3.1%); (5A) only the AMCA and the LMCA was absent (N = 4, 4.1%). Venous drainage was classified into four patterns, as follows: (type 1V) the SFV flows into the inferior mesenteric vein (IMV) then back to the splenic vein (N = 50, 52.1%); (2V) the SFV flows into the IMV then back to the superior mesenteric vein (SMV) (N = 19, 19.8%); (type 3V) the SFV independently flows into the splenic vein (N = 3, 3.1%); (type 4V) the SFV is absent (N = 24, 25.0%). CONCLUSION 3D-CTAC could reveal accurate preoperative tumor localization and vascular branching. These classifications should be helpful in performing accurate complete mesocolic excision and central vessel ligation for SFC.
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Affiliation(s)
- K Iguchi
- Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Konandai, Konan-ku, Yokohama, 234-0054, Japan
| | - H Mushiake
- Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Konandai, Konan-ku, Yokohama, 234-0054, Japan.
| | - S Hasegawa
- Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Konandai, Konan-ku, Yokohama, 234-0054, Japan
| | - T Fukushima
- Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Konandai, Konan-ku, Yokohama, 234-0054, Japan
| | - M Numata
- Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - H Tamagawa
- Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - M Shiozawa
- Department of Colorectal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - N Yukawa
- Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Y Rino
- Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - M Masuda
- Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
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9
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Iwasaki E, Minami K, Itoi T, Yamamoto K, Tsuji S, Sofuni A, Tsuchiya T, Tanaka R, Tonozuka R, Machida Y, Takimoto Y, Tamagawa H, Katayama T, Kawasaki S, Seino T, Horibe M, Fukuhara S, Kitago M, Ogata H, Kanai T. Impact of electrical pulse cut mode during endoscopic papillectomy: Pilot randomized clinical trial. Dig Endosc 2020; 32:127-135. [PMID: 31222794 DOI: 10.1111/den.13468] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 01/08/2019] [Accepted: 06/16/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Endoscopic papillectomy is increasingly being used for ampullary adenoma treatment. However, it remains challenging despite increased safety with treatment advances. The ideal power output and electrosurgical current mode for mucosal resection are not established. We aimed to identify the ideal electrical pulse for use during resection. METHODS This pilot randomized, single-blind, prospective, multicenter trial, recruited patients with ampullary adenomas and conventional anatomy who were scheduled to undergo endoscopic papillectomy. Endoscopic treatment was performed using a standardized algorithm and patients were randomized for endoscopic papillectomy with Endocut or Autocut. The primary outcome was the incidence of delayed bleeding. Incidence of procedure-related pancreatitis, successful complete resection, pathological findings, and other adverse events were secondary endpoints. RESULTS Sixty patients were enrolled over a 2-year period. The incidences of delayed bleeding (13.3% vs. 16.7%, P = 1.00) and pancreatitis (27% vs. 30%, P = 0.77) were similar between both groups. The rate of crush artifacts was higher in the Endocut than in the Autocut group (27% vs. 3.3%, P = 0.03). Immediate bleeding when resecting tumors greater than 14 mm in diameter was more common in the Autocut than in the Endocut group (88% vs. 46%, P = 0.04). CONCLUSIONS The Autocut and Endocut modes have similar efficacy and safety for endoscopic papillectomy. The Endocut mode may prevent immediate bleeding in cases with large tumor sizes, although it causes more frequent crush artifacts. REGISTRY AND THE REGISTRATION NUMBER The Japanese UMIN Clinical Trials Registry (UMIN-CTR: 000021382).
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Affiliation(s)
- Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Minami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Kenjiro Yamamoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Shujiro Tsuji
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Atsushi Sofuni
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Takayoshi Tsuchiya
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Reina Tanaka
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Ryosuke Tonozuka
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yoichi Takimoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tadashi Katayama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Seino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Minami K, Iwasaki E, Kawasaki S, Fukuhara S, Seino T, Katayama T, Takimoto Y, Tamagawa H, Machida Y, Horibe M, Kitago M, Ogata H, Kanai T. A long (7 cm) prophylactic pancreatic stent decreases incidence of post-endoscopic papillectomy pancreatitis: a retrospective study. Endosc Int Open 2019; 7:E1663-E1670. [PMID: 31788550 PMCID: PMC6877413 DOI: 10.1055/a-1010-5581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/06/2019] [Indexed: 02/06/2023] Open
Abstract
Background and study aims Endoscopic papillectomy (EP) is a minimally invasive treatment for ampullary neoplasms and is recognized as an alternative treatment to surgical resection; however, there are few reports on a suitable pancreatic stent (PS) after EP for preventing pancreatitis. The aim of this study was to evaluate the efficacy of a long PS after EP. Patients and methods In this retrospective single-center study, 39 patients with pathologically proven ampullary neoplasms who underwent EP between March 2012 and August 2018 were enrolled. The study participants were divided into two subgroups according to the PS length: those with a PS shorter than 5 cm (short PS group, n = 17) and those with a PS of 7 cm (long PS group, n = 22). The incidence of adverse events and risk factors for pancreatitis were evaluated. Results The diameter of all PSs was 5 Fr. Post-EP pancreatitis occurred in nine patients (23.1 %), with two cases of severe pancreatitis (5.1 %). Pancreatitis occurred more frequently in the short PS group (7/17, 41.2 %) than in the long PS group (2/22, 9.1 %) ( P = 0.026). There were no significant differences between the two groups in terms of other adverse events. Univariate and multivariate analyses showed that a long PS was the only factor associated with a decreased incidence of post-EP pancreatitis ( P = 0.042; odds ratio, 0.16; 95 % confidence interval, 0.027-0.94). Conclusion A long (7 cm) PS significantly decreased incidence of pancreatitis after EP. Prospective randomized studies with a larger number of patients and wider range of PS lengths are required.
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Affiliation(s)
- Kazuhiro Minami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Seino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tadashi Katayama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yoichi Takimoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Kitago
- Division of Hepato-Pancreato-Biliary and Transplant Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan,Corresponding author Takanori Kanai MD, PhD Chief Professor, Division of Gastroenterology and HepatologyDepartment of Internal MedicineKeio University School of Medicine35 ShinanomachiShinjuku-ku, Tokyo 160-8582Japan+81-(0)3-3353-6247
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11
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Minami K, Iwasaki E, Fukuhara S, Horibe M, Seino T, Kawasaki S, Katayama T, Takimoto Y, Tamagawa H, Machida Y, Kanai T, Itoi T. Electric Endocut and Autocut Resection for Endoscopic Papillectomy: A Systematic Review. Intern Med 2019; 58:2767-2772. [PMID: 31243201 PMCID: PMC6815892 DOI: 10.2169/internalmedicine.2720-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/18/2022] Open
Abstract
Objective Risks of bleeding and pancreatitis after mucosal resection using the purecut/autocut and blendcut/endocut modes for endoscopic papillectomy have not been fully clarified. Thus, a systematic review on electrosurgical cutting modes for endoscopic papillectomy was conducted focusing on the types and incidence of adverse events. Methods We searched the PubMed and Cochrane library for cases of endoscopic papillectomy recorded as of April 2017. Studies reporting the methods of electrically excising a tumor in the duodenal papilla and the number of adverse events were extracted. Studies were collected and examined separately based on the electrosurgical cutting mode, and the incidence rate for each adverse event was summarized. Results A total of 159 relevant articles were found; among them, 20 studies were included and 139 excluded. Five studies analyzed endoscopic papillectomy with the purecut/autocut mode and 16 with the blendcut/endocut mode. Only one study investigated both modes (purecut and endocut). With the purecut/autocut mode, the incidence of bleeding was 2.8-50%, and that of pancreatitis was 0-50% (mean: 12.8%). With the blendcut/endocut mode, the incidence of bleeding was 0-42.3%, and that of pancreatitis was 0%-17.9% (mean: 9.5%). Conclusion Both methods had high adverse event rates for endoscopic papillectomy. Thus, a standard method of endoscopic papillectomy, including the electrosurgical cutting mode, needs to be established.
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Affiliation(s)
- Kazuhiro Minami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Japan
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Takashi Seino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Tadashi Katayama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Youichi Takimoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
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Takimoto Y, Iwasaki E, Masaoka T, Fukuhara S, Kawasaki S, Seino T, Katayama T, Minami K, Tamagawa H, Machida Y, Ogata H, Kanai T. Novel mainstream capnometer system is safe and feasible even under CO 2 insufflation during ERCP-related procedure: a pilot study. BMJ Open Gastroenterol 2019; 6:e000266. [PMID: 30899539 PMCID: PMC6398869 DOI: 10.1136/bmjgast-2018-000266] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/18/2019] [Accepted: 02/01/2019] [Indexed: 11/29/2022] Open
Abstract
Background and aims There is a need to safely achieve conscious sedation during endoscopic retrograde cholangiopancreatography (ERCP). We evaluated the safety and feasibility of a mainstream capnometer system to monitor apnoea during ERCP under CO2 insufflation. Methods Non-intubated adult patients undergoing ERCP-related procedures with intravenous sedation were enrolled. End-tidal CO2 (EtCO2) was continuously monitored during the procedure under CO2 insufflation using a mainstream capnometer system, comprising a capnometer and a specially designed bite block for upper gastrointestinal endoscopy and ERCP. Oxygen saturation (SpO2) was also monitored continuously during the procedure. In this study, we evaluated the safety and feasibility of the capnometer system. Results Eleven patients were enrolled. Measurement of EtCO2 concentration was possible from the beginning to the end of the procedure in all 11 cases. There was no measurement failure, dislocation of the bite block, or adverse event related to the bite block. Apnoea linked to hypoxaemia occurred five times (mean duration, 174.4 s). Conclusion This study confirmed that apnoea was detected earlier than when using a percutaneous oxygen monitor. Measurement of EtCO2 concentration using the newly developed mainstream capnometer system was feasible and safe even under CO2 insufflation.
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Affiliation(s)
- Yoichi Takimoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuhiro Masaoka
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, KeioUniversity School of Medicine, Tokyo, Japan
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Seino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tadashi Katayama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Minami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yujiro Machida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, KeioUniversity School of Medicine, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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13
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Minami K, Iwasaki E, Itoi T, Fukuhara S, Horibe M, Seino T, Kawasaki S, Katayama T, Takimoto Y, Tamagawa H, Machida Y, Hamamoto Y, Ogata H, Kanai T. Successful EUS-guided antegrade stenting for malignant severe biliary obstruction combined with a newly developed plastic stent. Endosc Int Open 2018; 6:E1336-E1339. [PMID: 30410954 PMCID: PMC6221811 DOI: 10.1055/a-0719-4861] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/25/2018] [Indexed: 11/03/2022] Open
Abstract
Background and study aims We report the effectiveness of a newly developed plastic stent for preventing bile leakage after endoscopic ultrasonography (EUS)-guided antegrade stenting. This treatment was performed on a 59-year-old woman with malignant obstructive jaundice caused by peritoneal metastasis. First, we attempted transpapillary drainage using short-type single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography, but we could not achieve it. We then attempted EUS-guided antegrade stenting through the intrahepatic bile duct from the esophagojejunal anastomosis. We successfully inserted uncovered metallic stents for common bile duct and a newly plastic stent for hepaticojejunostomy from the antegrade approach. There were no adverse events after the treatment.
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Affiliation(s)
- Kazuhiro Minami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan,Corresponding author Eisuke Iwasaki, MD, PhD Division of Gastroenterology and HepatologyDepartment of Internal MedicineKeio University School of Medicine35 ShinanomachiShinjuku-ku, TokyoJapan+81-(0)3-5363-3967
| | - Takao Itoi
- Department of Gastroenterological Medicine, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Takashi Seino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Shintaro Kawasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Tadashi Katayama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Yoichi Takimoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Hiroki Tamagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Yujiro Machida
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan
| | - Yasuo Hamamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
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14
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Seino T, Kawasaki S, Shimokawa M, Tamagawa H, Toshimitsu K, Fujii M, Ohta Y, Matano M, Nanki K, Kawasaki K, Takahashi S, Sugimoto S, Iwasaki E, Takagi J, Itoi T, Kitago M, Kitagawa Y, Kanai T, Sato T. Human Pancreatic Tumor Organoids Reveal Loss of Stem Cell Niche Factor Dependence during Disease Progression. Cell Stem Cell 2018; 22:454-467.e6. [PMID: 29337182 DOI: 10.1016/j.stem.2017.12.009] [Citation(s) in RCA: 348] [Impact Index Per Article: 58.0] [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: 05/18/2017] [Revised: 10/30/2017] [Accepted: 12/14/2017] [Indexed: 12/13/2022]
Abstract
Despite recent efforts to dissect the inter-tumor heterogeneity of pancreatic ductal adenocarcinoma (PDAC) by determining prognosis-predictive gene expression signatures for specific subtypes, their functional differences remain elusive. Here, we established a pancreatic tumor organoid library encompassing 39 patient-derived PDACs and identified 3 functional subtypes based on their stem cell niche factor dependencies on Wnt and R-spondin. A Wnt-non-producing subtype required Wnt from cancer-associated fibroblasts, whereas a Wnt-producing subtype autonomously secreted Wnt ligands and an R-spondin-independent subtype grew in the absence of Wnt and R-spondin. Transcriptome analysis of PDAC organoids revealed gene-expression signatures that associated Wnt niche subtypes with GATA6-dependent gene expression subtypes, which were functionally supported by genetic perturbation of GATA6. Furthermore, CRISPR-Cas9-based genome editing of PDAC driver genes (KRAS, CDKN2A, SMAD4, and TP53) demonstrated non-genetic acquisition of Wnt niche independence during pancreas tumorigenesis. Collectively, our results reveal functional heterogeneity of Wnt niche independency in PDAC that is non-genetically formed through tumor progression.
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Affiliation(s)
- Takashi Seino
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Shintaro Kawasaki
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mariko Shimokawa
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroki Tamagawa
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kohta Toshimitsu
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masayuki Fujii
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yuki Ohta
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mami Matano
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kosaku Nanki
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kenta Kawasaki
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Sirirat Takahashi
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Shinya Sugimoto
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Eisuke Iwasaki
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Junichi Takagi
- Laboratory of Protein Synthesis and Expression, Institute for Protein Research, Osaka University, Suita 565-0871, Japan
| | - Takao Itoi
- Department of Gastroenterology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takanori Kanai
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Toshiro Sato
- Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan.
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15
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Kudo T, Kato T, Kagawa Y, Murata K, Ohta H, Noura S, Hasegawa J, Tamagawa H, Ohta K, Ikenaga M, Miyazaki S, Komori T, Nishimura J, Hata T, Matsuda C, Satoh T, Mizushima T, Yamamoto H, Doki Y, Mori M. Phase II dose titration study of regorafenib for patients with unresectable metastatic colorectal cancer who are progressed after standard chemotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.138] [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] Open
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16
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Yamazaki K, Nagase M, Tamagawa H, Ueda S, Tamura T, Murata K, Eguchi Nakajima T, Baba E, Tsuda M, Moriwaki T, Esaki T, Tsuji Y, Muro K, Taira K, Denda T, Funai S, Shinozaki K, Yamashita H, Sugimoto N, Okuno T, Nishina T, Umeki M, Kurimoto T, Takayama T, Tsuji A, Yoshida M, Hosokawa A, Shibata Y, Suyama K, Okabe M, Suzuki K, Seki N, Kawakami K, Sato M, Fujikawa K, Hirashima T, Shimura T, Taku K, Otsuji T, Tamura F, Shinozaki E, Nakashima K, Hara H, Tsushima T, Ando M, Morita S, Boku N, Hyodo I. Randomized phase III study of bevacizumab plus FOLFIRI and bevacizumab plus mFOLFOX6 as first-line treatment for patients with metastatic colorectal cancer (WJOG4407G). Ann Oncol 2016; 27:1539-46. [PMID: 27177863 DOI: 10.1093/annonc/mdw206] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [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: 03/30/2016] [Accepted: 05/09/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND FOLFIRI and FOLFOX have shown equivalent efficacy for metastatic colorectal cancer (mCRC), but their comparative effectiveness is unknown when combined with bevacizumab. PATIENTS AND METHODS WJOG4407G was a randomized, open-label, phase III trial conducted in Japan. Patients with previously untreated mCRC were randomized 1:1 to receive either FOLFIRI plus bevacizumab (FOLFIRI + Bev) or mFOLFOX6 plus bevacizumab (mFOLFOX6 + Bev), stratified by institution, adjuvant chemotherapy, and liver-limited disease. The primary end point was non-inferiority of FOLFIRI + Bev to mFOLFOX6 + Bev in progression-free survival (PFS), with an expected hazard ratio (HR) of 0.9 and non-inferiority margin of 1.25 (power 0.85, one-sided α-error 0.025). The secondary end points were response rate (RR), overall survival (OS), safety, and quality of life (QoL) during 18 months. This trial is registered to the University Hospital Medical Information Network, number UMIN000001396. RESULTS Among 402 patients enrolled from September 2008 to January 2012, 395 patients were eligible for efficacy analysis. The median PFS for FOLFIRI + Bev (n = 197) and mFOLFOX6 + Bev (n = 198) were 12.1 and 10.7 months, respectively [HR, 0.905; 95% confidence interval (CI) 0.723-1.133; P = 0.003 for non-inferiority]. The median OS for FOLFIRI + Bev and mFOLFOX6 + Bev were 31.4 and 30.1 months, respectively (HR, 0.990; 95% CI 0.785-1.249). The best overall RRs were 64% for FOLFIRI + Bev and 62% for mFOLFOX6 + Bev. The common grade 3 or higher adverse events were leukopenia (11% in FOLFIRI + Bev/5% in mFOLFOX6 + Bev), neutropenia (46%/35%), diarrhea (9%/5%), febrile neutropenia (5%/2%), peripheral neuropathy (0%/22%), and venous thromboembolism (6%/2%). The QoL assessed by FACT-C (TOI-PFC) and FACT/GOG-Ntx was favorable for FOLFIRI + Bev during 18 months. CONCLUSION FOLFIRI plus bevacizumab was non-inferior for PFS, compared with mFOLFOX6 plus bevacizumab, as the first-line systemic treatment for mCRC. CLINICAL TRIALS NUMBER UMIN000001396.
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Affiliation(s)
- K Yamazaki
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - M Nagase
- Department of Clinical Oncology, Jichi Medical University, Shimotsuke
| | - H Tamagawa
- Department of Surgery, Osaka General Medical Center, Osaka
| | - S Ueda
- Department of Medical Oncology, Kinki University Faculty of Medicine, Higashiosaka
| | - T Tamura
- Department of Medical Oncology, Nara Hospital Kinki University Faculty of Medicine, Ikoma
| | - K Murata
- Department of Surgery, Suita Municipal Hospital, Suita
| | - T Eguchi Nakajima
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki
| | - E Baba
- Department of Comprehensive Clinical Oncology, Kyushu University Faculty of Medical Sciences, Fukuoka
| | - M Tsuda
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi
| | - T Moriwaki
- Division of Gastroenterology, University of Tsukuba, Tsukuba
| | - T Esaki
- Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka
| | - Y Tsuji
- Department of Medical Oncology, Tonan Hospital, Sapporo
| | - K Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya
| | - K Taira
- Clinical Oncology, Osaka City General Hospital, Osaka
| | - T Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba
| | - S Funai
- Department of Surgery, Sakai Hospital Kinki University Faculty of Medicine, Sakai
| | - K Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima
| | - H Yamashita
- Department of Gastroenterology and Hepatology, Okayama Medical Center, Okayama
| | - N Sugimoto
- Department of Clinical Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka
| | - T Okuno
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe
| | - T Nishina
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matuyama
| | - M Umeki
- Department of Surgery, Hyogo Prefectural Awaji Medical Center, Sumoto
| | - T Kurimoto
- Department of Gastrointestinal Oncology, Nagoya Kyoritsu Hospital, Nagoya
| | - T Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School, Tokushima
| | - A Tsuji
- Department of Medical Oncology, Kochi Health Sciences Center, Kochi
| | - M Yoshida
- Division of Cancer Chemotherapy Center, Osaka Medical College Hospital, Takatsuki
| | - A Hosokawa
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Toyama
| | - Y Shibata
- Department of Chemotherapy, Miyazaki Prefectural Miyazaki Hospital, Miyazaki
| | - K Suyama
- Department of Medical Oncology, Toranomon Hospital, Tokyo
| | - M Okabe
- Department of Surgery, Kurashiki Central Hospital, Kurashiki
| | - K Suzuki
- Department of gastroenterology, Kushiro City General Hospital, Kushiro
| | - N Seki
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo
| | - K Kawakami
- Department of Gastroenterology, Muroran City General Hospital, Muroran
| | - M Sato
- Department of Gastroenterology and Hepatology, Ryuugasaki Saiseikai Hospital, Ryugasaki
| | - K Fujikawa
- Department of Gastroenterology, Hokkaido Cancer Center, Sapporo
| | - T Hirashima
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino
| | - T Shimura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - K Taku
- Division of Medical Oncology, Shizuoka General Hospital, Shizuoka
| | - T Otsuji
- Department of Gastroenterology, Dongo Hospital, Yamatotakada
| | - F Tamura
- Department of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto
| | - E Shinozaki
- Department of Gastroenterology, Cancer Institute Hospital of JFCR, Tokyo
| | - K Nakashima
- First Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | - H Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama
| | - T Tsushima
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - M Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - N Boku
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki
| | - I Hyodo
- Division of Gastroenterology, University of Tsukuba, Tsukuba
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Fujita Y, Yamazaki K, Oba M, Muro K, Negoro Y, Yoshida M, Suyama K, Kurimoto T, Sugimoto N, Seki N, Sato M, Ebi M, Tamagawa H, Ueda S, Tamura T, Boku N, Hyodo I, Yamanaka T, Tsurutani J, Nishio K. 2152 Exploratory analysis of predictive biomarkers of oxaliplatin versus irinotecan in combination with bevacizumab for patients with metastatic colorectal cancer in WJOG4407G study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31073-5] [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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Iwamoto S, Takahashi T, Tamagawa H, Nakamura M, Munemoto Y, Kato T, Hata T, Denda T, Morita Y, Inukai M, Kunieda K, Nagata N, Kurachi K, Ina K, Ooshiro M, Shimoyama T, Baba H, Oba K, Sakamoto J, Mishima H. FOLFIRI plus bevacizumab as second-line therapy in patients with metastatic colorectal cancer after first-line bevacizumab plus oxaliplatin-based therapy: the randomized phase III EAGLE study. Ann Oncol 2015; 26:1427-33. [PMID: 25908603 PMCID: PMC4478977 DOI: 10.1093/annonc/mdv197] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/15/2015] [Indexed: 11/13/2022] Open
Abstract
EAGLE was a randomized, multicenter phase III study which evaluated the superiority of bevacizumab 10 mg/kg plus FOLFIRI compared with bevacizumab 5 mg/kg plus FOLFIRI in patients with mCRC previously treated with first-line bevacizumab plus an oxaliplatin-based regimen. The results suggest that the higher 10 mg/kg dose offers no clear clinical benefit compared with bevacizumab 5 mg/kg in this setting. Background A targeted agent combined with chemotherapy is the standard treatment in patients with metastatic colorectal cancer (mCRC). The present phase III study was conducted to compare two doses of bevacizumab combined with irinotecan, 5-fluorouracil/leucovorin (FOLFIRI) in the second-line setting after first-line therapy with bevacizumab plus oxaliplatin-based therapy. Patients and methods Patients were randomly assigned to receive FOLFIRI plus bevacizumab 5 or 10 mg/kg in 2-week cycles until disease progression. The primary end point was progression-free survival (PFS), and secondary end points included overall survival (OS), time to treatment failure (TTF), and safety. Results Three hundred and eighty-seven patients were randomized between September 2009 and January 2012 from 100 institutions in Japan. Baseline patient characteristics were well balanced between the two groups. Efficacy was evaluated in 369 patients (5 mg/kg, n = 181 and 10 mg/kg, n = 188). Safety was evaluated in 365 patients (5 mg/kg, n = 180 and 10 mg/kg, n = 185). The median PFS was 6.1 versus 6.4 months (hazard ratio, 0.95; 95% confidence interval [CI] 0.75–1.21; P = 0.676), and median TTF was 5.2 versus 5.2 months (hazard ratio, 1.01; 95% CI 0.81–1.25; P = 0.967), respectively, for the bevacizumab 5 and 10 mg/kg groups. Follow-up of OS is currently ongoing. Adverse events, including hypertension and hemorrhage, occurred at similar rates in both groups. Conclusion Bevacizumab 10 mg/kg plus FOLFIRI as the second-line treatment did not prolong PFS compared with bevacizumab 5 mg/kg plus FOLFIRI in patients with mCRC. If bevacizumab is continued after first-line therapy in mCRC, a dose of 5 mg/kg is appropriate for use as second-line treatment. Clinical trial identifier UMIN000002557.
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Affiliation(s)
- S Iwamoto
- Department of Surgery, Kansai Medical University Hirakata Hospital, Hirakata
| | - T Takahashi
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu
| | - H Tamagawa
- Department of Gastroenterological Surgery, Osaka General Medical Center, Osaka
| | - M Nakamura
- Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto
| | - Y Munemoto
- Department of Surgery, Fukuiken Saiseikai Hospital, Fukui
| | - T Kato
- Department of Surgery, Kansai Rosai Hospital, Amagasaki
| | - T Hata
- Department of Surgery, Osaka University, Suita
| | - T Denda
- Department of Gastroenterology, Chiba Cancer Center, Chiba
| | - Y Morita
- Department of Radiology, Kobe Medical Center, Kobe
| | - M Inukai
- Department of Integrated Medicine, Kagawa University, Kita
| | - K Kunieda
- Department of Surgery, Gifu Prefectural General Medical Center, Gifu
| | - N Nagata
- Department of Surgery, Kitakyushu General Hospital, Kitakyusyu
| | - K Kurachi
- Second Department of Surgery, Hamamatsu University School of Medicine, Shizuoka
| | - K Ina
- Department of Medical Oncology, Nagoya Memorial Hospital, Nagoya
| | - M Ooshiro
- Department of Surgery, Toho University Medical Center Sakura Hospital, Sakura
| | - T Shimoyama
- Department of Chemotherapy, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo
| | - H Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumamoto
| | - K Oba
- Department of Biostatistics, School of Public Health, Graduate School of Medicine and Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo
| | | | - H Mishima
- Cancer Center, Aichi Medical University, Nagakute, Japan
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Mizushima T, Ide Y, Murata K, Ohashi I, Yasumasa K, Fukunaga M, Takemoto H, Tamagawa H, Kato T, Ikenaga M, Hasegawa J, Hata T, Takemasa I, Ikeda M, Satoh T, Yamamoto H, Sekimoto M, Nezu R, Doki Y, Mori M. Phase Ii Study of Combined Chemotherapy with 5-Week Cycles of S-1 and Cpt-11 (Iris) Plus Bevacizumab in Patients with Metastatic Colon Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.29] [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: 11/12/2022] Open
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Munemoto Y, Iwamoto S, Takahashi T, Tamagawa H, Nakamura M, Kato T, Hata T, Denda T, Morita Y, Inukai M, Kunieda K, Nagata N, Kurachi K, Ina K, Oshiro M, Shimoyama T, Baba H, Oba K, Sakamoto J, Mishima H. A Phase III Study of Eagle Comparing Two Doses of Bevacizumab Combined with Folfiri in the Second-Line Setting After First-Line Treatment with Bevacizumab Plus Oxaliplatin-Based Therapy : Kras Subgroup Findings. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.28] [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: 11/14/2022] Open
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21
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Kudo C, Miura M, Gamoh M, Niitani T, Tamagawa H, Takahashi K, Ichikawa S, Sugiyama K. Tumor lysis syndrome after treatment with sorafenib for hepatocellular carcinoma. Int Cancer Conf J 2014. [DOI: 10.1007/s13691-014-0186-2] [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: 10/24/2022] Open
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22
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Tamagawa H, Oshima T, Numata M, Yamamoto N, Shiozawa M, Morinaga S, Nakamura Y, Yoshihara M, Sakuma Y, Kameda Y, Akaike M, Yukawa N, Rino Y, Masuda M, Miyagi Y. Global histone modification of H3K27 correlates with the outcomes in patients with metachronous liver metastasis of colorectal cancer. Eur J Surg Oncol 2013; 39:655-61. [PMID: 23523318 DOI: 10.1016/j.ejso.2013.02.023] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 01/25/2013] [Accepted: 02/20/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND We evaluated the methylation patterns of histone H3 lysine 27 (H3K27), H3 lysine 36 (H3K36) and the expression of H3K27 methylase EZH2 in patients with colorectal carcinomas with metachronous liver metastasis to search for biomarkers identifying these patients. METHODS Double 2-mm core tissue microarrays were made from 54 paraffin-embedded samples of primary colorectal adenocarcinomas and corresponding liver metastases and examined using an immunohistochemical analysis of dimethylation and trimethylation in H3K27, H3K36 and EZH2. Positive tumor cell staining for each histone modification (H-score) was used to classify patients into low- and high-staining groups, which were then examined to identify any correlations between the clinicopathological parameters and the clinical outcomes. RESULTS The H-scores of H3K27me2 were lower in the liver metastases than in the corresponding primary tumors, while the H-scores of H3K36me2 were higher in the liver metastases than in the corresponding primary tumors (P < 0.001). H3K27me2 in the primary tumors correlated with tumor size (P = 0.016), H3K36me2 in the primary tumors correlated with histological type (P = 0.038), and H3K36me3 in the primary tumors correlated with lymph node metastasis (P = 0.017). In addition, lower levels of H3K27me2 in the primary tumors correlated with poorer survival rates (P = 0.039). The multivariate survival analysis showed that the H3K27me2 status is an independent prognostic factor for colorectal cancer patients (P = 0.047). CONCLUSIONS Our findings suggest that the methylation level of H3K27me2 detected with immunohistochemistry may be an independent prognostic factor for metachronous liver metastasis of colorectal carcinomas.
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Affiliation(s)
- H Tamagawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi, Yokohama, Japan.
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Watanabe T, Morinaga S, Akaike M, Numata M, Tamagawa H, Yamamoto N, Shiozawa M, Ohkawa S, Kameda Y, Nakamura Y, Miyagi Y. The cellular level of histone H3 lysine 4 dimethylation correlates with response to adjuvant gemcitabine in Japanese pancreatic cancer patients treated with surgery. Eur J Surg Oncol 2012; 38:1051-7. [DOI: 10.1016/j.ejso.2012.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 08/05/2012] [Accepted: 08/16/2012] [Indexed: 01/22/2023] Open
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Morinaga S, Yamamoto N, Shiozawa M, Tamagawa H, Ueno M, Nakamura Y, Miyagi Y, Ohkawa S, Yoichi K, Akaike M. Use of human equilibrative nucleoside transporter 1 to predict survival after adjuvant gemcitabine chemotherapy in resected pancreatic adenocarcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.224] [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
224 Background: Gemcitabine is a promising adjuvant treatment for patients with resected pancreatic adenocarcinoma. Human equilibrative nucleoside transporter 1 (hENT1) is the major transporter responsible for 2′, 2′-difluoro-2deoxycytidine (gemcitabine) uptake into cells. The aim of this study was to determine the outcomes according to the expression of hENT1 in tumor cells in patients treated with adjuvant gemcitabine chemotherapy after curative resection. Methods: We studied 27 pancreatic adenocarcinoma patients treated with gemcitabine adjuvant chemotherapy after curative resection and 8 gemcitabine naïve patients between 2006 and 2008. The hENT expressions were assessed using immunohistochemistry. The staining intensity of hENT1 protein was assigned a score from 0 to 3 based on staining with 0: no staining, 1: weakly positive, 2: moderately positive, 3: strongly positive. The percentage of positive tumor cells was scored as follows, 0: no positive tumor cell; 1: < 50% positive cells, 2: 51-80% positive cells, 3: > 81% positive cells. The hENT1 score was obtained by calculating the sum of these two scores. Each patients received adjuvant chemotherapy by either protocols as follows; GEM 1,000 mg/m2biweekly × 12 (6 months) or GEM 1,000 mg/m2Days 1,8,15; every 4 weeks for 6 months. Results: 11 patients were assigned to low hENT1 expression group (hENT1 score <4) and 16 patients to high hENT1 group (hENT1 score 4,5,6). The median DFS was 7.3 months (95% CI, 3.6-11.1) in the low hENT1 group, and 9.3 months (95% CI, 4.2-14.5) in the high hENT1 group. The median OS was 11.8 months (95% CI, 6.9- 16.6) in the low hENT1 group, and 22.2 months (95% CI, 11.5-32.9). The high hENT1 group had significantly longer DFS (Log-rank, p=0.04) and OS (p=0.02). In the gemcitabine naïve patients after curative resection, neither DFS nor OS correlated with hENT1 expression. Conclusions: In the pancreatic cancer patients treated with adjuvant gemcitabine chemotherapy after curative resection, both DFS and OS correlated with hENT1 expression. The expression of hENT1 may provides prognostic information and predictive for benefit from gemcitabine in these patients. No significant financial relationships to disclose.
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Affiliation(s)
- S. Morinaga
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - N. Yamamoto
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - M. Shiozawa
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - H. Tamagawa
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - M. Ueno
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Y. Nakamura
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Y. Miyagi
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - S. Ohkawa
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - K. Yoichi
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - M. Akaike
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
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Matsuda C, Ito T, Song J, Mizushima T, Tamagawa H, Kai Y, Hamanaka Y, Inoue M, Nishida T, Matsuda H, Sawa Y. Therapeutic effect of a new immunosuppressive agent, everolimus, on interleukin-10 gene-deficient mice with colitis. Clin Exp Immunol 2007; 148:348-59. [PMID: 17437423 PMCID: PMC1868878 DOI: 10.1111/j.1365-2249.2007.03345.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [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: 02/06/2023] Open
Abstract
A limited number of therapeutic strategies are currently available for patients with inflammatory bowel disease (IBD). In particular, the maintenance therapy after remission in Crohn's disease (CD) is not satisfactory and new approaches are needed. Interleukin-10 gene-deficient (IL-10-/-) mice, a well-characterized experimental model of CD, develop severe chronic colitis due to an aberrant Th1 immune response. Everolimus, an inhibitor of the mammalian target of rapamycin (mTOR), a new immunosuppressive reagent, has been used successfully in animal models for heart, liver, lung and kidney transplantation. In the present study, we examined the efficacy of everolimus in the treatment of chronic colitis in an IL-10-/- mouse model. Everolimus was administered orally for a period of 4 weeks to IL-10-/- mice with clinical signs of colitis. The gross and histological appearances of the colon and the numbers, phenotype and cytokine production of lymphocytes were compared with these characteristics in a control group. The 4-week administration of everolimus resulted in a significant decrease in the severity of colitis, together with a significant reduction in the number of CD4+ T cells in the colonic lamina propria as well as IFN-gamma production in colonic lymphocytes. Everolimus treatment of established colitis in IL-10-/- mice ameliorated the colitis, probably as a result of decreasing the number of CD4+ T cells in the colonic mucosa and an associated reduction in IFN-gamma production.
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Affiliation(s)
- C Matsuda
- Department of Surgery (E1), Osaka University Graduate School of Medicine, Japan
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26
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Nozaki K, Akiyama T, Tamagawa H, Kato S, Mizuno-Matsumoto Y, Nakagawa M, Maeda Y, Shimojo S. The first grid for the oral and maxillofacial region and its application for speech analysis. Methods Inf Med 2005; 44:253-6. [PMID: 15924186] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Introduction of a new grid-based method for analyzing speech functions which takes into account the related information of patients' data and the oral air flow with pronouncing analyzed by computational fluid dynamics. METHODS An on-line speech analyzer was developed for clinical use utilizing GridPort2.3.1 based on globus2.4.2, comprising several computational tools such as unified data storage, semantic data analysis, computational fluid dynamics analysis and three-dimensional visualization of calculated results from different hardware sources with various types of operation systems. RESULTS The power transportation layer between dental clinics and computational and storage resources could be provided by using a WWW-based portal. The backend data management system could be constructed using a storage resource broker (SRB) and extensible mark up language (XML). CONCLUSIONS The new method allows the construction of a data warehouse through this grid-based speech function analysis in order to extract the principal factors related to speech disorders.
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Affiliation(s)
- K Nozaki
- Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Uchikoshi F, Ito T, Nezu R, Tanemura M, Kai Y, Mizushima T, Nakajima K, Tamagawa H, Matsuda C, Matsuda H. Advantages of laparoscope-assisted surgery for recurrent Crohn's disease. Surg Endosc 2004; 18:1675-9. [PMID: 15931478 DOI: 10.1007/s00464-004-8802-4] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 05/12/2004] [Accepted: 06/03/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Laparoscopic surgery has been applied to patients with primary Crohn's disease, and its beneficial outcomes have been already investigated. However, there is no systematic study of laparoscopic surgery for patients with recurrent diseases. METHODS We performed reoperation for 43 patients with recurrent Crohn's disease, including 23 patients who underwent laparoscope-assisted surgery. RESULTS For all the patients, laparoscope-assisted surgery could be performed safely, even if the patients had been treated previously by open surgery or had undergone multiple abdominal procedures. Conversion to open or hand-assisted laparoscopic surgery was necessary for 16 patients (69.6%) because of dense adhesions (11 cases) or bulky tumor (5 cases). Importantly, even if the procedure was converted, the skin incision was significantly shorter than with open surgery, and postoperative recovery was faster, especially for the patients who underwent conversion to hand-assisted laparoscopic surgery. CONCLUSIONS Laparoscope-assisted surgery is feasible and advantageous in reoperation for patients with recurrent Crohn's disease.
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Affiliation(s)
- F Uchikoshi
- Department of Surgery, Osaka University Graduate School of Medicine, E1 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Isoda S, Imoto K, Uchida K, Hashiyama N, Yanagi H, Tamagawa H, Takanashi Y. “Sandwich Technique” via Right Ventricle Incision to Repair Postinfarction Ventricular Septal Defect. J Card Surg 2004; 19:149-50. [PMID: 15016054 DOI: 10.1111/j.0886-0440.2004.04028.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [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: 11/30/2022]
Abstract
We describe two cases where postinfarction ventricular septal defect (VSD) was treated with a new technique. Application of direct ultrasonography to the right ventricular (RV) wall enables the surgeon to visualize the region and perform appropriate incision into the right ventricle and trabecula resection. The VSD is sealed with gelatin-resorcin-formal (GRF) glue between two patches, one placed on the left ventricular side and the other on the right ventricular side. RV incision provides easy bleeding control and the "sandwich technique" using two patches and GRF sealing provides geometric preservation of the left ventricular shape and prevents residual shunt.
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Affiliation(s)
- S Isoda
- First Department of Surgery, School of Medicine, Yokohama City University, 4-57 Urafune-cho, Minami-ku,Yokohama, Japan.
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Sakamoto Y, Sakai M, Tamagawa H, Wang G, Horiuchi S, Hagiwara T, Miyazaki A. 4P-0997 Interaction of oxidized low-density lipoprotein with thrombospondin-1 leads to inhibition of activation of transforming growth factor-β. ATHEROSCLEROSIS SUPP 2003. [DOI: 10.1016/s1567-5688(03)91255-4] [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: 11/29/2022]
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31
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Kishi D, Takahashi I, Kai Y, Tamagawa H, Iijima H, Obunai S, Nezu R, Ito T, Matsuda H, Kiyono H. Alteration of V beta usage and cytokine production of CD4+ TCR beta beta homodimer T cells by elimination of Bacteroides vulgatus prevents colitis in TCR alpha-chain-deficient mice. J Immunol 2000; 165:5891-9. [PMID: 11067950 DOI: 10.4049/jimmunol.165.10.5891] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A major pathogenic factor for the development of inflammatory bowel disease (IBD) is the breakdown of the intestinal homeostasis between the host immune system and the luminal microenvironment. To assess the potential influence of luminal Ags on the development of IBD, we fed TCR alpha(-/-) mice an elemental diet (ED). ED-fed TCR alpha(-/-) mice showed no pathologic features of IBD, and their aberrant mucosal B cell responses were suppressed. Similar numbers of CD4(+), TCR betabeta homodimer T cells (betabeta T cells) were developed in the colonic mucosa of ED-fed mice; however, Th2-type cytokine productions were lower than those seen in diseased regular diet (RD)-fed mice. The higher cytokine production in diseased RD-fed mice could be attributed to the high incidence of Bacteroides vulgatus (recovered in 80% of these mice), which can induce Th2-type responses of colonic CD4(+), betabeta T cells. In contrast, ED-fed TCR alpha(-/-) mice exhibited a diversification of Vbeta usage of betabetaT cell populations from the dominant Vbeta8 one associated with B. vulgatus in cecal flora to Vbeta6, Vbeta11, and Vbeta14. Rectal administration of disease-free ED-fed mice with B. vulgatus resulted in the development of Th2-type CD4(+), betabeta T cell-induced colitis. These findings suggest that the ED-induced alteration of intestinal microenvironments such as the enteric flora prevented the development of IBD in TCR alpha(-/-) mice via the immunologic quiescence of CD4(+), betabeta T cells.
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MESH Headings
- Administration, Rectal
- Animals
- Antibody-Producing Cells/pathology
- Bacteroides/growth & development
- Bacteroides/immunology
- Bacteroides Infections/genetics
- Bacteroides Infections/immunology
- Bacteroides Infections/prevention & control
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/metabolism
- CD4-Positive T-Lymphocytes/microbiology
- CD4-Positive T-Lymphocytes/pathology
- Cecum/microbiology
- Cell Differentiation/genetics
- Cell Differentiation/immunology
- Cell Movement/genetics
- Cell Movement/immunology
- Cells, Cultured
- Coculture Techniques
- Colitis/genetics
- Colitis/immunology
- Colitis/prevention & control
- Colon/immunology
- Colon/metabolism
- Colon/microbiology
- Cytokines/antagonists & inhibitors
- Cytokines/biosynthesis
- Dimerization
- Food, Formulated
- Immune Tolerance/genetics
- Intestinal Mucosa/immunology
- Intestinal Mucosa/microbiology
- Intestinal Mucosa/pathology
- Leukocyte Count
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Receptors, Antigen, T-Cell, alpha-beta/biosynthesis
- Receptors, Antigen, T-Cell, alpha-beta/deficiency
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Spleen/immunology
- Spleen/metabolism
- Spleen/microbiology
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/metabolism
- T-Lymphocyte Subsets/microbiology
- T-Lymphocyte Subsets/pathology
- Th2 Cells/immunology
- Th2 Cells/metabolism
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Affiliation(s)
- D Kishi
- Department of Mucosal Immunology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
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Ojima M, Tamagawa H, Nagata H, Hanioka T, Shizukuishi S. Relation of motility of subgingival microflora as a clinical parameter to periodontal disease status in human subjects. J Clin Periodontol 2000; 27:405-10. [PMID: 10883869 DOI: 10.1034/j.1600-051x.2000.027006405.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIMS The purpose of this study was to evaluate the possible relationship between the motility of subgingival microflora and 5 clinical parameters commonly used in dental clinics. METHOD The clinical parameters were pocket depth, gingival inflammation, plaque accumulation, bleeding on probing and pus discharge. The motility of human subgingival microflora was estimated as the number of pixels remaining after subtraction of serial video frames using a high speed shutter camera and image analysis system, and was defined as the sum of pixels of 10 successive subtractions per sample over a 10-s time period. RESULTS The bacterial motility showed significant positive, moderate or low associations with the five clinical parameters. The highest correlation was observed between the bacterial motility and pocket depth (r=0.36, p=0.0001). Furthermore, clinically defined periodontal healthy and diseased sites were significantly different with respect to the bacterial motility (p<0.0001). To determine whether the bacterial motility was dependent or independent of the other clinical variables, the data were analyzed based on common factor analysis. Three factors were extracted and explained about 75% of the variance of the original 6 clinical parameters. Only the bacterial motility had a positive coefficient for all these three factors. The plot of bacterial motility was placed separately from those of other variables in the scatterplot of the loadings of factor 2 versus factor 1 and factor 2 versus factor 3. CONCLUSIONS This suggests that bacterial motility may be an independent variable among the clinical parameters. Taken together, these data indicate that bacterial motility provides unique information about the clinical periodontal condition and may be a useful tool for the monitoring of subgingival plaque in relation to periodontal disease.
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Affiliation(s)
- M Ojima
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Suita, Japan
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Ojima M, Tamagawa H, Hayashi N, Shizukuishi S. Dental interview system with a native-language interpreting engine. Stud Health Technol Inform 1999; 52 Pt 1:319-21. [PMID: 10384471] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
We developed a Dental Interview System with a Native-language Interpreting Engine (DISNIE) on the Internet. DISNIE uses simple natural sentences without dental terminology and interprets these sentences in five languages such as Japanese, English, Korean, Chinese and French, respectively. DISNIE is a good tool not only for patients who are able to read, write and speak only their mother languages but also for the staff at a dental hospital because of its accessibility via the Internet.
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Affiliation(s)
- M Ojima
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan.
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35
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Abstract
The purpose of this investigation was to quantitatively estimate bacterial motility by image analysis, and to apply this method for the measurement of motility of human subgingival microflora. We developed a semi-automated method for the quantification of bacterial motility using video microscopy, digitization and image processing. Moving images of both authentic bacterial samples and clinical samples were recorded using a phase contrast microscope with a high speed (1/100 s) shutter camera. The motility was evaluated by measuring the total number of pixels remaining after the subtraction of 2 serial video images. The total number of pixels was significantly correlated with both the sum of the velocity of each bacterial cell and the number of motile bacteria on the same original images. Motility of subgingival microflora from 140 clinical samples tested was measured at 0 pixels to 3600 pixels, whereas the effect of Brownian movement was less than 150 pixels. The motility of subgingival microflora estimated with this image analysis system did not differ much from objective judgments by the naked eyes of experts. These results suggest that a semi-automated image analysis system may be useful in the evaluation of the motility of human subgingival microflora.
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Affiliation(s)
- M Ojima
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Suita, Japan
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36
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Shizukuishi S, Hayashi N, Tamagawa H, Hanioka T, Maruyama S, Takeshita T, Morimoto K. Lifestyle and periodontal health status of Japanese factory workers. Ann Periodontol 1998; 3:303-11. [PMID: 9722714 DOI: 10.1902/annals.1998.3.1.303] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The present study investigated the association of lifestyles to periodontal health status of workers in a manufacturing company in Japan. In a annual health checkup, periodontal health status was assessed by using the Community Periodontal Index (CPI) criteria and analysed by modified Miller's CPI score. Lifestyle information was also obtained by a self-administered questionnaire. Bivariate and multivariate analyses were used to examine the relationship between lifestyle and oral health care variables and 2 indicators of periodontal health status. These were the modified Miller's CPI score and the probability of subjects in the upper 25th percentile of CPI distribution as an indicator of poor periodontal health. The modified Miller's CPI score was found to increase with age, but to vary according to the workers' lifestyles. In bivariate analyses, significant variables were age, smoking, alcohol consumption, toothbrushing frequency, toothbrushing method, and use of interdental cleaners. In multivariate analyses, age, smoking, and use of interdental cleaners had significantly independent effects. Amount of smoking or alcohol consumption was associated with periodontal health status. Excessive use of alcohol may contribute to the development of periodontal disease, although further investigations are required to confirm this finding. The data from this study indicate that lifestyles which include smoking and insufficient oral health care have an independent association with periodontal disease.
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Affiliation(s)
- S Shizukuishi
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan.
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37
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Abstract
In this study, we investigated whether Porphyromonas gingivalis can bind hemoglobin as an initial step in the acquisition of heme from hemoglobin. The binding of human hemoglobin by P. gingivalis cells was determined using [3H]hemoglobin. Hemoglobin binding occurred rapidly, reversibly and specifically. A Scatchard analysis of the binding data generated a linear plot, indicating a single population of binding proteins. The apparent Kd was 1.0 +/- 0.19 x 10(-6) M and there were 3.2 +/- 0.76 x 10(4) binding sites per cell. Hemoglobin binding was inhibited by unlabeled human hemoglobin but not by hemin and protoporphyrin IX. The binding was only partially inhibited by human serum albumin, transferrin, lactoferrin, catalase and cytochrome c. These results suggest that the ligand recognized by the binding protein may not be the heme moiety. The binding of hemoglobin considerably increased when the organisms were grown under hemin-limited conditions. Hemoglobin bound to outer membrane proteins extracted from P. gingivalis cells on a dot blot binding assay and binding ability was lost after heating bacterial proteins. These results suggest that P. gingivalis cells interact with human hemoglobin through specific binding sites on their surfaces as a preliminary step in iron acquisition.
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Affiliation(s)
- A Amano
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan
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38
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Tazaki K, Inoshita E, Amano A, Hanioka T, Tamagawa H, Shizukuishi S. Interaction of Porphyromonas gingivalis with transferrin. FEMS Microbiol Lett 1995; 131:161-6. [PMID: 7557325 DOI: 10.1016/0378-1097(95)00253-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
In this study, we characterized the binding of transferrin to Porphyromonas gingivalis using a classical receptor-binding assay, and examined the relationship between the binding and availability of transferrin for the growth of P. gingivalis. The binding of 125I-labeled human transferrin to P. gingivalis occurred rapidly, reversibly and specifically. Scatchard analysis yielded a Kd of 1.37 +/- 0.16 microM and an apparent number of 1.13 +/- 0.26 x 10(5) receptors per cell. The binding of transferrin was much increased when organisms were grown in iron-limited conditions. Among the species of black-pigmented anaerobic.rods, those strains of P. gingivalis which had high transferrin-binding activity exhibited unrestricted growth following the addition of transferrin to the hemin-free culture medium. On the other hand, the presence of transferrin in the culture medium did not support unrestricted growth of organisms that had low transferrin-binding activity. These results suggest that the binding of transferrin to P. gingivalis cells may be a preliminary step in iron acquisition, which allows them to survive in the healthy periodontal environment.
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Affiliation(s)
- K Tazaki
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan
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39
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Nagata H, Tazaki K, Amano A, Hanioka T, Tamagawa H, Shizukuishi S. Characterization of coaggregation and fibrinogen-binding by Porphyromonas gingivalis. J Osaka Univ Dent Sch 1994; 34:37-44. [PMID: 8935092] [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: 05/22/2023]
Abstract
We have examined whether the adhesin of Porphyromonas gingivalis which aggregates Streptococcus oralis contributes to its fibrinogen-binding. Various properties of coaggregation between P. gingivalis and S. oralis were compared with those of fibrinogen-binding to P. gingivalis cells. The coaggregation activity was measured by a turbidimetric method and the fibrinogen-binding activity was determined by using 125I-fibrinogen. Both the activities showed maximum values in the pH range from 5.0 to 6.0 and they were inhibited by arginine and lysine. Heating treatment of P. gingivalis 381 cells at 75 degrees C abrogated the activities. However, treatment of P. gingivalis 381 cells with proteinase K considerably reduced the fibrinogen-binding activity but not the coaggregation activity. Metal ions such as Zn2+ and Cu2+ inhibited the coaggregation activity but enhanced the fibrinogen-binding activity. The results also indicated that P. gingivalis strains 381, ATCC 33277 and SU-3 showed relatively higher activities both in coaggregation and fibrinogen-binding, whereas P. gingivalis strains W83, 51 and 165 showing lower fibrinogen-binding activity than P. gingivalis 381 did not coaggregate with S. oralis ATCC 9811. These findings suggest that coadhesin of P. gingivalis with S. oralis is not be associated with its fibrinogen-binding.
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Affiliation(s)
- H Nagata
- Department of Preventive Dentistry, Osaka University, Japan
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40
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Nagata H, Amano A, Hanioka T, Tamagawa H, Shizukuishi S, Miyata T. Inhibition of coaggregation between Porphyromonas gingivalis and Streptococcus oralis by fibrinogen fragments. FEMS Microbiol Lett 1993; 114:31-6. [PMID: 8293957 DOI: 10.1111/j.1574-6968.1993.tb06546.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The localization of regions of fibrinogen that inhibit coaggregation between Porphyromonas gingivalis and Streptococcus oralis was investigated. The coaggregation was inhibited by A alpha and gamma chains, but not by B beta chain. The inhibitory activity of fragment D was more potent than that of fragment E. Some cyanogen bromide-treated fragments isolated from A alpha and gamma chains including the NH2-terminal 148-207 amino acid residues of A alpha chain (A alpha 148-207) and gamma 1-78 showed inhibitory activities. A alpha 148-207 was further digested with lysyl endopeptidase. A alpha 158-176 and A alpha 192-206 which contained four and two arginine residues, respectively, retained the inhibitory activities. When the arginine residues of these two peptides were modified by phenylglyoxal, the inhibitory activities were much reduced. These findings suggest that the arginine residues of some specific regions of fibrinogen may play an important role in the inhibition of the coaggregation.
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Affiliation(s)
- H Nagata
- Department of Preventive Dentistry, Faculty of Dentistry, Osaka University, Japan
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Abstract
We studied the immediate effect of mechanical stimulation with a toothbrush on oxygen sufficiency in human gingivae. Teeth were brushed with a modified Bass technique at various forces (100, 200, and 300 g) for various times (5, 10, and 30 s). Hemoglobin (Hb) oxygen saturation was measured before and intermittently for 60 min after brushing, by non-invasive tissue reflectance spectrophotometry. Hb oxygen saturation increased within a few min after brushing and then slowly returned to the initial level. Toothbrushing at 200 g for 10 s caused the longest-lived increase in Hb oxygen saturation; saturation remained about 6% above the baseline level for more than 25 min. Before brushing, Hb oxygen saturation was significantly lower in inflamed gingivae than in healthy gingivae (p < 0.05). After brushing of inflamed gingivae, the Hb oxygen saturation almost reached the level measured in healthy gingivae before brushing. These findings suggest that stimulation with a toothbrush increases oxygen sufficiency in both healthy and inflamed gingivae.
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Affiliation(s)
- T Hanioka
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan
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42
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Murakami Y, Tamagawa H, Shizukuishi S, Tsunemitsu A, Aimoto S. Biological role of an arginine residue present in a histidine-rich peptide which inhibits hemagglutination of Porphyromonas gingivalis. FEMS Microbiol Lett 1992; 77:201-4. [PMID: 1334017 DOI: 10.1016/0378-1097(92)90156-i] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Inhibitory effects of synthetic fragments in histatin 8, having the sequence Lys-Phe-His-Glu-Lys-His-His-Ser-His-Arg-Gly-Tyr, on hemagglutination by Porphyromonas gingivalis 381 were examined. The hemagglutinating activity was reduced much more by the peptide Lys-His-His-Ser-His-Arg-Gly-Tyr than by the peptides Lys-His-His-Ser-His and/or Lys-Phe-His-Glu-Lys. These results suggest that the arginine residue may have an important role in the inhibition of hemagglutination by P. gingivalis.
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Affiliation(s)
- Y Murakami
- Department of Preventive Dentistry, Faculty of Dentistry, Osaka University, Japan
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43
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Hanioka T, Amano A, Inoshita E, Tamagawa H, Shizukuishi S. Changes in oxygen consumption in dog gingiva during induction of experimental periodontitis. J Dent Res 1992; 71:466-9. [PMID: 1573077 DOI: 10.1177/00220345920710030801] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The purpose of this study was to examine changes in oxygen consumption in dog gingiva during induction of experimental periodontitis. The disease was induced in adult mongrel dogs during a 16-week period by placement of silk ligatures around selected teeth. The oxygen consumption rate of gingival tissue was determined in vivo by a non-invasive technique, tissue reflectance spectrophotometry. Changes in such clinical parameters as gingival index, plaque index, pocket depth, attachment level, and gingival crevicular fluid flow indicated acute inflammatory responses during the first three weeks after ligation, followed by the appearance of chronic inflammation during the remaining 13 weeks. The oxygen consumption rate increased during the first seven days after ligation and stayed near the maximum level for 2-7 weeks; this was followed by a gradual decrease during the final nine weeks. These results suggest that gingival oxygen consumption increases rapidly with the increase of acute inflammation responses and then decreases slightly with the gradual development of chronic inflammation. Positive correlations were observed between the oxygen consumption rate and other clinical indices. Thus, the tissue reflectance spectrophotometry is a new, useful method for objective, quantitative, and non-invasive assessment of gingival oxygen consumption.
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Affiliation(s)
- T Hanioka
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan
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Amano A, Ishimoto T, Tamagawa H, Shizukuishi S. Role of superoxide dismutase in resistance of Porphyromonas gingivalis to killing by polymorphonuclear leukocytes. Infect Immun 1992; 60:712-4. [PMID: 1309723 PMCID: PMC257691 DOI: 10.1128/iai.60.2.712-714.1992] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [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: 12/26/2022] Open
Abstract
Porphyromonas gingivalis in which the synthesis of superoxide dismutase (SOD) was induced by nitrate or by aeration was rendered resistant to killing by polymorphonuclear leukocytes. SOD purified from either anaerobically maintained or aerated cells also inhibited bacterial killing when added exogenously, and no difference between the effects of the two SODs was observed. These results suggest that SOD may form part of a defense mechanism that helps protect P. gingivalis against killing by polymorphonuclear leukocytes.
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Affiliation(s)
- A Amano
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan
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45
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Abstract
This study describes the effect of transferrin as an iron source on the growth of Porphyromonas (formally Bacteroides) gingivalis. Bacterial growth was monitored spectrophotometrically. All strains of P. gingivalis tested grew well in medium containing transferrin. The growth of P. gingivalis depended not only on the concentration of transferrin, but also on the iron saturation level of the protein. However, growth was not stimulated with either the ferrous or ferric iron salts tested. The addition of dipyridyl to the medium containing transferrin suppressed the growth of P. gingivalis, which also did not show species-specificity for human transferrin. Transferrin-binding activity was found in P. gingivalis by solid-phase assay with peroxidase-conjugated human transferrin. These results suggest that P. gingivalis may be capable of utilizing transferrin as an iron source for growth in vivo.
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Affiliation(s)
- E Inoshita
- Department of Preventive Dentistry, Osaka University Faculty of Dentistry, Japan
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Ellis JM, Folkers K, Minadeo M, VanBuskirk R, Xia LJ, Tamagawa H. A deficiency of vitamin B6 is a plausible molecular basis of the retinopathy of patients with diabetes mellitus. Biochem Biophys Res Commun 1991; 179:615-9. [PMID: 1883384 DOI: 10.1016/0006-291x(91)91416-a] [Citation(s) in RCA: 30] [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: 12/29/2022]
Abstract
Eighteen patients with diabetes mellitus, some of whom had variously retinopathy, pregnancy, and the carpal tunnel syndrome, and were variously treated with steroids and vitamin B6, have been overviewed for periods of 8 months to 28 years. We have established an association of a deficiency of vitamin B6 with diabetes by monitoring the specific activity of the erythrocyte glutamic oxaloacetic transaminase and again by the association with the carpal tunnel syndrome (C.T.S.). It has been known for a decade that C.T.S. is caused by a B6 deficiency. The absence of retinopathy in vitamin B6-treated diabetic patients over periods of 8 months - 28 years appears monumental. These observations are like discovery and constitute a basis for a new protocol to establish the apparent relationship of a deficiency of vitamin B6 as a molecular cause of diabetic neuropathy. Blindness and vision are so important that the strength or weakness of the observations are not important; the conduct of a new protocol is important.
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Affiliation(s)
- J M Ellis
- Department of Medicine, Titus County Hospital, Mt. Pleasant, Texas
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Suzuki KT, Tamagawa H, Hirano S, Kobayashi E, Takahashi K, Shimojo N. Changes in element concentration and distribution in breast-milk fractions of a healthy lactating mother. Biol Trace Elem Res 1991; 28:109-21. [PMID: 1709027 DOI: 10.1007/bf02863077] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [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
Daily changes in components of breast milk with number of days of lactation after delivery were demonstrated by determining concentrations and distributions of several elements simultaneously. Concentrations of calcium, copper, magnesium, phosphorus, sulfur, and zinc were determined simultaneously by inductively coupled argon plasma-atomic-emission spectrometry (ICP) for whole milk and milk fractions (skimmed milk and whey) collected from 2 to 196 d postpartum from a healthy lactating mother. Calcium and phosphorus concentrations increased in transitional milk. With days postpartum, the other elements decreased from the highest concentrations in colostrum milk, the modes of decrease being characteristic for each element. Distributions of copper, iron, phosphorus, sulfur, and zinc in whey were determined on a gel-filtration column by HPLC with ICP detection (HPLC-ICP method). Distributions of the five elements and absorbance peaks at 254 and 280 nm changed dramatically day by day at the beginning (colostrum milk), resulting in constant distributions after 30 d (mature milk). These results suggest the important roles of daily changing constituents in breast milk, especially in colostrum milk, in the nutrition of the newborn. Several element peaks on a gel-filtration column were identified by comparison with standard samples.
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Affiliation(s)
- K T Suzuki
- National Institute for Environmental Studies, Ibaraki, Japan
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48
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Hanioka T, Amano A, Tamagawa H, Shizukuishi S. Evaluation of the depth sensitivity of tissue reflectance spectrophotometry in gingival measurement. J Osaka Univ Dent Sch 1990; 30:1-7. [PMID: 2130163] [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: 12/30/2022]
Abstract
Tissue reflectance spectrophotometry (TRS) can estimate hemoglobin concentration (Hb index) and oxygen saturation of hemoglobin (apparent SO2) in tissues. Reflectance spectra were measured in a gingiva-model and in human gingival biopsies by TRS. The gingiva-model was composed of human red cells and white gel in a cuvette placed on a black or white surface. The distance from the bottom surface of the cuvette to the optical probe was decreased from 5.0 to 0.5 mm. The Hb index in the gingiva-model on the black surface was constant before decreasing at less than a 3.0 mm distance. However, the Hb index in the gingiva-model on the white surface showed a decrease at less than a 1.5 mm distance. Apparent SO2 was constant at more than a 1.0 mm distance. Reflectance spectra were measured from human gingival tissue preparations, by slicing them off with microtome and making them less thick each time. Changes in reflectance spectra were observed in less than 1.0-1.5 mm thick specimens. These results suggest that the sensitivity in TRS measurement may exist within 1.0-1.5 mm from the gingival surface, and the limit of depth at which the TRS can measure may be within 3.0 mm.
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Affiliation(s)
- T Hanioka
- Osaka University Faculty of Dentistry
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49
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Abstract
Lovastatin is used for the treatment of hypercholesterolemia. It functions by inhibiting the enzyme, 3-hydroxy-3-methylglutaryl-coenzyme A reductase (EC 1.1.1.34), that is required for the conversion of 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonic acid. Since biosynthesis of both cholesterol and coenzyme Q (CoQ) requires mevalonic acid as a precursor, it was considered that lovastatin therapy would also result in a lowering of cellular CoQ levels. This study was conducted to determine whether lovastatin treatment does decrease CoQ levels and whether such decreases can be prevented by CoQ supplementation. Forty-five adult male Holtzman rats were randomly assigned to one of three treatment groups. Controls were fed ground laboratory rat chow ad libitum. The other two groups were fed ground laboratory rat chow containing 400 mg of lovastatin per kg of diet ad libitum. One of the lovastatin-fed groups received CoQ10 (15 mg per kg of body weight) daily via stomach intubation. After 4 weeks, samples of heart, liver, and blood were analyzed for CoQ concentrations. Results indicated that CoQ concentrations in all tissues analyzed were decreased in lovastatin-treated rats. Lovastatin-treated animals that were supplemented with CoQ10 had blood, heart, and liver CoQ10 concentrations that approximated or exceeded those of control animals. It is concluded that lovastatin does indeed lower tissue concentrations of CoQ and that a return to normal can be achieved by supplementation with CoQ.
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Affiliation(s)
- R A Willis
- Division of Graduate Nutrition, University of Texas, Austin 78712
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Abstract
Lovastatin is clinically used to treat patients with hypercholesterolemia and successfully lowers cholesterol levels. The mechanism of action of lovastatin is inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, an enzyme involved in the biosynthesis of cholesterol from acetyl-CoA. Inhibition of this enzyme could also inhibit the intrinsic biosynthesis of coenzyme Q10 (CoQ10), but there have not been definitive data on whether lovastatin reduces levels of CoQ10 as it does cholesterol. The clinical use of lovastatin is to reduce a risk of cardiac disease, and if lovastatin were to reduce levels of CoQ10, this reduction would constitute a new risk of cardiac disease, since it is established that CoQ10 is indispensable for cardiac function. We have conducted three related protocols to determine whether lovastatin does indeed inhibit the biosynthesis of CoQ10. One protocol was done on rats, and is reported in the preceding paper [Willis, R. A., Folkers, K., Tucker, J. L., Ye, C.-Q., Xia, L.-J. & Tamagawa, H. (1990) Proc. Natl. Acad. Sci. USA 87, 8928-8930]. The other two protocols are reported here. One involved patients in a hospital, and the other involved a volunteer who permitted extraordinary monitoring of CoQ10 and cholesterol levels and cardiac function. All data from the three protocols revealed that lovastatin does indeed lower levels of CoQ10. The five hospitalized patients, 43-72 years old, revealed increased cardiac disease from lovastatin, which was life-threatening for patients having class IV cardiomyopathy before lovastatin or after taking lovastatin. Oral administration of CoQ10 increased blood levels of CoQ10 and was generally accompanied by an improvement in cardiac function. Although a successful drug, lovastatin does have side effects, particularly including liver dysfunction, which presumably can be caused by the lovastatin-induced deficiency of CoQ10.
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