1
|
Arashiro T, Miwa M, Nakagawa H, Takamatsu J, Oba K, Fujimi S, Kikuchi H, Iwasawa T, Kanbe F, Oyama K, Kanai M, Ogata Y, Asakura T, Asami T, Mizuno K, Sugita M, Jinta T, Nishida Y, Kato H, Atagi K, Higaki T, Nakano Y, Tsutsumi T, Doi K, Okugawa S, Ueda A, Nakamura A, Yoshida T, Shimada-Sammori K, Shimizu K, Fujita Y, Okochi Y, Tochitani K, Nakanishi A, Rinka H, Taniyama D, Yamaguchi A, Uchikura T, Matsunaga M, Aono H, Hamaguchi M, Motoda K, Nakayama S, Yamamoto K, Oka H, Tanaka K, Inoue T, Kobayashi M, Fujitani S, Tsukahara M, Takeda S, Stucky A, Suzuki T, Smith C, Hibberd M, Ariyoshi K, Fujino Y, Arima Y, Takeda S, Hashimoto S, Suzuki M. COVID-19 vaccine effectiveness against severe COVID-19 requiring oxygen therapy, invasive mechanical ventilation, and death in Japan: A multicenter case-control study (MOTIVATE study). Vaccine 2024; 42:677-688. [PMID: 38114409 DOI: 10.1016/j.vaccine.2023.12.033] [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: 10/16/2023] [Revised: 12/03/2023] [Accepted: 12/09/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Since the SARS-CoV-2 Omicron variant became dominant, assessing COVID-19 vaccine effectiveness (VE) against severe disease using hospitalization as an outcome became more challenging due to incidental infections via admission screening and variable admission criteria, resulting in a wide range of estimates. To address this, the World Health Organization (WHO) guidance recommends the use of outcomes that are more specific to severe pneumonia such as oxygen use and mechanical ventilation. METHODS A case-control study was conducted in 24 hospitals in Japan for the Delta-dominant period (August-November 2021; "Delta") and early Omicron (BA.1/BA.2)-dominant period (January-June 2022; "Omicron"). Detailed chart review/interviews were conducted in January-May 2023. VE was measured using various outcomes including disease requiring oxygen therapy, disease requiring invasive mechanical ventilation (IMV), death, outcome restricting to "true" severe COVID-19 (where oxygen requirement is due to COVID-19 rather than another condition(s)), and progression from oxygen use to IMV or death among COVID-19 patients. RESULTS The analysis included 2125 individuals with respiratory failure (1608 cases [75.7%]; 99.2% of vaccinees received mRNA vaccines). During Delta, 2 doses provided high protection for up to 6 months (oxygen requirement: 95.2% [95% CI:88.7-98.0%] [restricted to "true" severe COVID-19: 95.5% {89.3-98.1%}]; IMV: 99.6% [97.3-99.9%]; fatal: 98.6% [92.3-99.7%]). During Omicron, 3 doses provided high protection for up to 6 months (oxygen requirement: 85.5% [68.8-93.3%] ["true" severe COVID-19: 88.1% {73.6-94.7%}]; IMV: 97.9% [85.9-99.7%]; fatal: 99.6% [95.2-99.97]). There was a trend towards higher VE for more severe and specific outcomes. CONCLUSION Multiple outcomes pointed towards high protection of 2 doses during Delta and 3 doses during Omicron. These results demonstrate the importance of using severe and specific outcomes to accurately measure VE against severe COVID-19, as recommended in WHO guidance in settings of intense transmission as seen during Omicron.
Collapse
Affiliation(s)
- Takeshi Arashiro
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan; Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Maki Miwa
- Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Hidenori Nakagawa
- Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan
| | - Junpei Takamatsu
- Department of Emergency Medicine, Kansai Rosai Hospital, Hyogo, Japan
| | - Kunihiro Oba
- Department of Pediatrics, Showa General Hospital, Tokyo, Japan
| | - Satoshi Fujimi
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Hitoshi Kikuchi
- Department of Emergency Medicine, Sagamihara Kyodo Hospital, Kanagawa, Japan
| | - Takamasa Iwasawa
- Department of Cardiology, Yokosuka General Hospital Uwamachi, Kanagawa, Japan
| | - Fumiko Kanbe
- Intensive Care Unit, Ageo Central General Hospital, Saitama, Japan
| | - Keisuke Oyama
- Kawaguchi Cardiovascular and Respiratory Hospital, Saitama, Japan
| | - Masayuki Kanai
- Department of Emergency and Critical Care Medicine, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Yoshitaka Ogata
- Department of Critical Care Medicine, Yao Tokushukai General Hospital, Osaka, Japan
| | - Takanori Asakura
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Takahiro Asami
- Department of Internal Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Keiko Mizuno
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Manabu Sugita
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Yusuke Nishida
- Department of General Internal Medicine and Infectious Diseases, Saitama Medical Center, Saitama, Japan
| | - Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Japan
| | - Kazuaki Atagi
- Division of Critical Care Medicine, Nara Prefecture General Medical Center, Nara, Japan
| | - Taiki Higaki
- Division of Critical Care Medicine, Nara Prefecture General Medical Center, Nara, Japan
| | - Yoshio Nakano
- Department of Internal Medicine, Kinan Hospital, Wakayama, Japan
| | - Takeya Tsutsumi
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Shu Okugawa
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Akihiro Ueda
- Department of Infectious Diseases, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Akira Nakamura
- Department of Internal Medicine, Asahi General Hospital, Chiba, Japan
| | - Toru Yoshida
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kaoru Shimada-Sammori
- Department of Emergency and Critical Care Medicine, Tokyo Metropolitan TAMA Medical Center, Tokyo, Japan
| | - Keiki Shimizu
- Department of Emergency and Critical Care Medicine, Tokyo Metropolitan TAMA Medical Center, Tokyo, Japan
| | - Yasuo Fujita
- Department of Emergency, Akita Red Cross Hospital, Akita, Japan
| | - Yasumi Okochi
- Department of Respiratory Medicine, Japan Community Health Care Organization Tokyo Yamate Medical Center, Tokyo, Japan
| | - Kentaro Tochitani
- Department of Infectious Diseases, Kyoto City Hospital, Kyoto, Japan
| | - Asuka Nakanishi
- Department of Pulmonary Medicine, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Hiroshi Rinka
- Department of Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Daisuke Taniyama
- Department of Infectious Diseases, Showa General Hospital, Tokyo, Japan
| | - Asase Yamaguchi
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Toshio Uchikura
- Department of Emergency and General Internal Medicine, Yokosuka General Hospital Uwamachi, Kanagawa, Japan
| | - Maiko Matsunaga
- Department of Pharmacy, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Hiromi Aono
- Department of Respiratory Medicine, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Masanari Hamaguchi
- Department of Critical Care Medicine, Yao Tokushukai General Hospital, Osaka, Japan
| | - Kentaro Motoda
- Department of Clinical Research, Yao Tokushukai General Hospital, Osaka, Japan
| | - Sohei Nakayama
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Kei Yamamoto
- Department of General Internal Medicine and Infectious Diseases, Saitama Medical Center, Saitama, Japan
| | - Hideaki Oka
- Department of General Internal Medicine and Infectious Diseases, Saitama Medical Center, Saitama, Japan
| | - Katsushi Tanaka
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Japan
| | - Takeshi Inoue
- Clinical Research Support Center, Asahi General Hospital, Chiba, Japan
| | - Mieko Kobayashi
- Clinical Research Support Center, Asahi General Hospital, Chiba, Japan
| | - Shigeki Fujitani
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Maki Tsukahara
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Saki Takeda
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ashley Stucky
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Chris Smith
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Martin Hibberd
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Koya Ariyoshi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yuji Fujino
- Non-Profit Organization Japan ECMO Network, Tokyo, Japan; Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuzo Arima
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shinhiro Takeda
- Kawaguchi Cardiovascular and Respiratory Hospital, Saitama, Japan; Non-Profit Organization Japan ECMO Network, Tokyo, Japan; Non-Profit Organization ICU Collaboration Network (ICON), Tokyo, Japan
| | - Satoru Hashimoto
- Non-Profit Organization Japan ECMO Network, Tokyo, Japan; Non-Profit Organization ICU Collaboration Network (ICON), Tokyo, Japan
| | - Motoi Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
2
|
Nakamichi S, Kubota K, Matsuyama K, Misumi T, Kozuki T, Sugawara S, Naoki K, Kobayashi N, Shukuya T, Shimokawa T, Ishihara M, Wakui H, Hosomi Y, Tanaka H, Saito H, Hosokawa S, Takiguchi Y, Kasai T, Nokihara H, Morita R, Aono H, Furuya N, Okamoto H. A Phase Ⅱ Study of Ubenimex Combined With Pembrolizumab, Nab-Paclitaxel, and Carboplatin for Previously Untreated Advanced Squamous Non-Small-Cell Lung Cancer: TORG2241 (UBE-Q). Clin Lung Cancer 2024; 25:85-90. [PMID: 37981477 DOI: 10.1016/j.cllc.2023.09.006] [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: 08/03/2023] [Accepted: 09/30/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND According to the results of the KEYNOTE-407 trial, pembrolizumab plus platinum-based chemotherapy is the standard of care for patients with previously untreated advanced squamous non-small-cell lung cancer (NSCLC). Ubenimex, a potent aminopeptidase inhibitor, is an oral drug with immunostimulatory and antitumor activities. We aim to assess the safety and efficacy of ubenimex in combination with pembrolizumab, nab-paclitaxel, and carboplatin in patients with previously untreated advanced squamous NSCLC. PATIENTS AND METHODS This prospective, single-arm, multicenter, phase II clinical trial is conducted to confirm the tolerability and efficacy of the tested drugs. Patients with previously untreated advanced squamous NSCLC will receive a predetermined daily dose of ubenimex orally plus 4 cycles of pembrolizumab, nab-paclitaxel, and carboplatin, followed by continuous administration of ubenimex and pembrolizumab for a maximum of 2 years. To confirm tolerability, the daily dose of ubenimex will begin at level 1 (30 mg), which will be increased to levels 2 (60 mg) and 3 (120 mg) according to the escalation criteria, with a standard 3 + 3 design for achieving the target dose-limiting toxicity rate of 33%. The efficacy, safety, and tolerability of ubenimex at the determined dose level will be analyzed. The primary endpoint of the efficacy evaluation will be the objective response rate assessed by an independent review committee. CONCLUSIONS This is the first study to evaluate the efficacy and safety of ubenimex combined with pembrolizumab, nab-paclitaxel, and carboplatin in patients with previously untreated advanced squamous NSCLC. The results will help devise future treatment strategies.
Collapse
Affiliation(s)
- Shinji Nakamichi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
| | - Kotone Matsuyama
- Department of Health Policy and Management, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama-shi, Kanagawa, Japan
| | - Toshiyuki Kozuki
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai-shi, Miyagi, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
| | - Nobuaki Kobayashi
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Takehito Shukuya
- Department of Respiratory Medicine, Juntendo University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Tsuneo Shimokawa
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Masashi Ishihara
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Hiroshi Wakui
- Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Tanaka
- Department of Internal Medicine, Niigata Cancer Center Hospital, Chuo-ku, Niigata, Japan
| | - Haruhiro Saito
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinobu Hosokawa
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama-shi, Okayama, Japan
| | - Yuichi Takiguchi
- Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takashi Kasai
- Division of Thoracic Oncology, Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya-shi, Tochigi, Japan
| | - Hiroshi Nokihara
- Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Hiroshima, Japan
| | - Ryo Morita
- Department of Respiratory Medicine, Akita Kousei Medical Center, Akita, Japan
| | - Hiromi Aono
- Department of Respiratory Medicine, Tokyo Metropolitan Police Hospital, Nakano-ku, Tokyo, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| |
Collapse
|
3
|
Kuroda T, Ichikawa K, Hinata S, Chiba K, Okabayashi K, Asato Y, Aono H, Marumo K. Educating patients with upper limb dysfunction on self-adjustment of the CPAP/NPPV mask: A case series. Respirol Case Rep 2023; 11:e01232. [PMID: 37840601 PMCID: PMC10568380 DOI: 10.1002/rcr2.1232] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023] Open
Abstract
We share our experiences of instructing three patients with severe upper limb dysfunction on how to self-adjust CPAP/NPPV masks. In Case 1, we simplified the procedure by suturing a part of the headband as the left forearm was amputated. In Case 2, the patient had congenitally short limbs with short stature; thus, we provided an additional belt to the headband to maintain the headband's configuration while wearing the mask. In Case 3, the patient had left hemiplegia due to stroke and, repetitive coaching was conducted during the recovery phase rehabilitation program. Difficulties with self-adjusting NPPV/CPAP masks can occur whenever there is limited hand mobility above the head, including upper limb dysfunction. Simplifying procedures and providing sufficient time for instruction could help achieve independence. There have been no previous reports describing similar training details. We believe that sharing this knowledge will be helpful to both patients and healthcare professionals.
Collapse
Affiliation(s)
- Tomoko Kuroda
- Nursing DepartmentTokyo Metropolitan Police HospitalTokyoJapan
| | | | - Satoshi Hinata
- Respirology Division, Department of Internal MedicineTokyo Metropolitan Police HospitalTokyoJapan
| | - Kaoru Chiba
- Respirology Division, Department of Internal MedicineTokyo Metropolitan Police HospitalTokyoJapan
| | - Ken Okabayashi
- Respirology Division, Department of Internal MedicineTokyo Metropolitan Police HospitalTokyoJapan
| | - Yuko Asato
- Respirology Division, Department of Internal MedicineTokyo Metropolitan Police HospitalTokyoJapan
| | - Hiromi Aono
- Respirology Division, Department of Internal MedicineTokyo Metropolitan Police HospitalTokyoJapan
| | - Kazuyoshi Marumo
- Respirology Division, Department of Internal MedicineTokyo Metropolitan Police HospitalTokyoJapan
- Hoken Kaikan ClinicTokyo Health Service AssociationTokyoJapan
| |
Collapse
|
4
|
Wada T, Hibino M, Aono H, Kyoda S, Iwadate Y, Shishido E, Ikeda K, Kinoshita N, Matsuda Y, Otani S, Kameda R, Matoba K, Nonaka M, Maeda M, Kumagai Y, Ako J, Shichiri M, Naoki K, Katagiri M, Takaso M, Iwamura M, Katayama K, Miyatsuka T, Orihashi Y, Yamaoka K. Efficacy and safety of single-dose ivermectin in mild-to-moderate COVID-19: the double-blind, randomized, placebo-controlled CORVETTE-01 trial. Front Med (Lausanne) 2023; 10:1139046. [PMID: 37283627 PMCID: PMC10240959 DOI: 10.3389/fmed.2023.1139046] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/21/2023] [Indexed: 06/08/2023] Open
Abstract
Background To investigate whether ivermectin inhibits SARS-CoV-2 proliferation in patients with mild-to-moderate COVID-19 using time to a negative COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) test. Methods CORVETTE-01 was a double-blind, randomized, placebo-controlled study (August 2020-October 2021) conducted in Japan. Overall, 248 patients diagnosed with COVID-19 using RT-PCR were assessed for eligibility. A single oral dose of ivermectin (200 μg/kg) or placebo was administered under fasting. The primary outcome was time to a negative COVID-19 RT-PCR test result for SARS-CoV-2 nucleic acid, assessed using stratified log-rank test and Cox regression models. Results Overall, 112 and 109 patients were randomized to ivermectin and placebo, respectively; 106 patients from each group were included in the full analysis set (male [%], mean age: 68.9%, 47.9 years [ivermectin]; 62.3%, 47.5 years [placebo]). No significant difference was observed in the occurrence of negative RT-PCR tests between the groups (hazard ratio, 0.96; 95% confidence interval [CI] 0.70-1.32; p = 0.785). Median (95% CI) time to a negative RT-PCR test was 14.0 (13.0-16.0) and 14.0 (12.0-16.0) days for ivermectin and placebo, respectively; 82.1% and 84% of patients achieved negative RT-PCR tests, respectively. Conclusion In patients with COVID-19, single-dose ivermectin was ineffective in decreasing the time to a negative RT-PCR test. Clinical Trial Registration ClinicalTrials.gov, NCT04703205.
Collapse
Affiliation(s)
- Tatsuhiko Wada
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Hiromi Aono
- Department of Respiratory Medicine, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Shunsuke Kyoda
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yosuke Iwadate
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Eri Shishido
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Keisuke Ikeda
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Nana Kinoshita
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yasuki Matsuda
- Department of Cardiovascular Medicine, Kitasato University Hospital, Kanagawa, Japan
| | - Sakiko Otani
- Department of Respiratory Medicine, Kitasato University Hospital, Kanagawa, Japan
- Department of Respiratory Medicine, Tama-Nambu Chiiki Hospital, Tokyo, Japan
| | - Ryo Kameda
- Department of Cardiovascular Medicine, Kitasato University Hospital, Kanagawa, Japan
| | - Kenta Matoba
- Department of Endocrinology and Metabolism, Kitasato University Hospital, Kanagawa, Japan
| | - Miwa Nonaka
- Global Clinical Research Coordinating Center, Kitasato University Hospital, Kanagawa, Japan
| | - Mika Maeda
- Laboratory of Clinical Pharmacoepidemiology and Research and Education Center for Clinical Pharmacy, School of Pharmacy, Kitasato University, Kanagawa, Japan
| | - Yuji Kumagai
- Clinical Trial Center, Kitasato University Hospital, Kanagawa, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University Hospital, Kanagawa, Japan
| | - Masayoshi Shichiri
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Kyosai Hospital, Tokyo, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University Hospital, Kanagawa, Japan
| | - Masato Katagiri
- Department of Medical Laboratory Sciences, Kitasato University School of Allied Health Sciences, Tokyo, Japan
| | - Masashi Takaso
- Department of Orthopedic Surgery, Kitasato University Hospital, Kanagawa, Japan
| | - Masatsugu Iwamura
- Department of Urology, Kitasato University Hospital, Kanagawa, Japan
| | - Kazuhiko Katayama
- Department of Infection Control and Immunology, Ōmura Satoshi Memorial Institute, Tokyo, Japan
| | - Takeshi Miyatsuka
- Department of Endocrinology and Metabolism, Kitasato University Hospital, Kanagawa, Japan
| | - Yasushi Orihashi
- Division of Clinical Research, Kitasato University Hospital, Kanagawa, Japan
| | - Kunihiro Yamaoka
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | | |
Collapse
|
5
|
Miyamoto S, Azuma K, Ishii H, Bessho A, Hosokawa S, Fukamatsu N, Kunitoh H, Ishii M, Tanaka H, Aono H, Nakahara Y, Kusaka K, Hosomi Y, Kikuchi N, Mori Y, Itani H, Hamada A, Yamada K, Okamoto H. Low-Dose Erlotinib Treatment in Elderly or Frail Patients With EGFR Mutation-Positive Non-Small Cell Lung Cancer: A Multicenter Phase 2 Trial. JAMA Oncol 2020; 6:e201250. [PMID: 32407455 DOI: 10.1001/jamaoncol.2020.1250] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance Although the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors for EGFR gene mutation-positive non-small cell lung cancer is well established, optimal dosing remains to be established, especially in elderly or frail patients. Objective To investigate the efficacy and safety of low-dose erlotinib in elderly or frail patients with EGFR mutation-positive non-small cell lung cancer. Design, Setting, and Participants Single-arm phase 2 trial with the Southwest Oncology Group (SWOG) 2-stage design that enrolled frail patients from 21 Japanese institutions after meeting the inclusion criteria. Chemotherapy-naive patients with EGFR-activating mutation-positive non-small cell lung cancer who were considered frail based on age, the Charlson Comorbidity Index, and Eastern Cooperative Oncology Group performance status were eligible for the study. Interventions Patients were initially administered 50 mg/d erlotinib for 4 weeks, which was modified based on response or adverse events. Dose increase was permitted for patients with stable disease after 4 weeks. Main Outcomes and Measures The primary end point was the independent review committee-confirmed objective response rate (ORR) at the dose of 50 mg/d. The study also evaluated the pharmacokinetics of low-dose erlotinib and influence of ABCB1 gene polymorphisms. Results Eighty patients were enrolled, with a median (range) age of 80 (49-90) years; 54 (68%) were men. An independent review committee confirmed a significant ORR of 60.0% (90% CI, 50.2%-69.2%). The disease control rate was 90.0% (90% CI, 82.7%-94.9%), median progression-free survival was 9.3 months (95% CI, 7.2-11.4 months), and median overall survival was 26.2 months (95% CI, 21.9-30.4 months). Mild adverse events were observed in some participants, with few patients exhibiting grade 3 or greater adverse events. Low-dose erlotinib treatment was temporarily suspended for 10 patients owing to adverse events. Five of 80 patients (6%) had their erlotinib dose reduced to 25 mg because of oral mucositis, paronychia, erythema multiforme, diarrhea, and anorexia. Two patients discontinued treatment because of adverse events (cutaneous ulcer and bone infection, and oral mucositis, respectively). There were no cases of interstitial lung disease or treatment-related deaths. The median (range) erlotinib plasma concentration was measured at 685 (153-1950) ng/mL. Seventy-three patients discontinued study treatment owing to disease progression (n = 60), death (n = 3), AEs (n = 4), and patient requests (n = 6). No clear association was observed between the pharmacokinetics of low-dose erlotinib and the treatment outcome. Conclusions and Relevance Low-dose erlotinib appears to be safe and effective in elderly or frail patients with EGFR mutation-positive non-small cell lung cancer and can be a valid treatment option. Trial Registration UMIN-CTR Identifier: UMIN000015949.
Collapse
Affiliation(s)
- Shingo Miyamoto
- Department of Medical Oncology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Akihiro Bessho
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Shinobu Hosokawa
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Nobuaki Fukamatsu
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Hideo Kunitoh
- Department of Medical Oncology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Mari Ishii
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hiroshi Tanaka
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hiromi Aono
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | - Yoshiro Nakahara
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kei Kusaka
- The Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Yukio Hosomi
- Department of Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Norihiro Kikuchi
- Department of Respiratory Medicine, Kasumigaura Medical Center, Tsuchiura, Japan
| | - Yoshiaki Mori
- Department of Respiratory Medicine, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Hidetoshi Itani
- Department of Respiratory Medicine, Japanese Red Cross Ise Hospital, Ise, Japan
| | - Akinobu Hamada
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Kazuhiko Yamada
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| |
Collapse
|
6
|
Zenke Y, Matsumoto S, Kato T, Miyamoto S, Imakita T, Mitsudomi T, Aono H, Ushio R, Furuya N, Nishino K, Takata S, Nakao M, Hara S, Tachihara M, Sekine A, Sakakibara-Konishi J, Toyozawa R, Yoh K, Goto K. Clinical impact of targetable gene alterations on therapeutic outcomes in stage II/III locally advanced non-small cell lung cancer patients. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
9038 Background: The clinical significance of genetic alterations in stage II/III non-small cell lung cancer (NSCLC) patients has not yet been clarified. We have prospectively analyzed NSCLC patients for cancer-related gene alterations and have followed up clinical course of the patients, establishing a large-scale clinico-genomic database in our nationwide genome screening project (LC-SCRUM-Japan). Methods: Submitted tumor samples were subjected to a targeted next-generation sequencing (NGS) system, Oncomine™ Comprehensive Assay. Therapeutic and prognostic data were collected and updated every year. Results: Since March 2015 to May 2019, 5166 non-squamous NSCLC patients from 263 institutions had been enrolled in the LC-SCRUM-Japan, and 754 of them were diagnosed as stage II/III. The median age of the 754 patients was 67 years (range, 21-92), and 503 (67%) were male, 595 (79%) smokers and 631 (84%) stage III. Of 640 available samples, 258 (40%) had targetable gene alterations, comprising 106 KRAS mut, 42 EGFR mut, 29 BRAF mut, 20 MET ex14skip/amp, 16 ALK fus, 12 ROS1 fus, 11 ERBB2 ex20ins, 8 RET fus, 7 EGFR ex20ins, 5 AKT1 mut, 1 NRG1 fus, 1 FGFR2/3 fus. In patients who received surgery (n = 159), 3-year disease-free survival rate was worse in patients with targetable gene alterations than in those without (40% vs 58% months; p = 0.03). In patients who received cytotoxic chemo-radiotherapy (n = 148), the response rate was similar in patients with targetable gene alterations and those without (70% vs. 77%); however, 3-year progression-free survival rate tended to be shorter in patients with targetable gene alterations than in those without (19% vs 35%; p = 0.08). Conclusions: In stage II/III NSCLC, the total frequency of targetable gene alterations was similar to that previously evaluated in our stage IV cohort (45%), and the current standard therapies showed early progression in the targetable gene-altered patients. A novel effective multimodality treatment in combination with targeted therapies is needed for this population.
Collapse
Affiliation(s)
| | | | - Terufumi Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | | | - Takuma Imakita
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Tetsuya Mitsudomi
- Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Japan
| | | | - Ryota Ushio
- Yokohama City University Medical Center, Yokohama, Japan
| | - Naoki Furuya
- St. Marianna University School of Medicine, Kawasaki, Japan
| | | | | | - Mika Nakao
- Shimane University Faculty of Medicine, Izumo, Japan
| | - Satoshi Hara
- Respiratory Division, Department of Internal Medicine, Itami City Hospital, Itami, Japan
| | - Motoko Tachihara
- Divisions of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akimasa Sekine
- Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | | | - Ryo Toyozawa
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kiyotaka Yoh
- National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Goto
- National Cancer Center Hospital East, Kashiwa, Japan
| |
Collapse
|
7
|
Takahashi Y, Akiho M, Aono H, Tsugitomi R, Tamura T. Evaluation of factors associated with the timing of pulmonary rehabilitation during hospitalisation in patients with interstitial lung disease: a two-centre retrospective study. European Journal of Physiotherapy 2020. [DOI: 10.1080/21679169.2019.1578826] [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: 10/27/2022]
Affiliation(s)
- Yuta Takahashi
- Department of Rehabilitation, St. Luke’s International Hospital, Tokyo, Japan
| | - Mitsutoshi Akiho
- Department of Rehabilitation, Mitsui Memorial Hospital, Tokyo, Japan
| | - Hiromi Aono
- Department of Pulmonary Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | - Ryosuke Tsugitomi
- Department of Pulmonary Medicine, St. Luke’s International Hospital, Tokyo, Japan
| | - Tomohide Tamura
- Department of Pulmonary Medicine, St. Luke’s International Hospital, Tokyo, Japan
| |
Collapse
|
8
|
Miyanaga A, Kubota K, Hosomi Y, Okuma Y, Minato K, Fujimoto S, Okamoto H, Satouchi M, Isobe H, Aono H, Takiguchi Y, Gemma A. Phase II trial of S-1 plus cisplatin combined with bevacizumab for advanced non-squamous non-small cell lung cancer (TCOG LC-1202). Jpn J Clin Oncol 2020; 49:749-754. [PMID: 31070750 DOI: 10.1093/jjco/hyz064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/08/2019] [Accepted: 04/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND S-1 plus cisplatin is a standard chemotherapy regimen for advanced non-small cell lung cancer (NSCLC). The addition of bevacizumab has been shown to significantly improve overall survival (OS) in patients with advanced non-squamous (NSq) NSCLC who received carboplatin plus paclitaxel, however, failed to show an OS advantage in patients who received cisplatin plus gemcitabine. METHODS Chemotherapy-naive patients with Stage IIIB, IV or recurrent non-SQ NSCLC were treated with a 3-week cycle of S-1 80 mg/m2 on days 1-14, cisplatin 60 mg/m2 on day 8 and bevacizumab 15 mg/kg on day 8 for 4-6 cycles. Patients without progressive disease (PD) received maintenance bevacizumab 15 mg/kg on day 1 with a 3-week cycle and S-1 80 mg/m2 every other day. The primary endpoint was progression-free survival (PFS). Secondary endpoints were objective response rate (ORR), OS, toxicity profile and Quality of life (QOL). RESULTS From June 2013 to January 2015, 39 eligible patients were enrolled from eight institutions. Thirty-one patients (79%) completed four cycles of induction chemotherapy, and maintenance chemotherapy was initiated in 23 patients (59%). Median PFS, OS and ORR were 7.3 months (95% CI: 5.9-8.7), 21.4 months (95% CI: 14.7-not reached) and 64%, respectively. The most common grade 3/4 toxicities were leukopenia (12.8%), neutropenia (23.0%) and hypertension (28.2%). QOL analyses showed detrimental effects after initiation of the regimen. CONCLUSIONS S-1 plus cisplatin in combination with bevacizumab met the primary endpoint in patients with advanced NSq-NSCLC. RR was anticipated to be high with acceptable toxicities.
Collapse
Affiliation(s)
- Akihiko Miyanaga
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo
| | - Yukio Hosomi
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo
| | - Yusuke Okuma
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo
| | | | | | | | | | | | | | - Yuichi Takiguchi
- Graduate School of Medicine, Chiba University, Department of Medical Oncology, Chiba, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo
| | | |
Collapse
|
9
|
Otani S, Yamada K, Miyamoto S, Azuma K, Ishii H, Bessho A, Hosokawa S, Kunitoh H, Miyazaki K, Tanaka H, Miura S, Aono H, Nakahara Y, Kusaka K, Hosomi Y, Hamada A, Okamoto H. MA21.11 A Multicenter Phase II Study of Low-Dose Erlotinib in Frail Patients with EGFR Mutation-Positive, Non-Small Cell Lung Cancer: TORG1425. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.681] [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: 10/25/2022]
|
10
|
Kurihara M, Koda H, Aono H, Sugimoto I, Sakurai Y, Sano T, Saito Y, Murayama S, Mori M. Rapidly progressive miliary brain metastasis of lung cancer after EGFR tyrosine kinase inhibitor discontinuation: An autopsy report. Neuropathology 2019; 39:147-155. [PMID: 30868686 DOI: 10.1111/neup.12542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 01/18/2023]
Abstract
Miliary brain metastasis is a rare type of brain metastasis, in which carcinoma cells disseminate to numerous foci confined to Virchow-Robin/subpial spaces. Symptoms usually progress within several months, and magnetic resonance imaging (MRI) shows multiple small contrast-enhancing lesions. We report an autopsy case of a patient who rapidly deteriorated within a week due to miliary brain metastasis after epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) discontinuation, without contrast-enhancing lesions on MRI. A 74-year-old woman was diagnosed with stage IV lung adenocarcinoma with EGFR L868R mutation 2 years before presentation. Gefitinib, an EGFR-TKI was started. After 7 months, multiple new punctate contrast-enhancing lesions in the cerebral cortex appeared. After switching to another EGFR-TKI, erlotinib, these lesions disappeared. One year later, erlotinib was discontinued because of disease progression in the lung and docetaxel was initiated. Sixteen days later, cognitive decline appeared which rapidly progressed to bedridden state in 4 days. MRI showed multiple cortical small fluid-attenuated inversion recovery high intensity lesions which lacked contrast enhancement. The patient exhibited a state of akinetic mutism within a few days, and died 52 days after the appearance of neurological symptoms. The rapid progression indicated disease flare after EGFR-TKI discontinuation. Autopsy revealed numerous foci of metastasis in the cerebral cortex, basal ganglia, thalamus, and cerebellum, in which cancer cells were mostly confined to the Virchow-Robin/subpial spaces. These pathological findings were compatible with previous reports of miliary brain metastasis. Recent reports suggest that early disseminated cancer cells can survive for a long time and even remain after chemotherapy in supportive niches, and Virchow-Robin spaces are the niches in the brain. Our case suggests that these cancer cells may rapidly proliferate as a withdrawal burst after discontinuation of molecular targeted drugs, and show pathological findings of miliary brain metastasis.
Collapse
Affiliation(s)
| | - Hirotomo Koda
- Department of Pathology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Hiromi Aono
- Department of Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | - Izumi Sugimoto
- Department of Neurology, Mitsui Memorial Hospital, Tokyo, Japan
| | | | - Terunori Sano
- Department of Pathology and Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuko Saito
- Department of Pathology and Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shigeo Murayama
- Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Masaya Mori
- Department of Pathology, Mitsui Memorial Hospital, Tokyo, Japan
| |
Collapse
|
11
|
Bessho A, Miyamoto S, Azuma K, Ishii H, Hosokawa S, Kunitoh H, Shimokawa T, Tanaka H, Aono H, Nakahara Y, Hosomi Y, Kusaka K, Yamada K, Okamoto H. A phase II study of low-dose erlotinib in frail patients with EGFR-mutant non-small cell lung cancer: TORG1425. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy374.034] [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: 11/13/2022] Open
|
12
|
Miyamoto S, Tokkito T, Bessho A, Fukamatsu N, Kunitoh H, Ishii M, Tanaka H, Aono H, Fukui T, Kusaka K, Hosomi Y, Hamada A, Yamada K, Okamoto H. ABCB1 genetic polymorphism and pharmacokinetic analysis of low dose erlotinib in frail patients with EGFR mutation (mt)-positive, non-small cell lung cancer: TORG1425. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.047] [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
|
13
|
Usui K, Yokoyama T, Kisohara A, Mori Y, Takeda Y, Ishida H, Kusano N, Kishi K, Katsushima U, Kuwako T, Aono H, Shikama Y, Minato K, Matsushima H, Uemura K, Ohashi Y, Kunitoh H. The plasma ctDNA monitoring during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in patients with EGFR mutant non-small cell lung cancer (JP-CLEAR trial). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.046] [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: 11/13/2022] Open
|
14
|
Ogawa Y, Umemura S, Murakami H, Shingoji M, Kobayashi N, Shimokawaji T, Daga H, Seto T, Okamoto N, Aono H, Fujiwara Y, Hara S, Kanaji N, Matsumoto S, Udagawa H, Yoh K, Goto K. Large-scale nationwide genomic screening system for small cell lung cancer in Japan (LC-SCRUM-Japan). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.8572] [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] Open
Affiliation(s)
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Haruyasu Murakami
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | | | | | | | - Haruko Daga
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Takashi Seto
- Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology and Bronchology, Osaka Habikino Medical Center, Habikino, Japan
| | | | - Yutaka Fujiwara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Hara
- Respiratory Division, Department of Internal Medicine, Itami City Hospital, Itami, Japan
| | - Nobuhiro Kanaji
- Department of Internal Medicine, Division of Hematology, Rheumatology, and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hibiki Udagawa
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| |
Collapse
|
15
|
Sakamoto T, Matsumoto S, Sugiyama E, Yoh K, Kobayashi N, Yokoyama T, Shingoji M, Kato T, Aono H, Hara S, Sugawara S, Sekine A, Goto K. Therapeutic and prognostic impact of genetic alterations identified in nationwide genome screening for squamous cell lung cancer (LC-SCRUM-Japan). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.9074] [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] Open
Affiliation(s)
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Eri Sugiyama
- Division of Cancer Immunology, National Cancer Center, Kashiwa, Japan
| | - Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Terufumi Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | | | - Satoshi Hara
- Respiratory Division, Department of Internal Medicine, Itami City Hospital, Itami, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Akimasa Sekine
- Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| |
Collapse
|
16
|
Yamada K, Miyamoto S, Azuma K, Ishii H, Bessho A, Fukamatsu N, Kunitoh H, Ishii M, Tanaka H, Aono H, Nakahara Y, Kusaka K, Hosomi Y, Kikuchi N, Mori Y, Itani H, Kasai T, Ichiki M, Seki N, Okamoto H. A multicenter phase II study of low-dose erlotinib in frail patients with EGFR mutation-positive, non-small cell lung cancer: Thoracic oncology research group (TORG) trial 1425. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.9063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- Kazuhiko Yamada
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | | | | | - Mari Ishii
- Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hiroshi Tanaka
- Department of Respiratory Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | | | | | - Kei Kusaka
- National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | | | | | - Takashi Kasai
- Department of Respiratory Medicine, Tochigi Cancer Center, Utsunomiya, Japan
| | | | | | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| |
Collapse
|
17
|
Murakami H, Umemura S, Shinoda M, Shingyoji M, Ogawa Y, Takeda K, Nosaki K, Okamoto N, Aono H, Hara S, Kuyama S, Sato A, Kanaji N, Okimoto T, Kataoka Y, Matsumoto S, Udagawa H, Yoh K, Tsuchihara K, Goto K. A nationwide genomic screening project for small cell lung cancer in Japan (LC-SCRUM-Japan). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.8518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
8518 Background: Recent genomic studies of small-cell lung cancer (SCLC) have identified promising therapeutic strategies for this highly lethal form of cancer. Thus, we established a nationwide lung cancer genomic screening project in Japan (LC-SCRUM-Japan) to identify SCLC patients harboring targetable genomic alterations for the development of novel targeted therapies. Methods: The samples were subjected to a next-generation sequencing (NGS) system, Oncomine™ Comprehensive Assay, enabling the simultaneous analysis of 143 cancer-related genes. Results: As of December 2016, 133 institutions were participating and 295 patients had been enrolled. The median age was 69 years (range, 14-90 years). Two hundred seventeen (74%) were male and most patients (93%) were smokers. Among 268 samples completed analysis, we identified high prevalence of inactivating TP53/RB1 mutations in 198 (74%) /82 (31) of cases, respectively. MYC/MYCL1/MYCN amplifications were detected in 10 (4%) /13 (5) /4 (1) of cases, respectively. The NGS analysis also showed that 62 (23%) of cases had at least one targetable genomic alterations, including 7 EGFR activating mutations (3%), 6 KRAS activating mutations (2%), and 8 FGFR1 copy number gains (3%). No case was positive for ALK or ROS1 fusions. Never-smokers (71% vs. 5%, p<0.001) were significantly frequent in the EGFR type compared to the others. The KRAS type showed significantly poor progression free survival (PFS) of the first-line chemotherapy compared to the others (median PFS 1.2 vs. 6.1 months, respectively; p<0.001). Mutations in the PI3K/AKT/mTOR pathway were detected in 22 (8%) of the tumors: 10 PIK3CA mutations (4%), 9 PTEN inactivating mutations (3%) and 3 TSC2 inactivating mutations (1%). Among them, a case with PTEN mutation was enrolled in the investigator initiated phase II study of gedatolisib named “EAGLE-PAT” (UMIN 000020585). Conclusions: We identified a series of targetable genomic alterations in SCLC. This nationwide screening system is helpful for identifying targetable genomic alterations and their clinical features, contributing to the development of novel targeted therapies for this disease. Updated screening results will be presented at the 2017 ASCO Annual Meeting.
Collapse
Affiliation(s)
- Haruyasu Murakami
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Koji Takeda
- Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Kaname Nosaki
- Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Norio Okamoto
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan
| | - Hiromi Aono
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | - Satoshi Hara
- Respiratory Division, Department of Internal Medicine, Itami City Hospital, Itami, Japan
| | | | - Akiko Sato
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Nobuhiro Kanaji
- Department of Internal Medicine, Division of Hematology, Rheumatology, and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | | | - Yuki Kataoka
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyoko, Japan
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hibiki Udagawa
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Katsuya Tsuchihara
- Division of Translational Research, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| |
Collapse
|
18
|
Sugiyama E, Matsumoto S, Kobayashi N, Aono H, Shingyoji M, Hotta K, Sekine A, Hara S, Furuya N, Nakagawa T, Nakazaki H, Harada T, Sugawara S, Takata S, Okamoto N, Taima K, Tomii K, Yoh K, Goto K. Clinical features of squamous cell lung cancer with targetable gene alterations in a nationwide genomic screening network in Japan (LC-SCRUM-Japan). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.9057] [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
9057 Background: Molecular-targeted therapies for precision medicine in squamous cell lung cancer (SqLC) have not yet been established. To identify precise patients for targeted therapies and to reveal their clinical characteristics, we have operated clinical sequencing of advanced SqLCs in our nationwide genomic screening project in Japan (LC-SCRUM-Japan) since March 2015. Methods: As of December 2016, 190 institutions across Japan were participating and 263 advanced SqLC patients had been enrolled in this project. Submitted tumor samples were subjected to a next-generation sequencing system, Oncomine™ Comprehensive Assay, enabling the simultaneous analysis of 143 cancer-related genes. Results: The median age of the 263 patients was 74 years (range, 27-87 years). Two hundred thirty (87%) were male and most patients (97%) were smokers. Among 211 available samples, potentially targetable gene alterations were detected in 58 (27%). Based on these gene alterations, the patients were subdivided into 4 groups, consisting of 25 (12%) with genetic alterations of FGFR family (FGFR type; 23 FGFR1 amplifications, 1 FGFR2 amplification and 1 FGFR3 fusion), 20 (9%) with genetic alterations of the PI3K pathway (PI3K type; 10 PIK3CA mutations, 8 PTEN mutations and 2 AKT mutations), 15 (7%) with other oncogene alterations (KRAS/EGFR/ALK type; 10 KRAS mutations, 3 EGFR mutations and 2 ALK fusions) and others. Comparative analyses of clinical characteristics between the 4 types showed that brain metastases were significantly more frequent in the FGFR type than the others (24% vs. 5%, p = 0.0007), and females (40% vs. 11%, p = 0.0009) and never-smokers (21% vs. 3%, p = 0.0004) were significantly frequent in the KRAS/EGFR/ALK type compared to the others. The prognostic significance of these genetic alterations has not yet been evaluated because of short follow-up time (median, 8.5 months). Conclusions: A series of potentially targetable gene alterations have been identified in SqLC patients. The SqLC patients had distinct clinical features according to the molecular subtypes, and genotype-directed therapeutic strategy should be developed for the individual subtypes.
Collapse
Affiliation(s)
- Eri Sugiyama
- Division of Cancer Immunology, National Cancer Center, Kashiwa, Japan
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Hiromi Aono
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | | | | | - Akimasa Sekine
- Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Satoshi Hara
- Respiratory Division, Department of Internal Medicine, Itami City Hospital, Itami, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Taku Nakagawa
- Department of Thoracic Surgery, Omagari Kosei Medical Center, Daisen, Japan
| | - Hirofumi Nakazaki
- Department of Respiratory Medicine, Matsue Red Cross Hospital, Matsue, Japan
| | - Taishi Harada
- Department of Medical Oncology, Fukuchiyama City Hospital, Fukuchiyama, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | | | - Norio Okamoto
- Osaka Prefectual Medical Center for Respiratory and Allergic Diseases, Osaka, Japan
| | | | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center, General Hospital, Kobe, Japan
| | - Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| |
Collapse
|
19
|
Okuma Y, Hosomi Y, Miyanaga A, Minato K, Fujimoto S, Aono H, Hattori Y, Isobe H, Okamoto H, Takiguchi Y, Kubota K. P3.02c-015 Phase II Trial of S-1/Cisplatin Combined with Bevacizumab for Advanced Non-Squamous Non-Small Cell Lung Cancer: TCOG LC-1202. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1810] [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: 11/15/2022]
|
20
|
Kubota K, Miyanaga A, Hosomi Y, Okuma Y, Minato K, Fujimoto S, Takiguchi Y, Okamoto H, Hattori Y, Isobe H, Aono H. Phase II trial of S-1 plus cisplatin combined with bevacizumab for advanced non-squamous non-small cell lung cancer (TCOG LC-1202). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw391.09] [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: 11/12/2022] Open
|
21
|
Shimokawaji T, Sugiyama E, Matsumoto S, Yoh K, Shingyoji M, Ohashi K, Kato T, Aono H, Ohe Y, Sugawara S, Furuya N, Nakazaki H, Taima K, Watanabe H, Harada T, Sakamoto T, Ikemura S, Tsuchihara K, Goto K. Development of a nationwide genomic screening network for squamous cell lung cancer in Japan (LC-SCRUM-Japan). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.9097] [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] Open
Affiliation(s)
| | - Eri Sugiyama
- Division of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | | | - Kadoaki Ohashi
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Terufumi Kato
- Kanagawa Cardiovascular and Respiratory Center, Yokohama-Shi, Japan
| | - Hiromi Aono
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Naoki Furuya
- Division of Respiratory Medicine, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Hirofumi Nakazaki
- Department of Respiratory Medicine, Matsue Red Cross Hospital, Matsue, Japan
| | | | | | - Taishi Harada
- Department of Medical Oncology, Fukuchiyama City Hospital, Fukuchiyama, Japan
| | - Tomohiro Sakamoto
- Division of Translational Research, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Chiba, Japan
| | | | - Katsuya Tsuchihara
- Division of Translational Research, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Koichi Goto
- National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| |
Collapse
|
22
|
Takagi Y, Hosomi Y, Oshita F, Okamoto H, Seki N, Minato K, Aono H, Yamada K, Okuma Y, Hida N, Sakamoto T, Miura Y, Yomota M, Satoh A, Kunitoh H, Sakamaki K, Shibuya M, Watanabe K. Feasibility study of docetaxel plus bevacizumab as first line therapy for elderly patients with advanced non-small-cell lung cancer: Thoracic Oncology Research Group (TORG) 1014. BMC Cancer 2015; 15:740. [PMID: 26481215 PMCID: PMC4612532 DOI: 10.1186/s12885-015-1756-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 06/27/2014] [Accepted: 10/09/2015] [Indexed: 01/22/2023] Open
Abstract
Background Docetaxel monotherapy is one of the standard treatments for non-small-cell lung cancer in elderly patients. The addition of bevacizumab to docetaxel seems promising; however, the feasibility of this combination has not been investigated in such patients. Methods Patients with advanced non-squamous non-small-cell lung cancer aged 70 years or older who had not previously received cytotoxic chemotherapy were enrolled. Patients in the Level 0 cohort received docetaxel 60 mg/m2 and bevacizumab 15 mg/kg, whereas those in the Level-1 cohort received docetaxel 50 mg/m2 and bevacizumab 15 mg/kg. Chemotherapy was repeated 3 weekly for six cycles. The primary endpoint was toxicity and the secondary endpoints were response rate, progression-free survival, overall survival, and proportion of patients who underwent three or more cycles of chemotherapy. Results Twenty-one patients were enrolled from December 2010 to September 2012 at six institutes. Of the nine patients enrolled in Level 0, two experienced dose-limiting toxicity (febrile neutropenia and prolonged Grade 4 neutropenia in one patient, and Grade 3 infection in another patient) during the first cycle. Enrollment to the Level 0 cohort was terminated because two patients developed Grade 4 sepsis during later cycles. The remaining 12 patients were enrolled in the Level-1 cohort, in which two dose-limiting toxicities (prolonged Grade 4 neutropenia and Grade 3 increased aminotransferase level) were observed. No patient in the Level-1 cohort experienced Grade 4 nonhematologic toxicity. Grade 4 neutropenia occurred in 89 % of Level 0 patients and 50 % of Level-1 patients. The proportion of patients who experienced Grade 3/4 infection, febrile neutropenia or sepsis was 44 % in the Level 0 cohort, and 8 % in the Level-1 cohort. The overall response rate to chemotherapy and progression-free survival were 29 % (95 % CI, 11–52 %) and 5.9 months (95 % CI, 3.6–9.1 months), respectively. Efficacy outcomes did not differ significantly between the cohorts. Conclusions Toxicities were tolerable in level-1 cohort. The recommended dose of combination chemotherapy with docetaxel and bevacizumab for elderly patients was determined as 50 mg/m2 of docetaxel and 15 mg/kg of bevacizumab and toxicities were tolerable. Further studies are warranted. Trial registration UMIN Clinical Trial Registry; UMIN000004240.
Collapse
Affiliation(s)
- Yusuke Takagi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
| | - Fumihiro Oshita
- Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.
| | - Hiroaki Okamoto
- Yokohama Municipal Citizen's Hospital, 56 Kazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
| | - Nobuhiko Seki
- Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan.
| | - Koichi Minato
- Gunma Prefectural Cancer Center, 617-1 Takahayashi-Nishicho, Ota City, Gunma, 373-8550, Japan.
| | - Hiromi Aono
- Mitsui Memorial Hospital, 1 Kanda-Izumicho, Chiyoda-ku, Tokyo, 101-8643, Japan.
| | - Kouzo Yamada
- Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
| | - Naoya Hida
- Yokohama Municipal Citizen's Hospital, 56 Kazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
| | - Takahiko Sakamoto
- Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan.
| | - Yosuke Miura
- Gunma Prefectural Cancer Center, 617-1 Takahayashi-Nishicho, Ota City, Gunma, 373-8550, Japan.
| | - Makiko Yomota
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
| | - Akira Satoh
- Yokohama Municipal Citizen's Hospital, 56 Kazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
| | - Hideo Kunitoh
- Mitsui Memorial Hospital, 1 Kanda-Izumicho, Chiyoda-ku, Tokyo, 101-8643, Japan. .,Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.
| | - Kentaro Sakamaki
- Kyoto University Graduate School of Medicine, Yoshida-Konoecho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Masahiko Shibuya
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
| | - Koshiro Watanabe
- Yokohama Municipal Citizen's Hospital, 56 Kazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
| |
Collapse
|
23
|
Yamada K, Aono H, Hosomi Y, Okamoto H, Kato T, Komase Y, Nishikawa M, Azuma K, Takeoka H, Okuma Y, Nakahara Y, Sato A, Oba MS, Morita S, Kunitoh H, Watanabe K. A prospective, multicentre phase II trial of low-dose erlotinib in non-small cell lung cancer patients with EGFR mutations pretreated with chemotherapy: Thoracic Oncology Research Group 0911. Eur J Cancer 2015; 51:1904-10. [PMID: 26174465 DOI: 10.1016/j.ejca.2015.06.120] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 05/26/2015] [Accepted: 06/13/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Low-dose erlotinib may be as effective as gefitinib or erlotinib at full dose in non-small cell lung cancer (NSCLC) patients with activating mutations of the epidermal growth factor receptor (EGFR) gene. METHODS Patients with chemotherapy pretreated NSCLC harbouring EGFR mutations received erlotinib at 50 mg/d until disease progression or unacceptable toxicities. The dose was escalated to 150 mg/d in patients showing no response (i.e. without major tumour shrinkage according to Response Evaluation Criteria in Solid Tumours (RECIST)) to the initial dose during the first 4 weeks. The primary end-point was the objective response rate at the dose of 50 mg/d. RESULTS Thirty-four patients from seven institutes were enrolled. The study was closed early when no response was confirmed in 15 patients, excluding the possibility that the primary end-point would be met. The objective response and disease control rates at the dose of 50 mg/d as determined by an independent review committee were 54.5% and 84.8%, respectively. Four additional patients achieved partial response with increased 150 mg/d dose. Progression-free survival and median survival times during the entire period of the study were 9.5 and 28.5 months, respectively. Treatment-related toxicities were generally mild, the most common being skin disorders and diarrhoea. Only one case experienced grade 3 toxicity, which was transient increase of hepatic enzymes. CONCLUSION The primary end-point was not met; low-dose erlotinib is not recommended for fit patients with NSCLC harbouring EGFR mutations. However, it may merit further evaluation for elderly or frail patients.
Collapse
Affiliation(s)
- Kazuhiko Yamada
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.
| | - Hiromi Aono
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Terufumi Kato
- Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, Kanagawa, Japan
| | - Masanori Nishikawa
- Department of Respiratory Medicine, Fujisawa City Hospital, Kanagawa, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroaki Takeoka
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yoshiro Nakahara
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan; Department of Respiratory Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Akira Sato
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Mari S Oba
- Department of Biostatistics, Yokohama City University Medical Center, Kanagawa, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideo Kunitoh
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan; Department of Medical Oncology, Japanese Red Cross Medical Center, Tokyo, Japan
| | | |
Collapse
|
24
|
Isaka M, Befu M, Matsubara N, Ishikawa M, Aono H, Namba S. Type 1 Achilles tendon rupture caused by grooming trauma in a young dog. Open Vet J 2014; 4:56-8. [PMID: 26623339 PMCID: PMC4629596] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 04/18/2014] [Indexed: 11/20/2022] Open
Abstract
Achilles tendon rupture is uncommon in small animal practice. A 9-month-old, female, mixed breed dog (weighing 2.2kg) was referred to our hospital with a primary complaint of right hind limb lameness. Complete right Achilles tendon rupture was diagnosed by physical examination and radiography. The tendon was surgically repaired the next day by using a three-loop and single near-far-far-near suture methods. Complete healing was achieved by 97 days post-surgery. This report describes the surgical technique used for complete Achilles tendon rupture repair in a young dog.
Collapse
Affiliation(s)
- M. Isaka
- Marble Veterinary Medical Center, 4-1-6 Ishikawa, Fujisawa, Kanagawa, Japan 252-0815,Corresponding Author: Dr. Mitsuhiro Isaka. Marble Veterinary Medical Center, 4-1-6 Ishikawa, Fujisawa, Kanagawa, Japan. Tel.: +81 466 86 2080, +81 466 86 0558.
| | - M. Befu
- Marble Veterinary Medical Center, 4-1-6 Ishikawa, Fujisawa, Kanagawa, Japan 252-0815
| | - N. Matsubara
- Marble Veterinary Medical Center, 4-1-6 Ishikawa, Fujisawa, Kanagawa, Japan 252-0815
| | - M. Ishikawa
- Marble Veterinary Medical Center, 4-1-6 Ishikawa, Fujisawa, Kanagawa, Japan 252-0815
| | - H. Aono
- Aono Pet Clinic, 31-2 Fukawa, Odawara, Kanagawa, Japan 250-0052
| | - S. Namba
- Marble Veterinary Medical Center, 4-1-6 Ishikawa, Fujisawa, Kanagawa, Japan 252-0815
| |
Collapse
|
25
|
Yamaji S, Uchida H, Mori S, Shi X, Kameo S, Aono H. The Current Situations and Issues in Phase I Studies in Japan (Phase I Capability from Pharmaceutical Company Perspective). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32133-5] [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: 10/25/2022] Open
|
26
|
Furukawa H, Iwasaki K, Samukawa M, Nagamachi K, Aono H, Matsumoto T, Ohkado A. [Impact of preoperative 64-row multislice computed tomography for congenital aortic stenosis; report of a case]. Kyobu Geka 2010; 63:1078-1081. [PMID: 21066852] [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: 05/30/2023]
Abstract
A 63-year-old woman was diagnosed as having severe aortic stenosis (AS) with 98 mmHg peak pressure gradient detected by echocardiography. Since, preoperative enhanced 64-row multislice computed tomography (MSCT) showed bicuspid aortic valve with only 2 sinuses of Valsalva, congenital aortic stenosis was suspected. The left and right coronary arteries originated from respective sinus of Valsalva, and severely thickened cusps of aortic valve were detected clearly by preoperative 64-row MSCT. Aortic valve replacement with a 21 mm ATS mechanical bileaflet prosthesis was performed without aortic annulus enlargement. The postoperative course was uneventful and postoperative 64-row MSCT indicated good performance of the ATS valve. Preoperative 64-row MSCT could be useful to detect complex aortic valve disease in detail. Moreover. 64-row MSCT might be a reliable tool to evaluate valvular heart disease.
Collapse
Affiliation(s)
- H Furukawa
- Department of Cardiovascular Surgery, Cardiovascular Center, Okayama Central Hospital, Okayama, Japan
| | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Hovering is a miracle of insects that is observed for all sizes of flying insects. Sizing effect in insect hovering on flapping-wing aerodynamics is of interest to both the micro-air-vehicle (MAV) community and also of importance to comparative morphologists. In this study, we present an integrated computational study of such size effects on insect hovering aerodynamics, which is performed using a biology-inspired dynamic flight simulator that integrates the modelling of realistic wing-body morphology, the modelling of flapping-wing and body kinematics and an in-house Navier-Stokes solver. Results of four typical insect hovering flights including a hawkmoth, a honeybee, a fruit fly and a thrips, over a wide range of Reynolds numbers from O(10(4)) to O(10(1)) are presented, which demonstrate the feasibility of the present integrated computational methods in quantitatively modelling and evaluating the unsteady aerodynamics in insect flapping flight. Our results based on realistically modelling of insect hovering therefore offer an integrated understanding of the near-field vortex dynamics, the far-field wake and downwash structures, and their correlation with the force production in terms of sizing and Reynolds number as well as wing kinematics. Our results not only give an integrated interpretation on the similarity and discrepancy of the near- and far-field vortex structures in insect hovering but also demonstrate that our methods can be an effective tool in the MAVs design.
Collapse
Affiliation(s)
- H Liu
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | | |
Collapse
|
28
|
Aono H, Ohwada T, Kaneko N, Fuji T, Iwasaki M. The post-operative changes in the level of inflammatory markers after posterior lumbar interbody fusion. ACTA ACUST UNITED AC 2007; 89:1478-81. [DOI: 10.1302/0301-620x.89b11.19478] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Inflammatory markers such as the C-reactive protein (CRP), white blood cell count and body temperature are easy to measure and are used as indicators of infection. The way in which they change in the early post-operative period after instrumented spinal surgery has not been reported in any depth. We measured these markers pre-operatively and at one, four, seven and 14 days postoperatively in 143 patients who had undergone an instrumented posterior lumbar interbody fusion. The CRP proved to be the only sensitive marker and had returned to its normal level in 48% of patients after 14 days. The CRP on day 7 was never higher than that on day 4. Age, gender, body temperature, operating time and blood loss were not related to the CRP level. A high CRP does not in itself suggest infection, but any increase after four days may presage infection.
Collapse
Affiliation(s)
- H. Aono
- Department of Orthopaedic Surgery, Osaka National Hospital, 2-1-14, Hoenzaka Chuo-ku, Osaka City, Osaka 540-0006, Japan
| | - T. Ohwada
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, 3-1-69, Inabaso Amagasaki City, Hyogo, 660-8511, Japan
| | - N. Kaneko
- Department of Orthopaedic Surgery, Osaka Koseinenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka City, Osaka 553-0003, Japan
| | - T. Fuji
- Department of Orthopaedic Surgery, Osaka Koseinenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka City, Osaka 553-0003, Japan
| | - M. Iwasaki
- Department of Orthopaedic Surgery, Osaka University Graduate, School of Medicine, 2-15 Yamadaoka Suita City, Osaka 565-0871, Japan
| |
Collapse
|
29
|
Sawabe T, Takahasi H, Saeki H, Niwa K, Aono H. Enhanced expression of active recombinant alginate lyase AlyPEEC cloned from a marine bacterium Pseudoalteromonas elyakovii in Escherichia coli by calcium compounds. Enzyme Microb Technol 2007. [DOI: 10.1016/j.enzmictec.2006.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
30
|
Aono H, Okamoto H, Kunikane H, Nagatomo A, Watanabe K, Nagai A. Transbronchial needle aspiration cytology of subcarinal lymph nodes for the staging procedure in the diagnosis of lung cancer. Respirology 2006; 11:782-5. [PMID: 17052308 DOI: 10.1111/j.1440-1843.2006.00928.x] [Citation(s) in RCA: 5] [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: 11/28/2022]
Abstract
OBJECTIVE AND BACKGROUND The aim of this study was to improve the staging of lung cancer with or without lymphadenopathy on chest CT by using transbronchial aspiration cytology (TBAC). METHODS TBAC of the subcarinal lymph nodes was performed on 153 consecutive patients with lung cancer, with or without subcarinal lymphadenopathy on chest CT. RESULTS Thirty-four patients had enlargement of the subcarinal lymph nodes (>1 cm). Eighteen of these had TBAC confirmation of metastases. Another seven patients with no mediastinal involvement on CT were positive for metastases on TBAC. TBAC was the only way to confirm lung cancer in two patients. Therefore, routinely performed subcarinal TBAC contributed to an improved non-operative staging of the patients and diagnosis in 16% (25/153) of the patients with lung cancer. Forty-nine patients with NSCLC had surgical resection of the tumour. Surgical procedure revealed metastases to the subcarinal lymph nodes in three patients in whom the preoperative TBAC diagnosis was normal. No significant complications due to TBAC occurred in any of the patients. CONCLUSION TBAC of the subcarinal lymph nodes is a minimally invasive technique for staging of lung cancer and can provide useful information for the diagnosis of metastases to the subcarinal lymph nodes.
Collapse
Affiliation(s)
- Hiromi Aono
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, and First Department of Medicine, Tokyo Women's Medical University, Japan.
| | | | | | | | | | | |
Collapse
|
31
|
Ohe Y, Niho S, Kakinuma R, Kubota K, Ohmatsu H, Goto K, Nokihara H, Kunitoh H, Saijo N, Aono H, Watanabe K, Tango M, Yokoyama A, Nishiwaki Y. A phase II study of cisplatin and docetaxel administered as three consecutive weekly infusions for advanced non-small-cell lung cancer in elderly patients. Ann Oncol 2004; 15:45-50. [PMID: 14679118 DOI: 10.1093/annonc/mdh015] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [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: 11/13/2022] Open
Abstract
BACKGROUND To evaluate the efficacy and safety of treatments for advanced non-small-cell lung cancer in elderly patients aged 75 years or older, we conducted a phase II study of cisplatin and docetaxel administered in three consecutive weekly infusions. PATIENTS AND METHODS The eligibility criteria for the study included the presence of chemotherapy-naive advanced non-small-cell lung cancer, age > or =75 years, Eastern Cooperative Oncology Group performance status of 0 or 1, a measurable lesion, adequate organ functions and signed informed consent. The chemotherapy regimen consisted of cisplatin (25 mg/m(2)) and docetaxel (20 mg/m(2)) on days 1, 8 and 15 every 4 weeks. RESULTS Between February 2000 and March 2002, 34 elderly patients with non-small-cell lung cancer were enrolled in the study and 33 patients were treated. Two complete responses and 15 partial responses were obtained for an objective response rate of 52% in 33 treated patients. The median survival period was 15.8 months, and the 1-year survival rate was 64%. Toxicities were mild with no grade 4 toxicities. Only grade 3 leukopenia (6%), neutropenia (12%), anemia (3%), hyponatremia (3%) and nausea/vomiting (3%) were observed. CONCLUSION Cisplatin and docetaxel administered in three consecutive weekly infusions was safe and effective for the treatment of elderly patients with chemotherapy-naive non-small-cell lung cancer.
Collapse
Affiliation(s)
- Y Ohe
- Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Matsukawa M, Koarai K, Shionoya S, Shinkai T, Nakada K, Matsui T, Aono H, Kobayashi N, Okubo A, Hayashi K, Ito M. Stratigraphy and sedimentary basin developments of the Tetori Group in its main area, central Japan. ACTA ACUST UNITED AC 2003. [DOI: 10.5575/geosoc.109.383] [Citation(s) in RCA: 19] [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: 10/14/2022]
|
33
|
Okamoto H, Watanabe K, Nagatomo A, Kunikane H, Aono H, Yamagata T, Kase M. Endobronchial ultrasonography for mediastinal and hilar lymph node metastases of lung cancer. Chest 2002; 121:1498-506. [PMID: 12006435 DOI: 10.1378/chest.121.5.1498] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [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: 11/01/2022] Open
Abstract
STUDY OBJECTIVES Conventional radiologic procedures are frequently unreliable in the diagnosis of mediastinal and hilar lymph node metastases of lung cancer. In order to improve diagnostic accuracy, we performed endobronchial ultrasonography (EBUS) during bronchofiberscopic examinations of patients with lung cancer. METHODS AND PATIENTS To evaluate mediastinal and hilar lymph node metastases, EBUS was performed prospectively using a radial scanning probe of 20 MHz through a bronchofiberscope. RESULTS We observed hilar lymph nodes (10R, 11R superior, 11R inferior, 12R, 10L, 11L, 12L) in 20 of 37 patients who underwent EBUS, and we could clearly identify whether direct invasion of the pulmonary artery by a lymph node had occurred. Of the 27 patients who showed no hilar lymph nodes on chest CT scan, lymph node swellings < 10 mm or > or = 10 mm in diameter were identified by EBUS in 9 patients and 2 patients, respectively. Interestingly, EBUS also revealed that the pulmonary artery was directly invaded by an interlobar lymph node < 10 mm in diameter in one patient. In most patients, lymph node 7 was easily identified and was clearly differentiated from the surrounding esophagus, vessels, and mediastinal fat tissue by EBUS. However, fused lymph nodes or lymph nodes with low central density when visualized by chest CT scan were occasionally observed as independent lymph nodes by EBUS. When compared with the pathologic diagnosis of lymph node metastasis in 16 patients who underwent surgery, the most specific and sensitive method for identifying lymph node metastases were EBUS alone (92%) and EBUS in combination with CT scan (100%), respectively. The overall accuracy of EBUS was 94% for the diagnosis of direct invasion of the pulmonary arteries by a hilar lymph node. CONCLUSIONS EBUS in combination with conventional radiologic tools may contribute to improved staging, especially in surgical cases with hilar lymph node metastases.
Collapse
Affiliation(s)
- Hiroaki Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
| | | | | | | | | | | | | |
Collapse
|
34
|
Aono H, Hirakawa M, Unruh GK, Kindscher JD, Goto H. Anesthetic induction agents, sympathetic nerve activity and baroreflex sensitivity: a study in rabbits comparing thiopental, propofol and etomidate. Acta Med Okayama 2001; 55:197-203. [PMID: 11512561 DOI: 10.18926/amo/31994] [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: 02/21/2023]
Abstract
The mechanisms of arterial hypotension following intravenous anesthetic induction agents are multifactorial. The purpose of this study was to evaluate and compare the effects of thiopental, propofol and etomidate on hemodynamics, sympathetic outflow and arterial baroreflex sensitivity using not only neuraxis-intact but also totally baro-denervated rabbits. A total of 60 rabbits was anesthetized with urethane, tracheotomized, and mechanically ventilated with oxygen in nitrogen (FiO2 0.5). The left renal sympathetic nerve was isolated and placed on a bipolar electrode to record renal sympathetic nerve activity (RSNA). Thirty animals underwent a surgical preparation of total baroreceptor denervation. Bolus injections of an anesthesia induction dose of thiopental 4 mg/kg and twice the induction dose of propofol 4 mg/kg significantly decreased RSNA to the same extent (19.4+/-6.7 and 19.7+/-5.2% reduction, mean +/- SEM) and mean arterial pressure (MAP) also to the same extent (19.5+/-4.6 and 22.1+/-3.1% reduction) in the neuraxis-intact animals. RSNA was increased (34.5+/-6%) without reduction of MAP by an induction dose of etomidate, 0.3 mg/kg. Sympathetic barosensitivity was attenuated even 10 min after thiopental at 4 mg/kg or propofol at 4 mg/kg (68% and 54% of control, respectively). Propofol at 2 mg/kg (induction dose) and etomidate at 0.6 mg/kg decreased RSNA and MAP only in the baro-denervated animals. It was found from the barosensitivity study that patients can be hemodynamically unstable even though blood pressure has returned to normal after thiopental and propofol administration. Data suggest that etomidate can even stimulate the sympathetic nervous system and increase sympathetic outflow. It was also clearly found from the baro-denervated animal study that thiopental was stronger than propofol in directly suppressing sympathetic outflow at the induction dose.
Collapse
Affiliation(s)
- H Aono
- Department of Anesthesiology, University of Kansas Medical Center Kansas City, 66160, USA
| | | | | | | | | |
Collapse
|
35
|
Saito I, Aono H, Ikebe T, Makino Y, Ozawa H. [The validity of revised death certificates (ICD-10) for ischemic heart disease in Oita City, Japan]. Nihon Koshu Eisei Zasshi 2001; 48:584-94. [PMID: 11579482] [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: 02/21/2023]
Abstract
PURPOSE Mortality statistics have recorded an increased number of deaths from ischemic heart disease (IHD) since death certificates were revised to reflect the International Classification of Diseases, tenth revision (ICD-10) in Japan, in 1995. However, it remains unclear whether the validity of IHD diagnosis improved after this revision. METHODS We conducted the Oita Cardiac Death Survey to validate IHD certified deaths that occurred among residents aged 25-74 in Oita City, Japan (mean population = 273,000). Of the eligible 342 fatalities, 328 cases (95.0%) were examined by a review of the medical records and/or interviews with physicians. The MONICA criteria were applied and provided a reference standard against which to assess the validity of certified fatal IHD. Sensitivity (Se), positive predictive value (PPV), specificity (Sp) and negative predictive value (NPV) for IHD as the cause of death were analyzed, assuming that all validated IHD deaths were true. Multivariate logistic models were used to determine associations of false positive and false negative cases with sex, age at time of death and place of death. RESULTS Vital statistics revealed 273 fatalities to be due to cardiac disease, including 143 from acute myocardial infarctions (AMI), 27 from other IHD, 52 from heart failure and 51 from other heart diseases. After validation, 25 'definite fatal AMI' and 71 'possible fatal AMI or IHD death' were identified among all subjects according to the MONICA criteria. In all, Se, PPV, Sp and NPV for IHD certified as the cause of death were 86.5% (95% Cl: 77.6-92.3), 50.3% (42.5-58.1), 64.7% (58.1-70.7), and 92.0% (86.5-95.5), respectively. PPV among persons aged 25-54 years was remarkably decreased. PPV and Sp among out-of-hospital deaths were significantly lower than for in-hospital deaths. Multivariate logistic models revealed out-of-hospital deaths and being aged 25-54 years to be significant predictors of false positive cases (odds ratio (OR) = 2.03, P < 0.001 versus in-hospital deaths and OR = 2.79, P < 0.05 versus ages of 65-74 years, respectively). CONCLUSIONS Because false positive cases increased among certified IHD deaths after the revision, PPV and Sp percentages decreased. Out-of-hospital deaths and being aged 25-54 years were associated with increased possibility of false positive. Given our findings, IHD deaths in vital statistics may increase due to the tendency of physicians to certify IHD as the cause of death in cases without clear sign suggestive of other causes.
Collapse
Affiliation(s)
- I Saito
- Department of Public Health and Hygiene, Oita Medical University
| | | | | | | | | |
Collapse
|
36
|
Nakazawa M, Ishii H, Aono H, Takai M, Honda T, Aratani S, Fukamizu A, Nakamura H, Yoshino S, Kobata T, Nishioka K, Nakajima T. Role of Notch-1 intracellular domain in activation of rheumatoid synoviocytes. Arthritis Rheum 2001; 44:1545-54. [PMID: 11465706 DOI: 10.1002/1529-0131(200107)44:7<1545::aid-art278>3.0.co;2-q] [Citation(s) in RCA: 50] [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] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Notch family proteins are transmembrane receptors that control cell fate and proliferation. Rheumatoid arthritis (RA) is characterized by activation and abnormal proliferation/differentiation of synoviocytes. We examined the expression of Notch-1 and its role in the activation of RA synoviocytes. METHODS The expression of Notch-1 protein was detected by a specific antibody raised against the Notch-1 intracellular domain. Notch-1 messenger RNA (mRNA) expression in synoviocytes was analyzed by Northern blotting. Notch-1 protein expression was confirmed by Western blotting with anti-Notch-1 antibody. To analyze the role of Notch-1 in synoviocyte proliferation, we examined the effects of antisense Notch-1 oligonucleotides (ODNs) and MW167, a gamma-secretase inhibitor. RESULTS Notch-1 protein and mRNA were detected in synovium from all study subjects. The nucleus of RA synoviocytes showed strong staining with anti-Notch-1 antibody, whereas there was predominantly cytoplasmic staining of normal and osteoarthritis (OA) synoviocytes. Western blotting showed a distinct approximately 63-kd protein detected by anti-Notch-1 antibody in nuclear extracts from RA synoviocytes, indicating that nuclear staining of RA synovium and synoviocytes is likely to be the result of nuclear localization of Notch-1 intracellular domain (NICD). Furthermore, tumor necrosis factor alpha (TNFalpha) increased NICD nuclear translocation in a dose-dependent manner. Antisense Notch-1 ODNs partially blocked the proliferation of RA synoviocytes and inhibited TNFalpha-induced proliferation in both OA and RA synoviocytes. In addition, gamma-secretase inhibitor, which blocks the production of NICD, also inhibited TNFalpha-induced proliferation of RA synoviocytes. CONCLUSION Our results demonstrate the expression of Notch-1 in synoviocytes and the presence of Notch-1 fragment in the nuclei of RA synoviocytes and suggest the involvement of Notch-1 signaling in the TNFalpha-induced proliferation of RA synoviocytes.
Collapse
MESH Headings
- Amyloid Precursor Protein Secretases
- Antisense Elements (Genetics)
- Arthritis, Rheumatoid/pathology
- Arthritis, Rheumatoid/physiopathology
- Aspartic Acid Endopeptidases
- Blotting, Northern
- Blotting, Western
- Cell Division/drug effects
- Cell Division/physiology
- Cell Nucleus/chemistry
- Cells, Cultured
- Endopeptidases/metabolism
- Enzyme Inhibitors/pharmacology
- Fluorescent Antibody Technique
- Gene Expression/drug effects
- Humans
- Membrane Proteins/analysis
- Membrane Proteins/chemistry
- Membrane Proteins/genetics
- Osteoarthritis, Knee/pathology
- Osteoarthritis, Knee/physiopathology
- Peptides
- Protein Structure, Tertiary
- RNA, Messenger/analysis
- Receptor, Notch1
- Receptors, Cell Surface
- Signal Transduction/physiology
- Synovial Membrane/chemistry
- Synovial Membrane/pathology
- Transcription Factors
- Tumor Necrosis Factor-alpha/pharmacology
Collapse
Affiliation(s)
- M Nakazawa
- St Marianna University School of Medicine, Kanagawa, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Kawai J, Shinagawa A, Shibata K, Yoshino M, Itoh M, Ishii Y, Arakawa T, Hara A, Fukunishi Y, Konno H, Adachi J, Fukuda S, Aizawa K, Izawa M, Nishi K, Kiyosawa H, Kondo S, Yamanaka I, Saito T, Okazaki Y, Gojobori T, Bono H, Kasukawa T, Saito R, Kadota K, Matsuda H, Ashburner M, Batalov S, Casavant T, Fleischmann W, Gaasterland T, Gissi C, King B, Kochiwa H, Kuehl P, Lewis S, Matsuo Y, Nikaido I, Pesole G, Quackenbush J, Schriml LM, Staubli F, Suzuki R, Tomita M, Wagner L, Washio T, Sakai K, Okido T, Furuno M, Aono H, Baldarelli R, Barsh G, Blake J, Boffelli D, Bojunga N, Carninci P, de Bonaldo MF, Brownstein MJ, Bult C, Fletcher C, Fujita M, Gariboldi M, Gustincich S, Hill D, Hofmann M, Hume DA, Kamiya M, Lee NH, Lyons P, Marchionni L, Mashima J, Mazzarelli J, Mombaerts P, Nordone P, Ring B, Ringwald M, Rodriguez I, Sakamoto N, Sasaki H, Sato K, Schönbach C, Seya T, Shibata Y, Storch KF, Suzuki H, Toyo-oka K, Wang KH, Weitz C, Whittaker C, Wilming L, Wynshaw-Boris A, Yoshida K, Hasegawa Y, Kawaji H, Kohtsuki S, Hayashizaki Y. Functional annotation of a full-length mouse cDNA collection. Nature 2001; 409:685-90. [PMID: 11217851 DOI: 10.1038/35055500] [Citation(s) in RCA: 487] [Impact Index Per Article: 21.2] [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: 01/31/2023]
Abstract
The RIKEN Mouse Gene Encyclopaedia Project, a systematic approach to determining the full coding potential of the mouse genome, involves collection and sequencing of full-length complementary DNAs and physical mapping of the corresponding genes to the mouse genome. We organized an international functional annotation meeting (FANTOM) to annotate the first 21,076 cDNAs to be analysed in this project. Here we describe the first RIKEN clone collection, which is one of the largest described for any organism. Analysis of these cDNAs extends known gene families and identifies new ones.
Collapse
Affiliation(s)
- J Kawai
- Laboratory for Genome Exploration Research Group, RIKEN Genomic Sciences Center, Yokohama Institute, Kanagawa, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Yano R, Nakamura T, Aono H, Wakiya Y, Masada M. [The amount of the loss of cyclosporine A dose correlated with the amount of leaching di (2-ethylhexyl) phthalate from polyvinyl chloride infusion tube]. YAKUGAKU ZASSHI 2001; 121:139-44. [PMID: 11218727 DOI: 10.1248/yakushi.121.139] [Citation(s) in RCA: 7] [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: 11/22/2022]
Abstract
An interaction between cyclosporine A (CyA) injection and infusion tubes were examined. We used polyvinyl chloride (PVC) and polybutadiene (PB) tubes. CyA injection (Sandimmun) was diluted (0.495 mg CyA/ml) with saline and dripped through infusion tubes. The amounts of unsolved substances, loss of CyA dose and leached di (2-ethylhexyl) phthalate (DEHP) during the drip study were compared. CyA was not lost into the PB tube and no DEHP was leached. Therefore, using PVC tube, 11.9 mg of CyA were lost with in 24 h after the beginning of the administration, and the concentration of leached DEHP amounted to 93.6 micrograms/ml at 12 h. We also investigated the effects of the component of the einfusion solution on the loss of CyA into PVC tube using saline, electrolyte maintenance solution, 5% glucose and 10% maltose. Sugar-containing solutions were found to have less effects than other solutions on the loss of CyA dose and DEHP leaching. The leaching of DEHP may be a major factor for the generation of unsolved substances and the loss of CyA dose. In the clinical use of CyA injection, PB tube is the best selection and the sugar-containing solution is a second selection when PB infusion tubes are hard to obtain.
Collapse
Affiliation(s)
- R Yano
- Department of Hospital Pharmacy, Fukui Medical University, 23 Shimoaizuki, Matsuoka-cho, Yoshida-gun, Fukui 910-1193, Japan
| | | | | | | | | |
Collapse
|
39
|
Matsuno H, Yudoh K, Watanabe Y, Nakazawa F, Aono H, Kimura T. Stromelysin-1 (MMP-3) in synovial fluid of patients with rheumatoid arthritis has potential to cleave membrane bound Fas ligand. J Rheumatol 2001; 28:22-8. [PMID: 11196534] [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: 02/19/2023]
Abstract
OBJECTIVE To investigate the relationship between matrix metalloproteinases (MMP) and the soluble form of Fas ligand (sFasL) in the synovial fluid (SF) of patients with rheumatoid arthritis (RA), and to determine which MMP have a major role in cleaving FasL. METHODS The concentrations of sFas and sFasL in SF from 48 patients with RA and 43 patients with osteoarthritis (OA) were measured using specific ELISA. The levels of different MMP (MMP-1, 2, 3, 7, 9) in SF were also measured by ELISA. The active forms of gelatinases were detected by gelatin zymogram. Human FasL-expressing transfected cells (hFasL/L5178Y) were used to investigate whether FasL is cleaved from membrane bound FasL. RESULTS Significantly higher levels of MMP-1, 3, and 9 were found in SF from RA patients compared to OA patients, but MMP-7 was not detectable in either group. The concentrations of sFas and sFasL in SF were also higher in RA than in OA patients. However, there was no relationship between the concentration of sFas and sFasL. Among MMP, MMP-3 concentrations in SF were closely correlated with the level of sFasL and with disease activity of RA. Enzymatic cleavage assay indicated that MMP-3 has potential to cleave the FasL expressed on hFasL/L5178Y cells and to produce sFasL. CONCLUSION There was significant correlation between the concentration of sFasL and MMP-3 in SF of patients with RA. In addition, our data indicate that the shedding of FasL may be regulated by MMP-3 in the joint of patients with RA.
Collapse
Affiliation(s)
- H Matsuno
- Department of Orthopaedic Surgery, Toyama Medical and Pharmaceutical University, Japan.
| | | | | | | | | | | |
Collapse
|
40
|
Abstract
Advanced arterial wall calcification in atherosclerosis imposes a serious rupturing effect on the aorta. However, the mechanism of dystrophic calcification linked to hyperlipidemia, that causes atherosclerosis remains unknown. Emerging morphological and biochemical evidence reveals that calcifiable vesicles may have a role in plaque calcification. To determine whether a high cholesterol diet can induce arterial calcification and produce or activate calcifiable vesicles in aortas, a rabbit model was used. After 2 months of daily high lipid feeding (supplemented with 2% cholesterol and 6% peanut oil), typical atherosclerotic lesions developed. However, the mineral, if present in aortas, was insufficient to be detected by Fourier transform-infrared spectroscopy (FT-IR) or alizarin red staining, indicative of a non-calcifying stage of atherosclerosis. Small segments of thoracic aortas were digested in a crude collagenase solution to release calcifiable vesicles. Vesicles were also isolated from normal aortas as control to consider the possibility that membrane vesicles may be produced by crude collagenase digestion, which could cause the degradation of some cells. Calcifiable vesicles were precipitated at 300,000 x g after subcellular particles were removed by centrifugation at 30,000 x g. Calcifiability of isolated vesicles was then tested using calcifying media containing physiological levels of Ca2+ and Pi and 1 mM ATP. Electron microscopic observations showed that the isolated vesicles were heterogeneous in size and shape and capable of depositing electron dense particles. Fourier transform infrared spectroscopic analysis of the deposited particles revealed the presence of an amorphous mineral phase. The spectroscopic mineral to matrix ratios, related to the amount of mineralization, indicated that vesicles from cholesterol-fed rabbits produced more minerals than control vesicles obtained from the normal aortas. Alizarin red staining for mineral further demonstrated substantially higher calcifiability of the experimental vesicles. A 3-5 h exposure of the vesicles to calcifying media caused significant deposition of 45Ca and 32Pi in a vesicle protein-concentration dependent manner. Similar to previously reported observations with human atherosclerotic aorta vesicles, rabbit vesicles were enriched in ATP-hydrolyzing enzymes including Mg2+- or Ca2+-ATPase and NTP pyrophosphohydrolase that are implicated in normal and pathological calcification. Altogether, these observations suggest that accumulation of the released calcifiable vesicles, as a result of high cholesterol diets, may have a role in dystrophic calcification in hyperlipidemia-related atherosclerosis.
Collapse
Affiliation(s)
- H H Hsu
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City 66160-7410, USA.
| | | | | | | | | |
Collapse
|
41
|
Nagashima M, Wauke K, Hirano D, Ishigami S, Aono H, Takai M, Sasano M, Yoshino S. Effects of combinations of anti-rheumatic drugs on the production of vascular endothelial growth factor and basic fibroblast growth factor in cultured synoviocytes and patients with rheumatoid arthritis. Rheumatology (Oxford) 2000; 39:1255-62. [PMID: 11085806 DOI: 10.1093/rheumatology/39.11.1255] [Citation(s) in RCA: 52] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine whether different combinations of disease-modifying anti-rheumatic drugs (DMARDs), including bucillamine (BUC), gold sodium thiomalate (GST), methotrexate (MTX), salazosulphapyridine (SASP) and dexamethasone (DEX; a steroid), act by inhibiting the production of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in cultured synoviocytes, causing a decrease in their serum concentrations in patients with rheumatoid arthritis (RA). METHODS The VEGF and bFGF concentrations in cultured synoviocytes and peripheral blood from patients with RA were measured by enzyme-linked immunosorbent assay and their serum concentrations were measured at two time points. RESULTS BUC and GST inhibited VEGF production even when given alone, and a combination of BUC, GST and MTX with DEX also inhibited VEGF production. None of the DMARDs or DEX inhibited bFGF production when given alone, but a combination of SASP and GST inhibited the production of bFGF in cultured synoviocytes. Serum VEGF concentrations were significantly decreased 6 months after the commencement of medication compared with their concentrations before medication. CONCLUSION Our results show that the effects of a combination of DEX with any two of BUC, GST, SASP and MTX on the production of VEGF and bFGF in cultured synoviocytes and on the serum concentrations of VEGF in patients with RA may be based on synergistic or additive effects of the drugs.
Collapse
Affiliation(s)
- M Nagashima
- Department of Joint Disease and Rheumatism, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Saito I, Folsom AR, Aono H, Ozawa H, Ikebe T, Yamashita T. Comparison of fatal coronary heart disease occurrence based on population surveys in Japan and the USA. Int J Epidemiol 2000; 29:837-44. [PMID: 11034966 DOI: 10.1093/ije/29.5.837] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although vital statistics have indicated large Japanese-American differences in mortality rates for coronary heart disease (CHD), the magnitude of difference has not been documented well using comparable validation of cause of death. METHODS Population-based fatal CHD data were compared between the Oita Cardiac Death Survey, Japan and the Atherosclerosis Risk in Communities (ARIC) Study, USA. Both studies (population: Oita City 198 093; the ARIC comunities 286 820) identified possible fatal CHD events (International Classification of Diseases, Ninth Revision [ICD-9]: 410-414, 250, 401-402, 427-429, 440, and 798-799) among residents aged 35-74 years during 1992-1993. Comparable criteria for classifying cause of death were applied. Sex-specific, age-adjusted mortality rates of CHD were calculated by place of death. RESULTS In all, 330 deaths in Oita and 1398 in the ARIC communities had eligible ICD-9 death certificate codes; CHD codes (ICD-9 410-414) comprised 30.6% of investigated deaths in Oita and 58.6% in ARIC. For men, the non-validated rate ratio for CHD deaths (ARIC:Oita City) was 5.9 (95% CI : 4.2-8.5), which fell to 4.7 (95% CI : 3.5-6.4) with validation and inclusion of sudden deaths within one hour of onset as fatal CHD. For women, the overall non-validated rate ratio was 4.6 (95% CI : 2.8-7.6), which fell to 3.9 (95% CI : 2.4-6.3) with validation and but there was little further change when the sudden deaths were added. CONCLUSIONS Our results suggest that differences in fatal CHD rates between Japanese and Americans were not as large as suggested by vital statistics when events were validated and sudden deaths were included.
Collapse
Affiliation(s)
- I Saito
- Department of Public Health and Hygiene, Oita Medical University, Oita, Japan.
| | | | | | | | | | | |
Collapse
|
43
|
Tsuji F, Matsuoka H, Aono H, Takai M, Horiuchi M, Nishimura K, Mita S. Effects of sulfhydryl compounds on interleukin-1-induced vascular endothelial growth factor production in human synovial stromal cells. Biol Pharm Bull 2000; 23:663-5. [PMID: 10823686 DOI: 10.1248/bpb.23.663] [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: 11/22/2022]
Abstract
We investigated the effects of various sulfhydryl compounds on interleukin-1 (IL-1)-induced vascular endothelial growth factor (VEGF) production in human synovial stromal cells (HSSC). HSSC stimulated by IL-1beta (100 ng/ml) produced VEGF and interleukin-6 (IL-6) in vitro. Monosulfhydryl compounds, N-acetylcysteine, D-penicillamine, tiopronin and the bucillamine-like disulfhydryl compound, compound A scarcely affected VEGF or IL-6 production at concentrations of 10(-5) and 10(-4) M. However, the disulfhydryl compound, bucillamine inhibited VEGF production but not IL-6 production at concentrations of 10(-5) and 10(-4) M. These results suggest that bucillamine may be a selective inhibitor of IL-1-induced VEGF production in HSSC, and that inhibition of VEGF production may require not only SH groups but also a specific chemical structure.
Collapse
Affiliation(s)
- F Tsuji
- Discovery Research Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan.
| | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
PURPOSE To elucidate mechanisms by which remifentanil, an ultra-short-acting mu-opioid receptor agonist, causes hypotension and bradycardia. METHODS Mean arterial pressure (MAP), heart rate (HR) and renal sympathetic nerve activity (RSNA) were measured and recorded after bolus injections of 1, 2 or 5 microg x kg(-1) of remifentanil in neuraxis intact (n=6 for each dose) and baro-denervated rabbits (n=6 for each dose). Arterial baroreflex sensitivity was assessed by depressor tests. An additional six baro-denervated animals received remifentanil, 5 microg x kg(-1) after pretreatment with naloxone, 40 microg x kg(-1). RESULTS All values were expressed in % change from baseline. In the neuraxis intact animals, MAP and HR were decreased briefly immediately after remifentanil injection. RSNA was increased dose-dependently: 137 +/- 8% (mean +/- SE), 170 +/- 14% (P < 0.05) and 225 +/- 29% (P < 0.05) after 1, 2 and 5 microg x kg(-1) remifentanil, respectively. RSNA was increased even after MAP and HR had returned to baseline values. The depressor tests revealed that remifentanil did not attenuate arterial baroreflex sensitivity. In the baro-denervated animals, MAP and HR decreased gradually to 77 +/- 3% (P < 0.05) and 94 +/- 1% (P < 0.05), respectively 300 sec after 5 microg x kg(-1) remifentanil. At that time, increased RSNA (159 +/- 9%, P < 0.05) had returned to baseline. Pretreatment with naloxone in the baro-denervated animals abolished these changes. CONCLUSION Remifentanil decreases HR and MAP by its central vagotonic effect and by stimulating peripheral mu-opioid receptors. These effects appear to be counteracted and masked by its central sympathotonic effect and by maintaining arterial baroreflex integrity.
Collapse
Affiliation(s)
- K Shinohara
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City 66160-7415, USA
| | | | | | | | | |
Collapse
|
45
|
Yokoyama K, Araki S, Sato H, Aono H. Circadian rhythms of seven heavy metals in plasma, erythrocytes and urine in men: observation in metal workers. Ind Health 2000; 38:205-212. [PMID: 10812843 DOI: 10.2486/indhealth.38.205] [Citation(s) in RCA: 18] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
To elucidate circadian rhythms (variation within a day) of 7 toxic or essential metals in plasma and erythrocytes in relation to the rhythms in urine in men, 19 male metal foundry workers were examined; they were exposed to lead (Pb), zinc (Zn) and copper (Cu) occupationally but separated from the exposure during the study. Circadian rhythms were found for plasma concentration of Pb, cadmium (Cd), Zn, Cu and chromium (Cr) in the workers. Circadian rhythms were also found for Pb, inorganic mercury (Hg), Zn and Cr in erythrocytes and for all metals except Zn in urine. Both the plasma and urinary levels of Pb, Cd, Cu and Cr together with urinary excretion of Mn and creatinine tended to decrease during night hours; both the erythrocyte and urinary levels of Hg together with both the plasma and erythrocyte levels of Zn tended to increase during morning hours. The results of profile analysis suggested that the circadian rhythm of Pb in urine was affected more strongly by its plasma and erythrocyte rhythms than by the rhythm of creatinine in urine, i.e. the rhythm of glomerular filtration; the urinary rhythms of Cd, Cr, and Mn were affected more by the creatinine rhythm; and the urinary rhythm of Cu was affected by both its plasma and creatinine rhythms. On the other hand, the urinary rhythm of Hg was assumed to be independent of the creatinine rhythm and be affected by its erythrocyte rhythm. The present study suggested that different biological limit values might be needed for different hours of the day especially for shift workers who are exposed to various heavy metals. Instead, further studies should be conducted to find the adjustment methods by which no circadian rhythms are discerned.
Collapse
Affiliation(s)
- K Yokoyama
- Department of Public Health and Occupational Medicine, Graduate School of Medicine, University of Tokyo, Japan
| | | | | | | |
Collapse
|
46
|
Hato N, Honda N, Gyo K, Aono H, Murakami S, Yanagihara N. [Treatment of Bell's palsy with acyclovir and prednisolone]. Nihon Jibiinkoka Gakkai Kaiho 2000; 103:133-8. [PMID: 10737002 DOI: 10.3950/jibiinkoka.103.133] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Many current studies have suggested that herpes simplex virus is a probable cause of Bell's palsy, and that treatment with antiviral agents such as acyclovir might benefit the patients. In the present study, 69 patients with Bell's palsy were treated with oral administration of acyclovir (2000 mg/day) and prednisolone (60-40 mg/day) at Ehime University Hospital between Oct. 1995 and Dec. 1998. Patients enrolled in this study met the following criteria: 1) severe or complete paralysis with a score lower than 20 by the 40-point Japanese grading system, and 2) treatment started within 7 days of onset. The overall recovery rate was 95.7% (66/69). The rate in patients who started this treatment within 3 days after disease onset was 100%, and this early treatment was highly efficacious in the prevention of nerve degeneration and resulted in a significantly better recovery. By comparison, the recovery rate in patients whose treatment was started 4 days or more after onset was only 84.2%. All patients who were given a diagnosis of zoster sine herpete and treated with acyclovir-prednisolone had a good outcome. These results suggest that early treatment, within 3 days after palsy onset, is necessary for effective acyclovir-prednisolone therapy of Bell's palsy.
Collapse
Affiliation(s)
- N Hato
- Department of Otolaryngology, Ehime University School of Medicine
| | | | | | | | | | | |
Collapse
|
47
|
Tamura S, Takemoto Y, Takami S, Kinoshita M, Kumano Y, Aono H, Mori M, Kakishita E. Efficacy of all-trans retinoic acid for molecular relapse of acute promyelocytic leukemia during remission. Oncol Rep 1999; 6:683-5. [PMID: 10203615 DOI: 10.3892/or.6.3.683] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We analyzed the efficacy of all-trans retinoic acid (ATRA) as an early treatment for four acute promyelocytic leukemia (APL) patients in remission who were PML/RARalpha-positive by reverse transcription-polymerase chain reaction or fluorescence in situ hybridization. ATRA 45 mg/m2 was administered orally. All became negative for PML/RARalpha transcripts after 3 to 6 months of ATRA treatment. However, the PML/RARalpha transcripts subsequently reverted to positive in three cases. Although retreatment with ATRA failed to prevent hematological relapse in two patients, one case remains in hematological remission. No serious side effects were encountered during ATRA treatment. These findings suggest that early treatment of ATRA for PML/RARalpha-positive APL patients in remission may have a therapeutic benefit and prolong the duration of hematological remission without chemotherapy.
Collapse
Affiliation(s)
- S Tamura
- Second Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Nagashima M, Yoshino S, Aono H, Takai M, Sasano M. Inhibitory effects of anti-rheumatic drugs on vascular endothelial growth factor in cultured rheumatoid synovial cells. Clin Exp Immunol 1999; 116:360-5. [PMID: 10337031 PMCID: PMC1905271 DOI: 10.1046/j.1365-2249.1999.00876.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [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: 11/20/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) is a potent inducer of angiogenesis and is constitutively expressed in the synovium of rheumatoid arthritis (RA). Over-expression of VEGF may play an important role in pathogenic vascularization and synovial hyperplasia of RA. In the present study, we examined whether disease-modifying anti-rheumatic drugs (DMARDs), including bucillamine (BUC), gold sodium thiomalate (GST), methotrexate (MTX) and salazosulfapiridine (SASP), act by inhibiting the production of VEGF by cultured synovial cells of patients with RA. Treatment of cultured synoviocytes with lipopolysaccharide (LPS) significantly increased VEGF production by cultured synovial cells. BUC significantly inhibited LPS-induced VEGF production, while GST tended to inhibit the production of VEGF. The inhibitory effects on VEGF production were dose-dependent. In contrast, MTX and SASP did not affect VEGF production. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis showed that BUC also inhibited LPS-induced VEGF mRNA expression in RA synovial cells. The present study provides the first evidence that BUC inhibits VEGF production and the expression of its mRNA in synovial cells of RA patients. Our results indicate that the anti-rheumatic effects of BUC are mediated by suppression of angiogenesis and synovial proliferation in the RA synovium through the inhibition of VEGF production by synovial cells.
Collapse
Affiliation(s)
- M Nagashima
- Department of Joint Disease and Rheumatism, Nippon Medical School, Tokyo, Japan
| | | | | | | | | |
Collapse
|
49
|
|
50
|
Tsuji F, Miyake Y, Aono H, Kawashima Y, Mita S. Effects of bucillamine and N-acetyl-L-cysteine on cytokine production and collagen-induced arthritis (CIA). Clin Exp Immunol 1999; 115:26-31. [PMID: 9933417 PMCID: PMC1905176 DOI: 10.1046/j.1365-2249.1999.00749.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.4] [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: 11/20/2022] Open
Abstract
We investigated the effects of bucillamine and N-acetyl-L-cysteine (NAC) on cytokine production and CIA. Bucillamine and NAC inhibited NF-kappaB activation and tumour necrosis factor-alpha (TNF-alpha) mRNA expression in human monocytic leukaemia cell line THP-1, and cytokine production from monocyte cell lines at concentrations >10-3 M. They also inhibited cytokine production and CIA in mice at a dose of 500 mg/kg. These results suggest that NF-kappaB inhibitors such as bucillamine and NAC may inhibit cytokine-related diseases, including arthritis.
Collapse
Affiliation(s)
- F Tsuji
- Discovery Research Division, Santen Pharmaceutical Co., Ltd, Osaka, Japan
| | | | | | | | | |
Collapse
|