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Iihara H, Iwai M, Morita R, Fujita Y, Ohgino K, Ishihara T, Hirose C, Suzuki Y, Masubuchi K, Kawazoe H, Kawae D, Aihara K, Endo S, Fukunaga K, Yamazaki M, Tamura T, Kitamura Y, Fukui S, Endo J, Suzuki A. Mirtazapine plus granisetron and dexamethasone for carboplatin-induced nausea and vomiting in patients with thoracic cancers: A prospective multicenter phase II trial. Lung Cancer 2024; 192:107801. [PMID: 38678830 DOI: 10.1016/j.lungcan.2024.107801] [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: 02/15/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Mirtazapine blocks 5-hydroxytryptamine type (5-HT)2A, 5-HT2C, 5-HT3 and histamine H1 receptors, similarly to olanzapine. This study aimed to investigate the efficacy and safety of mirtazapine plus granisetron and dexamethasone for carboplatin (CBDCA)-induced nausea and vomiting in patients with thoracic cancers. METHODS We conducted a prospective, open-label, single-arm, multicenter, phase II trial in four institutions in Japan. Registered patients were moderately to highly emetogenic chemotherapy-naïve, and were scheduled to receive CBDCA at area under the curve (AUC) ≥ 4 mg/mL per minute. Patients received mirtazapine 15 mg/day orally at bedtime for four consecutive days, in combination with granisetron and dexamethasone. Primary endpoint was complete response (CR; no emesis and no use of rescue medication) rate during the delayed period (24-120 h). RESULTS Between July 2022 and July 2023, 52 patients were enrolled, and 48 patients were evaluated. CR rates in the delayed (24-120 h), overall (0-120 h), and acute periods (0-24 h) were 83.3%, 83.3%, and 100%, respectively. No grade 3 or higher treatment-related adverse events were observed except for one patient who had grade 3 dry mouth as evaluated by Common Terminology Criteria for Adverse Events version 5.0. CONCLUSIONS Prophylactic antiemetic therapy with mirtazapine plus granisetron and dexamethasone shows promising efficacy and an acceptable safety profile. This three-drug combination appears to be a reasonable treatment approach in patients with thoracic cancers receiving a CBDCA-based regimen at AUC ≥ 4 mg/mL per minute.
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Affiliation(s)
- Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan; Patient Safety Division, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan; Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, 1-25-4 Daigakunishi, Gifu, Gifu 501-1196, Japan
| | - Masamichi Iwai
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Ryo Morita
- Department of Respiratory Medicine, Akita Kousei Medical Center, 1-1-1 Nishibukuro Iijima, Akita, Akita, 011-0948, Japan
| | - Yukiyoshi Fujita
- Division of Pharmacy, Gunma Prefectural Cancer Center, 617-1 Takahayashinishi, Ota, Gunma, 373-8550, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Yasuyuki Suzuki
- Department of Pharmacy, Akita Kousei Medical Center, 1-1-1 Nishibukuro Iijima, Akita, Akita, 011-0948, Japan
| | - Ken Masubuchi
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1 Takahayashinishi, Ota, Gunma 373-8550, Japan
| | - Hitoshi Kawazoe
- Division of Pharmaceutical Care Sciences, Center for Social Pharmacy and Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Daisuke Kawae
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Kanako Aihara
- Department of Pharmacy, Akita Kousei Medical Center, 1-1-1 Nishibukuro Iijima, Akita, Akita, 011-0948, Japan
| | - Satoshi Endo
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1 Takahayashinishi, Ota, Gunma 373-8550, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Mizuki Yamazaki
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Takuya Tamura
- Department of Pharmacy, Akita Kousei Medical Center, 1-1-1 Nishibukuro Iijima, Akita, Akita, 011-0948, Japan
| | - Yu Kitamura
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Shin Fukui
- Department of Respiratory Medicine, Akita Kousei Medical Center, 1-1-1 Nishibukuro Iijima, Akita, Akita, 011-0948, Japan
| | - Junki Endo
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan; Laboratory of Advanced Medical Pharmacy, Gifu Pharmaceutical University, 1-25-4 Daigakunishi, Gifu, Gifu, 501-1196, Japan.
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Awaya T, Endo J, Iijima R, Shimoda M, Moroi M. siRNA therapy improves multimodality imaging in hereditary transthyretin cardiac amyloidosis: a case report. QJM 2024; 117:304-306. [PMID: 38229248 DOI: 10.1093/qjmed/hcae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- T Awaya
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - J Endo
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - R Iijima
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - M Shimoda
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - M Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
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Minatogawa H, Izawa N, Shimomura K, Arioka H, Iihara H, Sugawara M, Morita H, Mochizuki A, Nawata S, Mishima K, Tsuboya A, Miyaji T, Honda K, Yokomizo A, Hashimoto N, Yanagihara T, Endo J, Kawaguchi T, Furuya N, Sone Y, Inada Y, Ohno Y, Katada C, Hida N, Akiyama K, Ichikura D, Konomatsu A, Ogura T, Yamaguchi T, Nakajima TE. Dexamethasone-sparing on days 2-4 with combined palonosetron, neurokinin-1 receptor antagonist, and olanzapine in cisplatin: a randomized phase III trial (SPARED Trial). Br J Cancer 2024; 130:224-232. [PMID: 37973958 PMCID: PMC10803798 DOI: 10.1038/s41416-023-02493-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND This study evaluated the non-inferiority of dexamethasone (DEX) on day 1, with sparing on days 2-4 in cisplatin-based chemotherapy. METHODS Patients with malignant solid tumors who were treated with cisplatin (≥50 mg/m²) were randomly assigned (1:1) to receive either DEX on days 1-4 (Arm D4) or DEX on day 1 (Arm D1) plus palonosetron, NK-1 RA, and olanzapine (5 mg). The primary endpoint was complete response (CR) during the delayed (24-120 h) phase. The non-inferiority margin was set at -15%. RESULTS A total of 281 patients were enrolled, 278 of whom were randomly assigned to Arm D4 (n = 139) or Arm D1 (n = 139). In 274 patients were included in the efficacy analysis, the rates of delayed CR in Arms D4 and D1 were 79.7% and 75.0%, respectively (risk difference -4.1%; 95% CI -14.1%-6.0%, P = 0.023). However, patients in Arm D1 had significantly lower total control rates during the delayed and overall phases, and more frequent nausea and appetite loss. There were no significant between-arm differences in the quality of life. CONCLUSION DEX-sparing is an alternative option for patients receiving cisplatin; however, this revised administration schedule should be applied on an individual basis after a comprehensive evaluation. CLINICAL TRIALS REGISTRY NUMBER UMIN000032269.
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Affiliation(s)
- Hiroko Minatogawa
- Department of Pharmacy, St. Marianna University Hospital, Kawasaki, Japan
| | - Naoki Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | | | - Hitoshi Arioka
- Department of Medical Oncology, Yokohama Rosai Hospital, Yokohama, Japan
| | | | - Mitsuhiro Sugawara
- Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara, Japan
| | - Hajime Morita
- Department of Pharmacy, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Ayako Mochizuki
- Department of gynecology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shuichi Nawata
- Department of Pharmacy, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Keisuke Mishima
- Department of Digestive surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Ayako Tsuboya
- Department of Pharmacy, Kawasaki municipal Tama Hospital, Kawasaki, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunori Honda
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Ayako Yokomizo
- Department of Pharmacy, St. Marianna University Hospital, Kawasaki, Japan
| | - Naoya Hashimoto
- Department of Pharmacy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takeshi Yanagihara
- Department of Medical Oncology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Junki Endo
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yumiko Sone
- Department of Clinical Pharmacy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yusuke Inada
- Department of Pharmacy, Yokohama Rosai Hospital, Yokohama, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chikatoshi Katada
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoya Hida
- Department of Respiratory Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, Yokohama, Japan
| | - Kana Akiyama
- Department of pharmacy, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Daisuke Ichikura
- Department of Pharmacy, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Akiko Konomatsu
- Department of Pharmacy, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Takashi Ogura
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
- Department of Clinical Oncology, Kawasaki municipal Tama Hospital, Kawasaki, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takako Eguchi Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.
- Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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Kinomura M, Iihara H, Fujii H, Hirose C, Endo J, Yanase K, Inui T, Kaito D, Sasaki Y, Gomyo T, Sakai-Masuda C, Kawae D, Kitamura YU, Fukui M, Kobayashi R, Ohno Y, Suzuki A. Effect of Mirtazapine for the Prevention of Nausea and Vomiting in Patients With Thoracic Cancer Receiving Platinum-based Chemotherapy. Anticancer Res 2023; 43:1301-1307. [PMID: 36854494 DOI: 10.21873/anticanres.16277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/18/2023] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND/AIM Mirtazapine, which exerts an antagonistic effect on 5-hydroxytryptamine type 5-HT2A, 5-HT2C, 5-HT3 and H1 receptors, is considered useful for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV). This study investigated the efficacy and safety of mirtazapine for the prevention of CINV in patients with thoracic cancer receiving platinum-based chemotherapy. PATIENTS AND METHODS A retrospective cohort study was conducted in patients with thoracic cancer receiving platinum-based chemotherapy with 15 mg mirtazapine once daily as a prophylactic antiemetic drug between January 2014 and December 2021. The effects of mirtazapine added to the standard antiemetic regimen for the prevention of CINV were evaluated in patients who had poor control of CINV in a preceding cycle and in patients who received the standard antiemetic therapy plus mirtazapine from their first cycle. RESULTS A total of 35 patients were evaluated. Of these, 14 had poor control of CINV in a preceding cycle and received the standard antiemetic therapy plus mirtazapine in the next cycle. The rate of complete response in the delayed period in these patients was significantly improved from the preceding cycle to the next cycle (35.7% vs. 85.7%, p=0.018). In contrast, the other 21 patients had received the standard antiemetic regimen plus mirtazapine from the first cycle. The rate of complete response in the delayed period in these patients receiving the triplet antiemetic regimen plus mirtazapine as part of a cisplatin-based or carboplatin-based regimen and in patients receiving a doublet antiemetic regimen plus mirtazapine in a carboplatin-based regimen was 100%, 85.7% and 100%, respectively. No severe adverse events, including somnolence, were observed with the addition of mirtazapine. CONCLUSION The addition of mirtazapine to the standard antiemetic regimen for CINV may be beneficial with acceptable safety when administered in association with platinum-based regimens to patients with thoracic cancer.
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Affiliation(s)
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Hironori Fujii
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Junki Endo
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Toshiya Inui
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuka Sasaki
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takenobu Gomyo
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chizuru Sakai-Masuda
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daisuke Kawae
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Y U Kitamura
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masachika Fukui
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Ryo Kobayashi
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.,Laboratory of Advanced Medical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan; .,Laboratory of Advanced Medical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
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5
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Yamazaki M, Komizo N, Iihara H, Hirose C, Yanase K, Yamada Y, Endo J, Yamashita S, Ohno Y, Todoroki K, Suzuki A, Hayashi H. Relationship Between Osimertinib Concentration and Clinical Response in Japanese Patients With Non-small Cell Lung Cancer. Anticancer Res 2023; 43:725-732. [PMID: 36697059 DOI: 10.21873/anticanres.16211] [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: 12/14/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND/AIM Osimertinib is the first-line treatment for patients with advanced epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC). The present study aimed to determine the previously unclarified association of osimertinib plasma trough concentrations with efficacy, adverse events, and genetic polymorphisms in Japanese patients with NSCLC harboring EGFR mutations. PATIENTS AND METHODS In this prospective study, blood samples of 25 patients who received osimertinib were collected to measure plasma osimertinib concentrations and to genotypically characterize ATP-binding cassette subfamily B member 1 and ATP-binding cassette subfamily G member 2 polymorphisms. Plasma osimertinib concentrations were analyzed using validated multiple reaction monitoring mode-based liquid chromatography-tandem mass spectrometry. Osimertinib concentration necessary to achieve optimal median progression-free survival (PFS) was determined using receiver operating characteristic curve analysis. PFS and overall survival were analyzed using the Kaplan-Meier method, and between-group differences were compared using the log-rank test. Plasma osimertinib concentrations between different patient groups were compared using the Mann-Whitney U-test. RESULTS Patients were divided into high and low concentration groups based on a plasma osimertinib cut-off concentration of 211 ng/ml. Median PFS was longer in the high trough concentration group than that in the low trough concentration group (46.3 vs. 16.8 months, p=0.029). Plasma osimertinib concentrations adjusted for dose and body weight did not differ between the patients with and without variant polymorphisms. CONCLUSION Monitoring plasma trough concentrations during maintenance might improve osimertinib treatment efficacy in patients with NSCLC harboring EGFR mutations.
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Affiliation(s)
- Mizuki Yamazaki
- Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.,Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Nao Komizo
- Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.,Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Komei Yanase
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuto Yamada
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.,Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Junki Endo
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shuji Yamashita
- Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kenichiro Todoroki
- Laboratory of Analytical and Bio-Analytical Chemistry, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.,Laboratory of Advanced Medical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Hideki Hayashi
- Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan; .,Department of Pharmacy, Gifu University Hospital, Gifu, Japan.,Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, Gifu, Japan
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Fan Z, Suzuki Y, Jiang L, Okabe S, Honda S, Endo J, Watanabe T, Abe T. Peripheral blood flow estimated by laser doppler flowmetry provides additional information about sleep state beyond that provided by pulse rate variability. Front Physiol 2023; 14:1040425. [PMID: 36776965 PMCID: PMC9908953 DOI: 10.3389/fphys.2023.1040425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
Pulse rate variability (PRV), derived from Laser Doppler flowmetry (LDF) or photoplethysmography, has recently become widely used for sleep state assessment, although it cannot identify all the sleep stages. Peripheral blood flow (BF), also estimated by LDF, may be modulated by sleep stages; however, few studies have explored its potential for assessing sleep state. Thus, we aimed to investigate whether peripheral BF could provide information about sleep stages, and thus improve sleep state assessment. We performed electrocardiography and simultaneously recorded BF signals by LDF from the right-index finger and ear concha of 45 healthy participants (13 women; mean age, 22.5 ± 3.4 years) during one night of polysomnographic recording. Time- and frequency-domain parameters of peripheral BF, and time-domain, frequency-domain, and non-linear indices of PRV and heart rate variability (HRV) were calculated. Finger-BF parameters in the time and frequency domains provided information about different sleep stages, some of which (such as the difference between N1 and rapid eye movement sleep) were not revealed by finger-PRV. In addition, finger-PRV patterns and HRV patterns were similar for most parameters. Further, both finger- and ear-BF results showed 0.2-0.3 Hz oscillations that varied with sleep stages, with a significant increase in N3, suggesting a modulation of respiration within this frequency band. These results showed that peripheral BF could provide information for different sleep stages, some of which was complementary to the information provided by PRV. Furthermore, the combination of peripheral BF and PRV may be more advantageous than HRV alone in assessing sleep states and related autonomic nervous activity.
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Affiliation(s)
- Zhiwei Fan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan,The Japan Society for the Promotion of Science (JSPS) Foreign Researcher, Tokyo, Japan
| | - Yoko Suzuki
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Like Jiang
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan,Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan
| | - Satomi Okabe
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan,Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan
| | | | | | | | - Takashi Abe
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan,*Correspondence: Takashi Abe,
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Fujii H, Araki A, Iihara H, Kaito D, Hirose C, Kinomura M, Yamazaki M, Endo J, Inui T, Yanase K, Sasaki Y, Gomyo T, Sakai C, Kawae D, Kitamura Y, Fukui M, Kobayashi R, Ohno Y, Suzuki A. Cancer cachexia as a determinant of efficacy of first-line pembrolizumab in patients with advanced non-small cell lung cancer. Mol Clin Oncol 2022; 16:91. [PMID: 35251642 PMCID: PMC8892465 DOI: 10.3892/mco.2022.2524] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/12/2022] [Indexed: 11/30/2022] Open
Abstract
Pembrolizumab, either as a type of monotherapy or in combination with cytotoxic anticancer agents, is effective in the treatment of advanced non-small cell lung cancer (NSCLC). However, the development of cancer cachexia may adversely affect anticancer drug therapy. The present study investigated the effect of cancer cachexia on clinical outcomes in patients with advanced NSCLC who received first-line pembrolizumab. The data of patients with advanced NSCLC receiving first-line monotherapy or combination therapy with pembrolizumab were retrospectively analyzed. The primary endpoint was time to treatment failure (TTF), and the secondary endpoints were overall survival (OS) and incidence of adverse events (AEs). Clinical outcome was compared between patients with and without cancer cachexia. A total of 53 patients were analyzed. Among all patients, median TTF and OS were significantly shorter in patients with cancer cachexia than in those without [TTF: 5.8 vs. 10 months; hazard ratio (HR): 2.13; 95% confidence interval (CI): 1.07-4.24; P=0.016; OS: 12.1 months vs. not reached; HR: 5.85; 95% CI: 2.0-17.1; P=0.001]. In addition, TTF in the pembrolizumab monotherapy group was significantly shorter in patients with cancer cachexia than in those without, but no significant difference was detected in patients receiving pembrolizumab combination therapy. The incidence of AEs did not significantly differ between patients with and without cancer cachexia, except with regard to hypothyroidism. In conclusion, although cancer cachexia is prognostic of a poor outcome in patients with advanced NSCLC who receive first-line pembrolizumab, cancer cachexia might not affect therapeutic efficacy in combination therapy with pembrolizumab and cytotoxic anticancer agents.
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Affiliation(s)
- Hironori Fujii
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Ayumu Araki
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Daizo Kaito
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Motohiko Kinomura
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Mizuki Yamazaki
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Junki Endo
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Toshiya Inui
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Komei Yanase
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Yuka Sasaki
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Takenobu Gomyo
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Chizuru Sakai
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Daisuke Kawae
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Yu Kitamura
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Masachika Fukui
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Ryo Kobayashi
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
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8
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Funaguchi N, Iihara H, Kaito D, Gomyo T, Sasaki Y, Yanase K, Endo J, Ito F, Hirose C, Ohno Y, Okura H. Efficacy of cisplatin plus vinorelbine adjuvant chemotherapy with split‑dose administration of cisplatin after complete resection of stage II‑IIIA non‑small cell lung cancer. Mol Clin Oncol 2022; 16:76. [DOI: 10.3892/mco.2022.2509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/13/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Norihiko Funaguchi
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu 501‑1194, Japan
| | - Daizo Kaito
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Takenori Gomyo
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Yuka Sasaki
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Komei Yanase
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Junki Endo
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Fumitaka Ito
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu 501‑1194, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Hiroyuki Okura
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
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9
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Sato Y, Iihara H, Kinomura M, Hirose C, Fujii H, Endo J, Yanase K, Kaito D, Sasaki Y, Gomyo T, Sakai C, Iwai M, Tsuboi Y, Ishihara T, Kobayashi R, Ohno Y, Suzuki A. Primary Prophylaxis of Febrile Neutropenia With Pegfilgrastim in Small-cell Lung Cancer Patients Receiving Amrubicin as Second-line Therapy. Anticancer Res 2021; 41:1615-1620. [PMID: 33788757 DOI: 10.21873/anticanres.14923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We evaluated the efficacy of primary prophylaxis with pegfilgrastim (PEG) for febrile neutropenia (FN) in small cell lung cancer (SCLC) patients receiving amrubicin (AMR). PATIENTS AND METHODS A retrospective cohort study was conducted in patients with SCLC receiving AMR as second-line therapy. RESULTS A total of 33 patients were treated with AMR (no PEG group), while 13 patients were treated with AMR plus prophylactic administration of PEG (PEG group). The severity of neutropenia was significantly reduced in the PEG group compared to the no PEG group (p=0.02). The incidence of FN in the no PEG and PEG groups was 27.3% and 7.7%, respectively. The time to development of FN tended to be longer in the PEG group compared to the no PEG group (p=0.132). CONCLUSION Primary prophylaxis with PEG may be beneficial in reducing the risk of FN in patients with SCLC receiving AMR.
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Affiliation(s)
- Yukina Sato
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | | | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Hironori Fujii
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Junki Endo
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuka Sasaki
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takenobu Gomyo
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chizuru Sakai
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masamichi Iwai
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoshiki Tsuboi
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Ryo Kobayashi
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan; .,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
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10
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Iihara H, Hirose C, Funaguchi N, Endo J, Ito F, Yanase K, Kaito D, Ohno Y, Suzuki A. Evaluation of clinical pharmacist interventions for adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy. Mol Clin Oncol 2021; 14:116. [PMID: 33903822 DOI: 10.3892/mco.2021.2278] [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: 08/12/2019] [Accepted: 02/12/2021] [Indexed: 11/06/2022] Open
Abstract
Due to the increasing complexity of cancer chemotherapy and its associated supportive care, the role of clinical pharmacists in cancer chemotherapy is becoming increasingly more important. The present study evaluated the clinical interventions of a single pharmacist on the adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy. A single-center, retrospective study was conducted at the 614-bed, tertiary care Gifu University Hospital. Hospitalized patients with thoracic cancer who received cancer chemotherapy in the respiratory medicine ward between April 2013 and May 2014 were enrolled. One of the two clinical pharmacists in charge was based in the respiratory medicine ward and implemented pharmaceutical care for the patients, including management of adverse events. Patient data were recorded in the electronic medical chart and retrospectively analyzed. A total of 445 patients with thoracic cancer received cancer chemotherapy in the respiratory medicine ward. A total of 152 interventions (101 patients) were performed by the clinical pharmacist prior to the administration of cancer chemotherapy, half of which comprised the addition of drugs to prevent adverse events. A total of 190 patients (39.4%) experienced grade ≥2 non-hematological or grade ≥3 hematological adverse events associated with cancer chemotherapy, and 223 medical interventions for relief of adverse events lowered the incidence of grade ≥2 non-hematological or grade ≥3 hematological adverse events to 17.8%. Of these, 45.3 and 7.5% of medical interventions for non-hematological and hematological adverse events, respectively, were implemented based on the pharmacist's recommendations. These findings revealed the marked contribution of a single clinical pharmacist in the respiratory medicine ward to the prevention and relief of adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy.
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Affiliation(s)
- Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu 501-1194, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu 501-1196, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu 501-1194, Japan
| | - Norihiko Funaguchi
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan.,Department of Respiratory Medicine, Asahi University Hospital, Gifu 500-8856, Japan
| | - Junki Endo
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Fumitaka Ito
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Komei Yanase
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Daizo Kaito
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu 501-1194, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu 501-1196, Japan
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11
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Shinya Y, Kimura M, Kawakami T, Hiraide T, Moriyama H, Kataoka M, Endo J, Itabashi Y, Murata M, Kohno T, Fukuda K. Efficacy and outcomes of balloon pulmonary angioplasty in elderly vs non-elderly chronic thromboembolic pulmonary hypertension patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2263] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Balloon pulmonary angioplasty (BPA) has been reported as an effective and safe treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, its safety and efficacy in elderly patients remains unknown.
Purpose
We investigated the effect of BPA on hemodynamics and respiratory parameters, functional capacity, and short- and long-term outcome in elderly patients.
Methods
From November 2012 to May 2018, 141 consecutive CTEPH patients who underwent BPA in a single university hospital were enrolled (age: 65 [54.5–74] years old, WHO functional class [WHO-FC] II/III/IV; 35/96/10). Patients were divided into two groups according to the age; elderly (≥75 years, N=32) and young groups (<75 years, N=109). Hemodynamics (right-sided heart catheterization), biomarkers (brain natriuretic peptide), respiratory function (spirometry and diffusion capacity measurement), and functional capacity (6-minute walk distance [6MWD] and WHO-FC) were evaluated at baseline and 1-year post BPA. Procedure-related complications (in hospital death, use of percutaneous cardiopulmonary support [PCPS], and pulmonary injury) and all cause death during the follow up period were also assessed.
Results
At baseline, although elderly group had less severe hemodynamics (mPAP: 33.1±6.7 vs 39.0±11.8 mmHg, p<0.05), they had poor exercise capacity and reduced pulmonary diffusion capacity, compared with young group (6MWD: 264.6±101.3 vs 369.7±105.2 m, %DLco: 42.0±12.0 vs 50.2±12.7%, all p<0.05). BPA improved hemodynamics, biomarkers, exercise capacity, and pulmonary diffusion capacity in both elderly and young groups (all p<0.05). There was no in-hospital death or use of PCPS in both groups, although the incidence of pulmonary injury was higher in elderly group (14.3% vs 5.3%, p<0.01). Under the normalized hemodynamics 1-year after BPA in both groups, exercise capacity and pulmonary diffusion capacity were worse in the elderly group than young groups (p<0.01). The incidence of all-cause death in the follow up period was higher in elderly group, all of which were due to non-pulmonary hypertension (PH)-related death (p<0.01).
Conclusion
BPA was effective in improving hemodynamics and respiratory parameters and functional capacity, in associated with no critical complication, regardless of the age. Elderly patients who were treated with BPA were associated with higher incidence of non-PH-related death.
Changes of mean PAP in the two groups
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Shinya
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - M Kimura
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Kawakami
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Hiraide
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - H Moriyama
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - M Kataoka
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - J Endo
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - Y Itabashi
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - M Murata
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Kohno
- Kyorin University School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Fukuda
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
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12
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Shinya Y, Hiraide T, Kataoka M, Momoi M, Goto S, Katsumata Y, Endo J, Sano M, Kosaki K, Fukuda K. A novel causative gene variant, TNFRSF13B p.Gly76Ser, in patients with pulmonary arterial hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2310] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary artery hypertension (PAH) is a poor prognostic disease. Some causative genes were reported as the PAH-associated genes. However, the pathogenetic variants in PAH-associated genes have not been identified in majority of patients with idiopathic PAH.
Purpose
Our aim was to investigate the new causative gene variants associated with PAH.
Methods
We performed whole-exome sequencing in 272 patients with idiopathic/heritable PAH. Structural analysis simulation was performed to define how the candidate gene variant affected the structure of protein.
Results
We identified the heterozygous substitution change of c.226G>A (p.Gly76Ser, rs146436713) in tumor necrotic factor receptor superfamily 13B gene (TNFRSF13B) (NM_012452.2) in 6 (2.2%) patients with idiopathic/heritable PAH, although the allele frequency of this rare variant is 0% in Integrative Japanese Genome Variation Database (control population database). Two of the six cases were blood relatives, although they did not have the known causative gene variants of PAH. One of these two relatives died of right heart failure despite the combination medical therapy, and her pathological anatomy demonstrated intimal thickening and medial hypertrophy in the pulmonary arteries, formation of plexiform lesions (Heath-Edwards classification grade V). Time-lapse images from structural analysis simulation showed the instability of N-terminal in the protein, which regulates the vascular inflammation, synthesized from TNFRSF13B p.Gly76Ser variant (Figure), suggesting that p.Gly76Ser variant may be involved in the development of PAH via aberrant inflammation in pulmonary vessels.
Conclusions
TNFRSF13B p.Gly76Ser variant is a candidate of causative gene variant for PAH.
Structural analysis of proteins
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Shinya
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Hiraide
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - M Kataoka
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - M Momoi
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - S Goto
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - Y Katsumata
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - J Endo
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - M Sano
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - K Kosaki
- Keio University School of Medicine, Center for Medical Genetics, Tokyo, Japan
| | - K Fukuda
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
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13
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Kimura M, Kohno T, Kawakami T, Shinya T, Hiraide T, Moriyama H, Kataoka M, Endo J, Itabash Y, Mitsushige M, Fukuda K. De-escalation/discontinuation of oxygen-therapy and medication is feasible and safe in chronic thromboembolic pulmonary hypertension patients treated with balloon pulmonary angioplasty. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2281] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
There has been increasing evidence of the efficacy of balloon pulmonary angioplasty (BPA) in improving the hemodynamics, exercise capacity, and biomarkers of patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, there is no consensus on the adjustment of home oxygen therapy (HOT) and pulmonary hypertension (PH)-specific medications after BPA in patients with CTEPH.
Purpose
We aimed to examine the current status of the de-escalation/discontinuation of HOT and PH-specific medications post-BPA, and clarify its effect on subsequent hemodynamics, biomarkers, and long-term clinical outcomes.
Methods and results
From November 2012 to July 2019, 134 consecutive CTEPH patients who underwent BPA at a single university hospital were enrolled (age; 63.6±13.4 years, female; n=87 [64.9%], WHO functional class [WHO-FC] II/III/IV; 33/92/9). Hemodynamic data, functional capacity (6-minute walk distance and WHO-FC), biomarkers (brain natriuretic peptide [BNP] and high-sensitivity troponin T [hs-TropT]), and respiratory function were evaluated at baseline, immediately and 1 year post-BPA. Clinical outcomes (all-cause death and heart failure [HF] admission) were also assessed during the follow up period. The total number of sessions was 6.3±2.0, and the number of target vessels was 14.3±2.0. Mean pulmonary arterial pressure decreased from 37.8±11.2 to 20.4±5.1 mmHg 1-year after BPA (p<0.01). The proportion of patients who required HOT (at rest or on exertion) and combination medical therapy (≥2 PH-specific medications) decreased 1 year post-BPA (from 59.0% to 7.5%, and from 41.8% to 10.4%, respectively; Figure). Among 79 patients who required HOT during daytime, 64 patients (81.0%) discontinued HOT just after BPA completion. Among 56 patients who required combination medical therapy, 29 (51.8%) discontinued combination therapy. Baseline factors influencing the continuation of HOT and combination medical therapy post-BPA were almost identical (i.e. lower exercise capacity and pulmonary diffusion capacity, and worse hemodynamics). Results showed that discontinuation of HOT and combination medical therapy did not affect the maintenance of improved hemodynamics and levels of BNP and hs-TropT, and no adverse clinical outcomes (all-cause death and HF hospitalization) were observed during 1 year post-BPA.
Conclusions
Most CTEPH patients discontinued HOT and PH-specific combination medical therapy after BPA, which was not associated with the deterioration of hemodynamics, functional capacity, or biomarkers. No adverse long-term outcomes were observed. De-escalation/discontinuation of HOT and PH-specific combination medical therapy after BPA is feasible and safe for patients with CTEPH.
De-escalation of HOT and medical therapy
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Kimura
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - T Kohno
- Kyorin University School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kawakami
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - T Shinya
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - T Hiraide
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - H Moriyama
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - M Kataoka
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - J Endo
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - Y Itabash
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - M Mitsushige
- Keio University Hospital, Cardiology, Tokyo, Japan
| | - K Fukuda
- Keio University Hospital, Cardiology, Tokyo, Japan
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14
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Hirose C, Iihara H, Funaguchi N, Endo J, Ito F, Yanase K, Kaito D, Sasaki Y, Gomyo T, Sakai C, Ohno Y, Suzuki A. Prophylactic effect of rikkunshito, an herbal medicine, for chemotherapy-induced nausea in thoracic cancer patients receiving carboplatin-based chemotherapy. Pharmazie 2019; 74:620-624. [PMID: 31685089 DOI: 10.1691/ph.2019.9497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Rikkunshito has been shown to improve upper gastrointestinal symptoms and anorexia. The aim of this study was to evaluate whether rikkunshito improves chemotherapy-induced nausea in thoracic cancer patients receiving carboplatin (CBDCA)-based chemotherapy. A retrospective before-and-after comparison study was conducted in patients with thoracic cancer receiving the first cycle of CBDCA-based chemotherapy. Among 61 eligible patients, 34 received standard antiemetic therapy with a combination of 5-hydroxytryptamine-3 receptor antagonist and dexamethasone from September 2012 and June 2013 (standard group), while the other 27 received the standard antiemetic therapy plus oral rikkunshito from July 2013 and December 2014 (rikkunshito group). The rates of no nausea showed no significant difference between the standard and rikkunshito group (Overall phase: 64.7 % for standard group vs 74.1 % for rikkunshito group, p = 0.579). Subgroup analysis indicated that, in female patients, the rates of no nausea in rikkunshito groups was significantly higher than in standard group (overall phase: 44.4 % vs 100 %, p = 0.034). Rikkunshito did not demonstrate an additional prophylactic effect on standard antiemetic therapy for nausea in patients with thoracic cancer receiving CBDCA-based chemotherapy, but showed a prophylactic effect of nausea in female patients.
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15
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Mori H, Sakai C, Iwai M, Sasaki Y, Gomyo T, Toyoshi S, Kaito D, Yanase K, Ito F, Endo J, Funaguchi N, Ohno Y, Minatoguchi S. Immune thrombocytopenia induced by nivolumab in a patient with non-small cell lung cancer. Respir Med Case Rep 2019; 28:100871. [PMID: 31198679 PMCID: PMC6557745 DOI: 10.1016/j.rmcr.2019.100871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 03/24/2019] [Revised: 05/30/2019] [Accepted: 06/02/2019] [Indexed: 11/16/2022] Open
Abstract
Antibodies targeting the receptor programmed death 1 on T cells have been approved for the treatment of lung cancer. Immune checkpoint inhibitors (ICIs) induce various immune-related adverse events. Life-threatening hematotoxicity can be provoked by ICI therapy. Although ICI-related endocrinopathy and interstitial lung disease have been well documented, hematotoxicity requiring intensive treatment is relatively rare. We describe a case of nivolumab induced thrombocytopenia after transient mild fever. A 77-year-old man with non-small cell lung cancer was administered nivolumab (240 mg/body, every 2 weeks) as second line therapy. On the day 2 after the first nivolumab infusion, he had a fever and his C-reactive protein level was elevated. Thoracic computed tomography revealed no interstitial lung disease or pneumonia. The fever resolved on day 9 and was not seen thereafter. On day 15 after the first nivolumab infusion, severe thrombocytopenia suddenly emerged. A bone marrow examination revealed no dysplasia or invasion. Based on the presence of high platelet-associated IgG titer, normal bone marrow plasticity and a lack of effectiveness of platelet infusion, we diagnosed nivolumab-induced immune thrombocytopenia. Daily administration of 60 mg of prednisolone restored the patient's platelet count and platelet-associated IgG. We also found that there was significant shrinkage of the primary lesion and that stable disease was achieved. One must be aware of this relatively rare side effect and the unusual clinical findings that could be associated with immunoreaction.
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Affiliation(s)
- Hidenori Mori
- Department of Respiratory Medicine, Hashima Community Medical Center, Gifu, Japan
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
- Corresponding author. Department of Respiratory Medicine, Hashima Community Medical Center, Shinsei-cho 3-246, Hashima-city, Gifu 501-6206, Japan
| | - Chizuru Sakai
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masamichi Iwai
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuka Sasaki
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takenobu Gomyo
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sayaka Toyoshi
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fumitaka Ito
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junki Endo
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Norihiko Funaguchi
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasushi Ohno
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinya Minatoguchi
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
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16
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Moriyama H, Murata M, Kawakami T, Kataoka M, Minakata Y, Endo J, Tsuruta H, Itabashi Y, Maekawa Y, Fukuda K. P4330Right ventricular diastolic strain rate reflects right ventricular diastolic function in patients with chronic thromboembolic pulmonary hypertension. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Sadamasu A, Yamaguchi S, Nakagawa R, Kimura S, Endo J, Akagi R, Sasho T. The recognition and incidence of peroneal tendon dislocation associated with a fracture of the talus. Bone Joint J 2017; 99-B:489-493. [PMID: 28385938 DOI: 10.1302/0301-620x.99b4.bjj-2016-0641.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/14/2016] [Indexed: 11/05/2022]
Abstract
AIMS The purposes of this study were to clarify first, the incidence of peroneal tendon dislocation in patients with a fracture of the talus and second the factors associated with peroneal tendon dislocation. PATIENTS AND METHODS We retrospectively examined 30 patients (30 ankles) with a mean age of 37.5 years, who had undergone internal fixation for a fracture of the talus. Independent examiners assessed for peroneal tendon dislocation using the pre-operative CT images. The medical records were also reviewed for the presence of peroneal tendon dislocation. The associations between the presence of dislocation with the patient characteristics or radiological findings, including age, mechanism of injury, severity of fracture, and fleck sign, were assessed using Fisher's exact tests. RESULTS The pre-operative CT images showed peroneal tendon dislocation in eight out of 30 patients. Dislocation was found later in one patient whose pre-operative CT image had not shown dislocation. The overall incidence of peroneal tendon dislocation was 30% (9/30). The presence of dislocation was associated with the presence of a fleck sign (p = 0.03). CONCLUSIONS Surprisingly, approximately one-third of the patients who underwent internal fixation for a fracture of the talus had peroneal tendon dislocation. This was associated with a fleck sign. Cite this article: Bone Joint J 2017;99-B:489-93.
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Affiliation(s)
- A Sadamasu
- Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - S Yamaguchi
- Chiba University, College of Liberal Arts and Sciences, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - R Nakagawa
- Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - S Kimura
- Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - J Endo
- Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - R Akagi
- Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - T Sasho
- Chiba University, Center for Preventive Medical Sciences, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
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Kaito D, Iihara H, Funaguchi N, Endo J, Ito F, Yanase K, Toyoshi S, Sasaki Y, Hirose C, Arai N, Kitahora M, Ohno Y, Itoh Y, Minatoguchi S. Efficacy of Single-dose First-generation 5-HT 3 Receptor Antagonist and Dexamethasone for Preventing Nausea and Vomiting Induced by Low-dose Carboplatin-based Chemotherapy. Anticancer Res 2017; 37:1965-1970. [PMID: 28373467 DOI: 10.21873/anticanres.11537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Carboplatin (CBDCA) is known to exhibit a high emetic risk among moderate-emetic risk anticancer drugs, and the dose of CBDCA varies in different therapies. In concurrent chemoradiotherapy (CCRT) for non-small cell lung cancer (NSCLC), the weekly administration of CBDCA (area under the curve (AUC) 2 mg/ml/min) and paclitaxel (PTX: 40 mg/m2) is frequently applied as standard therapy. However, the optimal antiemetic measures in the use of such low-dose CBDCA remain unclear. In this study, we retrospectively assessed the antiemetic effect of a single-dose of a first-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and dexamethasone in the weekly CBDCA+PTX therapy in CCRT. PATIENTS AND METHODS The subjects were patients with NSCLC who were administered weekly CBDCA+PTX therapy in CCRT between January 2011 and December 2016 at our Department. As an antiemetic measure, a first-generation 5-HT3RA, azasetron (10 mg, orally) or granisetron (3 mg, intravenously), and dexamethasone (9.9 mg, intravenously) were administered on day 1. The patients were evaluated for the following efficacy end-points for the first cycle: Complete response (CR; defined as no vomiting or retching episodes with no rescue medication) in the acute phase (0-24 hours), delayed phase (>24-120 hours), and overall phase (0-120 hours). Other efficacy endpoints evaluated were no vomiting or retching, and no nausea in all phases. RESULTS The subjects we assessed in this study were 46 patients who were administered weekly CBDCA+PTX therapy in CCRT. For the overall, acute, and delayed phases, the complete response rates were 89.1%, 100%, and 89.1%, respectively. The rate of no nausea in the overall, acute, and delayed phases was 78.3%, 100%, and 78.3%, respectively. The rate of no vomiting in the overall, acute, and delayed phases was 95.7%, 100%, and 95.7%, respectively. CONCLUSION A single dose of a first-generation 5-HT3RA and dexamethasone had a favorable suppressive effect on nausea and vomiting in weekly CBDCA+PTX therapy for NSCLC.
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Affiliation(s)
- Daizo Kaito
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | | | - Norihiko Funaguchi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.,Department of Respiratory Medicine, Murakami Memorial Hospital, Asahi University, Gifu, Japan
| | - Junki Endo
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fumitaka Ito
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sayaka Toyoshi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuka Sasaki
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Natsumi Arai
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoshinori Itoh
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Shinya Minatoguchi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
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19
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Ito F, Ohno Y, Toyoshi S, Kaito D, Koumei Y, Endo J, Kamamiya F, Mori H, Mori M, Morishita M, Funaguchi N, Minatoguchi S. Pharmacokinetics of consecutive oral moxifloxacin (400 mg/day) in patients with respiratory tract infection. Ther Adv Respir Dis 2015; 10:34-42. [PMID: 26660898 DOI: 10.1177/1753465815620338] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A population pharmacokinetic analysis was performed to investigate the pharmacokinetics of moxifloxacin (400 mg) following a once-daily oral administration in 28 patients with respiratory tract infection disease. The maximum plasma concentration and the area under the plasma concentration-time curve were 3.97 µg/ml and 51.74 µg·h/ml, respectively; these values were nearly equivalent to those of healthy adult men. Two adverse drug reactions (nausea, vomiting) occurred, but both reactions were mild and nonserious and the patients recovered without treatment. The pharmacokinetic profile of moxifloxacin in Japanese patients with respiratory tract infection and an underlying disease should thus be considered safe and comparable with that in healthy adult men, and adjustment of dose may do not need for age, sex, body weight, or renal function.
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Affiliation(s)
- Fumitaka Ito
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasushi Ohno
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Sayaka Toyoshi
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yanase Koumei
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junki Endo
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fumihiko Kamamiya
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hidenori Mori
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masahiro Mori
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Megumi Morishita
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Norihiko Funaguchi
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinya Minatoguchi
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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20
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Ito F, Kawasaki M, Ohno Y, Toyoshi S, Morishita M, Kaito D, Yanase K, Funaguchi N, Asano M, Endo J, Mori H, Kobayashi K, Nishigaki K, Miyazaki T, Takemura G, Minatoguchi S. Noninvasive Tissue Characterization of Lung Tumors Using Integrated Backscatter Intravascular Ultrasound: An Ex Vivo Comparative Study With Pathological Diagnosis. Chest 2015; 149:1276-84. [PMID: 26513315 DOI: 10.1378/chest.14-3042] [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: 12/05/2014] [Revised: 08/07/2015] [Accepted: 09/22/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Endobronchial ultrasonography (EBUS) facilitates a lung cancer diagnosis. However, qualitative tissue characterization of lung tumors is difficult using EBUS. Integrated backscatter (IBS) is an ultrasound technique that calculates the power of the ultrasound signal to characterize tissue components in coronary arteries. We hypothesized that qualitative diagnosis of lung tumors is possible using the IBS technique. The aim of the present study was to elucidate whether the IBS technique can be used in lung tissue diagnoses. METHODS Thirty-five consecutive patients who underwent surgery for lung cancer were prospectively enrolled. Surgical specimens of the lung and the tumor tissue were obtained, and the IBS values were measured within 48 h after surgery. Histologic images of lung and tumor tissues were compared with IBS values, and the relative interstitial area according to results of Masson's trichrome staining were determined by using an imaging processor. RESULTS The IBS values in tumor tissue were significantly lower than those in normal lung tissue (-50.9 ± 2.6 dB and -47.6 ± 2.6 dB, respectively; P < .001). The IBS values of adenocarcinomas associated with a good 5-year survival rate were higher than those of non-adenocarcinomas (-48.1 ± 1.6 dB and -52.6 ± 1.4 dB; P < .001). There were significant correlations between the IBS values and the relative interstitial area or micro air area in tumor (r = 0.53 and r = 0.67; P < .01). After combining normal lung tissue and adenocarcinomas with a good prognosis, the sensitivity and specificity for establishing the presence of lung tumors were 84% and 85%. CONCLUSIONS Qualitative diagnosis of lung tumors was possible, with a sensitivity of 84% and a specificity of 85%, using the ultrasound IBS technique.
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Affiliation(s)
- Fumitaka Ito
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masanori Kawasaki
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Yasushi Ohno
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sayaka Toyoshi
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Megumi Morishita
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Norihiko Funaguchi
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masahiro Asano
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junki Endo
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hidenori Mori
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Kobayashi
- Pathology Division, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiko Nishigaki
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tatsuhiko Miyazaki
- Pathology Division, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Genzou Takemura
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinya Minatoguchi
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
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21
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Matsumoto-Miyazaki J, Miyazaki N, Nishiwaki A, Endo J, Ushikoshi H, Ohno Y, Minatoguchi S. Acupuncture Treatment for Dyspnea due to Combined Pulmonary Fibrosis and Emphysema: A Case Report. J Altern Complement Med 2015; 21:804-9. [PMID: 26495997 DOI: 10.1089/acm.2015.0132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Combined idiopathic pulmonary fibrosis with pulmonary emphysema (CPFE) is a syndrome with a characteristic presentation of upper lobe emphysema and lower lobe fibrosis. Dyspnea on exertion (DOE) is a major symptom of CPFE. We report a patient with DOE due to CPFE who was successfully treated with acupuncture. DESIGN Case report. CASE PRESENTATION A 72-year-old Japanese man with a 4-year history of DOE was diagnosed with CPFE 2 years previously in another hospital. He received standard Western medicine treatment, which included bronchodilators. However, his DOE did not improve. Consequently, he visited our hospital for acupuncture treatment and received acupuncture treatment once a week for 1 year. RESULTS After 10 weeks of acupuncture treatment, the results of the 6-minute walk test (6-minute walking distance, 379 m; lowest oxygen saturation, 86%; modified Borg dyspnea scale score: 2 units) were better than those at baseline (352 m, 84%, 4 units, respectively). These values were sustained at both 30 weeks (470 m, 88%, 1 unit) and 60 weeks (473 m, 85%, 2 units). Serum interstitial biomarkers, Krebs von den Lungen and surfactant protein-D, decreased after commencement of acupuncture therapy. CONCLUSION A patient with CPFE showed improvements in dyspnea scores, exercise tolerance, and serum biomarkers during a 1-year course of acupuncture treatment. Use of acupuncture might be an effective adjunct therapy in relieving DOE due to CPFE. A large, well-designed cohort study that includes patients with CPFE treated with acupuncture should be conducted.
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Affiliation(s)
- Jun Matsumoto-Miyazaki
- 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Nagisa Miyazaki
- 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Ayuko Nishiwaki
- 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Junki Endo
- 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Hiroaki Ushikoshi
- 2 Advanced Critical Care Center, Gifu University Hospital , Gifu, Japan
| | - Yasushi Ohno
- 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Shinya Minatoguchi
- 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan
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22
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Yanase K, Funaguchi N, Iihara H, Yamada M, Kaito D, Endo J, Ito F, Ohno Y, Tanaka H, Itoh Y, Minatoguchi S. Prevention of radiation esophagitis by polaprezinc (zinc L-carnosine) in patients with non-small cell lung cancer who received chemoradiotherapy. Int J Clin Exp Med 2015; 8:16215-16222. [PMID: 26629136 PMCID: PMC4659025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 10/09/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Concurrent chemoradiotherapy (CCRT) plays an important role in multimodality therapy for non-small cell lung cancer. However, esophagitis often develops as a complication of CCRT, causing treatment delays and reducing the patient's quality of life. We examined the efficacy of polaprezinc (PZ), zinc L-carnosine used for the therapy of gastric ulcer, against the onset of esophagitis caused by CCRT for lung cancer. PATIENTS AND METHODS Patients who concurrently underwent chemotherapy with carboplatin and paclitaxel and thoracic radiotherapy at Gifu University Hospital during a period of January 2011 and May 2015 were the subjects of the present study. Patients received a mixture of sodium alginate solution and aluminum-magnesium hydroxide gel with (PZ group) or without (control group) PZ for prevention of radiation esophagitis. RESULTS PZ significantly inhibited the development of grade ≥2 radiation esophagitis (HR 0.397, 95% confidence interval, 0.160-0.990; P=0.047). In addition, PZ lowered the incidence of grade ≥2 esophagitis at the time point of 40 Gy irradiation (26.3% versus 63.2%, P=0.05). However, there were no significant differences in the incident rates of other adverse events associated with chemoradiotherapy between the PZ group and control group. Moreover, PZ had no significant influence on the tumor response rate. CONCLUSION PZ significantly retarded the development as well as the incidence of grade ≥2 esophagitis without affecting the tumor response.
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Affiliation(s)
- Komei Yanase
- Department of Cardiology and Respirology and Nephrology, Gifu University Graduate School of MedicineJapan
| | - Norihiko Funaguchi
- Department of Cardiology and Respirology and Nephrology, Gifu University Graduate School of MedicineJapan
- Department of Respiratory Medicine, Murakami Memorial Hospital, Asahi UniversityJapan
| | | | - Maya Yamada
- Department of Pharmacy, Gifu University HospitalJapan
| | - Daizo Kaito
- Department of Cardiology and Respirology and Nephrology, Gifu University Graduate School of MedicineJapan
| | - Junki Endo
- Department of Cardiology and Respirology and Nephrology, Gifu University Graduate School of MedicineJapan
| | - Fumitaka Ito
- Department of Cardiology and Respirology and Nephrology, Gifu University Graduate School of MedicineJapan
| | - Yasushi Ohno
- Department of Cardiology and Respirology and Nephrology, Gifu University Graduate School of MedicineJapan
| | | | | | - Shinya Minatoguchi
- Department of Cardiology and Respirology and Nephrology, Gifu University Graduate School of MedicineJapan
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Katsuragi J, Sasho T, Yamaguchi S, Sato Y, Watanabe A, Akagi R, Muramatsu Y, Mukoyama S, Akatsu Y, Fukawa T, Endo J, Hoshi H, Yamamoto Y, Sasaki T, Takahashi K. Hidden osteophyte formation on plain X-ray is the predictive factor for development of knee osteoarthritis after 48 months--data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2015; 23:383-90. [PMID: 25542776 DOI: 10.1016/j.joca.2014.11.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 11/17/2014] [Accepted: 11/25/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine whether the detection of osteophytes anywhere in the knee could serve as a pre-radiographic biomarker for osteoarthritis (OA) development. METHODS Baseline magnetic resonance imaging (MRIs) of 132 participants in the Osteoarthritis Initiative (OAI) were studied. Based on radiographs, 66 knees were assessed as osteoarthritis-free (no-osteoarthritis [NOA], or Kellgren/Lawrence [K/L] severity grade 0/1 both at baseline and 48 months), and another 66 knees were assessed as having radiographic OA changes (pre-radiographic osteoarthritis [PROA], or with K/L grade 0/1 at baseline and grade ≥ 2 at 48 months). Using baseline MRI data, we examined eight sites of osteophyte formation: the medial and lateral femoral condyle (MFC and LFC, respectively); medial and lateral tibial plateau (MTP and LTP, respectively); medial and lateral facets of the patellofemoral joint (PM and PL, respectively); tibial spine (TS); and femoral intercondylar notch (IC). Knee joint osteophyte size was assessed via the 8-point marginal osteophytes item of the whole-organ magnetic resonance imaging score (WORMS). The frequencies and distributions of osteophytes were compared between groups. RESULTS Mild-size osteophytes (defined as score ≥ 2) were observed more frequently at the MFC (P = 0.00278), MTP (P = 0.0046), TS (P = 0.0146), PM (P < 0.0001), PL (P = 0.0012), and IC (P < 0.0001) in PROA knees than in NOA knees. Moderate-size osteophytes (defined as score ≥ 4) were more frequently observed in PROA knees than in NOA knees only at the IC (P < 0.0001). CONCLUSION Knees with osteophyte formation at the IC, even those of K/L severity grade 0/1, are at risk for the development of radiographic OA by 48 months.
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Affiliation(s)
- J Katsuragi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - T Sasho
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - S Yamaguchi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - Y Sato
- Chiba University Hospital Clinical Research Center, Japan.
| | - A Watanabe
- Department of General Medical Services, Division of Radiology, Graduate School of Medicine, Chiba University, Japan.
| | - R Akagi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - Y Muramatsu
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - S Mukoyama
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - Y Akatsu
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - T Fukawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - J Endo
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - H Hoshi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - Y Yamamoto
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - T Sasaki
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
| | - K Takahashi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Japan.
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24
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Horiuchi N, Endo J, Wada N, Nozaki K, Nakamura M, Nagai A, Katayama K, Yamashita K. Dielectric properties of fluorine substituted hydroxyapatite: the effect of the substitution on configuration of hydroxide ion chains. J Mater Chem B 2015; 3:6790-6797. [DOI: 10.1039/c5tb00944h] [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] [Indexed: 11/21/2022]
Abstract
Dielectric properties of fluoridated hydroxyapatite (F-HAp; Ca5(PO4)3(OH)1−xFx) were measured. The results show that the F-substitution induces the specific configuration that contains hydrogen bonds in F-HAp.
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Affiliation(s)
- N. Horiuchi
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - J. Endo
- Department of Applied Chemistry
- Tokai University
- Hiratsuka
- Japan
| | - N. Wada
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - K. Nozaki
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - M. Nakamura
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - A. Nagai
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - K. Katayama
- Department of Applied Chemistry
- Tokai University
- Hiratsuka
- Japan
| | - K. Yamashita
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
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25
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Muramatsu Y, Sasho T, Saito M, Yamaguchi S, Akagi R, Mukoyama S, Akatsu Y, Katsuragi J, Fukawa T, Endo J, Hoshi H, Yamamoto Y, Takahashi K. Preventive effects of hyaluronan from deterioration of gait parameters in surgically induced mice osteoarthritic knee model. Osteoarthritis Cartilage 2014; 22:831-5. [PMID: 24704496 DOI: 10.1016/j.joca.2014.03.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 03/17/2014] [Accepted: 03/22/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) leads to pain and loss of function in affected joints. Gait disturbance results from these symptoms of OA, and gait analysis can be important to evaluate the progression of OA. The purpose of this study was to analyze gait pattern in a rodent model of OA and to assess the effects of intra-articular injection of hyaluronan (IAI-HA) by gait analysis, along with histological evaluation. DESIGN OA was induced by destabilization of the medial meniscus (DMM) of C57BL/6 mice. IAI-HA started 3 weeks after DMM surgery. Mice were allocated to three groups and were given either 800-kDa HA (800-HA), 6000-kDa HA (6000-HA) or saline. We compared these three groups with a sham group by gait analysis using CatWalk. Histological evaluation was performed to assess articular cartilage changes in the knee joints. RESULTS Mice injected with 800-HA or 6000-HA showed gait patterns similar to that of the sham mice, while the saline-injected group showed gait disturbances 12 and 16 weeks after DMM surgery. Histological changes in articular cartilage were similar among the 800-HA, 6000-HA and saline-treated groups, demonstrating OA progression throughout the experimental time points. Positive gait-related effects of IAI-HA might occur by its pain relieving effect and/or by preventing contracture. CONCLUSION IAI-HA prevented gait disturbances in the DMM model, but did not prevent histological changes associated with OA progression.
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MESH Headings
- Analysis of Variance
- Animals
- Biopsy, Needle
- Cartilage, Articular/drug effects
- Cartilage, Articular/pathology
- Disease Models, Animal
- Disease Progression
- Follow-Up Studies
- Gait/drug effects
- Hyaluronic Acid/administration & dosage
- Immunohistochemistry
- Injections, Intra-Articular
- Knee Joint/surgery
- Male
- Mice
- Mice, Inbred C57BL
- Osteoarthritis, Knee/drug therapy
- Osteoarthritis, Knee/etiology
- Osteoarthritis, Knee/pathology
- Random Allocation
- Reference Values
- Risk Assessment
- Statistics, Nonparametric
- Treatment Outcome
- Viscosupplements/administration & dosage
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Affiliation(s)
- Y Muramatsu
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - T Sasho
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - M Saito
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Orthopaedic Surgery, Sakura Medical Center, Toho University, Sakura, Japan.
| | - S Yamaguchi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - R Akagi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - S Mukoyama
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Y Akatsu
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - J Katsuragi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - T Fukawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - J Endo
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - H Hoshi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Y Yamamoto
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - K Takahashi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
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26
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Mori H, Yamada O, Ohno Y, Kaito D, Yanase K, Ito F, Endo J, Morishita M, Funaguchi N, Minatoguchi S. Paraneoplastic neurological syndrome in a patient with squamous cell lung cancer. Intern Med 2013; 52:1967-70. [PMID: 23994993 DOI: 10.2169/internalmedicine.52.0442] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 78-year-old man presented with urinary retention and difficulty walking. Both legs showed muscle weakness, and he was experiencing lower body hypoesthesia. T2-weighted magnetic resonance imaging revealed lesions with high signal intensity and enhancement in the spinal cord and cerebrum. A cerebrospinal fluid specimen showed inflammatory changes, but negative cytology findings. Chest computed tomography revealed a tumor measuring 40 mm in diameter, and a lung biopsy revealed the presence of squamous cell carcinoma. We diagnosed the patient with paraneoplastic neurological syndrome related to lung cancer. The patient was treated with steroid pulse therapy and chemotherapy, which relieved the symptoms and enabled the patient to achieve an independent gait.
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Affiliation(s)
- Hidenori Mori
- Department of Respiratory Medicine, Hashima Community Medical Center, Japan.
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27
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Endo J, Iihara H, Yamada M, Yanase K, Kamiya F, Ito F, Funaguchi N, Ohno Y, Minatoguchi S, Itoh Y. A randomized controlled non-inferiority study comparing the antiemetic effect between intravenous granisetron and oral azasetron based on estimated 5-HT3 receptor occupancy. Anticancer Res 2012; 32:3939-3947. [PMID: 22993341] [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: 06/01/2023]
Abstract
BACKGROUND The acute antiemetic effect was compared between oral azasetron and intravenous granisetron based on the 5-hydroxytryptamine(3) (5-HT(3)) receptor occupancy theory. PATIENTS AND METHODS Receptor occupancy was estimated from reported data on plasma concentrations and affinity constants to 5-HT(3) receptor. A randomized non-inferiority study comparing acute antiemetic effects between oral azasetron and intravenous granisetron was performed in 105 patients receiving the first course of carboplatin-based chemotherapy for lung cancer. RESULTS Azasetron exhibited the highest 5-HT(3) receptor occupancy among various first-generation 5-HT(3) antagonists. The complete response to oral azasetron was shown to be non-inferior to that of intravenous granisetron, in which the risk difference was 0.0004 (95% confidence interval: -0.0519-0.0527). The lower limit of the confidence intervals did not exceed the negative non-inferiority margin (-0.1). The complete response during the overall period was not different (68% versus 67%). CONCLUSION Oral azasetron was found to be non-inferior to intravenous granisetron in the acute antiemetic effect against moderately emetogenic chemotherapy.
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Affiliation(s)
- Junki Endo
- Second Department of Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
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28
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Baila B, Ohno Y, Nagamoto H, Kotosai K, Yabuuchi Y, Funaguchi N, Ito F, Endo J, Mori H, Takemura G, Fujiwara T, Fujiwara H, Minatoguchi S. Tetomilast attenuates elastase-induced pulmonary emphysema through inhibition of oxidative stress in rabbits. Biol Pharm Bull 2012; 35:494-502. [PMID: 22466552 DOI: 10.1248/bpb.35.494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Tetomilast was originally identified as a potent inhibitor of superoxide production in human neutrophils, and is of interest because it may relieve oxidative stress related to chronic obstructive pulmonary disease (COPD). Our objective was to determine whether tetomilast effectively protects against the development of porcine pancreatic elastase (PPE)-induced emphysema in rabbits. Rabbits were divided into three groups (sham n=19, PPE n=19, PPE/Tetomilast n=18). The rabbits were once daily orally administered vehicle solution or tetomilast 5 d/week for 4 weeks before the PPE instillation. We compared pulmonary function, inflammatory cell infiltration, oxidative stress, and the incidences of apoptosis among the three groups. Tetomilast suppressed PPE-induced increases in the incidence of apoptosis and the production of 8-hydroxy-deoxyguanosine (8-OHdG) in lung tissues. PPE-instilled rabbits treated with tetomilast showed significantly less mean linear intercept and significantly better pulmonary function than rabbits administered PPE alone. Tetomilast may inhibit the development of emphysema by attenuating pulmonary inflammation and apoptosis caused by PPE-induced oxidative stress.
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Affiliation(s)
- Bulin Baila
- Second Department of Internal Medicine, Graduate School of Medicine, Gifu University, Japan
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29
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Mori H, Ohno Y, Yanase K, Ito F, Kamiya F, Endo J, Funaguchi N, Minatoguchi S. [Case report; Polymerase chain reaction positivity of Pneumocystis jirovecii during primary lung cancer treatment]. Nihon Naika Gakkai Zasshi 2012; 101:1075-1078. [PMID: 22730737 DOI: 10.2169/naika.101.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Hidenori Mori
- Department of Respiratory Medicine, Hashima Community Medical Center, Japan
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30
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Okada H, Sato Y, Sata T, Sakurai M, Endo J, Yokoyama T, Mohri S. Antigen retrieval using sodium hydroxide for prion immunohistochemistry in bovine spongiform encephalopathy and scrapie. J Comp Pathol 2010; 144:251-6. [PMID: 21112058 DOI: 10.1016/j.jcpa.2010.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 07/20/2010] [Accepted: 10/18/2010] [Indexed: 11/25/2022]
Abstract
Formalin-fixed and paraffin wax-embedded (FFPE) tissue sections are usually used for histopathological and immunohistochemical analyses in prion diseases in animals and man. However, formalin fixation cross-links proteins, reducing disease-associated prion protein (PrP(Sc)) immunolabelling. To detect PrP(Sc) in animals naturally affected with bovine spongiform encephalopathy (BSE) and scrapie, we applied minimal pretreatment with sodium hydroxide (NaOH). This simple pretreatment, combined with enzymatic digestion using proteinase K (PK), was equally effective in the detection of PrP(Sc) in FFPE tissue, and superior in terms of speed, compared with the usual autoclaving method. The most effective results, without any section loss, were obtained with 10 μg/ml PK in phosphate buffered saline containing 0.1% Triton-X at room temperature for 10 min and 150 mM NaOH at 60 °C for 10 min. By this simple procedure, PrP(Sc) was visualized in the brain of animals with BSE and scrapie using a range of anti-PrP primary antibodies.
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Affiliation(s)
- H Okada
- Prion Disease Research Team, Prion Disease Research Center, National Institute of Animal Health, 3-1-5 Kan-nondai, Tsukuba, Ibaraki 305-0856, Japan.
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31
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Mori H, Ohno Y, Ito F, Endo J, Yanase K, Funaguchi N, Bai La BL, Minatoguchi S. Polymerase chain reaction positivity of Pneumocystis jirovecii during primary lung cancer treatment. Jpn J Clin Oncol 2010; 40:658-62. [PMID: 20395244 DOI: 10.1093/jjco/hyq040] [Citation(s) in RCA: 7] [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: 12/16/2022] Open
Abstract
OBJECTIVE When treating lung cancer, pneumocystic pneumonia is a life-threatening complication seen during chemotherapy. Polymerase chain reaction is used to detect its cause, Pneumocystis jirovecii, but polymerase chain reaction positives without pneumocystic pneumonia are sometimes seen. The purpose of this study was to assess the frequency of pneumocystic pneumonia during cancer treatment. METHODS Fifty induced sputum specimens and 4 bronchoalveolar lavage specimens collected from 50 patients with acute respiratory symptoms during anticancer therapy were retrospectively studied after classifying the patients into lung cancer (n = 29) and solid tumor (n = 21) groups. All of the patients in both groups had an interstitial shadow suspected of being pneumocystic pneumonia, and all had polymerase chain reaction tests. RESULTS Eleven of the 54 specimens were polymerase chain reaction positive, and 1 patient was clinically diagnosed with pneumocystic pneumonia. The incidence of polymerase chain reaction positivity in the lung cancer group was significantly higher than in the solid tumor group (31 vs. 5%; P = 0.03), and the incidence of subclinical pneumocystic pneumonia (29 vs. 5%; P = 0.059) also tended to be higher in that group. There were no significant biochemical differences between the two groups, irrespective of the polymerase chain reaction results. Among polymerase chain reaction-positive patients in the lung cancer group, the cumulative dose of corticosteroid administration tended to be higher than among the polymerase chain reaction-negative patients (P = 0.09). Following the polymerase chain reaction tests, nearly all polymerase chain reaction-positive patients without pneumocystic pneumonia received antipneumocystic agents, and none developed pneumocystic pneumonia. CONCLUSIONS Our findings suggest polymerase chain reaction positivity for P. jirovecii will be detected in a fraction of lung cancer patients. Although it is difficult to predict the need for administration of pneumocystic pneumonia treatment to subclinical pneumocystic pneumonia based on polymerase chain reaction and biochemical results, polymerase chain reaction-positive patients should be followed-up with antipneumocystic agents to ensure they are not at an early stage of pneumocystic pneumonia.
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Affiliation(s)
- Hidenori Mori
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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32
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Mori H, Ohno Y, Tsuge Y, Kawasaki M, Ito F, Endo J, Funaguchi N, La BLB, Kanematsu M, Minatoguchi S. Use of Multidetector Row CT to Evaluate the Need for Bronchial Arterial Embolization in Hemoptysis Patients. Respiration 2010; 80:24-31. [DOI: 10.1159/000253882] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Accepted: 08/24/2009] [Indexed: 11/19/2022] Open
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33
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Mori H, Ohno Y, Ito F, Funaguchi N, Yanase K, Endo J, Nakano M, Bai La BL, Minatoguchi S. Massive hematuria from the bilateral upper urinary tract in a patient treated for advanced lung cancer with gefitinib. Jpn J Clin Oncol 2009; 40:263-6. [PMID: 19897850 DOI: 10.1093/jjco/hyp141] [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] [Indexed: 11/12/2022] Open
Abstract
We report a case of gefitinib-induced bilateral upper urinary tract bleeding in an 82-year-old woman administered the drug daily for advanced non-small cell adenocarcinoma of the lung (T4N3M0). Hematuria is an uncommon adverse effect of gefitinib, and in most cases, the bleeding site is unknown. On the 44th day of oral gefitinib administration, the patient noted asymptomatic macroscopic bloody urine. Cystoscopy revealed bleeding from the bilateral ureteric orifices without hemorrhagic inflammation of the bladder. One week later, she was admitted complaining of severe abdominal pain, and her condition was found to be complicated by liver damage and renal dysfunction. We stopped gefitinib administration and started hydration and diuresis. Renal function and urine output soon recovered, and at the request of the patient, we restarted gefitinib, administering it every other day, which was sufficient to maintain antitumor activity and stabilize the disease. On the 41st day after restarting gefitinib, hematuria and proteinuria reappeared. We therefore stopped the gefitinib, and the patient was followed with supportive care. The patient's autopsy findings denied organic urologic diseases. Instead, the reproducibility of the hematuria from the upper urinary system strongly suggests an unexpected gefitinib-related adverse effect.
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Affiliation(s)
- Hidenori Mori
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Yanagido 1-1, 501-1194 Gifu, Japan
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34
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Mori H, Ohno Y, Yoshikawa T, Ito F, Endo J, Funaguchi N, Minatoguchi S. [Sarcoidosis-lymphoma syndrome with vertebral bone destruction]. Nihon Kokyuki Gakkai Zasshi 2009; 47:1057-1062. [PMID: 19994605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report a rare case of sarcoidosis-lymphoma syndrome with vertebral bone destruction. A 63-year-old woman was previously diagnosed as sarcoidosis by supraclavicular lymph node biopsy, and came to our hospital complaining of back pain. Both serum angiotensin-converting enzyme and lysozyme level had been continuously elevated. Magnetic resonance imaging revealed lumbar vertebral bone destruction. Histopathologic examination of lumbar vertebral tumor obtained by CT-guided biopsy revealed non-caseating epithelioid granuloma with CD 68 (+), AE1/AE3 (-), and no malignant cells. She was admitted to our hospital again for dyspnea and pancytopenia. We diagnosed active sarcoidosis and administered oral 30mg prednisolone daily. One month later, prednisolone became ineffective. Flow cytometry of tumor cells obtained from the gastric ulcer floor showed CD 5 (+), CD 20 (+), K chain monoclonality and we diagnosed B-cell non Hodgkin's lymphoma. She was treated by eight cycles of CHOP plus rituximab chemotherapy and achieved complete response. FDG uptake of the entire body decreased, whereas MRI revealed residual mass in the vertebrae. Sarcoidosis had been diagnosed for two and half years before lymphoma developed. Bone destruction is very rare and sarcoidosis is rarely the cause. This is quite an unusual case presenting histologically proved epithelioid granuloma and vertebral destruction in sarcoidosis-lymphoma syndrome.
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Affiliation(s)
- Hidenori Mori
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine
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35
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Mori H, Tanaka H, Ohno Y, Ito F, Funaguchi N, Endo J, La BLB, Minatoguchi S. Effect of intermittent systemic corticosteroid on bone metabolism in bronchial asthma patients. J Asthma 2009; 46:142-6. [PMID: 19253119 DOI: 10.1080/02770900802492095] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to assess the effect on bone mineral density (BMD) of systemic corticosteroid (SCS) intermittently administered for rescue from asthmatic exacerbation. Through digital image processing and calculation of four other indices, BMD was compared in groups of asthmatic patients receiving inhaled corticosteroid (ICS) alone or ICS plus intermittent SCS. We defined SCS as intermittent administration of the equivalent of 1 mg/day prednisolone in the management of asthma exacerbations during the previous 1 year. Serum NTX, a bone resorption marker, was significantly higher (p = 0.02) in the SCS group than the ICS group. SCS had no effect on BMD, although the frequency of patients at "high-risk" for osteoporosis according to the Female Osteoporosis Self-assessment Tool for Asia (FOSTA) tended to be higher in the SCS group (35%) than in the ICS (28%) or control (10%) group. Because patients in the ICS group already had impaired respiratory function due to repeated asthma exacerbations, it was difficult to determine whether it was asthma itself or SCS that is the risk factor for osteoporosis. In addition, the response of biochemical markers of bone turnover to intermittent SCS remains unclear and likely differs from that elicited by high-dose, short-term, or continuous SCS. That said, relatively low-dose intermittent administration of SCS raised levels of bone resorption markers, which likely reflects altered bone metabolism. Taken together, these findings suggest that, without consideration of its effects on bone, SCS administration should be avoided.
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Affiliation(s)
- Hidenori Mori
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Yanagido, Gifu, Japan
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36
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Funaguchi N, Ohno Y, Endo J, Itoh F, Mori H, Yuhgetsu H, Sawada M, Fujiwara H. [Paraneoplastic neurological syndrome accompanied by severe central hypoventilation and expression of anti-Hu antibody in a patient with small cell lung cancer]. Nihon Kokyuki Gakkai Zasshi 2008; 46:314-318. [PMID: 18516996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A 65-year-old man was admitted to our hospital complaining of diplopia, dysarthria, difficulty in walking and progressive dysesthesia that developed in his left hand and leg. Brain MRI revealed high signal intensity regions on T2-weighted and FLAIR images of the hippocampus and the corpus amygdaloideum. After admission, the patient's neurological symptoms progressed to delirium and dementia with hallucinations. When he eventually developed severe respiratory failure requiring ventilatory support, brain MRI revealed new high signal intensity regions on T2-weighted images of the medulla oblongata and pons. Chest CT scans showed a mass under the aortic arch, and based on subsequent histopathological examination of a transesophageal endoscopic ultrasonography-guided fine needle aspiration biopsy of the tumor, a diagnosis of small cell lung cancer was made. In addition, anti-Hu antibody was found in the patient's serum, leading to a diagnosis of paraneoplastic encephalomyelitis/sensory neuropathy. One course of chemotherapy (carboplatin + etoposide) was administered; however, the protocol was not completed because the patient developed severe pneumonia. Given that neurological symptoms usually precede a diagnosis of malignancy in paraneoplastic neurological syndromes, it is important that these are considered carefully, as they may contribute to early diagnosis and treatment. Here we report a rare case of severe central hypoventilation in paraneoplastic encephalomyelitis/sensory neuropathy.
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Affiliation(s)
- Norihiko Funaguchi
- Department of Cardiology, Respirology, Second Department of Internal Medicine, Regeneration and Advanced Medical Science Graduate School of Medicine, Gifu University
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37
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Uemura N, Nomura M, Inoue S, Endo J, Kishi S, Saito K, Ito S, Nakaya Y. Changes in hemodynamics and autonomic nervous activity in patients undergoing laparoscopic cholecystectomy: differences between the pneumoperitoneum and abdominal wall-lifting method. Endoscopy 2002; 34:643-50. [PMID: 12173086 DOI: 10.1055/s-2002-33252] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Intraoperative changes in circulatory hemodynamics and autonomic nervous activity were evaluated in 33 patients with cholelithiasis who underwent laparoscopic cholecystectomy. PATIENTS AND METHODS Of these patients, 18 were treated using a pneumoperitoneum (group G) and 15 using the abdominal wall-lifting method (group WL). Their ECG, blood pressure, arterial oxygen saturation, and expiratory carbon dioxide partial pressure were monitored. Autonomic nervous function was evaluated by spectral analysis of the heart rate. RESULTS Mean blood pressure increased significantly in group G during surgery, but did not vary in group WL during any stage of surgery. The high-frequency (HF) power, an index of parasympathetic activity, decreased significantly in group G after pneumoperitoneum. However, the HF power did not decrease significantly in group WL. The LF/HF ratio, an index of sympathetic activity, increased significantly in group G after pneumoperitoneum, but did not vary in group WL. In addition, the incidence of ventricular or supraventricular arrhythmias and the severity of the arrhythmias as determined by Lown's classification were higher in group G than in group WL. These findings suggest that intraoperative changes in autonomic nervous activity, due to increased intra-abdominal pressure, were smaller in patients undergoing laparoscopic cholecystectomy using the abdominal wall-lifting method than in those undergoing laparoscopic cholecystectomy using pneumoperitoneum. The results also demonstrated that hemodynamic changes were smaller in patients undergoing the abdominal wall-lifting method than in those undergoing pneumoperitoneum. CONCLUSIONS It was concluded that hemodynamics should be carefully monitored during pneumoperitoneum, and that the abdominal wall-lifting approach in laparoscopic cholecystectomy is a method worthy of consideration for elderly patients or those with cardiopulmonary complications.
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Affiliation(s)
- N Uemura
- Department of Gastroenterology, National Kochi Hospital, Kochi, Japan
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38
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Endo J, Nakamura T. [Theories of medicine in the newly discovered medical book "Hon'po Kagen Hishu" by San'ki Tashiro: basic prescriptions and modified prescriptions]. Nihon Ishigaku Zasshi 2001; 47:797-818. [PMID: 11944649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
While investigating the formation of the Gosei-ha school in Japan by Tashiro San'ki and Manase Dosan, we discovered "Hon'po Kagen Hishu", a heretofore unknown medical book by San'ki Tashiro. A comparison of this work with Sanki's "Wakyokushu" revealed the following points. (1) "Hon'po Kagen Hishu" is a medical book compiled by San'ki Tashiro, and is believed to have been put together after the newly-compiled "Wakyokushu" (1525). (2) The book is roughly divided into two parts: basic prescriptions and modified prescriptions. "Hon'po Kagen Hishu" reveals clearly that San'ki's medical theories form the key theories of these two parts. (3) Many of the basic prescriptions contained in "Hon'po Kagen Hishu" were existing prescriptions used by the Kyokuho-ha School which was popular in Japan at the time. The modified prescriptions conform to the bian zheng pei ji (selection of drug based on the differential diagnosis) theories of the Li-Zhu medical school. (4) Among the 15 prescriptions described in the 'Shobyou Tsuyo no Yakuho' chapter of "Hon'po Kagen Hisku" secret prescriptions from schools of thought including the Nakarai school were discovered, pointing to a connection between San'ki and the Nakarai school.
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Endo J. The greatest gift. J Am Med Dir Assoc 2001; 2:331-2. [PMID: 12812540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- J Endo
- Section of Geriatrics and Gerontology, Department of Internal Medicine, University of Nebraska Medical Center, USA
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40
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Nakamura T, Endo J, Sakim M. [Comparative studies on saccharated preparations in traditional medicine]. Yakushigaku Zasshi 2001; 31:12-22. [PMID: 11619102] [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: 02/21/2023]
Abstract
We studied the descriptions of saccharated preparations found in traditional medical books and reported the following points. 1. Among the preparations described in medical books in Uigurian traditional medicine, the most numerous are saccharated preparations. These are often used to ripen and detoxicate malignant body fluids. 2. The contents of ancient writings found in Turfan in Uiguru relate not only to Greek medicine but also to Ayurvedic and Tibetan medicine. The application of saccharated preparations described in these writings is similar to that mentioned above. 3. The most important book of Tibetan medicines, "Sibu Yidian (The Four Medical Tantras)" describes saccharated preparations as making viscous body fluids ripe and improving their passage. The same book also regards them as mitigative. 4. "Caraka samnita" and "Sushruta samhita" show that honey and sugar are used separately in most cases of Ayurvedic medicine and that they expel malignant body fluids. 5. According to books of Greek medicine, honey is often added to extracts of herbal medicine at the time of taking it, and is used to ripen, detoxicate, and expel malignant body fluids. 6. The origin of saccharated preparations seems to be related to similary humoral theories in Greek, Arab, Indian, and Tibetan medicine.
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Affiliation(s)
- T Nakamura
- Pharmaceutical Sciences, Science University of Tokyo
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41
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Endo J, Nakamura T, Yamaki H, Miyamoto H. [Studies of the fifth section in the introduction of the Qian jin yao fang - Writings quoted from the Shen nong ben cao jing and the Yao dui]. Yakushigaku Zasshi 2001; 28:1-5. [PMID: 11639713] [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
The fifth section in the introduction of the Qian jin yao fang is composed of three paragraphs. The first paragraph is the same as that of the Shen nong ben cao jing. The second and the third ones begin with the sentences of "Lei gong say ..." and "Yao dui says ..." respectively. We inquired into the origin of these three paragraphs. As a result of our investigation, we inferred that the first and the second paragraphs were part of the writings of the Lei gong ji zhu shen nong ben cao and that the third one was part of the Lei gong yao dui. We also pointed out that the substance of these paragraphs was influenced directly and indirectly by Buddhist medicine.
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Affiliation(s)
- J Endo
- Faculty of Pharmaceutical Sciences, Science University of Tokyo
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42
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Endo J, Nakamura T. [Comparative studies of the tridosha theory in Ayurveda and the theory of the four deranged elements in Buddhist medicine]. Kagakushi Kenkyu 2001; 34:1-9. [PMID: 11609159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
It has been said that the tridosha theory in Ayurveda originated from the theory of the three elements of the universe. The names of these three doshas, which are roughly equivalent to humour, are vata (wind), pitta (bile), and Kapha (phlegm), corresponding to the three elements of the universe: air, fire, and water. On the other hand, Buddhist medicine which has a close relation to Ayurveda is based on the theory of the four elements of the universe which includes the earth as well as the three elements mentioned above. Greek medicine on the other hand, is founded on the theory of the four humours, i.e. blood, yellow bile, black bile, and phlegm. Furthermore, even in Ayurveda, like in "Sushruta Samhita", the theory of the four humours can be found: this includes the above-mentioned tridosha plus blood as the fourth humour. "Timaios" by Plato also mentions this. We compared these various theories and pointed out that the tridosha theory had its origin in the theory of the four elements of the universe. The process of the formation of the tridosha theory is considered as follows: (1) "Earth" was segregated from the four elements of the universe owing to its solid properties, and was rearranged into the seven elements of the body called "dhatu"; and the other three elements. "water", "fire", and "air", were integrated as the tridosha theory, namely, the theory of the three humours, owing to their properties of fluid; (2) "Blood", assigned to the element of "earth", was segregated from the tridosha because "blood" was considered to be comprised of the properties of every humour without having its own peculiar properties. Therefore, the diseases caused by deranged "blood" were regarded as an aggregate disease caused by the other three deranged humours. Then the category of the disease, caused by deranged "earth", did not appear.
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Chin C, O'Hare B, Lerman J, Endo J. Comparison of exogenous surfactant and positive end-expiratory pressure therapies in a model of human breast milk-induced acute lung injury in rabbits. Br J Anaesth 2000; 84:600-7. [PMID: 10844837 DOI: 10.1093/bja/84.5.600] [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: 11/13/2022] Open
Abstract
To evaluate surfactant and positive end-expiratory pressure (PEEP) as potential therapies for the acute lung injury after tracheal instillation of 0.8 ml kg-1 human breast milk (HBM) acidified to pH 1.8, adult white rabbits were anaesthetized, tracheostomized, ventilated and randomized to (six rabbits per treatment): (i) no treatment after HBM (control); (ii) exogenous Bovine surfactant (100 mg kg-1) 1 h after HBM; (iii) PEEP-pre (0.5 kPa PEEP) before and after HBM; or (iv) PEEP-post (0.5 kPa PEEP) after HBM. A fifth group of six rabbits received no tracheal instillate (no aspirate). The alveolar to arterial oxygen tension gradient (A-aDO2) and dynamic compliance were measured pre-injury and hourly for 4 h. At post-mortem, the lungs were examined histologically. A-aDO2 in all four HBM-injured groups increased to a maximum at 1 h post-injury; A-aDO2 then returned towards the baseline in the surfactant and PEEP-post groups, but remained increased in the PEEP-pre and control groups. Dynamic compliance decreased in all four HBM-injured groups. A-aDO2 and compliance were unchanged in the no aspirate group. Bronchoalveolar architecture after surfactant therapy was normal. We conclude that surfactant is a more effective therapy for HBM-induced lung injury than either 0.5 kPa PEEP-post or PEEP-pre injury.
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Affiliation(s)
- C Chin
- Department of Anaesthesia, Hospital For Sick Children, Toronto, Ontario, Canada
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Endo J, Toyama-Sorimachi N, Taya C, Kuramochi-Miyagawa S, Nagata K, Kuida K, Takashi T, Yonekawa H, Yoshizawa Y, Miyasaka N, Karasuyama H. Deficiency of a STE20/PAK family kinase LOK leads to the acceleration of LFA-1 clustering and cell adhesion of activated lymphocytes. FEBS Lett 2000; 468:234-8. [PMID: 10692593 DOI: 10.1016/s0014-5793(00)01219-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 11/19/2022]
Abstract
Lymphocyte-oriented kinase (LOK) is a member of the STE20/p21-activated kinase (PAK) family and expressed predominantly in lymphoid organs. Generation of LOK-deficient mice revealed that the leukocyte-function-associated antigen (LFA-1)/intercellular adhesion molecules (ICAM)-mediated aggregation of mitogen-stimulated T cells was greatly enhanced in the absence of LOK. Though levels of total LFA-1 and ICAMs as well as the active form of LFA-1 on T cell blasts were comparable in the presence and absence of LOK, clustering of active LFA-1 detected by binding of soluble ICAM-1 was accelerated in the absence of LOK. These results suggest that LOK is potentially involved in the regulation of LFA-1-mediated lymphocyte adhesion.
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Affiliation(s)
- J Endo
- Department of Immunology, The Tokyo Metropolitan Institute of Medical Science, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan
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Harada Y, Endo J. [Sialyl SSEA-1 (SLX)]. Nihon Rinsho 1999; 57 Suppl:502-5. [PMID: 10778174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Y Harada
- Department of Laboratory Medicine, Shimane Medical University
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Endo J, Nakamura T. Medical thought of Dosan Manase's early years. (1) The meaning of the work "Toryu". Nihon Ishigaku Zasshi 1999; 45:323-38. [PMID: 11624025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Dosan Manase was a famous Japanese doctor in the Muromachi era and was in the vanguard of the Goseiha school of Sino-Japanese traditional medicine. In his "Shinmyakukudenshu" we found an interesting account to explain the meaning of the word "Toryu", which was often found in the medical books written in Dosan's early years. This word signifies "our school" in a general sense, but in this book Dosan used it with the additional meaning of his medical thought originating in Zhu dan xi who was a famous Chinese doctor in the Yuan age. In addition, he mentioned in the same book that Toryu was introduced from China into Japan by Dodo, succeeded by Sanki and propagated by himself. Moreover our extensive investigation of other medical literature showed that Dosan, in his early years, tried to develop a system of medical thought on the basis of that of Zhu dan xi. This is worthy of note because it differs considerably from the stance adopted in Dosan's later years : while he valued Zhu dan xi, he referred to many medical books by various authors, and tried not to favour any particular school.
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Abstract
BACKGROUND The authors compared the lung injury in rabbits that occurred after tracheal instillation of human breast milk (HBM) acidified to pH 1.8 with hydrochloric acid (HCl), HBM at its native pH (7.0), and HBM acidified with gastric juice to pH 1.8 and 3.0. METHODS The alveolar-to-arterial oxygen tension gradient and dynamic compliance were recorded before and hourly for 4 h after intratracheal instillation of 0.8 ml/kg HBM acidified with HCI (pH 1.8), HBM at its native pH (7.0), HBM acidified with gastric juice (pH 1.8 or 3.0), or 5% dextrose solution acidified with gastric juice (pH 1.8) as a control in 30 adult rabbits. The circulating neutrophil count and phagocyte oxidant activity were determined before and 1 and 4 h after instillation. RESULTS The alveolar-to-arterial oxygen tension gradient increased and dynamic compliance decreased significantly in all groups after instillation of HBM compared with baseline values and those in the control group. The severity of the lung injury after instillation of HBM at all pH values (1.8, 3.0, and 7.0) and after acidification with gastric juice or HCl was similar. The circulating neutrophil count increased steadily for 4 h after instillation (P < 0.013), whereas spontaneous phagocyte oxidant burst activity peaked at 1 h (P < 0.007) and returned to baseline by 4 h after instillation. CONCLUSIONS The severity of the lung injury after tracheal instillation of 0.8 ml/kg HBM in rabbits is similar at pH values between 1.8 and 7.0 after acidification with HCl or gastric juice. Tracheal instillation of HBM increases the circulating neutrophil count and phagocyte oxidant burst activity.
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Affiliation(s)
- B O'Hare
- Department of Anaesthesia and the Research Institute, The Hospital for Sick Children and University of Toronto, Ontario, Canada
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Chin C, Lerman J, Endo J. Acute lung injury after tracheal instillation of acidified soya-based or Enfalac formula or human breast milk in rabbits. Can J Anaesth 1999; 46:282-6. [PMID: 10210056 DOI: 10.1007/bf03012611] [Citation(s) in RCA: 9] [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: 10/20/2022] Open
Abstract
PURPOSE The aim of this study was to compare the severity of the acute lung injury after tracheal instillation of acidified soya-based or Enfalac infant formula, or human breast milk (HBM) in anesthetized rabbits. METHODS Alveolar-arterial oxygen tension gradient (A-aDO2) and dynamic compliance were measured before (baseline) and hourly for four hours after tracheal instillation of 0.8 ml x kg(-1) soya-based or Enfalac infant formula or HBM (all acidified to pH 1.8 with hydrochloric acid) or no fluid (control) in 24 anesthetized and tracheotomized adult rabbits. The A-aDO2, the difference between alveolar and arterial oxygen tensions, was corrected for barometric pressure and carbon dioxide tension. Dynamic compliance was the ratio of the expired tidal volume to the peak inspiratory airway pressure, normalized to body weight. RESULTS Baseline A-aDO2 and dynamic compliance were similar among the four groups. In the control rabbits, A-aDO2 remained unchanged throughout the four hours, whereas mean A-aDO2 increased 180 mm Hg in the soya-based group (P < 0.0025) and 350 and 275 mm Hg in the Enfalac and HBM groups respectively (P < 0.0002). The order of the A-aDO2 post-instillation was Enfalac approximately/= HBM > soya > control (P < 0.0002). Dynamic compliance decreased 10-12% in the control rabbits during the four post-instillation measurements compared with baseline (P < 0.033), decreased 20% in the soya-based group (P < 0.0002) and 40-50% in the Enfalac and HBM groups (P < 0.0002). CONCLUSION The severity of the acute lung injury after intratracheal instillation of infant feeds in a volume of 0.8 ml x kg(-1) and at pH 1.8 in rabbits depends in part, on the type of feed: Enfalac approximately/= HBM > soya > control.
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Affiliation(s)
- C Chin
- Department of Anaesthesia and the Research Institute, The Hospital for Sick Children and University of Toronto, Ontario
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Kondo Y, Nomura M, Nada T, Endo J, Yukinaka M, Saito K, Ichikawa S, Ito S, Nakaya Y. Ischaemic electrocardiographic changes after massive blood transfusion: findings based on myocardial scintigraphy using 99mTc-MIBI and 123I-MIBG. Acta Cardiol 1999; 53:279-83. [PMID: 9922806] [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: 02/10/2023]
Abstract
We performed myocardial scintigraphy on a patient with ischaemic electrocardiographic changes after massive blood transfusion. Although there was no defect by 99mTc-MIBI scintigraphy, 123I-MIBG scintigraphy was observed suggesting denervation after massive blood transfusion. Myocardial scintigraphy using 99mTc-MIBI or 123I-MIBG can be useful for the evaluation of myocardial dysfunction with reversible myocardial infarction.
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Affiliation(s)
- Y Kondo
- Second Department of Internal Medicine, School of Medicine, University of Tokushima, Japan
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Abstract
A 44 year old man with Brugada syndrome and ventricular fibrillation had an autonomic disorder, shown by spectral analysis of heart rate variability and 123I-MIBG myocardial scintigraphy. Periodic variation of the ST segments was detected by Holter ECG. Increased high frequency power (0.15-0.40 Hz), an index of parasympathetic nerve activity, was observed just before ST segment elevation. In addition, local dysfunction of sympathetic nerves in the left ventricle was detected by 123I-MIBG myocardial scintigraphy. Unbalanced autonomic nerve function plays an important role in inducing Brugada-type ECG signs.
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Affiliation(s)
- M Nomura
- Second Department of Internal Medicine, School of Medicine, University of Tokushima, Japan
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