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Katsuya Y, Yoshida T, Takashima A, Yonemori K, Ohba A, Yazaki S, Yagishita S, Nakahama H, Kobayashi O, Yanagida M, Irino Y, Hamada A, Yamamoto N. Immunogenicity after vaccination of COVID-19 vaccines in patients with cancer: a prospective, single center, observational study. Int J Clin Oncol 2024; 29:386-397. [PMID: 38381163 PMCID: PMC10963526 DOI: 10.1007/s10147-024-02470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Patients with cancer, particularly those undergoing chemotherapy, are at risk from the low immunogenicity of Coronavirus Disease 19 (COVID-19) vaccines. METHODS This prospective study assessed the seroconversion rate of COVID-19 vaccines among patients with cancer and hospital staff. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein-specific IgG (S-IgG) concentrations were evaluated before the first vaccination, and 1-3 and 4-6 months after the second vaccination. The primary endpoint was the seroconversion rate measured 1-3 months after the second vaccine. RESULTS In total, 590 patients and 183 healthy hospital staff were analyzed. At 1-3 months after the second vaccination, the S-IgG antibody concentration exceeded the cut-off value (20 BAU/mL) in 96.1% (567/590) of the patients with cancer and 100% (183/183) of the healthy controls (p = 0.0024). At 4-6 months after the second vaccination, the S-IgG antibody concentration exceeded the cut-off value (20 BAU/ml for S-IgG) in 93.1% (461/495) of the patients with cancer and 100% (170/170) of the healthy controls (p < 0.0001). Old age, being male, and low lymphocyte count were related to low SARS-CoV-2 S-IgG levels 1-3 months after the second vaccination among patients, while body mass index, smoking history, and serum albumin level were not. Patients undergoing platinum combination therapy and alkylating agent among cytotoxic drugs, and PARP inhibitor, mTOR inhibitor, and BCR-ABL inhibitor exhibited a low S-IgG antibody concentration compared to the no treatment group. CONCLUSIONS COVID-19 vaccine immunogenicity was reduced among patients with cancer, especially under several treatment regimens.
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Affiliation(s)
- Yuki Katsuya
- Department of Experimental Therapeutics, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan.
| | - Tatsuya Yoshida
- Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Atsuo Takashima
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Akihiro Ohba
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Shu Yazaki
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Shigehiro Yagishita
- Division of Molecular Pharmacology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Hiroko Nakahama
- Department of Nursing, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Masatoshi Yanagida
- Applied Diagnostic Research Group, Central Research Laboratories, Sysmex Corporation, 4-4-4 Takatsukadai, Nishi-ku, Kobe, 651-2271, Japan
| | - Yasuhiro Irino
- Applied Diagnostic Research Group, Central Research Laboratories, Sysmex Corporation, 4-4-4 Takatsukadai, Nishi-ku, Kobe, 651-2271, Japan
| | - Akinobu Hamada
- Division of Molecular Pharmacology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1050045, Japan
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Tedesco J, Nakahama H, Abdelsattar Z. Totally robotic en bloc left upper lobectomy and chest wall resection after neoadjuvant chemoradiation. Multimed Man Cardiothorac Surg 2023; 2023. [PMID: 37921749 DOI: 10.1510/mmcts.2023.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
This patient presented with a stage IIIB advanced lung cancer with chest wall invasion. She was treated with neoadjuvant chemoradiation therapy and had an excellent treatment response. The management of T3N2 disease is controversial, but given her treatment response and age, she was discussed by the multidisciplinary tumour board and referred for surgical evaluation. She was offered a robotic en bloc lobectomy and chest wall dissection.
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Affiliation(s)
- John Tedesco
- Department of Cardiothoracic Surgery, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Hiroko Nakahama
- Department of General Surgery, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Zaid Abdelsattar
- Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Chicago IL
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Kohara I, Fujiwara N, Tamaki S, Nakahama H, Nosaki A, Hosoya M, Yabuki M, Yamamoto M, Kojima C, Fujiwara K. Development of a Japanese Scale that Evaluates the Level of Nursing Support Provided to Patients for Decision-Making in Cancer Clinical Trials. J Cancer Educ 2023; 38:1548-1556. [PMID: 37024607 DOI: 10.1007/s13187-023-02297-6] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
Clinical nurses need learning programs that are useful in nursing support for patients' decision-making (NSPDM) regarding cancer clinical trials (CCTs). The usefulness of the learning program can be evaluated if the practices of NSPDM before and after participation in the learning program can be compared. We developed a scale to measure the level of self-assessed NSPDM regarding participation in a CCT. Thirty-two items of scale were developed in Japanese based on previous literature. Based on the results of a pilot study, items with similar meanings were removed and the validity of the 26 scale items was statistically examined in terms of construct validity and reliability. The study population was clinical nurses and included clinical research nurses. We received 102 valid responses from clinical nurses. Based on the bias of the boxplot distribution and the ceiling and floor effects for the items analysis of the 26-item draft scale, 17 items remained. Exploratory factor analysis (EFA) revealed that the scale consisted of three subscales and 17 items. Regarding fit indices of the model, the goodness-of-fit index (GFI), adjusted GFI (AGFI), comparative fit index (CFI), and root mean square error of application (RMSEA) were 0.775, 0.704, 0.477, and 0.081, respectively. The Cronbach's alpha coefficient for the overall scale was 0.951, with subscales ranging from 0.820 to 0.942. The validity and reliability of this scale were acceptable. This scale may be helpful to evaluate the usefulness of learning programs, i.e., the practice level of NSPDM.
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Affiliation(s)
- Izumi Kohara
- School of Nursing, Jichi Medical University, Tochigi, Japan.
| | - Noriko Fujiwara
- Department of Palliative Medicine and Advanced Clinical Oncology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Shuko Tamaki
- Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroko Nakahama
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Akiko Nosaki
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Miki Hosoya
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Midori Yabuki
- Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
| | - Mayumi Yamamoto
- Department of Nursing, Jichi Medical University Hospital, Tochigi, Japan
| | - Chiemi Kojima
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
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Nakahama H, Jaradeh M, Abdelsattar ZM, Lubawski J, Vigneswaran WT. The impact of marginal lung function on outcomes in the era of minimally invasive thoracic surgery. J Thorac Dis 2022; 13:6800-6809. [PMID: 35070364 PMCID: PMC8743406 DOI: 10.21037/jtd-21-1382] [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: 08/21/2021] [Accepted: 10/28/2021] [Indexed: 11/24/2022]
Abstract
Background The effect of marginal lung function on outcomes after lung resection has traditionally been studied in the context of open thoracic surgery. Its impact on postoperative outcomes in the era of minimally invasive lung resection is unclear. Methods In this retrospective cohort study, we included adult patients who underwent minimally invasive lung resection at our institution between January 2017 and May 2020 for known malignancy or lung nodule. Marginal lung function was defined as pre-operative forced expiratory volume in 1 second (FEV1) and/or diffusion lung capacity of carbon monoxide <60% of predicted. Our outcomes included a composite outcome of pulmonary morbidity and/or 30- and 90-day mortality, and hospital length of stay. We used multivariable logistic and Poisson regression models to identify associations with outcomes, and Kaplan-Meier and Cox models to estimate survival. Results Of 300 patients, 88 (29%) had marginal lung function. Patients in the marginal group were more likely to be female (69% vs. 56%; P=0.028), and more likely to have: hypertension (HTN) (83% vs. 71%; P=0.028), chronic obstructive pulmonary disease (COPD) (38% vs. 12%; P<0.001), interstitial lung disease (ILD) (9% vs. 3%; P<0.019), and ischemic heart disease (28% vs. 18%; P=0.033). Patients were similar in terms of age (68±8 vs. 68±10 years; P=0.932), and other comorbidities. Anatomic lung resection comprised 56.8% of the marginal group vs. 74% in the non-marginal group (P=0.003). The most common complication was prolonged air leak (18.2% vs. 11.8%; P=0.479). Marginal lung function had a trend toward increased composite respiratory complications (22.7% vs. 15.1%; P=0.112) and 90-day mortality (5.7% vs. 4.2%; P=0.591), although they did not reach statistical significance. There was a statistically significant 1-day average increase in length of stay in the marginal lung function cohort (4.6 vs. 3.4 days; P<0.015) with a stronger association with diffusion lung capacity of carbon monoxide than FEV1. Survival was similar (marginal function HR =1.0; P=0.994). Conclusions In the era of minimally invasive thoracic surgery, lung resection in patients with marginal lung function may be considered in select patients. These findings aid in the selection consideration and counseling of this patient population.
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Affiliation(s)
- Hiroko Nakahama
- Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Mark Jaradeh
- Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Zaid M Abdelsattar
- Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - James Lubawski
- Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Wickii T Vigneswaran
- Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA
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Yazaki S, Yoshida T, Kojima Y, Yagishita S, Nakahama H, Okinaka K, Matsushita H, Shiotsuka M, Kobayashi O, Iwata S, Narita Y, Ohba A, Takahashi M, Iwasa S, Kobayashi K, Ohe Y, Yoshida T, Hamada A, Doi T, Yamamoto N. Difference in SARS-CoV-2 Antibody Status Between Patients With Cancer and Health Care Workers During the COVID-19 Pandemic in Japan. JAMA Oncol 2021; 7:1141-1148. [PMID: 34047762 DOI: 10.1001/jamaoncol.2021.2159] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Patients with cancer and health care workers (HCWs) are at high risk of SARS-CoV-2 infection. Assessing the antibody status of patients with cancer and HCWs can help understand the spread of COVID-19 in cancer care. Objective To evaluate serum SARS-CoV-2 antibody status in patients with cancer and HCWs during the COVID-19 pandemic in Japan. Design, Setting, and Participants Participants were enrolled for this prospective cross-sectional study between August 3 and October 30, 2020, from 2 comprehensive cancer centers in the epidemic area around Tokyo, Japan. Patients with cancer aged 16 years or older and employees were enrolled. Participants with suspected COVID-19 infection at the time of enrollment were excluded. Exposures Cancer of any type and cancer treatment, including chemotherapy, surgery, immune checkpoint inhibitors, radiotherapy, and targeted molecular therapy. Main Outcomes and Measures Seroprevalence and antibody levels in patients with cancer and HCWs. Seropositivity was defined as positivity to nucleocapsid IgG (N-IgG) and/or spike IgG (S-IgG). Serum levels of SARS-CoV-2 IgM and IgG antibodies against the nucleocapsid and spike proteins were measured by chemiluminescent enzyme immunoassay. Results A total of 500 patients with cancer (median age, 62.5 years [range, 21-88 years]; 265 men [55.4%]) and 1190 HCWs (median age, 40 years [range, 20-70 years]; 382 men [25.4%]) were enrolled. In patients with cancer, 489 (97.8%) had solid tumors, and 355 (71.0%) had received anticancer treatment within 1 month. Among HCWs, 385 (32.3%) were nurses or assistant nurses, 266 (22.4%) were administrative officers, 197 (16.6%) were researchers, 179 (15.0%) were physicians, 113 (9.5%) were technicians, and 50 (4.2%) were pharmacists. The seroprevalence was 1.0% (95% CI, 0.33%-2.32%) in patients and 0.67% (95% CI, 0.29%-1.32%) in HCWs (P = .48). However, the N-IgG and S-IgG antibody levels were significantly lower in patients than in HCWs (N-IgG: β, -0.38; 95% CI, -0.55 to -0.21; P < .001; and S-IgG: β, -0.39; 95% CI, -0.54 to -0.23; P < .001). Additionally, among patients, N-IgG levels were significantly lower in those who received chemotherapy than in those who did not (median N-IgG levels, 0.1 [interquartile range (IQR), 0-0.3] vs 0.1 [IQR, 0-0.4], P = .04). In contrast, N-IgG and S-IgG levels were significantly higher in patients who received immune checkpoint inhibitors than in those who did not (median N-IgG levels: 0.2 [IQR, 0.1-0.5] vs 0.1 [IQR, 0-0.3], P = .02; S-IgG levels: 0.15 [IQR, 0-0.3] vs 0.1[IQR, 0-0.2], P = .02). Conclusions and Relevance In this cross-sectional study of Japanese patients with cancer and HCWs, the seroprevalence of SARS-CoV-2 antibodies did not differ between the 2 groups; however, findings suggest that comorbid cancer and treatment with systemic therapy, including chemotherapy and immune checkpoint inhibitors, may influence the immune response to SARS-CoV-2.
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Affiliation(s)
- Shu Yazaki
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Yoshida
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Shigehiro Yagishita
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Hiroko Nakahama
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Keiji Okinaka
- Department of General Internal Medicine, National Cancer Center Hospital East, Chiba, Japan
| | - Hiromichi Matsushita
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Mika Shiotsuka
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiro Ohba
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoru Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenya Kobayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Akinobu Hamada
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Toshihiko Doi
- Department of Experimental Therapeutics, National Cancer Center Hospital East, Chiba, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
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Nakahama H, Poulikidis K, Lubawski J, Vigneswaran WT. When is a patient high risk for resection? A changing paradigm with minimally invasive lung surgery. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e20059] [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: 11/20/2022] Open
Abstract
e20059 Background: The predicted post-operative forced expiratory volume after 1 second (FEV1) and the diffusing capacity of the lung for carbon monoxide (DLCO) are predictors of postoperative complications and survival. Despite the benefits of minimally invasive surgery in patients with marginal lung function current practice guidelines advocates non-surgical approach for treatment from evidence derived from patients undergoing thoracotomy. It is necessary to define what should be minimum acceptable lung function for resection in the era of minimally invasive surgery. Methods: Single institution retrospective study of 61 patients with pre-operative predicted FEV1 and DLCO < 60% that underwent lung resection for pulmonary lung nodules suspected to be malignant between January 2017 to June 2018. Patient demographic and clinical data were collected and the 30-day or in-hospital morbidity and mortality were assessed. Results: 28 (46%) patients with pre-operative predicted FEV1 < 60% and 33 (54%) with DLCO < 60% were reviewed. 10 patients had both FEV1 and DLCO < 60%. There were 12 patients (28% in FEV1, 12% in DLCO group) who had < 40% of pre-operative predicted values. 15 (65%) of FEV1 group and 15 (45%) of DLCO group had anatomic lung resections with either a lobectomy or a segmentectomy. 24 (39%) of cases were done robotically and the remaining with VATS. 80% of patients had cancer in their final pathology. Patients were 68± 7 years old, 34 (56%) were male. Significant baseline clinical findings include high incidence of smoking (82% in FEV1, 97% in DLCO group), HTN (71% in FEV1, 81% in DLCO group), COPD (61% in FEV1, 48% in DLCO group), CAD (25% in FEV1, 30% in DLCO group), and a total of 2 patients suffered previous CVD. Most common complications included persistent air leak > 5 days (21% in FEV1 and DLCO group) and arrhythmia (14% in FEV1, 15% in DLCO group). Of those with an air leak, 50% in the FEV1 group and 29% in the DLCO group had predicted values < 40%. Three patients developed pneumothorax post chest tube removal necessitating chest tube replacement, all of whom had predicted values < 40%. One patient developed acute DVT and PE and another patient required mechanical ventilation for > 48 hours. There were no 30-day mortalities. Conclusions: Lung resection using minimally invasive technique had low rates of 30-day morbidity in patients with reduced pulmonary function. Majority of complications observed were minor. Minimally invasive lung resection is possible and may be extended to selected patients with pre-operative predicted DLCO or FEV1 < 40% suspected of malignancy.
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Affiliation(s)
| | | | | | - Wickii T. Vigneswaran
- Department of Thoracic and Cardiovascular Surgery, Loyola Unversity Medical Center, Maywood, IL
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Nakahama H, Jankowski M, Dixon SR, Abbas AE. Long-term outcome of brachytherapy treatment for coronary in-stent restenosis: Ten-year follow-up. Catheter Cardiovasc Interv 2019; 93:E211-E216. [PMID: 30280480 DOI: 10.1002/ccd.27866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/02/2018] [Accepted: 08/12/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objective of this study was to determine the long-term major adverse cardiac events (MACE) in patients treated with intracoronary brachytherapy (ICBT) for coronary in-stent restenosis (ISR). BACKGROUND ICBT was commonly used to treat coronary ISR prior to the availability of drug-eluting stents (DES). The long-term outcomes of ICBT for ISR remain unknown. METHODS Six hundred and eighty consecutive patients who underwent ICBT treated for ISR between September 1998 and April 2005 were included in the study. Clinical and angiographic data were collected and the long-term MACE were measured for all-cause death, myocardial infarction (MI), and target vessel revascularization (TVR) at 10-year follow-up. RESULTS Patients were 63 ± 11 years old (66% male). The majority of patients were treated with a bare metal stent 670/680 (99%) prior to ICBT. Significant baseline clinical findings include high incidence of smokers 479/680 (70%), hyperlipidemia 638/680 (94%), and multivessel disease 526/680 (77%). The majority of target lesions were diffuse 407/680 (60%), and either in the left anterior descending 258/680 (38%) or right coronary artery 215/680 (32%). At 10-year follow-up, the rate of death was 25%, MI was 22.4%, and TVR was 48%. CONCLUSION MACE at 10-year follow-up following ICBT for ISR indicates steady rate of death and MI and declining rate of TVR after 5 years.
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Affiliation(s)
- Hiroko Nakahama
- Beaumont Hospital Royal Oak, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Michelle Jankowski
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Simon R Dixon
- Beaumont Hospital Royal Oak, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Amr E Abbas
- Beaumont Hospital Royal Oak, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Rochester, Michigan
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Tomomatsu J, Iwasa S, Saka H, Takahashi S, Nakano K, Morita S, Inoue M, Nakahama H, Kogure Y, Kakizume T, Natsume K, Aoki T, Quadt C, Yamada Y, Ando Y. A phase 1 study of BYL719, an α-isoform selective PI3K inhibitor, in Japanese patients with advanced solid malignancies. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.020] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Nakahama H, Okada M, Miyazaki M, Imai N, Yokokawa T, Kubori S. Distinct Responses of Interleukin-6 and Other Laboratory Parameters to Treatment in a Patient with Polyarteritis Nodosa—A Case Report. Angiology 2016; 43:512-6. [PMID: 1350713 DOI: 10.1177/000331979204300610] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors describe a patient in whom the serum levels of interleukin-6 (IL-6) and other laboratory parameters were monitored. The IL-6 and C-reac tive protein (CRP) levels, which were extremely high before treatment, declined rapidly with administration of prednisolone. Rheumatoid factor, IgG, and platelets count declined more gradually. Thus, determination of the serum IL-6 level might be useful in diagnosing and monitoring polyarteritis nodosa.
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Affiliation(s)
- H Nakahama
- Department of Medicine, Kansai Rosai Hospital, Hyogo, Japan
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Abstract
The advent of pluripotent stem cells (PSCs) enabled a multitude of studies for modeling the development of diseases and testing pharmaceutical therapeutic potential in vitro. These PSCs have been differentiated to multiple cell types to demonstrate its pluripotent potential, including cardiomyocytes (CMs). However, the efficiency and efficacy of differentiation vary greatly between different cell lines and methods. Here, we describe two different methods for acquiring CMs from human pluripotent lines. One method involves the generation of embryoid bodies, which emulates the natural developmental process, while the other method chemically activates the canonical Wnt signaling pathway to induce a monolayer of cardiac differentiation.
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Affiliation(s)
| | - Elisa Di Pasquale
- Humanitas Clinical and Research Center, Rozzano, MI, Italy.
- Istituto di Ricerca Genetica e Biomedica, National Research Council of Italy, Milan, Italy.
- C/O Humanitas Clinical and Research Center, Via Manzoni, 56, 20089, Rozzano, MI, Italy.
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11
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Di Pasquale E, Salvarani N, Kunderfranco P, Crasto S, Miragoli M, Nakahama H, Rutigliano L, Carullo P, Forni F, Faggian G, Condorelli G. Generation of Ipsc-based cardiac models to investigate mechanisms of dilated cardiomyopathy due to Lamin A/C mutations. Vascul Pharmacol 2015. [DOI: 10.1016/j.vph.2015.11.027] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Horio M, Kakihara M, Nakahama H, Fukuhara Y, Ueda N, Orita Y, Kamada T, Pastan I, Handler J. Kidney-derived cells show multidrug secretory transport. Contrib Nephrol 2015; 95:143-8. [PMID: 1687282 DOI: 10.1159/000420652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M Horio
- First Department of Medicine, Osaka University Medical School, Japan
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13
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Di Pasquale E, Nakahama H, Kunderfranco P, Miragoli M, Forni A, Roncarati R, Carullo P, Faggian G, Condorelli G. 265Generation of iPSC-based cardiomyocytes for investigating mechanisms of dilated cardiomyopathy due to Lamin A/C mutations. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu083.1] [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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Di Pasquale E, Lodola F, Miragoli M, Denegri M, Avelino-Cruz JE, Buonocore M, Nakahama H, Portararo P, Bloise R, Napolitano C, Condorelli G, Priori SG. CaMKII inhibition rectifies arrhythmic phenotype in a patient-specific model of catecholaminergic polymorphic ventricular tachycardia. Cell Death Dis 2013; 4:e843. [PMID: 24113177 PMCID: PMC3824678 DOI: 10.1038/cddis.2013.369] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 07/25/2013] [Accepted: 07/29/2013] [Indexed: 12/12/2022]
Abstract
Induced pluripotent stem cells (iPSC) offer a unique opportunity for developmental studies, disease modeling and regenerative medicine approaches in humans. The aim of our study was to create an in vitro 'patient-specific cell-based system' that could facilitate the screening of new therapeutic molecules for the treatment of catecholaminergic polymorphic ventricular tachycardia (CPVT), an inherited form of fatal arrhythmia. Here, we report the development of a cardiac model of CPVT through the generation of iPSC from a CPVT patient carrying a heterozygous mutation in the cardiac ryanodine receptor gene (RyR2) and their subsequent differentiation into cardiomyocytes (CMs). Whole-cell patch-clamp and intracellular electrical recordings of spontaneously beating cells revealed the presence of delayed afterdepolarizations (DADs) in CPVT-CMs, both in resting conditions and after β-adrenergic stimulation, resembling the cardiac phenotype of the patients. Furthermore, treatment with KN-93 (2-[N-(2-hydroxyethyl)]-N-(4methoxybenzenesulfonyl)]amino-N-(4-chlorocinnamyl)-N-methylbenzylamine), an antiarrhythmic drug that inhibits Ca(2+)/calmodulin-dependent serine-threonine protein kinase II (CaMKII), drastically reduced the presence of DADs in CVPT-CMs, rescuing the arrhythmic phenotype induced by catecholaminergic stress. In addition, intracellular calcium transient measurements on 3D beating clusters by fast resolution optical mapping showed that CPVT clusters developed multiple calcium transients, whereas in the wild-type clusters, only single initiations were detected. Such instability is aggravated in the presence of isoproterenol and is attenuated by KN-93. As seen in our RyR2 knock-in CPVT mice, the antiarrhythmic effect of KN-93 is confirmed in these human iPSC-derived cardiac cells, supporting the role of this in vitro system for drug screening and optimization of clinical treatment strategies.
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Affiliation(s)
- E Di Pasquale
- Istituto di Ricerca Genetica e Biomedica, National Research Council of Italy, Milan, Italy
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Sato K, Miki I, Nakahama H, Katusmata N, Watanabe T. Attitudes Regarding Informing Clinical Study Result to Participants in Japan. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32480-7] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Miki I, Sato K, Nakahama H, Katsumata N, Watanabe T. Attitudes regarding informing clinical study result to participants in Japan. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e19557] [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: 11/20/2022] Open
Abstract
e19557 Background: Informing the participants about study result is increased demand in recent years. Some studies reported that almost all participants want to receive study result. However, how much information do participants want and how do researcher offer were not mentioned. Moreover there were concerned about resource for providing study result and the attitude regarding informing result to participants in Japan was not studied. The purpose of this study was aimed to discuss and propose the way of informing study results to Japanese participants. Methods: Summarizing study result and a self-administrated questionnaire survey were conducted. Summary was created from abstract of academic paper with lay language and illustration using color. Objective study was Oral Uracil and Tegafur Compared With Classic Cyclophosphamide, Methotrexate, Fluorouracil As Postoperative Chemotherapy in Patients With Node-Negative, High-Risk Breast Cancer: National Surgical Adjuvant Study for Breast Cancer 01 Trial “N-SAS-BC01 trial”(J Clin Oncol 2009). Objective subject was participants of N-SAS-BC01 trial in National Cancer Center Hospital. A cross table and inductive analyze were performed. Results: Summary of result was made A4 (letter size) form 4sheet. 58 patients responded to questionnaire of 116 patients (50%). In 58 responders, 92% of them preferred to be informed of the result. About 80% of responders answered that summary was clear to understand and 30% of them reported that the document should contain more information. The way of receive result preferred by the mail. When the result included bad news, 67% of responders wanted to receive result; on the other hand, three patients answered that they would not to receive because of psychological harmful influence. Conclusions: These answers suggested that participants in Japan desired to inform study result. Therefore, Clinical study result should be provided participants whenever it takes time to get results, including bad news in a careful way. Summary of result should be created using lay language and illustration. Planning the cost, keeping participant contact list, and noticing participants that study result would be informed were needed at the start of the study.
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Affiliation(s)
- Izumi Miki
- National Cancer Center Hospital East, Chiba, Japan
| | - Keiko Sato
- Kyoto University Graduate School of Medicine, Kyoto, Japan
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Niizuma S, Iwanaga Y, Yahata T, Goto Y, Kita T, Miyazaki S, Nakahama H. Plasma B-type natriuretic peptide levels reflect the presence and severity of stable coronary artery disease in chronic haemodialysis patients. Nephrol Dial Transplant 2008; 24:597-603. [DOI: 10.1093/ndt/gfn491] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Nakahama H, Obata K, Sugita M. Differential effects of probucol on two distinct experimental rat nephrosis models. Nephrology (Carlton) 2008. [DOI: 10.1046/j.1440-1797.2000.00012.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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]
Affiliation(s)
- H Nakahama
- Division of Hypertension and Nephrology, National Cardiovascular Center, and
| | - K Obata
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Osaka, Japan
| | - M Sugita
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Osaka, Japan
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Hamaguchi T, Kato K, Yasui H, Morizane C, Ikeda M, Ueno H, Muro K, Yamada Y, Okusaka T, Shirao K, Shimada Y, Nakahama H, Matsumura Y. A phase I and pharmacokinetic study of NK105, a paclitaxel-incorporating micellar nanoparticle formulation. Br J Cancer 2007; 97:170-6. [PMID: 17595665 PMCID: PMC2360299 DOI: 10.1038/sj.bjc.6603855] [Citation(s) in RCA: 177] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This phase I study was designed to examine the maximum tolerated dose (MTD), the dose-limiting toxicities (DLTs), the recommended dose (RD) for phase II, and the pharmacokinetics of NK105, a new polymeric micelle carrier system for paclitaxel (PTX). NK105 was administered as a 1-h intravenous infusion every 3 weeks, without antiallergic premedication. The starting dose was 10 mg m−2, and the dose was escalated according to the accelerated titration method. Nineteen patients were recruited. The tumour types treated included pancreatic (n=11), bile duct (n=5), gastric (n=2), and colonic (n=1) cancers. Neutropenia was the most common haematological toxicity. A grade 3 fever developed in one patient given 180 mg m−2. No other grades 3 or 4 nonhaematological toxicities, including neuropathy, was observed during the entire study period. DLTs occurred in two patients given 180 mg m−2 (grade 4 neutropenia lasting for more than 5 days). Thus, this dose was designated as the MTD. Grade 2 hypersensitivity reactions developed in only one patient given 180 mg m−2. A partial response was observed in one patient with pancreatic cancer. The maximum concentration (Cmax) and area under the concentration (AUC) of NK105 were dose dependent. The plasma AUC of NK105 at 150 mg m−2 was approximately 15-fold higher than that of the conventional PTX formulation. NK105 was well tolerated, and the RD for the phase II study was determined to be 150 mg m−2 every 3 weeks. The results of this phase I study warrant further clinical evaluation.
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Affiliation(s)
- T Hamaguchi
- Department of Medicine National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
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Yasuda H, Kamide K, Takiuchi S, Matayoshi T, Hanada H, Kada A, Yang J, Miwa Y, Yoshii M, Horio T, Yoshihara F, Nakamura S, Nakahama H, Tei C, Miyata T, Kawano Y. Association of single nucleotide polymorphisms in endothelin family genes with the progression of atherosclerosis in patients with essential hypertension. J Hum Hypertens 2007; 21:883-92. [PMID: 17525706 DOI: 10.1038/sj.jhh.1002234] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Endothelin-1 (ET-1) is a potent vasoconstrictive peptide and its activity is mediated by the receptors ET type A (EDNRA) and ET type B (EDNRB). Although ET-1 is thought to play an important role in the development of atherosclerosis, it remains unclear whether polymorphisms of ET-1 family genes, including the ET-1 gene (EDN1), EDNRA, EDNRB and the genes for endothelin converting enzymes 1 and 2 (ECE1 and ECE2), are associated with the progression of atherosclerosis. We investigated the relationship between 11 single nucleotide polymorphisms (SNPs) of ET-1 family genes (including three in EDN1, one in EDNRA, two in EDNRB, four in ECE1 and one in ECE2) and atherosclerotic changes assessed using pulse wave velocity (PWV) and carotid ultrasonography in 630 patients with essential hypertension (EHT). In male subjects, we found significant differences in brachial-ankle PWV (baPWV) in additive and recessive models in EDNRB-rs5351 after Bonferroni correction. Also in male subjects, there were significant differences in mean intima-media thickness (IMT) in additive and recessive models in EDNRA-rs5333 after Bonferroni correction. We found no significant correlation between any SNPs in the ET family genes and baPWV, IMT and Plaque score (PS) in female subjects. Furthermore, after multiple logistic regression analysis, only EDNRB-rs5351 indicated as an independent risk of atherosclerosis in male hypertensive subjects. Of the endothelin-related genes, EDNRB-rs5351 was the most susceptible SNP associated with atherosclerosis in male hypertensives, and the genetic background may be involved in the progression of atherosclerosis in EHT patients.
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Affiliation(s)
- H Yasuda
- Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Osaka, Japan
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21
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Tomiyama M, Horio T, Kamide K, Nakamura S, Yoshihara F, Nakata H, Nakahama H, Kawano Y. Reverse white-coat effect as an independent risk for left ventricular concentric hypertrophy in patients with treated essential hypertension. J Hum Hypertens 2006; 21:212-9. [PMID: 17167525 DOI: 10.1038/sj.jhh.1002127] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent studies have shown that the converse phenomenon of white-coat hypertension called 'reverse white-coat hypertension' or 'masked hypertension' is associated with poor cardiovascular prognosis. We assessed the hypothesis that this phenomenon may specifically influence left ventricular (LV) structure in treated hypertensive patients. A total of 272 outpatients (mean age, 65 years) with chronically treated essential hypertension and without remarkable white-coat effect were enrolled. Patients were classified into two groups according to office and daytime ambulatory systolic blood pressure (SBP); that is subjects without (Group 1: office SBP > or =daytime SBP, n=149) and with reverse white-coat effect (Group 2: office SBP<daytime SBP, n=123). LV mass index and relative wall thickness were echocardiographically determined. In all subjects, LV mass index and relative wall thickness were positively correlated with daytime and 24-h SBP, but not with office SBP. In addition, these two indices were inversely correlated with office--daytime SBP difference. LV mass index (136+/-31 and 115+/-28 g/m(2), mean+/-s.d.) and relative wall thickness (0.49+/-0.09 and 0.46+/-0.07) were significantly greater in Group 2 than in Group 1. As for LV geometric patterns, Group 2 had a significantly higher rate of concentric hypertrophy compared with Group 1 (48 and 28%). Multivariate analyses revealed that the presence of reverse white-coat effect was a predictor for LV concentric hypertrophy, independent of age, sex, hypertension duration, antihypertensive treatment and ambulatory blood pressure levels. Our findings demonstrate that reverse white-coat effect is an independent risk factor for LV hypertrophy, especially concentric hypertrophy, in treated hypertensive patients.
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Affiliation(s)
- M Tomiyama
- Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, Suita, Japan
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Kato K, Hamaguchi T, Yasui H, Okusaka T, Ueno H, Ikeda M, Shirao K, Shimada Y, Nakahama H, Muro K, Matsumura Y. Phase I study of NK105, a paclitaxel-incorporating micellar nanoparticle, in patients with advanced cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2018 Background: NK105 is a new polymeric micelle carrier system for paclitaxel (PTX). A preclinical study revealed that the plasma AUC and tumor AUC of NK105 were 90-fold higher and 25-fold higher, respectively, than those of free-PTX, i.e., the conventional PTX formulation. NK105 had higher in vivo antitumor activity and lower neurotoxicity than free-PTX. This phase I study was designed to examine the MTD, DLTs, recommended dose (RD) for phase II, and the pharmacokinetics of NK105. Methods: NK105 was administered as a 1-hour intravenous infusion every 3 weeks, without antiallergic premedication. The starting dose was 10 mg PTX equivalent/m2, and the dose was escalated according to the accelerated titration method. Results: To date, 17 patients (pts) have received the following doses: 10 mg/m2 (n=1); 20 mg/m2 (n=1); 40 mg/m2 (n=1); 80 mg/m2 (n=1); 110 mg/m2 (n=3); 150 mg/m2 (n=5); and 180 mg/m2 (n=5). The tumor types treated included pancreatic (n=9), bile duct (n=5), gastric (n=2), and colonic (n=1) cancers. Neutropenia was the most common hematological toxicity. Grade 3 fever developed in 1 pt given 180 mg/m2. No other grade 3 or 4 non-hematological toxicity, including neuropathy, was observed. DLTs occurred in pts given 180 mg/m2 (grade 4 neutropenia lasting for more than 5 days). This dose was designated as the MTD. Allergic reactions developed in only one pt at 180 mg/m2, who was sensitive to other drugs such as antibiotics anti-inflammatory. A partial response was observed in one pt with pancreatic cancer and pts with colonic and gastric cancer had stable disease. The Cmax and AUC of NK105 were dose dependent. The plasma AUC of NK105 at 180 mg/m2 was approximately 30-fold higher than that of the conventional formulation of PTX. Conclusions: Accrual is ongoing at the 150 mg/m2 dose level to determine the RD. DLT was Grade 4 neutropenia. NK105 produces prolonged high levels of PTX in plasma. A 1-hour infusion of NK105 every 3 weeks was feasible, well tolerated, and effective in patients with pancreatic cancer. Even after the long term usage, only grade 1 or 2 neuropathy was observed. NK105 will be evaluated in Phase II studies of patients with advanced pancreatic and gastric cancers. No significant financial relationships to disclose.
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Affiliation(s)
- K. Kato
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - T. Hamaguchi
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - H. Yasui
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - T. Okusaka
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - H. Ueno
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - M. Ikeda
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - K. Shirao
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - Y. Shimada
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - H. Nakahama
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - K. Muro
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - Y. Matsumura
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
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Nakamura S, Yoshihara F, Kamide K, Nakahama H, Nishigami K, Fukuchi K, Ogino H, Kawano Y. Microalbuminuria and deterioration of renal function after elective repair of infrarenal abdominal aortic aneurysm. Clin Nephrol 2006; 65:165-72. [PMID: 16550747 DOI: 10.5414/cnp65165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIMS Renal dysfunction affects the prognosis of patients after aortic surgery. However, the factors associated with the postoperative deterioration of renal function has not been clarified precisely. METHOD We prospectively examined renal function in 80 patients (age: 73 +/- 7 years, 66 males) who required the elective repair of infrarenal abdominal aortic aneurysm (AAA). Serum creatinine (Scr) was measured. 24-h-creatinine clearance (Ccr) and urinary albumin excretion (UAE) were determined. Renal volume and mean renal length were calculated using the data obtained by ultrasonography. 48 patients showed normal UAE (< 30 mg/day), and 24 had microalbuminuria (30-300 mg/day) and 8 had overt proteinuria (> 300 mg/day). Scr were 0.9 +/- 0.4, 1.0 +/- 0.3 and 2.1 +/- 1.3 mg/dl, respectively. RESULTS On Day 5 after surgery, 12 patients (15%) showed deterioration of renal function as defined either by an increase in Scr (> or = 0.5 mg/dl) or by a decrease in Ccr > or =20%). The acute deterioration of renal function was related to mean renal volume, mean renal length, duration of operation and the use of antibiotics. At Month 12 after surgery, Scr increased in the overt proteinuria group. The deterioration of renal function at Month 12 was found in 8 patients (10%) with microalbuminuria or overt proteinuria, and related to preoperative Ccr, UAE, mean renal volume, mean renal length, smoking status and blood pressure. CONCLUSION We conclude that the deterioration of renal function occurred in considerable number of patients with AAA after elective operation on acute and chronic phase, although the development of end-stage renal failure is rare. Factors related to the acute and late deterioration appears to be different. UAE and renal size should be measured, even if Scr is in normal range at preoperative observation.
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Affiliation(s)
- S Nakamura
- Division of Hypertension and Nephrology, National Cardiovascular Center, Osaka, Japan.
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Miyazato J, Horio T, Takiuchi S, Kamide K, Sasaki O, Nakamura S, Nakahama H, Inenaga T, Takishita S, Kawano Y. Left ventricular diastolic dysfunction in patients with chronic renal failure: impact of diabetes mellitus. Diabet Med 2005; 22:730-6. [PMID: 15910624 DOI: 10.1111/j.1464-5491.2005.01500.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [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: 11/27/2022]
Abstract
AIMS Left ventricular (LV) hypertrophy and LV diastolic dysfunction are cardiac changes commonly observed in patients with chronic renal failure (CRF) as well as hypertension. Although the impairment of LV diastolic function in patients with diabetes mellitus has been shown, little is known about the specific effect of diabetes on LV diastolic function in patients with CRF. The present study was designed to investigate the impact of diabetic nephropathy on LV diastolic dysfunction, independent of LV hypertrophy, in CRF patients. METHODS In 67 patients with non-dialysis CRF as a result of chronic glomerulonephritis (n = 33) or diabetic nephropathy (n = 34), and 134 hypertensive patients with normal renal function, two-dimensional and Doppler echocardiographic examinations were performed, and LV dimension, mass, systolic function, and diastolic function were evaluated. RESULTS LV mass was increased and LV diastolic dysfunction was advanced in subjects with CRF compared with hypertensive controls. In the comparison of echocardiographic parameters between the two groups of CRF patients, i.e. chronic glomerulonephritis and diabetic nephropathy groups, all indices of LV diastolic function were more deteriorated in the diabetic nephropathy group than in the chronic glomerulonephritis group, although LV structure including hypertrophy and systolic function did not differ between the groups. In a multiple regression analysis, the presence of diabetes (i.e. diabetic nephropathy group) was a significant predictor of LV diastolic dysfunction in CRF subjects, independent of other influencing factors such as age, blood pressure, renal function, anaemia and LV hypertrophy. CONCLUSION The present findings suggest that LV diastolic dysfunction, independent of LV hypertrophy, is specifically and markedly progressed in patients with CRF as a result of diabetic nephropathy.
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Affiliation(s)
- J Miyazato
- Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan
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Nakahama H, Sakaguchi K, Horita Y, Sasaki O, Nakamura S, Inenaga T, Takishita S. Treatment of severe hypothyroidism reduced serum creatinine levels in two chronic renal failure patients. Nephron Clin Pract 2001; 88:264-7. [PMID: 11423759 DOI: 10.1159/000046000] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Short-term hypothyroidism has been associated with a reversible rise in serum creatinine levels in patients with normal renal function. A remarkable decline in serum creatinine levels associated with a treatment of severe and prolonged hypothyroidism has rarely been reported so far. We present here 2 patients with chronic renal failure in whom treatment for hypothyroidism resulted in a significant and sustained reduction of their serum creatinine levels. These cases indicate that because hypothyroidism may aggravate the serum creatinine levels, TSH should be considered in screening procedures of patients with chronic renal failure presenting with recent accelerated aggravation of renal function. Hypothyroidism per se, one of its complications or one of its associated autoimmune diseases might play a role in modifying the underlying renal problem.
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Affiliation(s)
- H Nakahama
- Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Japan.
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Horita Y, Inenaga T, Nakahama H, Ishibashi-Ueda H, Kawano Y, Nakamura S, Horio T, Okuda N, Ando M, Takishita S. Cause of residual hypertension after adrenalectomy in patients with primary aldosteronism. Am J Kidney Dis 2001; 37:884-9. [PMID: 11325668 DOI: 10.1016/s0272-6386(05)80002-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The cause of residual hypertension after adrenalectomy for primary aldosteronism (PA) is unknown. The purpose of this study is to investigate the characteristic pathological kidney features associated with PA. Between 1977 and 1999 at our hospital, 26 patients with PA caused by a unilateral adrenal cortical adenoma (Conn's syndrome) underwent unilateral adrenalectomy with concurrent open-wedge renal biopsy. Patients were categorized into two groups: (1) those with normotension with diastolic blood pressure less than 90 mm Hg who were not administered antihypertensive drugs, and (2) those with residual hypertension with diastolic blood pressure of 90 mm Hg or greater who were administered medication for 6 months after surgery. Thirteen patients were cured of hypertension postoperatively, and 12 patients were administered antihypertensive medications. Glomerulosclerosis, renal arteriolosclerosis, and preoperative left ventricular mass (LVM) index were worse in the group with residual hypertension than in that with normotension (17.8% +/- 7.8% versus 9.6% +/- 3.8%; P = 0.01; 2.5 +/- 0.5 versus 1.6 +/- 0.4, Bader's grade; P = 0.005; and 165 +/- 31 versus 139 +/- 24 g/m(2); P = 0.02, respectively). Severity of tubulointerstitial injury, preoperative duration of hypertension, preoperative severity of proteinuria, plasma aldosterone level, and serum potassium concentration were not significantly different between the two groups. In conclusion, severity of glomerulosclerosis and arteriolosclerosis and LVM are related to blood pressure after adrenalectomy in patients with PA.
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Affiliation(s)
- Y Horita
- Departments of Medicine, Pathology, and Cardiovascular Surgery, Division of Hypertension and Nephrology, National Cardiovascular Center, Osaka, Japan.
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Nakahama H, Sakaguchi K. Small dose oral corticosteroid treatment rapidly improved renal function in a patient with an acute aggravation of chronic renal failure due to cholesterol embolism. Nephrol Dial Transplant 2001; 16:872-3. [PMID: 11274298 DOI: 10.1093/ndt/16.4.872] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nakahama H, Obata K, Sugita M, Oka K, Moriyama T. Co-administration of furosemide augments tacrolimus-induced impairment in kidney function in rats. Ren Fail 2001; 22:525-34. [PMID: 11041285 DOI: 10.1081/jdi-100100894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Sodium-depletion in rats reproduces functional and morphological tacrolimus nephrotoxicity observed in man. Potent diuretics induce sodium-depletion. Our objective was to determine the effect of a loop diuretic furosemide on tacrolimus-mediated functional and pathological impairment of the kidney in rats. Sprague-Dawley rats were divided into four groups; group 1, rats received vehicle (saline) only; group 2, rats were treated with tacrolimus (1 mg/kg body weight) and furosemide (5 mg/kg body weight); group 3, rats were treated with tacrolimus alone; and group 4, rats were treated with furosemide (5 mg/kg body weight) alone. On day 28, tail blood pressure was measured and the rats were placed in metabolic cages for urine collection. After 24 hr the rats were sacrificed. Tacrolimus alone tended to cause growth retardation, hypotension, hypomagnesemia and a rise in blood urea nitrogen. Furosemide co-administration enhanced the effects of tacrolimus on hypotension, hypomagnesemia and a rise in blood urea nitrogen. The renal histology characterized by cytoplasmic vacuolization of the proximal tubules was not different between the rats treated with both tacrolimus and furosemide and the rats treated with tacrolimus alone. A strong immunostaining for FKBP-12, a tacrolimus-binding protein, was observed in the medulla of the kidneys of rats treated with tacrolimus either with or without furosemide. These results indicate that furosemide further augments tacrolimus induced impairment in kidney function, and that furosemide should be used with discretion in patients on tacrolimus therapy.
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Affiliation(s)
- H Nakahama
- Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Japan.
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Nakahama H, Obata K, Sugita M, Horio M, Oka K, Moriyama T. Effect of FK 506 in the treatment of autoimmune glomerulonephritis in Brown Norway rats. Nephron Clin Pract 2000; 81:421-7. [PMID: 10095178 DOI: 10.1159/000045326] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mercuric chloride (HgCl2) induces a lymphoproliferative disorder and autoimmune glomerulonephritis in Brown Norway (BN) rats. The effects of a new immunosuppressant, FK 506, on this model of glomerulonephritis were studied. BN rats were treated with HgCl2 according to a standard protocol (HgCl2 1 mg/kg s.c. 3 times/week). FK 506 was inoculated subcutaneously daily from day 15 to day 28. Animals were divided into 4 groups: group 1, rats were treated with normal saline alone and sacrificed on day 28; group 2, rats were treated with HgCl2 alone and sacrificed on day 14; group 3, rats were treated with HgCl2 alone and sacrificed on day 28, and group 4, rats were treated with HgCl2 and FK 506 (from day 15 to day 28) and sacrificed on day 28. Rats developed proteinuria by day 7, which reached a plateau level by day 14. On day 14, renal histology showed prominent mesangial cellular proliferation and the expansion of mesangial matrix. Electron microscopic study showed the effacement of visceral epithelial foot processes and the microvillous transformation of the visceral epithelium. Immunofluorescence study showed strong linear staining for IgG and the adhesion molecule ICAM-1 in all glomeruli. Treatment with FK 506 (1 mg/kg s.c. daily) resulted in a remarkable reduction in proteinuria on day 28 (493.5 +/- 48.3 vs. 24.4 +/- 13.5 mg/day) and an improvement in the morphological lesions. These findings suggest that FK 506 could be useful in the treatment of some human glomerulonephritides.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
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30
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Nakahama H, Takishita S. [Hypertension after renal transplantation]. Nihon Rinsho 2000; 58 Suppl 2:475-8. [PMID: 11028383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Affiliation(s)
- H Nakahama
- Department of Medicine, National Cardiovascular Center
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31
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Kuribayashi K, Ihaku D, Nakamura H, Nishioka Y, Nakahama H, Kitada O, Sugita M, Nakata Y. [Pleural malignant mesothelioma complicated by multiple myeloma]. Nihon Kokyuki Gakkai Zasshi 1999; 37:471-5. [PMID: 10434546] [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
A 79-year-old woman was admitted because of dyspnea. Chest X-ray films and computed tomographic scans disclosed left pleural effusion and diffuse pleural thickening. A diagnosis of multiple myeloma was made on the basis of blood tests and bone marrow aspiration biopsy findings. Multiple myeloma was the suspected cause of the pleural lesions. However, a postmortem diagnosis of malignant mesothelioma of the pleura was made on the basis of histological and immunohistological studies of autopsy specimens.
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Affiliation(s)
- K Kuribayashi
- 5th Department of Internal Medicine, Hyogo College of Medicine
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32
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Nakahama H, Obata K, Nakajima T, Nakamura H, Kitada O, Sugita M, Fujita Y, Kawada N, Moriyama T. Renin-angiotensin system component gene polymorphism in Japanese bronchial asthma patients. J Asthma 1999; 36:187-93. [PMID: 10227270 DOI: 10.3109/02770909909056316] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The influence of renin-angiotensin system (RAS) component gene polymorphism in the pathogenesis of bronchial asthma was investigated in an association study involving 119 bronchial asthma patients and 208 control subjects. The selected RAS polymorphisms were angiotensinogen (Agt) T235/M235 and angiotensin I-converting enzyme (ACE) insertion/deletion (I/D). The control allelic frequencies of the Agt T235/M235 (0.84/0.16) and ACE I/D (0.63/0.37) in this study were similar to the previous reports in Japanese normal population. The allelic frequencies of the Agt T235/M235 (0.84/0.16) and ACE I/D (0.65/ 0.35) among the asthma patients were not significantly different from those among the control subjects. There was no association between severity of bronchial asthma and the selected RAS component gene polymorphism. From these data, we conclude that in the Japanese population, the RAS component gene polymorphism is not associated with increased risk for bronchial asthma.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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33
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Nakahama H, Nakamura H, Kitada O, Sugita M. Chronic drug-induced tubulointerstitial nephritis with renal failure associated with propylthiouracil therapy. Nephrol Dial Transplant 1999; 14:1263-5. [PMID: 10344375 DOI: 10.1093/ndt/14.5.1263] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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34
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Nakahama H, Kuribayashi K, Sugita M, Shinkawa T. Cytoprotective effect of ulinastatin, a Kunitz-type protease inhibitor, on hypoxic injury in L2 cells treated with antimycin A via stabilization of lysosomal fragility. Pulm Pharmacol Ther 1999; 12:1-6. [PMID: 10208830 DOI: 10.1006/pupt.1998.9998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The cytoprotective effect of ulinastatin, a Kunitz-type protease inhibitor, was studied in L2 cells treated with antimycin A, which induces depletion of cellular adenosine triphosphate (ATP), so-called <<chemical hypoxia>>. Antimycin A treatment with 2 microM significantly elevated the release of N-acetyl-beta-D-glucosaminidase (NAG), a lysosomal enzyme, to 51.99+/-7.36%. In this condition, ulinastatin tended to inhibit the release of NAG at a concentration of 1000 U/ml (39.74+/-3.80%) and significantly ameliorated it at a concentration of 3000 U/ml (32.35+/-4.17%). Furthermore, ulinastatin at 10 U/ml showed a suppression on the fragility of lysosomal membrane isolated from L2 cells. These results indicate that ulinastatin has a prominent protective effect on hypoxic injury in L2 cells, and the lysosomal stabilizing effect is possibly involved as a mechanism of this action.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicines, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan
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35
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Nishioka Y, Kitada O, Meguro T, Aragane K, Tanimukai T, Nakamura H, Nakahama H, Matsuyama T, Sugita M, Yano T, Takenaka Y, Takamitsu Y. [Nedaplatin and etoposide combination chemotherapy in a patient with small cell carcinoma undergoing hemodialysis]. Gan To Kagaku Ryoho 1999; 26:527-30. [PMID: 10097751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
A 61-year-old man with chronic renal failure caused by polycystic kidney disease requiring hemodialysis three times weekly developed small cell carcinoma of the lung. The patient received combination chemotherapy with nedaplatin (50 mg) and etoposide (50 mg). Blood levels were monitored, showing that nedaplatin was more dialyzable than cisplatin. The patient achieved a complete response. These results suggest that nedaplatin-etoposide combination chemotherapy may be safer than cisplatin-containing regimen for patients with chronic renal failure hemodialysis and that a satisfactory response can be expected.
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Affiliation(s)
- Y Nishioka
- 5th Dept. of Internal Medicine, Hyogo College of Medicine
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36
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Nakahama H, Obata K, Matsuyama T, Sugita M, Horio M, Oka K, Moriyama T. Effect of a novel immunosuppressant, FK 506, on autoimmune glomerulonephritis in Brown Norway rats. Nephron Clin Pract 1999; 81:215-20. [PMID: 9933758 DOI: 10.1159/000045279] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mercuric-chloride (HgCl2) induces a lymphoproliferative disorder and autoimmune glomerulonephritis in Brown Norway rats. The effects of a new immunosuppressant FK 506 on this model of glomerulonephritis were studied. Brown Norway rats were treated with HgCl2 according to a standard protocol (HgCl2 1 mg/kg s.c. 3 times/ week). Rats developed proteinuria at day 7, which reached a plateau level at day 14. On day 14, renal histology showed prominent mesangial cellular proliferation and the expansion of mesangial matrix. Electron microscopic study showed the effacement of visceral epithelial foot processes and the microvillous transformation of the visceral epithelium. Immunofluorescence study showed a strong linear staining for IgG and the adhesion molecule ICAM-1 in all glomeruli. Coadministration of FK 506 (1 mg/kg s.c. daily) prevented the appearance of proteinuria at day 14 (621.4 +/- 30.5 vs. 2.2 +/- 2.7 mg/day) and the morphological lesions. These findings suggest that FK 506 could be useful for the therapy of certain types of human glomerulonephritis.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
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37
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Abstract
Serum levels of CYFRA 21-1(cytokeratin-19 fragment) and ProGRP (pro-gastrin-releasing peptide), the new prognostic markers of lung cancer, were measured by ELISA (enzyme-linked immunoadsorbent assay) in 27 (for CYFRA 21-1; male 13, female 14; age 54+/-17 years) or 22 (for ProGRP; male 9, female 13; age 59+/-18 years) patients with various serum creatinine levels, 42 haemodialysis (HD) patients (male 24, female 18; age 59+/-14 years) and 30 continuous ambulatory peritoneal dialysis (CAPD) patients (male 18, female 12; age 48+/-9 years). All the patients were without clinical and radiological signs of lung cancer. Positive correlations were found between serum creatinine and serum CYFRA 21-1 and ProGRP levels. Serum levels of CYFRA 21-1 were above the cutoff limit (3.5 ng/mL) in 57% of HD patients (mean 4.07+/-1.56 ng/mL) and in 73% of CAPD patients (mean 4.87+/-1.56 ng/mL). Serum levels of ProGRP were above the cutoff limit (46.0 pg/mL) in 90% of HD patients (mean 107.0+/-59.4 pg/mL) and in 93% of CAPD patients (mean 112.4+/-44.5 pg/mL). Our data indicate that evaluation of renal function is essential when the measurement of these tumor markers is to be applied as one of the diagnostic tools of lung cancer.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Japan
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38
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Nakahama H, Nakamura H, Kuribayashi K, Ihaku D, Ikeda I, Nishioka Y, Kitada O, Sugita M. Two cases of eosinophilic gastroenteritis associated with analgesic-induced bronchial asthma. Respirology 1998; 3:95-7. [PMID: 9692516 DOI: 10.1111/j.1440-1843.1998.tb00103.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Two patients (one male and one female) with bronchial asthma were diagnosed as having eosinophilic gastroenteritis (EG). The condition was revealed by biopsies through fibrescopic endoscopy. According to the Klein classification, they had mucosal disease. The symptoms were abdominal pain and nausea. The symptoms subsided with corticosteroid administration in one patient and with palliative treatment in the other patient. It was suggested that fibrescopic endoscopy biopsy is needed to identify coexisting EG if a bronchial asthma patient complains of severe gastrointestinal symptoms.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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39
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Orita Y, Nakahama H. Diuretic therapy. Intern Med 1998; 37:219-21. [PMID: 9550617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Y Orita
- The Department of Clinical Laboratory Science, School of Medicine, Osaka University, Yamadaoka, Suita
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40
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Orita Y, Nakahama H. [Disorders of body water regulation and the therapy using diuretics]. Nihon Naika Gakkai Zasshi 1997; 86:1660-1664. [PMID: 9410979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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41
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Nakamura H, Ikeda I, Nakahama H, Kitada O, Sugita M. [Large-cell carcinoma presenting as diffuse thickening of the pleura and resembling malignant mesothelioma]. Nihon Kyobu Shikkan Gakkai Zasshi 1997; 35:451-4. [PMID: 9212673] [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: 02/04/2023]
Abstract
A 65-year-old man had a right-sided pleural effusion. A thoracic CT scan revealed diffuse pleural thickening resembling malignant mesothelioma. Repeated needle biopsies did not yield a definitive diagnosis. At autopsy, diffuse pleural thickening was found, and examination of a specimen of lung tissue showed large-cell carcinoma. Hyalinized fibrous tissue with malignant cell infiltration was seen in the thickened pleural tissue and metastatic pleuritis was diagnosed. Large-cell carcinoma of the lung should be considered in the differential diagnosis of pleural thickening.
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Affiliation(s)
- H Nakamura
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Japan
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42
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Nakahama H. [Antimicrobial nephrotoxicity]. Ryoikibetsu Shokogun Shirizu 1997:547-9. [PMID: 9277812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine
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43
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Nakahama H. [Nephrotoxicity of antineoplastic agents (antibiotics)]. Ryoikibetsu Shokogun Shirizu 1997:539-41. [PMID: 9277810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine
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44
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Sugita M, Nakahama H. [Milk-alkali syndrome]. Ryoikibetsu Shokogun Shirizu 1997:232-4. [PMID: 9277904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M Sugita
- Fifth Department of Internal Medicine, Hyogo College of Medicine
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Abstract
Effects of ulinastatin (a Kunitz-type proteinase inhibitor) administration was examined in a model of acute ischemic renal injury induced by bilateral renal artery occlusion in rats. Compared with rats administered vehicle, rats administered ulinastatin (150,000 U/kg body weight) intravenously 30 min preischemia had significantly lower serum creatinine and blood urea nitrogen, and much less injury evident by examination of kidney histologies over the course of 48 h postreperfusion. We conclude that ulinastatin exerts a protective effect against ischemic renal injury.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Japan
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46
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Nakamura H, Nakahama H, Nishioka Y, Kitada O, Sugita M. [Long-term follow-up and autopsy of a Japanese patient who had emphysema associated with alpha 1-antitrypsin deficiency]. Nihon Kyobu Shikkan Gakkai Zasshi 1996; 34:1040-3. [PMID: 8937152] [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: 02/03/2023]
Abstract
A 49-year-old woman was found to have emphysema associated with alpha 1-antitrypsin deficiency in February 1975. She was followed until her death in October, 1994. The Pi phenotype was M null and the genotype was M malton. She had been on home oxygen therapy since 1987. An autopsy revealed the typical bullous lungs with panacinar emphysema. We know of no previous case in Japan of emphysema associated with alpha 1-antitrypsin deficiency.
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Affiliation(s)
- H Nakamura
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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Abstract
Hypercalcemia is often associated with a urinary concentration defect. During antidiuresis, organic osmolytes [sorbitol, myo-inositol, taurine, and glycerophosphorylcholine (GPC)] accumulate in the renal inner medulla and are essential for urinary concentration. To clarify the relationship between organic osmolytes and urinary concentration defect in hypercalcemia, examination was made of the effects of hypercalcemia on renal medullary osmolytes content. Rats were put in a state of hypercalcemia by a calcium-rich diet supplemented with CaCO3 (2.5%/wt) and daily s.c. injection of 1.25(OH)2VitD3 (1.6 micrograms/kg). They were killed on days 7 and 14. Hypercalcemia induced a urinary concentration defect. Myo-inositol, sorbitol, and GPC contents in the renal medulla were significantly reduced. Aldose reductase activity decreased significantly. Hypercalcemia would thus appear to directly affect renal medullary content of organic osmolytes, thereby modifying renal concentration ability.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Japan
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48
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Orita Y, Nakahama H. [Diuretics]. Nihon Rinsho 1995; 53 Su Pt 1:960-5. [PMID: 8753599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Y Orita
- Department of Clinical Laboratory Science, School of Allied Health Sciences, Faculty of Medicine Osaka University
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Nakahama H, Tanaka Y, Shirai D, Nishihara F, Takamitsu Y, Nakanishi T, Sugita M. Elevated serum pepsinogens in chronic renal failure patients. Nephron Clin Pract 1995; 70:211-6. [PMID: 7566306 DOI: 10.1159/000188586] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Human pepsinogens, the precursors of pepsin, originating from the stomach mucosa, are classified into two biochemically distinct groups, namely pepsinogen I (PG I) and pepsinogen II (PG II). We studied the serum levels of PG I and II in 51 normal volunteers, 23 chronic glomerulonephritis patients, 21 continuous ambulatory peritoneal dialysis (CAPD) patients and 40 hemodialysis patients. Serum pepsinogen levels were measured with a competitive binding double antibody radioimmunoassay. In the group of chronic glomerulonephritis patients, a positive correlation between the serum creatinine and the pepsinogen levels were found. The serum pepsinogen levels were remarkably elevated in CAPD and hemodialysis patients. The median levels of post-hemodialysis PG I (265.4 +/- 165.2 ng/ml) and PG II (41.7 +/- 38.0 ng/ml) were significantly higher than prehemodialysis values (PG I 207.4 +/- 127.5 ng/ml, PG II 29.0 +/- 16.6 ng/ml). Pepsinogen release by isolated gastric glands of guinea pigs was suppressed by guanidinosuccinic acid and was facilitated by calcium. The data suggest that both removal of guanidinosuccinic acid and infusion of calcium during hemodialysis contribute to the raised serum levels of these pepsinogens after hemodialysis.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Japan
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Nakahama H, Nakanishi T, Uno H, Takaoka T, Taji N, Uyama O, Kitada O, Sugita M, Miyauchi A, Sugishita T. Prostate cancer-induced oncogenic hypophosphatemic osteomalacia. Urol Int 1995; 55:38-40. [PMID: 7571183 DOI: 10.1159/000282746] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A 65-year-old male with prostate carcinoma showed mild hypocalcemia of 7.9 mg/dl, marked hypophosphatemia of 1.7 mg/dl, hyperphosphaturia (tubular reabsorption of phosphorus 43% and tubular threshold for phosphorus of 0.6 mg/dl), low serum 1,25 (OH)2D level of less than 5 pg/ml and osteomalacia indicated by a marked increase of relative osteoid volume and fractional formation rate in the undecalcified section. Oncogenic osteomalacia due to prostatic carcinoma with suppression of 1,25 (OH)2D production and phosphaturia was suggested.
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Affiliation(s)
- H Nakahama
- Fifth Department of Internal Medicine, Hyogo College of Medicine, Japan
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