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Honma M, Kanai Y, Murotani K, Ito K, Ohata C, Yamazaki F, Saeki H, Seishima M, Mizutani Y, Kitabayashi H, Imafuku S. Effectiveness of brodalumab in improving itching and skin pain in Japanese patients with psoriasis: The
ProLOGUE
study. J Dermatol 2022; 50:453-461. [PMID: 36540010 DOI: 10.1111/1346-8138.16682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/31/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
Itching and skin pain are bothersome symptoms of psoriasis, but evidence is limited regarding the treatment effectiveness on these symptoms in daily clinical settings. We assessed the changes in the levels of itching and skin pain after brodalumab treatment in Japanese patients with psoriasis using patient-reported outcomes (PROs). Patients with psoriasis who have inadequate response to existing treatments were enrolled in the single-arm, open-label, multicenter, prospective ProLOGUE study and received brodalumab 210 mg subcutaneously in daily clinical practice. Psoriasis Area and Severity Index (PASI) and PRO assessments were performed at baseline and weeks 12 and 48. Seventy-three patients (men, 82.2%; median age, 54.0 years) were enrolled. The Itch Numeric Rating Scale (NRS; p < 0.0001 at weeks 12 and 48) and Skin Pain NRS (week 12, p = 0.0004; week 48, p < 0.0001) scores significantly decreased from baseline. The Itch NRS score was significantly higher in patients with a Dermatology Life Quality Index (DLQI) score of ≥2 (vs. 0/1; p < 0.0001 at weeks 12 and 48) and in patients with a Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9) global satisfaction domain score of ≤70% (vs. >70%; week 12, p = 0.0120; week 48, p = 0.0348). The Itch NRS score cutoff value for achieving a PASI score of ≤2, DLQI score of 0/1, and TSQM-9 global satisfaction domain score of >70% was 1 at week 12 and 0 at week 48. Brodalumab treatment was associated with improvement in itching and skin pain in Japanese patients with psoriasis. An Itch NRS score of 0 can be a long-term treatment goal for psoriasis (Japan Registry of Clinical Trials identifier: jRCTs031180037).
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Affiliation(s)
- Masaru Honma
- Department of Dermatology Asahikawa Medical University Asahikawa Japan
| | | | | | - Kei Ito
- Department of Dermatology JR Sapporo Hospital Sapporo Japan
| | - Chika Ohata
- Department of Dermatology Osaka General Medical Center Osaka Japan
| | | | - Hidehisa Saeki
- Department of Dermatology Nippon Medical School Tokyo Japan
| | - Mariko Seishima
- Department of Dermatology Gifu University Graduate School of Medicine Gifu Japan
| | - Yoko Mizutani
- Department of Dermatology Gifu University Graduate School of Medicine Gifu Japan
| | | | - Shinichi Imafuku
- Department of Dermatology Fukuoka University Faculty of Medicine Fukuoka Japan
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Saeki H, Kanai Y, Murotani K, Ito K, Miyagi T, Takahashi H, Tada Y, Higashiyama M, Hashimoto Y, Kitabayashi H, Imafuku S. Work productivity in real-life employed patients with plaque psoriasis: Results from the ProLOGUE study. J Dermatol 2022; 49:970-978. [PMID: 35856276 PMCID: PMC9796840 DOI: 10.1111/1346-8138.16517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/23/2022] [Accepted: 06/21/2022] [Indexed: 01/07/2023]
Abstract
Psoriasis poses a substantial economic burden by reducing the work productivity of affected patients. We aimed to evaluate the negative impact of plaque psoriasis on work productivity and effectiveness of brodalumab in improving work productivity impairment in real-life employed patients. This analysis was conducted in employed patients from ProLOGUE, an open-label, multicenter, prospective cohort study (Japan Registry of Clinical Trials identifier: jRCTs031180037). Outcomes included association of Work Productivity and Activity Impairment-Psoriasis (WPAI-PSO) domain scores with scores from various patient-reported outcome measures or Psoriasis Area and Severity Index (PASI) scores at baseline. Change from baseline in WPAI-PSO domain scores following brodalumab treatment was also evaluated. Of the 73 patients enrolled, 51, 48, and 40 patients were considered employed at baseline, Week 12, and Week 48 of brodalumab treatment, respectively. In the model adjusted by age and sex, the work productivity loss score correlated with the Dermatology Life Quality Index (DLQI), itch Numeric Rating Scale (NRS), Patient Health Questionnaire-8 (PHQ-8), and skin pain NRS scores (partial Spearman correlation coefficient [ρ] = 0.608, 0.510, 0.461, and 0.424, respectively); presenteeism score correlated with the DLQI, itch NRS, and skin pain NRS scores (ρ = 0.568, 0.500, and 0.403, respectively); and activity impairment score correlated with the DLQI and PHQ-8 scores (ρ = 0.530 and 0.414, respectively). None of the WPAI-PSO domain scores correlated with the PASI score. All WPAI-PSO domain scores (except absenteeism) significantly reduced from baseline to Weeks 12 (p < 0.0001) and 48 (p < 0.001) with brodalumab treatment. In conclusion, work productivity impairment in psoriasis was associated with various subjective symptoms that can be captured using patient-reported outcome measures. Brodalumab treatment improved work productivity in real-life employed patients with plaque psoriasis.
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Affiliation(s)
- Hidehisa Saeki
- Department of DermatologyNippon Medical SchoolTokyoJapan
| | | | | | - Kei Ito
- Department of DermatologyJR Sapporo HospitalSapporo‐shiJapan
| | - Takuya Miyagi
- Department of DermatologyUniversity of the RyukyusOkinawaJapan
| | | | - Yayoi Tada
- Department of DermatologyTeikyo University School of MedicineTokyoJapan
| | | | - Yuki Hashimoto
- Department of DermatologyToho University School of MedicineTokyoJapan
| | | | - Shinichi Imafuku
- Department of DermatologyFukuoka University Faculty of MedicineFukuokaJapan
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Imafuku S, Ohata C, Okubo Y, Tobita R, Saeki H, Mabuchi T, Hashimoto Y, Murotani K, Kitabayashi H, Kanai Y. Effectiveness of brodalumab in achieving treatment satisfaction for patients with plaque psoriasis: the ProLOGUE study. J Dermatol Sci 2022; 105:176-184. [DOI: 10.1016/j.jdermsci.2022.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/25/2022] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
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Ohata C, Kanai Y, Murotani K, Kitabayashi H, Imafuku S. Difference in health-related quality of life between anxiety and depressive symptoms in Japanese patients with plaque psoriasis: the ProLOGUE study. J Eur Acad Dermatol Venereol 2021; 36:e57-e59. [PMID: 34418174 PMCID: PMC9292753 DOI: 10.1111/jdv.17621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022]
Affiliation(s)
- C Ohata
- Department of Dermatology, Osaka General Medical Center, Osaka, Japan
| | - Y Kanai
- Medical Affairs, Kyowa Kirin Co., Ltd., Tokyo, Japan
| | - K Murotani
- Biostatistics Center, Kurume University, Fukuoka, Japan
| | - H Kitabayashi
- Medical Affairs, Kyowa Kirin Co., Ltd., Tokyo, Japan
| | - S Imafuku
- Department of Dermatology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
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Yamamoto S, Bieber BA, Komaba H, Hanafusa N, Kitabayashi H, Nomura T, Cases A, Combe C, Pisoni RL, Robinson BM, Fukagawa M. Medical Director Practice of Advising Increased Dietary Protein Intake in Hemodialysis Patients With Hyperphosphatemia: Associations With Mortality in the Dialysis Outcomes and Practice Patterns Study. J Ren Nutr 2021; 32:243-250. [PMID: 33820694 DOI: 10.1053/j.jrn.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/11/2021] [Accepted: 02/14/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Patients undergoing hemodialysis (HD) may have poor nutritional status and hyperphosphatemia. Nephrologists sometimes manage hyperphosphatemia by prescribing phosphate binders and/or recommending restriction of dietary phosphate including protein-rich foods; the later may, however, adversely affect nutritional status. DESIGN AND METHODS The analysis includes 8805 HD patients on dialysis ≥ 120 days in 12 countries in Dialysis Outcomes and Practice Patterns Study (DOPPS) phase 4 (2009-2011), from 248 facilities. The primary exposure variable was response to the following question: "For patients with serum albumin 3.0 g/dL and phosphate 6.0 mg/dL, do you recommend to (A) increase or (B) decrease/no change in dietary protein intake (DPI)?". The association between medical director's practice of recommending an increase in DPI and all-cause mortality was analyzed with Cox regression adjusted for potential confounders. Linear and logistic regressions were used to model the cross-sectional associations between DPI advice practice and intermediate markers of patient nutrition. RESULTS Median follow-up was 1.6 years. In the case scenario, 91% of medical directors in North America had a practice of recommending DPI increase compared to 58% in Europe (range = 36%-83% across 7 countries) and 56% in Japan. The practice of advising DPI increase was weakly associated with lower mortality [HR (95% CI): 0.88 (0.76-1.02)]. The association tended to be stronger in patients with age 70+ years [HR (95% CI): 0.82 (0.69-0.97), P = .12 for interaction]. The practice of advising DPI increase was associated with 0.276 mg/dL higher serum creatinine levels (95% CI: 0.033-0.520) after adjustment for case mix. CONCLUSIONS Medical director's practice of recommending an increase in DPI for HD patients with low albumin and high phosphate levels was associated with higher serum creatinine levels and potentially lower all-cause mortality. To recommend protein intake liberalization in parallel with phosphate management by physicians may be a critical practice for better nutritional status and outcomes in HD patients.
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Affiliation(s)
- Suguru Yamamoto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Brian A Bieber
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | - Hirotaka Komaba
- Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan
| | - Norio Hanafusa
- Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Takanobu Nomura
- Medical Affairs Department, Kyowa Kirin Co. Ltd., Tokyo, Japan
| | - Aleix Cases
- Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Ronald L Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | | | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan
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Yamaguchi Y, Kanai Y, Kitabayashi H, Okada H, Nakagawa H. Relationship between serum trough levels and efficacy of brodalumab from a post hoc exploratory analysis of a Japanese study in patients with plaque psoriasis. J Dermatol 2020; 48:324-333. [PMID: 33161605 PMCID: PMC7984373 DOI: 10.1111/1346-8138.15690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/18/2020] [Indexed: 11/29/2022]
Abstract
Previous clinical studies have shown that efficacy and serum brodalumab levels are dose dependent in patients with psoriasis receiving the same dose of brodalumab during the study. This study aimed to investigate the association between dosage, serum levels, and efficacy of brodalumab in Japanese patients with plaque psoriasis with dosage variations during the study. This was a post hoc exploratory analysis of a 108‐week, multicenter, open‐label extension study, which changed into a post‐marketing surveillance study following brodalumab approval in Japan. Eligible patients with plaque psoriasis (n = 129) received brodalumab 140 mg every 4 weeks on Day 1; dosage change at physician’s discretion from 140 mg every 8 weeks to 210 mg every 2 weeks was permitted; patients switched to 210 mg every 2 weeks during the post‐marketing surveillance study. Exploratory endpoints included serum brodalumab levels at Weeks 28 and 108, its association with Psoriasis Area and Severity Index score, and Psoriasis Area and Severity Index score in patients receiving brodalumab 210 mg every 2 weeks at end of study. Median brodalumab trough levels were significantly higher (P < 0.05) at higher vs. lower dosages at Weeks 28 (n = 126) and 108 (n = 111) except for 140 mg every 2 weeks vs. 210 mg every 2 weeks at Week 108 and higher in patients with lower Psoriasis Area and Severity Index scores—significantly different only for Psoriasis Area and Severity Index score 0 vs. >2 at Week 28 (P = 0.0153). Of 100 patients receiving 210 mg every 2 weeks at end of study, 89% had a Psoriasis Area and Severity Index score ≤2. In patients with plaque psoriasis, brodalumab efficacy may depend upon sustained serum trough levels and can be restored by using the approved dose.
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Affiliation(s)
- Yukie Yamaguchi
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | | | - Hiroki Okada
- Clinical Sciences Research Laboratories, Translational Research Unit, R&D Division, Kyowa Kirin Co., Ltd., Tokyo, Japan
| | - Hidemi Nakagawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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Hattori N, Kitabayashi H, Kanda T, Nomura T, Toyama K, Mori A. A Pooled Analysis From Phase 2b and 3 Studies in Japan of Istradefylline in Parkinson's Disease. Mov Disord 2020; 35:1481-1487. [PMID: 32501582 PMCID: PMC7496465 DOI: 10.1002/mds.28095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 04/17/2020] [Accepted: 04/19/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Characterization of patient factors associated with istradefylline efficacy may facilitate personally optimized treatment. OBJECTIVES We aimed to examine which patient factors are associated with favorable istradefylline treatment outcomes in PD patients with motor complications. METHODS We performed a pooled analysis of data from two identical phase 2b and 3 Japanese studies of istradefylline. Logistic regression models were used to assess the association of 12 patient characteristics with favorable outcomes. RESULTS Off time reduction and increased good on time with istradefylline provided a significantly favorable response in patients aged ≥65 years. Off time reduction was more favorable in patients with ≥8-hour daily off time at baseline. Improvement in UPDRS Part III was favorable in patients with UPDRS Part III baseline score ≥ 20. CONCLUSIONS Several patient factors influenced the effect of istradefylline on motor fluctuations, motor function, activities of daily living, and clinical impression. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Tomoyuki Kanda
- Medical Affairs Department, Kyowa Kirin Co., Ltd., Tokyo, Japan
| | - Takanobu Nomura
- Medical Affairs Department, Kyowa Kirin Co., Ltd., Tokyo, Japan
| | - Keizo Toyama
- R&D Division, Kyowa Kirin Co., Ltd., Tokyo, Japan
| | - Akihisa Mori
- Medical Affairs Department, Kyowa Kirin Co., Ltd., Tokyo, Japan
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Yamamoto S, Bieber B, Komaba H, Kitabayashi H, Nomura T, Cases A, Combe C, Pisoni R, Robinson B, Fukagawa M. P1455PRIORITIZATION BY MEDICAL DIRECTORS OF NUTRITIONAL PROTEIN VERSUS DIETARY PHOSPHORUS CONTROL IN HEMODIALYSIS PATIENTS: ASSOCIATION WITH MORTALITY IN THE DIALYSIS OUTCOMES AND PRACTICE PATTERNS STUDY (DOPPS). Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and Aims
Patients undergoing dialysis for end-stage kidney disease (ESKD) have poorer nutritional status than the general population, and worse nutritional status is associated with poor clinical outcomes. Hyperphosphatemia is common in dialysis patients owing to abnormal mineral and bone metabolism. Nephrologists manage hyperphosphatemia by prescribing phosphate binders and/or recommending restriction of dietary protein intake; the latter may, however, adversely affect nutritional status. In this analysis, we address the hypothesis that, even in the presence of hyperphosphatemia, liberalizing dietary protein leads to better patient outcomes.
Method
The analysis includes 11,628 hemodialysis (HD) patients in 12 countries in DOPPS phase 4 (2009-2011), from 254 facilities where the medical director completed a survey reporting facility practices. Demographic data, comorbid conditions, laboratory values, and medications were abstracted from patient records. Mortality was assessed during study follow-up. The primary exposure variable was response to the following question: “For patients with serum albumin 3.0 g/dL and phosphate 6.0 mg/dL, do you typically recommend to (A) increase or (B) not change or decrease dietary protein intake?” The primary outcome was all-cause mortality, analyzed by Cox regression, stratified by country, accounting for facility clustering using robust sandwich covariance estimators, and adjusted for case-mix and laboratory values. Linear regression was used to model the associations between the exposure variable and intermediate nutritional markers including serum albumin, creatinine, and phosphorus. We used multiple imputation to replace missing values for model covariates.
Results
Median follow-up was 1.4 years. In the case scenario, 91% of medical directors in North America recommended to increase protein intake compared to 58% in Europe (range=36-83% across 7 countries) and 56% in Japan (Figure). Advice to increase dietary protein intake was associated with 0.33 mg/dL higher serum creatinine levels (95% CI: 0.08-0.57) after adjustment for case mix, while clinically meaningful associations were not observed for serum albumin and phosphorus. Advice to increase dietary protein intake was weakly associated with lower mortality [HR (95% CI): 0.89 (0.77-1.03)]. The association with survival was stronger in patients with age 70+ years [HR (95% CI): 0.81(0.68-0.96), P=0.08 for interaction] and for those without diabetes [HR (95% CI): 0.81(0.66-0.98), P=0.20 for interaction]
Conclusion
In this large international cohort study, the medical director’s stated preference to recommend an increase in dietary protein intake for HD patients with low albumin and high phosphorus levels was most common in North America and was associated with higher patient serum creatinine levels and potentially lower all-cause mortality. Additional research into the possible benefits of protein intake liberalization for HD patients, even in the presence of hyperphosphatemia, is warranted.
This abstract was directly supported by Kyowa Kirin Co.,Ltd..
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Affiliation(s)
- Suguru Yamamoto
- Niigata University Graduate School of Medical and Dental Sciences, Division of Clinical Nephrology and Rheumatology, Niigata, Japan
| | - Brian Bieber
- Arbor Research Collaborative for Health, United States of America
| | - Hirotaka Komaba
- Tokai University School of Medicine, Division of Nephrology, Endocrinology and Metabolism, Isehara, Japan
| | | | - Takanobu Nomura
- Kyowa Hakko Kirin Co. Ltd., Medical Affairs Department, Isehara, Japan
| | | | | | - Ronald Pisoni
- Arbor Research Collaborative for Health, United States of America
| | - Bruce Robinson
- Arbor Research Collaborative for Health, United States of America
| | - Masafumi Fukagawa
- Tokai University School of Medicine, Division of Nephrology, Endocrinology and Metabolism, Isehara, Japan
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Hashimoto T, Kitabayashi H, Ito K, Nasu H, Ishihara A, Nishio Y. Effect of heat-treatment on the pH sensitivity of stainless-steel electrodes as pH sensors. Heliyon 2019; 5:e01239. [PMID: 30976665 PMCID: PMC6441752 DOI: 10.1016/j.heliyon.2019.e01239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/18/2019] [Accepted: 02/07/2019] [Indexed: 11/20/2022] Open
Abstract
Effect of heat-treatment on the pH sensitivity of uncoated stainless-steel electrodes was investigated to comprehend the pH sensitivity of metal-oxide coated stainless-steel electrodes as novel pH sensors. The pH sensitivity of stainless-steel electrodes as-received and heat-treated at 500 °C, 600 °C and 700 °C for 24 h were 91 %, 94 %, 102 % and 91 %, respectively. The pH sensitivity tended to increase with increasing heat-treatment time at a given temperature. Thus, the most suitable heat-treatment condition for the stainless-steel electrodes was 600 °C for 24 h. The austenite phase (fcc) was the main phase on the surface of the heat-treated stainless-steel electrodes. Unexpectedly, the change in the martensite phase (bcc) as the second phase with heat-treatment temperature was similar to the pH sensitivity, with the martensite phase affecting the pH sensitivity. Therefore, it appeared that the pH sensitivity of the metal-oxide coated stainless-steel electrodes was affected by the underlying stainless-steel as well as the outer metal-oxide film coating. A prototype stainless-steel tube electrode was used as a working electrode for demonstrating the depth profiling of pH. The stainless-steel tube electrode showed good performance for measuring pH depth profiles compared to commercially available glass electrodes.
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Yui H, Otagiri K, Nakamura C, Sakai T, Kitabayashi H. P2306Impact of gender difference on abdominal fat accumulation and coronary artery disease severity stratified by computed tomography-derived SYNTAX score. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tomotake H, Yamamoto N, Kitabayashi H, Kawakami A, Kayashita J, Ohinata H, Karasawa H, Kato N. Preparation of Tartary Buckwheat Protein Product and Its Improving Effect on Cholesterol Metabolism in Rats and Mice Fed Cholesterol-Enriched Diet. J Food Sci 2007; 72:S528-33. [DOI: 10.1111/j.1750-3841.2007.00474.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kato H, Yamada S, Yasuda S, Yamaguchi K, Kitabayashi H, Kamada T, Mizoe JE, Ohto M, Tsujii H. Two-fraction carbon ion radiotherapy for hepatocellular carcinoma: Preliminary results of a phase I/II clinical trial. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4124] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. Kato
- National Institute of Radiological Sciences, Chiba, Japan
| | - S. Yamada
- National Institute of Radiological Sciences, Chiba, Japan
| | - S. Yasuda
- National Institute of Radiological Sciences, Chiba, Japan
| | - K. Yamaguchi
- National Institute of Radiological Sciences, Chiba, Japan
| | - H. Kitabayashi
- National Institute of Radiological Sciences, Chiba, Japan
| | - T. Kamada
- National Institute of Radiological Sciences, Chiba, Japan
| | - J.-E. Mizoe
- National Institute of Radiological Sciences, Chiba, Japan
| | - M. Ohto
- National Institute of Radiological Sciences, Chiba, Japan
| | - H. Tsujii
- National Institute of Radiological Sciences, Chiba, Japan
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Yokoseki O, Suzuki J, Kitabayashi H, Watanabe N, Wada Y, Aoki M, Morishita R, Kaneda Y, Ogihara T, Futamatsu H, Kobayashi Y, Isobe M. cis Element decoy against nuclear factor-kappaB attenuates development of experimental autoimmune myocarditis in rats. Circ Res 2001; 89:899-906. [PMID: 11701617 DOI: 10.1161/hh2201.099373] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nuclear factor-kappaB (NFkappaB) plays a significant role in the coordinated transactivation of cytokine, inducible NO synthase (iNOS), and adhesion molecule genes. Although inflammation is an essential pathological feature of myocarditis, the role of NFkappaB in this process remains obscure. We examined the role of NFkappaB in the progression of rat experimental autoimmune myocarditis (EAM) and tested the hypothesis that NFkappaB blockade with a decoy against the cis element of NFkappaB can prevent the progression of EAM. Lewis rats were immunized with purified porcine cardiac myosin to establish EAM on day 0. NFkappaB decoy was infused into the rat coronary artery on day 0 (group NF0), 7 (group NF7), or 14 (group NF14) and harvested on day 21. Scrambled decoy was infused on day 0 (group SD0), 7 (group SD7), or 14 (group SD14) and served for control groups. The ratios of myocarditis-affected areas to the ventricular cross-sectional area of all treatment groups were significantly lower than those of the control groups (group NF0, 33+/-18% versus SD0, 53+/-14%; group NF7, 19+/-15% versus SD7, 50+/-16%; and group NF14, 34+/-10% versus SD14, 52+/-14%). Immunohistochemical and immunoblot analyses showed expression of ICAM-1, iNOS, IL-2, and TNFalpha in myocardium of scrambled decoy groups, and this expression was effectively suppressed by NFkappaB decoy treatment. Thus, we found that NFkappaB is a key regulator in the progression of EAM and that in vivo transfection of NFkappaB decoy reduces the severity of EAM.
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Affiliation(s)
- O Yokoseki
- Department of Internal Medicine I, Shinshu University School of Medicine, Nagano, Japan
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Tanaka H, Kinoshita O, Uchikawa S, Kasai H, Nakamura M, Izawa A, Yokoseki O, Kitabayashi H, Takahashi W, Yazaki Y, Watanabe N, Imamura H, Kubo K. Successful prevention of recurrent ventricular fibrillation by intravenous isoproterenol in a patient with Brugada syndrome. Pacing Clin Electrophysiol 2001; 24:1293-4. [PMID: 11523620 DOI: 10.1046/j.1460-9592.2001.01293.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Intravenous administration of isoproterenol restored the ST-segment configuration to nearly normal in the right precordial leads and completely prevented spontaneous VF attacks in a patient with Brugada syndrome. The formation of a Brugada-type ECG has been attributed to the transmural dispersion of repolarization of the right ventricular epicardium and related to modulation of the autonomic nervous system. Our case may provide clues to the pathophysiological mechanism of this syndrome.
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Affiliation(s)
- H Tanaka
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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Kitabayashi H, Smith PM. Analysis of SAW propagation in gratings on ZnO/diamond substrates. IEEE Trans Ultrason Ferroelectr Freq Control 2001; 48:249-261. [PMID: 11367792 DOI: 10.1109/58.896137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The space harmonic method is used to analyze surface acoustic wave (SAW) propagation under an infinite periodic metal grating on ZnO/diamond composite layered substrates. Dispersion properties for shorted and open gratings are derived as a function of the thickness of the grating electrodes. From these dispersion relations, the coupling of modes (COM) parameters are derived. Energy profiles inside ZnO/diamond show that the energies contained in each of the ZnO and diamond layers are of the same order when the thickness of the ZnO layer is P/pi (P = grating period) and that the energy is contained within two wavelengths below the ZnO/diamond interface.
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Affiliation(s)
- H Kitabayashi
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada L8S 4K1
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Imamura H, Momose T, Kitabayashi H, Takahashi W, Yazaki Y, Takenaka H, Isobe M, Sekiguchi M, Kubo K. Pulmonary hypertension as a result of asymptomatic portosystemic shunt. Jpn Circ J 2000; 64:471-3. [PMID: 10875741 DOI: 10.1253/jcj.64.471] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This report describes a patient with severe pulmonary hypertension accompanied by a congenital intrahepatic portosystemic shunt. Primary pulmonary hypertension was suspected initially because none of the classic symptoms of a portosystemic shunt were present. Physicians should note that disorders of the portal system may cause pulmonary hypertension even in the absence of symptoms suggesting liver disease.
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Affiliation(s)
- H Imamura
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
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17
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Kitabayashi H, Isobe M, Watanabe N, Suzuki J, Yazaki Y, Sekiguchi M. FTY720 prevents development of experimental autoimmune myocarditis through reduction of circulating lymphocytes. J Cardiovasc Pharmacol 2000; 35:410-6. [PMID: 10710126 DOI: 10.1097/00005344-200003000-00010] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
FTY720 is a new immunosuppressant agent and selectively decreases the number of circulating lymphocytes. In this study, we compared the effects of FTY720 with those of tacrolimus on experimental autoimmune myocarditis (EAM) in rats. A significant decrease in circulating lymphocyte counts was noted after a single administration of FTY720 in normal rats. At day 0, 7-week-old male Lewis rats were immunized with purified porcine cardiac myosin emulsified in complete Freund's adjuvant. FTY720 or tacrolimus was administered intraperitoneally daily. The number of myocarditis-affected areas in the FTY720 treatment groups with doses of 0.1 mg/kg/ day was significantly lower than those in control groups at days 14 and 28. In addition, at day 28, the myocarditis-affected areas in the FTY720 treatment group were significantly smaller than those in the tacrolimus treatment group receiving the same dose. Effects of early administration (days 0-10) and delayed administration (days 11-20) of FTY720 also were examined. At day 28, the myocarditis-affected areas in the early therapy group were significantly lower than those in the control group. In conclusion, we demonstrated that the development of EAM could be prevented by FTY720. These data also indicated that lymphocyte-mediated immunity is critically involved in the development of EAM.
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Affiliation(s)
- H Kitabayashi
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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Yasuo M, Nagano S, Yazaki Y, Koizumi T, Kitabayashi H, Imamura H, Amano J, Isobe M. Pulmonary embolism due to right ventricular thrombus in a case of Behcet's disease. Jpn Circ J 1999; 63:909-11. [PMID: 10598901 DOI: 10.1253/jcj.63.909] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Right ventricular thrombus is a very rare manifestation of cardiovascular Behcet's disease. A 25-year-old man was admitted to hospital due to cough and fever of unknown origin. He experienced repetitive pulmonary embolism due to a right ventricular thrombus, which was surgically removed. A diagnosis of Behcet's disease was made based on his clinical course and the histological findings of the right ventricular wall and the skin lesion. He was quickly relieved of his symptoms after warfarinization and cyclosporine therapy.
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Affiliation(s)
- M Yasuo
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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19
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Fujii T, Tanaka M, Yazaki Y, Kitabayashi H, Koizumi T, Kubo K, Sekiguchi M, Yano K. [Estimation of pulmonary hypertension in lung and valvular heart diseases by perfusion lung scintigraphy]. Nihon Kokyuki Gakkai Zasshi 1999; 37:458-65. [PMID: 10434544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
To estimate pulmonary hypertension, we measured postural differences in pulmonary blood flow for the lateral decubitus positions on perfusion lung scintigrams with Tc-99 m macro-aggregated albumin, applying the method devised by Tanaka et al (Eur J Nucl Med 17: 320-326, 1990). Utilizing a scintillation camera coupled to a minicomputer system, changes in the distribution of pulmonary blood flow caused by gravitational effects, namely, changes in the total count ratios for the right lung versus the left lung in the right and left lateral decubitus positions (R/L), were obtained for 44 patients with lung disease, 95 patients with valvular heart disease, and 23 normal subjects. Mean standard deviation in the R/L ratios was 3.09 +/- 1.28 for the normal subjects, 1.97 +/- 0.89 for the patients with lung disease, and 1.59 +/- 0.59 for the patients with valvular heart disease. The R/L ratios correlated with mean pulmonary arterial pressure and cardio-thoracic ratios in the lung disease and valvular heart disease groups, with pulmonary arteriolar resistance in the former, and with pulmonary capillary wedge pressure in the latter. Defining pulmonary hypertension (> 20 mmHg) as an R/L ratio of less than 1.81, which is the mean-1 standard deviation for normal subjects, the sensitivity and the specificity of the R/L ratio for the diagnosis of pulmonary hypertension were 62.9% and 76.2%, respectively, for the lung disease patients, and 80.3% and 61.8%, respectively, for the valvular heart disease patients. This method seems to be useful for the pathophysiologic evaluation of pulmonary perfusion in cases of lung disease and valvular heart disease.
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Affiliation(s)
- T Fujii
- School of Allied Medical Sciences, Shinshu University School of Medicine, Nagano, Japan
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Yazaki Y, Isobe M, Takahashi W, Kitabayashi H, Nishiyama O, Sekiguchi M, Takemura T. Assessment of myocardial fatty acid metabolic abnormalities in patients with idiopathic dilated cardiomyopathy using 123I BMIPP SPECT: correlation with clinicopathological findings and clinical course. Heart 1999; 81:153-9. [PMID: 9922350 PMCID: PMC1728928 DOI: 10.1136/hrt.81.2.153] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the clinical and prognostic value of identifying metabolic abnormalities of myocardial fatty acid metabolism in idiopathic dilated cardiomyopathy using iodine-123 beta-methyl-iodophenyl pentadecanoic acid (123I BMIPP). SETTING Cardiac care division in national hospital. PATIENTS 32 consecutive patients with idiopathic dilated cardiomyopathy in whom both 123I BMIPP and thallium-201 myocardial single photon emission computed tomography were performed. METHODS The uptake of each tracer was scored visually from 0 (normal) to 3 (defect) in 17 segments (eight basal, eight midventricular, and one apical). A total score for all 17 segments was compared with clinicopathological variables. Prognostic value of mismatches between the two tracers were also evaluated. RESULTS The 123I BMIPP total score was correlated with pulmonary capillary wedge pressure (r = 0.68, p < 0.001), left ventricular end diastolic pressure (r = 0.65, p < 0.001), percentage fractional shortening at six months' follow up (r = -0.58, p = 0. 001), myocyte diameter (r = 0.66, p < 0.001), and percentage area of interstitial fibrosis (r = 0.69, p < 0.001) measured by morphometry in the biopsy specimens. During a mean (SD) follow up of 20 (11) months, deterioration of the New York Heart Association functional class was observed in 11 of the 32 patients; four of these died. Segments with a greater decrease in 123I BMIPP than thallium-201 uptake (type B mismatching) were often observed in patients with deterioration (88/187, 29% v 58/357, 16%; p < 0.001). CONCLUSIONS The extent of the abnormality of myocardial fatty acid metabolism in idiopathic dilated cardiomyopathy reflects the severity of haemodynamic deterioration and histopathological changes. Type B mismatching is one of the important prognostic indicators in idiopathic dilated cardiomyopathy.
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Affiliation(s)
- Y Yazaki
- Division of Cardiology, National East Nagano Hospital, Nagano, Japan
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Fujii T, Tanaka M, Yazaki Y, Kitabayashi H, Koizumi T, Sekiguchi M, Gomi T, Yano K, Itoh A. [Estimation of 123I-metaiodobenzylguanidine lung uptake in heart and lung diseases--with reference to lung uptake ratio and decrease of lung uptake]. Kaku Igaku 1997; 34:1005-11. [PMID: 9455040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was performed in 64 patients with heart and lung diseases. Distribution of MIBG in the chest was evaluated by planar images, using counts ratios of the heart to the mediastinum (H/M) and the unilateral lung to the mediastinum (Lu/M). Most of patients with heart diseases showed obvious lung uptake of MIBG. The ratios of H/M were 1.75 +/- 0.20 in the group without heart failure and 1.55 +/- 0.19 in the group with heart failure. The ratios of Lu/M in the right and left lung were 1.56 +/- 0.16 and 1.28 +/- 0.16 in the group without heart failure. And those were 1.45 +/- 0.16 and 1.19 +/- 0.15 in the group with heart failure. But 3 patients complicated with chronic pulmonary emphysema and one patient with interstitial pneumonia due to dermatomyositis showed markedly decreased lung uptake. The ratios of Lu/M in the right and left lung of these patients were 1.20, 1.17; 1.17, 1.13; 1.01, 0.97 and 1.27, 0.94, respectively. These results suggest that the lung uptake of MIBG may reflect the state of pulmonary endothelial cell function in clinical situations, considering that it has been demonstrated that MIBG may be useful as a marker of pulmonary endothelial cell function in the isolated rat lung.
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Affiliation(s)
- T Fujii
- School of Allied Medical Sciences, Shinshu University School of Medicine
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Fujii T, Tanaka M, Yazaki Y, Kitabayashi H, Koizumi T, Hongo M, Sekiguchi M, Itoh A, Gomi T, Yano K. [Myocardial scintigraphic studies with 123I-MIBG, 201Tl and 99mTc-PYP in patients with cardiac amyloidosis]. Kaku Igaku 1997; 34:1033-9. [PMID: 9455044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Myocardial scintigraphic studies, using 123I-metaiodobenzylguanidine (MIBG), 99mTc-pyrophosphate (PYP) and 201Tl were performed in 4 patients with cardiac amyloidosis. In MIBG myocardial images, 2 patients with familial amyloid polyneuropathy (FAP) showed complete or partial defect and the other 2 with primary amyloidosis had normal myocardial uptake of MIBG. In PYP myocardial images, diffuse myocardial uptake of PYP was mild in 2 patients with FAP and moderate in the other 2. 201Tl myocardial images revealed normal myocardial uptake of 201Tl in 2 patients with FAP and 1 with primary amyloidosis, and intense myocardial uptake in the other one with primary amyloidosis. These results suggest that myocardial scintigraphies with PYP and 201Tl may be useful for the detection of cardiac amyloidosis and estimation of its pathophysiology. And MIBG myocardial scintigraphy may provide useful information about sympathetic nerve abnormalities which vary with type of the fibril protein, clinical syndromes and disease process of cardiac amyloidosis.
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Affiliation(s)
- T Fujii
- School off Allied Medical Sciences, Shinshu University School of Medicine
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