1
|
Araki T, Kanda S, Ide T, Sonehara K, Komatsu M, Tateishi K, Minagawa T, Kiniwa Y, Kawakami S, Nomura S, Okuyama R, Hanaoka M, Koizumi T. Antiplatelet drugs may increase the risk for checkpoint inhibitor-related pneumonitis in advanced cancer patients. ESMO Open 2023; 8:102030. [PMID: 37852033 PMCID: PMC10774871 DOI: 10.1016/j.esmoop.2023.102030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/31/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are indicated for various cancers and are the mainstay of cancer immunotherapy. They are often associated with ICI-related pneumonitis (CIP), however, hindering a favorable clinical course. Recently, non-oncology concomitant drugs have been reported to affect the efficacy and toxicity of ICIs; however, the association between these drugs and the risk for CIP is uncertain. The aim of this study was to assess the impact of baseline concomitant drugs on CIP incidence in ICI-treated advanced cancer patients. PATIENTS AND METHODS This was a single-center retrospective study that included a cohort of 511 patients with advanced cancer (melanoma and non-small-cell lung, head and neck, genitourinary, and other types of cancer) treated with ICIs. Univariable analysis was conducted to identify baseline co-medications associated with CIP incidence. A propensity score matching analysis was used to adjust for potential CIP risk factors, and multivariable analysis was carried out to assess the impact of the identified co-medications on CIP risk. RESULTS Forty-seven (9.2%) patients developed CIP. In these patients, the organizing pneumonia pattern was the dominant radiological phenotype, and 42.6% had grade ≥3 CIP, including one patient with grade 5. Of the investigated baseline co-medications, the proportion of antiplatelet drugs (n = 50, 9.8%) was higher in patients with CIP (23.4% versus 8.4%). After propensity score matching, the CIP incidence was higher in patients with baseline antiplatelet drugs (22% versus 6%). Finally, baseline antiplatelet drug use was demonstrated to increase the risk for CIP incidence regardless of cancer type (hazard ratio, 3.46; 95% confidence interval 1.21-9.86). CONCLUSIONS An association between concomitant antiplatelet drug use at baseline and an increased risk for CIP was seen in our database. This implies the importance of assessing concomitant medications for CIP risk management.
Collapse
Affiliation(s)
- T Araki
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - S Kanda
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan.
| | - T Ide
- Department of Pharmacy, Shinshu University School of Medicine, Matsumoto, Japan
| | - K Sonehara
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - M Komatsu
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - K Tateishi
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Minagawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Y Kiniwa
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - S Kawakami
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - S Nomura
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - R Okuyama
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - M Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Koizumi
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
2
|
Todo M, Suzuki T, Hanaoka M, Asai H. Application of new waveform analysis methods reflecting F-wave diversity -classification of F-wave diversity according to differences in the derived muscles. Heliyon 2023; 9:e20551. [PMID: 37800073 PMCID: PMC10550510 DOI: 10.1016/j.heliyon.2023.e20551] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Abstract
Background The F wave waveforms show diversity according to the number and size of re-firing cells, but there is still no analytical method that reflects this feature. We previously reported that five classifications of F waves are obtained from the ulnar nerve. However, the diversity of F waves derived from the lower extremities may not be similar. We therefore compared the diversity of F waves in the upper and lower extremities in healthy subjects. New method F waves were measured during tibial nerve stimulation in 26 healthy subjects. The amount of amplitude decrease was calculated from the amplitude value after the additive averaging process and based on the average amplitude value of each stimulus, and the relationship between the peak latency and density was examined. Results The amount of amplitude decrease due to the additive averaging process was negatively correlated with the density of negative peaks. The diversity of F waves could be categorized into four class based on the histograms. Comparison with existing method The new method uses a novel additive average method that reflects the diversity of F waves. Furthermore, it uses a histogram to visualize the cancellation between waveforms. Conclusion We developed an analysis method that reflects the diversity of F waves in a novel manner, which visualizes cancellation between waveforms using a histogram.
Collapse
Affiliation(s)
- Marina Todo
- Department of Physical Therapy, Faculty of Health Sciences, Kansai University of Health Sciences, 2-11-1, Wakaba, Sennangun, Kumatori, Osaka, Japan
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, 2-11-1, Wakaba, Sennangun, Kumatori, Osaka, Japan
| | - Toshiaki Suzuki
- Department of Physical Therapy, Faculty of Health Sciences, Kansai University of Health Sciences, 2-11-1, Wakaba, Sennangun, Kumatori, Osaka, Japan
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, 2-11-1, Wakaba, Sennangun, Kumatori, Osaka, Japan
| | - Masaaki Hanaoka
- Department of e-Health Science, Graduate School of Medicine, Shinshu University, 3-1-1, Asahi, Matsumoto City, Nagano, Japan
| | - Hitoshi Asai
- Department of Physical Therapy, Graduate Course of Rehabilitation Science, School of Health Sciences, College of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, 5-11-80, Kotatsuno, Kanazawa City, Ishikawa, Japan
| |
Collapse
|
3
|
Ozawa M, Hirawa N, Haze T, Haruna A, Kawano R, Komiya S, Ohki Y, Suzuki S, Kobayashi Y, Fujiwara A, Saka S, Hanaoka M, Mitsuhashi H, Yamaguchi S, Ohnishi T, Tamura K. The implication of calf circumference and grip strength in osteoporosis and bone mineral density among hemodialysis patients. Clin Exp Nephrol 2023; 27:365-373. [PMID: 36574105 PMCID: PMC10023647 DOI: 10.1007/s10157-022-02308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/02/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Chronic kidney disease-mineral and bone disorder (CKD-MBD), nutritional status, and uremia management have been emphasized for bone management in hemodialysis patients. Nevertheless, valuable data on the importance of muscle mass in bone management are limited, including whether conventional management alone can prevent osteoporosis. Thus, the importance of muscle mass and strength, independent of the conventional management in osteoporosis prevention among hemodialysis patients, was evaluated. METHODS Patients with a history of hemodialysis 6 months or longer were selected. We assessed the risk for osteoporosis associated with calf circumference or grip strength using multivariable adjustment for indices of CKD-MBD, nutrition, and dialysis adequacy. Moreover, the associations between bone mineral density (BMD), calf circumference, grip strength, and bone metabolic markers were also evaluated. RESULTS A total of 136 patients were included. The odds ratios (95% confidence interval) for osteoporosis at the femoral neck were 1.25 (1.04-1.54, P < 0.05) and 1.08 (1.00-1.18, P < 0.05) per 1 cm shorter calf circumference or 1 kg weaker grip strength, respectively. Shorter calf circumference was significantly associated with a lower BMD at the femoral neck and lumbar spine (P < 0.001). Weaker grip strength was also associated with lower BMD at the femoral neck (P < 0.01). Calf circumference or grip strength was negatively correlated with bone metabolic marker values. CONCLUSION Shorter calf circumference or weaker grip strength was associated with osteoporosis risk and lower BMD among hemodialysis patients, independent of the conventional therapies.
Collapse
Affiliation(s)
- Moe Ozawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuhito Hirawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan.
| | - Tatsuya Haze
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital, Yokohama, Japan
| | - Aiko Haruna
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Rina Kawano
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shiro Komiya
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yuki Ohki
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Shota Suzuki
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Yusuke Kobayashi
- YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital, Yokohama, Japan
| | - Akira Fujiwara
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Sanae Saka
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Masaaki Hanaoka
- Kamiooka Jinsei Clinic, Kousaikai Medical Corporation, Yokohama, Japan
| | | | - Satoshi Yamaguchi
- Yokohama Jinsei Hospital, Kousaikai Medical Corporation, Yokohama, Japan
| | - Toshimasa Ohnishi
- Kamiooka Jinsei Clinic, Kousaikai Medical Corporation, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| |
Collapse
|
4
|
Kanai D, Wakui H, Hanaoka M, Haze T, Azushima K, Shinoda S, Tsukamoto S, Taguchi S, Kinguchi S, Kanaoka T, Toya Y, Hirawa N, Kato H, Watanabe F, Hanaoka K, Mitsuhashi H, Yamaguchi S, Ohnishi T, Tamura K. Blunted humoral immune response to the fourth dose of BNT162b2 COVID-19 vaccine in patients undergoing hemodialysis. Clin Exp Nephrol 2023:10.1007/s10157-023-02342-0. [PMID: 36977892 PMCID: PMC10047466 DOI: 10.1007/s10157-023-02342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND We aimed to investigate the impact of a fourth dose of BNT162b2 vaccine (Comirnaty®, Pfizer-BioNTech) on anti-SARS-CoV-2 (anti-S IgG) antibody titers in patients receiving hemodialysis (HD) and healthcare workers (HCWs). METHODS A multi-institutional retrospective study at five dialysis clinics in Japan was conducted using 238 HD patients and 58 HCW controls who received four doses of the BNT162b2 mRNA vaccine. Anti-S IgG titers were measured at 1, 3, and 6 months after the second dose, at 1 and 5/6 months after the third dose, and at 1 month after the fourth dose of vaccine. RESULTS The log anti-S IgG titers of the HD patients after the second vaccination were significantly lower than those of the control group, but equalized 1 month after the third vaccination: 9.94 (95% CI 9.82-10.10) vs. 9.81 (95% CI 9.66-9.96), (P = 0.32). In both groups, the fold-increase in anti-S IgG titers was significantly lower after the fourth dose than after the third dose of vaccine. In addition, there was a strong negative correlation between antibody titers 1 month after the fourth vaccination and antibody titers immediately before the vaccination. In both groups, the waning rate of anti-S IgG titers from the post-vaccination peak level after the third vaccine dose was significantly slower than that after the second dose. CONCLUSIONS These findings suggest that the humoral immune response was blunted after the fourth dose of the conventional BNT162b2 vaccine. However, multiple vaccinations could extend the window of humoral immune protection.
Collapse
Affiliation(s)
- Daisuke Kanai
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Hiromichi Wakui
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Masaaki Hanaoka
- Kohsaikai Kamioooka Jinsei Clinic, Yokohama, Kanagawa, Japan
| | - Tatsuya Haze
- YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Kengo Azushima
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Satoru Shinoda
- Department of Biostatistics, School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Shunichiro Tsukamoto
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Shinya Taguchi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Sho Kinguchi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Tomohiko Kanaoka
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yoshiyuki Toya
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Nobuhito Hirawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | | | - Kanako Hanaoka
- Kohsaikai Kamioooka Jinsei Clinic, Yokohama, Kanagawa, Japan
| | | | | | | | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan.
| |
Collapse
|
5
|
Kanai D, Wakui H, Haze T, Azushima K, Kinguchi S, Tsukamoto S, Kanaoka T, Urate S, Toya Y, Hirawa N, Kato H, Watanabe F, Hanaoka K, Hanaoka M, Mitsuhashi H, Yamaguchi S, Ohnishi T, Tamura K. SARS-CoV-2 spike protein antibody titers 6 months after SARS-CoV-2 mRNA vaccination among patients undergoing hemodialysis in Japan. Clin Exp Nephrol 2022; 26:988-996. [PMID: 35751753 PMCID: PMC9244285 DOI: 10.1007/s10157-022-02243-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/26/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is shown to prevent severe illness and death in hemodialysis (HD) patients, but the immune response to vaccines is reduced in this population. This study compared SARS-CoV-2 spike protein antibody titers between HD patients and healthy controls in Japan for up to 6 months following vaccination. METHODS A multi-institutional retrospective study at five clinics in Japan was conducted using 412 HD patients and 156 healthy controls who received two doses of the BNT162b2 (Pfizer-BioNTech) mRNA vaccine. Anti-SARS-CoV-2 spike protein S1 IgG antibody titers were measured at 1, 3, and 6 months after the second dose. The attenuation speed was calculated as slope (i.e., -β) using a linear mixed-effects model toward the log-transformed antibody titers. RESULTS The HD group had significantly lower month 1 antibody titers (Ab-titer-1) than the controls, and these remained lower through month 6 (95% CI: 2617.1 (1296.7, 5240.8) vs. 7285.4 (4403.9, 11,000.0) AU/mL at Ab-titer-1, and 353.4 (178.4, 656.3) vs. 812.0 (498.3, 1342.7) AU/mL at Ab-titer-6 (p < 0.001, respectively)). Lower log Ab-titer-1 levels in the HD group were significantly associated with a lower log Ab-titer-6 (0.90 [0.83, 0.97], p < 0.001). The -β values in the HD patients and healthy controls were -4.7 ± 1.1 and -4.7 ± 1.4 (year-1), respectively. CONCLUSION SARS-CoV-2 spike protein antibody titers were significantly lower in HD patients than in healthy controls at 1 (peak) and 6 months after the second vaccination. Low peak antibody titers contributed to low 6-month antibody titers.
Collapse
Affiliation(s)
- Daisuke Kanai
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Hiromichi Wakui
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Tatsuya Haze
- Center for Nobel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University, Yokohama, Kanagawa, Japan
| | - Kengo Azushima
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Sho Kinguchi
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Shunichiro Tsukamoto
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Tomohiko Kanaoka
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Shingo Urate
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yoshiyuki Toya
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Nobuhito Hirawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | | | - Kanako Hanaoka
- Kohsaikai Kamioooka Jinsei Clinic, Yokohama, Kanagawa, Japan
| | - Masaaki Hanaoka
- Kohsaikai Kamioooka Jinsei Clinic, Yokohama, Kanagawa, Japan
| | | | | | | | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| |
Collapse
|
6
|
Kanai D, Wakui H, Haze T, Azushima K, Kinguchi S, Kanaoka T, Toya Y, Hirawa N, Kato H, Uneda K, Watanabe F, Hanaoka K, Hanaoka M, Mitsuhashi H, Yamaguchi S, Ohnishi T, Tamura K. Improved Immune Response to the Third COVID-19 mRNA Vaccine Dose in Hemodialysis Patients. Kidney Int Rep 2022; 7:2718-2721. [PMID: 36120389 PMCID: PMC9464310 DOI: 10.1016/j.ekir.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 11/05/2022] Open
|
7
|
Todo M, Suzuki T, Hanaoka M, Asai H. A new waveform analysis method reflecting the diversity of F-wave Waveforms-Waveform types in healthy subjects based on the combined use of the additive averaging method and histograms. J Neurosci Methods 2022; 369:109474. [PMID: 34995647 DOI: 10.1016/j.jneumeth.2022.109474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/26/2021] [Accepted: 01/02/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND F-waves, which are an indicator of the excitability of spinal cord anterior horn cells, are characterized by diverse waveforms. However, no analytical method has yet been development that fully reflects the diversity of such waveforms. The present study examined whether or not the change in the amplitude by the additive averaging process reflects the dispersion of the peak. NEW METHOD The average amplitude of each waveform and the decrease in the amplitude after the additive averaging process were determined. The correlation between the decrease in the amplitude and the density of the peak was then examined. The histogram was also used to classify the type of waveform dispersion based on the characteristics of the peak latency. RESULTS No correlation was found between the change in the amplitude and the peak density. However, the F-waves obtained from the ulnar nerve of healthy subjects were able to be classified into five types. COMPARISON WITH EXISTING METHOD The parameters of an F-wave analysis are the rise latency, the amplitude and the persistence, and many reports have examined F-waves based on the changes in these values. The present study explored new parameters focusing on the waveform of F-waves reflecting the motor unit. CONCLUSION The results of this study may help to establish a standard of comparison when using the F wave to evaluate spasticity due to upper motor neuron disorders.
Collapse
Affiliation(s)
- Marina Todo
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Japan; Clinical Physical Therapy Laboratory, Kansai University of Health Sciences, Japan.
| | - Toshiaki Suzuki
- Clinical Physical Therapy Laboratory, Kansai University of Health Sciences, Japan; Graduate School of Health Sciences, Graduate School of Kansai University of Health Science, Japan.
| | - Masaaki Hanaoka
- Department of e-Health Science, Graduate School of Medicine, Shinshu University, Japan.
| | - Hitoshi Asai
- Department of Physical Therapy, Graduate Course of Rehabilitation Science, School of Health Sciences, College of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Japan.
| |
Collapse
|
8
|
Nishie K, Sato S, Hanaoka M. Anamorelin for cancer cachexia. Drugs Today (Barc) 2022; 58:97-104. [DOI: 10.1358/dot.2022.58.3.3381585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
9
|
Yamaoka Y, Shiomi A, Kagawa H, Hino H, Manabe S, Kato S, Hanaoka M. Which is more important in the management of splenic flexure colon cancer: strict central lymph node dissection or adequate bowel resection margin? Tech Coloproctol 2020; 24:873-882. [PMID: 32548666 DOI: 10.1007/s10151-020-02260-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/05/2019] [Accepted: 06/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND What qualifies as optimal lymph node (LN) dissection in the surgical management of splenic flexure colon cancer (SFCC) still remains controversial because few studies have evaluated the distribution of LN metastasis of SFCC. The aim of this study was to clarify detailed distribution of LN metastasis and long-term outcomes of SFCC. METHODS This retrospective study enrolled patients who had curative colectomy for primary transverse or descending colon cancer of pathological stage I, II, or III at a single high-volume cancer center between April 2002 and December 2018. The 538 eligible patients were divided into three groups: patients with SFCC (SFCC group, n = 168), patients with proximal transverse colon cancer (PTCC group, n = 290), and patients with distal descending colon cancer (DDCC group, n = 80). LNs were classified into horizontal (pericolic) and vertical (intermediate and main) nodes. Intermediate and main LN station numbers were defined according to the Japanese Society for Cancer of the Colon and Rectum classification. Distributions of LN metastasis and long-term outcomes were compared. RESULTS In the SFCC group, the mean age was 67.3 ± 10.5 years and 110 patients (65.5%) were male. The proportion of patients with LN metastasis in the intermediate or main region was significantly lower in the SFCC group (8%) than in the PTCC (37%) (p < 0.01) or DDCC group (29%) (p < 0.01) in pathological stage III patients. In the SFCC group, the incidence of pericolic LN metastasis on the oral side of tumor (43%) was significantly higher than in the PTCC group (21%) (p < 0.01) and was similar to that in the DDCC group (42%) (p = 0.51), while in the SFCC group, the incidence of pericolic LN metastasis on the anal side of tumor (17%) was lower than in the PTCC group (31%) and was also similar to that in the DDCC group (21%). There were no significant differences in disease-specific survival rates among all groups. CONCLUSIONS LN metastasis occurred mainly in the pericolic region, especially on the oral side of the tumor in SFCC. It may, therefore, be important to have an adequate bowel resection margin, especially on the oral side, for SFCC.
Collapse
Affiliation(s)
- Y Yamaoka
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
| | - A Shiomi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - H Kagawa
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - H Hino
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - S Manabe
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - S Kato
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - M Hanaoka
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| |
Collapse
|
10
|
Kinguchi S, Wakui H, Ito Y, Kondo Y, Azushima K, Osada U, Yamakawa T, Iwamoto T, Yutoh J, Misumi T, Aoki K, Yasuda G, Yoshii T, Yamada T, Ono S, Shibasaki-Kurita T, Hosokawa S, Orime K, Hanaoka M, Sasaki H, Inazumi K, Yamada T, Kobayashi R, Ohki K, Haruhara K, Kobayashi Y, Yamanaka T, Terauchi Y, Tamura K. Improved home BP profile with dapagliflozin is associated with amelioration of albuminuria in Japanese patients with diabetic nephropathy: the Yokohama add-on inhibitory efficacy of dapagliflozin on albuminuria in Japanese patients with type 2 diabetes study (Y-AIDA study). Cardiovasc Diabetol 2019; 18:110. [PMID: 31455298 PMCID: PMC6710883 DOI: 10.1186/s12933-019-0912-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/12/2019] [Indexed: 12/12/2022] Open
Abstract
Background The Y-AIDA study was designed to investigate the renal- and home blood pressure (BP)-modulating effects of add-on dapagliflozin treatment in Japanese individuals with type 2 diabetes mellitus (T2DM) and albuminuria. Methods We conducted a prospective, multicenter, single-arm study. Eighty-six patients with T2DM, HbA1c 7.0–10.0%, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min/1.73 m2, and urine albumin-to-creatinine ratio (UACR) ≥ 30 mg/g creatinine (gCr) were enrolled, and 85 of these patients were administered add-on dapagliflozin for 24 weeks. The primary and key secondary endpoints were change from baseline in the natural logarithm of UACR over 24 weeks and change in home BP profile at week 24. Results Baseline median UACR was 181.5 mg/gCr (interquartile range 47.85, 638.0). Baseline morning, evening, and nocturnal home systolic/diastolic BP was 137.6/82.7 mmHg, 136.1/79.3 mmHg, and 125.4/74.1 mmHg, respectively. After 24 weeks, the logarithm of UACR decreased by 0.37 ± 0.73 (P < 0.001). In addition, changes in morning, evening, and nocturnal home BP from baseline were as follows: morning systolic/diastolic BP − 8.32 ± 11.42/− 4.18 ± 5.91 mmHg (both P < 0.001), evening systolic/diastolic BP − 9.57 ± 12.08/− 4.48 ± 6.45 mmHg (both P < 0.001), and nocturnal systolic/diastolic BP − 2.38 ± 7.82/− 1.17 ± 5.39 mmHg (P = 0.0079 for systolic BP, P = 0.0415 for diastolic BP). Furthermore, the reduction in UACR after 24 weeks significantly correlated with an improvement in home BP profile, but not with changes in other variables, including office BP. Multivariate linear regression analysis also revealed that the change in morning home systolic BP was a significant contributor to the change in log-UACR. Conclusions In Japanese patients with T2DM and diabetic nephropathy, dapagliflozin significantly improved albuminuria levels and the home BP profile. Improved morning home systolic BP was associated with albuminuria reduction. Trial registration The study is registered at the UMIN Clinical Trials Registry (UMIN000018930; http://www.umin.ac.jp/ctr/index-j.htm). The study was conducted from July 1, 2015 to August 1, 2018. Electronic supplementary material The online version of this article (10.1186/s12933-019-0912-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sho Kinguchi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Hiromichi Wakui
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Yuzuru Ito
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yoshinobu Kondo
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kengo Azushima
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, Singapore
| | - Uru Osada
- Department of Diabetes and Endocrinology, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Tadashi Yamakawa
- Department of Endocrinology and Diabetes, Yokohama City University Center Hospital, Yokohama, Japan
| | - Tamio Iwamoto
- Department of Nephrology and Hypertension, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Jun Yutoh
- Department of Nephrology and Hypertension, Yokohama Minami Kyousai Hospital, Yokohama, Japan
| | - Toshihiro Misumi
- Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazutaka Aoki
- Department of Internal Medicine, Kanagawa Dental University, Yokosuka, Japan
| | - Gen Yasuda
- Department of Nephrology and Hypertension, Yokohama City University Center Hospital, Yokohama, Japan
| | - Taishi Yoshii
- Department of Endocrinology and Metabolism, Yokohama Minami Kyousai Hospital, Yokohama, Japan
| | - Takayuki Yamada
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Syuji Ono
- Department of Nephrology and Hypertension, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Tomoko Shibasaki-Kurita
- Department of Nephrology and Hypertension, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Saho Hosokawa
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kazuki Orime
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Masaaki Hanaoka
- Department of Nephrology and Hypertension, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Hiroto Sasaki
- Department of Diabetes and Endocrinology, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Kohji Inazumi
- Department of Diabetes and Endocrinology, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Taku Yamada
- Department of Diabetes and Endocrinology, Saiseikai Yokohama South Hospital, Yokohama, Japan
| | - Ryu Kobayashi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kohji Ohki
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kotaro Haruhara
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yusuke Kobayashi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.,Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University, Yokohama, Japan
| | - Takeharu Yamanaka
- Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| |
Collapse
|
11
|
Baba S, Katsumata Y, Okamoto Y, Kawaguchi Y, Hanaoka M, Kawasumi H, Yamanaka H. Reliability of the SF-36 in Japanese patients with systemic lupus erythematosus and its associations with disease activity and damage: a two-consecutive year prospective study. Lupus 2017; 27:407-416. [DOI: 10.1177/0961203317725586] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We aimed to validate the reliability of the Medical Outcomes Study Short Form-36 (SF-36) among Japanese patients with systemic lupus erythematosus (SLE). Japanese patients with SLE ( n = 233) completed the SF-36 and other related demographic questionnaires, and physicians simultaneously completed the SLE Disease Activity Index 2000 (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Patients were prospectively followed for a repeat assessment the following year. The SF-36 subscales demonstrated acceptable internal consistency (Cronbach’s α of 0.85–0.89), and an overall good test–retest reliability (intraclass correlation coefficient >0.70). The average baseline SF-36 subscale/summary scores except for “bodily pain” were significantly lower than those of the Japanese general population ( p < 0.05). The SDI showed an inverse correlation with the SF-36 subscale/summary scores except for “vitality” and “mental component summary” at baseline, whereas the SLEDAI-2K did not. In the second year, “social functioning” and “mental component summary” of the SF-36 deteriorated among patients whose SDI or SLEDAI-2K score increased (effect sizes < −0.20). In conclusion, the SF-36 demonstrated acceptable reliability among Japanese patients with SLE. Health-related quality of life measured by the SF-36 was reduced in Japanese patients with SLE and associated with disease damage, rather than disease activity.
Collapse
Affiliation(s)
- S Baba
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Y Katsumata
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Y Okamoto
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Y Kawaguchi
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - M Hanaoka
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - H Kawasumi
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - H Yamanaka
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| |
Collapse
|
12
|
Kamel Abdel Aal A, Moawad S, Jackson B, Hanaoka M, Baalmann C, Ertel N, Pettibon K, Harris A, Patel A, Lambertsen Z, Newman G, Saddekni S. Tumor response and survival outcomes of very small drug-eluting beads used in trans-arterial chemoembolization for unresectable hepatocellular carcinoma. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.900] [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: 11/28/2022] Open
|
13
|
Kamel Abdel Aal A, Shoreibah M, Kim S, Jackson B, Moawad S, Hanaoka M, Massoud M, Saddekni S. Psoas muscle density predicts survival of cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1011] [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: 10/20/2022] Open
|
14
|
Hanaoka M, Katsumata Y, Kawaguchi Y, Yamanaka H. AB0620 Evaluation of Usefullness of Klebs Von Den Lungen-6 as A Biomarker of Interstitial Lung Disease with Polymyositis and Dermatomyositis Including That in The Short Time Course after Treatment. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
15
|
Hama M, Ushiki A, Kosaka M, Yamazaki Y, Yasuo M, Yamamoto H, Hanaoka M. Health-related quality of life in patients with pulmonary non-tuberculous mycobacteria infection. Int J Tuberc Lung Dis 2016; 20:747-52. [DOI: 10.5588/ijtld.15.0460] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
16
|
Nishina H, Katsumata Y, Hanaoka M, Kawaguchi Y, Yamanaka H. THU0330 Validiity of Protein-To-Creatinine Ratio in An Untimed Urine Specimen and Estimated Glomerular Filtration Rate as Measures of Proteinuria and Renal Function in Patients with Lupus Nephritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
17
|
Ogata Y, Kamijo M, Hanaoka M. A quantitative assessment of the mechanical effects on the lumbar spine and the effects on straight leg raising and lumbar flexion of segmental sustained rotation. J Phys Ther Sci 2016; 28:1318-24. [PMID: 27190475 PMCID: PMC4868235 DOI: 10.1589/jpts.28.1318] [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: 12/17/2015] [Accepted: 01/14/2016] [Indexed: 12/02/2022] Open
Abstract
[Purpose] This study were to examine the strength and relative direction of the applied
force from lumbar segmental sustained rotation (LSSR) on the lumbar spinous process, and
to clarify the effects of LSSR on straight leg raising (SLR) and lumbar flexion (LF).
[Subjects] 18 pain-free healthy adults volunteered for this study. [Methods] Applied force
and direction were measured between the L5–S1 segments using tri-axial pressure sensors.
Subjects participated in 3 trials. Subjects underwent localized right rotation, held for
10 seconds, of the L5 in relation to the S1. Sham group subjects followed LSSR group
protocols; however L5–S1 rotation was absent. Control subjects rested on a plinth. SLR and
LF were measured pre and post-trial. [Results] Outcome data for LSSR forces were as
follows; x (0.06N (±0.29)), y (‒5.26N (±0.01)), z (6.16N (±1.33)), and resultant vector
magnitude (8.19N (±1.12)). LSSR relative direction results were as follows: x-axis angle,
89. 6 ° (±1.5); y-axis, 130.9 ° (±5.6); and z-axis, 41.6 ° (±4.7). The LSSR group’s LF and
SLR were significantly increased compared with those of the sham and control groups.
[Conclusion] The identified resultant vector magnitude was 8.19N, less than other
techniques. LSSR effectively improves LF and bilateral SLR.
Collapse
Affiliation(s)
- Yoetsu Ogata
- Koriyama Institute of Health Sciences: 2-9-3 Zukei, Koriyama, Fukushima 963-8834, Japan
| | - Masayoshi Kamijo
- Course of Kansei Engineering, Faculty of Textile Science and Technology, Shinshu University, Japan
| | - Masaaki Hanaoka
- Koriyama Institute of Health Sciences: 2-9-3 Zukei, Koriyama, Fukushima 963-8834, Japan
| |
Collapse
|
18
|
Okamoto Y, Katsumata Y, Baba S, Kawaguchi Y, Gono T, Hanaoka M, Kawasumi H, Yamanaka H. Validation of the Japanese version of the Systemic Lupus Activity Questionnaire that includes physician-based assessments in a large observational cohort. Lupus 2015; 25:486-95. [DOI: 10.1177/0961203315617844] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 10/26/2015] [Indexed: 11/17/2022]
Abstract
The Systemic Lupus Activity Questionnaire (SLAQ) is a patient-reported outcome for systemic lupus erythematosus (SLE). We aimed to translate it into Japanese and further investigate its validity and reliability. The English version of the SLAQ was translated into Japanese and administered to Japanese SLE patients at our university clinic. Physicians assessed disease activity using the SLE Disease Activity Index 2000 (SLEDAI-2K). The patients were prospectively followed for repeat assessment a year later. Ultimately, 255 patients participated. The patients’ 10-point ratings of disease activity and SLAQ scores were significantly correlated (Spearman’s ρ = 0.53). The SLAQ score was weakly correlated with the SLE Disease Activity Index 2000 (SLEDAI-2K)-nolab (omitting laboratory items; ρ = 0.18) but not with the SLEDAI-2K ( ρ = 0.02). These results suggested its convergent and discriminant validity. The SLAQ demonstrated acceptable internal consistency (Cronbach’s α = 0.80), and good test–retest reliability (intraclass correlation coefficient = 0.85). The effect sizes and the standardized response means of the SLAQ were as follows: clinical worsening, 0.26 and 0.31, and improvement, −0.39 and −0.41, respectively, which indicated a small but significant responsiveness. The Japanese version of the SLAQ demonstrated acceptable reliability and validity; its performance was comparable to that of the original version.
Collapse
Affiliation(s)
- Y Okamoto
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Y Katsumata
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - S Baba
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Y Kawaguchi
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - T Gono
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - M Hanaoka
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - H Kawasumi
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - H Yamanaka
- The Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| |
Collapse
|
19
|
Morishita K, Karasuno H, Yokoi Y, Morozumi K, Ogihara H, Ito T, Hanaoka M, Fujiwara T, Fujimoto T, Abe K. Effects of therapeutic ultrasound on range of motion and stretch pain. J Phys Ther Sci 2014; 26:711-5. [PMID: 24926137 PMCID: PMC4047237 DOI: 10.1589/jpts.26.711] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 12/05/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to clarify the effects of therapeutic ultrasound on range of motion and stretch pain and the relationships between the effects. [Subjects] The subjects were 15 healthy males. [Methods] Subjects performed all three interventions: (1) ultrasound (US group), (2) without powered ultrasound (placebo group), and (3) rest (control group). Ultrasound was applied at 3 MHz with an intensity of 1.0 W/cm(2) and a 100% duty cycle for 10 minutes. The evaluation indices were active and passive range of motion (ROM), stretch pain (visual analog scale; VAS), and skin surface temperature (SST). The experimental protocol lasted a total of 40 minutes; this was comprised of 10 minutes before the intervention, 10 minutes during the intervention (US, placebo, and control), and 20 minutes after the intervention. [Results] ROM and SST were significantly higher in the US group than in the placebo and control groups for the 20 minutes after ultrasound, though there was no change in stretch pain. [Conclusion] The effects of ultrasound on ROM and SST were maintained for 20 minutes after the intervention. The SST increased with ultrasound and decreased afterwards. Additionally, the SST tended to return to baseline levels within 20 minutes after ultrasound exposure. Therefore, these effects were caused by a combination of thermal and mechanical effects of the ultrasound.
Collapse
Affiliation(s)
- Katsuyuki Morishita
- Koriyama Institute of Health Sciences, Japan ; Interdisciplinary Graduate School of Science and Technology, Shinshu University, Japan
| | | | - Yuka Yokoi
- Koriyama Institute of Health Sciences, Japan ; Interdisciplinary Graduate School of Science and Technology, Shinshu University, Japan
| | | | - Hisayoshi Ogihara
- Koriyama Institute of Health Sciences, Japan ; Interdisciplinary Graduate School of Science and Technology, Shinshu University, Japan
| | - Toshikazu Ito
- Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | | | - Takayuki Fujiwara
- Koriyama Institute of Health Sciences, Japan ; Interdisciplinary Graduate School of Science and Technology, Shinshu University, Japan
| | - Tetsuya Fujimoto
- Interdisciplinary Graduate School of Science and Technology, Shinshu University, Japan
| | - Koji Abe
- Interdisciplinary Graduate School of Science and Technology, Shinshu University, Japan
| |
Collapse
|
20
|
Gono T, Kawaguchi Y, Kaneko H, Katsumata Y, Takagi K, Ichida H, Hanaoka M, Baba S, Okamoto Y, Ota Y, Kataoka S, Yamanaka H. SAT0185 Characteristics of Cytokine Profiles and Prognositc Factors in Interstitial Lung Disease with Polymyositis/Dermatomyositis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
21
|
Noordally ZB, Ishii K, Atkins KA, Wetherill SJ, Kusakina J, Walton EJ, Kato M, Azuma M, Tanaka K, Hanaoka M, Dodd AN. Circadian Control of Chloroplast Transcription by a Nuclear-Encoded Timing Signal. Science 2013; 339:1316-9. [DOI: 10.1126/science.1230397] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
22
|
Gono T, Sato S, Kawaguchi Y, Kuwana M, Hanaoka M, Katsumata Y, Takagi K, Baba S, Okamoto Y, Ota Y, Yamanaka H. Anti-MDA5 antibody, ferritin and IL-18 are useful for the evaluation of response to treatment in interstitial lung disease with anti-MDA5 antibody-positive dermatomyositis. Rheumatology (Oxford) 2012; 51:1563-70. [DOI: 10.1093/rheumatology/kes102] [Citation(s) in RCA: 204] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
23
|
Miura D, Hanaoka M, Shimomura A, Iwatani T, Kawabata H, Fujii T. 442 Are There Any Differences of Biomarker Changes in Short Term Neoadjuvant Ais (Exemestane Vs. Letrozole)? Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70508-7] [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: 11/28/2022]
|
24
|
Gono T, Kawaguchi Y, Kaneko H, Nishimura K, Hanaoka M, Kataoka S, Okamoto Y, Katsumata Y, Yamanaka H. Anti-NR2A antibody as a predictor for neuropsychiatric systemic lupus erythematosus. Rheumatology (Oxford) 2011; 50:1578-85. [DOI: 10.1093/rheumatology/keq408] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
|
25
|
Affiliation(s)
- N Fukunaga
- Department of Neurosurgery, Tokushima Red Cross Hospital, Irinoguchi, Komtsushima-cho, Komatsushima-shi, Tokushima, Japan.
| | | | | |
Collapse
|
26
|
Chen Y, Hanaoka M, Droma Y, Chen P, Voelkel NF, Kubo K. Endothelin-1 receptor antagonists prevent the development of pulmonary emphysema in rats. Eur Respir J 2009; 35:904-12. [PMID: 19897563 DOI: 10.1183/09031936.00003909] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We hypothesised that endothelin (ET)-1 plays an important role in the pathogenesis of emphysema. We attempted to apply ET-1 receptor antagonists to demonstrate and further elucidate the molecular pathogenesis pathways through which ET-1 may cause emphysematous changes. Sprague-Dawley rats were divided into four groups: control, cigarette smoke extract (CSE), CSE+BQ-123 (a selective endothelin receptor type A (ET(A)) antagonist) and CSE+bosentan (a mixed ET(A)/ET(B) receptor antagonist). The CSE was injected intraperitoneally once a week for 3 weeks, and BQ-123 or bosentan was administered daily for the same duration. The expression of ET(A) receptor, apoptosis index, caspase-3 activity, matrix metalloproteinase (MMP)-2 and MMP-9 activity, and tumour necrosis factor (TNF)-alpha and interleukin (IL)-1beta concentrations were measured in the lung tissue. The ET-1 levels and antioxidant activity were measured in the serum. Both BQ-123 and bosentan prevented the development of CSE-induced emphysema, blocked the expression of ET(A) receptor, inhibited pulmonary apoptosis, inactivated MMP-2 and MMP-9 activities in the lung tissues, reduced the concentrations of inflammatory cytokines TNF-alpha and IL-1beta, and improved the biological antioxidant activity in the serum. Emphysema development is suppressed by ET-1 receptor antagonists. ET-1 may cause emphysematous changes through molecular pathogenesis pathways involving apoptosis, proteinase and antiproteinase imbalance, inflammation and oxidative stress.
Collapse
Affiliation(s)
- Y Chen
- First Dept of Medicine, Shinshu University School of Medicine, Asahi, Matsumoto, Japan
| | | | | | | | | | | |
Collapse
|
27
|
Sawashita J, Onitsuka S, Gen-no H, Ishikawa S, Iino F, Tateishi N, Murakami T, Seki Y, Nagaiwa T, Hanaoka M, Hama S, Nose H, Higuchi K. Effects of mild calorie restriction and high-intensity interval walking in middle-aged and older overweight Japanese. Exp Gerontol 2009; 44:666-75. [PMID: 19638306 DOI: 10.1016/j.exger.2009.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 05/31/2009] [Accepted: 07/22/2009] [Indexed: 10/20/2022]
Abstract
We investigated whether a combination of mild calorie restriction (MCR) and high-intensity interval walking (HIW) improved physical fitness more than HIW alone in middle-aged and older overweight Japanese (40-69years old, BMI23.6kg/m(2)). Forty-seven women and 16 men were divided into MCR+HIW and HIW groups. All subjects performed HIW: 5 sets of 3-min low-intensity walking (40% peak aerobic capacity for walking, VO(2peak)) and 3-min high-intensity walking (70% VO(2peak)) per day, 4days per week, for 16weeks while energy expenditure was monitored with a tri-axial accelerometer. The MCR+HIW group consumed meal replacement formula (240kcal): a mixture of low-carbohydrates and -fat and high-protein, for either lunch or dinner everyday and therefore, had approximately 87% of the energy intake of the HIW group during the intervention period. Although the HIW group showed improvements in BMI, blood pressure, and several blood chemicals, the MCR+HIW group had greater improvement. Moreover, the medical expenditure for the 6months including the intervention period was 59% lower in the MCR+HIW group than in the HIW group. Our strategy of a short-term combination of MCR and HIW may thus prevent lifestyle-associated diseases and improve health in middle-aged and older overweight Japanese.
Collapse
Affiliation(s)
- Jinko Sawashita
- Departments of Aging Biology, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine, Matsumoto, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Takehara K, Kawakami Y, Egawa M, Hanaoka M, Samura O, Kumagai M, Mizunoe T, Saji F. Prognostic factors in patients with bulky stage Ib or II cervical carcinoma undergoing neoadjuvant chemotherapy and radical hysterectomy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16548] [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: 11/20/2022] Open
|
29
|
Kawakami Y, Miyamoto K, Takehara K, Kumagai M, Samura O, Hanaoka M, Egawa M, Mizunoe T, Taniyama K, Saji F. Downregulation of RUNX3 by protein mislocation and gene inactivation in human epithelial ovarian cancer cells. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16545] [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: 11/20/2022] Open
|
30
|
Abstract
16049 Background: Adenosquamous carcinoma (ASC) of the uterine cervix is a rare mixture of malignant squamous and glandular epithelial elements. Clinical analyses of this disease were hardly performed independently from those of adenocarcinoma (AC) of the uterine cervix since both of the patients with these diseases show poorer outcome, compared with those with squamous cell carcinoma, which is present in the majority of cervical cancer. In this study, we investigated clinical features including diagnosis and treatment of this disease. Methods: During 1980–2006, total of 270 patients, who were diagnosed as carcinoma of the uterine cervix, were included in our analysis. A retrospective review of patients with ASC were preformed in their age, stage, lymph node metastasis, tumor markers (SCC, CEA, CA125 and CA19–9), treatment, relapse rate and its location, and survival. Results: There were total of 17 and 34 patients, who were histologically confirmed as having ASC (6.3%) and AC (12.6%) of the uterine cervix, respectively. All the ASC patients underwent surgery. The average age of the patients was 45.0 (26–78). The distribution of illness stages among the patients were IA, 4; IB, 8; IIA, 2; IIB, 2; IIIB, 1. Lymph node metastasis was seen in two patients (11.8%). There were no significant difference in these indexes between ASC and AC. Elevation of serum CA125 was observed in two ASC patients but no AC patients. The recurrence rates were 17.6% and 14.7% in ASC and AC, respectively. Five-year survival were 77.8% in ASC and 78.0% in AC, whereas 92.2% in SCC. Conclusions: These analyses indicate that clinical behavior and its outcome of ASC is similar to those of AC. The treatment based on these clinical features may be a useful to improve the prognosis of this disease. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- Y. Kawakami
- NHO Japan, Kure Medical Ctr / Chugoku Cancer Ctr, Hiroshima, Japan
| | - K. Takehara
- NHO Japan, Kure Medical Ctr / Chugoku Cancer Ctr, Hiroshima, Japan
| | - M. Kumagai
- NHO Japan, Kure Medical Ctr / Chugoku Cancer Ctr, Hiroshima, Japan
| | - M. Hanaoka
- NHO Japan, Kure Medical Ctr / Chugoku Cancer Ctr, Hiroshima, Japan
| | - Y. Akimoto
- NHO Japan, Kure Medical Ctr / Chugoku Cancer Ctr, Hiroshima, Japan
| | - T. Mizunoe
- NHO Japan, Kure Medical Ctr / Chugoku Cancer Ctr, Hiroshima, Japan
| | - F. Saji
- NHO Japan, Kure Medical Ctr / Chugoku Cancer Ctr, Hiroshima, Japan
| |
Collapse
|
31
|
Fujimoto K, Yasuo M, Urushibata K, Hanaoka M, Koizumi T, Kubo K. Airway inflammation during stable and acutely exacerbated chronic obstructive pulmonary disease. Eur Respir J 2005; 25:640-6. [PMID: 15802337 DOI: 10.1183/09031936.05.00047504] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.8] [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: 11/05/2022]
Abstract
The aim of this study was to clarify the mechanism of increased airway inflammation during an acute exacerbation. A total of 68 chronic obstructive pulmonary disease patients in a stable phase were enrolled and followed-up for 2-3 yrs. Inflammatory cells were analysed, and interleukin (IL)-8, neutrophil elastase, eotaxin, tryptase and RANTES (regulated on activation, normal T-cell expressed and secreted) were measured in sputum, both in a stable phase and during acute exacerbation. Out of 68 patients, 30 (unstable group) developed an acute exacerbation and expectorated adequate sputum during exacerbation. Thirty-two patients (stable group) did not develop any exacerbation for 2-3 yrs. The number of neutrophils, lymphocytes and eosinophils, and the levels of IL-8, eosinophil cationic protein (ECP), eotaxin and tryptase in sputum obtained from patients in both groups during the stable phase were significantly higher than those from healthy nonsmokers. There were no significant differences in cell analysis and biomarkers between the two groups, but patients in the unstable group showed more severe airflow limitation. In the unstable group, total cells, lymphocytes, neutrophils and eosinophils, and IL-8, neutrophil elastase, ECP and RANTES levels were significantly increased during an exacerbation from values in a stable phase. These findings suggest that exacerbation of chronic obstructive pulmonary disease may associate with additional increases in airway inflammation mediated by neutrophils, lymphocytes, eosinophils, interleukin-8 and RANTES.
Collapse
Affiliation(s)
- K Fujimoto
- First Dept of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
| | | | | | | | | | | |
Collapse
|
32
|
Pinar M, Hanaoka M, Hesse M, Schmid H. Über die Struktur eines neuartigen Indolalkaloids, des Talbotins. 141. Mitteilung über Alkaloide [1]. Helv Chim Acta 2004. [DOI: 10.1002/hlca.19710540104] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
33
|
Hanaoka M, Kobayashi M, Yamazaki H. Automatic sleep stage scoring based on waveform recognition method and decision-tree learning. ACTA ACUST UNITED AC 2002. [DOI: 10.1002/scj.10248] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
34
|
Droma Y, Hanaoka M, Hotta J, Naramoto A, Koizumi T, Fujimoto K, Honda T, Kobayashi T, Kubo K. Pathological features of the lung in fatal high altitude pulmonary edema occurring at moderate altitude in Japan. High Alt Med Biol 2002; 2:515-23. [PMID: 11809092 DOI: 10.1089/152702901753397081] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/12/2022] Open
Abstract
In order to characterize the pathological features of high altitude pulmonary edema (HAPE) occurring at moderate altitude in Japan, we performed routine hematoxylin and eosin (HE) staining in lung materials from HAPE autopsied cases. We also undertook advanced immunohistochemical staining for observation of type II pneumocytes, pulmonary surfactant (PS), and mast cells in the lung of HAPE cases to examine the biological changes within the lung parenchyma. The pathological findings of HAPE were characterized by alveolar edema, congestion of pulmonary vessels, alveolar hyaline membranes, alveolar hemorrhage, and multithrombi and fibrin clots, but maintained alveolar structure. The immunostaining results showed that the type II pneumocytes were cellular fusion, deformity, and exfoliation from the walls of alveoli; the PS not only lined the alveolar surface, but was also patchily distributed within alveoli; and the number of mast cells were increased (9.0 +/- 0.9 cells/mm(2)) compared to that in controls (1.1 +/- 0.4 cells/mm(2)) (p < 0.01). We conclude that the pathological features of HAPE at moderate altitude in Japan are similar to others reported worldwide, and that the type II pneumocytes, PS, and mast cells may contribute to some extent to pathophysiological parts in the development and progression of HAPE.
Collapse
Affiliation(s)
- Y Droma
- Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Ogihara Y, Isono K, Kojima T, Endo A, Hanaoka M, Shiina T, Terachi T, Utsugi S, Murata M, Mori N, Takumi S, Ikeo K, Gojobori T, Murai R, Murai K, Matsuoka Y, Ohnishi Y, Tajiri H, Tsunewaki K. Structural features of a wheat plastome as revealed by complete sequencing of chloroplast DNA. Mol Genet Genomics 2002; 266:740-6. [PMID: 11810247 DOI: 10.1007/s00438-001-0606-9] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.4] [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: 07/17/2001] [Accepted: 10/15/2001] [Indexed: 10/27/2022]
Abstract
Structural features of the wheat plastome were clarified by comparison of the complete sequence of wheat chloroplast DNA with those of rice and maize chloroplast genomes. The wheat plastome consists of a 134,545-bp circular molecule with 20,703-bp inverted repeats and the same gene content as the rice and maize plastomes. However, some structural divergence was found even in the coding regions of genes. These alterations are due to illegitimate recombination between two short direct repeats and/or replication slippage. Overall comparison of chloroplast DNAs among the three cereals indicated the presence of some hot-spot regions for length mutations. Whereas the region with clustered tRNA genes and that downstream of rbcL showed divergence in a species-specific manner, the deletion patterns of ORFs in the inverted-repeat regions and the borders between the inverted repeats and the small single-copy region support the notion that wheat and rice are related more closely to each other than to maize.
Collapse
Affiliation(s)
- Y Ogihara
- Kihara Institute for Biological Research and Graduate School of Integrated Science, Yokohama City University, Yokohama 244-0813, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Tsushima K, Yamaguchi S, Furihata K, Hotta J, Sasabayashi M, Urushihata K, Takashi S, Tsukadaira A, Yamazaki Y, Satou E, Hanaoka M, Koizumi T, Fujimoto K, Ohkubo Y, Kubo K. [A case of renal cell carcinoma complicated with interstitial pneumonitis, complete A-V block and pleural effusion during interferon-alpha therapy]. Nihon Kokyuki Gakkai Zasshi 2001; 39:893-8. [PMID: 11855092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
A 76-year-old man with postoperative renal cell carcinoma accompanied by multiple lung metastasis was being treated with recombinant interferon-alpha. After administration of 3 MU/day on 3 days/week for 1 month, he complained of headache and tinnitus. During continuous treatment for 3 months, he complained of appetite loss, low-grade fever and dyspnea. He was then referred to our Department of Internal Medicine. Electrocardiography indicated a complete A-V block, and chest radiography (CXR) showed a reticular shadow in both lower lung fields and bilateral pleural effusion. Chest computed tomography (CT) indicated subpleural emphysematous changes, multiple nodules, consolidation shadow with ground glass opacity in both lower lobes, and bilateral pleural effusion. The findings in the bronchoalveolar lavage (BAL) fluid included increases in the numbers of lymphocytes and eosinophils. We reached a diagnosis of interferon-alpha-induced pneumonitis on the basis of the patient's clinical course, and the CXR, chest CT and BAL fluid findings. Treatment with methylprednisolone pulse therapy for 3 days and then administration of prednisolone for 1 month resulted in marked improvement in the complete A-V block and interstitial pneumonitis. At day 7 after discontinuation of prednisolone, the serum level of C-reactive protein increased, and CXR showed bilateral pleural effusion. We therefore believe that the pleural effusion was probably also induced by interferon-alpha. Interferon is an effective drug for chronic hepatitis C and malignant diseases. Many complications have been reported during interferon therapy. However, although these complications, such as interstitial pneumonitis, complete A-V block and pleural effusion, have rarely been reported, careful attention is required during interferon therapy in case any appear.
Collapse
Affiliation(s)
- K Tsushima
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
[reaction: see text]. Treatment of the allenyl sulfoxides and sulfones possessing a proper delta-hydroxy appendage at the C-1 position with potassium tert-butoxide effected endo mode ring closure at the sp-hybridized carbon center of the allenyl moiety to provide the five- to eight-membered oxacycles in high yields.
Collapse
Affiliation(s)
- C Mukai
- Faculty of Pharmaceutical Sciences Kanazawa University, Takara-machi, Kanazawa 920-0934, Japan.
| | | | | |
Collapse
|
38
|
Abstract
The first and stereoselective total syntheses of (-)-ichthyothereol (1) and its acetate ((+)-2) were achieved by incorporation of the two chiral centers of diethyl L-tartrate. The starting diethyl L-tartrate was converted into trans-2-ethynyl-3-hydroxytetrahydropyran 14 in a stereoselective manner via the endo mode cyclization of the epoxy-alkyne derivative 12. The alcohol 12 was then transformed into (E)-iodoolefin derivative 15, which was exposed to a coupling reaction with 1-tributylstannyl-1,3,5-heptyne (19), derived from the corresponding 1-trimethylsilyl-1,3,5-heptyne (18), under Stille conditions to produce the all-carbon framework of the target natural products. Chemical modification of the coupled product 20 under conventional conditions completed the first total synthesis of (-)-ichthyothereol (1) and its acetate ((+)-2).
Collapse
Affiliation(s)
- C Mukai
- Faculty of Pharmaceutical Sciences, Kanazawa University, Takara-machi 13-1, Kanazawa 920-0934, Japan.
| | | | | |
Collapse
|
39
|
Sakaguchi J, Higashi T, Azuma T, Suzuki T, Iwasaki N, Kondo N, Nagata O, Kato H, Hanaoka M. An improved synthesis of butyl 4-[(4-amino-5-chloro-2-methoxybenzoyl)amino]-1-piperidineacetate (AU-224). Chem Pharm Bull (Tokyo) 2001; 49:788-90. [PMID: 11411541 DOI: 10.1248/cpb.49.788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A new and facile route for the synthesis of the novel gastrointestinal prokinetic butyl 4-[(4-amino-5-chloro-2-methoxybenzoyl)amino]-1-piperidineacetate (1b), which exhibited potent gastro- and colon-prokinetic activities by oral administration without significant side effects, was established. The key intermediate, butyl 4-amino-1-piperidineacetate (16), was prepared from commercially available 4-amino-1-benzylpiperidine (2) in a high yield with four steps. Compound 1b was prepared by condensation of commercially available 4-amino-5-choloro-2-methoxybenzoic acid (7) with 16 in 84% yield. This improved synthetic route was appropriate for large-scale synthesis of 1b.
Collapse
Affiliation(s)
- J Sakaguchi
- Research Division, Hokuriku Seiyaku Co., Ltd., Katsuyama, Fukui, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Ge RL, Shai HR, Takeoka M, Hanaoka M, Koizumi T, Matsuzawa Y, Kubo K, Kobayashi T. Atrial natriuretic peptide and red cell 2,3-diphosphoglycerate in patients with chronic mountain sickness. Wilderness Environ Med 2001; 12:2-7. [PMID: 11294551 DOI: 10.1580/1080-6032(2001)012[0002:anparc]2.0.co;2] [Citation(s) in RCA: 6] [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: 11/04/2022]
Abstract
BACKGROUND Individuals with chronic mountain sickness (CMS) show severe hypoxemia, excessive polycythemia, and marked pulmonary hypertension. The pathophysiologic mechanisms of CMS are still not completely understood. METHODS We determined plasma atrial natriuretic peptide (ANP), red cell 2,3-diphosphoglycerate (2,3-DPG), hematocrit, hemoglobin, and arterialized ear lobe blood gas values in 13 patients with CMS (9 Hans, 4 Tibetans) and 18 control Han Chinese men of similar age, height, and weight who had been living at 4300 m on the Tibetan plateau of Qinghai Province, China, for approximately 14 years. RESULTS A significantly higher level of ANP was found in the CMS patients compared to the non-CMS patients (113.4+/-5.5 pg/mL vs 87.6+/-4.7 pg/mL, P < .01), and the levels of ANP correlated positively with the hemoglobin concentration (r = 0.8282, P < .01). The 2,3-DPG levels in the CMS patients were significantly increased compared to the non-CMS subjects (5.23+/-0.16 mmol/L vs 4.40+/-0.12 mmol/L, P < .01), and the 2,3-DPG concentrations in the CMS patients were negatively correlated with their PaO2 values (r = -0.7898, P < .01). The CMS patients had significantly higher PaCO2 levels, lower pH values, lower PaO2 levels, and greater alveolar-arterial oxygen differences (PAO2 - PaO2) compared to the non-CMS subjects. CONCLUSIONS These findings suggest that overproduction of ANP and 2,3-DPG at high altitudes may play an important role in the pathophysiology of chronic mountain sickness.
Collapse
Affiliation(s)
- R L Ge
- Qinghai High Altitude Medical Science Institute, Xinging, Qinghai, China
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Mukai C, Yamaguchi S, Kim IJ, Hanaoka M. Co2(CO)8-mediated endo mode cyclization of epoxy-alcohol: synthesis of 2-ethynyl-3-hydroxy-2-methyltetrahydropyran and 2-ethynyl-3-hydroxy-3-methyltetrahydropyran derivatives. Chem Pharm Bull (Tokyo) 2001; 49:613-8. [PMID: 11383616 DOI: 10.1248/cpb.49.613] [Citation(s) in RCA: 12] [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] [Indexed: 11/22/2022]
Abstract
Successive treatment of 4,5-epoxy-5-methyl-7-trimethylsilyl-6-heptyne-1-ol with Co2(CO)8 at 0 degrees C and a catalytic amount of BF3 x OEt2 at -78 degrees C gave the tetrahydropyran derivatives with the cobalt-complexed moiety. Similarly 4,5-epoxy-4-methyl-7-trimethylsilyl-6-heptyne-1-ol underwent ring closure under the above conditions to provide the corresponding tetrahydropyran derivatives. The preferential endo mode cyclization over the exo one was observed in these experiments.
Collapse
Affiliation(s)
- C Mukai
- Faculty of Pharmaceutical Sciences, Kanazawa University, Japan.
| | | | | | | |
Collapse
|
42
|
Sakaguchi J, Iwsaki N, Iwanaga Y, Saito T, Takahara E, Kato H, Hanaoka M. Synthesis and gastrointestinal prokinetic activity of novel benzamide derivatives with amphoteric side chains. Chem Pharm Bull (Tokyo) 2001; 49:424-36. [PMID: 11310669 DOI: 10.1248/cpb.49.424] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/22/2022]
Abstract
Novel benzamide derivatives (19-24, 32a-c, 43d-f), each possessing a cycloaminoalkanecarboxylic acid side chain, were synthesized and their gastrointestinal prokinetic and dopamine D2 receptor antagonist activities were evaluated. 4-[(4-Amino-5-chloro-2-methoxybenzoyl)amino]-1-piperidineacetic acid (19) exhibited the most potent gastro- and colon-prokinetic activities, through intravenous administration to conscious dogs, and also showed the reduced dopamine D2 receptor antagonistic activity. However, 19 showed only weak gastrointestinal prokinetic activity after oral administration. Several ester prodrugs (44-62) of 19 were tested for pharmacological activities as well as physicochemical and metabolic stability; the butyl ester (46) was consequently selected as a promising gastrointestinal prokinetic agent with reduced side effects.
Collapse
Affiliation(s)
- J Sakaguchi
- Research Division, Hokuriku Seiyaku Co., Ltd., Katsuyama, Fukui, Japan.
| | | | | | | | | | | | | |
Collapse
|
43
|
Matsuo T, Tsukamoto Y, Tamura M, Hanaoka M, Nagaoka T, Kobayashi Y, Higashihara M, Yokoyama H, Saegusa N. Acute respiratory failure due to "pulmonary calciphylaxis" in a maintenance haemodialysis patient. Nephron Clin Pract 2001; 87:75-9. [PMID: 11174029 DOI: 10.1159/000045887] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Calciphylaxis is a rapidly developing, fatal process of vascular calcium deposition with prominent cutaneous manifestation. We treated a long-term haemodialysis patient who developed an analogous disorder limited to the lungs. A 57-year-old man was admitted for initiation of peritoneal dialysis because limited cardiac reserve precluded further haemodialysis. He was treated successfully for pneumonia until hypoxia and progressive hypercalcaemia developed. (99m)Tc-methylene disphosphonate scintigraphy showed diffusely increased pulmonary uptake. Death supervened despite aggressive and successful treatment of hypercalcaemia. Autopsy studies included immunohistochemistry and morphometric studies of bone. Alveolar capillary walls showed diffuse calcium deposition. Both gross and microscopical findings differed from those of typical metastatic calcification in dialysis patients. Immunoreactivity for parathyroid hormone-related protein was present in the lesions. Bone histomorphometry indicated mild osteitis fibrosa. Pneumonia is believed to have caused local synthesis of parathyroid hormone-related protein that, along with high calcium x phosphorus product, contributed to calcium deposition. By analogy with the cutaneous process we termed the deposition "pulmonary calciphylaxis".
Collapse
Affiliation(s)
- T Matsuo
- Fourth Department of Internal Medicine, Kitasato University, Kanagawa, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Yamamoto H, Koizumi T, Kaneki T, Hanaoka M, Kubo K. Effects of lecithinized superoxide dismutase and a neutrophil elastase inhibitor (ONO-5046) on hyperoxic lung injury in rat. Eur J Pharmacol 2000; 409:179-83. [PMID: 11104832 DOI: 10.1016/s0014-2999(00)00725-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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: 11/19/2022]
Abstract
Reactive oxygen and neutrophil metabolites have been implicated in the development of hyperoxic lung injury. We determined the protective effects of either a superoxide dismutase or neutrophil elastase inhibitor and the combination of both agents on the development of hyperoxic lung injury in rats. Two drugs (lecithinized superoxide dismutase and ONO-5046) were used in the present study. Lecithinized superoxide dismutase, a lecithin derivative bound to recombinant CuZn superoxide dismutase, has a higher affinity for cells such as polymorphonuclear leukocytes and endothelial cells than recombinant human superoxide dismutase. N-[2-[4-2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl]¿ aminoacetic acid (ONO-5046), a specific neutrophil elastase inhibitor, which was developed as a low-molecular weight inhibitor, showed protective effects against various lung injuries. Rats were exposed to over 90% oxygen for 72 h, and bronchoalveolar lavage was performed to evaluate the permeability and neutrophil accumulation in the lungs. Rats were treated with lecithinized superoxide dismutase (30,000 U/day, intravenously n=7) or ONO-5046 (10 mg/kg, intramuscularly twice a day, n=7) or a combination of both drugs (n=7). Albumin concentration and neutrophil counts in bronchoalveolar lavage fluid were compared between animals with and without drug treatment. Either lecithinized superoxide dismutase or ONO-5046 treatment significantly decreased albumin concentration and neutrophil counts in bronchoalveolar lavage fluid compared to those in the animals of the hyperoxia-alone group (n=9). However, albumin leakage and neutrophil accumulation in the rat lung treated with combined agents were identical to that of either the lecithinized superoxide dismutase or ONO-5046 treatment. These findings suggest that lecithinized superoxide dismutase and ONO-5046 are useful drugs to protect against hyperoxic lung injury in rats. However, there were no additive effects by the combination in preventing hyperoxic lung injury.
Collapse
Affiliation(s)
- H Yamamoto
- First Department of Medicine, Shinshu University School of Medicine, 3-1-1 Asahi Matsumoto, 390-8621, Japan
| | | | | | | | | |
Collapse
|
45
|
Morishita T, Nomura M, Hanaoka M, Saruta T, Matsuo T, Tsukamoto Y. A new assay method that detects only intact osteocalcin. Two-step non-invasive diagnosis to predict adynamic bone disease in haemodialysed patients. Nephrol Dial Transplant 2000; 15:659-67. [PMID: 10809807 DOI: 10.1093/ndt/15.5.659] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We studied the usefulness of a new assay method that detects only the intact human osteocalcin molecule in haemodialysed patients. METHODS Iliac bone biopsy specimens obtained from 62 haemodialysed patients were analysed. RESULTS Bone formation rates (BFR/BS) correlated positively with serum intact osteocalcin concentrations (n=62), osteocalcin concentrations assayed by a conventional method (n=31), parathyroid hormone (PTH) concentrations (n=62), and total alkaline phosphatase concentrations (r=0.602, 0. 588, 0.650, and 0.401 respectively). Based on ROC curve and Youden index analysis, the optimal cut-off value to distinguish adynamic bone disease from a mild lesion was 195 pg/ml of serum PTH concentration (Youden index=0.233) or 30 ng/ml of serum intact osteocalcin concentration (Youden index=0.628). The optimal cut-off value to distinguish between hyperparathyroid bone and a mild lesion was 455 pg/ml of serum PTH level (Youden index=0.63) or 50 ng=ml of serum intact osteocalcin concentration (Youden index=0.634). Since both ROC curve and Youden index suggested that the serum PTH concentration was not a good marker to distinguish adynamic bone from a mild lesion or hyperparathyroid bone, we designed a two-step procedure. The first step was the diagnosis of adynamic bone (cut-off: 65 pg/ml) or hyperparathyroid bone (cut-off: 455 pg/ml) according to serum PTH concentration. In a second step, we assessed serum intact osteocalcin concentration in patients with serum PTH concentrations between 65 and 455 pg/ml. The cut-off values for adynamic and hyperparathyroid bone in this diagnostic approach were 30 and 70 ng/ml respectively. As a result, 49 out of 62 patients were diagnosed properly. The Youden index of this two-step diagnosis was 0.527 and 0.661 for adynamic bone and hyperparathyroid bone respectively. Sensitivity markedly improved to 94.4% and 96.2% for adynamic bone and hyperparathyroid bone respectively, without sacrificing specificity (84.0 and 88.8% respectively). CONCLUSION Measurement of serum intact osteocalcin concentration is useful for the diagnosis of adynamic bone in haemodialysed patients. A two-step procedure involving also simultaneous measurement of serum PTH concentration further improved the sensitivity of each individual marker while maintaining specificity.
Collapse
Affiliation(s)
- T Morishita
- Division of Nephrology, Fourth Department of Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | | | | | | | | | | |
Collapse
|
46
|
Kubo K, Yamazaki Y, Hanaoka M, Nomura H, Fujimoto K, Honda T, Ota M, Kamijou Y. Analysis of HLA antigens in Mycobacterium avium-intracellulare pulmonary infection. Am J Respir Crit Care Med 2000; 161:1368-71. [PMID: 10764335 DOI: 10.1164/ajrccm.161.4.9906094] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mycobacterium avium-intracellulare (MAI) pulmonary infection may occur in subjects with no preexisting lung disease and no known immunodeficiency, showing radiologically nodular bronchiectasis. There have remained some unresolved problems in the pathogenesis of the disorder, including the predominance in elderly women and the presence of not deteriorated or deteriorated disease. In the present study, we examined whether immunogenetic susceptibility is present in the disorder. We evaluated 64 cases of MAI disease and analyzed their short-term natural history by assessing symptoms, sputum bacteriology, and chest computed tomographic findings. The frequencies of human leukocyte antigen (HLA) alleles in patients were compared with those in 100 healthy Japanese control subjects. We assayed the HLA-A, -B, -C, -DR, and -DQ antigens serologically. Among 64 patients, 37 (35 females) did not show deterioration, whereas 27 (24 females) showed deterioration after an interval of 30 +/- 15 mo. There was no significant frequency of HLA-B and -C alleles in either group. In 37 not deteriorated patients, DR-6 was positive in 14 (37.8%) patients but in only 16 (16%) control subjects (p = 0.0061, odds ratio [OR] = 3.20). DQ-4 was positive in 10 (27.0%) patients but in only 10 (10%) control subjects (p = 0. 0122, OR = 3.33). In 27 deteriorated patients, HLA-A26 was positive in 14 (51.9%) patients but in only 21 (21.0%) control subjects (p = 0.0015, OR = 4.05). MAI pulmonary infection with nodular bronchiectasis shows two types of outcome, deteriorated and not deteriorated. The subjects with A-26 antigen might indicate the deterioration of MAI infection.
Collapse
Affiliation(s)
- K Kubo
- Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Heishi M, Tazawa H, Matsuo T, Saruta T, Hanaoka M, Tsukamoto Y. A novel Van91 I polymorphism in the 1st intron of the parathyroid hormone (PTH)/PTH-related peptide (PTHrP) receptor gene and its effect on the urinary cAMP response to PTH. Biol Pharm Bull 2000; 23:386-9. [PMID: 10784412 DOI: 10.1248/bpb.23.386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was designed to identify a parathyroid hormone (PTH)/PTH-related peptide (PTHrP) receptor gene polymorphism in a healthy Japanese population. All known 13 introns of this gene were amplified by PCR, except the 1st intron, which was amplified by the long-PCR method. No restriction fragment length polymorphisms (RFLPs) were detected by BsmI or XbaI in any of these introns. Twenty-one other restriction enzymes (Hind III, Bgl II, Sty I, Pvu II, Eco81 I, Van91 I, BstX I, Sse8387 I, EcoR I, BamH I, Mbo II, Tth111 I, PshA I, Eam1105 I, Not I, Srf I, Bgl I, Fok I, Sfi I, Apa I, Taq I) were tested on the 1st intron. Furthermore, digestion by Van911 (CCANNNNNTGG) identified a single, two-allele polymorphism with a fragment of approximately 3.5 kb (V allele) or a fragment of 3.1 and 0.4 kb (v allele). The frequency of the Van91 I polymorphism in 106 healthy Japanese volunteers was 77.4% for type vv, 19.8% for type Vv and 2.8% for type VV. In addition, the urinary cAMP response to exogenous [1-34]PTH was studied in 17 healthy volunteers and found to be significantly greater in persons with type Vv than type vv (p<0.05). In conclusion, the Van91 I polymorphism of the PTH/PTHrP receptor gene can be used to study the role of polymorphism in various disorders involving PTH or PTHrP.
Collapse
Affiliation(s)
- M Heishi
- Sumitomo Metal Bio-Science Inc., Sagamihara, Kanagawa, Japan
| | | | | | | | | | | |
Collapse
|
48
|
Hanaoka M, Tanaka M, Ge RL, Droma Y, Ito A, Miyahara T, Koizumi T, Fujimoto K, Fujii T, Kobayashi T, Kubo K. Hypoxia-induced pulmonary blood redistribution in subjects with a history of high-altitude pulmonary edema. Circulation 2000; 101:1418-22. [PMID: 10736286 DOI: 10.1161/01.cir.101.12.1418] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary hypertension has been suggested to play an important role in development of high-altitude pulmonary edema (HAPE), and individual susceptibility has been suggested to be associated with enhanced pulmonary vascular response to hypoxia. We hypothesized that much greater pulmonary vasoconstriction would be induced by acute alveolar hypoxia in HAPE-susceptible (HAPE-s) subjects and that changes in pulmonary blood flow distribution could be demonstrated by radionuclide study. METHODS AND RESULTS We performed ventilation-perfusion scintigraphy in 8 HAPE-s subjects and 5 control subjects while each was in the supine position and acquired functional images of pulmonary blood flow and ventilation under separate normoxic and hypoxic (arterial oxygen saturation, 70%) conditions. We also measured acceleration time/right ventricular ejection time (AcT/RVET) with Doppler echocardiography under each condition in both groups. Moreover, we assayed human leukocyte antigen (HLA) alleles serologically in the HAPE-s group. Pulmonary blood flow was significantly shifted from the basal lung region to the apical lung region under hypoxia in HAPE-s subjects, although no significant change in regional ventilation was observed. With Doppler echocardiography, HAPE-s subjects showed increased pulmonary arterial pressure during hypoxia compared with control subjects. The magnitude of cephalad redistribution of lung blood flow was significantly higher in the HLA-DR6-positive than in HLA-DR6-negative HAPE-s subjects. CONCLUSIONS These findings suggest that acute hypoxia induces much greater cephalad redistribution of pulmonary blood flow that results from exaggerated vasoconstriction in the basal lung in HAPE-s subjects. Furthermore, pulmonary vascular hyperreactivity to hypoxia may be associated with HLA-DR6.
Collapse
Affiliation(s)
- M Hanaoka
- First Department of Medicine, and Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Hanaoka M, Hirasawa T, Cho WJ, Yasuda S. Convenient synthesis of 2,3,9,10-tetraoxygenated protoberberine alkaloids and their 13-methyl alkaloids. Chem Pharm Bull (Tokyo) 2000; 48:399-404. [PMID: 10726865 DOI: 10.1248/cpb.48.399] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/22/2022]
Abstract
New and convenient synthesis of 2,3,9,10-tetraoxygenated protoberberine alkaloids and their 13-methyl alkaloids through the same intermediates was developed. Acylation of the brominated benzylphenethylamine (13) with alpha-chloro-alpha-(methylthio)acetyl chloride, followed by cyclization with stannic chloride, furnished the key intermediates 4-methylthio-3-phenethylisoquinolin-3-ones (14), which were methylated to provide their methyl derivatives (17). Both isoquinolin-3-ones (14, 17) were easily transformed into protoberberine alkaloids (16) and their 13-methyl alkaloids (21) in good yield.
Collapse
Affiliation(s)
- M Hanaoka
- Faculty of Pharmaceutical Sciences, Kanazawa University, Japan
| | | | | | | |
Collapse
|
50
|
Tsukamoto Y, Hanaoka M, Matsuo T, Saruta T, Nomura M, Takahashi Y. Effect of 22-oxacalcitriol on bone histology of hemodialyzed patients with severe secondary hyperparathyroidism. Am J Kidney Dis 2000; 35:458-64. [PMID: 10692271 DOI: 10.1016/s0272-6386(00)70198-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [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: 11/23/2022]
Abstract
To examine the effectiveness of 22-oxacalcitriol (OCT) injection on the improvement of severe osteitis fibrosa, we studied 10 hemodialyzed patients (age, 59 +/- 12 years). The initial OCT dose was 5 microg and was administered three times weekly at the end of each hemodialysis session. OCT doses (1, 3, 5, 10, 15, and 20 microg) were changed in subsequent weeks to maintain serum calcium levels at less than 11.5 mg/dL. Administration of OCT significantly suppressed serum intact parathyroid hormone (PTH) from an initial level of 1,193 +/- 584 to 775 +/- 552 pg/mL in the 24th week (n = 10). OCT increased PTH levels again to 857 +/- 635 pg/mL in the 48th week (n = 7). Among the 10 patients, 5 patients (high responders) showed more than a 50% suppression of serum intact PTH levels at the end of the study. The rest of the patients had hypercalcemia and did not receive increased OCT doses (low responders). At the start of the treatment, the only difference between high and low responders was serum calcium level. Serum calcium levels (adjusted for serum albumin level) increased from 9.7 +/- 0.7 mg/dL (n = 10) at the beginning to 10.5 +/- 0.6 mg/dL (n = 10) in the 24th week and to 11. 1 +/- 0.7 mg/dL (n = 7) in the 48th week. Six patients (1 to 6) agreed to undergo a second bone biopsy in the 24th week of OCT administration. In bone histomorphometric measurements, OCT significantly changed bone marrow fibrosis, mineralization (labeled mineralizing surface and bone formation rate), and osteoid formation (osteoid volume and thickness). In conclusion, intravenous OCT effectively suppressed PTH secretion and improved the bone histological characteristics of severe osteitis fibrosa, especially in patients with initial serum calcium levels less than 10 mg/dL. With concerns about OCT causing adynamic bone, additional bone histological data are needed to ensure the long-term safety of OCT.
Collapse
Affiliation(s)
- Y Tsukamoto
- Division of Nephrology, Fourth Department of Internal Medicine, Kitasato University School of Medicine, Kanagawa, Japan.
| | | | | | | | | | | |
Collapse
|