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Aoyama N, Nishiyama M, Namba H, Ikeuchi M, Fujimoto S, Terada Y. Tumor-induced osteomalacia. QJM 2023; 116:78-79. [PMID: 36066446 DOI: 10.1093/qjmed/hcac219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Aoyama
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, 1-185, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan
| | - M Nishiyama
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, 1-185, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan and Health Care Center, Kochi University, 1-5-2, Akebono-cho, Kochi City, Kochi 780-8520, Japan
| | - H Namba
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, 1-185, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan
| | - M Ikeuchi
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, 1-185, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan
| | - S Fujimoto
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, 1-185, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan
| | - Y Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, 1-185, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan
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Hamaya R, Yonetsu T, Aoyama N, Watanabe Y, Tashiro A, Niida T, Isobe M, Maejima Y, Iwata T, Sasano T. Contribution of dental health in cardiovascular secondary prevention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2319] [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
Backgrounds
Previous studies have suggested that periodontitis is associated with cardiovascular disease (CVD), partly through exaggerated systematic inflammation through pathogens breaking into the bloodstream and their metabolic products. However, the clinical evidence in the cardiovascular secondary prevention is limited. In addition, there is a paucity of data about the contribution of comprehensively assessed dental health, including dental caries or teeth loss, to CVD incidence. Consequently, current ESC guideline for CVD prevention just briefly refers the contribution of dental health [1].
Objective
To investigate the associations between teeth loss, periodontitis, and dental caries and incident major adverse cardiovascular events (MACE) in patients with existing CVD.
Methods
Patients with known CVD who were admitted to the Department of Cardiology between May 2012 and August 2015 were prospectively, consecutively enrolled. Patients underwent comprehensive dental examinations, including counts of lost teeth, dental caries, and periodontal measurements of clinical attachment loss (CAL), periodontal probing pocket depth (PPD), and bleeding on probing (BOP) by trained periodontists during the hospital stay. We assessed the associations between these dental measures and MACE, defined as a composite of cardiac death, acute myocardial infarction, stroke, and hospital re-admission for worsened congestive heart failure, using multivariate COX proportional hazard models and restricted mean survival time (RMST) analyses. P-values were adjusted by Bonferroni methods.
Results
Among 888 patients included for the present analyses, the mean age was 63.9 (SD: 13.1) years and there were 242 (27.3%) women. During a median follow-up of 4.6 (IQR: 1.4, 6.7) years, incident MACE was confirmed in 142 patients. In multivariate COX proportional hazard models, one more tooth loss was associated with 3 (95% CI: 1, 5) % higher hazard of MACE (adjusted p=0.020). Kaplan-Meier curves showing survival from MACE according to the quartiles of teeth loss were described in Figure 1. Compared with patients with 0 to ≤4 lost teeth, periods free from MACE (95% CI) by 5-years of follow-up were on average shorter by 0.17 (−0.04, 0.37) years, 0.26 (0.04, 0.49) years, and 0.59 (0.34, 0.85) years in patients with 5 to ≤7, 8 to ≤13, and >13 lost teeth, respectively. The RMST differences with varied cutoff years were shown in Figure 2. There were no significant associations between the number of dental caries, CAL, PPD, and BOP and MACE incidence.
Conclusion
In hospitalized patients due to existing cardiovascular diseases, total number of lost teeth was associated with incident MACE. Given that teeth loss is an ultimate consequence of periodontitis or dental caries, the present findings imply that efforts to prevent losing teeth by maintaining dental health would be effective measures for cardiovascular secondary prevention.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Hamaya
- Harvard T. H. Chan School of Public Health , Boston , United States of America
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - N Aoyama
- Kanagawa Dental University , Kanagawa , Japan
| | - Y Watanabe
- Tokyo Medical and Dental University , Tokyo , Japan
| | - A Tashiro
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Niida
- Tokyo Medical and Dental University , Tokyo , Japan
| | - M Isobe
- Sakakibara Memorial Hospital , Tokyo , Japan
| | - Y Maejima
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Iwata
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
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Aoyama N, Suzuki J, Kobayashi N, Hanatani T, Ashigaki N, Yoshida A, Shiheido Y, Sato H, Minabe M, Izumi Y, Isobe M. Associations among tooth loss, systemic inflammation and antibody titers to periodontal pathogens in Japanese patients with cardiovascular disease. J Periodontal Res 2017; 53:117-122. [DOI: 10.1111/jre.12494] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 11/29/2022]
Affiliation(s)
- N. Aoyama
- Division of Periodontology Department of Oral Interdisciplinary Medicine Graduate School of Dentistry Kanagawa Dental University Yokosuka Japan
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - J.‐I. Suzuki
- Department of Advanced Clinical Science and Therapeutics The University of Tokyo Tokyo Japan
- Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan
| | - N. Kobayashi
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - T. Hanatani
- Division of Periodontology Kyushu Dental University Kitakyushu Fukuoka Japan
| | - N. Ashigaki
- Department of Oral Microbiology Tsurumi University Yokohama Japan
| | - A. Yoshida
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - Y. Shiheido
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - H. Sato
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - M. Minabe
- Division of Periodontology Department of Oral Interdisciplinary Medicine Graduate School of Dentistry Kanagawa Dental University Yokosuka Japan
| | - Y. Izumi
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - M. Isobe
- Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan
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Aoyama N. Clinical characteristics of patients on hemodialysis with peripheral arterial disease. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Harada M, Matsunaga A, Aoyama N, Abe Y, Yoneki K, Ishikawa R, Watanabe T, Shigeta K, Miyako Y, Kutsuna T, Matsuzawa R, Yoshida A. Decreased physical activity is associated with an increased incidence or progression of peripheral artery disease in hemodialysis patients. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3331] [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: 10/23/2022]
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Ogawa Y, Kubota K, Aoyama N, Ohgi K, Tadokoro M, Yamanishi T, Kariya S, Nogami M, Nishioka A, Miyamura M. PET-CT-Guided Nonsurgical Chemo-Radiosensitization Treatment (KORTUC II) for Patients With Locally-Advanced Breast Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.542] [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: 10/26/2022]
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Ezoe K, Yabuuchi A, Kuroda T, Aoyama N, Kato O, Kato K. The restorative effects of adipose derived mesenchymal stem cells (A-MSCs) on damaged ovaries. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1873] [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: 10/26/2022]
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Aoyama N, Kurosawa T, Fukuda N, Moriguchi M, Kono K, Nishii M, Nishinari M, Soma K. Therapeutic strategy for extracorporeal life support in patients with acute myocardial infarction complicating cardiopulmonary arrest. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht311.5913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Huang B, Jiang C, Qin L, Cui Y, Liu J, Stimpfel M, Cvjeticanin B, Virant-Klun I, Yabuuchi A, Ezoe K, Kuroda T, Aoyama N, Aono F, Takehara Y, Kato O, Kato K, Oh DS, Lee KS, Joo JK, Jeong JE, Joo BS, Boiani M, Nordhoff V, Schlatt S, Schwarzer C. Stem cells. Hum Reprod 2013. [DOI: 10.1093/humrep/det224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ogawa Y, Kubota K, Aoyama N, Ohgi K, Kataoka Y, Tadokoro M, Tamura T, Kariya S, Nogami M, Nishioka A. PO-0686: Non surgical new bio-radiosensitization treatment (KORTUC-BCT) for patients with stage I or II breast cancer. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32992-3] [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: 11/29/2022]
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Ogawa Y, Kubota K, Aoyama N, Ohgi K, Kataoka Y, Tadokoro M, Tamura T, Kariya S, Nogami M, Nishioka A. Non-surgical Breast-conservation Treatment (KORTUC-BCT) Using a New Image-guided, Enzyme-targeted, and Breast Cancer Stem Cell-targeted Radiosensitization Treatment (KORTUC II) for Patients With Stage I or II Breast Cancer. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.195] [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: 10/27/2022]
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Aoyama N, Ogawa Y, Kubota K, Ohgi K, Suzuki Y, Kataoka Y, Tadokoro M, Kariya S, Nogami M, Nishioka A. EP-1239 NEW RADIOSENSITIZATION TREATMENT (KORTUC-SC) FOR CHEMO-RESISTANT SUPRA-CLAVICULAR LYMPH NODES METASTASIS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71572-4] [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: 11/25/2022]
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13
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Aoyama N, Suzuki JI, Ogawa M, Watanabe R, Kobayashi N, Hanatani T, Yoshida A, Ashigaki N, Izumi Y, Isobe M. Clarithromycin suppresses the periodontal bacteria-accelerated abdominal aortic aneurysms in mice. J Periodontal Res 2011; 47:463-9. [PMID: 22181324 DOI: 10.1111/j.1600-0765.2011.01454.x] [Citation(s) in RCA: 20] [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: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Although clarithromycin (CAM) has many biological functions, including regulation of MMPs, little is known about its effect on abdominal aortic aneurysms. Periodontopathic bacteria have been reported to be associated with several kinds of circulatory diseases. The purpose of this study was therefore to clarify the effect of CAM on periodontopathic bacteria-accelerated abdominal aortic aneurysms. MATERIAL AND METHODS Abdominal aortic aneurysm was produced in mice by the peri-aortic application of 0.25 m CaCl(2). The mice were inoculated once per week with live Porphyromonas gingivalis, which is one of the major periodontopathic bacteria. Test mice (n=8) were given a daily oral dose of CAM, while control mice (n=13) were not. RESULTS Four weeks after the operation, the P. gingivalis-injected and CAM-treated mice showed a significant decrease in the aortic diameter in comparison with the mice only injected with P. gingivalis. Histopathologically, the samples obtained from the P. gingivalis-injected and CAM-treated mice showed less elastic degradation. Moreover, the plasma MMP-2 concentration of the CAM-treated mice decreased significantly. CONCLUSION These findings suggest that CAM administration is useful to suppress periodontal bacteria-accelerated abdominal aortic aneurysms via MMP regulation.
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Affiliation(s)
- N Aoyama
- Section of Periodontology, Department of Hard Tissue Engineering, Graduate School of Medicine and Dentistry, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
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Ogawa Y, Kubota K, Tadokoro M, Yamanishi T, Aoyama N, Suzuki Y, Iwasa H, Kariya S, Nogami M, Nishioka A. KORTUC II - A New Image-guided, Enzyme-targeted, and Breast Cancer Stem Cell Targeted Radiosensitization Treatment for Patients with Stage I and II Breast Cancers. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.409] [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: 10/16/2022]
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Oqawa Y, Kubota K, Tadokoro M, Aoyama N, Suzuki Y, Ohgi K, Iwasa H, Yamanishi T, Kariya S, Nishioka A. 5020 POSTER DISCUSSION KORTUC II – a New Image-Guided, Enzyme-Targeted, and Breast Cancer Stem Cell-targeted Chemo-radiosensitization Treatment for Patients With Locally Advanced Breast Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71462-9] [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: 10/17/2022]
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Ogawa Y, Kubota K, Tadokoro M, Yamanishi T, Hamada N, Kariya S, Nishioka A, Suzuki Y, Aoyama N, Nogami M, Yokota N, Sasaki T, Yaogawa S, Tsuzuki A, Akima R, Suzuki K, Tokuhiro S. 777 poster US-GUIDED & ENZYME-TARGETING RADIOSENSITIZATION TREATMENT (KORTUC II) WITHOUT ANY SURGERY FOR PATIENTS WITH BREAST CANCER OF STAGES I & II. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70899-4] [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: 10/18/2022]
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17
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Aoyama N, Suzuki J, Wang D, Ogawa M, Kobayashi N, Hanatani T, Takeuchi Y, Izumi Y, Isobe M. Porphyromonas gingivalis promotes murine abdominal aortic aneurysms via matrix metalloproteinase-2 induction. J Periodontal Res 2010; 46:176-83. [PMID: 21143481 DOI: 10.1111/j.1600-0765.2010.01326.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVE Abdominal aortic aneurysm (AAA) is a common and lethal disorder, and MMPs are highly expressed in AAA lesions. Large numbers of periodontopathic bacteria have been reported to be present in specimens obtained from the aortic walls of patients with an AAA. The purpose of this study was to analyze the influence of periodontopathic bacteria on AAA dilatation. MATERIAL AND METHODS AAAs were produced in mice by the periaortic application of 0.25 M CaCl(2), and NaCl was used as a control. The mice were inoculated once weekly with live Porphyromonas gingivalis, live Aggregatibacter actinomycetemcomitans or vehicle. RESULTS Four weeks after the periaortic application of either CaCl(2) or NaCl, a significant increase was observed in the aortic diameter of P. gingivalis-challenged mice compared with the vehicle control mice (p < 0.05), whereas there was no statistically significant increase in the aortic diameter of the A. actinomycetemcomitans-challenged mice. Immunohistochemical analysis found significantly higher numbers of CD8-positive and MOMA2-positive cells and significantly higher levels of MMP-2 in the aneurysmal samples of P. gingivalis-challenged mice compared with control mice. Live P. gingivalis promoted a significant proliferation of splenocytes in comparison with P. gingivalis-lipopolysaccharide and live A. actinomycetemcomitans (p < 0.05). CONCLUSION These findings demonstrate that challenge with P. gingivalis, but not with A. actinomycetemcomitans, can accelerate, or even initiate, the progression of experimental AAA through the increased expression of MMPs.
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Affiliation(s)
- N Aoyama
- Section of Periodontology, Department of Hard Tissue Engineering, Graduate School of Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
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Kawachiya S, Takehara Y, Kato K, Osada H, Aoyama N, Kato O. Cytogenetic study in early spontaneous abortion after IVF and ICSI. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.995] [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: 10/19/2022]
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19
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Crippa A, Magli MC, Robles F, Capoti A, Ferraretti AP, Gianaroli L, Gallina A, Bonaparte E, Moretti M, Colpi GM, Nerva F, Contalbi G, Vacalluzzo L, Tabano S, Grati FR, Gazzano G, Sirchia SM, Simoni G, Miozzo M, Handyside A, Gabriel A, Thornhill AR, Clemente E, Reitter C, Affara N, Griffin DK, Macek M, Feldmar P, Kluckova H, Hrehorcak M, Diblik J, Paulasova P, Turnovec M, Vilimova S, Macek M, Fontes L, Haddad L, Borges E, Iaconelli A, Braga DPAF, Vianna-Morgante AM, Komsky A, Kasterstein E, Komarovsky D, Bern O, Maslansky B, Kaplan T, Raziel A, Friedler S, Gidoni Y, Ben-Ami I, Ron-El R, Strassburger D, Maggiulli R, Monahan D, Neri QV, Hu JCY, Rosenwaks Z, Palermo GD, Beyazyurek C, Ekmekci GC, Tac HA, Ajredin N, Verlinsky O, Fiorentino F, Kahraman S, Camp M, Hesters L, Le Lorc'h M, Frydman R, Romana S, Frydman N, Perez Sanz J, Matorras R, Arluzea J, Romin Y, Bilbao J, Gonzalez-Santiago N, Manova-Todorova K, Koff A, Rivera-Pomar JM, de la Hoz-Torres C, Xanthopoulou L, Ghevaria H, Mantzouratou A, Serhal P, Doshi A, Delhanty JD, Ye Y, Qian Y, Jin F, Munne S, Gutierrez C, Wagner C, Hill D, Wiemer K, Fischer J, Kaplan B, Danzer H, Surrey M, Opsahl M, Hladikova B, Sobek A, Tkadlec E, Kyselova K, Sobek A, Nichi M, Figueira RCS, Braga DPAF, Setti AS, Iaconelli A, Borges E, Colturato SS, Setti AS, Figueira RCS, Braga DPAF, Iaconelli A, Borges E, Rubio C, Domingo J, Rodrigo L, Mercader A, De los Santos MJ, Pehlivan T, Bosch E, Fernandez M, Simon C, Remohi J, Pellicer A, Perez-Nevot B, Lendinez AM, Palomares AR, Polo M, Rodriguez A, Reche A, Ruiz-Galdon M, Reyes-Engel A, Knauff EAH, Blauw HM, Kok K, Wijmenga C, Fauser BCJM, Franke L, Paffoni A, Paracchini V, Ferrari S, Restelli L, Coviello DA, Scarduelli C, Seia M, Ragni G, Aoyama N, Takehara Y, Kawachiya S, Kuroda T, Kawasaki N, Yamadera R, Suzuki T, Kato K, Kato O, Xu QH, Zhang ZG, Zhou P, Wei ZL, Huang DK, Xing Q, Cao YX, Fauque P, Ripoche MA, Tost J, Journot L, Jouannet P, Vaiman D, Dandolo L, Jammes H, Hellani A, Elsheikh A, Abuamero KK, Elakoum S, Palomares AR, Lendinez AM, Perez-Nevot B, Martinez F, Perez de la Blanca E, Ruiz-Galdon M, Reyes-Engel A, Sobek A, Hladikova B, Tkadlec E, Koutna O, Cepelak T, Kyselova K, Sobek AJR. Posters * Reproductive Genetics (PGD/PGS). Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.534] [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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Yoshii T, Tamai S, Aoyama N, Minamide J, Takagi S, Motohashi O, Nakayama N, Nishimura K, Takata K, Kameda Y. Clinical outcome of endoscopic mucosal resection (EMR) in clinical stage I (cSt I ) esophageal cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15569] [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
e15569 Background: When a tumor invades to the muscularis mucosa or submucosal layer (T1a-MM or T1b, in Japan), cSt I esophageal cancer(EC) has 10–50%. risk of lymph node metastasis (LNM). Surgery, though very invasive, is the standard radical therapy for the patients(pts.) with such stage EC. Endoscopic mucosal resection (EMR), which conserves the esophagus, is a minimally invasive and attractive therapeutic modality for such pts. However, the clinical outcomes of EMR for these pts. have been not fully elucidated. Methods: We conducted retrospective analysis of the clinical courses of 44 pts. who underwent EMR for newly diagnosed T1a-MM or T1bcN0M0 EC between 1994 and 2007at our hospital, and who could be followed up for at least 1 year. Statistical analysis was performed by the Kaplan-Meier methods and the Cox proportional hazard model. Results: Patients decided on the following treatments immediately after EMR based on informed consent and their general condition; 2 underwent surgery, one underwent prophylactic chemotherapy(CHT) and 41 selected follow-up without any additional therapy. Of the 41, 20 selected this course by choice, 12 because of severe concurrent disease; 2 because of poor performance status and 7 because of other multiple primary cancers (MPCs). Twelve pts. died; 2 were cause specific; (4.5%), 8 from MPCs and, 2 from unknown causes. Median age was 67 years old (range 53–80), and 5 were female. No critical comlications were noted. Median follow-up time was 1542days (375–3786). 5 developed LNM. One with prophylactic CHT, was followed by surgery, and another was followed by CHT, who showed cause specific deaths later. Other 3 pts. followed by chemoradiotherapy, did not show cause specific death. Overall and cause specific survival rates at 5 years were 67.3% and 91.8%, respectively. Multivariate analysis revealed that either severe concurrent disease or MPCs significanctly influenced survival (p=0.041, HR 5.437(95%CI 1.073–25.542)). 8 and 6 pts. developed metachronous EC and local recurrence, respectively. Apart from one, they could be retreated endoscopicaly. Conclusions: EMR is a very useful therapeutic modality for cSt I EC, not only for local control but also as a clinically sufficient treatment; especially in pts. with severe concurrent disease. No significant financial relationships to disclose.
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Affiliation(s)
- T. Yoshii
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - S. Tamai
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - N. Aoyama
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - J. Minamide
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - S. Takagi
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - O. Motohashi
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - N. Nakayama
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - K. Nishimura
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - K. Takata
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
| | - Y. Kameda
- Kanagawa Cancer Center, Yokohama, Japan; Prefectural office of Kanagawa District, Yokohama, Japan
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Kato S, Amano H, Ito Y, Aoyama N, Shibuya M, Majima M, Izumi T. The Role of VEGFR1 Tyrosine Kinase Signaling in Enhancement of Angionegesis in Acute Hindlimb Ischemia in Mice. J Mol Cell Cardiol 2008. [DOI: 10.1016/j.yjmcc.2008.09.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Igaki H, Kato H, Ando N, Shinoda M, Shimizu H, Nakamura T, Ozawa S, Yabusaki H, Aoyama N, Kurita A, Fukuda H. A randomized trial of postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus neoadjuvant chemotherapy for clinical stage II/III squamous cell carcinoma of the thoracic esophagus (JCOG 9907). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4510] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kuwayama H, Asaka M, Sugiyama T, Fukuda Y, Aoyama N, Hirai Y, Fujioka T. Rabeprazole-based eradication therapy for Helicobacter pylori: a large-scale study in Japan. Aliment Pharmacol Ther 2007; 25:1105-13. [PMID: 17439512 DOI: 10.1111/j.1365-2036.2007.03298.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Large-scale studies of rabeprazole-based Helicobacter pylori eradication therapy have not been reported in Japan. AIMS To evaluate H. pylori eradication by rabeprazole-based therapy with reference to antibiotic susceptibility, CYP2C19 genotype, and rabeprazole and clarithromycin dosages. METHODS From 35 centres 479 H. pylori-positive patients with gastric or duodenal ulcer were randomized to four treatment groups: Group 1 (10 mg rabeprazole + 750 mg amoxicillin + 200 mg clarithromycin twice daily for 7 days); Group 2 (10 mg, 750 mg, 400 mg); Group 3 (20 mg, 750 mg, 200 mg) and Group 4 (20 mg, 750 mg, 400 mg). RESULTS Eradication rates were 86% (102 of 119), 89% (97 of 109), 91% (106 of 116) and 90% (104 of 115) for Groups 1-4, respectively. The eradication rate was 95% (360 of 379) for clarithromycin-susceptible strains, and 50% (30 of 60) for clarithromycin-resistant strains. The eradication rates were 88% (332 of 379) and 96% (77 of 80) in extensive metabolizers and poor metabolizers, respectively. CONCLUSIONS Rabeprazole-based therapies achieved 50% eradication of clarithromycin-resistant H. pylori, and even achieved good rates in extensive metabolizers. Accordingly, rabeprazole can be recommended as part of a first-line proton pump inhibitor-based triple therapy for H. pylori.
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Affiliation(s)
- H Kuwayama
- Department of Gastroenterology and Hepatology, University Hospital at Koshigaya, Dokkyo University School of Medicine, Koshigaya, Japan
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Fukuda M, Shirasaka D, Aoyama N, Miki I, Kachi M, Morita Y, Tamura T, Kasuga M. No significant difference in neutrophil activation found among three H2RAs. Dig Liver Dis 2007; 39:130-5. [PMID: 17161670 DOI: 10.1016/j.dld.2006.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2006] [Revised: 08/29/2006] [Accepted: 09/19/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND Even with the most effective treatment, Helicobacter pylori eradication is difficult in some patients. Therefore, patients sometimes require acid-suppressive therapy without H. pylori eradication. It has been reported that ranitidine inhibits neutrophil activation, whereas famotidine does not. However, few studies have been published concerning the activation of neutrophils before and after treatment using clinical doses of histamine-2 receptor antagonists in patients with H. pylori infection. AIM To examine the effects of neutrophil activation after treatment with three different histamine-2 receptor antagonists. PATIENTS This prospective, open-label, randomised, parallel-group study was conducted. Thirty patients with H. pylori infection were enrolled. These subjects were randomly assigned to receive one of the following treatments: (a) 150 mg ranitidine, (b) 20mg famotidine, or (c) 10 mg lafutidine b.d., for 4 weeks. Before and after histamine-2 receptor antagonist treatment, histological findings, myeloperoxidase activity, and interleukin-8 in the gastric mucosa were evaluated. RESULTS On the basis of the histological findings between before and after histamine-2 receptor antagonist treatment, no significant differences were found in any groups. Similarly, there were no significant differences in myeloperoxidase activity or interleukin-8 levels. CONCLUSION In patients with H. pylori, when used at clinical doses, any histamine-2 receptor antagonists can be used without concerning about inhibition of neutrophil activation.
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Affiliation(s)
- M Fukuda
- Division of Digestive Disease, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki, Chuo, Kobe, Hyogo 650-0017, Japan
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Hasuo T, Semba S, Li D, Omori Y, Shirasaka D, Aoyama N, Yokozaki H. Assessment of microsatellite instability status for the prediction of metachronous recurrence after initial endoscopic submucosal dissection for early gastric cancer. Br J Cancer 2006; 96:89-94. [PMID: 17179982 PMCID: PMC2360225 DOI: 10.1038/sj.bjc.6603532] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The technique of endoscopic submucosal dissection (ESD) has been developed for en bloc resection of early gastric cancer (EGC); however, little is known about the risk of metachronous cancer in the remnant stomach after initial ESD. In this study, we investigated the correlation between microsatellite instability (MSI) status and the incidence of metachronous recurrence of gastric cancer. According to the genetic/molecular background determined with MSI status and expression levels of hMLH1 and p53 tumour suppressor, 110 EGCs removed with ESD were subclassified into three groups: the mutator/MSI-type (8%), suppressor/p53-type (45%) and unclassified type (47%). Interestingly, patients with the mutator/MSI-type tumour had a high incidence (67%) of metachronous recurrence of gastric cancer within a 3-year observation after initial ESD, which was significantly higher than those with the suppressor/p53-type and unclassified type tumours (P<0.01). Although we investigated mucin phenotypes, there was no correlation between mucin phenotype and the recurrence of EGC. These findings suggest that subclassification of molecular pathological pathways in EGCs is required for the assessment of patients with a high risk of recurrent gastric cancer. The information delivered from our investigation is expected to be of value for decisions about therapy and surveillance after ESD.
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Affiliation(s)
- T Hasuo
- Division of Surgical Pathology, Department of Biomedical Informatics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Semba
- Division of Surgical Pathology, Department of Biomedical Informatics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - D Li
- Division of Surgical Pathology, Department of Biomedical Informatics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Omori
- Division of Surgical Pathology, Department of Biomedical Informatics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - D Shirasaka
- Department of Endoscopy and Division of Diabetes, Digestive and Kidney Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Cellular and Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Aoyama
- Department of Endoscopy and Division of Diabetes, Digestive and Kidney Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Yokozaki
- Division of Surgical Pathology, Department of Biomedical Informatics, Kobe University Graduate School of Medicine, Kobe, Japan
- E-mail:
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Aoyama N, Takahashi N, Saito S, Maeno N, Ishihara R, Ji X, Miura H, Ikeda M, Suzuki T, Kitajima T, Yamanouchi Y, Kinoshita Y, Yoshida K, Iwata N, Inada T, Ozaki N. Association study between kynurenine 3-monooxygenase gene and schizophrenia in the Japanese population. Genes Brain Behav 2006; 5:364-8. [PMID: 16716206 DOI: 10.1111/j.1601-183x.2006.00231.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Several lines of evidence suggest that metabolic changes in the kynurenic acid (KYNA) pathway are related to the etiology of schizophrenia. The inhibitor of kynurenine 3-monooxygenase (KMO) is known to increase KYNA levels, and the KMO gene is located in the chromosome region associated with schizophrenia, 1q42-q44. Single-marker and haplotype analyses for 6-tag single nucleotide polymorphisms (SNPs) of KMO were performed (cases = 465, controls = 440). Significant association of rs2275163 with schizophrenia was observed by single-marker comparisons (P = 0.032) and haplotype analysis including this SNP (P = 0.0049). Significant association of rs2275163 and haplotype was not replicated using a second, independent set of samples (cases = 480, controls = 448) (P = 0.706 and P = 0.689, respectively). These results suggest that the KMO is unlikely to be related to the development of schizophrenia in Japanese.
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Affiliation(s)
- N Aoyama
- Department of Psychiatry, Nagoua University Graduate School of Medicine, Nagoya, Japan
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Matsumoto Y, Miki I, Aoyama N, Shirasaka D, Watanabe Y, Morita Y, Toyoda M, Mitani T, Miyachi H, Tamura T, Kasuga M. Levofloxacin- versus metronidazole-based rescue therapy for H. pylori infection in Japan. Dig Liver Dis 2005; 37:821-5. [PMID: 16040284 DOI: 10.1016/j.dld.2005.06.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Revised: 06/14/2005] [Accepted: 06/14/2005] [Indexed: 12/11/2022]
Abstract
BACKGROUND The ideal second-line treatment regimens for Helicobacter pylori infection may differ between the areas, countries and races. AIM The aim was to confirm which was the better regimen for second-line therapy after treatment failure with a standard triple therapy in Japan, a high dosage of levofloxacin- or metronidazole-based therapy. PATIENTS Sixty outpatients with persistent H. pylori infection after a standard triple therapy were enrolled in this prospective, open-label and randomised trial. METHODS The subjects were randomly administered levofloxacin (300 mg b.d.)- or metronidazole (500 mg b.d.)-based therapy with lansoprazole (30 mg b.d.) and amoxicillin (1000 mg b.d.) for 7 days, and the cure rates and side effects were analysed. Antimicrobial susceptibility was also examined before second-line therapy using the E-test. RESULTS Good compliance was obtained without severe side effects in both the groups except for two patients. The cure rates, expressed as intention-to-treat and per-protocol analyses, respectively, were 70.0 and 72.4% in the levofloxacin group, and 96.7 and 100% in the metronidazole group. Each regimen often overcame even clarithromycin-resistant strains. CONCLUSION Metronidazole-based triple therapy is recommended as second-line therapy in Japan, and levofloxacin-based therapy can be an alternative treatment option.
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Affiliation(s)
- Y Matsumoto
- Division of Diabetes, Digestive and Kidney Diseases, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Abstract
BACKGROUNDS AND AIMS Echinacea angustifolia is a widespread species distributed throughout the Great Plains region of North America. Genetic differentiation among populations was investigated along a 1500 km north-south climatic gradient in North America, a region with no major geographical barriers. The objective of the study was to determine if genetic differentiation of populations could be explained by an isolation-by-distance model or by associations with climatic parameters known to affect plant growth and survival. METHODS Historical climatic data were used to define the nature of the climatic gradient and AFLP markers were used to establish patterns of population genetic differentiation among ten Echinacea populations collected from North Dakota to Oklahoma. A total of 1290 fragments were scored using six EcoRI/MseI and three PstI/MseI primer combinations. Assessment of the correlation between climatic, genetic and geographic distances was assessed by Mantel and partial Mantel tests. KEY RESULTS PstI/MseI combinations produced significantly fewer fragments, but a larger percentage was unique compared with EcoRI/MseI markers. Using estimates of F(ST), populations in Oklahoma and southern Kansas were identified as the most divergent from the other populations. Both the neighbour-joining tree and principal co-ordinate analysis clustered the populations in a north-south spatial orientation. About 60% of the genetic variation was found within populations, 20% among populations and the remaining 20% was partitioned among groups that were defined by the topology of the neighbour-joining tree. Significant support was found for the isolation-by-distance model independent of the effects of annual mean precipitation, but not from annual mean temperature and freeze-free days. CONCLUSIONS Echinacea angustifolia populations exhibit genetic divergence along a north-south climatic gradient. The data support an isolation-by-distance restriction in gene flow that is independent of annual mean precipitation.
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Affiliation(s)
- D W Still
- Department of Horticulture, Plant and Soil Science, California State Polytechnic University, Pomona, 3801 W Temple Avenue, Pomona, CA 91768, USA.
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Aoyama N, Tsunoda M, Imai K. Improved assay for catechol-O-methyltransferase activity utilizing norepinephrine as an enzymatic substrate and reversed-phase high-performance liquid chromatography with fluorescence detection. J Chromatogr A 2005; 1074:47-51. [PMID: 15941038 DOI: 10.1016/j.chroma.2005.03.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We have previously established a rapid catechol-O-methyltransferase (COMT) assay using norepinephrine (NE) as a natural substrate and flow-injection analysis. In this study, the method is improved for screening of COMT inhibitors or activators using reversed-phase high-performance liquid chromatographic separation with fluorescence detection. The excess substrate, NE, was removed by the addition of borate in the eluent for HPLC to make an ionic complex with NE, which was eluted faster than the enzymatic product, normetanephrine. The method had good precision and accuracy, and was able to assay one sample in 5 min, showing the usability for screening of COMT inhibitors or activators.
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Affiliation(s)
- Nozomi Aoyama
- Laboratory of Bio-Analytical Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Ohkusa T, Maekawa T, Arakawa T, Nakajima M, Fujimoto K, Hoshino E, Mitachi Y, Hamada S, Mine T, Kawahara Y, Nagai T, Aoyama N, Yoshida N, Tadokoro K, Chida N, Konda Y, Seno H, Shimatani T, Inoue M, Sato N. Effect of CYP2C19 polymorphism on the safety and efficacy of omeprazole in Japanese patients with recurrent reflux oesophagitis. Aliment Pharmacol Ther 2005; 21:1331-9. [PMID: 15932363 DOI: 10.1111/j.1365-2036.2005.02486.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The polymorphic enzyme cytochrome P450 2C19 affects omeprazole metabolism. This influence on metabolism might affect serum gastrin levels, and safety, during long-term treatment of reflux oesophagitis. AIM To examine the relationship between cytochrome P450 2C19 genotype and the safety profile of long-term omeprazole treatment. METHODS A total of 119 Japanese patients with recurrent reflux oesophagitis underwent cytochrome P450 2C19 genotyping prior to receiving daily omeprazole 10 mg or 20 mg for 6-12 months, during which adverse event frequency, serum gastrin levels and endoscopic findings were monitored. RESULTS The incidences of adverse events, serious adverse events and adverse events leading to withdrawal did not differ between homozygous extensive metabolizer (n = 46), heterozygous extensive metabolizer (n = 53) or poor metabolizer (n = 20) groups. In all genotype groups, serum gastrin increased during the first 3 months of dosing but stabilized thereafter. No significant differences were seen either in the rate of reflux oesophagitis healing or symptom improvement among genotype groups. CONCLUSIONS Long-term treatment with omeprazole was well-tolerated in Japanese patients, irrespective of their cytochrome P450 2C19 metabolic genotype, indicating that dose adjustment depending on metabolic genotype is not required during treatment with omeprazole.
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Affiliation(s)
- T Ohkusa
- Juntendo University School of Medicine, Hongo, Tokyo, Japan
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Tanabe M, Fukushima T, Usui N, Aoyama N, Tsunoda M, Imai K. Intravenous administration of 2,7,8-trimethyl-2-(beta-carboxyethyl)-6-hydroxy chroman (gamma-CEHC) to rats and determination of its plasma concentration and urinary sodium excretion. Biomed Chromatogr 2005; 18:727-34. [PMID: 15386582 DOI: 10.1002/bmc.385] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A natriuretic hormone, 2,7,8-trimethyl-2-(beta-carboxyethyl)-6-hydroxy chroman (gamma-CEHC) was administered intravenously to male Sprague-Dawley rats and the plasma concentration of gamma-CEHC along with urinary sodium (Na+) excretion was investigated. The plasma gamma-CEHC concentrations were fluorimetrically determined by a column-switching HPLC method consisting of both phenyl and octadecyl silica columns, following a pre-column fluorescence derivatization with a fluorescence reagent, 4-N,N-dimethylaminosulfonyl-7-piperazino-2,1,3-benzoxadiazole (DBD-PZ). In rats fed with a high-NaCl (8.0%) diet, plasma gamma-CEHC concentrations rapidly decreased by 20% in 15-45 min after the administration of gamma-CEHC, while Na+ excretion gradually increased with time. Considering these results, the Na+ excretion effect appeared not to be associated with plasma gamma-CEHC concentration. In addition, attempts were made to examine a main urinary metabolite of gamma-CEHC, a large amount of 6-O-sulfated gamma-CEHC found to be present in the urine using an HPLC-tandem mass spectrometry. Thus, it is plausible that gamma-CEHC was easily metabolized to 6-O-sulfated metabolite and excreted into urine in rats.
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Affiliation(s)
- Maiko Tanabe
- Laboratory of Bio-Analytical Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
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Affiliation(s)
- Y Sano
- Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-city, Chiba 277-8577, Japan.
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Ponchon T, Makuuchi H, Morita Y, Fukuda M, Mitani T, Shirasaka D, Aoyama N, Amano Y, Moriyama I, Oose T, Kinoshita Y. Images of early cancer: esophageal squamous-cell carcinoma. Endoscopy 2004; 36:811-20. [PMID: 15326577 DOI: 10.1055/s-2004-825846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- T Ponchon
- Dept. of Digestive Diseases, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyons Cédex 03, France.
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Affiliation(s)
- S Maekawa
- Dept. of General Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Wambura C, Aoyama N, Shirasaka D, Kuroda K, Watanabe Y, Miki I, Tamura T, Kasuga M. Cell kinetic balance in gastric mucosa with intestinal metaplasia after Helicobacter pylori eradication: 2-year follow-up study. Dig Liver Dis 2004; 36:178-86. [PMID: 15046186 DOI: 10.1016/j.dld.2003.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Proliferation and apoptosis events are altered in Helicobacter pylori infection. However, whether H. pylori eradication has an effect on the disturbed kinetics in metaplastic mucosa has not been well elucidated. AIM To investigate the effect of eradication on the gastric cell kinetics. SUBJECTS AND METHODS Initially, biopsies were obtained from 74 H. pylori-infected subjects and repeated 12 and 24 months after eradication. Biopsies were immunohistochemically stained for apoptosis by single-stranded DNA, for proliferation by Ki-67 antibodies and for intestinal metaplasia MUC2, MUC5AC, MUC6 and CD10. RESULTS While antral apoptosis in intestinal metaplasia was significantly lower than in non-intestinal metaplasia, proliferation was significantly higher (greater and lesser curvatures, P < 0.05, respectively). This resulted in a significantly lower apoptosis/proliferation ratio in intestinal metaplasia than in non-intestinal metaplasia (antrum greater and lesser curvatures and corpus greater curvature, P < 0.05). After successful eradication, apoptosis and proliferation decreased in both intestinal metaplasia and non-intestinal metaplasia. The pattern of reduction of apoptosis and proliferation differed in these two groups. However, in the corpus, the reduction resulted in a significant increase in the apoptosis/proliferation ratio in both. CONCLUSION Proliferation and apoptosis are unevenly and disproportionately altered in H. pylori infection leading to an imbalance in cell kinetics. Eradication of the organism improves the balance and may possibly play a role in the prevention of malignancy transformation in the metaplastic mucosa.
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Affiliation(s)
- C Wambura
- Division of Diabetes, Digestive and Kidney Diseases, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
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Watanabe Y, Aoyama N, Shirasaka D, Maekawa S, Kuroda K, Miki I, Kachi M, Fukuda M, Wambura C, Tamura T, Kasuga M. Levofloxacin based triple therapy as a second-line treatment after failure of helicobacter pylori eradication with standard triple therapy. Dig Liver Dis 2003; 35:711-5. [PMID: 14620620 DOI: 10.1016/s1590-8658(03)00432-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Successful eradication of Helicobacter pylori infection after failure of standard triple therapy is difficult. The efficacy and safety of levofloxacin based triple therapy as a first-line therapy has-been studied. AIMS The aim was to evaluate the efficacy and tolerability of levofloxacin based therapy after a failed standard triple therapy. PATIENTS We conducted a prospective, uncontrolled study of a consecutive series of 33 patients who failed eradication with 1 week of lansoprazole-amoxicillin-clarithromycin triple therapy. METHODS The subjects were retreated with 1 week of LA-LVFX triple therapy (lansoprazole, 30 mg twice daily; amoxicillin, 1000 mg twice daily: levofloxacin, 200 mg twice daily). Cure of infection was defined as negative results from culture, histology and a urea breath test 4 to 8 weeks after the second-line therapy. RESULTS The eradication rate was 69.7% (23/33) by both intention-to-treat and per-protocol analyses (95% confidence interval=61-79%). Seven (21.2%) patients experienced mild side-effects, such as soft stools and taste disturbance. No patient stopped the medication on account of adverse effects. CONCLUSIONS Levofloxacin based triple therapy is an effective second-line treatment after a failed standard triple therapy.
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Affiliation(s)
- Y Watanabe
- Division of Diabetes, Digestive and Kidney Diseases, Department of Clinical Molecular Medicine, Kobe University School of Medicine, Kobe, Japan
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Kaihara T, Kusaka T, Nishi M, Kawamata H, Imura J, Kitajima K, Itoh-Minami R, Aoyama N, Kasuga M, Oda Y, Hattori M, Fujimori T. Dedifferentiation and decreased expression of adhesion molecules, E-cadherin and ZO-1, in colorectal cancer are closely related to liver metastasis. J Exp Clin Cancer Res 2003; 22:117-23. [PMID: 12725331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Carcinoma cells with high metastatic potential often show a dedifferentiated phenotype at the primary site. In this study, a total of 48 cases (24 primary tumors of colorectal cancer (Pr-CRC) with liver metastasis, 24 without) were examined for E-cadherin and ZO-1 expression by immunohistochemical staining, and for their dedifferentiated phenotype. The expression levels of E-cadherin and ZO-1 were markedly decreased in the cancer cells of tumors with liver metastasis. Moreover, dedifferentiation of cancer cells, which was evaluated by the modified Gleason score, was also related to liver metastasis. However, none of the conventional clinicopathologic parameters of invasion, except lymph node metastasis, showed any relationship with liver metastasis. These results indicate that dedifferentiation and a decreased expression of E-cadherin and ZO-1 are closely related to liver metastasis.
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Affiliation(s)
- T Kaihara
- Dept. of Surgical and Molecular Pathology, Dokkyo University School of Medicine, Tochigi, Japan
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Kaido T, Nakase H, Goda K, Shin Y, Aoyama N, Sakaki T. Value of 3D CTA in association with accessory anterior cerebral artery with ruptured anterior communicating artery aneurysm. Acta Neurochir (Wien) 2003; 145:157-8. [PMID: 12601465 DOI: 10.1007/s00701-002-1038-y] [Citation(s) in RCA: 2] [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: 10/26/2022]
Affiliation(s)
- T Kaido
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
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Kawamata T, Katayama Y, Mori T, Aoyama N, Tsubokawa T. Mechanisms of the mass effect of cerebral contusion: ICP monitoring and diffusion MRI study. Acta Neurochir Suppl 2003; 81:281-3. [PMID: 12168326 DOI: 10.1007/978-3-7091-6738-0_72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVE Cerebral contusion is sometimes associated with a non-hemorrhagic mass effect which progresses rapidly within 12-48 hours post-trauma. In order to determine the mechanisms underlying such a mass effect, we analyzed data obtained from ICP monitoring and diffusion MRI in a total of 38 patients with cerebral contusion. METHODS Diffusion imaging and ADC mapping were performed employing 1.5 T echo planar MRI. ADC values were expressed as a ratio relative to the values of intact brain areas. RESULTS In 6 patients, ICP became uncontrollable medically and surgical resection of the contused brain tissue was eventually performed. Within 24 hours post-trauma, diffusion images revealed a low intensity core and a high intensity rim in the contusion. The ADC ratio increased in the central area (1.13 +/- 0.21) and decreased in the peripheral area (0.67 +/- 0.14). A crescent-shaped zone of very high ADC ratio (1.45 +/- 0.14) was observed at the border between these two areas during the period of 24-48 hours. CONCLUSIONS It appears that the capacitance of edema fluid accumulation is elevated by cellular disintegration in the central area, whereas the resistance to edema fluid propagation is elevated by cellular swelling in the peripheral area. We suggest that such events facilitate extracellular edema fluid accumulation within contused brain tissue and contribute, together with cellular swelling itself, to the non-hemorrhagic mass effect of cerebral contusion.
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Affiliation(s)
- T Kawamata
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
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Kohno K, Takagaki Y, Aoyama N, Yokoyama H, Takehana H, Izumi T. A peptide fragment of beta cardiac myosin heavy chain (beta-CMHC) can provoke autoimmune myocarditis as well as the corresponding alpha cardiac myosin heavy chain (alpha-CMHC) fragment. Autoimmunity 2002; 34:177-85. [PMID: 11908775 DOI: 10.3109/08916930109007382] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The validity of the general belief that alpha cardiac myosin heavy chain (alpha-CMHC) is primarily responsible for causing experimental autoimmune myocarditis because of the more profound tolerance induction to beta-CMHC due to its expression during the embryonic stage has been examined. In order to completely avoid cross-contamination among components of the two myosin heavy chains, recombinant myosin fragments were synthesized in Escherichia coli using cDNA fragments of rat alpha- and beta-CMHC cloned by reverse transcription polymerase chain reaction (RT-PCR). Two fragments corresponding to amino acid residues 1107-1164 derived from alpha- and beta-heavy chains were equally capable of provoking severe myocarditis in Lewis rats when immunized in complete Freund's adjuvant. No significant differences in the severity, as judged from histological scoring, were observed between the diseases induced by the two different peptide fragments, indicating conclusively that beta-CMHC is as pathogenic as alpha-CMHC.
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Affiliation(s)
- K Kohno
- Department of Internal Medicine and Cardiology, Kitasato University School of Medicine, Kanagawa, Japan.
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Kuroda K, Aoyama N, Tamura T, Sakashita M, Maekawa S, Inoue T, Wambura C, Shirasaka D, Minami R, Maeda S, Kuroda Y, Kasuga M. Variation in MT expression in early-stage depressed-type and polypoid-type colorectal tumours. Eur J Cancer 2002; 38:1879-87. [PMID: 12204670 DOI: 10.1016/s0959-8049(02)00233-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Metallothionein (MT) expression is observed in various carcinomas, but its role is not fully understood. To clarify the clinicopathological significance of MT, 87 colorectal adenomas and 128 early-stage carcinomas were immunohistochemically analysed for MT expression. The degree of MT immunostaining of a specimen was graded according to the proportion of MT-positive cells; negative (<5%) and positive (focally 5-50%, diffusely >50%). MT expression significantly decreased with tumour development. For carcinomas, MT-positivity was significantly associated with depth of invasion (T1 60% versus T2 33%; P<0.01), vascular involvement (positive 35% versus negative 61%; P<0.01) and morphology (polypoid 62% versus depressed 26%; P<0.01). Regarding MT-positive distribution, the diffuse-positive rate in MT-positive polypoid lesions was 28%, while MT-positive depressed lesions were all diffusely stained (P<0.01). In conclusion, our results suggested that decreasing MT expression is an early event in colorectal carcinogenesis and may reflect local invasion. Furthermore, MT-positive distribution may reflect genetic differences between the polypoid and depressed-type.
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Affiliation(s)
- K Kuroda
- Department of Clinical Molecular Medicine, Division of Diabetes, Digestive and Kidney Disease, Kobe University Graduate School of Medicine, Kobe, Japan
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Abstract
A rapid assay employing flow injection analysis (FIA) to determine the activity of purified catechol-O-methyltransferase (COMT) from porcine liver is described. The method was based on the determination of normetanephrine, the 3-O-methyl metabolite of the substrate norepinephrine. Excess norepinephrine was removed from the incubation mixture by alumina extraction twice to allow normetanephrine to be subjected to flow injection analysis, coulometrical oxidation, fluorogenic reaction with ethylenediamine and fluorescence detection. K(m) and V(max) values for COMT obtained with the system were 503 microM and 4.51 nmol/min/mg protein, respectively. The method is suitable for screening of COMT inhibitors or activators, as a large number of samples, up to 200, can be processed in one working day.
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Affiliation(s)
- Nozomi Aoyama
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Suehiro S, Shibata T, Hattori K, Hirai H, Fujii H, Aoyama N, Ikuta T, Sakaguchi M, Kinoshita H. Early and long-term results of coronary artery bypass grafting in dialysis patients. Jpn J Thorac Cardiovasc Surg 2001; 49:660-5. [PMID: 11757338 DOI: 10.1007/bf02912475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We evaluated the surgical outcome of coronary artery bypass grafting in dialysis patients. METHODS We retrospectively analyzed 25 consecutive dialysis patients requiring isolated coronary artery bypass grafting. Their mean age was 61.6 years and average dialysis duration 80.4 months. RESULTS Eight patients (32%) had emergency or urgent surgery. The mean number of bypassed vessels was 3.3 +/- 1.2. Internal thoracic artery grafts were used in 19 patients and gastroepiploic artery grafts in 5. Two (8%) died during hospitalization and complications occurred in 11 (44%). No cerebral complications were observed. All survivors showed ameliorated symptoms and improved overall function. Of 14 late deaths, 5 were cardiac-related, with 2 involving obvious myocardial ischemic events. Actuarial survival, including hospital deaths, at 1 year was 70.9%, at 3 years was 43.5%, and at 5 years was 34.8%. Cardiac-death-free survival was 70.2% at 3 years and 70.2% at 5 years. CONCLUSION Coronary artery bypass grafting in dialysis patients is associated with a higher incidence of complications but has acceptable surgical mortality and effectively relieves angina symptoms.
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Affiliation(s)
- S Suehiro
- Department of Cardiovascular Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
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Sakaeda T, Nakamura T, Horinouchi M, Kakumoto M, Ohmoto N, Sakai T, Morita Y, Tamura T, Aoyama N, Hirai M, Kasuga M, Okumura K. MDR1 genotype-related pharmacokinetics of digoxin after single oral administration in healthy Japanese subjects. Pharm Res 2001; 18:1400-4. [PMID: 11697464 DOI: 10.1023/a:1012244520615] [Citation(s) in RCA: 254] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE To evaluate the MDR1 genotype frequency in the Japanese population and to study the relationship between the MDR1 genotype and the pharmacokinetics of digoxin after single oral administration in healthy subjects. METHODS The MDR1 genotype at exon 26 was determined in 114 healthy volunteers by polymerase chain reaction-restriction fragment length polymorphism. The serum concentration-time profile of digoxin was examined after single oral administration at a dose of 0.25 mg. RESULTS It was found that 35.1 % (40/114) of subjects were homozygous for the wild-type allele (C/C). 52.6% (60/114) were compound heterozygotes with a mutant T-allele (C3435T) (C/T), and 12.3% (14/114) were homozygous for the mutant allele (T/T). There was no effect of gender or age on the distribution. The serum concentration of digoxin after a single oral administration increased rapidly, attaining a steady state in all subjects; however, it was lower in the subjects harboring the T-allele. AUC0-4 h values (+/-SD) were 4.11 +/- 0.57, 3.20 +/- 0.49. and 3.27 +/- 0.58 ng h/ml, respectively, with a significant difference between C/C and C/T or T/T. CONCLUSIONS The serum concentration of digoxin after single oral administration was lower in the subjects harboring a mutant allele (C3435T) at exon 26 of the MDR1 gene.
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Affiliation(s)
- T Sakaeda
- Department of Hospital Pharmacy, School of Medicine, Kobe University, Japan
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Kita T, Sakaeda T, Adachi S, Sakai T, Aoyama N, Hatanaka H, Kasuga M, Okumura K. N-Acetyltransferase 2 genotype correlates with sulfasalazine pharmacokinetics after multiple dosing in healthy Japanese subjects. Biol Pharm Bull 2001; 24:1176-80. [PMID: 11642327 DOI: 10.1248/bpb.24.1176] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sulfapyridine (SP) is metabolized by polymorphic N-acetyltransferase 2 (NAT2) [EC 2.3.1.5]. In this study, the correlation between the NAT2 genotype and the pharmacokinetics of SP after multiple oral dosing of sulfasalazine (SASP) was examined to elucidate the effect of multiple dosing on the predictability of the phenotype by NAT2 genotyping. Seven healthy subjects were classified into two groups; the homozygotes for the wild-type allele, NAT2*4/*4 (Group I) and the compound heterozygotes for the mutant allele (NAT2*4/*6A or NAT2*4/*7B) (Group II). All received once-daily 1 g of SASP (Salazopyrin) orally for 8 d. Plasma concentrations and urinary recoveries of SASP, SP and N-acetylsulfapyridine (AcSP) were monitored for 8 d. At 24 h on Day 1, the plasma concentration of SASP was lower and those of SP and AcSP were higher in Group II compared with Group I, but there was no significant difference. The plasma concentration ratio of AcSP to SP (AcSP/SP) tended to be lower in Group II. Urinary recoveries of SP and AcSP were increased in Group II, and their ratio was slightly reduced in Group II. Multiple dosing for 8 d resulted in an increase in the plasma concentrations of SASP, SP and AcSP. The difference between Group I and II was marked compared with single dosing, resulting in a significant difference in the plasma concentration of SP and the ratio of AcSP/SP. The simple input-output pharmacokinetic model applied for the analysis of plasma concentrations and urinary recoveries of SP and AcSP suggested the acetylation of SP into AcSP was 2.7-fold reduced in Group II (p=0.064).
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Affiliation(s)
- T Kita
- Department of Hospital Pharmacy, School of Medicine, Kobe University, Japan
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Hayashi K, Ando N, Watanabe H, Ide H, Nagai K, Aoyama N, Takiyama W, Ishida K, Isono K, Makuuchi H, Imamura M, Shinoda M, Ikeuchi S, Kabuto T, Yamana H, Fukuda H. Phase II evaluation of protracted infusion of cisplatin and 5-fluorouracil in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group (JEOG) Trial (JCOG9407). Jpn J Clin Oncol 2001; 31:419-23. [PMID: 11689594 DOI: 10.1093/jjco/hye090] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Surgery for advanced esophageal carcinoma has its limits as regards aggressiveness and therapeutic effect, therefore effective multimodality treatment is required to obtain better survival. The objective of this study was to evaluate whether daily continuous infusion of CDDP could achieve a higher clinical response rate with less toxicity than its drip infusion in the previous phase II study that we had conducted. METHODS Patients with primary extensive or relapsed esophageal carcinoma after esophagectomy, which had distant organ metastasis and histologically proven SCC, were eligible for this study. A dose of 20 mg/m(2) of cisplatin and 800 mg/m(2) of 5-fluorouracil was given by continuous infusion for 24 h on days 1-5. This treatment was repeated every 4 weeks for up to four cycles. A total of 36 men and six women with a median age of 64 (range 39-75) years were registered and 36 patients were eligible. RESULTS The overall response rate of the registered patients was 33.3% (12/36) and the median response duration was 175 days. Median survival time was 201.5 days and the 1-year survival rate was 27.8%. Change from bolus to continuous infusion of cisplatin affected neither the type nor the degree of toxicity. CONCLUSION Daily continuous infusion of cisplatin was not associated with higher response or lower toxicity than those seen with the high-dose bolus or multibolus treatment regimens. We conclude that this regimen in this setting is not worthy of further phase III trials. JEOG is now evaluating other drug combination regimens.
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Affiliation(s)
- K Hayashi
- Department of Surgery, Institute of Gastroenterology,Tokyo Women's Medical University, Tokyo, Japan.
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Kawamata T, Katayama Y, Aoyama N, Mori T. Heterogeneous mechanisms of early edema formation in cerebral contusion: diffusion MRI and ADC mapping study. Acta Neurochir Suppl 2001; 76:9-12. [PMID: 11450099 DOI: 10.1007/978-3-7091-6346-7_2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Severe cerebral contusion is sometimes associated with early edema formation within 24-48 hours post-trauma, and this frequently results in progressive ICP elevation and clinical deterioration. To investigate the underlying mechanisms of such severe contusion edema, diffusion imaging and ADC mapping were performed in 20 patients with cerebral contusion, employing 1.5 T echo planar MRI. Within 24 hours post-trauma, the diffusion images demonstrated a low intensity core in the central area and a high intensity rim in the peripheral area of contusion. The ADC value increased in the central area (ADC ratio (contusion/normal brain) = 1.13 +/- 0.13) and decreased in the peripheral area (ADC ratio = 0.83 +/- 0.13). This suggested that intra- and extracellular components underwent disintegration and homogenization within the central area, whereas cellular swelling was predominant in the peripheral area. A crescent-shaped zone of very high ADC value (ADC ratio = 1.38-1.61) was observed at the border between these two areas during the period of 24-48 hours post-trauma in some cases, apparently indicating that edema fluid was accumulated within a space formed by homogenization. The ADC values in the peripheral area shifted to an increase after 48-72 hours post-trauma. These findings imply that multiple mechanisms operate in early edema formation in cerebral contusion. It appears that the capacity for edema fluid accumulation increases in the central area and resistance for edema fluid propagation is elevated by cellular swelling in the peripheral area. We suggest that a combination of such events facilitates edema fluid accumulation in the central area and contributes, together with the cellular swelling in the peripheral area, to the mass effect of contusion edema. Diffusion MRI and ADC mapping represent powerful tools for investigating spatially as well as temporally heterogeneous mechanisms of contusion edema.
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Affiliation(s)
- T Kawamata
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
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Tsutsumi K, Aoyama N, Kitahara T, Endo M, Takahashi I, Kashiwa M, Imai Y, Soma K, Ohwada T. Midazolam for continuous sedation in Japanese patients in the critical care setting: phase II study. J Int Med Res 2001; 29:335-41. [PMID: 11675907 DOI: 10.1177/147323000102900410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This prospective, phase II study was carried out to evaluate the efficacy and safety of midazolam as a sedative agent in nine critically ill Japanese patients without coma who had been admitted to an intensive care unit. An adequate level of sedation (sedative score [SS] 4-6) was induced by midazolam 0.14 - 0.39 mg/kg and maintained with a dose range of 0.08 - 0.24 mg/kg per h. One patient was excluded from the efficacy analysis since optimum sedation was not maintained by continuous infusion. The percentage of time during which SS 5 was achieved varied among the patients. The most frequent adverse events were hypotension, partial pressure of carbon dioxide elevation and premature ventricular contraction. Population pharmacokinetic analysis suggested that lower drug clearance rates were correlated with the presence of complications. The 50% of effective concentration values of SS 5, estimated by logistic regression analysis, varied greatly (mean, 251 ng/ml). In conclusion, midazolam infusion achieved successful sedation in this critical care setting. The optimum dose differed among the patients, however, and was influenced by the presence of complications.
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Affiliation(s)
- K Tsutsumi
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Sakai T, Aoyama N, Kita T, Sakaeda T, Nishiguchi K, Nishitora Y, Hohda T, Sirasaka D, Tamura T, Tanigawara Y, Kasuga M, Okumura K. CYP2C19 genotype and pharmacokinetics of three proton pump inhibitors in healthy subjects. Pharm Res 2001; 18:721-7. [PMID: 11474773 DOI: 10.1023/a:1011035007591] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To predict the CYP2C19 genotype-dependence in anti-Helicobacter pylori (H. pylori) therapy when lansoprazole or rabeprazole was used instead of omeprazole as a proton pump inhibitor (PPI). METHODS A comparative pharmacokinetic study with each PPI was designed as an open, randomized, and crossover study of 18 Japanese healthy volunteers who were classified into the homozygous, heterozygous extensive metabolizer and the poor metabolizer based on the CYP2C19 genotype determined by PCR-RFLP method. Each subject received a single oral dose of 20 mg omeprazole, 30 mg lansoprazole, or 20 mg sodium rabeprazole, with at least 1 week washout period between treatments. Plasma concentrations of PPIs and their metabolites were monitored until 12 h after medication. RESULTS Pharmacokinetic profiles of omeprazole and lansoprazole were well correlated with the CYP2C19 genotype. The heterozygous extensive metabolizer was slightly different from the homozygote, but there was no statistically significant difference. The CYP2C19 genotype dependence found for lansoprazole was not obvious compared with omeprazole. As for rabeprazole, the pharmacokinetic profile was independent of the CYP2C19 genotype. CONCLUSIONS CYP2C19 genotype dependence will be found in the anti-H. pylori therapy even when lansoprazole is used as the PPI.
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Affiliation(s)
- T Sakai
- Second Department of Internal Medicine, School of Medicine, Kobe University, Japan
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