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Yuki S, Fukushima H, Amano T, Nakamura M, Kudo M, Sonoda N, Tateyama M, Kawamoto Y, Hatanaka K, Sogabe S, Miyagishima T, Akakura N, Kato T, Takagi T, Iwanaga I, Miyashita K, Onodera M, Saitoh S, Sakata Y, Komatsu Y. The efficacy of first-line IRIS with or without bevacizumab in patients with metastatic colorectal cancer: Analysis of two phase II studies. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e14604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14604 Background: The safety and efficacy of first-line IRIS (S-1 in combination with irinotecan; Komatsu Y, et al. Oncology, 2011) and IRIS/Bev (IRIS in combination with bevacizumab (Bev); Komatsu Y, et al. Acta Oncol, 2012/Yuki S, et al. 2013 ASCO-GI) have been evaluated in patients with metastatic colorectal cancer (mCRC). This time, no randomized studies comparing these regimens have been performed. This retrospective analysis compared efficacy and safety data for the two regimens from separate phase II studies performed at Hokkaido Gastrointestinal Cancer Study Group (HGCSG). Methods: Patients with histologically confirmed unresectable metastatic or recurrent CRC and received no prior chemotherapy were enrolled. In the first trial, patients received irinotecan 100 mg/m2 on day 1,15 and oral S-1 40 mg/m2 twice daily on days 1-14 every 4 weeks (IRIS study: HGCSG0302). In the second trial, patients received the same regimen plus Bev 5 mg/kg on day 1,15 (IRIS/Bev study). Results: A total of 40 and 52 patients were enrolled the IRIS and IRIS/Bev studies, respectively. Patient characteristics were generally similar in both groups, whereas there were more cases of good performance status and less number of metastatic organ in IRIS/Bev group. The median overall survival was 39.6 months in IRIS/Bev, as compared with 23.4 months in IRIS, corresponding to a hazard ratio for death of 0.418 (p<0.001). The median progression-free survival was 17.0 months in IRIS/Bev, as compared with 8.6 months in IRIS (hazard ratio for disease progression, 0.418; p<0.001); the corresponding response rate were 63.5 percent and 52.5 percent (p=0.393).In a multivariate analysis of PFS and OS, IRIS/Bev (n=52) was significantly associated with longer PFS and OS compared with IRIS alone (n=40). Conclusions: In this retrospective comparison of two studies, the addition of Bev to IRIS appeared to improve outcome compared with IRIS alone in the first-line treatment of patients with mCRC.
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Kato R, Ishihara Y, Kawanabe N, Sumiyoshi K, Yoshikawa Y, Nakamura M, Imai Y, Yanagita T, Fukushima H, Kamioka H, Takano-Yamamoto T, Yamashiro T. Gap-junction-mediated Communication in Human Periodontal Ligament Cells. J Dent Res 2013; 92:635-40. [DOI: 10.1177/0022034513489992] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Periodontal tissue homeostasis depends on a complex cellular network that conveys cell-cell communication. Gap junctions (GJs), one of the intercellular communication systems, are found between adjacent human periodontal ligament (hPDL) cells; however, the functional GJ coupling between hPDL cells has not yet been elucidated. In this study, we investigated functional gap-junction-mediated intercellular communication in isolated primary hPDL cells. SEM images indicated that the cells were in contact with each other via dendritic processes, and also showed high anti-connexin43 (Cx43) immunoreactivity on these processes. Gap-junctional intercellular communication (GJIC) among hPDL cells was assessed by fluorescence recovery after a photobleaching (FRAP) analysis, which exhibited dye coupling between hPDL cells, and was remarkably down-regulated when the cells were treated with a GJ blocker. Additionally, we examined GJs under hypoxic stress. The fluorescence recovery and expression levels of Cx43 decreased time-dependently under the hypoxic condition. Exposure to GJ inhibitor or hypoxia increased RANKL expression, and decreased OPG expression. This study shows that GJIC is responsible for hPDL cells and that its activity is reduced under hypoxia. This is consistent with the possible role of hPDL cells in regulating the biochemical reactions in response to changes in the hypoxic environment.
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Ishida M, Toda K, Miyagawa S, Nishi H, Yoshikawa Y, Fukushima S, Yoshioka D, Saito T, Kubota K, Fukushima H, Shirakawa Y, Kuratani T, Sawa Y. Recipient Cytokine Levels Are Associated with Primary Cardiac Allograft Failure. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Iwanaga I, Yuki S, Fukushima H, Ishiguro A, Takahata T, Miyagishima T, Kudo M, Uehata Y, Sakata Y, Komatsu Y. An open, multicenter, phase II clinical trial to evaluate efficacy and safety of S-1 split cisplatin in patients with advanced gastric cancer (AGC): HGCSG0702—Safety analysis. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
121 Background: From the results of SPIRITS trial, S-1 plus cisplatin has been regarded as standard first-line chemotherapy for patients with AGC in Japan. However, many facilities are forced hospitalization of hydration upon administration of high dose Cisplatin (60mg/m2). Therefore, in Hokkaido Gastrointestinal Cancer Study Group (HGCSG), to investigate the safety and efficacy, we conducted a multicenter phase II clinical trials of S-1 plus split cisplatin as a therapeutic strategy that can be administered in the outpatient. Methods: Eligibility criteria included pathologically confirmed AGC; no prior chemotherapy; Age 20 to 75, ECOG performance status (PS) of 0 to 1; adequate organ function; and written informed consent. S-1 (40-60 mg depending on patients body surface area) was given orally, twice daily for 3 consecutive weeks, and 30 mg/m2 cisplatin was given intravenously on day 1 and 15, followed by 2-week rest period, within a 5-week cycle. Primary endpoint was the response rate (RR), and secondary endpoints were progression-free survival, overall survival, safety profile, and duration of hospitalization. Results: Between Mar 2008 and Mar 2012, 40 pts were enrolled. Patients characteristics were as follows: median age 63 years (range 41-75), Male: female 30:10, PS 0:1 33:7. Median no. of cycles was 3. The most common non-hematological adverse events (AE) were anorexia (70%), nausea (60%), fatigue (60%) and diarrhea (48%) and hematological AE were anemia (88%), neutropenia (83%), leukocytopenia (68%) and thrombocytopenia (60%). The main grade 3-4 AE were neutropenia (40%), anemia (30%), anorexia (30%) and fatigue (15%). These AE were as expected. The median dose intensity of S-1 was 270mg/m2/week (relative dose intensity (RDI) 80%), and cisplatin was 10.1mg/m2/week (RDI 84%). These toxicities were tolerable and manageable. No treatment-related death was observed. Conclusions: We conclude that this S-1 plus split cisplatin regimen was well tolerated in the treatment of AGC, and most patients could be administered in the outpatient. We are planning the final efficacy analysis for February 2013.
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Dazai M, Fukushima H, Sato Y, Yuki S, Ohnuma H, Okuda H, Tsuji Y, Kawamoto Y, Hatanaka K, Iwanaga I, Koike M, Kato T, Nakamura M, Sogabe S, Fujikawa K, Hosokawa A, Hisai H, Tateyama M, Sakata Y, Komatsu Y. Retrospective cohort study on the safety and efficacy of panitumumab for patients with metastatic colorectal cancer: The HGCSG1002 study—Analysis of adverse events. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
554 Background: Panitumumab (Pmab) is a fully human monoclonal antibody specific to the epidermal growth factor receptor. It has been associated with very few infusion reactions, but has been pointed out more severe skin toxicity, compared to cetuximab which is a chimeric antibody.To evaluate the safety of Pmab for patients (pts) with metastatic colorectal cancer (mCRC) in daily clinical practice in Japan, retrospectively. Methods: Two hundred pts with mCRC treated by Pmab contained chemotherapy were retrospectively registered from 20 centers in Japan (HGCSG1002 study). Adverse events were evaluated using Common Terminology Criteria for Adverse Events(CTCAE) Version 4.0. Results: Of 195 pts were able to evaluate for adverse events. Patients’ characteristics were as follows; male/female 112/83, median age 64 (range 40-82), ECOG performance status (0/1/2-) 103/71/21. Treatment line (1st/2nd/more than 3rd): 17/26/152. Grade 3 or higher adverse events related to Pmab were hypomagnesemia (11.5%), rash acneiform (14.3%), paronychia (4.6%). Adverse events accounted for 7.3% of pts discontinuation, but there were no treatment-related deaths. Grade 3 or higher hypomagenesaemia and rash acneiform were observed more often in more than 3rd line treatment, compared to 1st or 2nd line treatment (1st or 2nd/3rd-, 1/ 17, p=0.128, 2/26, p= 0.05). Conclusions: Severe hypomagnesemia was observed more often in daily practice in Japan, compared with previous reports. Grade 3 or higher hypomagnesemia and rash acneiform were observed more often in more than 3rd line setting, compared with 1st or 2nd line settings.
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Yuki S, Komatsu Y, Fukushima H, Sasaki T, Amano T, Miyagishima T, Hatanaka K, Nakamura M, Tateyama M, Sakata Y. Phase II trial of combined chemotherapy with irinotecan, S-1, and bevacizumab (IRIS/Bev) in patients with metastatic colorectal cancer (mCRC): Final analysis—Hokkaido Gastrointestinal Cancer Study Group (HGCSG) trial. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
460 Background: The FIRIS study (Muro K et al. Lancet Oncol 2010;11:853–860) previously demonstrated the non-inferiority of Irinotecan plus S-1 (IRIS) to FOLFIRI for mCRC, with progression-free survival (PFS) as the primary endpoint. We previously reported that IRIS plus bevacizumab (IRIS/Bev) is very effective as first-line treatment (Komatsu Y et al. Acta Oncol. 2012 May 4). We now report the final results of this study. Methods: Eligible patients had to have mCRC with a confirmed diagnosis of adenocarcinoma, an age of >20 years, ECOG performance status (PS) of 0-1, and no history of prior chemotherapy. S-1 (40-60 mg depending on patients body surface area) was given orally, twice daily for 2 consecutive weeks, and 100 mg/m2irinotecan and 5 mg/kg bevacizumab was given intravenously on day 1 and 15, followed by 2-week rest period, within a 4-week cycle. The primary endpoint was safety. The secondary endpoints included overall response (OR), PFS, and overall survival (OS). Results: A total of 53 patients were enrolled from October 2007 through March 2009. The results were reported for 52 patients with evaluable lesions. The clinical characteristics of the patients were as follows. The median age was 63.5 years (range, 48 to 82). The male:female ratio was 3:2. The most common grade 3 or 4 adverse events were neutropenia (27%) and diarrhea (17%). Grade 3 or 4 hypertension (21%) was attributed to bevacizumab, but there were no life-threatening adverse events, such as gastrointestinal perforation. On an intention-to-treat basis, OR was 63.5% [95% confidence interval (CI) 50.4-76.5%], and the disease control rate was 94.2%. With a median follow-up time of 51.7 months, median PFS was 17.0 months (95%C.I. 14.2-19.8 months) and median survival time was 39.6 months (95%C.I. 34.2-45.0 months). Conclusions: IRIS/Bev is a remarkably active and generally well-tolerated first-line treatment for patients with mCRC. Randomized control trial comparing this regimen with oxaliplatin containing regimen(XELOX or mFOLFOX6 plus bevacizumab: TRICOLORE study) is already started. Clinical trial information: NCT00569790.
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Sogabe S, Fukushima H, Yuki S, Kobayashi Y, Miyagishima T, Okuda H, Kusumi T, Doi A, Tsuji Y, Kawamoto Y, Ehira N, Koike M, Meguro T, Takahashi Y, Yoshizaki K, Muto S, Ishiguro A, Kato S, Sakata Y, Komatsu Y. Retrospective cohort study on the safety and efficacy of panitumumab (Pmab) for patients with metastatic colorectal cancer (mCRC): The HGCSG1002 study—Analysis of clinical early predictor for the efficacy. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
593 Background: Inhibition of the EGFR pathway has become a key part in the treatment of colorectal cancer. There were few studies for clinical early predictive markers. To investigate the early magnesium (Mg2+), calcium (Ca2+), albumin (Alb), CEA and CA 19-9 plasma level reductions as a predictor for clinical outcome in terms of progression free survival (PFS) and overall survival (OS). Methods: 200 patients (pts) with mCRC treated by Pmab contained chemotherapy were retrospectively registered from 20 centers in Japan (HGCSG 1002 study). Of these, the pts that were refractory to or intolerant for 5-FU/ irinotecan/ oxaliplatin, and were never administered anti-EGFR-antibody, were included in this analysis. Mg2+, Ca2+, Alb, CEA and CA19-9 plasma levels were obtained from medical records. The differences in terms of PFS and OS according to the presence of Mg2+, Ca2+, Alb, CEA and CA19-9 reductions were evaluated by the log-rank test. Results: Of 67 pts were able to evaluate for this analysis. Pts’ characteristics were as follows: male/female 38/29, median age 64 (range 45-81), ECOG PS (0/1/2- ) 45/17/5. Response rate and disease control rate were 16.4% and 65.7%, PFS and OS were 4.3 m and 12.4 m, respectively. There were no correlations between Ca/Alb plasma level reductions and PFS/OS. Mg2+ reduction of at least 50% respect to the basal value during the course of treatment was significantly correlated with improved OS and PFS (OS, P=0.03; PFS, P=0.01), but the early reduction (until the 4th week or the 8th week after start of chemotherapy) was not correlated with OS and PFS. An early CEA serum level reduction of at least 40% until the 8th week was significantly correlated with improved OS and PFS (OS, P=0.04; PFS, P=0.07), moreover of at least 30% until the 4th week was correlated to longer PFS (P=0.053). Similar results were seen in CA19-9. Conclusions: An early CEA plasma level reduction of at least 30% or 40% was suggested to be a predictor for PFS in Pmab containing chemotherapy for mCRC pts. Although Mg2+ serum level reduction was correlated to clinical outcome, but could not show that is an early predictor for PFS and OS in our study.
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Kobayashi Y, Fukushima H, Sasaki T, Yuki S, Okuda H, Kusumi T, Doi A, Tsuji Y, Hatanaka K, Uebayashi M, Koike M, Kato T, Nakamura M, Sato Y, Ohta T, Kudo M, Konno J, Iwai K, Sakata Y, Komatsu Y. Retrospective cohort study on the safety and efficacy of panitumumab for patients with metastatic colorectal cancer: The HGCSG1002 study—Analysis of after cetuximab refractory. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
541 Background: In the previous studies, panitumumab (Pmab) has been demonstrated the efficacy for patients with metastatic colorectal cancer (mCRC) in all treatment lines. It is still controversial about the efficacy of Pmab for patients that had progressed on prior cetuximab (Cmab), though there had been a few reports (from Metges et al. and Wadlow et al.) regarding the efficacy of Pmab after Cmab refractory or intolerance. To evaluate the efficacy and safety of Pmab in patients with cetuximab-refractory mCRC, in comparison with anti-EGFR antibody naïve patients (Cmab-naïve) and Cmab-refractory or intolerance patients (prior-Cmab). Methods: Two hundred patients with mCRC treated by Pmab contained chemotherapy were retrospectively registered from 20 centers in Japan (HGCSG 1002 study). Of these, the patients that were refractory to or intolerant for 5-FU/ irinotecan/ oxaliplatin, and were administered Pmab monotherapy were included in this analysis. Results: Of 93 patients (44 prior-Cmab and 49 Cmab-naïve) were evaluated. There were no significant differences in the baseline characteristics of the patients in each group. The incidence of Grade 3 or higher any skin toxicities were higher in the Cmab-naïve (26.5.%) than in the prior-Cmab (11.4%). The overall response rate (RR) was not significantly difference (prior-Cmab/ Cmab-naïve, 9.1%/ 10.2%), but the disease control rate (DCR) was slightly higher in Cmab-naïve group (38.6%/ 55.1%, p=0.15). Progression free survival (PFS) and overall survival (OS) were follows: prior-Cmab/ Cmab-naïve, 2.8m/ 3.1m, 6.8m / 9.5m. There was a significant difference between the two groups in OS curve (p=0.04). Conclusions: Pmab was safely administered to heavily pretreated mCRC patients in daily practice. Although there were no significant differences in RR, DCS and PFS between prior-Cmab and Cmab-naïve, but the median OS was longer for the Cmab-naïve group compared with the prior-Cmab group. Therapeutic efficacies of Pmab for prior-Cmab patients did not comparable to those for Cmab-naïve patients. We are now performing a phase II trial on the efficacy of Pmab for Cmab-refractory mCRC patients.
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Shitara K, Yuki S, Yamazaki K, Naito Y, Fukushima H, Komatsu Y, Yasui H, Takano T, Muro K. Validation study of a prognostic classification in patients with metastatic colorectal cancer who received irinotecan-based second-line chemotherapy. J Cancer Res Clin Oncol 2012; 139:595-603. [PMID: 23250506 DOI: 10.1007/s00432-012-1349-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 10/31/2012] [Indexed: 12/14/2022]
Abstract
PURPOSE Five prognostic factors had been previously identified in patients with metastatic colorectal cancer (MCRC) who received irinotecan-based second-line chemotherapy. Patients were classified into three prognostic groups based on significant differences in median overall survival (OS). This study is conducted to validate this classification in an external validation cohort. METHODS This retrospective study included 193 patients of an external validation cohort who received irinotecan-based second-line chemotherapy after first-line oxaliplatin-based chemotherapy, with or without bevacizumab at three institutions. RESULTS Three of the five predefined factors (poorly differentiated adenocarcinoma, LDH ≥400 IU/L, progression-free survival of first-line therapy <6 months) remained highly significant in the validation cohort, although two (performance status 2 and peritoneal metastasis) were associated with borderline significance. The distribution of the three prognostic groups (low risk = no factors, intermediate risk = 1 factor, high risk = 2 or more factors) was low risk (n = 68; 35 %), intermediate risk (n = 80; 41 %), and high risk (n = 45; 23 %). The median OS of each group were 19.8, 11.0, and 7.9 months, respectively, with significant differences between groups, as found in the previous cohort. CONCLUSION The previous prognostic classification of patients with MCRC who received irinotecan-based second-line chemotherapy was validated in another independent cohort. Validation in prospective studies is warranted.
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Ichikawa K, Abe T, Fukushima H, Fujita R, Okada M, Yonekura K, Shimomura T, Utsugi T. 355 A Novel Highly Potent AKT Inhibitor TAS-117 Demonstrated Synergistic Antitumor Activity in Combination with Paclitaxel Through Enhancement of Apoptosis Induction. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72153-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Komatsu Y, Yuki S, Kawamoto Y, Hayashi H, Kato T, Hosokawa A, Iwanaga I, Muto O, Hatanaka K, Nakamura M, Tsuji Y, Tateyama M, Fukushima H, Kudo M, Sakata Y. Safety Report of a Phase II Trial of Irinotecan Plus S-1 (Iris) with Cetuximab in Pre-Treated Patients with KRAS Wild Type of Metastatic Colorectal Cancer: HGCSG0902. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32205-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Miyashita K, Kang JH, Saga A, Takahashi K, Shimamura T, Yasumoto A, Fukushima H, Sogabe S, Konishi K, Uchida T, Fujinaga A, Matsui T, Sakurai Y, Tsuji K, Maguchi H, Taniguchi M, Abe N, Fazle Akbar SM, Arai M, Mishiro S. Three cases of acute or fulminant hepatitis E caused by ingestion of pork meat and entrails in Hokkaido, Japan: Zoonotic food-borne transmission of hepatitis E virus and public health concerns. Hepatol Res 2012; 42:870-8. [PMID: 22568494 DOI: 10.1111/j.1872-034x.2012.01006.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM In developed countries including Japan, the transmission route of indigenous hepatitis E virus (HEV) infection is obscure. Accordingly, public health implications of indigenous HEV infection have not been well addressed. The aim of this study was to clarify the route of transmission of a small outbreak of acute hepatitis E and assess the public health implications of indigenous zoonotic HEV transmission. METHODS Three patients with non-A, B and C acute hepatitis, two of whom presented in a critical condition, were assessed for HEV infection using polymerase chain reaction and their route of infection; the genome sequences of the infecting HEV were also analyzed. A phylogenetic tree based on the full, or near full, HEV RNA sequences were constructed by neighbor-joining method. RESULTS All three patients ingested grilled pork meat and entrails at the same barbecue restaurant in Abashiri, Hokkaido, Japan. When comparing partial to entire, or nearly entire, nucleotide sequences of HEV detected in these patients, they were 99.9-100% identical to each other. These genotype 4 isolates had great resemblance to the genome sequences of the isolates from the mini-outbreak in 2004 in Kitami, a city adjacent to Abashiri. These Kitami/Abashiri strains were segregated into a single cluster on the phylogenetic tree of HEV genotype 4 indigenous to Japan. CONCLUSION Indigenous HEV transmission via a zoonotic food-borne route has been demonstrated in Kitami and Abashiri via pork meat and entrails contaminated with virulent HEV strains. Because a similar outbreak can recur in the future, infection sources and distribution routes should be clarified rapidly for public health.
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Komatsu Y, Yuki S, Sogabe S, Fukushima H, Nakatsumi H, Kobayashi Y, Iwanaga I, Nakamura M, Hatanaka K, Miyagishima T, Kudo M, Munakata M, Meguro T, Tateyama M, Sakata Y. Phase II study of combined chemotherapy with irinotecan and S-1 (IRIS) plus bevacizumab in patients with inoperable recurrent or advanced colorectal cancer. Acta Oncol 2012; 51:867-72. [PMID: 22554343 DOI: 10.3109/0284186x.2012.682629] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND In Japan, a study comparing the effectiveness and safety of irinotecan plus S-1 (IRIS) with those of a combination of 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI) as second-line treatment in patients with advanced or recurrent colorectal cancer demonstrated that IRIS was non-inferior to FOLFIRI. We previously reported that IRIS is also effective as first-line treatment. PATIENTS AND METHODS Eligibility criteria included inoperable recurrent colorectal cancer with a confirmed diagnosis of adenocarcinoma, age ≥20 years, and no history of prior chemotherapy. S-1 (40-60 mg twice daily) was given orally on Days 1 to 14, and irinotecan (100 mg/m(2)) and bevacizumab (5 mg/kg) were given intravenously on Days 1 and 15 of a 28-day cycle. The primary endpoint was safety. The secondary endpoints included overall response (OR), progression-free survival (PFS), and overall survival (OS). RESULTS A total of 52 eligible patients were enrolled from October 2007 through March 2009. In safety analysis, the incidences of grade 3 or 4 adverse reactions were as follows: neutropenia, 27%; hypertension, 21%; and diarrhea, 17%. The overall response rate was 57.7%. Median progression-free survival was 16.7 months. CONCLUSION IRIS plus bevacizumab is a well-tolerated, highly effective chemotherapeutic regimen that is easy to administer.
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Yamane K, Nambu T, Yamanaka T, Ishihara K, Tatami T, Mashimo C, Walker CB, Leung KP, Fukushima H. Pathogenicity of exopolysaccharide-producing Actinomyces oris isolated from an apical abscess lesion. Int Endod J 2012; 46:145-54. [PMID: 22900599 PMCID: PMC3557718 DOI: 10.1111/j.1365-2591.2012.02099.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 06/25/2012] [Indexed: 01/13/2023]
Abstract
Aim To demonstrate a capacity for producing exopolysaccharides (EPSs) and an ability to form biofilm on abiotic materials of Actinomyces oris strain K20. Methodology The productivity of EPSs and the ability to form biofilm of strain K20 were evaluated by measuring viscosity of spent culture media and by scanning electron microscopy (SEM) and the biofilm assay on microtitre plates, respectively. High-performance liquid chromatography was used to determine the chemical composition of the viscous materials. To examine the role of the viscous materials attributable to the pathogenicity in this organism, the ability of strain K20 to induce abscess formation was compared in mice to that of ATCC 27044. Results The viscosity of the spent culture media of K20 was significantly higher than that of ATCC 27044. Strain K20 showed dense meshwork structures around the cells and formed biofilms on microtitre plates, whereas ATCC 27044 did not. Chemical analysis of the viscous materials revealed that they were mainly composed of neutral sugars with mannose constituting 77.5% of the polysaccharides. Strain K20 induced persistent abscesses in mice lasting at least 5 days at a concentration of 108 cells mL−1, whereas abscesses induced by ATCC 27044 healed and disappeared or decreased in size at day 5. Conclusions Strain K20 produced EPSs, mainly consisting of mannose, and formed biofilms. This phenotype might play an important role for A. oris to express virulence through the progression of apical periodontitis.
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Fukushima H, Kawanabe N, Murata S, Ishihara Y, Yanagita T, Balam TA, Yamashiro T. SSEA-4 is a marker of human deciduous periodontal ligament stem cells. J Dent Res 2012; 91:955-60. [PMID: 22895512 DOI: 10.1177/0022034512458123] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although human deciduous teeth are an ideal source of adult stem cells, no method for identifying deciduous periodontal ligament (D-PDL) stem cells has so far been developed. In the present study, we investigated whether stage-specific embryonic antigen (SSEA)-4 is a marker that could be used to isolate D-PDL stem cells. The isolated D-PDL cells met the minimum criteria for mesenchymal stem cells (MSCs): They showed plastic adherence, specific-surface antigen expression, and multipotent differentiation potential. SSEA-4+ D-PDL cells were detected in vitro and in vivo. A flow cytometric analysis demonstrated that 22.7% of the D-PDL cells were positive for SSEA-4. SSEA-4+ clonal D-PDL cells displayed multilineage differentiation potential: They were able to differentiate into adipocytes, osteoblasts, and chondrocytes in vitro. A clonal assay demonstrated that 61.5% of the SSEA-4+ D-PDL cells had adipogenic, osteogenic, and chondrogenic potential. Our present study demonstrated that SSEA-4+ D-PDL cells are a subset of multipotent stem cells. Hence, SSEA-4 is a specific marker that can be used to identify D-PDL stem cells.
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Fukushima H, Satomura S, Kawai T, Tanaka M, Kamegawa T, Matsuno F. Modeling and Control of a Snake-Like Robot Using the Screw-Drive Mechanism. IEEE T ROBOT 2012. [DOI: 10.1109/tro.2012.2183050] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Leonard A, Wolff J, Sengupta R, Marassa J, Piwnica-Worms D, Rubin J, Pollack I, Jakacki R, Butterfield L, Okada H, Fangusaro J, Warren KE, Mullins C, Jurgen P, Julia S, Friedrich CC, Keir S, Saling J, Roskoski M, Friedman H, Bigner D, Moertel C, Olin M, Dahlheimer T, Gustafson M, Sumstad D, McKenna D, Low W, Nascene D, Dietz A, Ohlfest J, Sturm D, Witt H, Hovestadt V, Quan DAK, Jones DTW, Konermann C, Pfaff E, Korshunov A, Rizhova M, Milde T, Witt O, Zapatka M, Collins VP, Kool M, Reifenberger G, Lichter P, Lindroth AM, Plass C, Jabado N, Pfister SM, Pizer B, Salehzadeh A, Brodbelt A, Mallucci C, Brassesco M, Pezuk J, Morales A, de Oliveira J, Roberto G, Umezawa K, Valera E, Rego E, Scrideli C, Tone L, Veringa SJE, Van Vuurden DG, Wesseling P, Vandertop WP, Noske DP, Wurdinger T, Kaspers GJL, Hulleman E, Wright K, Broniscer A, Bendel A, Bowers D, Crawford J, Fisher P, Hassall T, Armstrong G, Baker J, Qaddoumi I, Robinson G, Wetmore C, Klimo P, Boop F, Onar-Thomas A, Ellison D, Gajjar A, Cruz O, de Torres C, Sunol M, Rodriguez E, Alonso L, Parareda A, Cardesa T, Salvador H, Celis V, Guillen A, Garcia G, Muchart J, Trampal C, Martin ML, Rebollo M, Mora J, Piotrowski A, Kowalska A, Coyle P, Smith S, Rogers H, Macarthur D, Grundy R, Puccetti D, Salamat S, Kennedy T, Fangusaro J, Patel N, Bradley K, Casey K, Iskandar B, Nakano Y, Okada K, Osugi Y, Yamasaki K, Fujisaki H, Fukushima H, Inoue T, Matsusaka Y, Sakamoto H, Hara J, De Vleeschouwer S, Ardon H, Van Calenbergh F, Sciot R, Wilms G, Van Loon J, Goffin J, Van Gool S, Puccetti D, Salamat S, Rusinak D, Patel N, Bradley K, Casey K, Knight P, Onel K, Wargowski D, Stettner A, Iskandar B, Al-Ghafari A, Punjaruk W, Coyle B, Kerr I, Xipell E, Rodriguez M, Gonzalez-Huarriz M, Tunon MT, Zazpe I, Tejada-Solis S, Diez-Valle R, Fueyo J, Gomez-Manzano C, Alonso MM, Pastakia D, McCully C, Murphy R, Bacher J, Thomas M, Steffen-Smith E, Saleem K, Waldbridge S, Widemann B, Warren K, Miele E, Buttarelli F, Arcella A, Begalli F, Po A, Baldi C, Carissimo G, Antonelli M, Donofrio V, Morra I, Nozza P, Gulino A, Giangaspero F, Ferretti E, Elens I, De Vleeschouwer S, Pauwels F, Van Gool S, Fritzell S, Eberstal S, Sanden E, Visse E, Darabi A, Siesjo P, McDonald P, Wrogemann J, Krawitz S, Del Bigio M, Eisenstat D, Wolff J, Kwiecien R, Pietsch T, Faldum A, Kortmann RD, Warmuth-Metz M, Rutkowski S, Slavc I, Kramm CM, Uparkar U, Geyer R, Ermoian R, Ellenbogen R, Leary S, Triscott J, Hu K, Fotovati A, Yip S, Kast R, Toyota B, Dunn S, Hegde M, Corder A, Chow K, Mukherjee M, Ashoori A, Brawley V, Heslop H, Gottschalk S, Yvon E, Ahmed N, Wong TT, Yang FY, Lu M, Liang HF, Wang HE, Liu RS, Teng MC, Yen CC, Agnihotri S, Ternamian C, Jones C, Zadeh G, Rutka J, Hawkins C, Filipek I, Drogosiewicz M, Perek-Polnik M, Swieszkowska E, Baginska BD, Jurkiewicz E, Perek D, Kuehn A, Falkenstein F, Wolff J, Kwiecien R, Pietsch T, Gnekow A, Kramm C, Brooks MD, Jackson E, Piwnica-Worms D, Mitra RD, Rubin JB, Liu XY, Korshunov A, Schwartzentruber J, Jones DTW, Pfaff E, Sturm D, Fontebasso AM, Quang DAK, Albrecht S, Kool M, Dong Z, Siegel P, Von Diemling A, Faury D, Tabori U, Lichter P, Plass C, Majewski J, Pfister SM, Jabado N, Lulla R, Echevarria M, Alden T, DiPatri A, Tomita T, Goldman S, Fangusaro J, Qaddoumi I, Lin T, Merchant TE, Kocak M, Panandiker AP, Armstrong GT, Wetmore C, Gajjar A, Broniscer A, Gielen GH, Muehlen AZ, Kramm C, Pietsch T, Hubert C, Ding Y, Toledo C, Paddison P, Olson J, Nandhabalan M, Bjerke L, Bax D, Carvalho D, Bajrami I, Ashworth A, Lord C, Hargrave D, Reis R, Workman P, Jones C, Little S, Popov S, Jury A, Burford A, Doey L, Al-Sarraj S, Jurgensmeier J, Jones C, Carvalho D, Bjerke L, Bax D, Chen L, Kozarewa I, Baker S, Grundy R, Ashworth A, Lord C, Hargrave D, Reis R, Jones C, Bjerke L, Perryman L, Burford A, Bax D, Jury A, Popov S, Box G, Raynaud F, Hargrave D, Eccles S, Jones C, Viana-Pereira M, Pereira M, Burford A, Jury A, Popov S, Perryman L, Bax D, Forshew T, Tatevossian R, Sheer D, Pimental J, Pires M, Reis R, Jones C, Sarkar C, Jha P, Patrick IRP, Somasundaram K, Pathak P, Sharma MC, Suri V, Suri A, Gerges N, Haque T, Nantel A, Faury D, Jabado N, Lee C, Fotovati A, Triscott J, Chen J, Venugopal C, Singhal A, Dunham C, Kerr J, Verreault M, Yip S, Wakimoto H, Jones C, Jayanthan A, Narendran A, Singh S, Dunn S, Giraud G, Holm S, Gustavsson B, Van Gool S, Kizyma R, Kizyma Z, Dvornyak L, Kotsay B, Epari S, Sharma P, Gurav M, Gupta T, Shetty P, Moiyadi A, Kane S, Jalali R. HIGH GRADE GLIOMAS. Neuro Oncol 2012; 14:i56-i68. [PMCID: PMC3483348 DOI: 10.1093/neuonc/nos102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
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Tachiiri S, Tanaka K, Kosuga T, Yanagawa M, Fukushima H, Hayakawa K. EP-1138 ANALYSIS OF TUMRO COVERAGE IN IMAGE-GUIDED POST-OPERATIVE VAGINAL HDR BRACHYTHERAPY OF CERVICAL CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hatanaka K, Yuki S, Nakatsumi H, Kogawa T, Fukushima H, Fujikawa K, Sato Y, Saito M, Munakata M, Komatsu Y. Retrospective cohort study on the safety and efficacy of cetuximab for metastatic colorectal cancer patients: HGCSG0901—Analysis of predictive markers. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
683 Background: The anti-EGFR antibody Cetuximab (Cmab) do not provide therapeutic effect to patients with KRAS mutations. It has been reported that there is no correlation between the staining intensity of EGFR and efficacy of Cmab. Moreover, the previous studies have suggested that the intensity of skin toxicity that occurs after the administration is a predictive marker of Cmab. Methods: Of 269 cases registered in the multi-institutional retrospective study (HGCSG0901) treated with Cmab, 252 patients for 3rd line or after treatment line were analyzed. Each degree of skin toxicity, KRAS mutation status and EGFR expression status, respectively, were analyzed for response rates, progression-free survival (PFS) and overall survival (OS). The Response Evaluation in Solid Tumors (RECIST) criteria version 1.0 was used to assess tumor response. The Kaplan–Meier method was used to determine PFS and OS. Log-rank test was used to compare each regimen in terms of PFS and OS. All statistical tests were performed using SPSS. Results: KRAS status: wild type (WT)/mutant type (MT): 135/32, EGFR status: positive/negative: 210/38, Skin toxicity: Grade 0/1/2/3: 31/50/128/43. Analysis of KRAS status: Response rate: WT 23.7%/MT 6.3% (p=0.028), Progression-free survival: WT 4.8 months /MT 2.1 months (p<0.001), Overall survival: WT 9.9 months/MT 5.3 months (p=0.003). There was a significant correlation between the degree of skin toxicity and efficacy. However, EGFR expression status showed no differences in efficacy. Conclusions: Here, we reported the results of efficacy analysis for each predictive marker of Cmab. As with previous reports, patients with KRAS mutations did not benefit from Cmab. Degree of skin toxicity was a useful indicator of effectiveness after starting treatment, whereas EGFR status was not effective predictor in daily practice setting.
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Fukushima H, Bailone RL, Weiss LA, Martins ML, Zaniboni-Filho E. Triploidy in the hematology of jundia juveniles (Siluriformes: Heptapteridae). BRAZ J BIOL 2012; 72:147-51. [DOI: 10.1590/s1519-69842012000100017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 01/17/2011] [Indexed: 11/22/2022] Open
Abstract
This study compared the hematological characteristics of diploid and triploid of jundia, Rhamdia quelen juveniles, an important freshwater fish cultured in south Brazil. Hematological morphometry of erythrocytes were determined in blood smears under a light microscope. The blood was used to measure the number of red blood cells (RBC) with a hemocytometer Neubauer chamber, and the numbers of white blood cells (WBC) and thrombocytes that were obtained using an indirect method. The results showed that triploidy increased (p < 0.01) the size and volume of the erythrocytes. Nevertheless, as expected, triploidy decreased (p < 0.01) the number of circulating erythrocytes, leucocytes and trombocytes in the blood of jundia. Moreover differential cell counts were different in diploids and triploids, suggesting that triploidy affects the number of cells and their proportion in blood. Lymphocytes were the most predominant cells in the differential counting of diploid fish (62.5%) while monocytes were predominant in triploid fish (49.6%). These results suggest performance differences between ploidies of jundia, and require future studies to evaluate the potential of triploid jundia in the culture conditions and resistance to infection.
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Fukushima H, Yuki S, Kobayashi Y, Hatanaka K, Kusumi T, Hosokawa A, Miyagishima T, Takeuchi S, Kudo M, Komatsu Y. Retrospective cohort study on the safety and efficacy of bevacizumab for metastatic colorectal cancer patients: The HGCSG0801 study—Analysis of bevacizumab beyond progression (BBP). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
684 Background: Bevacizumab (BV) is widely used in first-line chemotherapy for metastatic colorectal cancer in Japan, but the use of beyond bevacizumab first progression (BBP) has been controversial yet. Methods: Of patients treated with first-line BV in our retrospective cohort study (HGCSG0801), patients treated with BBP (n=22) and those without BBP ( n=19) in second-line setting were analyzed. The National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 was used to assess adverse events. The Response Evaluation in Solid Tumors (RECIST) criteria version 1.0 was used to assess tumor response. The Kaplan–Meier method was used to determine PFS and OS. Log-rank test was used to compare each group in terms of PFS and OS. All statistical tests were performed using SPSS. Results: PS (0/1/2) before second line chemotherapy was 18/3/1 in BBP and 10/8/1 in NBBP, respectively. In the safety analysis, five patients in BBP showed a worsening/newer hypertension, which wasn’t a clinical problem. In the efficacy analysis, the response rate was 22.8% in BBP and 0% in NBBP. The median PFS was better in BBP (6.7 months in BBP and 2.7 months in NBBP), but there was no significant difference in median OS from first BV administration between two groups (27.3 months in BBP and 22.2 months in NBBP). Conclusions: We analyzed BBP in daily practice in Japan. Adverse events were well tolerated, but survival advantage of BBP was not suggested. About the efficacy of BBP, we are waiting the results of ongoing Phase III trials.
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Fukushima H, Shimizu S, Inatsu Y. Yersinia enterocolitica and Yersinia pseudotuberculosis Detection in Foods. J Pathog 2011; 2011:735308. [PMID: 22567341 PMCID: PMC3335482 DOI: 10.4061/2011/735308] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 06/07/2011] [Indexed: 11/20/2022] Open
Abstract
Yersinia enterocolitica and Y. pseudotuberculosis which can cause yersiniosis in humans and animals are thought to be significant food-borne pathogens and be important as hygiene indicator in food safety. The pathogenic Y. enterocolitica serotypes/biotypes are O:3/4 and 3 variant VP negative, O:5, 27/2, O:8/1b, and O:9/2, have been reported worldwide. Y. pseudotuberculosis is distributed less widely than Y. enterocolitica. Isolation methods usually involve selective and recovery enrichment of the food sample followed by plating onto selective media, confirmation of typical colonies and testing for virulence properties of isolated strains. Recently, DNA-based methods, such as PCR assays, have been developed to detect pathogenic Y. enterocolitica and Y. pseudotuberculosis in foods more rapidly, and sensitivity than can be achieved by conventional culture methods. This paper reviews commercially available conventional and PCR-based procedures for the detection of pathogenic Yersinia in food. These methods are effective as the isolation and detection methods to target pathogenic Y. enterocolitica and Y. pseudotuberculosis in foods.
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Kaneko G, Furukawa S, Kurosu Y, Yamada T, Takeshima H, Nishida M, Mitsuboshi T, Otaka T, Shirasu K, Koda T, Takemasa Y, Aki S, Mochizuki T, Fukushima H, Fukuda Y, Kinoshita S, Asakawa S, Watabe S. Correlation with larval body size of mRNA levels of growth hormone, growth hormone receptor I and insulin-like growth factor I in larval torafugu Takifugu rubripes. JOURNAL OF FISH BIOLOGY 2011; 79:854-874. [PMID: 21967578 DOI: 10.1111/j.1095-8649.2011.03037.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The full-length of insulin-like growth factor (IGF) complementary (c)DNAs encoded by igf-I and igf-II from torafugu pufferfish Takifugu rubripes were cloned in the present study. The deduced amino acid sequences of the two genes showed c. 80% identity each with those of Igf-I and Igf-II from other teleosts, respectively. Two growth hormone (GH) receptors, ghr1 and ghr2, were also cloned in silico using the T. rubripes Fugu genome database. The transcripts of T. rubripes igf-I were detected in slow muscle, heart, skin, gill, liver and intestine but not in fast muscle, spleen and testis of adult fish, whereas those of igf-II were found in all tissues examined. Subsequently, the accumulated messenger (m)RNA levels of igf-I and igf-II were investigated in an F(2) population derived from a male of an apparent fast-growing T. rubripes strain and a wild female T. rubripes together with those of other growth-related genes encoding Gh, Ghr1 and Ghr2, and with those of prolactin (Prl) and leptin (Lep) previously reported. The accumulated mRNA levels of igf-I, gh and ghr1 were significantly correlated to growth rate at larval stages in the population, but not for those of igf-II, prl, ghr2 and lep. Although it is unclear whether or not this phenotype is directly related to the heredity of the fast-growing strain, the findings suggest that the expression of igf-I, gh and ghr1 is involved in the regulation of growth rate at larval stages in T. rubripes.
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Sogabe S, Yuki S, Takano H, Kobayashi Y, Nakatsumi H, Sasaki T, Kawamoto Y, Fukushima H, Iwanaga I, Uehata Y, Komatsu Y, Asaka M. [A case of sigmoid colon cancer with temporary dysarthria associated with irinotecan]. Gan To Kagaku Ryoho 2011; 38:1375-1377. [PMID: 21829085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A40 -year-old woman visited our hospital with adenocaricinoma of the sigmoid colon with multiple liver metastases and ovarian metastasis. Because of a stenosis of the primary tumor, she underwent a colostomy before chemotherapy. 5-fluorouracil and irinotecan and leucovorin(FOLFIRI)was selected as first-line chemotherapy. At the start of chemotherapy, just after the end of irinotecan and leucovorin administration, the patient developed dysarthria. There were no neurological abnormalities or hematological abnormalities. The treatment was temporarily discontinued, and the dysarthria completely disappeared within 90 minutes. 5-fluorouracil was administered after the disappearance of dysarthria. Within 60 minutes of the administration of irinotecan and leucovorin at the second chemotherapy treatment, the patient developed dysarthria again. The patient had no neurological or hematological abnormalities. Magnetic resonance imaging(MRI)showed no abnormalities. The treatment was stopped and dysarthria disappeared within 60 minutes as it did the first time. At each time, no treatment for dysarthria was performed. This patient refused to continue irinotecan because of dysarthria. Therefore, chemotherapy without irinotecan was continued for the third time onward. In the previous literature, 8 cases of dysarthria caused by irinotecan were reported as a rare toxicity. In all cases, dysarthria was temporary and reversible. Because the mechanism of dysarthria is unclear, specific treatment and precaution for dysarthria is not recommended. Since dysarthria is reversible, however, irinotecan might be continued until progression.
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Komatsu Y, Yuki S, Sogabe S, Fukushima H, Iwanaga I, Kudo M, Tateyama M, Meguro T, Uebayashi M, Saga A, Sakata Y, Asaka M. Phase II study of combined treatment with irinotecan and S-1 (IRIS) in patients with inoperable or recurrent advanced colorectal cancer (HGCSG0302). Oncology 2011; 80:70-5. [PMID: 21659785 DOI: 10.1159/000328739] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 03/24/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This phase II study was designed to evaluate the efficacy and safety of oral fluoropyrimidine S-1 plus irinotecan (IRIS regimen) in patients with previously untreated metastatic colorectal cancer. METHODS The response rate was the primary endpoint. Safety, progression-free survival time, and median survival time were secondary endpoints. The subjects were untreated patients with inoperable advanced colorectal cancer. Irinotecan was administered at a dose of 100 mg/m² (on days 1 and 15). S-1 (40 mg/m²) was administered for 2 weeks (on days 1 to 14) and followed by a 2-week rest. RESULTS Forty patients were enrolled. Four patients had grade 4 neutropenia, and six patients had grade 3 diarrhea. No other serious hematologic or nonhematologic adverse reactions occurred, and all patients received IRIS safely on an outpatient basis. The response rate was 52.5% (95% confidence interval [CI], 36.1-68.5%). Median progression-free survival was 8.6 months (95% CI, 5.3-11.9), and median survival time was 23.4 months (95% CI, 15.9-30.8). CONCLUSIONS IRIS produced a high response rate and could be given safely. IRIS may become a first-line treatment for inoperable or recurrent advanced colorectal cancer.
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