Personal imports of drugs to Japan in 2005--an analysis of import certificates

BACKGROUND

Personal imports of unapproved drugs are made by physicians and patients in Japan. Such imports require submission of a request for an import certificate from the Regional Bureau of Health and Welfare (RBHW). So far, there have been few reports on personal imports of drugs in Japan.

OBJECTIVE

To assess the extent and nature of personal imports of drugs in Japan.

METHODS

The date, product name and amount of drug imported were provided by RBHW for each personal import made by physicians in 2005. All imports were classified into several groups including whether they were for 'prescription drugs for non-cosmetic use (PDNC)' or 'prescription drugs for cosmetic use (PDC)'. Identification of PDNC was made by International Non-proprietary Name (INN). All drugs were classified under therapeutic groups. For the most frequently imported unapproved drugs, the approval year in the US/EU and development status in Japan were recorded.

RESULTS

A total of 12 196 personal imports were initiated by physicians in 2005. 5428 were for PDNCs corresponding to 242 drugs by INN. 55 PDNCs were each the subject of 10 or more imports. 11 drugs (252 imports) out of the top 55 PDNCs were available on the Japanese market during 2005 and 44 (4713 imports) were not approved. Of the 44 unapproved drugs, 11 (1019 imports) had been approved and 10 (2785 imports) were in the pre-registration phase as of December 31, 2006. Of the 44 unapproved drugs, 12 (1213 imports) were approved during 2000-2004, and 17 (3138 imports), during 1995-1999 in the US or EU. While the majority of imported drugs were antineoplastic drugs, drugs for various kinds of non-serious diseases were also imported.

CONCLUSIONS

A substantial number of unapproved drugs were being imported to Japan. A formal system for monitoring the use of those drugs should be established.

Inhibitory actions of the phosphatidylinositol 3-kinase inhibitor LY294002 on the human Kv1.5 channel

BACKGROUND AND PURPOSE

Kv1.5 channels conduct the ultra-rapid delayed rectifier potassium current (I(Kur)), and in humans, Kv1.5 channels are highly expressed in cardiac atria but are scarce in ventricles. Pharmacological blockade of human Kv1.5 (hKv1.5) has been regarded as effective for prevention and treatment of re-entry-based atrial tachyarrhythmias. Here we examined blockade of hKv1.5 channels by LY294002, a well-known inhibitor of phosphatidylinositol 3-kinase (PI3K).

EXPERIMENTAL APPROACH

hKv1.5 channels were heterologously expressed in Chinese hamster ovary cells. Effects of LY294002 on wild-type and mutant (T462C, H463C, T480A, R487V, A501V, I502A, I508A, L510A and V516A) hKv1.5 channels were examined by using the whole-cell patch-clamp method.

KEY RESULTS

LY294002 rapidly and reversibly inhibited hKv1.5 current in a concentration-dependent manner (IC(50) of 7.9 micromol.L(-1)). In contrast, wortmannin, a structurally distinct inhibitor of PI3K, had little inhibitory effect on hKv1.5 current. LY294002 block of hKv1.5 current developed with time during depolarizing voltage-clamp steps, and this blockade was also voltage-dependent with a steep increase over the voltage range for channel openings. The apparent binding (k(+1)) and unbinding (k(-1)) rate constants were calculated to be 1.6 micromol.L(-1) (-1).s(-1) and 5.7 s(-1) respectively. Inhibition by LY294002 was significantly reduced in several hKv1.5 mutant channels: T480A, R487V, I502A, I508A, L510A and V516A.

CONCLUSIONS AND IMPLICATIONS

LY294002 acts directly on hKv1.5 currents as an open channel blocker, independently of its effects on PI3K activity. Amino acid residues located in the pore region (Thr480, Arg487) and the S6 segment (Ile502, Ile508, Leu510, Val516) appear to constitute potential binding sites for LY294002.

Acetate uptake efficiency of polyphosphate-accumulating organisms under exposure to surfactants

We investigated the influence of surfactants such as linear alkylbenzene sulfonates (LAS) and alcohol ethoxylates (AE) on acetate uptake by polyphosphate-accumulating organisms (PAOs) under anaerobic conditions, using the phosphate requirement for acetate uptake (+DeltaP/-DeltaAc ratio). In order to estimate the +DeltaP/-DeltaAc ratio, anaerobic batch tests were conducted using activated sludge collected from an anaerobic/oxic sequencing batch reactor used to treat municipal wastewater continuously supplemented with a detergent containing LAS and AE. We demonstrated that LAS and AE have both positive and negative impacts on acetate uptake by PAOs. The disadvantage is that long-term exposure to the detergent inhibits acetate uptake by PAOs, thus deteriorating the efficiency, even if the surfactants are no longer present during the tests. Furthermore, the existence of LAS and/or AE with acetate further diminishes the efficiency. The advantage is that LAS and AE are potential sources of polyhydroxyalkanoate for PAOs, because acetate is produced from the surfactants under anaerobic conditions.

What do the indices of reproductive skew measure?

Several indices of reproductive skew that quantify the degree of unequal partitioning of reproductive output among individuals have been proposed without consensus on their merits and defects. We believe that the major reason for the disagreement is the lack of discussion on what the population parameter of skew (population skew or true skew) should measure. In our view, the skew index should be an unbiased estimate of a population skew, and the estimated skew needs to satisfy the following two conditions. First, if the group size is equal and the distribution of potential of reproductive output (pi), which is scaled by the proportion of the individual's to the total group reproductive output, is also fixed, skew remains constant even when the total number of offspring in the group changes. Second, if the group size is different, skew should have intuitive biological meaning. Our analyses revealed that, among various indices so far proposed, only the skews estimated by Kokko and Lindström's lambda and Morisita's I(delta) satisfy the first condition. However, the two indices estimate different population parameters, thus implying different biological meanings. Morisita's I(delta) is a linear function of CV(2) (squared coefficient of variation) of pi, and lambda is a positive function of [Formula: see text] when offspring number follows a multinomial distribution. In the special cases where a group consists of discrete classes of breeders and nonbreeders, lambda behaves roughly inversely parallel to the absolute number of breeders, while I(delta) moves almost parallel to the proportion of nonbreeders. Furthermore, lambda is sensitive to the total proportion of reproductive output possessed by the dominants but is relatively less sensitive to the number of subordinates. We discussed the possible situations where either of the two indices will be useful.

Absolute calibration of imaging plate for GeV electrons

An imaging plate has been used as a useful detector of energetic electrons in laser electron acceleration and laser fusion studies. The absolute sensitivity of an imaging plate was calibrated at 1 GeV electron energy using the injector Linac of SPring-8. The sensitivity curve obtained up to 100 MeV in a previous study was extended successfully to GeV range.

Operation with a single-channel thin-fibre arthroscope in patients with internal derangement of the temporomandibular joint

We evaluated the use of operation by single-puncture arthroscopy in 55 patients (62 joints) with locked temporomandibular joints (TMJ). We used a single-channel thin-fibre arthroscope (M & M Co., Tokyo, Japan) and a holuminium yttrium aluminium garnet (Ho:YAG) laser (Lumenis Co., Tokyo, Japan). The preoperative mean (SD) maximum interincisal measurement (distance between the edge of the lower and upper incisor) was 26.0 (4.9) mm, and it was increased by 15.0mm 12 weeks after operation. The preoperative mean (SD) visual analogue score (VAS) was 6.3(2.0), and after 12 weeks it had been reduced to 1.6 (1.1). There were no other complaints. Single-puncture arthroscopy with the Ho:YAG laser is simple and useful. There were no other complications, and the results obtained were satisfactory.

Securing the coronoid process during a coronoidotomy

Sagittal application of a titanium mini screw in the coronoid process at the time of coronoidotomy is a very efficient method for easy removal.

Multi-millijoule, diode-pumped, cryogenically-cooled Yb:KY(WO(4))(2) chirped-pulse regenerative amplifier

A diode-pumped, cryogenically-cooled Yb:KYW regenerative amplifier utilizing chirped-pulse amplification and regenerative pulse shaping has been developed. An amplified pulse with an energy of 5.5 mJ and a broad bandwidth of 3.4 nm is achieved.

High-energy, diode-pumped, picosecond Yb:YAG chirped-pulse regenerative amplifier for pumping optical parametric chirped-pulse amplification

A diode-pumped, cryogenic-cooled Yb:YAG regenerative amplifier utilizing gain-narrowing has been developed. A 1.2-ns chirped-seed pulse was simultaneously amplified and compressed in the regenerative amplifier, which generated a 35-ps pulse with ~8-mJ of energy without a pulse compressor. Second-harmonics of the amplified pulse was used to pump picosecond two-color optical parametric amplification.

Identification of marker genes distinguishing human periodontal ligament cells from human mesenchymal stem cells and human gingival fibroblasts

BACKGROUND AND OBJECTIVE

Molecular gene markers, which can distinguish human bone marrow mesenchymal stem cells from human fibroblasts, have recently been reported. Messenger RNA levels of tissue factor pathway inhibitor-2, major histocompatibility complex-DR-alpha, major histocompatibility complex-DR-beta, and neuroserpin are higher in human bone marrow mesenchymal stem cells than in human fibroblasts. However, human bone marrow mesenchymal stem cells express less apolipoprotein D mRNA than human fibroblasts. Periodontal ligament cells are a heterogeneous cell population including fibroblasts, mesenchymal stem cells, and progenitor cells of osteoblasts or cementoblasts. The use of molecular markers that distinguish human bone marrow mesenchymal stem cells from human fibroblasts may provide insight into the characteristics of human periodontal ligament cells. In this study, we compared the molecular markers of human periodontal ligament cells with those of human bone marrow mesenchymal stem cells and human gingival fibroblasts.

MATERIAL AND METHODS

The mRNA expression of the molecular gene markers was analyzed using real-time polymerase chain reaction. Statistical differences were determined with the two-sided Mann-Whitney U-test.

RESULTS

Messenger RNA levels of major histocompatibility complex-DR-alpha and major histocompatibility complex-DR-beta were lower and higher, respectively, in human periodontal ligament cells than in human bone marrow mesenchymal stem cells or human gingival fibroblasts. Human periodontal ligament cells showed the lowest apolipoprotein D mRNA levels among the three types of cells.

CONCLUSION

Human periodontal ligament cells may be distinguished from human bone marrow mesenchymal stem cells and human gingival fibroblasts by the genes for apolipoprotein D, major histocompatibility complex-DR-alpha, and major histocompatibility complex-DR-beta.

Ultra-broadband optical parametric chirped-pulse amplification using an Yb: LiYF(4) chirped-pulse amplification pump laser

We demonstrate ultra-broadband optical parametric chirpedpulse amplification of 300-nm bandwidth pumped by a broadband pulse delivered from a diode-pumped, cryogenically-cooled Yb:YLF chirped- pulse amplification laser.

Rottlerin synergistically enhances imatinib-induced apoptosis of BCR/ABL-expressing cells through its mitochondrial uncoupling effect independent of protein kinase C-δ

Although the BCR/ABL tyrosine kinase inhibitor imatinib is highly effective for treatment of chronic myeloid leukemia (CML) and Philadelphia-chromosome positive acute lymphoblastic leukemia (ALL), relapse with emerging imatinib-resistance mutations in the BCR/ABL kinase domain poses a significant problem. Here, we demonstrate that rottlerin, a putative protein kinase C-delta (PKCdelta)-specific inhibitor, acts synergistically with imatinib to induce apoptosis of BCR/ABL-expressing K562 and Ton.B210 cells. However, rottlerin inhibited neither PKCdelta nor BCR/ABL in these cells. On the other hand, rottlerin, previously characterized also as a mitochondrial uncoupler, transiently but significantly reduced mitochondrial membrane potential and gradually induced mitochondrial membrane permeabilization. Moreover, two other mitochondrial uncouplers, FCCP and DNP, very similarly induced apoptosis of BCR/ABL-expressing cells in a synergistic manner with imatinib. Imatinib synergistically enhanced mitochondrial membrane permeabilization induced by mitochondrial uncouplers, which led to release of cytochrome c into the cytoplasm and activation of caspases-3 and -9. Rottlerin also enhanced the cytotoxic effect of imatinib in leukemic cells from patients with CML blast crisis and Ph-positive ALL or a cell line expressing the imatinib-resistant E255K BCR/ABL mutant. The present study indicates that rottlerin synergistically enhances imatinib-induced apoptosis through its mitochondrial uncoupling effect independent of PKCdelta and may contribute to the development of new treatment strategy to overcome the imatinib resistance and to cure the BCR/ABL expressing leukemias.

Endoscopic thermal ablation therapies for hepatocellular carcinoma; multi-center study

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Background: Differences of efficacy between radiofrequency ablation (RFA) and microwave coagulation (MWC) for hepatocellular carcinoma (HCC) is still unknown. So we performed multi-center study to assess factors contributing to survival among patients treated by endoscopic thermal ablation for single HCC. Methods: 396 patients in six institutions with single HCC who were firstly treated by endoscopic thermal ablation were enrolled in this study and assessed retrospectively. Among 396 patients, 347 were treated under general anesthesia and 49 were treated local anesthesia. 144 were treated by MWC and 252 were treated by RFA. 383 were ablated laparoscopically and 13 were done thoracoscopically. 230 HCCs were located superficial position of liver and 166 were deep position. Classification with Child-Turcotte-Pugh score, the Japan Integrated Staging score, and the Cancer of the Italian Program scoring system were performed. All patients were analyzed survival rates by Kaplan-Meier method and differences among groups were compared by the log-rank test. Results: Five year survival rates of all 396 patients were 63% and ten year survival rates were 42%. Differences between general and local anesthesia were not significant (p = 0.28). Differences between MWC and RFA were not significant (p = 0.77). Location of HCCs were not significant (p = 0.89). Differences among groups classified by Child-Turcotte-Pugh score were significant (p = 0.017). Classification by the Japan Integrated Staging score was not significant (p = 0.24). However, classification by the Cancer of the Italian Program scoring system were significant (p = 0.001). Conclusions: Endoscopic thermal ablation therapies for HCC was effective. Differences of efficacy between RFA and MWC were not found.

No significant financial relationships to disclose.

BCR/ABL and IL-3 activate Rap1 to stimulate the B-Raf/MEK/Erk and Akt signaling pathways and to regulate proliferation, apoptosis, and adhesion

The Ras family small GTPase Rap1 is activated by hematopoietic cytokines, such as interleukin (IL)-3, to induce beta1 integrin-mediated cell adhesion or by the BCR/ABL fusion tyrosine kinase to stimulate the MEK/Erk signaling pathway. Here, we demonstrate that the abrogation of Rap1 activation by SPA-1, a Rap1-specific GAP, inhibits activation of B-Raf, MEK, Erk, and Akt in a murine hematopoietic cell line, Ton.B210, stimulated with IL-3 or inducibly expressing BCR/ABL. Furthermore, Rap1 inactivation had an inhibitory effects on proliferation and survival of Ton.B210 cells, which were more remarkable when cells were stimulated by BCR/ABL than by IL-3. Induction of BCR/ABL expression increased adhesion of Ton.B210 cells to fibronectin in a manner at least partly dependent on its kinase activity, and Rap1 inhibition by SPA-1 partially inhibited BCR/ABL-induced adhesion of cells. Thus, IL-3- or BCR/ABL-induced activation of Rap1 may play important roles in regulation of cell proliferation and survival through activation of the B-Raf/MEK/Erk and Akt signaling pathways and in induction of integrin-mediated cell adhesion. Furthermore, as compared with IL-3, BCR/ABL is more dependent on Rap1-mediated signaling to induce cell proliferation and survival and, thus, Rap1 may represent an attractive target for novel therapies for leukemias caused by BCR/ABL.