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Ichikawa W, Uehara K, Minamimura K, Tanaka C, Sadahiro S, Shinozaki K, Fukumoto K, Takii Y, Otsuji T, Kambara T, Gamoh M, Morita S, Ando Y, Arai M, Sugihara M, Sugiyama T, Ohashi Y, Sakata Y. 2100 Impact of UGT1A1 genotype and irinotecan exposure on outcomes in Japanese patients with advanced colorectal cancer treated by irinotecan-based regimens. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31022-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ikeda M, Yamanaka T, Yamazaki K, Yamaguchi K, Muro K, Kusumoto T, Uetake H, Sato T, Kato T, Nishina T, Kanazawa A, Oki E, Chao C, Maddala T, Krishnakumar J, Akagi K, Ochiai A, Ohashi Y, Ohtsu A, Yoshino T. PD-012 Validation study of the 12-gene Recurrence Score (RS) in patients (pts) with stage II and III colon cancer (CC) without adjuvant chemotherapy; SUNRISE Study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv234.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ichikawa W, Uehara K, Minamimura K, Tanaka C, Takii Y, Miyauchi H, Sadahiro S, Fujita K, Moriwaki T, Nakamura M, Takahashi T, Tsuji A, Shinozaki K, Morita S, Ando Y, Okutani Y, Sugihara M, Sugiyama T, Ohashi Y, Sakata Y. An internally and externally validated nomogram for predicting the risk of irinotecan-induced severe neutropenia in advanced colorectal cancer patients. Br J Cancer 2015; 112:1709-16. [PMID: 25880011 PMCID: PMC4430714 DOI: 10.1038/bjc.2015.122] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/16/2015] [Accepted: 03/07/2015] [Indexed: 02/08/2023] Open
Abstract
Background: In Asians, the risk of irinotecan-induced severe toxicities is related in part to UGT1A1*6 (UGT, UDP glucuronosyltransferase) and UGT1A1*28, variant alleles that reduce the elimination of SN-38, the active metabolite of irinotecan. We prospectively studied the relation between the UGT1A1 genotype and the safety of irinotecan-based regimens in Japanese patients with advanced colorectal cancer, and then constructed a nomogram for predicting the risk of severe neutropenia in the first treatment cycle. Methods: Safety data were obtained from 1312 patients monitored during the first 3 cycles of irinotecan-based regimen in a prospective observational study. In development of the nomogram, multivariable logistic regression analysis was used to test the associations of candidate factors to severe neutropenia in the first cycle. The final nomogram based on the results of multivariable analysis was constructed and validated internally using a bootstrapping technique and externally in an independent data set (n=350). Results: The UGT1A1 genotype was confirmed to be associated with increased risks of irinotecan-induced grade 3 or 4 neutropenia and diarrhoea. The final nomogram included type of regimen, administered dose of irinotecan, gender, age, UGT1A1 genotype, Eastern Cooperative Oncology Group performance status, pre-treatment absolute neutrophil count, and total bilirubin level. The model was validated both internally (bootstrap-adjusted concordance index, 0.69) and externally (concordance index, 0.70). Conclusions: Our nomogram can be used before treatment to accurately predict the probability of irinotecan-induced severe neutropenia in the first cycle of therapy. Additional studies should evaluate the effect of nomogram-guided dosing on efficacy in patients receiving irinotecan.
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Abstract
A patient, having been treated by total cystectomy and Bricker's conduit operation for prostatic duct carcinoma with intraepithelial extension into the prostatic urethra and bladder, developed an annular, psoriasiform eruption around the external orifice of the urethra two and one-half years later. A biopsy of this lesion showed pagetoid changes of the epidermis. Microscopic examination of the surgical specimen, consisting of the glans penis and corpus spongiosum, demonstrated intraepithelial-tumor permeation into the glans penis, penile urethra, and periurethral glands (Littre). It seems reasonable to conclude that this is an unusual case of Paget's disease of the glans penis which probably originated from a prostatic duct carcinoma.
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Ohashi Y, Shiba E, Toyama T, Kurebayashi J, Noguchi S, Iwase H. P092 QOL score changes in breast cancer patients: 2-year vs. 3-or-more-year administration of leuprorelin. Breast 2015. [DOI: 10.1016/s0960-9776(15)70137-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Ohashi Y, Sumitani K, Tokunaga M, Ishihara N, Okubo T, Fujisawa T. Consumption of partially hydrolysed guar gum stimulates Bifidobacteria and butyrate-producing bacteria in the human large intestine. Benef Microbes 2015; 6:451-5. [PMID: 25519526 DOI: 10.3920/bm2014.0118] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Partially hydrolysed guar gum (PHGG) is a water-soluble dietary fibre that is non-digestible in the upper gastrointestinal tract. It is believed that PHGG benefits the health of hosts by altering the colonic microbiota and stimulating short-chain fatty acid (SCFA) production. However, it remains unclear which bacteria ferment PHGG in the human large intestine. In this study, the effect of PHGG on faecal bacteria was analysed to specify the bacteria that contribute to the fermentation of PHGG in the human large intestine. Ten healthy volunteers consumed PHGG (6 g/day) for 2 weeks. Faeces were collected at 2 weeks prior to consumption, at the end of 2 weeks of consumption, and 2 weeks after consumption of PHGG. Bacterial DNA was extracted from these collected faeces and subjected to real-time PCR using bacterial group- or species-specific primers. The copy number of the butyryl-CoA CoA-transferase gene and the 16S rRNA gene copy numbers of Bifidobacterium, the Clostridium coccoides group, the Roseburia/ Eubacterium rectale group, Eubacterium hallii, and butyrate-producing bacterium strain SS2/1 were significantly increased by the intake of PHGG. Other bacteria and bacterial groups were not significantly influenced by the intake of PHGG. It was believed that the Roseburia/E. rectale group bacteria, Bifidobacterium, the lactate-utilising, butyrate-producing bacteria, E. hallii and bacterium strain SS2/1, would contribute to the fermentation of PHGG in the human large intestine. PHGG may benefit health by stimulating Bifidobacterium and butyrate-producing bacteria in the human large intestine.
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Mizuiri S, Ohashi Y. ACE and ACE2 in kidney disease. World J Nephrol 2015; 4:74-82. [PMID: 25664248 PMCID: PMC4317630 DOI: 10.5527/wjn.v4.i1.74] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 07/16/2014] [Accepted: 10/27/2014] [Indexed: 02/06/2023] Open
Abstract
Renin angiotensin system (RAS) activation has a significant influence on renal disease progression. The classical angiotensin-converting enzyme (ACE)-angiotensin II (Ang II)-Ang II type 1 (AT1) axis is considered to control the effects of RAS activation on renal disease. However, since its discovery in 2000 ACE2 has also been demonstrated to have a significant impact on the RAS. The synthesis and catabolism of Ang II are regulated via a complex series of interactions, which involve ACE and ACE2. In the kidneys, ACE2 is expressed in the proximal tubules and less strongly in the glomeruli. The synthesis of inactive Ang 1-9 from Ang I and the catabolism of Ang II to produce Ang 1-7 are the main functions of ACE2. Ang 1-7 reduces vasoconstriction, water retention, salt intake, cell proliferation, and reactive oxygen stress, and also has a renoprotective effect. Thus, in the non-classical RAS the ACE2-Ang 1-7-Mas axis counteracts the ACE-Ang II-AT1 axis. This review examines recent human and animal studies about renal ACE and ACE2.
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Matsuyama M, Ishii H, Furuse J, Ohkawa S, Maguchi H, Mizuno N, Yamaguchi T, Ioka T, Ajiki T, Ikeda M, Hakamada K, Yamamoto M, Yamaue H, Eguchi K, Ichikawa W, Miyazaki M, Ohashi Y, Sasaki Y. Phase II trial of combination therapy of gemcitabine plus anti-angiogenic vaccination of elpamotide in patients with advanced or recurrent biliary tract cancer. Invest New Drugs 2014; 33:490-5. [PMID: 25502982 PMCID: PMC4387249 DOI: 10.1007/s10637-014-0197-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/03/2014] [Indexed: 12/31/2022]
Abstract
Background Elpamotide is an HLA-A*24:02-restricted epitope peptide of vascular endothelial growth factor receptor 2 (VEGFR-2) and induces cytotoxic T lymphocytes (CTLs) against VEGFR-2/KDR. Given the high expression of VEGFR-2 in biliary tract cancer, combination chemoimmunotherapy with elpamotide and gemcitabine holds promise as a new therapy. Patients and Methods Patients with unresectable advanced or recurrent biliary tract cancer were included in this single-arm phase II trial, with the primary endpoint of overall survival. Survival analysis was performed in comparison with historical control data. The patients concurrently received gemcitabine once a week for 3 weeks (the fourth week was skipped) and elpamotide once a week for 4 weeks. Results Fifty-five patients were registered, of which 54 received the regimen and were included in the full analysis set as well as the safety analysis set. Median survival was 10.1 months, which was longer than the historical control, and the 1-year survival rate was 44.4 %. Of these patients, injection site reactions were observed in 64.8 %, in whom median survival was significantly longer (14.8 months) compared to those with no injection site reactions (5.7 months). The response rate was 18.5 %, and all who responded exhibited injection site reactions. Serious adverse reactions were observed in five patients (9 %), and there were no treatment-related deaths. Conclusion Gemcitabine and elpamotide combination therapy was tolerable and had a moderate antitumor effect. For future development of therapies, it will be necessary to optimize the target population for which therapeutic effects could be expected.
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Tai R, Ohashi Y, Mizuiri S, Aikawa A, Sakai K. Association between ratio of measured extracellular volume to expected body fluid volume and renal outcomes in patients with chronic kidney disease: a retrospective single-center cohort study. BMC Nephrol 2014; 15:189. [PMID: 25435421 PMCID: PMC4268815 DOI: 10.1186/1471-2369-15-189] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 11/25/2014] [Indexed: 01/13/2023] Open
Abstract
Background Excess extracellular volume is a major clinical problem in patients with chronic kidney disease (CKD). However, whether the extracellular volume status is associated with disease progression is unclear. We investigated the association between the extracellular volume status and renal outcomes. Methods We performed a retrospective cohort study of 149 patients with CKD who underwent bioelectrical impedance analysis (BIA) from 2005 to 2009. Patients were categorized according to tertiles of extracellular volume status. The extracellular volume status was assessed by examining the ratio of extracellular water measured by BIA (ECWBIA) to the total body water calculated using the Watson formula (TBWWatson). The main outcomes were adverse renal outcomes as defined by a decline of ≥50% from the baseline glomerular filtration rate or initiation of renal replacement therapy. Results A higher %ECWBIA/TBWWatson ratio tended to be associated with older age, male sex, diabetes mellitus, resistant hypertension, lower renal function, lower serum albumin levels, higher proteinuria levels, and a higher frequency of furosemide use. In the multivariate analysis, proteinuria remained independently associated with the %ECWBIA/TBWWatson ratio. Both the intracellular and extracellular water volumes decreased with age (correlation between ICW and age, r = -0.30, P < 0.001; correlation between ECW and age, r = -0.17, P = 0.03). Consequently, the %ECWBIA in the body fluid composition increased with age. During a median follow-up of 4.9 years, patients in the highest tertile of the %ECWBIA/TBWWatson ratio were at greater risk of adverse renal outcomes (16.6 per 100.0 patient years) than were those in the lowest tertile (8.1 per 100.0 patient years) or second tertile (5.6 per 100.0 patient years) (log-rank P = 0.005). After adjustment for covariates, the %ECWBIA/TBWWatson ratio was significantly associated with adverse renal outcomes (hazard ratio, 1.21; 95 % confidence interval, 1.10–1.34; P < 0.001). Conclusions The ECWBIA/TBWWatson ratio was independently associated with adverse renal outcomes. Proteinuria was independently associated with the extracellular volume status. The balance between ICW and ECW changes with age in that the percentage of ECW content in the body fluid composition increases. Elderly patients with CKD may thus be susceptible to volume overload. Electronic supplementary material The online version of this article (doi:10.1186/1471-2369-15-189) contains supplementary material, which is available to authorized users.
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Ohashi Y, Okamura M, Hirosawa A, Akatsuka A, Shiina I, Yoshimatsu K, Yamori T, Dan S. 574 M-COPA, a Golgi disruptor, inhibits cell surface expression of MET protein and exhibits antitumor activity against MET-addicted cancers. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ueki C, Sakaguchi G, Akimoto T, Shintani T, Ohashi Y, Sato H. 263 * INFLUENCE OF PREVIOUS PERCUTANEOUS CORONARY INTERVENTION ON CLINICAL OUTCOME OF CORONARY ARTERY BYPASS GRAFTING: A META-ANALYSIS OF COMPARATIVE STUDIES. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yamane Y, Sakai H, Kurimoto F, Sudo J, Tsuzuki H, Takahashi S, Hosomi Y, Tanai C, Yoh K, Goto Y, Ohashi Y, Kunitoh H. Observational Study of Treatment with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors (Egfr-Tki) in Activating Egfr Mutation-Positive (Egfrm+) Advanced or Recurrent Non-Small-Cell Lung Cancer (Nsclc) After Radiological Progression to First-Line Therapy with Egfr-Tki. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tsunoda K, Kumagai A, Tsunoda N, Ohashi Y, Takeda Y, Sugiyama Y. A case with a soft sarcoma after the complete cure of a primary malignant tumor of the salivary gland occurring at the same site. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Goto Y, Yoh K, Naito Y, Kishi K, Ohashi Y, Kunitoh H. Prospective Observational Cohort Study of Second-Line Chemotherapy Administration After the First-Line Platinum-Based Chemotherapy for Patients with Advanced Nsclc in Japan (Sapphire Study): Update Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ohsumi S, Mukai H, Ohashi Y. Factors Affecting Enrollment in a Randomized Controlled Trial for Japanese Metastatic Breast Cancer Patients (SELECT BC-FEEL)--A Prospective Study. Jpn J Clin Oncol 2014; 44:696-701. [DOI: 10.1093/jjco/hyu065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Onuigbo M, Agbasi N, Wu MJ, Shu KH, Kugler E, Cohen E, Krause I, Goldberg E, Garty M, Krause I, Jansen J, De Napoli IE, Schophuizen CM, Wilmer MJ, Mutsaers HA, Heuvel LP, Grijpma DW, Stamatialis D, Hoenderop JG, Masereeuw R, Van Craenenbroeck AH, Van Craenenbroeck EM, Van Ackeren K, Vrints CJ, Hoymans VY, Couttenye MM, Erkmen Uyar M, Tutal E, Bal Z, Guliyev O, Sezer S, Liu L, Wang C, Tanaka K, Kushiyama A, Sakai K, Hara S, Ubara Y, Ohashi Y, Kunugi Y, Kawazu S, Untersteller K, Seiler S, Rogacev KS, Emrich IE, Lennartz CS, Fliser D, Heine GH, Hoshino T, Ookawara S, Miyazawa H, Ueda Y, Ito K, Kaku Y, Hirai K, Mori H, Yoshida I, Kakuta S, Hayama N, Amemiya M, Okamoto H, Inoue S, Tabei K, Campos P, Dias C, Baptista J, Papoila AL, Ortiz A, Inchaustegui L, Soto K, Moon KH, Yang S, Lee DY, Kim HW, Kim B, Isnard Bagnis C, Guerraoui A, Zenasni F, Idier L, Chauveau P, Cerqueira A, Quelhas-Santos J, Pestana M, Choi JY, Jin DC, Choi YJ, Kim WY, Nam SA, Cha JH, Cernaro V, Loddo S, Lacquaniti A, Romeo A, Costantino G, Montalto G, Santoro D, Trimboli D, Ricciardi CA, Lacava V, Buemi M, Emrich IE, Zawada AM, Rogacev KS, Seiler S, Obeid R, Geisel J, Fliser D, Heine GH, Meneses GC, Silva Junior G, Costa MFB, Goncalves HS, Daher EF, Liborio AB, Martins AMC, Ekart R, Hojs N, Bevc S, Hojs R, Lim CS, Hwang JH, Chin HJ, Kim S, Kim DK, Kim S, Park JH, Shin SJ, Lee SH, Choi BS, Lemoine S, Panaye M, Juillard L, Dubourg L, Hadj-Aissa A, Guebre-Egziabher F, Silva Junior G, Vieira APF, Couto Bem AX, Alves MP, Meneses GC, Martins AMC, Liborio AB, Daher EF, Ito K, Ookawara S, Miyazawa H, Ueda Y, Kaku Y, Hirai K, Hoshino T, Mori H, Yoshida I, Tabei K, Stefan G, Capusa C, Stancu S, Margarit D, Petrescu L, Nedelcu ED, Mircescu G, Szarejko-Paradowska A, Rysz J, Hung CC, Chen HC, Ristovska V, Grcevska L, Podesta MA, Reggiani F, Cucchiari D, Badalamenti S, Buemi M, Ponticelli C, Graziani G, Nouri-Majalan N, Moghadasimousavi S, Eshaghyeh Z, Greenwood S, Koufaki P, Maclaughlin H, Rush R, Hendry BM, Macdougall IC, Mercer T, Cairns H. CKD LAB METHODS, PROGRESSION & RISK FACTORS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Ohashi Y, Kobayashi S, Arai T, Nemoto T, Aoki C, Nagata M, Sakai K. Focal Segmental Glomerulosclerosis Secondary to Juxtaglomerular Cell Tumor during Pregnancy: A Case Report. Case Rep Nephrol Dial 2014; 4:88-94. [PMID: 24926309 PMCID: PMC4035682 DOI: 10.1159/000362757] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Juxtaglomerular cell tumor is a rare renal neoplasm. Secondary hypertension with juxtaglomerular cell tumor can be seen in females in their 20s and 30s. We present a case of juxtaglomerular cell tumor during pregnancy. A 32-year-old female was hospitalized for refractory hypertension and nephrotic syndrome in the 23rd gestational week. One year before admission, she had been diagnosed with hypertension; plasma renin activity at that time had been 2.3 ng/ml/h. Her blood pressure was uncontrolled during pregnancy, and proteinuria was detected in the 12th gestational week despite the administration of antihypertensive medications. Laboratory data showed proteinuria, hypokalemia, and hypoalbuminemia. In the 25th gestational week, she underwent surgical termination of the pregnancy because of congestive heart failure and acute renal injury. After the termination of the pregnancy and the delivery of a viable fetus, her hypertension and nephrotic syndrome were found to persist with a high plasma renin activity (13 ng/ml/h). Ultrasonography showed a 5.5-cm left renal cystic mass with a partially solid component at the lower renal pole. The left kidney with the renal mass was excised by laparoscopic nephrectomy. Plasma renin activity normalized the next day, with a decrease in blood pressure to 120–130/80–90 mm Hg; however, proteinuria remained at ≥3.5 g/day. On the basis of histopathological findings, the patient was diagnosed with a juxtaglomerular cell tumor and focal segmental glomerulosclerosis. Juxtaglomerular cell tumor is a rare renin-secreting tumor associated with refractory hypertension in young females and is a possible cause of hypertension during pregnancy.
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Shima Y, Kitaoka K, Nakase J, Goshima K, Takahashi R, Toratani T, Kosaka M, Ohashi Y, Tsuchiya H, Munehiro T, Aiba T. YOUNG FEMALE ATHLETES HAVE CHANGED CONSIDERABLY IN THE TWO YEARS AFTER BASELINE EVALUATION IN A PROSPECTIVE STUDY. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sugiyama T, Fujiwara K, Ohashi Y, Yokota H, Hatae M, Ohno T, Nagai Y, Mitsuhashi N, Ochiai K, Noda K. Phase III placebo-controlled double-blind randomized trial of radiotherapy for stage IIB-IVA cervical cancer with or without immunomodulator Z-100: a JGOG study. Ann Oncol 2014; 25:1011-7. [PMID: 24569914 DOI: 10.1093/annonc/mdu057] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Based on the result of our previous study showing better overall survival (OS) at the lower dose (0.2 µg) of immunomodulator Z-100 than higher dose (40 µg) in patients with locally advanced cervical cancer who received radiotherapy, we conducted a placebo-controlled double-blind randomized trial. PATIENTS AND METHODS Patients of stages IIB-IVA squamous cell carcinoma of the uterine cervix were randomly assigned to receive Z-100 at 0.2 µg (Z) or placebo (P). The study agent was given subcutaneously twice a week during the radiotherapy, followed by maintenance therapy by administering once every 2 weeks until disease progression. Primary end point was OS, and secondary end points were recurrence-free survival, and toxicity. RESULTS A total of 249 patients were randomized. Death events occurred extremely slower than expected, and Independent Data Monitoring Committee recommended to analyze the survival result prematurely. The 5-year OS rate was 75.7% [95% confidence interval (CI) 66.4% to 82.8%] for Arm Z and 65.8% (95% CI 56.2% to 73.8%) for Arm P (P = 0.07); hazard ratio was 0.65 (95% CI 0.40-1.04). Survival benefit in Arm Z was observed regardless of chemoradiation or radiation alone. There was no trend in recurrence-free survival between the two arms. Side-effects were not different between two arms. CONCLUSION Z-100 showed a trend of improvement on OS in locally advanced cervical cancer, although the statistical power was less than anticipated because survival rates were unexpectedly higher than expected for both arms. Validation of potential survival benefit of immune modulation should be made. TRIAL REGISTRATION umin.ac.jp/ctr Identifier: C000000221.
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Ohashi Y, Masubuchi Y, Venkateshwarlu D, Ganesan V, Yakhmi J, Yoshida T, Kikkawa S. Local structure around the flux pinning centers in superconducting niobium silicon oxynitride (Nb0.87Si0.09□0.04)(N0.87O0.13). J SOLID STATE CHEM 2014. [DOI: 10.1016/j.jssc.2013.11.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ohtani S, Masuda N, Im YH, Im SA, Park BW, Kim SB, Yanagita Y, Takao S, Ohno S, Aogi K, Iwata H, Yoshidome K, Nishimura R, Ohashi Y, Lee SJ, Toi M. Abstract P3-12-03: Adjuvant capecitabine in breast cancer patients with pathologic residual disease after neoadjuvant chemotherapy: First safety analysis of CREATE-X (JBCRG-04). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-12-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Patients (pts) without pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) have a poor prognosis compared with pts achieving a pCR with NAC. It is not clear whether further systemic chemotherapy is beneficial for pts with no pCR. CREATE-X (UMIN000000843) is an ongoing collaborative Korean (KRN)/Japanese (JPN) prospective multicenter open-label randomized phase III trial evaluating this clinical question using capecitabine (X) in pts with no pCR after NAC. We report first safety results, focusing on hand-foot syndrome (HFS), the timing of radiotherapy (RT) and hormone therapy (HT), and differences between KRN and JPN pts.
Methods
Pts with residual invasive cancer after anthracycline- and/or taxane-containing NAC were randomized to standard post-surgical treatment (RT, HT as appropriate) with or without 8 cycles of X (1250 mg/m2 bid, days 1–14 q3w). RT was given before or after X. Pts with hormone receptor (HR)-positive disease received HT either with or after X, according to each center's prespecified standard practice. After evaluation of the tolerability of 6 cycles of X in the first 50 pts, the independent data monitoring committee recommended extending X to 8 cycles.
Results
Between Feb 2007 and Jul 2012, 910 pts were enrolled (304 in Korea, 606 in Japan). At the time of data cut-off (May 20, 2013), data were available from 866 pts. Median age was 48 years in both arms. In the investigational arm, RT was given before X in 260 pts and after X in 33 pts; 73 pts received prophylactic vitamin B6 (VB6). In HR-positive pts HT was given with X in 200 pts and after X in 24 pts. The relative dose intensity of X was 85.7% in JPN pts and 95.2% in KRN pts. Grade (G) 3/4 neutropenia, HFS (G3 only), fatigue, and diarrhea were significantly (p<0.05) more common with X than no X. G3 HFS occurred in 11.1% of pts receiving X, and was significantly more common in JPN vs KRN pts (p = 0.016). No significant difference in HFS was observed between pts who received vs did not receive VB6 (p = 0.392). G3/4 alanine aminotransferase (ALT) abnormalities were significantly more common in pts receiving RT after vs before X (p<0.001) and in pts receiving HT after vs concurrently with X (p<0.001).
n/N(%) Investigational armControl arm (n = 430)(n = 436)HR status Positive275/430(64)275/436(63)Negative141/430(33)143/436(33)Unknown14/430(3)18/436(4)G 3/4 toxicity Neutropenia36/385(9)5/326(2)Fatigue6/426(1)0/417(0)Diarrhea12/426(3)1/417(<1)HFS(G3)47/424(11)0 JPN40/296(14)0 KRN7/128(5)0 VB66/73(8)- No VB641/351(12)-ALT abnormality10/409(2)3/391(<1) with RT8/285(3)1/280(<1) X → RT8/31(26)- RT → X0/254(0)- without RT2/124(2)2/111(2) with HT2/214(1)1/267(<1) X + HT0/190(0)- X → HT2/24(8)- wothout HT8/195(4)2/124(2)
Conclusions
Addition of 8 cycles of X to standard adjuvant therapy is feasible and tolerable, resulting in a modest yet acceptable increase in toxicities. The timing of RT and HT administration relative to X influenced the incidence of adverse events. HFS was more common in JPN than KRN pts, although further investigation of the potential cause of this difference is required. These findings should be interpreted in light of efficacy data, expected in 2015.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-12-03.
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Ichikawa W, Uehara K, Minamimura K, Tanaka C, Takii Y, Morita S, Ando Y, Sugiyama T, Ohashi Y, Sakata Y. Nomogram for Prediction of Toxicities in Advanced Colorectal Cancer (ACRC) Treated with Irinotecan (IRI)-Based Regimens. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt459.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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73
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Takano M, Yamamoto K, Tabata T, Minegishi Y, Yokoyama T, Morita S, Ando Y, Sugiyama T, Ohashi Y, Sakata Y. Evaluation of UGT1A1 Genotyping for Predicting Individual Toxicity of Irinotecan Plus Platinum Analog Regimens. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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74
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Iwata F, Ohashi Y, Ishisaki I, Picco L, Ushiki T. Development of nanomanipulator using a high-speed atomic force microscope coupled with a haptic device. Ultramicroscopy 2013; 133:88-94. [DOI: 10.1016/j.ultramic.2013.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 05/29/2013] [Accepted: 06/20/2013] [Indexed: 11/29/2022]
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75
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Ohashi Y, Thomas G, Nurko S, Stephany B, Fatica R, Chiesa A, Rule AD, Srinivas T, Schold JD, Navaneethan SD, Poggio ED. Association of metabolic syndrome with kidney function and histology in living kidney donors. Am J Transplant 2013; 13:2342-51. [PMID: 23865821 PMCID: PMC3886854 DOI: 10.1111/ajt.12369] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/06/2013] [Accepted: 05/08/2013] [Indexed: 01/25/2023]
Abstract
The selection of living kidney donors is based on a formal evaluation of the state of health. However, this spectrum of health includes subtle metabolic derangements that can cluster as metabolic syndrome. We studied the association of metabolic syndrome with kidney function and histology in 410 donors from 2005 to 2012, of whom 178 donors were systematically followed after donation since 2009. Metabolic syndrome was defined as per the NCEP ATPIII criteria, but using a BMI > 25 kg/m(2) instead of waist circumference. Following donation, donors received counseling on lifestyle modification. Metabolic syndrome was present in 50 (12.2%) donors. Donors with metabolic syndrome were more likely to have chronic histological changes on implant biopsies than donors with no metabolic syndrome (29.0% vs. 9.3%, p < 0.001). This finding was associated with impaired kidney function recovery following donation. At last follow-up, reversal of metabolic syndrome was observed in 57.1% of donors with predonation metabolic syndrome, while only 10.8% of donors developed de novo metabolic syndrome (p < 0.001). In conclusion, metabolic syndrome in donors is associated with chronic histological changes, and nephrectomy in these donors was associated with subsequent protracted recovery of kidney function. Importantly, weight loss led to improvement of most abnormalities that define metabolic syndrome.
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