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Sakai F, Sone S, Kawai T, Maruyama A, Kiyono K, Morimoto M, Haniuda M, Honda T, Ishii K, Ikeda SI, Kobayashi O, Nishimura H. Ultrasonography of Thymoma with Pathologic Correlation. Acta Radiol 2016. [DOI: 10.1177/028418519403500106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Preoperative ultrasonograms of 11 surgically proved thymomas and ex vivo ultrasonograms of 3 resected specimens were compared with pathologic findings of resected specimens. Among 11 thymomas 7 appeared solid, 3 were solid with several cystic regions, and the remaining one was unilocular cystic in appearance. Cystic regions on ultrasonograms corresponded to cystic changes on pathologic specimens. Six malignant thymomas showed a typical lacy appearance on ultrasonograms, which corresponded to the lobulated configuration separated by fibrous septa shown on the pathologic specimens.
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Takano A, Kawakami N, Miyamoto Y, Matsumoto T, Naruse N, Kobayashi O. P-61 * DEVELOPMENT AND FEASIBILITY STUDY OF WEB-BASED INTERVENTION PROGRAM FOR PEOPLE WITH DRUG PROBLEMS IN JAPAN. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu054.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tanibuchi Y, Matsumoto T, Kobayashi O, Wada K. SY13-2-1 * CURRENT STATUS OF SUBSTANCE ABUSE IN JAPAN; FOCUSED ON EVASIVE DRUGS. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu052.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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4
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Yoshizawa H, Sato K, Makino M, Kobayashi O, Tanaka H, Miura S, Watanabe S, Tanaka J, Kagamu H, Ichiei N. The Efficacy of Triplet Antiemetic Therapy for Chemotherapy-Induced Nausea and Vomiting in Lung Cancer Patients Receiving Highly Emetogenic Chemotherapy: Palonosetron (PALO), Aprepitant (APR), and Dexamethasone (DEX). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34125-9] [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: 10/25/2022] Open
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Watanabe T, Cho H, Yoshikawa T, Tsuburaya A, Kobayashi O. Impact of c-kit mutations, including codons 557 and/or 558, on the recurrence-free survival after curative surgery in patients with GIST. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12 Background: Recently, c-kit exon 11 deletions, including codons 557 and/or 558, have been reported to predict a worse prognosis in GIST patients. However, it is difficult to prove the correlation between genotype and tumor aggressiveness in the imatinib- adjuvant era because exon 11 mutations respond well to imatinib. In this study, we evaluated the impact of c-kit mutational status on recurrence-free survival (RFS) after resection of primary GIST. Methods: Clinical and pathological characteristics of 89 GIST patients in our single institution study were retrospectively analyzed. Tumors were categorized into 4 subgroups based on their mutational locations; A1: mutated codons including neither 557 nor 558, A2: either 557 or 558, B1: only 557 and 558, B2: both 557 and 558. All of the patients underwent curative surgery, and none received adjuvant imatinib. The median duration of follow-up was 49 months. Results: Tumors originated from the stomach (n=75/89, 84%), small intestine (n=10), and colorectum (n=4). Mutation subgroup B was associated with both Fletcher and Miettinen high-risk categories. The 2-year recurrence free survival rate for A1, A2, B1, B2, was 84.9%, 85.7%, 50%, 57%, respectively. Group B2 had a significantly worse RFS than groups A1 (p=0.0004) and A2 (p=0.0014). Multivariate analysis for RFS indicated that only the mutational subgroup was a significant prognostic factor (p=0.03, HR=2.42). Conclusions: C-kit mutations, including both 557 and 558, affected the RFS of GIST patients after curative surgery, but those including either 557 or 558 did not. Our results indicate that the locations of c-kit mutations are associated with PFS, and they may therefore affect the selection of candidates with GIST for adjuvant imatinib. No significant financial relationships to disclose.
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Affiliation(s)
| | - H. Cho
- Kanagawa Cancer Center, Yokohama, Japan
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Abstract
We report a unique case of a biopsy-proven rectal cancer exhibiting spontaneous complete regression in an extremely short period of 3 months. An 80-year-old man visited our hospital because of a positive fecal occult blood test. Colonoscopy showed a sessile polyp, about 25 mm in diameter, in the middle part of the rectum. Instead of endoscopic resection, two endoscopic biopsies were taken for histological evaluation, as an invasive cancer was endoscopically suspected.Well-differentiated invasive adenocarcinoma was revealed, and thus surgical resection was planned. At the second colonoscopy for endoscopic tattooing before surgery, the polyp was found to have unexpectedly developed into a flat lesion. Furthermore, the surgically removed specimen showed that the flat lesion had transformed to a depressed lesion, and surprisingly, no cancerous tissue was detected histologically.
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Affiliation(s)
- S Sakamoto
- Department of Gastroenterology, Juntendo Univerity Nerima Hospital, Tokyo 177-8521, Japan
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7
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Nishida T, Kanda T, Wada N, Kobayashi O, Yamamoto M, Sawaki A, Boku N, Koseki M, Doi T, Toh Y. 9413 Phase II trial of adjuvant imatinib mesylate after resection of localized, primary high risk gastrointestinal stromal tumour (GIST) in Japan. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)72001-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Kobayashi O, Noto M, Sakurai T, Iwamoto A. T-705, A Novel Anti-Influenza Virus Compound - the Safety, Tolerability and Pharmacokinetics in Human. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.802] [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: 10/21/2022] Open
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10
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Tokumaru AM, Kamakura K, Terada H, Kobayashi O, Kanemaru A, Kato T, Murayam S, Yamakawa M, Mizuno M. Asymptomatic self-limiting diffuse white matter lesions in subacute to chronic stage of herpes simplex encephalitis. Neuroradiol J 2008; 21:316-22. [PMID: 24256899 DOI: 10.1177/197140090802100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 03/13/2008] [Indexed: 11/17/2022] Open
Abstract
This study evaluated white matter changes in the subacute and chronic stages of herpes simplex encephalitis (HSE). Subjects comprised 15 patients with HSE. All patients were examined using MRI at onset, and then at seven to ten days, three to five weeks and two to three months after onset. In addition, the six patients who displayed white matter signal abnormalities were examined at six months and <one year after onset. Cell count, protein levels, polymerase chain reaction (PCR) of herpes simplex virus in cerebrospinal fluid (CSF), and exacerbation of neurological symptoms as well as dose of acyclovir were compared between patients with and without white matter abnormalities. Diffuse white matter signal changes were identified at the subacute stage (3-5 weeks after onset) of HSE in six patients (6/15, 40%). No significant relationship was observed between the presence of white matter signal abnormalities and laboratory data, acyclovir dose or clinical symptoms. These signal abnormalities disappeared or improved by two years without any clinical treatment. Diffuse white matter signal abnormalities occur frequently in the subacute stage of HSE. Although the mechanisms underlying these white matter lesions have not been elucidated, subclinical immune-mediated processes may be considered. Repeat MRI studies over a long period are necessary for evaluating the clinical process of patients with HSE.
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Affiliation(s)
- A M Tokumaru
- Department of Radiology, Tokyo Metropolitan Medical Center of Gerontology; Tokyo, Japan -
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Kikuchi S, Obata Y, Yagyu K, Lin Y, Nakajima T, Kobayashi O, Kikuichi M, Ohta K, Ushijima R. 3510 POSTER Serum vascular endothelial growth factor (VEGF), VEGF receptor-1 and -2 among gastric cancer patients and healthy subjects. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71013-3] [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: 11/16/2022] Open
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12
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Yoshii T, Miyagi Y, Nakamura Y, Motohashi O, Nishimura K, Nakayama N, Takagi S, Kobayashi O, Kameda Y. Correlation between the expression abnormalities of E-cadherin-β-catenin complex and lymph node metastasis (LNM) in early gastric cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15105 Background: Therapy for early gastric cancer (GC) varies according to risk of LNM. When the possibility of LNM is very remote, the primary lesion can be resected by the minimally invasive endoscopic surgery only. Therefore, useful parameters predicting LNM are needed. E-cadherin, a component of the cell-cell junctional structure, is known to correlate with GC. In vitro, previous studies elucidated that disorders of cell-cell junction increased the potential of metastasis, and that phosphorylation of β-catenin by c-erbB-2 induced loss of membranous E-cadherin and β-catenin, resulting in junctional structure disorders. Here we evaluated significance of analysis of these molecules in LNM prediction in early GC. Methods: The clinicopathological features and immunohistochemical expressions of E-cadherin, β-catenin, and c-erbB-2 in the primary lesion were studied in 28 patients (LNM +ve group: 14, LNM1 -ve group: 14) selected from 272 patients who underwent radical surgery for early GC between April 2000 to March 2004 at our hospital. All the patients consented to use of their stomach tissues for the clinical study afterwards. Statistical analysis was performed by t-test or χ2 test. Results: The clinicopathological features showed no significant differences between both groups. Loss of the membranous E-cadherin was noticed in 12 (85%) of the 14 LNM +ve patients, and in 8 (57%) of the 14 LNM -ve patients (p=0.209). This result was more remarkable in the intestinal type GC as the corresponding figures were 83% (5 of 6 ) and 16% (1 of 6) (p=0.083), respectively. Loss of the membranous β-catenin also showed a remarkable similar trend in the intestinal type GC, and the corresponding figures were 100% (6 of 6) and 50% (3 of 6) (p=0.182), respectively. Two patients showed over-expression of c-erbB2 and nuclear accumulation of β-catenin, and both had intestinal type GC with LNM. Conclusions: These results suggested that the same molecular signal pathway - as in vitro - including E-cadherin, β-catenin, and c-erbB2 induced LNM in early GC (intestinal type). We concluded that analysis of the expressions of these molecules is useful for not only LNM prediction but also determination of the therapeutic modality especially in intestinal type early GC. No significant financial relationships to disclose.
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Affiliation(s)
- T. Yoshii
- Kanagawa Cancer Center, Yokohama, Japan
| | - Y. Miyagi
- Kanagawa Cancer Center, Yokohama, Japan
| | | | | | | | | | - S. Takagi
- Kanagawa Cancer Center, Yokohama, Japan
| | | | - Y. Kameda
- Kanagawa Cancer Center, Yokohama, Japan
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Chin K, Iishi H, Imamura H, Kobayashi O, Imamoto H, Esaki T, Kato M, Tanaka Y, Furukawa H. Irinotecan plus S-1 (IRIS) versus S-1 alone as first line treatment for advanced gastric cancer: Preliminary results of a randomized phase III study (GC0301/TOP-002). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4525] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4525 Background: Irinotecan has single agent activity and combination activity with S-1 reportedly in phase I/II studies with advanced gastric cancer patients (pts). S-1, oral fluoropyrimidine, also has activity on gastric cancer. A multicenter, randomized phase III trial comparing IRIS to S-1 alone in advanced gastric cancer was conducted. Methods: Pts with previously untreated gastric cancer were randomized to Arm A (oral S-1 80 mg/m2/day from day 1 to 28 followed by a 14-day rest period), or Arm B (oral S-1 80 mg/m2/day from day 1 to 21 and intravenous irinotecan 80 mg/m2 on days 1 and 15 followed by a 14-day rest). Treatment was continued unless disease progression was observed. Inclusion criteria: PS (ECOG) of 0 to 2; adequate major organ functions. Primary endpoint was overall survival. Results: From June 2004 to November 2005, 326 pts were randomized to arm A (162 pts) and arm B (164 pts). Pts characteristics (arm A vs. arm B) were as follows: median age: 63 vs. 63 years, PS 0–1: 97% vs. 97%, and distribution of subtype of intestinal/diffuse/others: 44%/55%/1% vs. 41%/58%/1%. Among 187 RECIST-evaluable pts (93 vs 94) reviewed by independent review panel, best response rates were 26.9% for arm A and 41.5% for arm B(p=0.035). Among 319 toxicity-evaluable patients (161 vs 158), grade 3 or 4 toxicities for arm A vs arm B (% of pts) were as follows: neutropenia 9.3% vs 26.6%, diarrhea 5.6% vs 15.8%, anorexia 9.9% vs 15.8%, nausea 3.7% vs 7.0%, vomiting 0.6% vs 2.5%. Conclusions: IRIS is effective, and well tolerated in pts with advanced gastric cancer. Survival analysis is underway. No significant financial relationships to disclose.
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Affiliation(s)
- K. Chin
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - H. Iishi
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - H. Imamura
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - O. Kobayashi
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - H. Imamoto
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - T. Esaki
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - M. Kato
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - Y. Tanaka
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
| | - H. Furukawa
- Cancer Institute Hospital, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular, Osaka, Japan; Sakai Municipal Hospital, Osaka, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kinki University Medical School, Osaka, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka, Japan; Osaka General Medical Center, Osaka, Japan
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14
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Fujitani K, Sasako M, Iwasaki Y, Yoshimura K, Sano T, Nashimoto A, Fukushima N, Arai K, Kinoshita T, Kobayashi O, Tanemura H. A phase II study of preoperative chemotherapy (CX) with S-1 and cisplatin followed by gastrectomy for clinically resectable type 4 and large type 3 gastric cancer: JCOG 0210. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4609] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4609 Background: Prognosis of both linitis plastica (type 4) and large ulcero-invasive type (type 3) gastric cancer is poor even after curative resection. We conducted a phase II study to evaluate the safety and efficacy of preoperative CX with S-1 and cisplatin followed by gastrectomy in patients (pts) with these tumors. Methods: Eligibility criteria included histologically proven adenocarcinoma of the stomach; clinically resectable gastric cancer of type 4 or type 3 of =8 cm; cN0–2; cM0; PS 0–1; 20–75 years old. Pts received two 28-day cycles of induction CX of S-1 (80–120 mg/body, po, day 1–21) and cisplatin (60mg/m2, iv, day 8). Gastrectomy with D2/3 dissection was performed within 3 to 5 weeks after CX. No adjuvant therapy was added until recurrence after the curative gastrectomy. Primary endpoints were the proportion of protocol achievement and incidence of treatment related death (TRD). Sample size was determined to reject the rate of 45% under the expectation of 60% with power of 80% and alpha of 10%. Results: Fifty pts, 29 males and 21 females with a median age of 61 years (range: 32–75), were entered in this study between 03/2003 and 12/2003. Type 3/4 ratio was 20/30. Surgical exploration was carried out in 48 pts (96%). Among 49 eligible pts, 36 pts (73%; 95% CI, 59–85%) received two cycles of induction CX and R0 resection. One TRD was observed during the first course of CX due to uncontrollable hemorrhage from the primary tumor. Median survival time and the 3- year OS were 1.44 years (95% CI, 1.26–1.98) and 26.0% (95% CI, 14.9–38.6%), respectively. Pathological response, defined as disappearance of more than one third of the primary tumor, was confirmed in 24 pts (48%) and pathological complete response was seen in 1 pts (2%). During the CX, grade 3/4 neutropenia and anorexia occurred in 7 pts (14%), respectively. Postoperative morbidity included pneumonia in 2 pts, pancreatic leakage in 4, and intraperitoneal abscess in 3, without any mortality. Conclusions: Preoperative CX with S-1 and cisplatin followed by gastrectomy was safe and promising for type 4 and large type 3 gastric cancer. The results of ongoing phase III study to evaluate this treatment are awaited. No significant financial relationships to disclose.
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Affiliation(s)
- K. Fujitani
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - M. Sasako
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - Y. Iwasaki
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - K. Yoshimura
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - T. Sano
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - A. Nashimoto
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - N. Fukushima
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - K. Arai
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - T. Kinoshita
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - O. Kobayashi
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
| | - H. Tanemura
- The Gastric Cancer Surgical Study Group of JCOG, Tokyo, Japan
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Narahara H, Koizumi W, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O. Randomized phase III study of S-1 alone versus S-1 + cisplatin in the treatment for advanced gastric cancer (The SPIRITS trial) SPIRITS: S-1 plus cisplatin vs S-1 in RCT in the treatment for stomach cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4514] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4514 Background: S-1 has been widely used against advanced gastric cancer (AGC) not only as monotherapy but also in combination with other cytotoxic compounds. Results of a phase I/II study combining S-1 + cisplatin (CDDP) were very encouraging with a high response rate (RR) of 76%, and the MST (Median Survival Time) of 383 days (Koizumi W et al, Br J Cancer, 2003). Based on these results, a phase III study comparing S-1 alone with S-1 + CDDP has been conducted to further evaluate the efficacy and safety for S-1 + CDDP as a standard treatment for AGC. Methods: This is a randomized, controlled, open-label, parallel, multicenter study. Patients (pts) are randomized to one of two treatment arms. Arm A: Pts receive oral S-1 (40 mg/m2) twice daily 28 days followed by 14 days rest. Arm B: Pts receive oral S-1 (40 mg/m2) twice daily 21 days followed by 14 days rest plus CDDP (60 mg/m2) iv on day 8. Eligibility criteria included unresectable/recurrent AGC, age 20–74, no prior chemotherapy for AGC. Primary endpoint was overall survival (OS). Main secondary endpoints included RR, time to treatment failure (TTF) and toxicity. Based on planned sample size of 284 pts, the trial was designed to have 90% power to detect an improvement in median OS from 8 to 12 months (2-sided log-rank test; significance level 0.05). Results: 305 pts (Arm A/B, 152/153) were randomized between Mar 2002 and Nov 2004. The eligible pts were 299 (Arm A/B, 150/149). Median age was 62.0/61.5 yrs. At a 2 yrs follow-up since last patient in, the MST for Arm A was 335.5 days (95%CI: 292.0 - 402.0) and for Arm B was 396.0 days (95%CI: 342.0 - 471.0). The OS for Arm B was superior to Arm A (log-rank p=0.0366, hazard ratio: 0.774, 95% CI: 0.608 - 0.985). RR was 31.1% for Arm A and 54.0% for Arm B. In Arm A vs Arm B, the most common grade 3/4 toxicities were: leucopenia, 2.0% vs 11.5%; neutropenia, 10.7% vs 39.9%; anemia (decreased Hb), 4.0% vs 25.7%; nausea, 1.3% vs 11.5%; anorexia, 6.0% vs 30.4%. No treatment related death was observed. Conclusions: The combination treatment of S-1 and CDDP met primary endpoint of OS, and was found to be effective and well tolerated in pts with AGC. Accordingly, this regimen can be regarded as one of first-line standard treatment for AGC. No significant financial relationships to disclose.
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Affiliation(s)
- H. Narahara
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - W. Koizumi
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - T. Hara
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - A. Takagane
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - T. Akiya
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - M. Takagi
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - K. Miyashita
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - T. Nishizaki
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
| | - O. Kobayashi
- Osaka Medical Center for Cancer and CV Diseases, Osaka, Japan; Kitasato University East Hospital, Kanagawa, Japan; Kouseiren Takaoka Hospital, Toyama, Japan; Iwate Medical University, Iwate, Japan; Gunma Prefectual Cancer Center, Gunma, Japan; Shizuoka General Hospital, Shizuoka, Japan; National Hospital Org Nagasaki Medical Center, Nagasaki, Japan; Matsuyama Red Cross Hospital, Ehime, Japan; Kanagawa Cancer Center, Kanagawa, Japan
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Ikeda R, Yoshida K, Takagane A, Tsuburaya A, Kobayashi O, Sunouchi H, Matsukawa M, Tanimoto K, Hiyama K, Nishiyama M. Pharmacogenomic (PG) analysis for prediction of individual response to paclitaxel in 5-FU-refractory metastatic gastric cancer: Prediction formula of tumor response using novel marker genes and genotypes associated with the toxicity. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.2538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2538 Background: Taxanes offer hope for improving outcomes of metastatic gastric cancer patients including 5-FU failure cases, but the response remarkably varies among patients. We conducted this prospective PG study for paclitaxel monotherapy to develop a prediction formula of efficacy and to identify potent genetic markers of toxicity. Methods: Paclitaxel was intravenously given on Days 1, 8, and 15, every 4 weeks in 5-FU failure metastatic gastric cancer patients with typical eligibility criteria. Tumor and blood samples were collected before the initial paclitaxel administration for PG. PK analysis was done on day 1 of cycle 1. Tumor response and toxicity were evaluated by RECIST and CTCAE, respectively. Results: Forty-nine pts were enrolled, and up to date, 48 and 44 pts have been determined for worst toxicity and best tumor response, respectively. Observed response rate was 27.3% (12/44), and common grade 3/4 toxicities were neutropenia (31.3%) and leucopenia (20.8%). PG analysis demonstrated that CYP2C8*1C (w/v=27, v/v=5) and CYP2C8 -411T>C (w/v=24, v/v=10) were weakly associated with grade 3/4 leucopenia (p=0.087 and 0.092), and CYP2C8 IVS7+49T> A (w/v=9, v/v=6) might correlate with grade 3/4 anemia (p=0.039), although none of them correlated with any PK parameter. We identified 4 novel potent marker genes (SEPT5, MARN2, PER3, and PISA3) for paclitaxel efficacy in vitro through microarray expression analysis, and then successfully developed the best linear models, which converted the quantified expression data into objective clinical response, in terms of best tumor response (r=0.985, AICS=-5.269) and overall survival (r=0.980, AICS=6.953), using 15 and 13 data sets of gene expression and clinical response, respectively. At present, utility-confirmation analyses using other clinical samples appeared to show that the formulae could accurately predict tumor response. Conclusions: Polygenetic strategies using several known polymorphisms for toxicity and a prediction formula using 4 novel genes for efficacy would be of predictive value for individual response to paclitaxel. No significant financial relationships to disclose.
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Affiliation(s)
- R. Ikeda
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - K. Yoshida
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - A. Takagane
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - A. Tsuburaya
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - O. Kobayashi
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - H. Sunouchi
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - M. Matsukawa
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - K. Tanimoto
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - K. Hiyama
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
| | - M. Nishiyama
- Hiroshima Cancer Ther Dev Org, Hiroshima, Japan; Hiroshima Univ, Hiroshima, Japan; Iwate Med Univ, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; Kawakita General Hosp, Tokyo, Japan; Showa Univ Toyosu Hosp, Tokyo, Japan
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Kachi S, Okazaki M, Takeda H, Igarashi H, Kobayashi O, Watanabe H, Nakata K, Kawai S, Aoshima M, Watanabe T, Goto H. Outbreak of Nocardia farcinica infection with the same pattern in randomly amplified polymorphic DNA analysis. J Hosp Infect 2006; 62:502-6. [PMID: 16483691 DOI: 10.1016/j.jhin.2005.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2004] [Accepted: 02/09/2005] [Indexed: 11/30/2022]
Abstract
We experienced three cases of nocardiosis by Nocardia farcinica in the same ward within a six-month period. The result of gene analysis by randomly amplified polymorphic DNA gave the same pattern. Thus, these three cases were considered to be caused by the same strain of N. farcinica, implying the presence of nosocomial infection.
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Affiliation(s)
- S Kachi
- First Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
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Sakamoto J, Morita S, Tsuburaya A, Kodera Y, Matsui T, Kobayashi O. Efficacy of adjuvant chemotherapy with oral fluorinated pyrimidines for patients with curatively resected gastric cancer. A meta-analysis of centrally randomized controlled clinical trials. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Sakamoto
- Kyoto Univ, Kyoto, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Nagoya Univ, Nagoya, Japan; Aichi Prefectural Hosp, Okazaki, Japan
| | - S. Morita
- Kyoto Univ, Kyoto, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Nagoya Univ, Nagoya, Japan; Aichi Prefectural Hosp, Okazaki, Japan
| | - A. Tsuburaya
- Kyoto Univ, Kyoto, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Nagoya Univ, Nagoya, Japan; Aichi Prefectural Hosp, Okazaki, Japan
| | - Y. Kodera
- Kyoto Univ, Kyoto, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Nagoya Univ, Nagoya, Japan; Aichi Prefectural Hosp, Okazaki, Japan
| | - T. Matsui
- Kyoto Univ, Kyoto, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Nagoya Univ, Nagoya, Japan; Aichi Prefectural Hosp, Okazaki, Japan
| | - O. Kobayashi
- Kyoto Univ, Kyoto, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Nagoya Univ, Nagoya, Japan; Aichi Prefectural Hosp, Okazaki, Japan
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Yoshida T, Osaragi T, Murakami H, Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M. Sequential chemotherapy of S-1/weekly paclitaxel in patients with peritoneal metastasis of gastric cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Yoshikawa T, Kobayashi O, Tsuburaya A, Cho H, Yoshida T, Murakami H, Osaragi T, Sairenji M, Motohashi H. Plasma TIMP-1 as an independent prognostic factor in patients with gastric cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - H. Cho
- Kanagawa Cancer Ctr, Yokohama, Japan
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Kobayashi O, Tsuburaya A, Yoshikawa T, Osaragi T, Murakami H, Yoshida T, Sairenji M. Relevance of peritoneal lavage cytology before and after gastrectomy in CY1 and R1 surgery for primary advanced gastric cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- O. Kobayashi
- Kanagawa Cancer Ctr, Yokohma, Japan; Kanagawa Cancer Ctr, Yokohama, Japan
| | - A. Tsuburaya
- Kanagawa Cancer Ctr, Yokohma, Japan; Kanagawa Cancer Ctr, Yokohama, Japan
| | - T. Yoshikawa
- Kanagawa Cancer Ctr, Yokohma, Japan; Kanagawa Cancer Ctr, Yokohama, Japan
| | - T. Osaragi
- Kanagawa Cancer Ctr, Yokohma, Japan; Kanagawa Cancer Ctr, Yokohama, Japan
| | - H. Murakami
- Kanagawa Cancer Ctr, Yokohma, Japan; Kanagawa Cancer Ctr, Yokohama, Japan
| | - T. Yoshida
- Kanagawa Cancer Ctr, Yokohma, Japan; Kanagawa Cancer Ctr, Yokohama, Japan
| | - M. Sairenji
- Kanagawa Cancer Ctr, Yokohma, Japan; Kanagawa Cancer Ctr, Yokohama, Japan
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Rino Y, Takanashi Y, Shiopzawa M, Cho H, Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Imada T. Abnormal response of growth hormone to thyrotropin releasing hormone injection in patients with gastric cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Y. Rino
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - Y. Takanashi
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - M. Shiopzawa
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - H. Cho
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - T. Yoshikawa
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - A. Tsuburaya
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - O. Kobayashi
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - M. Sairenji
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
| | - T. Imada
- Yokohama City Univ Sch of Medicine, Yokohama, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; Yokohama City Universituy Medcl Ctr, Yokohama, Japan
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Nomura T, Ohkusa T, Okayasu I, Yoshida T, Sakamoto M, Hayashi H, Benno Y, Hirai S, Hojo M, Kobayashi O, Terai T, Miwa H, Takei Y, Ogihara T, Sato N. Mucosa-associated bacteria in ulcerative colitis before and after antibiotic combination therapy. Aliment Pharmacol Ther 2005; 21:1017-27. [PMID: 15813838 DOI: 10.1111/j.1365-2036.2005.02428.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND We proposed that Fusobacterium varium is one of the causative agents in ulcerative colitis. AIM To examine the efficacy of antibiotic combination therapy against F. varium and to investigate the mucosa-associated bacteria before and after the therapy using a new molecular approach. METHODS Twenty patients with ulcerative colitis were randomly assigned into the antibiotic treatment group (amoxicillin, tetracycline and metronidazole for 2 weeks) and no-antibiotics group. Clinical assessment, colonoscopic and histological evaluations were performed at 0 and 3-5 months after the treatment. DNA from mucosal bacteria was isolated from biopsy specimens. We investigated the mucosa-associated bacterial components by terminal restriction fragment length polymorphism with the restriction enzyme HhaI and MspI, and quantified the change in the number of bacteria by real-time polymerase chain reaction. Immunohistochemical detection of F. varium in biopsy specimens was also performed. RESULTS After the treatment, the clinical assessment, colonoscopic and histological scores improved in the antibiotic group compared with the control group. Three peaks of terminal restriction fragment length polymorphism decreased after treatment only in the antibiotic group. Eubacterium rectale, Dorea formicigenerans, Clostridium clostridioforme and F. varium were included in these peaks. Based on the real-time polymerase chain reaction study, only F. varium was significantly reduced after treatment. In the immunostaining, post-treatment scores in treatment group were significantly lower than that in control group. CONCLUSIONS Antibiotics combination therapy was effective for ulcerative colitis. The number of mucosa-associated F. varium significantly decreased after the treatment.
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Affiliation(s)
- T Nomura
- Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Jensen PØ, Moser C, Kobayashi O, Hougen HP, Kharazmi A, Høiby N. Faster activation of polymorphonuclear neutrophils in resistant mice during early innate response to Pseudomonas aeruginosa lung infection. Clin Exp Immunol 2004; 137:478-85. [PMID: 15320896 PMCID: PMC1809146 DOI: 10.1111/j.1365-2249.2004.02554.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Polymorphonuclear neutrophils (PMNs) are crucial for the outcome of Pseudomonas aeruginosa lung infection in patients with cystic fibrosis. We compared PMNs and inflammatory cytokines in the lungs and blood from susceptible BALB/c and resistant C3H/HeN mice 1 and 2 days after intratracheal challenge with alginate embedded P. aeruginosa. These parameters were correlated with the quantitative bacteriology and histopathology of the lungs. After challenge, the content of granulocyte colony-stimulating factor (G-CSF) and macrophage inflammatory protein-2 (MIP-2) was increased in the lungs and the sera and the percentage of PMNs was increased in the blood. However, 2 days after challenge the concentration of G-CSF and MIP-2 was higher in the lungs and sera of BALB/c mice. CD11b expression was higher on the PMNs of the C3H/HeN mice. The expression of CD62L on PMNs of both strains of mice was decreased 1 day after bacterial challenge, whereas the expression was increased after 2 days of challenge on PMNs of C3H/HeN mice only. These changes were accompanied by a more severe lung inflammation in BALB/c mice and faster clearance of the bacteria in C3H/HeN mice. In conclusion, the rapid early bacterial clearance in the lungs of C3H/HeN mice could be explained by faster activation of the PMNs, as indicated by the higher up-regulation of CD11b. The severe lung inflammation in BALB/c mice may be caused by the early higher content of G-CSF in the sera mobilizing PMNs from the bone marrow and the persistent chemotactic gradient provided by MIP-2 in the lungs.
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Affiliation(s)
- P Ø Jensen
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark.
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Yoshida T, Murakami H, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H. CPT-11 + CDDP in patients with metastatic and recurrent gastric cancer as a third-line chemotherapy. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Murakami H, Tsuburaya A, Yoshida T, Kobayashi O, Sairenji M. Randomized study to evaluate the efficacy of protease inhibitor(PI) in patients who underwent R0 resection of gastric cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yoshida K, Tetsuya T, Takagane A, Saito K, Tsuburaya A, Kobayashi O, Yamamoto W, Matsukawa M, Kuwano H, Nishiyama M. Phase I trial of weekly paclitaxel in 5-FU failure metastatic gastric cancer with pharmacogenomic analysis. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- K. Yoshida
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - T. Tetsuya
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - A. Takagane
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - K. Saito
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - A. Tsuburaya
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - O. Kobayashi
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - W. Yamamoto
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - M. Matsukawa
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - H. Kuwano
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
| | - M. Nishiyama
- Hiroshima University, Hiroshima, Japan; Iwate Medical Univ., Iwate, Morioka, Japan; Kanagawa Cancer Ctr Hosp, Yokohama, Japan; ShowaUniv. Toyosu Hosp, Tokyo, Japan; Gunma Univ, Gunma, Japan
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Cho H, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H. A risk estimation with tumor size, serosal invasion and MIB-1 labeling index for gastrointestinal stromal tumor (GIST) of the stomach. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. Cho
- Miura Municipal Hospital, Miura, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - A. Tsuburaya
- Miura Municipal Hospital, Miura, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - O. Kobayashi
- Miura Municipal Hospital, Miura, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - M. Sairenji
- Miura Municipal Hospital, Miura, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - H. Motohashi
- Miura Municipal Hospital, Miura, Japan; Kanagawa Cancer Center, Yokohama, Japan
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Yoshikawa T, Morinaga S, Noguchi Y, Yamamoto Y, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H. Prognostic value of intratumoral tissue inhibitor of matrix metalloproteinase-1 in patients with gastric cancer-prospective follow up results-. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- T. Yoshikawa
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - S. Morinaga
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - Y. Noguchi
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - Y. Yamamoto
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - A. Tsuburaya
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - O. Kobayashi
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - M. Sairenji
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - H. Motohashi
- Yokohama City Kowan Hospital, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
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Kobayashi O, Murakami H, Yoshida T, Yoshikawa T, Tsuburaya A, Sairenji M, Notohashi H. Trend for better survival after the introduction of oral fluoropyrimidine, S-1, in patients with recurrent gastric cancer (RGC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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34
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Ohkawa A, Miwa H, Namihisa A, Kobayashi O, Nakaniwa N, Ohkusa T, Ogihara T, Sato N. Diagnostic performance of light-induced fluorescence endoscopy for gastric neoplasms. Endoscopy 2004; 36:515-21. [PMID: 15202048 DOI: 10.1055/s-2004-814409] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND STUDY AIM Malignant tumors generate autofluorescent patterns that differ from those of normal tissue. However, whether autofluorescent diagnosis could be genuinely useful in screening for gastric neoplasms has not been well investigated in clinical practice. Accordingly, we retrospectively studied our experience with this diagnostic technique for various gastric lesions and assessed its diagnostic utility. PATIENTS AND METHODS Autofluorescence diagnosis of 109 gastric lesions in 79 patients was done, without knowledge of the diagnosis by conventional white light endoscopy, retrospectively and independently by three endoscopists with 6 years', two years' and no experience of the technique. After examination of the interobserver bias in the assessment of autofluorescent pseudocolor in light-induced fluorescence endoscopy (LIFE), the relationship between pseudocolor and characteristics of gastric lesions (including histology, macroscopic type, and depth of invasion) were investigated. RESULTS The kappa statistic for agreement in pseudocolor diagnosis between the three endoscopists was 0.71. The assessment of pseudocolor by all of the observers was in agreement in 67 of the total of 109 lesions (61.5 %). Experience with the LIFE technique did not improve the accuracy of pseudocolor determination. All of the cancers, 87.5 % of the adenomas, and 50.9 % of the benign lesions were recognized as having an abnormal autofluorescent image. None of the gastric cancers and 49.1 % of the benign lesions were evaluated as having a normal autofluorescence image. The histopathological and macroscopic types of tumors and their depths of invasion were not reflected in the autofluorescence diagnosis. CONCLUSIONS LIFE provided a sensitivity of 96.4 % and specificity of 49.1 %, suggesting that this technique has limited clinical utility, regardless of the merits of acceptable interobserver bias and lack of necessity for experience with this technique.
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Affiliation(s)
- A Ohkawa
- Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo, Japan
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35
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Hirose M, Miwa H, Kobayashi O, Oshida K, Misawa H, Kurosawa A, Watanabe S, Sato N. Inhibition of proliferation of gastric epithelial cells by a cyclooxygenase 2 inhibitor, JTE522, is also mediated by a PGE2-independent pathway. Aliment Pharmacol Ther 2002; 16 Suppl 2:83-9. [PMID: 11966528 DOI: 10.1046/j.1365-2036.16.s2.28.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cyclooxygenase-2 (COX-2) is one of the rate-limiting enzymes for prostaglandin synthesis from arachidonic acid. Although it is known that inhibition of cyclooxygenase activity delays ulcer healing, the regulatory relationship between COX-2 and its metabolites in gastric epithelial cell proliferation is not well known. AIM To investigate whether COX-2 has an effect on gastric mucosal cell proliferation and further studied whether such effect is mediated only by prostaglandin E2 (PGE2), a representative metabolite of arachidonates in the gastric mucosa. METHODS Artificial wounds of defined area size were created on complete monolayer cell sheets of isolated rat gastric epithelial cells and rat gastric cell line RGM1 under the addition of arachidonic acid or a COX-2 selective inhibitor, JTE522. Repair of wounds was assessed by monitoring wound size, with cell proliferation detected using 5-bromodeoxyuridine staining. Quantity of secreted PGE2 was measured by enzyme immunoassay. RESULTS Stimulation of foetal calf serum increased the expression of COX-2 protein and inhibition of COX-2 retarded wound healing with reduction of cell proliferation. Arachidonic acid increased PGE2 production and accelerated restoration. Combination of JTE522 and arachidonic acid resulted in a marked retardation of wound healing compared to the control, but JTE522 did not completely suppress the increase in cellular PGE2 content following the addition of arachidonate. CONCLUSIONS The difference in the effects of JTE522 on PGE2 production and on wound healing suggest that the involvement of COX-2 in gastric epithelial cell proliferation is not mediated solely by PGE2.
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Affiliation(s)
- M Hirose
- Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan
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36
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Moser C, Jensen PO, Kobayashi O, Hougen HP, Song Z, Rygaard J, Kharazmi A, H by N. Improved outcome of chronic Pseudomonas aeruginosa lung infection is associated with induction of a Th1-dominated cytokine response. Clin Exp Immunol 2002; 127:206-13. [PMID: 11876741 PMCID: PMC1906339 DOI: 10.1046/j.1365-2249.2002.01731.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.7] [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] [Indexed: 11/20/2022] Open
Abstract
Repeated challenge with antigen is involved in the pathogenesis of a variety of pulmonary diseases. Patients with cystic fibrosis (CF) experience recurrent pulmonary colonization with Pseudomonas aeruginosa before establishment of chronic lung infection. To mimic recurrent lung infections in CF patients, the lungs of susceptible BALB/c mice were re-infected with P. aeruginosa 14 days after the initial infection. Singly-infected BALB/c mice, as well as non-infected mice, were used as controls. Decreased mortality and milder lung inflammation in re-infected BALB/c mice, as well as a tendency for improved clearance of bacteria, was observed when compared with singly-infected mice. The improved outcome in re-infected mice correlated with changes in CD4 cell numbers. Surface expression of LFA-1 on pulmonary CD4 cells was increased in re-infected compared with singly-infected mice. Moreover, resistance to re-infection was paralleled by a shift towards a Th1-dominated response and increased IL-12 production. No significant increase in serum IgG was observed in the re-infected mice. In conclusion, these results indicate a protective role for a Th1-dominated response, independent of antibody production, in chronic P. aeruginosa lung infection in CF.
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Affiliation(s)
- C Moser
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Denmark.
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37
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Kobayashi O. [Airway biofilm disease and autoimmunity]. Nihon Naika Gakkai Zasshi 2001; 90:2438-42. [PMID: 11917869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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38
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Ohtami S, Kobayashi O, Ohtami H. Analysis of intractable factors in chronic airway infections: role of the autoimmunity induced by BPI-ANCA. J Infect Chemother 2001; 7:228-38. [PMID: 11810589 DOI: 10.1007/s101560170018] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2001] [Accepted: 07/16/2001] [Indexed: 11/26/2022]
Abstract
The role of anti-neutrophil cytoplasmic autoantibodies against bactericidal/permeability-increasing protein (BPI-ANCA) in chronic airway infections was investigated. The serum BPI-ANCA titer was correlated with the severity of clinical symptoms in patients with chronic airway infections (P < 0.01), and the serum BPI-ANCA titer decreased with the improvement of the clinical picture, compared with its deterioration (P < 0.05). The serum BPI-ANCA titer was significantly higher in patients with far-advanced lesions on chest X-rays than in patients with milder lesions (P < 0.01) and in patients with reduced respiratory function (P < 0.05). Also, the serum BPI-ANCA titer was significantly higher in patients with prolonged colonization of gram-negative bacteria than in those without prolonged gram-negative bacterial colonization (P < 0.05). When neutrophils from healthy volunteers were incubated with BPI-ANCA before stimulation with lipopolysaccharide (LPS), neutrophil elastase levels decreased in a dose-dependent manner (P < 0.01). The phagocytic activity of neutrophils was significantly inhibited by BPI-ANCA in a dose-dependent manner (P < 0.01). The above findings suggest that BPI-ANCA, an autoimmune factor, appears during the course of chronic airway infections, and that this autoimmune factor may make chronic airway infections more intractable, by inhibiting the phagocytic activity of neutrophils for gram-negative bacteria.
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Affiliation(s)
- S Ohtami
- First Department of Internal Medicine, Kyorin University, School of Medicine, 6-20-2 Sinkawa, Mitaka, Tokyo 181-8611, Japan.
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39
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Kobayashi O, Konishi K, Kanari M, Cho H, Yoshikawa T, Tsuburaya A, Sairenji M, Motohashi H. [Significance of radical recurrent tumor resection for recurrent gastric cancer as assessed by prognosis]. Gan To Kagaku Ryoho 2001; 28:1647-50. [PMID: 11707999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
To evaluate the relationship between radical surgery of recurrent tumor and prognosis in cases of recurrent gastric cancer, we analyzed data on 202 patients with relapsed gastric cancer, focusing on surgical recurrent tumor removal. In our series, 18 of the 202 patients underwent radical recurrent tumor resection. Resected tumors were located in the ovarium (n = 4), colorectum (n = 3), liver (n = 3), lymph node (n = 2), locoregional stoma (n = 2), and peritoneum, adrenal gland, brain, and lung (n = 1 each). No surgery-related mortality occurred. One patient remains alive over 5 years after hepatectomy without recurrence, and 17 died within 3 years: 7 patients from primary recurrence and 10 from multiple modes of recurrence. Median survival after recurrence (MSTAR) in the 18 radical surgery patients was 14 months, against 5 months in those treated palliatively (p = 0.0001). MSTAR for the ovary and the liver were 30 months and 15 months in the radical surgery cases, and 2.5 months for the ovary and 5 months for the liver in the palliative cases. Significant differences were thus seen between radical and palliative cases in the ovary (p = 0.010) and in the liver (p = 0.036). Median survival after gastrectomy was 45 months in the radical surgery cases, and 28 months in the palliative cases (p = 0.024). In postoperative gastric cancer follow-up, early detection of recurrence and radical surgery may well benefit patients with relapse, especially in the liver and ovary, in terms of survival.
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Affiliation(s)
- O Kobayashi
- Dept. of Gastrointestinal Surgery, Kanagawa Cancer Center
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40
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Kobayashi O, Miwa H, Watanabe S, Tsujii M, Dubois RN, Sato N. Cyclooxygenase-2 downregulates inducible nitric oxide synthase in rat intestinal epithelial cells. Am J Physiol Gastrointest Liver Physiol 2001; 281:G688-96. [PMID: 11518681 DOI: 10.1152/ajpgi.2001.281.3.g688] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) expression has been demonstrated in inflamed intestinal mucosa. Although regulation of COX-2 and iNOS expression has been studied extensively, the interplay between these two enzymes remains unclear. Because they play crucial roles in inflammation and/or carcinogenesis, we investigated whether COX-2 regulates iNOS expression and evaluated the effects of COX-2 inhibitor and arachidonic acid (AA) on iNOS induction. The COX-2 gene coding region was stably transfected into rat intestinal epithelial cells (RIE sense cells). After interferon-gamma (IFN-gamma) and lipopolysaccharide (LPS) administration, iNOS and COX-2 expression was evaluated by Western blotting. PGE(2) was measured by the enzyme immunoassay (EIA) method. Expression of IFN response factor-1, phosphorylated extracellular signal-related kinase-1 and -2, and Ikappa-Balpha was evaluated. Activator protein-1 and nuclear factor-kappaB (NF-kappaB) were examined by gel mobility shift assay; a supershift assay was performed to identify the NF-kappaB complex components. JTE-522 or AA was added before IFN-gamma and LPS administration, and effects on iNOS and PGE(2) induction were evaluated by Western blotting or EIA. iNOS protein and mRNA expression was inhibited in RIE sense cells. Although NF-kappaB activation was suppressed and Ikappa-Balpha protein was more stable, respectively, in RIE sense cells, no difference was noted in other transcription factors. JTE-522 increased iNOS protein expression in RIE cells. We conclude that COX-2 suppressed iNOS expression in RIE cells through suppression of NF-kappaB by stabilizing Ikappa-Balpha.
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Affiliation(s)
- O Kobayashi
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
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41
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Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H, Noguchi Y. Should scirrhous gastric carcinoma be treated surgically? Clinical experiences with 233 cases and a retrospective analysis of prognosticators. Hepatogastroenterology 2001; 48:1509-12. [PMID: 11677997] [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: 02/22/2023]
Abstract
BACKGROUND/AIMS The prognosis of patients with scirrhous gastric carcinoma has been poorest. METHODOLOGY To clarify the role of surgical treatment, 233 patients with a primary scirrhous gastric carcinoma were retrospectively analyzed. RESULTS Of the 233 patients, 182 underwent surgical resection, while the other 51 did not. The median survival time of those with unresectable tumors was 88.0 +/- 15.3 days and that of those who underwent resection was 380.0 +/- 41.8 days. In the 182 patients who underwent resection, multivariate analysis revealed four significant factors; lymphatic invasion, serosal invasion, curability, and lymph node dissection. Of these, curability was the most significant. The median survival time of patients whose tumor were curatively resected was 727.0 +/- 116.3 days, significantly longer than 272 +/- 34.9 days for those whose resection ended noncuratively. In 65 patients whose tumor was curatively resected, subset analyses of factors by multivariate analyses revealed an absence of serosal invasion as the single significant prognosticator. The 5-year survival rate was 55.6% in patients with scirrhous cancer without serosal invasion. CONCLUSIONS For patients with scirrhous gastric carcinoma, palliative resection should not be attempted for poor outcome. However, if curative resection seems feasible, radical surgery would be justified, especially for tumors without serosal exposure.
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Affiliation(s)
- T Yoshikawa
- Third Department of Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-Ku, Yokohama 241, Japan.
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42
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Kobayashi O, Kanari M, Yoshikawa T, Tsuburaya A, Sairenji M, Motohashi H. [Significance of laparoscopy for response assessment of chemotherapy in gastric cancer]. Gan To Kagaku Ryoho 2001; 28:1141-4. [PMID: 11525033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
UNLABELLED We performed laparoscopy before and after chemotherapy in two patients with relapsed and advanced gastric cancer, whose major metastatic sites had been diagnosed as being in the peritoneum. A change in tumor responses when assessed by laparoscopy was found. Case 1: A 63-year-old man presented with an umbilical metastasis and suspected peritoneal metastases after gastrectomy. Laparoscopy revealed peritoneal metastases before chemotherapy. After one course of chemotherapy the umbilical tumor disappeared (CR). Laparoscopy after two courses of chemotherapy revealed increasing peritoneal metastases (PD). The overall response was PD. Case 2: A 67-year-old woman was referred to our hospital with a diagnosis of type 4 gastric cancer. Staging laparoscopy revealed massive lymph node metastases and the patient was positive in peritoneal washing cytology. After four courses of chemotherapy, the primary tumor and the metastatic lymph nodes had decreased in size (PR). In contrast, laparoscopy revealed increasing peritoneal metastases (PD). The overall response was PD. CONCLUSION In patients with peritoneal and other modes of metastasis, tumor response to chemotherapy may be misjudged by conventional imaging alone. Intraperitoneal examination by laparoscopy provides accurate information, including the tumor response to chemotherapy.
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Affiliation(s)
- O Kobayashi
- Dept. of Gastrointestinal Surgery, Kanagawa Cancer Center
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43
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Matsumoto H, Kobayashi O, Sekine I. [Multiple sclerosis with consciousness disturbance: a case report]. No To Hattatsu 2001; 33:265-9. [PMID: 11391971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
We report here a nine-year-old girl with multiple sclerosis having consciousness disturbance at admission. Neurological examination revealed drowsiness, unstable emotion, decreased visual acuity, disturbance of convergence, and clumsy coordination movements. Her cerebrospinal fluid IgG and myelin basic protein were increased. Electroencephalogram showed intermittent, high voltage slow waves predominant in the frontal lobes. Magnetic resonance imaging (MRI) found multiple demyelinating plaques in the brainstem, thalamus, periventricular white matter. The brainstem reticular formation was involved. Since she had had bilateral acute optic neuritis and papillitis two years before the admission, the diagnosis of multiple sclerosis was made. Methylprednisolone pulse therapy improved her neurological symptoms and MRI findings. Multiple sclerosis in children, unlike that in adults, may present with symptoms mimicking an encephalopathy. Our case suggested that consciousness disturbance in childhood multiple sclerosis results from lesions in the brainstem activating reticular formation including the thalamus.
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Affiliation(s)
- H Matsumoto
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Saitama
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44
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Uehara K, Kobayashi M, Hirasaki A, Asao Y, Kobayashi O. [Myasthenia gravis is improved temporarily at postburn period]. Masui 2001; 50:521-4. [PMID: 11424470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
A 62-year-old woman with a 25-year history of myasthenia gravis (MG) was admitted to our hospital due to burn injury over 20-25% of the total body surface area. Five months before admission, the serum concentration of acetylcholine receptor (AchR) antibodies was 80.9 nmol.l-1 (normal range < 0.3 nmol.l-1). Anticholinesterase agents had been administered for MG, but were discontinued six days after admission due to muscarinic side effects, but no symptoms of MG appeared. Thirteen days after admission, the AchR antibody titer was 21.2 nmol.l-1. Free skin grafting was performed under general anesthesia without any event. About 80 days after admission, weakness of extraocular muscles appeared. Positive tensilon test and the characteristic electromyographic findings revealed deterioration of MG, and anticholinesterase agents were resumed. Ten months after admission, the AchR antibody titer was 50.4 nmol.l-1. The mechanism of the temporary improvement of MG symptoms does not appear to be explained by the diffuse immunosuppression after burn. At a postburn period, nicotinic AchRs at the neuromuscular junction are known to be temporarily induced. This up-regulation may have caused the temporary improvement in this patient.
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Affiliation(s)
- K Uehara
- Department of Anesthesiology and Resuscitology, Okayama University Medical School, Okayama 700-8558
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45
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Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H, Yanoma S, Noguchi Y. Intratumoral concentrations of tissue inhibitor of matrix metalloproteinase 1 in patients with gastric carcinoma a new biomartker for invasion and its impact on survival. Cancer 2001; 91:1739-44. [PMID: 11335899 DOI: 10.1002/1097-0142(20010501)91:9<1739::aid-cncr1192>3.0.co;2-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Previously, the authors clarified that the plasma concentration of tissue inhibitor of matrix metalloproteinase 1 (TIMP-1) in patients with gastric carcinoma was a significant predictor of tumor invasiveness and metastasis. METHODS To further clarify the clinical significance of TIMP-1, the authors used an enzyme-linked immunoassay to assess TIMP-1 protein concentrations in samples of tumor tissue from 86 patients who underwent primary resection for gastric carcinoma. Concentrations in samples of normal gastric mucosa from 73 of these patients also were assessed. RESULTS Tissue TIMP-1 concentrations were significantly greater in gastric tumors than in normal gastric mucosa and were associated significantly with a variety of pathologic factors, including macroscopic type, depth of tumor invasion in the gastric wall, presence of lymphatic vessel invasion, pattern of tumor infiltration into the surrounding tissue, and disease stage. Significantly greater TIMP-1 concentrations were found in tumors that were exposed to the serosal surface compared with tumors that were limited to the submucosal layer. TIMP-1 protein was significantly greater in tumors with lymphatic vessel invasion, an infiltrative pattern into the surrounding tissue (INF-gamma), and in tumors from patients with Stage III disease. Survival was significantly poorer in patients with TIMP-1 concentrations > or = 10.0 ng/mg total protein. When patients were stratified by disease stage, survival was significantly different in patients with Stage III disease. Multivariate analysis demonstrated that intratumoral concentrations of TIMP-1 were the most significant independent factor for survival. CONCLUSIONS These findings suggest that the intratumoral concentration of TIMP-1 protein may be a good indicator of tumor aggressiveness and can serve as a significant independent predictor of survival in patients with gastric carcinoma.
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Affiliation(s)
- T Yoshikawa
- The Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
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Abstract
BACKGROUND Most cancers and adenomas of the GI tract are easily detected by light-induced fluorescence endoscopy (LIFE-GI). However, some tumors are poorly visualized by using this technique. To investigate whether the spraying of noradrenaline on the lesion provides better visualization of the boundaries of neoplasms, the conventional and LIFE-GI endoscopic observations were made before and after spraying of nonadrenaline. METHODS Seven patients with gastric cancers were studied. After a conventional fiberscopic examination, a LIFE-GI procedure was performed, and then 20 mL of 0.02% noradrenaline solution was sprayed on the lesion. RESULTS The normal mucosa became paler than the tumor after spraying noradrenaline, thereby clarifying the tumor boundary in the LIFE-GI image. CONCLUSIONS The combined use of pharmacoendoscopy with LIFE-GI is useful in the detection of gastric malignant tumors because it enhances the boundaries of these lesions.
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Affiliation(s)
- A Namihisa
- Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan
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47
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Hayakawa J, Motohashi H, Sairenji M, Kobayashi O, Takahashi M, Usuda Y. The effects of intraoperative glucose infusion on portal blood insulin concentration and hepatic mitochondrial redox state during surgery: comparison of short-term and continuous infusions. Surg Today 2001; 30:228-34. [PMID: 10752774 DOI: 10.1007/s005950050050] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The relationships between the blood glucose level, portal blood immunoreactive insulin (IRI) concentration, ketogenesis, and hepatic mitochondrial redox state associated with intraoperative glucose administration were evaluated in patients undergoing total gastrectomy. A total of 26 patients were randomly allocated to two groups according to the type of infusion given; group 1 was given a short-term glucose infusion of 25 g in 30 min and group 2 was given a continuous glucose infusion of 10 g/h. The blood glucose concentration peaked 30 min after the glucose infusion was commenced, then decreased in group 1, despite a continuous rise in group 2. A temporary but significantly higher blood glucose level was observed in group 1 than in group 2, 30 and 60 min after the infusion was commenced. The portal blood IRI concentrations and arterial ketone body ratio (AKBR) continued to increase and the blood ketone body concentrations continued to decline after the start of the glucose infusion in both groups; however, after 60 and 120 min, the portal blood IRI and AKBR levels were significantly higher, and the blood ketone body levels significantly lower in group 1 than in group 2. These findings suggest that intraoperative glucose administration is beneficial for insulin secretion, ketogenesis, and the hepatic mitochondrial redox state, and that short-term infusion is superior to continuous infusion.
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Affiliation(s)
- J Hayakawa
- Department of Anesthesia, Kanagawa Cancer Center Hospital, Yokohama, Japan
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48
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Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H, Kameda Y, Noguchi Y. Neoadjuvant chemotherapy with a combination of irinotecan and cisplatin in advanced gastric cancer--a case report. Hepatogastroenterology 2000; 47:1575-8. [PMID: 11149004] [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: 02/18/2023]
Abstract
We report a case of advanced gastric carcinoma successfully treated with a combination of irinotecan and cisplatin as neoadjuvant chemotherapy. The patient, a 78-year-old man, had type 2 gastric cancer, which had metastasized to the paraaortic lymph nodes. He was treated with irinotecan, 70 mg on day 1 and day 15, and cisplatin, 80 mg on day 1. The course was repeated every 4 weeks. Two courses of treatment resulted in a marked reduction of both the primary tumor and lymph nodes. Subsequently, the patient underwent curative surgery consisting of total gastrectomy, splenectomy, and D3 lymph node dissection. No surgical complications were observed. On microscopic examination, only a few tumor cells were detected in the granulation tissues of the resected stomach and in the lymph nodes. This would be the first case to demonstrate the effectiveness and the safety of irinotecan and cisplatin used in the neoadjuvant setting for treatment of advanced gastric carcinoma.
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Affiliation(s)
- T Yoshikawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-Ku, Yokohama 241-0815, Japan.
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Abstract
Walker-Warburg syndrome (WWS) is an autosomal recessive disorder characterized by type II lissencephaly, cerebellar and retinal anomalies, and congenital muscular dystrophy. We report a female diagnosed with WWS based on clinical criteria. This patient was found to have fetal hydrocephalus on ultrasonography at 29 weeks of gestation, and exhibited severe hypotonia, ocular malformations, and hydrocephalus at birth. MRI revealed type II lissencephaly, hydrocephalus, and other severe brain malformations. Genetic analysis was performed to distinguish WWS from severe Fukuyama-type congenital muscular dystrophy (FCMD), which has numerous findings in common. This revealed no expression of the founder haplotype or single-stranded conformation polymorphism (SSCP) abnormalities. Since the life expectancy of patients with FCMD is longer, differential diagnosis should be performed precisely.
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Affiliation(s)
- Y Asano
- Department of Pediatrics, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan.
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50
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Chadani Y, Kondoh T, Kamimura N, Matsumoto T, Matsuzaka T, Kobayashi O, Kondo-Iida E, Kobayashi K, Nonaka I, Toda T. Walker-Warburg syndrome is genetically distinct from Fukuyama type congenital muscular dystrophy. J Neurol Sci 2000; 177:150-3. [PMID: 10980312 DOI: 10.1016/s0022-510x(00)00328-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A female patient who fulfilled the diagnostic criteria of Walker-Warburg syndrome had muscle biopsy finding of muscular dystrophy. There was normal expression of merosin (laminin alpha2 chain) and dystrophin and only slightly reduced dystrophin-associated glycoprotein expression. On genetic analysis, she had no specific haplotype, the common mutation of 3kb insertion, or point mutations in the Fukuyama-type congenital muscular dystrophy gene, suggesting that the two diseases are not genetically identical.
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Affiliation(s)
- Y Chadani
- Department of Pediatrics, Nagasaki University School of Medicine, Nagasaki, Japan.
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