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Yamamoto T, Mochida Y, Irie K, Altanbagana NU, Fuchida S, Aida J, Takeuchi K, Fujita M, Kondo K. Regional Inequalities in Oral Frailty and Social Capital. JDR Clin Trans Res 2024:23800844241238648. [PMID: 38654451 DOI: 10.1177/23800844241238648] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models. METHODS This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital (n = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density (n = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs). RESULTS The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11-1.23) (reference: metropolitan). CONCLUSION These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas. KNOWLEDGE TRANSFER STATEMENT The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas.
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Affiliation(s)
- T Yamamoto
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - Y Mochida
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - K Irie
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - N U Altanbagana
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - S Fuchida
- Department of Education Planning, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Takeuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - M Fujita
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - K Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Chiba, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Sue S, Oka H, Kunishi Y, Suzuki Y, Suzuki S, Kaneko T, Komatsu K, Naito M, Kato Y, Sasaki T, Kaneko H, Irie K, Kondo M, Maeda S. Comparison of metronidazole versus clarithromycin in first-line vonoprazan-based triple therapy for Helicobacter pylori: A multicenter randomized trial in Japan. JGH Open 2024; 8:e13069. [PMID: 38650971 PMCID: PMC11034001 DOI: 10.1002/jgh3.13069] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/11/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
Background and Aim To date, no randomized trials have compared the efficacy of 7-day vonoprazan, amoxicillin, and metronidazole triple therapy (VAM) versus 7-day vonoprazan, amoxicillin, and clarithromycin triple therapy (VAC) as a first-line treatment for Helicobacter pylori eradication. This study was performed to compare the efficacy of VAM and VAC as first-line treatments. Methods This prospective multicenter randomized trial was performed in Japan and involved 124 H. pylori-positive patients without a history of eradication. Patients without antibiotic resistance testing of H. pylori were eligible. The patients were randomized to receive either VAC (vonoprazan 20 mg + amoxicillin 750 mg + clarithromycin 200 or 400 mg twice a day) or VAM (vonoprazan 20 mg + amoxicillin 750 mg + metronidazole 250 mg twice a day) for 7 days, with stratification by age and sex. Eradication success was evaluated using the 13C-urea breath test. We evaluated safety using patient questionnaires (UMIN000025773). Results The intention-to-treat and per-protocol eradication rates of VAM were 91.3% (95% confidence interval [CI], 82.0-96.7%) and 92.6% (95% CI, 83.7-97.6%), respectively, and those of VAC were 89.1% (95% CI, 77.8-95.9%) and 96.1% (95% CI, 86.5-99.5%), respectively. No significant difference was observed between VAM and VAC in either analysis (P = 0.76 and P = 0.70, respectively). Abdominal fullness was more frequent in patients who received VAM than VAC. Conclusions These findings suggest that VAM as a first-line treatment in Japan can be categorized as grade B (intention-to-treat cure rate of 90-95%) and have potential as a first-line national insurance -approved regimen.
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Affiliation(s)
- Soichiro Sue
- Department of GastroenterologyYokohama City University Graduate school of MedicineYokohamaJapan
| | - Hiroyuki Oka
- Department of GastroenterologyYokohama Minami Kyousai HospitalYokohamaJapan
| | - Yosuke Kunishi
- Department of GastroenterologyKanagawa Prefectual Ashigarakami HospitalMatsudaJapan
| | - Yuichi Suzuki
- Department of GastroenterologyYokohama City University Graduate school of MedicineYokohamaJapan
- Department of GastroenterologyYokosuka City HospitalYokosukaJapan
| | - Shingo Suzuki
- Department of GastroenterologyYokohama Ekisaikai HospitalYokohamaJapan
| | - Takashi Kaneko
- Department of GastroenterologyYokohama Minami Kyousai HospitalYokohamaJapan
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Kazuo Komatsu
- Department of GastroenterologyYokosuka City HospitalYokosukaJapan
| | - Makoto Naito
- Department of GastroenterologyYokohama Ekisaikai HospitalYokohamaJapan
| | - Yoshio Kato
- Department of GastroenterologyKanagawa Prefectual Ashigarakami HospitalMatsudaJapan
| | - Tomohiko Sasaki
- Department of GastroenterologyYokohama City University Graduate school of MedicineYokohamaJapan
| | - Hiroaki Kaneko
- Department of GastroenterologyYokohama City University Graduate school of MedicineYokohamaJapan
| | - Kuniyasu Irie
- Department of GastroenterologyYokohama City University Graduate school of MedicineYokohamaJapan
| | - Masaaki Kondo
- Department of GastroenterologyYokohama Minami Kyousai HospitalYokohamaJapan
| | - Shin Maeda
- Department of GastroenterologyYokohama City University Graduate school of MedicineYokohamaJapan
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Goda Y, Irie K, Anan H, Suzuki Y, Ikeda A, Ikeda R, Kaneko H, Sue S, Miwa H, Maeda S. The usefulness of texture and color enhancement imaging to identify the minor papilla orifice. DEN Open 2024; 4:e358. [PMID: 38586252 PMCID: PMC10995446 DOI: 10.1002/deo2.358] [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] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/10/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024]
Abstract
In clinical cases of pancreas divisum, endoscopic retrograde cholangiopancreatography often necessitates cannulation of the pancreatic duct through the minor papilla. Nevertheless, this procedure can be challenging because of the small size of the minor papilla and the difficulty in visualizing the ductal orifice. A new image-enhanced endoscopy technique called texture and color enhancement imaging (TXI) has been developed, which enhances texture, brightness, and color compared with white-light imaging, resulting in subtle differences in the surface mucosa. Herein, we describe the case of a 73-year-old man with pancreas divisum in whom TXI was useful in identifying the orifice of the minor papilla. He was referred to our hospital with repetitive acute exacerbation of chronic pancreatitis. Since contrast-enhanced computed tomography revealed a pancreatic stone in the main pancreatic duct, endoscopic retrograde cholangoepancreatography was performed as a therapeutic intervention. Despite the initial difficulty in identifying the orifice of the minor papilla on white-light imaging, TXI enhanced its visibility successfully, enabling dorsal pancreatic duct cannulation via the minor papilla. Subsequently, endoscopic pancreatic sphincterotomy was performed and a 6Fr plastic stent was placed. Post-endoscopic therapy, the patient's abdominal pain was relieved. TXI was useful in identifying the minor papilla orifice and led to successful cannulation.
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Affiliation(s)
- Yoshihiro Goda
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Kuniyasu Irie
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Hideyuki Anan
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Yuichi Suzuki
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Aya Ikeda
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Ryosuke Ikeda
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Hiroaki Kaneko
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Soichiro Sue
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
| | - Haruo Miwa
- Gastroenterological CenterYokohama City University Medical CenterKanagawaJapan
| | - Shin Maeda
- Division of GastroenterologyYokohama City University School of Medicine Graduate School of MedicineKanagawaJapan
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Kaneko T, Ishii T, Hamanaka J, Goda Y, Irie K, Doba N, Kunishi Y, Miwa H, Sugimori K, Maeda S. Novel 8-wire basket catheter is useful for endoscopic removal of common bile duct stones up to 10 mm: A multicenter prospective study. J Hepatobiliary Pancreat Sci 2024; 31:213-221. [PMID: 38174419 DOI: 10.1002/jhbp.1400] [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] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND/PURPOSE Endoscopic treatment of common bile duct (CBD) stones involves the use of basket or balloon catheters; however, what is the appropriate device remains controversial. In this study we aimed to prospectively evaluate the usefulness of a novel 8-wire helical basket (8WB) catheter made of Nitinol for the removal of CBD stones ≤10 mm. METHODS We conducted a multicenter prospective trial. Patients with CBD stones ≤10 mm were enrolled. The primary endpoint was the rate of complete stone removal within 10 min using the 8WB. The number of cases was determined using a previous study of stone removal by a conventional basket catheter as a historical control. RESULTS A total of 155 patients were enrolled and 139 were ultimately included in the analysis. Patients with a single stone were the most common (84 cases, 60.4%), with a median maximum stone diameter of 5 mm. The median stone removal time using the 8WB was 6 min. The complete stone removal rate was 95.0% (132/139). Adverse events were observed in 14 patients (10.1%). CONCLUSIONS The novel 8WB catheter is useful in the treatment of CBD stones ≤10 mm, presenting a high complete stone removal rate in this study. TRIAL REGISTRATION NUMBER jRCT1032200324.
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Affiliation(s)
- Takashi Kaneko
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Tomohiro Ishii
- Department of Gastroenterology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan
| | - Jun Hamanaka
- Department of Gastroenterology, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - Yoshihiro Goda
- Department of Gastroenterology, Fujisawa City Hospital, Fujisawa, Japan
| | - Kuniyasu Irie
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Nobutaka Doba
- Department of Gastroenterology, Yokosuka City Hospital, Yokosuka, Japan
| | - Yosuke Kunishi
- Department of Gastroenterology, Kanagawa Prefectural Ashigarakami Hospital, Ashigarakami, Japan
| | - Haruo Miwa
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazuya Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Shin Maeda
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Irie K, Yamamoto T. A Case of Pyoderma Gangrenosum-Like Ulcers Progressing into Neutrophilic Panniculitis in a Patient With Myelodysplastic Syndrome. Actas Dermosifiliogr 2023:S0001-7310(23)00926-2. [PMID: 38008246 DOI: 10.1016/j.ad.2023.02.034] [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] [Received: 01/05/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 11/28/2023] Open
Affiliation(s)
- K Irie
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan.
| | - T Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
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Iizuka C, Sue S, Onodera S, Ikeda A, Ikeda R, Goda Y, Irie K, Kaneko H, Maeda S. Risk assessment of metachronous gastric cancer after endoscopic submucosal dissection based on endoscopic intestinal metaplasia. JGH Open 2023; 7:783-789. [PMID: 38034056 PMCID: PMC10684977 DOI: 10.1002/jgh3.12989] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/16/2023] [Indexed: 12/02/2023]
Abstract
Background and Aim The incidence of metachronous gastric cancer (MGC) after endoscopic treatment for early gastric cancer (EGC) is high, but a method of risk assessment for MGC based on endoscopic findings has not been established. In this study, we focused on endoscopic intestinal metaplasia (IM) and investigated the risk for MGC after endoscopic submucosal dissection (ESD) for EGC. Methods This retrospective observational study involved patients who underwent curative ESD for EGC from April 2015 to January 2021. We assessed endoscopic IM using the pretreatment endoscopic examination images. The severity of endoscopic IM was classified into four levels: 0 (none), 1 (mild), 2 (moderate), and 3 (severe). Four different gastric areas were evaluated. We divided the patients into a low-score group and a high-score group, and compared the cumulative incidence of MGC. Results In total, 156 patients who met the inclusion criteria were followed up for at least 12 months after ESD, and MGC developed in 14 patients during a mean period oof 41.5 months. The endoscopic IM scores in the lesser curvature of the antrum, lesser curvature of the corpus, and greater curvature of the corpus were higher in patients with MGC than in those without MGC. In the corpus, the 5-year cumulative incidence of MGC was significantly higher in the high-score group than in the low-score group (29.8% vs 10.0%, P = 0.004). Conclusion The severity of endoscopic corpus IM was associated with MGC. Thus, patients with severe corpus IM at the time of ESD require careful examination and intensive follow-up.
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Affiliation(s)
- Chino Iizuka
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Soichiro Sue
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Sho Onodera
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Aya Ikeda
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Ryosuke Ikeda
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Yoshihiro Goda
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kuniyasu Irie
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Hiroaki Kaneko
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Shin Maeda
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
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Fuga M, Tanaka T, Tachi R, Yamana S, Irie K, Kajiwara I, Teshigawara A, Ishibashi T, Hasegawa Y, Murayama Y. Contrast Injection from an Intermediate Catheter Placed in an Intradural Artery is Associated with Contrast-Induced Encephalopathy following Neurointervention. AJNR Am J Neuroradiol 2023; 44:1057-1063. [PMID: 37536732 PMCID: PMC10494956 DOI: 10.3174/ajnr.a7944] [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] [Received: 03/22/2023] [Accepted: 06/22/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND PURPOSE Contrast-induced encephalopathy can result from neurotoxicity of contrast medium in the affected area. The development of intermediate catheters has allowed guidance of catheters to more distal arteries. This study focused on the association between contrast-induced encephalopathy and contrast injection from an intermediate catheter guided into a distal intradural artery during neurointervention for cerebral aneurysms. MATERIALS AND METHODS We retrospectively reviewed 420 consecutive aneurysms in 396 patients who underwent neurointervention for extracranial aneurysms and unruptured intracranial aneurysms at our institution from February 2012 to January 2023. Patients were divided into a group with contrast-induced encephalopathy and a group without. To identify risk factors for contrast-induced encephalopathy, we compared clinical, anatomic, and procedural factors between groups by multivariate logistic regression analysis and stepwise selection. RESULTS Among the 396 patients who underwent neurointervention for cerebral aneurysms, 14 (3.5%) developed contrast-induced encephalopathy. Compared with the group without contrast-induced encephalopathy, the group with contrast-induced encephalopathy showed significantly higher rates of patients on hemodialysis, previously treated aneurysms, intradural placement of a catheter for angiography, nonionic contrast medium, and flow-diversion procedures in univariate analyses. Stepwise multivariate logistic regression analysis revealed intradural placement of a catheter for angiography (OR = 40.4; 95% CI, 8.63-189) and previously treated aneurysms (OR = 8.20; 95% CI, 2.26-29.6) as independent predictors of contrast-induced encephalopathy. CONCLUSIONS Contrast injection from an intradural artery and retreatment of recurrent aneurysms were major risk factors for contrast-induced encephalopathy. Attention should be paid to the location of the intermediate catheter for angiography to avoid developing contrast-induced encephalopathy.
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Affiliation(s)
- M Fuga
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - T Tanaka
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
| | - R Tachi
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - S Yamana
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
| | - K Irie
- Department of Neurosurgery (K.I.), Japanese Red Cross Medical Center, Tokyo, Japan
| | - I Kajiwara
- Department of Neurosurgery (I.K.), National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
| | - A Teshigawara
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - T Ishibashi
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
| | - Y Hasegawa
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - Y Murayama
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
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Sue S, Suzuki Y, Sasaki T, Kaneko H, Irie K, Komatsu K, Maeda S. Prospective Study of Vonoprazan-Based First-Line Triple Therapy with Amoxicillin and Metronidazole for Clarithromycin-Resistant Helicobacter pylori. J Clin Med 2023; 12:5443. [PMID: 37685510 PMCID: PMC10488100 DOI: 10.3390/jcm12175443] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/10/2023] Open
Abstract
AIM This was a prospective, multicenter, single-arm intervention, against historical controls, study of the efficacy of a vonoprazan-based 7-day triple regimen with metronidazole (VPZ-AMPC-MNZ) as a first-line therapy for eradicating clarithromycin-resistant Helicobacter pylori (H. pylori). METHODS We enrolled 35 patients positive for clarithromycin-resistant H. pylori, as assessed by culture, without a history of eradication. These 35 patients were prospectively eradicated with VPZ-AMPC-MNZ. As historical controls, we also assessed 98 patients with clarithromycin-resistant H. pylori from our prior prospective studies, who achieved H. pylori eradication with a 7-day triple regimen including clarithromycin (VPZ-AMPC-CAM). A preplanned analysis was performed as a superiority study against the historical controls (VPZ-AMPC-MNZ compared to VPZ-AMPC-CAM). In each regimen, vonoprazan was used at 20 mg bid, amoxicillin at 750 mg bid, metronidazole at 250 mg bid, and clarithromycin at 200 mg or 400 mg bid for 7 days. We assessed the outcome of eradication therapy using a 13C-urea breath test or H. pylori stool antigen test. We evaluated safety using patient questionnaires. RESULTS The intention-to-treat (ITT) and per-protocol (PP) eradication rates of VPZ-AMPC-MNZ were both 100% (95% confidence interval (95% CI) 90.0-100%, n = 35). The eradication rates of VPZ-AMPC-CAM were 76.5% (95% CI 66.9-84.5%, n = 98) in the ITT analysis and 77.3% (95% CI 67.7-85.2%, n = 97) in the PP analysis. The eradication rate of VPZ-AMPC-MNZ was significantly higher than that of VPZ-AMPC-CAM in both the ITT (p = 0.00052) and PP (p = 0.00095) analyses. CONCLUSIONS The findings suggest that 7-day VPZ-AMPC-MNZ was superior to 7-day VPZ-AMPC-CAM as a first-line regimen for eradicating clarithromycin-resistant H. pylori. We suggest VPZ-AMPC-MNZ as the standard first-line regimen for eradication of clarithromycin-resistant H. pylori in Japan.
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Affiliation(s)
- Soichiro Sue
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (S.S.); (Y.S.); (T.S.)
| | - Yuichi Suzuki
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (S.S.); (Y.S.); (T.S.)
- Department of Gastroenterology, Yokosuka City Hospital, Yokosuka 240-0195, Japan
| | - Tomohiko Sasaki
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (S.S.); (Y.S.); (T.S.)
| | - Hiroaki Kaneko
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (S.S.); (Y.S.); (T.S.)
| | - Kuniyasu Irie
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (S.S.); (Y.S.); (T.S.)
| | - Kazuto Komatsu
- Department of Gastroenterology, Yokosuka City Hospital, Yokosuka 240-0195, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (S.S.); (Y.S.); (T.S.)
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Sue S, Kondo M, Sato T, Oka H, Sanga K, Ogashiwa T, Matsubayashi M, Kaneko H, Irie K, Maeda S. Vonoprazan and high-dose amoxicillin dual therapy for Helicobacter pylori first-line eradication: A single-arm, interventional study. JGH Open 2022; 7:55-60. [PMID: 36660051 PMCID: PMC9840190 DOI: 10.1002/jgh3.12852] [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: 08/03/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 12/13/2022]
Abstract
Background To date, no interventional trial has assessed the efficacy and safety of vonoprazan and high-dose (500 mg four times daily, 2000 mg/day) amoxicillin dual therapy in terms of Helicobacter pylori eradication. We explored whether this was an appropriate first-line treatment. Methods This prospective, dual-center, single-arm interventional study was performed in Japan. Twenty H. pylori-positive patients lacking any eradication history were treated with vonoprazan 20 mg twice daily and amoxicillin 500 mg four times daily (qid) for 7 days. Eradication was evaluated using a stool H. pylori antigen test. We evaluated safety using patient questionnaires. This study was registered in the jRCT database (jRCT031200128). Results The intention-to-treat and per-protocol eradication rates were 90% (95% confidence interval [CI] 68.3-98.8%, n = 20) and 94.4% (95% CI 72.7-99.9%, n = 18) respectively. No significant adverse event was recorded. Conclusion Vonoprazan/high-dose amoxicillin dual therapy can be a safe standard first-line therapy. We are now undergoing a randomized controlled trial comparing dual therapy and vonoprazan-based triple therapy.
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Affiliation(s)
- Soichiro Sue
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Masaaki Kondo
- Department of GastroenterologyYokohama Minami Kyousai HospitalYokohamaJapan
| | - Takeshi Sato
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Hiroyuki Oka
- Department of GastroenterologyYokohama Minami Kyousai HospitalYokohamaJapan
| | - Katsuyuki Sanga
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Tsuyoshi Ogashiwa
- Department of GastroenterologyYokohama Minami Kyousai HospitalYokohamaJapan
| | - Mao Matsubayashi
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Hiroaki Kaneko
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kuniyasu Irie
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Shin Maeda
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
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10
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Hieda M, Futami S, Tanaka H, Moriyama S, Masui S, Kisanuki M, Hatakeyama K, Irie K, Yokoyama T, Fukata M, Arita T, Maruyama T, Nomura H, Akashi K. Natural history of severe aortic stenosis in elderly heart failure patients who declined transcatheter aortic valve implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2548] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Transcatheter aortic valve implantation (TAVI) is an established minimally invasive treatment for elderly patients with severe aortic stenosis (AS). Although it is a relatively minimally invasive procedure, many elderly patients cannot undergo TAVI due to advanced age, advanced dementia, significantly impaired ADL, or because the patient or family does not wish to undergo TAVI. In general, severe AS patients died 5 years after an angina attack, 3 years after syncope symptoms, and 2 years after heart failure symptoms. However, few studies have investigated the prognosis of elderly patients with severe AS who declined TAVI.
Purpose
This study aimed to comprehend the natural history of elderly severe AS patients who declined aortic valve intervention and identify risk factors for death in the TAVI era.
Methods
We retrospectively reviewed 2,786 echocardiographic data from our hospital between 2017 and 2021. We identified 504 patients with AS in the echocardiography database. The severe AS was defined by the following echocardiography parameters: peak aortic flow velocity ≥4.0 m/s, aortic valve mean gradient ≥40 mmHg, aortic valve area (AVA)<1.0 cm2, or AVA index<0.6 cm2/m2. Patients with mild and moderate AS and patients who underwent surgical or transcatheter aortic valve intervention were excluded. Eventually, 82 patients fulfilled the study criteria and were analyzed in this study. Clinical events were investigated, and Cox proportional hazards analysis was performed to elucidate risk factors for mortality.
Results
The mean age was 89±6 years, and 63 (77%) were women. AHA/ACC classification was Stage A/B/C/D: 0%/52.4%/39.0%/8.5%. As event occurrence, we detected 34 (41.5%) all-cause deaths, 41 (50.0%) major adverse cardiovascular events, 32 (39.0%) development of heart failure, 13 (15.9%) chest pain attacks, and 3 (3.7%) syncope. The time from diagnosis of severe AS to all-cause death was 227±273 days, and the 1-, 2-, and 3-year survival rates were 61.5%, 46.2%, and 36.9%, respectively. Of the heart failure-onset population, 16 (50.0%) were found to have severe AS on initial heart failure admission. The incidence of heart failure at 1, 2, and 3 years after diagnosis of severe AS was 60.1%, 56.7%, and 45.4%, respectively. The time from heart failure to death was 107±147 days. Cox proportional hazards analysis adjusted with age, sex, comorbidities revealed that dementia (HR 4.5, P=0.014) and Katz index <5 (HR7.8, P=0.009) were independent risk factors for mortality.
Conclusions
Compared to the comprehension of the natural history of AS patients, the prognosis in severe AS patients who declined TAVI was extremely poor. Although the elderly patients did not have a high rate of angina attacks or syncope symptoms, probably due to their reduced ADL, the results suggest that dementia prevention and maintenance of exercise tolerance are essential since dementia and reduced ADL (Katz<5) are independent risk factors for mortality.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Clinical Research Promotion Foundation Reiwa 2 Michinari Hieda
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Affiliation(s)
- M Hieda
- Kyushu University Hospital , Fukuoka , Japan
| | - S Futami
- Kyushu University Hospital , Fukuoka , Japan
| | - H Tanaka
- Kyushu University Hospital , Fukuoka , Japan
| | - S Moriyama
- Kyushu University Hospital , Fukuoka , Japan
| | - S Masui
- Kyushu University Hospital , Fukuoka , Japan
| | - M Kisanuki
- Kyushu University Hospital , Fukuoka , Japan
| | | | - K Irie
- Kyushu University Hospital , Fukuoka , Japan
| | - T Yokoyama
- Kyushu University Hospital , Fukuoka , Japan
| | - M Fukata
- Kyushu University Hospital , Fukuoka , Japan
| | - T Arita
- Fukuoka Wajiro Hospital , Fukuoka , Japan
| | - T Maruyama
- Kyushu University Hospital , Fukuoka , Japan
| | - H Nomura
- Haradoi Hospital , Fukuoka , Japan
| | - K Akashi
- Kyushu University Hospital , Fukuoka , Japan
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11
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Shalehin N, Seki Y, Takebe H, Fujii S, Mizoguchi T, Nakamura H, Yoshiba N, Yoshiba K, Iijima M, Shimo T, Irie K, Hosoya A. Gli1 +-PDL Cells Contribute to Alveolar Bone Homeostasis and Regeneration. J Dent Res 2022; 101:1537-1543. [PMID: 35786034 DOI: 10.1177/00220345221106921] [Citation(s) in RCA: 1] [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] [Indexed: 01/09/2023] Open
Abstract
The periodontal ligament (PDL) contains mesenchymal stem cells (MSCs) that can differentiate into osteoblasts, cementoblasts, and fibroblasts. Nevertheless, the distribution and characteristics of these cells remain uncertain. Gli1, an essential hedgehog signaling transcription factor, functions in undifferentiated cells during embryogenesis. Therefore, in the present study, the differentiation ability of Gli1+ cells was examined using Gli1-CreERT2/ROSA26-loxP-stop-loxP-tdTomato (iGli1/Tomato) mice. In 4-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were only slightly detected in the PDL, around endomucin-expressing blood vessels. These cells had proliferated over time, localizing in the PDL as well as on the bone and cementum surfaces at day 28. However, in 8-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were quiescent, as most cells were not immunoreactive for Ki-67. These cells in 8-wk-old mice exhibited high colony-forming unit fibroblast activity and were capable of osteogenic, chondrogenic, and adipogenic differentiation in vitro. In addition, after transplantation of teeth of iGli1/Tomato mice into the hypodermis of wild-type mice, Tomato fluorescence indicating the progeny of Gli1+ cells was detected in the osteoblasts and osteocytes of the regenerated bone. These results demonstrate that Gli1+ cells in the PDL were MSCs and could contribute to the alveolar bone regeneration.
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Affiliation(s)
- N Shalehin
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - Y Seki
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan.,Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - H Takebe
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - S Fujii
- Division of Oral Surgery, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - T Mizoguchi
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - H Nakamura
- Department of Oral Anatomy, Matsumoto Dental University, Nagano, Japan
| | - N Yoshiba
- Division of Cariology, Department of Oral Health Science, Operative Dentistry and Endodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Yoshiba
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - M Iijima
- Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - T Shimo
- Division of Oral Surgery, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - K Irie
- Division of Anatomy, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - A Hosoya
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
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12
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Yamada H, Kaneko H, Kuwashima H, Sugimori M, Tsuyuki S, Sanga K, Irie K, Sasaki T, Kondo M, Miyake A, Maeda S. The Origin of Epithelium with Low-Grade Atypia in Early Gastric Cancer. Digestion 2022; 103:217-223. [PMID: 35172301 PMCID: PMC9153352 DOI: 10.1159/000521875] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 12/13/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Helicobacter pylori (HP) infection causes chronic inflammation and atrophy of the gastric mucosa and thus a high risk of gastric cancer (GC). With the increasing success of HP infection treatment, a larger number of GCs that develop after eradication can be assessed. Several studies have shown that epithelium with low-grade atypia (ELA) is a frequent characteristic of these GCs, but the origin of this condition is unknown. In this study, we compared the mucin phenotype, cellular proliferation, and p53 staining in ELA and cancerous tissues obtained from patients with GC with and without HP eradication. METHODS The study population consisted of 23 patients with GC that developed after successful HP eradication therapy (eradicated group) and 24 patients with GC and HP infection (infected group). The prevalence of ELA was determined by hematoxylin and eosin staining. Tumor tissue and ELA samples were further analyzed by immunohistochemical staining for Muc5AC, Muc2, p53, and Ki-67. RESULTS The ELA coverage rate was significantly higher in the eradicated group than in the infected group. Gastric-type mucin was frequently expressed by the ELA, and the mucin phenotypes of ELA and cancerous areas differed in 75% of cases. The Ki-67 labeling index was consistently lower in ELA than in the cancerous mucosa. Fourteen of 21 (66.7%) cancerous lesions, but only 3 ELA samples, were p53-positive. CONCLUSION In most cases, ELA on the surfaces of GCs seems to have originated from normal gastric cells, not from cancer cells.
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Affiliation(s)
- Hiroaki Yamada
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan,*Hiroaki Yamada,
| | - Hiroaki Kaneko
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Hirofumi Kuwashima
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Makoto Sugimori
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Sho Tsuyuki
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Katsuyuki Sanga
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Kuniyasu Irie
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Tomohiko Sasaki
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Masaaki Kondo
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan
| | - Akio Miyake
- Division of Pathological Diagnosis, Yokohama City University Hospital, Yokohama, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University, Yokohama, Japan,**Shin Maeda,
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13
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Mukaiyama K, Irie K, Takeda M, Yamashita R, Uemura S, Kanazawa S, Nagai-Tanima M, Aoyama T. Load distribution and forearm muscle activity during cylinder grip at various grip strength values. Hand Surgery and Rehabilitation 2022; 41:176-182. [DOI: 10.1016/j.hansur.2021.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 10/19/2022]
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14
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Horita N, Miyagi E, Mizushima T, Hagihara M, Hata C, Hattori Y, Hayashi N, Irie K, Ishikawa H, Kawabata Y, Kitani Y, Kobayashi N, Kobayashi N, Kurita Y, Miyake Y, Miyake K, Oguri S, Ota I, Shimizu A, Takeuchi M, Yamada A, Yamamoto K, Yukawa N, Masuda M, Oridate N, Ichikawa Y, Kaneko T. Severe anaphylaxis caused by intravenous anti-cancer drugs. Cancer Med 2021; 10:7174-7183. [PMID: 34505396 PMCID: PMC8525120 DOI: 10.1002/cam4.4252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/14/2021] [Accepted: 08/20/2021] [Indexed: 12/21/2022] Open
Abstract
Background The incidence and risk factors of severe anaphylaxis by intravenous anti‐cancer drugs are unclear, whereas those of milder reactions have been reported. Study Design Electronic medical charts of cancer patients who have undergone intravenous chemotherapy between January 2013 and October 2020 in a university hospital were retrospectively reviewed. Non‐epithelial malignancies were also included in the analysis. "Severe anaphylaxis" was judged using Brown's criteria: typical presentation of anaphylaxis and one or more of hypoxia, shock, and neurologic compromise. (UMIN000042887). Results Among 5584 patients (2964 males [53.1%], 2620 females [46.9%], median age 66 years), 88,200 person‐day anti‐cancer drug administrations were performed intravenously, and 27 severe anaphylaxes were observed. The causative drugs included carboplatin (14 cases), paclitaxel (9 cases), and cisplatin, docetaxel, trastuzumab, and cetuximab (1 case each). The person‐based lifetime incidence of severe anaphylaxis for patients who received at least one intravenous chemotherapy was 0.48% (27/5584, 95% confidence interval (CI) 0.30%–0.67%) and the administration‐based incidence was 0.031% (27/88,200, 95% CI 0.019%–0.043%). Among 124 patients who received at least 10 carboplatin administrations, 10 patients experienced carboplatin‐induced severe anaphylaxis (10/124, 8.1%, 95% CI 3.0%–13.1%). Carboplatin caused severe anaphylaxis after at least 9‐min interval since the drip started. Thirteen out of 14 patients experienced carboplatin‐induced severe anaphylaxis within a 75‐day interval from the previous treatment. Paclitaxel infusion caused severe anaphylaxis after a median of 5 min after the first drip of the day at a life‐long incidence of 0.93% (9/968, 95% CI 0.27%–1.59%). Conclusion We elucidated the high‐risk settings of chemotherapy‐induced severe anaphylaxis.
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Affiliation(s)
- Nobuyuki Horita
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Taichi Mizushima
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Maki Hagihara
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Chiaki Hata
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Yuki Hattori
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Narihiko Hayashi
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Kuniyasu Irie
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Hideyuki Ishikawa
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Yusuke Kawabata
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Yosuke Kitani
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | | | - Nobuaki Kobayashi
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Yusuke Kurita
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Yohei Miyake
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Kentaro Miyake
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Senri Oguri
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Ichiro Ota
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Ayako Shimizu
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Masanobu Takeuchi
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Akimitsu Yamada
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Kojiro Yamamoto
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Norio Yukawa
- Chemotherapy Committee, Yokohama City University Hospital, Yokohama, Japan
| | - Munetaka Masuda
- Department of Surgery, Yokohama City University Hospital, Yokohama, Japan
| | - Nobuhiko Oridate
- Department of Otorhinolaryngology Head and Neck Surgery, Yokohama City University Hospital, Yokohama, Japan
| | - Yasushi Ichikawa
- Department of Oncology, Yokohama City University Hospital, Yokohama, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Hospital, Yokohama, Japan
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15
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Maeda S, Hikiba Y, Fujiwara H, Ikenoue T, Sue S, Sugimori M, Matsubayashi M, Kaneko H, Irie K, Sasaki T, Chuma M. NAFLD exacerbates cholangitis and promotes cholangiocellular carcinoma in mice. Cancer Sci 2021; 112:1471-1480. [PMID: 33506599 PMCID: PMC8019203 DOI: 10.1111/cas.14828] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/13/2021] [Accepted: 01/25/2021] [Indexed: 12/15/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is an increasingly common condition, affecting up to 25% of the population worldwide. NAFLD has been linked to several conditions, including hepatic inflammation, fibrosis, and hepatocellular carcinoma (HCC), however the role of NAFLD in cholangitis and the development of cholangiocellular carcinoma (CCC) remains poorly understood. This study investigated whether a high-fat diet (HFD) promotes cholangitis and the development of CCC in mice. We used liver-specific E-cadherin gene (CDH1) knockout mice, CDH1∆Liv , which develop spontaneous inflammation in the portal areas along with periductal onion skin-like fibrosis, similar to that of primary sclerosing cholangitis (PSC). An HFD or normal diet (ND) was fed to CDH1∆Liv mice for 7 mo. In addition, CDH1∆Liv mice were crossed with LSL-KrasG12D mice, fed an HFD, and assessed in terms of liver tumor development. The extent of cholangitis and number of bile ductules significantly increased in mice fed an HFD compared with ND-administered CDH1∆Liv mice. The numbers of Sox9 and CD44-positive stem cell-like cells were significantly increased in HFD mice. LSL-KrasG12D /CDH1∆Liv HFD mice exhibited increased aggressiveness along with the development of numerous HCC and CCC, whereas LSL-KrasG12D /CDH1∆Liv ND mice showed several macroscopic tumors with both HCC and CCC components. In conclusion, NAFLD exacerbates cholangitis and promotes the development of both HCC and CCC in mice.
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Affiliation(s)
- Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yohko Hikiba
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroaki Fujiwara
- Division of Gastroenterology, Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan
| | - Tsuneo Ikenoue
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Soichiro Sue
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Makoto Sugimori
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mao Matsubayashi
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroaki Kaneko
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kuniyasu Irie
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomohiko Sasaki
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Makoto Chuma
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
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16
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Sue S, Sasaki T, Kaneko H, Irie K, Kondo M, Maeda S. Helicobacter pylori rescue treatment with vonoprazan, metronidazole, and sitafloxacin in the presence of penicillin allergy. JGH Open 2021; 5:307-311. [PMID: 33553672 PMCID: PMC7857288 DOI: 10.1002/jgh3.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/12/2022]
Abstract
Background and Aim To assess the efficacy and safety of 7‐day Helicobacter pylori rescue treatment consisting of a vonoprazan (VPZ), metronidazole (MNZ), and sitafloxacin (STFX) regimen (VPZ‐MNZ‐STFX therapy) in patients with penicillin allergy. Methods This was a registered prospective intervention study. Patients with penicillin allergy who were diagnosed with H. pylori infection and had a history of H. pylori eradication were eligible for inclusion. Seventeen patients were prospectively treated with VPZ 20 mg bid, MNZ 250 mg bid, and STFX 100 mg bid for 7 days. Safety was evaluated using a questionnaire on adverse effects. Results The eradication rate of 7‐day VPZ‐MNZ‐SFTX therapy was 88.2% (95% confidence interval: 63.6–98.5%; n = 17) in both intention‐to‐treat and per‐protocol analyses. On the questionnaire, 25% of patients reported experiencing diarrhea, with a score of 2 or 3. All patients undergoing VPZ‐MNZ‐STFX therapy completed 100% of their medication course. Conclusion Rescue H. pylori eradication with VPZ‐MNZ‐STFX therapy is effective and well tolerated in patients with penicillin allergy (UMIN000016335, jRCTs031180133).
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Affiliation(s)
- Soichiro Sue
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Tomohiko Sasaki
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Hiroaki Kaneko
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Kuniyasu Irie
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Masaaki Kondo
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Shin Maeda
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
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17
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Ogushi K, Chuma M, Uojima H, Hidaka H, Numata K, Kobayashi S, Hirose S, Hattori N, Fujikawa T, Nakazawa T, Wada N, Iwasaki S, Fukushima T, Sano Y, Ueno M, Kawano K, Tsuruya K, Shomura M, Watanabe T, Matsunaga K, Kunishi Y, Saigusa Y, Irie K, Iwabuchi S, Kako M, Morimoto M, Kagawa T, Tanaka K, Maeda S. Safety and Efficacy of Lenvatinib Treatment in Child-Pugh A and B Patients with Unresectable Hepatocellular Carcinoma in Clinical Practice: A Multicenter Analysis. Clin Exp Gastroenterol 2020; 13:385-396. [PMID: 33061517 PMCID: PMC7534867 DOI: 10.2147/ceg.s256691] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose To assess the safety, efficacy and prognostic impact of clinical factors related to lenvatinib treatment in Child-Pugh class A (CP-A) and class B (CP-B) patients with unresectable hepatocellular carcinoma (u-HCC). Methods Patients with u-HCC who were treated with lenvatinib at multiple centers in Japan were retrospectively analyzed for treatment outcomes according to their respective CP status. Radiological objective response (OR) was assessed using modified response evaluation criteria in solid tumors (mRECIST) guidelines. Results Baseline demographic parameters were comparable between 126 (69.6%) patients with CP-A disease and 55 patients (30.4%) with CP-B disease. Frequency of lenvatinib-related adverse events, including decreased appetite (P=0.034), diarrhea (P=0.040), elevated serum bilirubin (P=0.016) and vomiting (P=0.009), were higher in CP-B than in CP-A patients. Relative dose intensity (RDI) was significantly higher in CP-A (0.69) than CP-B patients (0.50, P <0.001). Furthermore, OR rate (44.0%) was markedly higher in CP-A5 patients as compared to CP-A6 (25.5%), CP-B7 (22.2%), and CP-B8 patients (5.3%), respectively (P=0.002). In multivariable analysis, performance status (0 vs 1, 2, P=0.026), CP class (A vs B, P=0.045) and RDI (≥0.7 vs <0.7, P=0.034) were identified as factors associated with response to lenvatinib treatment. Overall survival (OS) at 12 months was significantly different between CP-A (66.3%) and CP-B patients (30.0%, P=0.002), and between CP 5-7 (59.2%) and CP 8 patients (34.8%, P=0.003). In multivariable analysis, CP class (A vs B, P=0.007) and Barcelona clinic liver cancer (BCLC) stage (B vs C, P=0.002) were associated with OS following lenvatinib treatment. Conclusion Lenvatinib treatment offers significant benefits in patients with good liver function in real-world practice. The various characteristics identified in this study might be helpful as clinical predictors of response to lenvatinib and survival in clinical practice. Further studies are required to address eligibility for lenvatinib treatment in CP 7 patients.
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Affiliation(s)
- Katsuaki Ogushi
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Makoto Chuma
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Haruki Uojima
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hisashi Hidaka
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Satoshi Kobayashi
- Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Shunji Hirose
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Nobuhiro Hattori
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tomoaki Fujikawa
- Department of Gastroenterology, Shonan Fujisawa General Hospital, Fujisawa, Japan
| | - Takahide Nakazawa
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Naohisa Wada
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Shuitirou Iwasaki
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Taito Fukushima
- Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Yusuke Sano
- Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Makoto Ueno
- Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Kuniyuki Kawano
- Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Kota Tsuruya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Masako Shomura
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Tsunamasa Watanabe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kotaro Matsunaga
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yosuke Kunishi
- Department of Gastroenterology, Kanagawa Prefectural Ashigarakami Hospital, Kanagawa, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kuniyasu Irie
- Department of Gastroenterology, Yokohama City University Hospital, Yokohama, Japan
| | - Shogo Iwabuchi
- Department of Gastroenterology, Shonan Fujisawa General Hospital, Fujisawa, Japan
| | - Makoto Kako
- Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Manabu Morimoto
- Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Tatehiro Kagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Katsuaki Tanaka
- Gastroenterology Division, Hadano Red Cross Hospital, Hadano, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Hospital, Yokohama, Japan
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Miwa H, Sugimori K, Kaneko T, Ishii T, Iwase S, Irie K, Sanga K, Tozuka Y, Hirotani A, Komiyama S, Sato T, Tezuka S, Goda Y, Numata K, Maeda S. Clinical outcome of a highly flexible duodenal stent for gastric outlet obstruction: A multicenter prospective study. JGH Open 2020; 4:729-735. [PMID: 32782963 PMCID: PMC7411653 DOI: 10.1002/jgh3.12326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/05/2020] [Indexed: 12/17/2022]
Abstract
Background and Aim Endoscopic duodenal stenting for patients with malignant gastric outlet obstruction (GOO) has been widespread; however, clinical trials evaluating the structures of duodenal stents are lacking. Thus, we aimed to investigate the clinical outcomes of a highly flexible duodenal stent for GOO patients. Methods A prospective study of duodenal stenting for GOO patients from five hospitals between August 2017 and August 2018 was performed. WallFlex Duodenal Soft were used in all procedures. The primary endpoint was clinical success, defined as an improvement in the GOO scoring system. Results The study enrolled 31 patients (12 women, 19 men) with GOO, with a median age of 70 (range 52–90) years. Primary diseases were pancreatic cancer, gastric cancer, biliary tract cancer, and others in 14, 10, 3, and 4 patients, respectively. The technical success rate was 97%, and the clinical success rate was 87%. Simultaneous biliary drainage was performed in 19% of patients. Adverse events occurred in three patients. Chemotherapy was given in 41% of clinically successful cases, and the median overall survival time after stent placement was 82 days (range, 30–341 days), and. Stent dysfunction occurred in 30% of clinically successful cases (stent ingrowth in seven and stent overgrowth in one patient). The median time to stent dysfunction was 157 days (range, 11–183 days). Six patients were treated with additional stent placement after dysfunction. Conclusion Placement of a highly flexible duodenal stent is an effective and safe treatment for patients with GOO (UMIN‐CTR 000028783).
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Affiliation(s)
- Haruo Miwa
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Kazuya Sugimori
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Takashi Kaneko
- Department of Gastroenterology Yokohama Minami Kyousai Hospital Yokohama Japan
| | - Tomohiro Ishii
- Department of Gastroenterology Saiseikai Yokohamashi Nanbu Hospital Yokohama Japan
| | - Shigeru Iwase
- Department of Gastroenterology Fujisawa City Hospital Fujisawa Japan
| | - Kuniyasu Irie
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Katsuyuki Sanga
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Yuichiro Tozuka
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Akane Hirotani
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Satoshi Komiyama
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Takeshi Sato
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Shun Tezuka
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Yoshihiro Goda
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Kazushi Numata
- Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
| | - Shin Maeda
- Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan
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Matsumoto S, Watanabe K, Kobayashi N, Irie K, Yamanaka S, Kaneko T. Pembrolizumab-induced secondary sclerosing cholangitis in a non-small cell lung cancer patient. Respirol Case Rep 2020; 8:e00560. [PMID: 32284868 PMCID: PMC7148160 DOI: 10.1002/rcr2.560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
A 50-year-old woman with stage IV lung adenocarcinoma received seven cycles of pembrolizumab as third-line chemotherapy. Following the failure of pembrolizumab, she commenced fourth-line chemotherapy of docetaxel and ramucirumab. The patient complained of epigastric pain and a computed tomography (CT) scan revealed oedema-like thickening of the gallbladder wall, dilation of the bile ducts from the common to the intrahepatic bile ducts, and thickening of the common bile duct wall without any visible obstructions. Accumulation of fluorodeoxyglucose (FDG) in the gallbladder wall and bile duct was also detected with positron emission tomography (PET)-CT. A biopsy of the extrahepatic bile duct showed non-specific inflammation. Antibiotic treatment was not effective and pathogens were not detected. The patient was diagnosed with secondary sclerosing cholangitis (SSC) by pembrolizumab. She received 80 mg/day of prednisolone (PSL); however, SSC recurred with tapering of PSL. SSC then improved with steroid pulse therapy and subsequently 50 mg/day azathioprine and 80 mg/day PSL.
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Affiliation(s)
- Sachiko Matsumoto
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Keisuke Watanabe
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Nobuaki Kobayashi
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kuniyasu Irie
- Division of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Shoji Yamanaka
- Department of PathologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Takeshi Kaneko
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
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20
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Sugimori M, Sugimori K, Tsuchiya H, Suzuki Y, Tsuyuki S, Kaneta Y, Hirotani A, Sanga K, Tozuka Y, Komiyama S, Sato T, Tezuka S, Goda Y, Irie K, Miwa H, Miura Y, Ishii T, Kaneko T, Nagahama M, Shibata W, Nozaki A, Maeda S. Quantitative monitoring of circulating tumor DNA in patients with advanced pancreatic cancer undergoing chemotherapy. Cancer Sci 2020; 111:266-278. [PMID: 31746520 PMCID: PMC6942439 DOI: 10.1111/cas.14245] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 12/14/2022] Open
Abstract
According to cancer genome sequences, more than 90% of cases of pancreatic ductal adenocarcinoma (PDAC) harbor active KRAS mutations. Digital PCR (dPCR) enables accurate detection and quantification of rare mutations. We assessed the dynamics of circulating tumor DNA (ct-DNA) in patients with advanced PDAC undergoing chemotherapy using dPCR. KRAS G12/13 mutation was assayed by dPCR in 47 paired tissue- and ct-DNA samples. The 21 patients were subjected to quantitative ct-DNA monitoring at 4 to 8-week intervals during chemotherapy. KRAS mutation was detected in 45 of those 47 patients using tissue DNA. In the KRAS mutation-negative cases, next-generation sequencing revealed KRAS Q61K and NRAS Q61R mutations. KRAS mutation was detected in 23/45 cases using ct-DNA (liver or lung metastasis, 18/19; mutation allele frequency [MAF], 0.1%-31.7%; peritoneal metastasis, 3/9 [0.1%], locally advanced, 2/17 [0.1%-0.2%]). In the ct-DNA monitoring, the MAF value changed in concordance with the disease state. In the 6 locally advanced cases, KRAS mutation appeared concurrently with liver metastasis. Among the 6 cases with liver metastasis, KRAS mutation disappeared during the duration of stable disease or a partial response, and reappeared at the time of progressive disease. The median progression-free survival was longer in cases in which KRAS mutation disappeared after an initial course of chemotherapy than in those in which it was continuously detected (248.5 vs 50 days, P < .001). Therefore, ct-DNA monitoring enables continuous assessment of disease state and could have prognostic utility during chemotherapy.
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Affiliation(s)
- Makoto Sugimori
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kazuya Sugimori
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Hiromi Tsuchiya
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Yoshimasa Suzuki
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Sho Tsuyuki
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Yoshihiro Kaneta
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Akane Hirotani
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Katsuyuki Sanga
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Yuichiro Tozuka
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Satoshi Komiyama
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Takeshi Sato
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Shun Tezuka
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Yoshihiro Goda
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Kuniyasu Irie
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Haruo Miwa
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Yuuki Miura
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Tomohiro Ishii
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Takashi Kaneko
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Masatsugu Nagahama
- Department of GastroenterologyShowa University Fujigaoka HospitalYokohamaJapan
| | - Wataru Shibata
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
- Division of Translational ResearchAdvanced Medical Research CenterYokohama City UniversityYokohamaJapan
| | - Akito Nozaki
- Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Shin Maeda
- Department of GastroenterologyYokohama City University Graduate School of MedicineYokohamaJapan
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21
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Kuramoto K, Beppu T, Irie K, Kinoshita K, Sato N, Akahoshi S, Yoshida Y, Yuki H, Hamada Y. Hepatobiliary and Pancreatic: Intra-ductal biliary schwannoma. J Gastroenterol Hepatol 2019; 34:1674. [PMID: 31210364 DOI: 10.1111/jgh.14679] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 03/30/2019] [Indexed: 12/09/2022]
Affiliation(s)
- K Kuramoto
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - T Beppu
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - K Irie
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - K Kinoshita
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - N Sato
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - S Akahoshi
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - Y Yoshida
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - H Yuki
- Department of Radiology, Yamaga City Medical Center, Yamaga, Japan
| | - Y Hamada
- Department of Pathology, Fukuoka University, Fukuoka, Japan
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22
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Kaneta Y, Sato T, Hikiba Y, Sugimori M, Sue S, Kaneko H, Irie K, Sasaki T, Kondo M, Chuma M, Shibata W, Maeda S. Loss of Pancreatic E-Cadherin Causes Pancreatitis-Like Changes and Contributes to Carcinogenesis. Cell Mol Gastroenterol Hepatol 2019; 9:105-119. [PMID: 31526907 PMCID: PMC6889596 DOI: 10.1016/j.jcmgh.2019.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS E-cadherin (Cdh1) is a key molecule for adherence required for maintenance of structural homeostasis. Loss of E-cadherin leads to poor prognosis and the development of resistance to chemotherapy in pancreatic cancer. Here, we evaluated the physiological and pathologic roles of E-cadherin in the pancreas. METHODS We crossbred Ptf1a-Cre mice with Cdh1f/f mice to examine the physiological roles of E-cadherin in the pancreas. In addition, we crossbred these mice with LSL-KrasG12D/+ mice (PKC) to investigate the pathologic roles of E-cadherin. We also generated a tamoxifen-inducible system (Ptf1a-CreERT model). Organoids derived from these models using lentiviral transduction were analyzed for immunohistochemical features. Established cell lines from these organoids were analyzed for migratory and invasive activities as well as gene expression by complementary DNA microarray analyses. RESULTS None of the Ptf1a-Cre mice crossbred with Cdh1f/f mice survived for more than 28 days. We observed aberrant epithelial tubules that resembled the structure of acinar-to-ductal metaplasia after postnatal day 6, showing features of pancreatitis. All of the PKC mice died within 10 days. We observed tumorigenicity with increasing stroma-like aggressive tumors. Ptf1a-CreERT models showed that deletion of E-cadherin led to earlier pancreatic intraepithelial neoplasm formation. Cells established from PKC organoids had greater migratory and invasive activities, and these allograft tumors showed a poorly differentiated phenotype. Gene expression analysis indicated that Hdac1 was up-regulated in PKC cell lines and a histone deacetylase 1 inhibitor suppressed PKC cell proliferation. CONCLUSIONS Under physiological conditions, E-cadherin is important for maintaining the tissue homeostasis of the pancreas. Under pathologic conditions with mutational Kras activation, E-cadherin plays an important role in tumor formation via the acquisition of tumorigenic activity.
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Affiliation(s)
- Yoshihiro Kaneta
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Takeshi Sato
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yohko Hikiba
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Makoto Sugimori
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Soichiro Sue
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Hiroaki Kaneko
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kuniyasu Irie
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tomohiko Sasaki
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Masaaki Kondo
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Makoto Chuma
- Gastroenterological Centre, Yokohama City University Medical Centre, Yokohama, Japan
| | - Wataru Shibata
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan,Advanced Medical Research Center, Yokohama City University, Yokohama, Japan
| | - Shin Maeda
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan,Correspondence Address correspondence to: Shin Maeda, MD, PhD Department of Gastroenterology, Graduate School of Medicine Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. fax: (81) 45-787-2327.
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23
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Miwa H, Numata K, Sugimori K, Sanga K, Hirotani A, Tezuka S, Goda Y, Irie K, Ishii T, Kaneko T, Tanaka K, Maeda S. Differential diagnosis of gallbladder polypoid lesions using contrast-enhanced ultrasound. Abdom Radiol (NY) 2019; 44:1367-1378. [PMID: 30478647 DOI: 10.1007/s00261-018-1833-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of the study is to evaluate the utility of contrast-enhanced ultrasound (CEUS) for the differential diagnosis of gallbladder polypoid lesions (GPLs). METHODS Thirty-six patients with GPLs (17 with gallbladder cancer, 19 with benign polyps) who underwent CEUS were enrolled in the study. The mean age of patients was 65.7 ± 12.6 years. Perflubutane-based contrast agent and high-mechanical index mode, which can eliminate the background B-mode and provide precise visualization of tumor vessels, were used for CEUS, and two blinded readers evaluated the images, retrospectively. RESULTS Patient age and size of malignant GPLs (72.4 ± 9.4 years and 23.4 ± 7.5 mm) were significantly greater than those for benign lesions (59.6 ± 12.3 years and 12.4 ± 2.9 mm) (P < 0.01, respectively), and the receiver operating characteristic analysis showed the cut-off value as over 65 years and 16 mm. Univariate analysis showed that heterogeneity in B-mode (80% [12/15]), sessile shape (76% [13/17]), dilated vessel (71% [12/17]), irregular vessel (82% [14/17]), and heterogeneous enhancement (59% [10/17]) on CEUS were significantly correlated with malignant GPLs (P < 0.01, respectively). On CEUS, the diagnostic criterion for malignant GPLs was defined as having one or more of the above four features because of the highest accuracy. Sensitivity, specificity, and accuracy for malignant GBLs were 88%, 68%, and 78% for patient age; 76%, 89%, and 83% for size of GPLs; 80%, 68%, and 74% for B-mode; and 94%, 89%, and 92% for CEUS, respectively. CONCLUSIONS CEUS is useful for the differential diagnosis of malignant and benign GPLs.
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Sue S, Shibata W, Sasaki T, Kaneko H, Irie K, Kondo M, Maeda S. Randomized trial of vonoprazan-based versus proton-pump inhibitor-based third-line triple therapy with sitafloxacin for Helicobacter pylori. J Gastroenterol Hepatol 2019; 34:686-692. [PMID: 30151994 DOI: 10.1111/jgh.14456] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM This was a prospective, randomized trial of the efficacy of vonoprazan-based and proton-pump inhibitor-based 7-day triple regimens with amoxicillin and sitafloxacin as a third-line therapy for eradicating Helicobacter pylori after failure of clarithromycin-based and metronidazole-based first-line and second-line therapy. METHODS We enrolled 63 patients positive for H. pylori in whom first-line and second-line regimens for eradicating failed. Patients were randomized to the V-AS group (vonoprazan 20-mg bid, amoxicillin 750-mg bid, and sitafloxacin 100-mg bid for 7 days) or PPI-AS group (esomeprazole 20-mg bid, rabeprazole 10-mg bid, or lansoprazole 30-mg bid; amoxicillin 750-mg bid; and sitafloxacin 100-mg bid for 7 days). We assessed the outcome of eradication therapy using the 13 C-urea breath test. We evaluated safety using patient questionnaires. This study was registered in the UMIN Clinical Trials Registry (UMIN000016336). RESULTS The intention-to-treat and per-protocol eradication rates of V-AS were 75.8% (95% confidence interval [CI]: 57.7-88.9%) and 83.3% (95% CI: 65.3-94.4%), respectively. The respective eradication rates of PPI-AS were 53.3% (95% CI: 34.3-71.7%) and 57.1% (95% CI: 37.2-75.5%). In per-protocol analyses, the eradication rate of the V-AS group was significantly higher than that of the PPI-AS group (P = 0.043); however, no significant differences were observed in intention-to-treat analyses (P = 0.071). Questionnaire scores did not differ significantly between the groups. CONCLUSIONS The findings suggest that 7-day triple therapy with vonoprazan, amoxicillin, and sitafloxacin is more effective than proton-pump inhibitor, amoxicillin, and sitafloxacin as a third-line regimen for eradicating H. pylori.
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Affiliation(s)
- Soichiro Sue
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Wataru Shibata
- Advanced Medical Research Center, Yokohama City University, Yokohama, Japan
| | - Tomohiko Sasaki
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroaki Kaneko
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kuniyasu Irie
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masaaki Kondo
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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25
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Sato N, Tasaki T, Noguchi H, Irie K, Nakayama T. Pulmonary tumor thrombotic microangiopathy (PTTM): 24 case series and its criteria for pathological diagnosis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy304.039] [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
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26
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Nishigori S, Numata K, Irie K, Fukuda H, Chuma M, Maeda S. Fusion imaging with contrast-enhanced ultrasonography for evaluating the early therapeutic efficacy of radiofrequency ablation for small hypervascular hepatocellular carcinomas with iso-echoic or unclear margins on conventional ultrasonography. J Med Ultrason (2001) 2018; 45:405-415. [PMID: 29362966 DOI: 10.1007/s10396-018-0861-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 08/14/2017] [Accepted: 12/26/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE We evaluated the efficacy of fusion imaging combining contrast-enhanced ultrasonography (CEUS) images and arterial phase contrast-enhanced CT (CECT) or hepatobiliary phase magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (EOB-MRI) images for the early evaluation of the effectiveness of radiofrequency ablation (RFA) for small hypervascular hepatocellular carcinoma (HCC) with iso-echoic or unclear margins on conventional US. METHODS Forty HCCs (22 iso-echoic and 18 unclear margin lesions) with mean diameters of 13.7 mm were treated using RFA under the guidance of fusion imaging with CEUS. The adequacy of RFA was evaluated using fusion imaging with CEUS 1 day after RFA. CECT or EOB-MRI was performed 1 month after RFA. We reviewed the images obtained using both modalities. RESULTS When the 1-month CECT or EOB-MRI scans were used as the reference standard, the sensitivity, specificity, and accuracy of the 1-day fusion imaging for the diagnosis of the adequate ablation of these HCCs were 97, 100, and 98%, respectively; the kappa value for the agreement between the findings using the two modalities was 0.655. CONCLUSION Fusion imaging with CEUS appears to be a useful method for the early evaluation of the efficacy of RFA for the treatment of HCCs with iso-echoic or unclear margins on conventional US.
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Affiliation(s)
- Shuhei Nishigori
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
| | - Kuniyasu Irie
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Hiroyuki Fukuda
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Makoto Chuma
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Shin Maeda
- Division of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Kobayashi S, Ueno M, Sugimori K, Morizane C, Kojima Y, Irie K, Goda Y, Morimoto M, Ohkawa S. Phase II study of fixed dose-rate gemcitabine plus S-1 as a second-line treatment for advanced biliary tract cancer. Cancer Chemother Pharmacol 2017; 80:1189-1196. [PMID: 29071413 DOI: 10.1007/s00280-017-3461-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 04/04/2017] [Accepted: 10/10/2017] [Indexed: 02/01/2023]
Abstract
PURPOSE Gemcitabine plus platinum is considered standard first-line chemotherapy for patients with advanced biliary tract cancer. However, no standard second-line therapy has been established for this disease. According to reports, S-1 exerts anti-tumor effects on advanced biliary tract cancer and gemcitabine is more effective via fixed dose-rate administration. We evaluated the efficacy and safety of a combination of fixed dose-rate gemcitabine and S-1 after failure of gemcitabine or gemcitabine plus cisplatin therapy. METHODS This single-arm phase II study (clinical trial number: UMIN000005918) set the response rate as the primary endpoint and used a MiniMax two-stage design with a null hypothesis < 7% and alternative hypothesis ≥ 25%. Thirty-five patients were needed to yield a power of 90% and α value of 0.05. Patients received gemcitabine (1000 mg/m2, div, 100-min period, day 1) and S-1 (40 mg/m2 twice daily, oral, days 1-7), every 2 weeks until disease progression or intolerable adverse events were observed. RESULTS Forty-one patients were enrolled, and 3 of 23 first-stage patients responded. The overall response rate was 9.8% [95% confidence interval (CI): 2.7-19.2%]. The median overall and progression-free survival were 7.0 [95% CI: 5.3-8.6] and 2.6 months (95% CI: 1.6-3.5), respectively. The most common grade 3-4 adverse events were leukopenia (19.5%), neutropenia (19.5%), anemia (14.6%), thrombocytopenia (7.3%), and anorexia (4.8%). CONCLUSION Second-line fixed dose-rate gemcitabine plus S-1 was not sufficiently effective and tolerable in patients with advanced biliary tract cancer refractory to gemcitabine or gemcitabine plus cisplatin.
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Affiliation(s)
- Satoshi Kobayashi
- Hepatobiliary and Pancreatic Oncology Division, Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.
| | - Makoto Ueno
- Hepatobiliary and Pancreatic Oncology Division, Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Kazuya Sugimori
- Department of Gastroenterology, Yokohama City University Medical Center, Yokohama, Japan
| | - Chigusa Morizane
- Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yasushi Kojima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kuniyasu Irie
- Hepatobiliary and Pancreatic Oncology Division, Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Yoshihiro Goda
- Hepatobiliary and Pancreatic Oncology Division, Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Manabu Morimoto
- Hepatobiliary and Pancreatic Oncology Division, Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Shinichi Ohkawa
- Hepatobiliary and Pancreatic Oncology Division, Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
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Goda Y, Morimoto M, Irie K, Kobayashi S, Ueno M, Moriya S, Tezuka S, Ohkawa S, Morinaga S, Numata K, Tanaka K, Maeda S. Switch to miriplatin for multinodular hepatocellular carcinoma unresponsive to transarterial chemoembolization with epirubicin: a prospective study. Jpn J Clin Oncol 2017; 47:1151-1156. [DOI: 10.1093/jjco/hyx131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/21/2017] [Indexed: 01/05/2023] Open
Affiliation(s)
- Yoshihiro Goda
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center
| | - Manabu Morimoto
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center
| | - Kuniyasu Irie
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center
| | | | - Makoto Ueno
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center
| | - Satoshi Moriya
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center
| | - Shun Tezuka
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center
| | - Shinichi Ohkawa
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center
| | | | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center
| | - Katsuaki Tanaka
- Gastroenterological Center, Yokohama City University Medical Center
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Irie K, Fukata M, Fujita K, Noda H, Moriyama S, Yokoyama T, Arita T, Odashiro K, Akashi K, Maruyama TORU. P839The Association between atrial fibrillation-related traits and low skeletal muscles. Europace 2017. [DOI: 10.1093/ehjci/eux151.021] [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
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Fukata M, Mukai Y, Fujita K, Irie K, Kawai S, Inoue S, Tsutusi H, Akashi K. P1402An effective therapeutic technique of hot balloon ablation in atrial fibrillation regarding contact force concept. Europace 2017. [DOI: 10.1093/ehjci/eux158.030] [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
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Abstract
Elastic system fibers are load-bearing proteins found in periodontal tissue. There are three types—oxytalan, elaunin, and elastic fibers—which differ in their relative microfibril and elastin contents. Oxytalan fibers are known to be distributed in the periodontal ligaments and gingiva, whereas elaunin and elastic fibers are present only in the gingiva. We examined gene expression and accumulation of tropoelastin in the cell-matrix layers of human gingival fibroblasts (HGF) and periodontal ligament fibroblasts (HPLF) in vitro. HGF and HPLF were cultured in MEM containing 10% newborn calf serum for 8 wks. Northern blotting and RT-PCR analyses showed that only HGF expressed mRNA encoding tropoelastin. Western blotting analysis demonstrated 77-kDa protropoelastin and 68-kDa tropoelastin only in the cell-matrix layer of HGF cultured for 8 wks. These results suggest that the different tropoelastin expression patterns reflect the difference between HGF and HPLF phenotypes.
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Affiliation(s)
- E. Tsuruga
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
| | - K. Irie
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
| | - Y. Sakakura
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
| | - T. Yajima
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
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Morimoto M, Kobayashi S, Moriya S, Ueno M, Tezuka S, Irie K, Goda Y, Ohkawa S. Short-term efficacy of transarterial chemoembolization with epirubicin-loaded superabsorbent polymer microspheres for hepatocellular carcinoma: comparison with conventional transarterial chemoembolization. Abdom Radiol (NY) 2017; 42:612-619. [PMID: 27624498 DOI: 10.1007/s00261-016-0900-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/08/2023]
Abstract
PURPOSE This study aimed to compare the short-term efficacy of transarterial chemoembolization (TACE) with epirubicin-loaded superabsorbent polymer embolics (SAP) and conventional TACE in TACE-naïve patients with unresectable hepatocellular carcinoma (HCC). METHODS Fifty consecutive patients (mean age, 72.8 years; hepatitis C, 46%; BCLC-A or B, 52% or 48%) treated with TACE with SAP during 2013-2015 and 55 consecutive patients (mean age, 71.8 years; hepatitis C, 40%; BCLC-A or B, 51% or 49%) treated with conventional TACE during 2011-2013 were evaluated. Safety evaluations were based on CTCAE ver. 4.0. Short-term efficacies, i.e., at 1 month after TACE, were assessed using the European Association for the Study of the Liver criteria. Overall survival rates were calculated using the Kaplan-Meier method. Short-term response markers were analyzed by univariate and multivariate analyses. RESULTS There was no significant difference in the incidence of any grade of adverse events. The objective response rates were 50% and 62% in patients treated with TACE with SAP and with conventional TACE, respectively (P = 0.358). The overall survival rates were not significantly different (P = 0.810); the 1-year survival rates and the median survival time of the patients treated with TACE with SAP and with conventional TACE were 76% and 74%, and 18 months and 21 months, respectively. Overall survival was related to the short-term response. An alpha-fetoprotein level <1,000 ng/mL was a significant short-term response marker on multivariate analysis. CONCLUSIONS For TACE-naïve patients, TACE with SAP and conventional TACE had comparable safety and short-term efficacies.
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Affiliation(s)
- Manabu Morimoto
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.
| | - Satoshi Kobayashi
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Satoshi Moriya
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Makoto Ueno
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Shun Tezuka
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Kuniyasu Irie
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Yoshihiro Goda
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Shinichi Ohkawa
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
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Hata A, Nanjo S, Okuda C, Kaji R, Masago K, Fujita S, Irie K, Okada H, Okada H, Okada H, Fukushima S, Katakami N. 451PD Osimertinib at 80 mg for refractory leptomeningeal metastases in T790M-positive EGFR-mutant non-small cell lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw594.015] [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
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Hata A, Nanjo S, Okuda C, Kaji R, Masago K, Fujita S, Irie K, Okada H, Okada H, Okada H, Fukushima S, Katakami N. 451PD Osimertinibat 80mg for refractoryleptomeningeal metastases in T790M-positive EGFR-mutant non-small cell lung cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00609-8] [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: 10/22/2022] Open
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Abstract
Elastic system fibers, comprised of microfibrils and tropoelastin, are extracellular components of periodontal tissue. During development, the microfibrils act as a template on which tropoelastin is deposited. However, the process of elastic system fiber remodeling is not fully understood. Therefore, we examined whether matrix metalloproteinases (MMPs) are involved in the remodeling of fibrillins (major components of microfibrils) by human gingival fibroblasts and periodontal ligament (PDL) fibroblasts. Gingival and PDL fibroblasts were cultured for 6 weeks. In some cultures, MMP inhibitor or tissue inhibitor of matrix metalloproteinsase-2 (TIMP-2) was added to the medium for an additional 2 weeks. Active MMP-2 (62 kDa) appeared as cell-membrane-associated or in extracellular matrix only in PDL fibroblast cell layers. The addition of MMP inhibitor or TIMP-2 significantly increased fibrillin-2 accumulation in PDL fibroblast cell layers, and decreased the amount of fibrillin-2 fragments, suggesting that active MMP-2 may degrade fibrillin-2, and that MMPs may play a role in the remodeling of elastic system fibers in PDL.
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Affiliation(s)
- E Tsuruga
- Department of Oral Anatomy, School of Dentistry, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293, Japan.
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Okada Y, Sadoshima S, Saku Y, Kitazono T, Irie K, Ogasawara T, Utsunomiya H, Fujishima M. Influence of haemorrhagic transformation on the outcome of thrombolytic therapy for patients with acute brain embolism. Neurol Res 2016; 14:167-70. [PMID: 1355879 DOI: 10.1080/01616412.1992.11740042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Y Okada
- Department of Cerebrovascular Disease, St. Mary's Hospital, Kurume, Japan
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Kobayashi S, Ueno M, Kameda R, Moriya S, Irie K, Goda Y, Tezuka S, Yanagida N, Ohkawa S, Aoyama T, Morinaga S, Morimoto M. Duodenal stenting followed by systemic chemotherapy for patients with pancreatic cancer and gastric outlet obstruction. Pancreatology 2016; 16:1085-1091. [PMID: 27424479 DOI: 10.1016/j.pan.2016.07.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/13/2016] [Accepted: 07/09/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Endoscopic duodenal stenting has recently been proposed as a substitute for surgical gastrojejunostomy for the treatment of gastric outlet obstruction. We aimed to evaluate the efficacy and safety of duodenal stenting followed by systemic chemotherapy for patients with advanced pancreatic cancer with gastric outlet obstruction. METHODS This was a single-center, retrospective cohort study, conducted at an academic medical center, of 71 patients with advanced pancreatic cancer and gastric outlet obstruction (mean age: 67.6 years; range: 31-92 years) who underwent duodenal stenting with or without subsequent chemotherapy. Overall survival, duration of oral intake of foods, the rate of introduction of chemotherapy, progression-free survival, and adverse events were evaluated. RESULTS Stent placement was technically successful in 69 (97%) patients. Thirty-six (51%) patients were treated with chemotherapy: 17 with gemcitabine alone, 15 with S-1 alone, 3 with FOLFIRINOX, and 1 with paclitaxel. Median progression-free survival and overall survival after chemotherapy were 2.6 months (95% confidence interval: 1.3-3.9 months) and 4.7 months (95% confidence interval: 2.6-6.8 months), respectively. Cases of grade 3 anemia were frequently observed during chemotherapies following duodenal stenting (32%). Tumor stage, performance status, neutrophil-to-lymphocyte ratio, and introduction of chemotherapy were independent prognostic factors for survival (hazard ratios of 3.73, 2.21, 2.69, and 1.85 with p-values of <0.001, 0.010, <0.001, and 0.045, respectively). CONCLUSIONS The findings of this study suggest that endoscopic duodenal stenting is an advantageous treatment in advanced pancreatic cancer patients with gastric outlet obstruction regarding its safety and smooth conduction of subsequent chemotherapies.
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Affiliation(s)
- Satoshi Kobayashi
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan.
| | - Makoto Ueno
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Ryo Kameda
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Satoshi Moriya
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Kuniyasu Irie
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshihiro Goda
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Shun Tezuka
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Naoki Yanagida
- Department of Gastroenterology, Yamato Municipal Hospital, Yamato, Japan
| | - Shinichi Ohkawa
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Toru Aoyama
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Soichiro Morinaga
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Manabu Morimoto
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
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Kobayashi S, Ueno M, Hara H, Irie K, Goda Y, Moriya S, Tezuka S, Tanaka M, Okusaka T, Ohkawa S, Morimoto M. Unexpected Side Effects of a High S-1 Dose: Subanalysis of a Phase III Trial Comparing Gemcitabine, S-1 and Combinatorial Treatments for Advanced Pancreatic Cancer. Oncology 2016; 91:117-26. [PMID: 27303788 DOI: 10.1159/000446989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/17/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In this subanalysis of a phase III trial using three categorized doses of S-1, the influence of the actual doses on safety and efficacy was evaluated. METHODS We compared the efficacy and safety of the S-1 or gemcitabine plus S-1 combination (GS) arm between the top 10% group and the bottom 10% group according to the initial doses of S-1: ≥77.6 versus ≤65.9 mg/m2/day (n = 28 vs. 28) in the S-1 arm, and ≥65.1 versus ≤53.8 mg/m2/day (n = 27 vs. 28) in the GS arm. RESULTS Overall and progression-free survival were not significantly different between these two groups: hazard ratios of 0.818 and 0.761 with p values of 0.498 and 0.330 in the S-1 arm, and hazard ratios of 0.836 and 0.759 with p values of 0.557 and 0.323 in the GS arm, respectively. Incidences of grade 3-4 hematological toxicities were significantly higher in the top 10% group than in the bottom 10% group: 42.9 versus 14.3 and 85.2 versus 57.1%, with p values of 0.037 and 0.037 in the S-1 and the GS combination arm, respectively. CONCLUSIONS Higher actual doses of S-1 were associated with a higher incidence of hematological toxicity even in the same dose setting.
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Affiliation(s)
- Satoshi Kobayashi
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama City, Japan
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Greer A, Irie K, Hashim A, Leroux BG, Chang AM, Curtis MA, Darveau RP. Site-Specific Neutrophil Migration and CXCL2 Expression in Periodontal Tissue. J Dent Res 2016; 95:946-52. [PMID: 27013641 DOI: 10.1177/0022034516641036] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The oral microbial community is the best-characterized bacterial ecosystem in the human host. It has been shown in the mouse that oral commensal bacteria significantly contribute to clinically healthy periodontal homeostasis by influencing the number of neutrophils that migrate from the vasculature to the junctional epithelium. Furthermore, in clinically healthy tissue, the neutrophil response to oral commensal bacteria is associated with the select expression of the neutrophil chemokine CXCL2 but not CXCL1. This preliminary study examined the contribution of commensal bacteria on neutrophil location across the tooth/gingival interface. Tissue sections from the root associated mesial (anterior) of the second molar to the root associated distal (posterior) of the second molar were examined for neutrophils and the expression of the neutrophil chemokine ligands CXCL1 and CXCL2. It was found that both the number of neutrophils as well as the expression of CXCL2 but not CXCL1 was significantly increased in tissue sections close to the interdental region, consistent with the notion of select tissue expression patterns for neutrophil chemokine expression and subsequent neutrophil location. Furthermore, mice gavaged with either oral Streptococcus or Lactobacillus sp. bacteria induced a location pattern of neutrophils and CXCL2 expression similar to the normal oral flora. These data indicate for the first time select neutrophil location and chemokine expression patterns associated with clinically healthy tissue. The results reveal an increased inflammatory load upon approaching the interproximal region, which is consistent with the observation that the interproximal region often reveals early clinical signs of periodontal disease.
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Affiliation(s)
- A Greer
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - K Irie
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - A Hashim
- Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - B G Leroux
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - A M Chang
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - M A Curtis
- Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - R P Darveau
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
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Kobayashi S, Ueno M, Irie K, Goda Y, Moriya S, Tedzuka S, Ohkawa S, Morimoto M. 2378 Prognostic significance of a new proteomic profile in patients with advanced pancreatic adenocarcinoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kobayashi S, Ueno M, Irie K, Goda Y, Aoyama T, Morinaga S, Ohkawa S, Morimoto M. Potential prognostic significance of a new proteomic profile in patients with advanced pancreatic adenocarcinoma. Pancreatology 2015; 15:525-530. [PMID: 26255025 DOI: 10.1016/j.pan.2015.07.003] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/07/2015] [Accepted: 07/12/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Seven-signal proteomic approach has recently been developed as a new proteomic profile measured by matrix-assisted laser desorption/ionization mass spectrometry. The aim of this study was to evaluate prognostic significance of this proteomic value in patients with pancreatic adenocarcinoma. METHODS Blood samples from the patients with pancreatic adenocarcinoma were prospectively collected before treatments including surgical resection and systemic chemotherapies. The seven-signal proteomic profiles of the samples were measured, and the prognostic significance of the proteomic value was evaluated through comparison with other existing prognostic markers. RESULTS Cut-off value of the proteomic profiles at 52 stratified overall prognosis of the patients (6.5 months vs. 10.9 months with the values ≥52 vs. <52, p = 0.020). In subgroup analyses of inoperable cases with carcinoembryonic antigen level of <5 ng/ml or performance status of 0-1, the proteomic value at 52 stratified their prognosis (p = 0.002 and p = 0.006, respectively). CONCLUSIONS The new seven-signal proteomics showed useful prognostic significance for patients with pancreatic adenocarcinoma. Further studies with a large sample size would be required to evaluate whether this proteomic approach possibly complements the existing parameters, such as carcinoembryonic antigen and performance status.
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Affiliation(s)
- Satoshi Kobayashi
- Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Japan.
| | - Makoto Ueno
- Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Japan
| | - Kuniyasu Irie
- Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Japan
| | - Yoshihiro Goda
- Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Japan
| | - Toru Aoyama
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Japan
| | - Soichiro Morinaga
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Japan
| | - Shinichi Ohkawa
- Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Japan
| | - Manabu Morimoto
- Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Japan
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Takao H, Ishibashi T, Yuki I, Kaku S, Kan I, Nishimura K, Mori R, Watanabe M, Kanbayashi Y, Yeh Y, Irie K, Sakano T, Arita H, Oobatake T, Murayama Y. E-035 new app to support decision making during stroke emergencies: ‘join’. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.110] [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: 11/03/2022]
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Ishibashi T, Murayama Y, Yuki I, Ebara M, Arakawa H, Irie K, Takao H, Kaku S, Kan I, Nishimura K, Suzuki T, Watanabe M, Sakamoto H. E-100 comparison of the clinical outcomes among 3 coiling generations in unruptured aneurysms. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.175] [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: 11/04/2022]
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Irie K, Novince CM, Darveau RP. Impact of the Oral Commensal Flora on Alveolar Bone Homeostasis. J Dent Res 2014; 93:801-6. [PMID: 24935067 DOI: 10.1177/0022034514540173] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 03/05/2014] [Accepted: 05/28/2014] [Indexed: 12/21/2022] Open
Abstract
Homeostasis of healthy periodontal tissues is affected by innate and adaptive immunosurveillance mechanisms in response to the normal oral flora. Recent comparisons of germ-free (GF) and normal specific-pathogen-free (SPF) mice have revealed the impact of host immunosurveillance mechanisms in response to the normal oral flora on alveolar bone height. Prior reports that alveolar bone height is significantly less in normal SPF mice compared with their age- and strain-matched GF counterparts suggest that naturally occurring alveolar bone loss is a normal component of healthy periodontal tissue homeostasis. In this report, histomorphometric analyses confirmed increased alveolar bone loss and revealed increased numbers of TRAP+ osteoclastic cells lining the alveolar bone surface in SPF compared with GF mice. Increased numbers of RANKL+ cells and IL17+ cells in the periodontium of SPF mice demonstrate possible molecular mechanisms mediating the up-regulated osteoclastogenesis and alveolar bone loss in SPF mice compared with GF mice. Increased numbers of T-lymphocytic cells and T-helper cells in the junctional epithelium of SPF mice compared with GF mice suggest that the adaptive immune response contributes to physiologic alveolar bone loss in the healthy periodontium. This GF animal model study notably begins to elucidate the impact of host immunosurveillance mechanisms in response to the normal oral flora, mediating catabolic alveolar bone homeostasis in the healthy periodontium.
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Affiliation(s)
- K Irie
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195, USA Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya, Aichi, 464-8650, Japan Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - C M Novince
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195, USA
| | - R P Darveau
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195, USA
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Muroi C, Fujioka M, Mishima K, Irie K, Fujimura Y, Nakano T, Fandino J, Keller E, Iwasaki K, Fujiwara M. Effect of ADAMTS-13 on cerebrovascular microthrombosis and neuronal injury after experimental subarachnoid hemorrhage. J Thromb Haemost 2014; 12:505-14. [PMID: 24476338 DOI: 10.1111/jth.12511] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 09/08/2013] [Accepted: 12/17/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Microthrombosis and reactive inflammation contribute to neuronal injury after subarachnoid hemorrhage (SAH). ADAMTS-13 cleaves von Willebrand factor multimers, and inhibits thrombus formation and, seemingly, inflammatory reactions. OBJECTIVE To investigate the effect of ADAMTS-13 in experimental SAH. METHODS A total of 100 male C57/BL6 mice were randomly assigned to four groups: sham (n = 15), SAH (n = 27), vehicle (n = 25), and ADAMTS-13 (n = 23; 100 μL per 10 g of body weight of 100 μg of ADAMTS-13 per 1 mL of 0.9% NaCl; 20 min after SAH). Neurologic performance was assessed on days 1 and 2 after SAH. Animals were killed on day 2. The amounts of subarachnoid blood, microthrombi, apoptosis and degenerative neurons were compared. The degree of neuronal inflammation and vasospasm was also compared. In five mice each (SAH and ADAMTS-13 groups), bleeding time was assessed 2 h after SAH. RESULTS Systemic administration of ADAMTS-13 achieved significant amelioration of microthrombosis and improvement in neurologic performance. ADAMTS-13 reduced the amount of apoptotic and degenerative neurons. A tendency for decreased neuronal inflammation was observed. ADAMTS-13 did not show any significant effect on vasospasm. The degree of systemic inflammation was not changed by ADAMTS-13 administration. ADAMTS-13 neither increased the amount of subarachnoid blood nor prolonged the bleeding time. CONCLUSIONS ADAMTS-13 may reduce neuronal injury after SAH by reducing microthrombosis formation and neuronal inflammation, thereby providing a new option for mitigating the severity of neuronal injury after SAH.
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Affiliation(s)
- C Muroi
- Department of Neuropharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan; Institute of Aging and Brain Sciences, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan; Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland; Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
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Kobayashi N, Murayama Y, Yuki I, Ishibashi T, Ebara M, Arakawa H, Irie K, Takao H, Kajiwara I, Nishimura K, Karagiozov K, Urashima M. Natural course of dissecting vertebrobasilar artery aneurysms without stroke. AJNR Am J Neuroradiol 2014; 35:1371-5. [PMID: 24610902 DOI: 10.3174/ajnr.a3873] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The natural history and therapeutic management of dissecting vertebrobasilar aneurysms without ischemic or hemorrhagic stroke (nonstroke dissecting vertebrobasilar aneurysms) are not well-established. We conservatively followed patients with nonstroke dissecting vertebrobasilar aneurysms and evaluated the factors related to clinical and morphologic deterioration. MATERIALS AND METHODS One hundred thirteen patients were enrolled and divided by clinical presentation at diagnosis: asymptomatic (group 1, n = 52), pain only (group 2, n = 56), and mass effect (group 3, n = 5). Patients were conservatively managed without intervention and antithrombotic therapy. Clinical outcomes and morphologic changes were analyzed. RESULTS A total of 113 patients who were diagnosed with nonstroke dissecting vertebrobasilar aneurysm had a mean follow-up of 2.9 years (range, 27 days to 8 years). Throughout that period, 1 patient in group 1 (1.9%) and 1 patient in group 2 (1.8%) showed clinical deterioration due to mass effect, and 1 patient in group 3 (20%) developed ischemic stroke followed by subarachnoid hemorrhage. Most patients (97.3%) were clinically unchanged. Three patients who had clinical deterioration showed aneurysm enlargement (P < .001). Aneurysms remained morphologically unchanged in 91 patients (80.5%). Aneurysm enlargement was seen in 5 patients (4.4%); risk of enlargement was significantly associated with either maximum diameter (hazard ratio = 1.30; 95% CI, 1.11-11.52; P = .001) or aneurysm ≥10 mm (hazard ratio = 18.0; 95% CI, 1.95-167; P = .011). CONCLUSIONS The natural course of these lesions suggests that acute intervention is not always required and close follow-up without antithrombotic therapy is reasonable. Patients with symptoms due to mass effect or aneurysms of >10 mm may require treatment.
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Affiliation(s)
- N Kobayashi
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - Y Murayama
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - I Yuki
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - T Ishibashi
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - M Ebara
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - H Arakawa
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - K Irie
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - H Takao
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - I Kajiwara
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - K Nishimura
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - K Karagiozov
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - M Urashima
- Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan
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Irie K, Ueno M, Kobayashi S, Gouda Y, Ohkawa S, Manabu M. The biomarkers of gemcitabine and erlotinib treatment in advanced pancreatic cancer. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.3_suppl.358] [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
358 Background: A combination of gemcitabine+erlotinib is one of the standard chemotherapies in advanced pancreatic cancer (APC). Since APC patients often take antiulcer drugs to prevent gastritis (e.g., NSAIDs to reduce cancer pain), erlotinib concentration is generally decreased through the mechanism of CYP3A4. Furthermore, unlike lung cancer, the biomarkers for APC are not obvious except rash. Here, we examined biomarkers of gemcitabine+erlotinib treatment in APC patients including the presence of antiulcer drugs. Methods: The subjects were 59 advanced pancreatic cancer patients. They were treated with gemcitabine+erlotinib starting from Nov. 2011 to Apr. 2013. Gemcitabine was administered at 1000 mg/m2, on days 1, 8, and 15 for every 4 weeks, and erlotinib was taken 100 mg daily. The progression-free survival (PFS), UICC stage, sex, age, CRP concentration, performance status (PS), rash, and presence of antiulcer drugs were examined. The PFS curve was plotted according to the method of Kaplan and Meier. The difference in the PFS was calculated using the log-rank test, and a multivariate analysis was conducted using Cox hazard model. Results: UICC stages were as follows; i.e., stage II: 1, stage III: 8, and stage IV: 50. There were 36 males and 23 females, and their ages ranged from 41 to 82 years old (median: 65). The CRP concentrations ranged from 0.02 to 11.5 mg/dl (median: 0.57). 37 patients received antiulcer drugs, and 48 patients had rash. The univariate analysis revealed that the CRP concentration and rash were significant (p=0.009 and p=0.005, respectively). Low CRP (<0.57mg/dl) and presence of rash were related to good PFS. The multivariate analysis also revealed that the CRP concentration (HR, 0.34; 95%CI, 0.16-072; p=0.005) and rash (HR, 0.40; 95%CI, 0.16-0.96; p=0.04) were significant. The presence of antiulcer drugs on PFS was insignificant. Conclusions: The CRP concentration and rash were biomarkers of gemcitabine+erlotinib treatment in APC patients.
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Affiliation(s)
- Kuniyasu Irie
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Makoto Ueno
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Satoshi Kobayashi
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshihiro Gouda
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinichi Ohkawa
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Morimoto Manabu
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
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Kobayashi S, Ueno M, Ohkawa S, Irie K, Goda Y, Morimoto M. Renal Toxicity Associated with Weekly Cisplatin and Gemcitabine Combination Therapy for Treatment of Advanced Biliary Tract Cancer. Oncology 2014; 87:30-9. [DOI: 10.1159/000362604] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 03/24/2014] [Indexed: 11/19/2022]
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Takao H, Ishibashi T, Saguchi T, Arakawa H, Ebara M, Irie K, Murayama Y. Validation and initial application of a semiautomatic aneurysm measurement software: a tool for assessing volumetric packing attenuation. AJNR Am J Neuroradiol 2013; 35:721-6. [PMID: 24231852 DOI: 10.3174/ajnr.a3777] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Precise aneurysm measurements and volume embolization ratios are essential for long-term durability of endovascular coil embolization. We evaluated the accuracy of newly developed semiautomatic cerebral aneurysm measurement software, NeuroVision, and explored the value of volume embolization ratio in the prediction of re-treatment. MATERIALS AND METHODS We compared software-derived volume measurements of 4 silicone aneurysm models with those calculated with an approximation formula and ground truth values (validation study). We used NeuroVision to retrospectively evaluate outcomes of 100 unruptured aneurysms (97 patients) treated with embolization (clinical study). Aneurysm size (height, width, and neck), volume, and volume embolization ratios were calculated for 3 groups (stable, recanalization, and re-treatment) and were compared. RESULTS This validation study illustrated higher accuracy of NeuroVision in computing aneurysm volume compared with an approximation formula: percentage absolute errors were 4.50% ± 3.18% and 23.07% ± 17.60%, with maximal percentage absolute errors of 8.99% and 45.63%, respectively. Of 100 unruptured aneurysms, 20 recanalized and 12 were re-treated. Average volume embolization ratios of stable and re-treated aneurysms were 24.88% ± 5.91% and 20.50% ± 4.06%, respectively (P ≤ .01). The optimal volume embolization ratio cutoff point for re-treatment was < 19.15%, at which the Youden index was 0.50 (sensitivity, 58.33%; specificity, 87.50%; area under the receiver operating characteristic curve, 0.74). CONCLUSIONS The NeuroVision software provided accurate aneurysm volume measurements and may be a useful standardized tool to measure aneurysm size and volume, especially for multicenter clinical studies. Volume embolization ratio may be a valuable predictor of aneurysm occlusion changes.
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Affiliation(s)
- H Takao
- From the Division of Endovascular Neurosurgery and Neurosurgery (H.T., T.I., H.A., M.E., K.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
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Ibayashi S, Irie K, Kitayama J, Nagao T, Kitazono T, Fujishima M. Ischemic brain metabolism in patients with chronic cerebrovascular disease: Increased oxygen extraction fraction and cerebrospinal fluid lactate. J Stroke Cerebrovasc Dis 2013; 9:166-71. [PMID: 24192022 DOI: 10.1053/jscd.2000.7219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/1999] [Accepted: 01/07/2000] [Indexed: 11/11/2022] Open
Abstract
The aim of the present study is to elucidate the existence of chronically ischemic metabolism concomitant with misery perfusion of the brain in patients with chronic cerebrovascular disease. For this purpose, we measured cerebral blood flow (CBF) and oxygen metabolism by positron emission tomography (PET) and also determined cerebrospinal fluid (CSF) lactate as an indicator of the ischemic brain metabolism. Twenty-eight patients with chronic ischemic stroke and transient ischemic attack (TIA), who had angiographically occlusive (n = 11), stenotic (n = 10), and nonstenotic changes (n = 7) of the carotid artery and/or the intracranial major artery, were selected for this study. CBF, oxygen extraction fraction (OEF), cerebral metabolic rate for oxygen (CMRO2), and cerebral blood volume (CBV) were determined by PET, and CSF lactate and pyruvate were determined by enzymatic method in the patients with various grades of stenotic changes of the carotid artery. There were no significant differences in PET parameters and CSF variables among the groups of the occlusive, stenotic, and nonstenotic carotid artery. However, CSF lactate was correlated negatively with mean bilateral hemispheric (m)CBF (R(2) = 0.229, P<.01), positively with mOEF (R(2) = 0.278, P<.005) and more highly with mCMRO2/CBF (absolute extraction of oxygen content to the brain) (R(2) = 0.473, P<.0001) in all patients. There was no correlation between CSF lactate and mCMRO2 or mCBV. None of the cases in the nonstenotic group showed mOEF greater than 0.45, or mCMRO2/CBF greater than 7.9 vol%, while 80% of the cases in the stenotic group and 82% of the cases in the occlusive group showed mOEF and mCMRO2/CBF exceeding the above-mentioned values, respectively. The present findings, that increased mOEF and mCMRO2/CBF were significantly correlated with increased CSF lactate, indicate the brain to be in a metabolically ischemic state or increased anaerobic glycolysis with oxygen metabolism maintained in patients with chronic ischemic stroke.
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Affiliation(s)
- S Ibayashi
- Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Higashi-ku, Fukuoka, Japan
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