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Morishima R, Shimizu T, Kimura H, Bokuda K, Saotome T, Nakayama Y, Takahashi K. High doses of opioids usage for amyotrophic lateral sclerosis patients with non-invasive ventilation. Acta Neurol Belg 2024; 124:101-107. [PMID: 37543533 DOI: 10.1007/s13760-023-02344-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/19/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION While opioids have been found to be useful in relieving suffering in amyotrophic lateral sclerosis (ALS), there is a lack of evidence concerning how and how much to use them in practice. This study was conducted to clarify how opioids were used for patients with ALS. METHODS We performed a retrospective case-based analysis at a single tertiary neurology center in Tokyo from 2010 to 2018. We enrolled patients with ALS who had died before the end of 2018. We examined the opioid dosage equivalent of morphine hydrochloride and patients' clinical backgrounds, focusing on ventilatory support. RESULTS Morphine was administered in 110 patients with ALS, and 84 were followed up until their death. Of these 84 patients, 57 (69.9%) did not use mechanical ventilation until death (no-MV group), and 21 (22.9%) utilized only non-invasive ventilation (NIV group). Final morphine dosage in the NIV group was significantly higher (mean 65.7 mg [SD 54.6], range 10-200 mg) than in the no-MV group (mean 31.7 mg [SD 26.9], range 0-120 mg; p = 0.015, Welch's t-test). The NIV group needed psychotropic drugs more frequently than the no-MV group (62% [n = 13] vs. 35% [n = 20]). CONCLUSION Patients in the NIV group used opioids for a statistically significantly longer time and at a higher dose than those in the no-MV group. Symptom control with opioids alone may be difficult, and the development of multifaceted evaluation and care is desirable.
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Affiliation(s)
- Ryo Morishima
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan.
- Unit for Intractable Disease Care Unit, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
| | - Toshio Shimizu
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan
- Unit for Intractable Disease Care Unit, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Hideki Kimura
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Kota Bokuda
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan
- Unit for Intractable Disease Care Unit, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Takako Saotome
- Department of Rehabilitation Medicine, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Yuki Nakayama
- Unit for Intractable Disease Care Unit, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan
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Nakajima T, Sankai Y, Takata S, Kobayashi Y, Ando Y, Nakagawa M, Saito T, Saito K, Ishida C, Tamaoka A, Saotome T, Ikai T, Endo H, Ishii K, Morita M, Maeno T, Komai K, Ikeda T, Ishikawa Y, Maeshima S, Aoki M, Ito M, Mima T, Miura T, Matsuda J, Kawaguchi Y, Hayashi T, Shingu M, Kawamoto H. Cybernic treatment with wearable cyborg Hybrid Assistive Limb (HAL) improves ambulatory function in patients with slowly progressive rare neuromuscular diseases: a multicentre, randomised, controlled crossover trial for efficacy and safety (NCY-3001). Orphanet J Rare Dis 2021; 16:304. [PMID: 34233722 PMCID: PMC8261928 DOI: 10.1186/s13023-021-01928-9] [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: 05/24/2021] [Accepted: 06/27/2021] [Indexed: 11/15/2022] Open
Abstract
Background Rare neuromuscular diseases such as spinal muscular atrophy, spinal bulbar muscular atrophy, muscular dystrophy, Charcot-Marie-Tooth disease, distal myopathy, sporadic inclusion body myositis, congenital myopathy, and amyotrophic lateral sclerosis lead to incurable amyotrophy and consequent loss of ambulation. Thus far, no therapeutic approaches have been successful in recovering the ambulatory ability. Thus, the aim of this trial was to evaluate the efficacy and safety of cybernic treatment with a wearable cyborg Hybrid Assistive Limb (HAL, Lower Limb Type) in improving the ambulatory function in those patients.
Results We conducted an open-label, randomised, controlled crossover trial to test HAL at nine hospitals between March 6, 2013 and August 8, 2014. Eligible patients were older than 18 years and had a diagnosis of neuromuscular disease as specified above. They were unable to walk for 10 m independently and had neither respiratory failure nor rapid deterioration in gait. The primary endpoint was the distance passed during a two-minute walk test (2MWT). The secondary endpoints were walking speed, cadence, and step length during the 10-m walk test (10MWT), muscle strength by manual muscle testing (MMT), and a series of functional measures. Adverse events and failures/problems/errors with HAL were also evaluated. Thirty patients were randomly assigned to groups A or B, with each group of 15 receiving both treatments in a crossover design. The efficacy of a 40-min walking program performed nine times was compared between HAL plus a hoist and a hoist only. The final analysis included 13 and 11 patients in groups A and B, respectively. Cybernic treatment with HAL resulted in a 10.066% significantly improved distance in 2MWT (95% confidence interval, 0.667–19.464; p = 0.0369) compared with the hoist only treatment. Among the secondary endpoints, the total scores of MMT and cadence at 10MWT were the only ones that showed significant improvement. The only adverse effects were slight to mild myalgia, back pain, and contact skin troubles, which were easily remedied.
Conclusions HAL is a new treatment device for walking exercise, proven to be more effective than the conventional method in patients with incurable neuromuscular diseases. Trial registration: JMACTR, JMA-IIA00156
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Affiliation(s)
- Takashi Nakajima
- Departments of Neurology and Rehabilitation Medicine, National Hospital Organization Niigata National Hospital, 3-52 Akasaka, Kashiwazaki, Niigata, 945-8585, Japan.
| | - Yoshiyuki Sankai
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan.,CYBERDYNE Inc., Tsukuba, Japan
| | - Shinjiro Takata
- Department of Orthopedics and Rehabilitation, National Hospital Organization Tokushima National Hospital, Yoshinogawa, Japan
| | - Yoko Kobayashi
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yoshihito Ando
- Division of Neurology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Masanori Nakagawa
- Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshio Saito
- Division of Child Neurology, Department of Neurology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Kayoko Saito
- Institute of Medical Genetics, Tokyo Women's Medical University, Shinjuku, Japan
| | - Chiho Ishida
- Department of Neurology, National Hospital Organization Iou National Hospital, Kanazawa, Japan
| | - Akira Tamaoka
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takako Saotome
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Tetsuo Ikai
- Department of Rehabilitation, Tokyo Women's Medical University, Shinjuku, Japan
| | - Hisako Endo
- Departments of Neurology and Rehabilitation Medicine, National Hospital Organization Niigata National Hospital, 3-52 Akasaka, Kashiwazaki, Niigata, 945-8585, Japan
| | - Kazuhiro Ishii
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Mitsuya Morita
- Division of Neurology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Takashi Maeno
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Kiyonobu Komai
- Department of Neurology, National Hospital Organization Iou National Hospital, Kanazawa, Japan
| | - Tetsuhiko Ikeda
- Departments of Neurology and Rehabilitation Medicine, National Hospital Organization Niigata National Hospital, 3-52 Akasaka, Kashiwazaki, Niigata, 945-8585, Japan
| | - Yuka Ishikawa
- Department of Pediatric Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Shinichiro Maeshima
- Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiya Ito
- Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuya Mima
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshihiko Miura
- Department of Rehabilitation, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Jun Matsuda
- Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan
| | | | | | | | - Hiroaki Kawamoto
- CYBERDYNE Inc., Tsukuba, Japan.,Faculty of Engineering, Information and Systems, University of Tsukuba, Tsukuba, Japan
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Shimizu T, Shimizu N, Onozaki K, Arai T, Kimura H, Morishima R, Bokuda K, Saotome T, Sato A, Nakayama Y, Takahashi K. [A proposal of a novel palliative care scale and analysis of suffering in amyotrophic lateral sclerosis]. Rinsho Shinkeigaku 2021; 61:361-367. [PMID: 34011812 DOI: 10.5692/clinicalneurol.cn-001571] [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: 11/05/2022]
Abstract
OBJECTIVE We proposed a novel palliative care scale (Amyotrophic Lateral Sclerosis Palliative Care Scale: ALSPCS) for patients with ALS, and analyzed the suffering reported by patients. METHODS Thirty-one patients participated in the study. The ALSPCS has 15 items to evaluate physical and psychological suffering; patients scored their subjective suffering on a scale of 0-5 for each item. This study analyzed 13 of 15 items. RESULTS The mean scores obtained from the patients were as follows: 'dyspnea', 2.5; 'pain', 2.4; 'restlessness', 2.4; 'thirst', 3.0; 'burning sensation', 2.0; 'choking', 2.0; 'nausea', 0.4; 'constipation', 1.5; 'insomnia', 2.5; 'anxiety', 3.5; 'loneliness', 2.4; 'irritation', 2.1; and 'communication difficulty', 2.3. Multiple correlation analysis using Spearman's rank correlation coefficient showed significant correlations of dyspnea with restlessness, thirst, burning sensation and anxiety; of restlessness with dyspnea, thirst, loneliness and irritation; and of anxiety with dyspnea, thirst and loneliness (P < 0.0038 after Bonferroni's correction). In the principal component analysis, every item showed a positive loading value in the first principal component. Dyspnea, restlessness, thirst, anxiety, loneliness and irritation had loading values >0.7; thus, these symptoms might be the main features in ALS patients. The total scores or each ALSPCS score showed no significant association with post-assessment survival period. CONCLUSION This study, using ALSPCS, showed that the subjective suffering of ALS patients was variable and strongly correlated with each other. Appropriate and comprehensive assessment of physical and psychological affliction with ALSPCS could be potentially useful in verifying the effectiveness of palliative care for end-of-life stage ALS patients in the future.
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Affiliation(s)
- Toshio Shimizu
- Department of Neurology, Tokyo Metropolitan Neurological Hospital.,Palliative Care Team, Tokyo Metropolitan Neurological Hospital
| | - Naoko Shimizu
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital.,Nursing Division, Tokyo Metropolitan Neurological Hospital
| | - Kanae Onozaki
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital.,Nursing Division, Tokyo Metropolitan Neurological Hospital
| | - Tamami Arai
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital.,Nursing Division, Tokyo Metropolitan Neurological Hospital
| | - Hideki Kimura
- Department of Neurology, Tokyo Metropolitan Neurological Hospital.,Palliative Care Team, Tokyo Metropolitan Neurological Hospital
| | - Ryo Morishima
- Department of Neurology, Tokyo Metropolitan Neurological Hospital.,Palliative Care Team, Tokyo Metropolitan Neurological Hospital
| | - Kota Bokuda
- Department of Neurology, Tokyo Metropolitan Neurological Hospital.,Palliative Care Team, Tokyo Metropolitan Neurological Hospital
| | - Takako Saotome
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital.,Department of Rehabilitation, Tokyo Metropolitan Neurological Hospital
| | - Arata Sato
- Palliative Care Team, Tokyo Metropolitan Neurological Hospital.,Department of Neuropsychiatry, Tokyo Metropolitan Neurological Hospital
| | - Yuki Nakayama
- Unit for Intractable Disease Nursing Care, Tokyo Metropolitan Institute of Medical Science
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Saotome T, Nojima M, Iwase S, Komaki H. Effect of activities of daily living on quality of life among Japanese adults with duchenne muscular dystrophy: A cross-sectional study. J Int Soc Phys Rehabil Med 2021. [DOI: 10.4103/jisprm-000134] [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] Open
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5
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Yorimoto K, Ariake Y, Saotome T, Mori-Yoshimura M, Tsukamoto T, Takahashi Y, Kobayashi Y. Lung Insufflation Capacity with a New Device in Amyotrophic Lateral Sclerosis: Measurement of the Lung Volume Recruitment in Respiratory Therapy. Prog Rehabil Med 2020; 5:20200011. [PMID: 32789279 PMCID: PMC7365237 DOI: 10.2490/prm.20200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/12/2020] [Indexed: 11/09/2022] Open
Abstract
Objective The aim of this study was to validate the usefulness of the measurement of lung insufflation capacity (LIC) using the LIC TRAINER (LT) in patients with amyotrophic lateral sclerosis (ALS). Methods This retrospective study was conducted in the rehabilitation departments of the Japanese National Center of Neurology and Psychiatry and involved 20 ALS patients who underwent respiratory therapy between April 1, 2014, and December 2017. The vital capacity (VC), maximum insufflation capacity (MIC), and LIC measurements at the start of respiratory therapy were extracted from the medical records, and patients were divided into three groups: group A, VC could not be measured; group B, VC could be measured, but MIC was less than VC; and group C, MIC was larger than VC. LIC could be measured in all groups. In group C, paired t-tests were used to analyze whether there was a significant difference in the volumes measured using different methods. Results LIC was 950, 1863±595, and 2980±1176 ml in groups A (n=1), B (n=10), and C (n=9), respectively. In groups A and B, LIC could be measured in all patients, even when VC or MIC could not be measured. In group C, the measured LIC value was significantly greater than MIC (p=0.003). Conclusion LIC could be successfully measured using the LT. By using the LT, it was feasible to conveniently perform LIC measurements, suggesting that it could be a useful device for performing respiratory therapy in ALS patients.
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Affiliation(s)
- Keisuke Yorimoto
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yosuke Ariake
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takako Saotome
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Madoka Mori-Yoshimura
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Tadashi Tsukamoto
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yoko Kobayashi
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
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Takahashi H, Kawakita D, Fushimi C, Nagao T, Hirai H, Saigusa N, Masubuchi T, Matsuki T, Okada T, Baba D, Miura K, Saotome T, Tada Y. Trastuzumab plus docetaxel in patients with advanced HER2-positive salivary duct carcinoma: Exploratory biomarker analyses. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.060] [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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7
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Fushimi C, Kawakita D, Takahashi H, Nagao T, Hirai H, Saigusa N, Masubuchi T, Matsuki T, Okada T, Baba D, Miura K, Saotome T, Tada Y. Combined androgen blockade in patients with advanced androgen receptor-positive salivary gland carcinoma: Exploratory biomarker analyses. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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8
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Saotome T. 064 Three cases of Persistent Genital Arousal Disorder(PGAD). J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.507] [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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Fushimi C, Tada Y, Takahashi H, Nagao T, Ojiri H, Masubuchi T, Matsuki T, Miura K, Kawakita D, Hirai H, Hoshino E, Kamata S, Saotome T. A prospective phase II study of combined androgen blockade in patients with androgen receptor-positive metastatic or locally advanced unresectable salivary gland carcinoma. Ann Oncol 2018; 29:979-984. [PMID: 29211833 PMCID: PMC5913639 DOI: 10.1093/annonc/mdx771] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background There is no standard first-line chemotherapy for recurrent/metastatic (RM) or unresectable locally advanced (LA) salivary gland carcinoma (SGC). Patients and methods We conducted a single institution, open-label, single arm, phase II trial of combined androgen blockade (CAB) for androgen receptor (AR)-positive SGC. Leuprorelin acetate was administered subcutaneously at a dose of 3.75 mg every 4 weeks. Bicalutamide was administered orally at a daily dose of 80 mg. Patients were treated until progressive disease or unacceptable toxicities. Results Thirty-six eligible patients were enrolled. Thirty-three patients had RM disease and three patients had LA disease. The pathological diagnoses were salivary duct carcinoma (34 patients, 94%) and adenocarcinoma, NOS (two patients, 6%). The best overall response rate was 41.7% [n = 15, 95% confidence interval (CI), 25.5%-59.2%], the clinical benefit rate was 75.0% (n = 27, 95% CI, 57.8%-87.9%). The median progression-free survival was 8.8 months (95% CI, 6.3-12.3 months) and the median overall survival was 30.5 months (95% CI, 16.8 months to not reached). Additional analyses between treatment outcomes and clinicopathological factors or biomarkers including AR positivity, human epidermal growth factor receptor 2 status, and its complex downstream signaling pathway gene mutations showed no statistically significant differences. Elevated grade 3 liver transaminases and increased serum creatinine were reported in two patients, respectively. Discontinuation of leuprorelin acetate or bicalutamide due to adverse event occurred in one patient. Conclusion This study suggests that CAB has equivalent efficacy and less toxicity for patients with AR-positive RM or unresectable LA SGC compared with conventional chemotherapy, which warrants further study. Clinical Trial Registration UMIN-CTR (http://www.umin.ac.jp/ctr/index-j.htm), identification number: UMIN000005703.
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Affiliation(s)
- C Fushimi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Y Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan.
| | - H Takahashi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - T Nagao
- Department of Anatomic Pathology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - H Ojiri
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - T Masubuchi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - T Matsuki
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - K Miura
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - D Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - H Hirai
- Department of Anatomic Pathology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - E Hoshino
- Support Unit for Conducting Clinically Essential Studies, Graduate School of Public Health, St Luke's International University, Tokyo, Japan
| | - S Kamata
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - T Saotome
- Division of Medical Oncology, Matsudo City Hospital, Chiba, Japan
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Saotome T, Iwase S, Nojima M, Hewitt B, Chye R. Assessment of activities of daily living and quality of life among palliative care inpatients: A preliminary prospective cohort study. Progress in Palliative Care 2018. [DOI: 10.1080/09699260.2018.1427677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Takako Saotome
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Satoru Iwase
- Division of Palliative Medicine, Department of General Internal Medicine, Saitama Medical University, Saitama, Japan
| | - Masanori Nojima
- Center for Translational Research, Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| | - Bronwen Hewitt
- Cancer Services, Musculoskeletal/Ambulatory Care Team, Physiotherapy, Liverpool Hospital, Level 2, Health Services Building, Corner of Campbell and Goulburn Street, Liverpool, Australia
| | - Richard Chye
- Sacred Heart Supportive & Palliative Care, Sacred Heart Health Service, Darlinghurst, Australia
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Kondo Y, Takahashi Y, Kobayashi Y, Saotome T, Bando K, Ariake Y, Katsuta W, Murata M. Measurement error of the balance evaluation systems test in spinocerebellar degeneration. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.874] [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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Tanaka K, Sata M, Komuro I, Saotome T, Yamashita Y, Asakura T. P5377Biodegradable extremely small diameter vascular graft made of silk fibroin leads rapid vascular remodeling; a preliminary evaluation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Yorimoto K, Ariake Y, Ogawa J, Saotome T, Kobayashi Y. Adaptation and serviceability of the maximum insufflation capacity (MIC) training to the patients with amyotrophic lateral sclerosis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.212] [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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14
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Saotome T, Klein L, Faux S. Cancer rehabilitation: a barometer for survival? Support Care Cancer 2015; 23:3033-41. [DOI: 10.1007/s00520-015-2673-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 02/22/2015] [Indexed: 12/31/2022]
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Horikawa Y, Tsuchiya N, Yuasa K, Narita S, Saito M, Takayama K, Nara T, Tsuruta H, Obara T, Numakura K, Satoh S, Habuchi T, Hu X, Guo J, Lin Z, Sun L, Xu Z, Cang C, Wang G, Kanda T, Sakamoto K, Matsuki A, Ohashi R, Hirota S, Fujimori Y, Matsuda Y, Yajima K, Kosugi S, Hatakeyama K, Kitahara K, Watanabe M, Nakazono S, Wada N, Kakizaki H, Li J, Gong FJ, Sun PN, Shen L, Li Q, Li N, Qiu M, Liu J, Yi C, Luo D, Li Z, Gou H, Yang Y, Cao D, Shen Y, Wang X, Xu F, Bi F, Li Q, Zhang X, Li N, Wei W, Luo HY, Wang ZQ, Wang FH, Qiu MZ, Teng KY, Ruan DY, He YJ, Li YH, Xu RH, Matsusaka S, Mizunuma N, Suenaga M, Shinozaki E, Mishima Y, Terui Y, Hatake K, Nara E, Kodaira M, Mishima Y, Yokoyama M, Saotome T, Terui Y, Takahashi S, Hatake K, Nishimura N, Nakano K, Kodaira M, Ueda K, Yamada S, Mishima Y, Yokoyama M, Saotome T, Takahashi S, Terui Y, Hatake K, Nozawa M, Mochida Y, Nishigaki K, Nagae S, Uemura H, Oh SY, Jeong CY, Hong SC, Lee WS, Kim HG, Lee GW, Hwang IG, Jang JS, Kwon HC, Kang JH, Ozaka M, Ogura M, Matsusaka S, Shinozaki E, Suenaga M, Chin K, Mizunuma N, Hatake K, Pua PF, Ganzon D, Chan V, Sailaja K, Vishnupriya S, Raghunadharao D, Markandeya G, Reddy PRK, Reddanna P, Praveen D, Sakamoto K, Kanda T, Matsuki A, Takano T, Hanyu T, Yajima K, Kosugi S, Hirota S, Hatakeyama K, Shigekawa T, Ijichi N, Takayama S, Tsuda H, Ikeda K, Horie K, Osaki A, Saeki T, Inoue S, Subhashini J, Rajesh B, Rajesh I, Ravindran P, Takagi K, Chin K, Oba M, Kuboki Y, Ichimura T, Oto M, Kawazoe Y, Watanabe T, Ozaka M, Ogura M, Suenaga M, Shinozaki E, Matsusaka S, Mizunuma N, Hatake K, Ueda K, Saotome T, Yamada S, Nishimura N, Nara E, Nakano K, Kodaira M, Katsube A, Mishima Y, Terui Y, Yokoyama M, Takahashi S, Hatake K, Yao X, Yang Q, Li C, Diao L, Chen X, Yu Z, Zuo W, Wang Y, He Y, Zhang X, Cai S, Wang Z, Xu J, Zhan W, Zhang YF, Misumi M, Takeuchi H, Nakamiya N, Shigekawa T, Matsuura K, Fujiuchi N, Osaki A, Saeki T. CLINICAL OUTCOMES. Jpn J Clin Oncol 2011. [DOI: 10.1093/jjco/hyq254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Kodaira M, Takahashi S, Takeuchi K, Yuasa T, Saotome T, Yonese J, Fukui I, Hatake K. Sorafenib-induced erythema multiforme for metastatic renal cell carcinoma. Ann Oncol 2010; 21:1563-1565. [PMID: 20573851 DOI: 10.1093/annonc/mdq299] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Kodaira
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - S Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research.
| | | | - T Yuasa
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - T Saotome
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - J Yonese
- Department of Urology, Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - I Fukui
- Department of Urology, Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - K Hatake
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
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17
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Nishimura N, Nishimura M, Yamada S, Ueda K, Mishima Y, Yokoyama M, Saotome T, Terui Y, Takahashi S, Hatake K. Incidence and severity of oral mucositis induced by conventional chemotherapy: A comprehensive prospective analysis of 227 cancer patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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18
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Kodaira M, Takahashi S, Yamada S, Ueda K, Mishima Y, Takeuchi K, Yamamoto N, Ishikawa Y, Yokoyama M, Saotome T, Terui Y, Hatake K. Bone metastasis and poor performance status are prognostic factors for survival of carcinoma of unknown primary site in patients treated with systematic chemotherapy. Ann Oncol 2009; 21:1163-1167. [PMID: 20019088 DOI: 10.1093/annonc/mdp583] [Citation(s) in RCA: 22] [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: 11/13/2022] Open
Abstract
BACKGROUND Cancer of unknown primary site (CUP) generally has a poor prognosis, and there is no established standard therapy. There have been no reports of a prognostic model for CUP patients treated with a single regimen of systemic chemotherapy. METHODS Univariate and multivariate prognostic factor analysis for overall survival (OS) were conducted retrospectively in 58 consecutive CUP patients treated with carboplatin plus paclitaxel (Taxol) therapy as a first-line treatment. RESULTS Univariate prognostic factor analysis revealed baseline performance status (PS) of two or more, low serum albumin level, pleural effusion, bone metastasis, and liver metastasis as adverse prognostic factors. Cox proportional hazards analysis showed that poor PS and bone metastasis had the most powerful adverse impact on survival. We developed a prognostic model using those two variables-a good-risk group (PS 0-1 without bone metastasis) and a poor-risk group (PS > or =2 or bone metastasis). The poor-risk group showed significantly poorer OS than the good-risk group (1 year OS 36.8% versus 67.1%, P = 0.0003). CONCLUSIONS Poor PS and bone metastasis were identified as independent adverse prognostic factors in CUP. A simple prognostic model was developed and seems useful for decision making as to whether chemotherapy is indicated for CUP patients.
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Affiliation(s)
- M Kodaira
- Department of Medical Oncology, Cancer Institute Hospital
| | - S Takahashi
- Department of Medical Oncology, Cancer Institute Hospital.
| | - S Yamada
- Department of Medical Oncology, Cancer Institute Hospital
| | - K Ueda
- Department of Medical Oncology, Cancer Institute Hospital
| | - Y Mishima
- Department of Medical Oncology, Cancer Institute Hospital
| | - K Takeuchi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - N Yamamoto
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Y Ishikawa
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - M Yokoyama
- Department of Medical Oncology, Cancer Institute Hospital
| | - T Saotome
- Department of Medical Oncology, Cancer Institute Hospital
| | - Y Terui
- Department of Medical Oncology, Cancer Institute Hospital
| | - K Hatake
- Department of Medical Oncology, Cancer Institute Hospital
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19
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Saotome T, Sekino M, Eto F, Ueno S. Evaluation of diffusional anisotropy and microscopic structure in skeletal muscles using magnetic resonance. Magn Reson Imaging 2005; 24:19-25. [PMID: 16410174 DOI: 10.1016/j.mri.2005.09.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2005] [Revised: 09/30/2005] [Accepted: 09/30/2005] [Indexed: 01/25/2023]
Abstract
The pulsed-gradient spin-echo (PGSE) nuclear magnetic resonance (NMR) method is used for detecting the diffusion of water molecules in biological tissues. Because tissues generally have diffusional anisotropy, their diffusion properties are denoted by a tensor. In this study, we evaluated the diffusional anisotropy and microscopic structure in atrophied skeletal muscles using the PGSE NMR method. The left sciatic nerve was severed in twelve 9-week-old rats. Neurotomy caused neurogenic muscular atrophy at the left gastrocnemius. At 2, 4 and 8 weeks after neurotomy, magnetic resonance signals were selectively acquired from a 2 x 2 x 2 mm(3) voxel, which was located on the left gastrocnemius. The diffusion tensor, the mean diffusivity (MD) and the fractional anisotropy (FA) were calculated from the signals. A theoretical model of the diffusion in muscles was derived from Tanner's equation. The muscle fiber diameter was estimated by fitting the model to the measured signals. The measurements were also performed for normal rats as controls. No significant difference was found in the MD and the estimated intracellular diffusion coefficient between the control group and the denervated group. The denervated group had significantly higher FA compared with the control group (P<.05). The estimated muscle fiber diameter of the denervated group was significantly smaller than the estimated value of the control group (P<.05). These differences were found at 8 weeks after neurotomy. The proposed method is effective for evaluating changes in the microscopic structure of skeletal muscles.
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Affiliation(s)
- Takako Saotome
- Department of Biomedical Engineering, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan.
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20
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Konishi H, Eguchi Y, Fujii M, Saotome T, Sasaki T, Takahashi K, Sudo M, Morii H, Minouchi T, Yamaji A. Unusual hypersensitivity to warfarin in a critically ill patient. J Clin Pharm Ther 2004; 29:485-90. [PMID: 15482394 DOI: 10.1111/j.1365-2710.2004.00583.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A patient was admitted to the intensive care unit because of respiratory failure, and warfarin therapy was started at 2 mg/day for the treatment of pulmonary embolism, together with other medications. Despite the low dosage of warfarin, international normalized ratio (INR) was markedly elevated from 1.15 to 11.28 for only 4 days, and bleeding symptoms concurrently developed. Vitamin K2 was infused along with discontinuation of warfarin. One day later, the INR was found to have decreased, and bleeding was also improved. An objective causality assessment indicated a probable relationship between clotting abnormality and warfarin administration, although the degree of elevation of the INR was unusual in the light of the daily warfarin dose and duration of its exposure. Based on the clinical status of the patient, it was suspected that several conditions contributed to the abnormal hypersensitivity to warfarin. Contributory factors probably included pharmacokinetic interactions with co-administrated drugs, vitamin K deficiency caused by decreased dietary intake, reduced gut bacterial production, impaired intestinal absorption and hepatic synthetic capacity, and increased consumption of clotting factors. In view of our experience in the present case, it should be stressed that close monitoring of coagulation capacity is necessary in critically ill patients in order to avoid fatal haemorrhage after initiating warfarin therapy regardless of the dosage.
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Affiliation(s)
- H Konishi
- Department of Hospital Pharmacy, Shiga University of Medical Science, Seta, Otsu, Japan.
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21
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Ito Y, Aiba K, Horikoshi N, Saotome T, Irie T, Sugiyama K, Nakane M, Hashimoto D, Yoshida N, Mizunuma N, Takahashi S, Tanigawara Y. Dose-finding phase I study of simultaneous weekly infusion with doxorubicin and docetaxel in patients with advanced breast cancer. Int J Clin Oncol 2001; 6:242-7. [PMID: 11723746 DOI: 10.1007/pl00012112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Combination therapy with doxorubicin (DOX) and docetaxel (DOC), given 3 weeks apart, is one of the standard regimens used for treating metastatic breast cancer, but it frequently generates febrile neutropenia. To find a safer regimen with less myelotoxicity and the appropriate dose intensity, we conducted a phase I study of simultaneous weekly infusion with DOX and DOC. METHODS Twenty-five patients with advanced breast cancer were treated with an intravenous push-injection of DOX that was immediately followed by a 1-h infusion of DOC. This was repeated every week for at least 6 weeks. The premedication employed was three 4-mg doses of dexamethasone every week. Patients were divided into four groups for which the doses of DOX and DOC were escalated in 5-mg/m2 increments. RESULTS In the 18 patients who were treated with DOX 15 or 20 mg/m2 and DOC 25 mg/m2, or lower, the regimen was found to be tolerable, without febrile episodes. The regimen with 20 mg/m2 of DOX and 30 mg/m2 of DOC was the maximum tolerated dose. Other indications of grade 3 toxicity included asthenia in 4% of patients, anorexia in 8%, and vomiting in 8%. Of the 25 patients, 14 had a partial response. The overall response rate was 56% (95% confidence interval [CI], 35% to 77%). The recommended dose for further trial was 20 mg/m2 of DOX and 25 mg/m2 of DOC. CONCLUSION Simultaneous weekly infusion with DOX and DOC was feasible, with modest neutropenia and preserved dose intensity. This regimen may be helpful in the management of patients with advanced breast cancer.
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Affiliation(s)
- Y Ito
- Department of Medical Oncology, Cancer Institute Hospital, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research, 1-37-1 Kami-Ikebukuro, Toshima-ku, Tokyo 170-8455, Japan.
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22
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Andoh A, Saotome T, Sato H, Tsujikawa T, Araki Y, Fujiyama Y, Bamba T. Epithelial expression of caveolin-2, but not caveolin-1, is enhanced in the inflamed mucosa of patients with ulcerative colitis. Inflamm Bowel Dis 2001; 7:210-4. [PMID: 11515846 DOI: 10.1097/00054725-200108000-00005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Caveolae are vesicular invaginations of the plasma membrane that act as a scaffold of the assembly of many classes of signaling molecules. Caveolins are the principal structural component of caveolae membranes, and three distinct forms of caveolins have been identified: caveolin-1, caveolin-2, and caveolin-3. In this study, we evaluated the changes in the caveolin-1 and caveolin-2 expression in the inflamed mucosa of patients with IBD. Tissue samples were obtained endoscopically from patients with ulcerative colitis (UC) (n = 18), Crohn's disease (n = 10) and ischemic colitis (n = 8). Normal colorectal tissues were also obtained (n = 15). The caveolin expression was evaluated by standard immunohistochemical procedure. In normal colonic mucosa, caveolin-1 expression was detected in the smooth-muscle cells of the muscularis mucosae and the endothelial cells, but caveolin-2 expression was not detected. In the inflamed mucosa of patients with active UC, caveolin-2 expression was clearly detectable as small scattered foci on the luminal surfaces of epithelial cells, but caveolin-1 expression was similar to that in normal mucosa. Caveolin-2 expression increased in accordance with the disease activity of UC. This enhanced caveolin-2 expression was not detected in active Crohn's disease or ischemic colitis. In conclusion, we demonstrated that the epithelial expression of caveolin-2 is markedly enhanced in the inflamed mucosa of patients with UC. It is likely that the enhanced caveolin-2 expression in patients with UC was associated with the altered signal transductions in the intestinal epithelial cells. Furthermore, our results suggest that there are differences in the phenotypic features of epithelial cells between UC and Crohn's disease.
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Affiliation(s)
- A Andoh
- Department of Internal Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu, Japan
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23
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Abstract
Irinotecan hydrochloride (CPT-11), a DNA topoisomerase-I inhibitor, is now widely used in the treatment of various solid tumors, including colorectal, gastric, breast, lung, and ovarian cancer. Despite the good response shown in the late phase-II study, CPT-11 was not often employed in the treatment of malignant lymphoma, mainly because of severe leukopenia and diarrhea caused by the recommended schedule: 40 mg/m2 of CPT-11 on days 1 to 3, 8 to 10, 15 to 17, then discontinued for at least 2 weeks. In clinical use, administration of CPT-11 had to be ceased on days 15 to 17 in almost all cases, and on days 8 to 10 in a considerable number of patients. Subsequently, a lower dose schedule (less than 40 mg/m2) was developed. Our phase II trial employing a reduced dose of CPT-11 on days 1 and 2, plus ADM on day 3 with 3-week interval in patients with refractory and relapsed NHL showed a fairly good response of relapsed B-cell lymphoma and a substantial response of T-cell lymphoma with acceptable toxicity. The combination of a topoisomerase-I inhibitor (CPT-11) and a topoisomerase-II inhibitor is an interesting concept for the treatment of NHL. Another phase II trial in combination with CPT-11 and other anti-cancer drugs, particularly cisplatin or topoisomerase-II inhibitors, is warranted. A superior salvage chemotherapy regimen could be found in the future by investigating combinations of low-dose CPT-11 and cisplatin or topoisomerase-II inhibitors.
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Affiliation(s)
- T Takagi
- Division of Laboratory Medicine, Chiba Cancer Center Hospital, Japan.
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24
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Nakamura F, Shintani Y, Saotome T, Fujiyama Y, Bamba T. Effects of synthetic serine protease inhibitors on proliferation and collagen synthesis of human pancreatic periacinar fibroblast-like cells. Pancreas 2001; 22:317-25. [PMID: 11291936 DOI: 10.1097/00006676-200104000-00015] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Protease inhibitors are currently used as therapeutic agents for chronic pancreatitis in Japan. We previously reported that human pancreatic periacinar fibroblast-like cells (hPFCs) could be cultured from isolated pancreatic acini, and those are thought to play a crucial role in pancreatic fibrosis correlating with platelet-derived growth factor (PDGF) and transforming growth factor beta1 (TGF-beta1) (Pancreas 1997;14: 373-82). The present study was designed to examine the effects of synthetic serine protease inhibitors (FOY-007 and FOY-305) on proliferation and collagen synthesis of hPFCs under cytokine stimulation. The cell proliferation and collagen synthesis were evaluated using assays of [3H]-thymidine incorporation and procollagen type I c-terminal peptide (PIP), and [14C]-proline incorporation to de novo synthesized collagen, respectively. The cell proliferation stimulated by PDGF was inhibited by the application of FOY-007 dose dependently (1-100 microM) and FOY-305 at 100 microM. FOY-007 attenuated the collagen synthesis and PIP production stimulated by TGF-beta1 dose dependently, but FOY-305 inhibited only PIP production. Both protease inhibitors demonstrated no effect on the proliferation and collagen synthesis of hPFCs when they were not stimulated by PDGF or TGF-beta1. Thus, serine protease inhibitors act on hPFCs to diminish the effects of PDGF on proliferation and the effects of TGF-beta1 on collagen synthesis.
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Affiliation(s)
- F Nakamura
- Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
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25
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Abstract
A pre-embedding double immunostaining technique was used to study the synaptic relationships between orexin-like immunoreactive axon terminals and preopiomelanocortin (POMC)-like immunoreactive neurons in the rat arcuate nucleus. Most of the synapses were axo-dendritic, while some axo-somatic synapses were also found. Both the axo-somatic and axodendritic synapses were symmetrical. In some cases the presynaptic orexin-like immunoreactive axon terminals contained a few large dense-cored vesicles. The results suggest that the orexinergic axon terminals in the arcuate nucleus may play an important role in the regulation of food intake via synapses through POMC neurons.
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Affiliation(s)
- J L Guan
- Department of Anatomy, Showa University School of Medicine, Tokyo, Japan
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26
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Horikoshi N, Saotome T, Yoshida N, Aiba K. [Oral cancer chemotherapy in the clinic]. Gan To Kagaku Ryoho 2000; 27:1641-6. [PMID: 11057313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The present status of oral chemotherapeutic agents and the treatment of cancer were reviewed. Twenty anticancer agents are commercially available in Japan excluding hormonal and BRM agents. Cancers for the outpatient chemotherapy are limited because useful drugs are few for such circumstances. Now new potent agents such as S-1, capecitabine and molecular targeting are available. This kind of chemotherapy is needed for growing number of elderly patients for QOL and medical cost.
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Affiliation(s)
- N Horikoshi
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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27
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Andoh A, Takaya H, Saotome T, Shimada M, Hata K, Araki Y, Nakamura F, Shintani Y, Fujiyama Y, Bamba T. Cytokine regulation of chemokine (IL-8, MCP-1, and RANTES) gene expression in human pancreatic periacinar myofibroblasts. Gastroenterology 2000; 119:211-9. [PMID: 10889171 DOI: 10.1053/gast.2000.8538] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.3] [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: 12/17/2022]
Abstract
BACKGROUND & AIMS We have previously isolated and characterized human pancreatic periacinar myofibroblasts. In this study, to define the role of these cells in the pathogenesis of acute pancreatitis, we investigated chemokine expression in them. METHODS Secretion of chemokines (interleukin [IL]-8, monocyte chemoattractant protein [MCP]-1, RANTES, and MIP [macrophage inflammatory protein]-1alpha) was evaluated by ELISA, Northern blotting, and nuclear run-on assays. The activation of NF-kappaB and NF-IL6 was assessed by an electrophoretic gel mobility shift assay. RESULTS IL-8 and MCP-1 secretion was rapidly induced by both IL-1beta and tumor necrosis factor (TNF)-alpha. RANTES secretion was induced more slowly and was induced mainly by TNF-alpha. However, MIP-1alpha secretion was not induced by any stimuli. These responses were also observed at the messenger RNA level, and they were accompanied by an increase in transcriptional rate. The increase in transcriptional activation of chemokine genes correlated with the NF-kappaB and NF-IL6 activation. Furthermore, a blockade of NF-kappaB activation by PDTC and TPCK markedly reduced the IL-1beta- or TNF-alpha-induced chemokine gene expression. CONCLUSIONS Chemokine secretion is differentially regulated in pancreatic periacinar myofibroblasts, suggesting a role for these cells in mediating the infiltration and accumulation of inflammatory cells in the pancreas.
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Affiliation(s)
- A Andoh
- Department of Internal Medicine, Shiga University of Medical Science, Seta-Tukinowa, Otsu, Japan.
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Saotome T, Takagi T, Sakai C, Kumagai K, Tamaru J. Combination chemotherapy with irinotecan and adriamycin for refractory and relapsed non-Hodgkin's lymphoma. Ann Oncol 2000; 11:115-6. [PMID: 10690400 DOI: 10.1023/a:1008368905546] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Twenty-five patients with relapsed or refractory non-Hodgkin's lymphoma were treated by combination chemotherapy with irinotecan hydrochloride (CPT-11) and adriamycin (ADM): CPT-11, 25 mg/m2 on days 1 and 2; ADM, 40 mg/m2 on day 3. Nine (36%) of twenty-five patients achieved CR. Fairly good responses were seen in relapsed B-cell lymphomas (4 of 8 in diffuse large B-cell lymphoma and 2 of 2 in follicular lymphoma grade 1), and substantial responses in T-cell lymphomas (1 of 4 in peripheral T-cell lymphoma and 2 of 7 in adult T-cell leukemia/lymphoma). Leukopenia was frequent but tolerable, and diarrhea minimal. Combination chemotherapy with a reduced dose CPT-11 and ADM was useful in the treatment of relapsed non-Hodgkin's lymphoma.
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Affiliation(s)
- T Saotome
- Hematology-Oncology Division, Chiba Cancer Center Hospital, Japan
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29
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Sakai C, Saotome T, Takeshita A, Nakaseko C, Kumagai K, Takagi T. [Improvement of quality of life (QOL) and life prolongation by CPT-11 + adriamycin (ADM) therapy: report of 4 cases of non-Hodgkin's lymphoma refractory to conventional chemotherapies]. Gan To Kagaku Ryoho 1999; 26:709-14. [PMID: 10234305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CPT-11 + ADM therapy (CPT-11 40 mg/body x 2 days; Day 1 & 2, combined with ADM 20 to 60 mg/body x 1 day; Day 3) was given to four patients with relapsed and advanced non-Hodgkin's lymphoma, which was refractory to conventional chemotherapies. The symptoms of the patients at the beginning of CPT-11 + ADM therapy were fever (in two cases), dyspnea due to pleural effusion (in two), severe backache (in one), and jaundice with splenomegaly (in one). Their Karnofsky performance scales were 20 or 30%. Soon after the initiation of CPT-11 + ADM therapy, their clinical conditions improved dramatically, and they obtained a partial remission lasting 3.5 to 9 months. During the period of controlling lymphomas by this therapy, all patients had some time at home for 2 to 8 months. The adverse effects were vomiting, diarrhea, neutropenia and thrombocytopenia, but no lethal infection or hemorrhage was seen. We conclude that CPT-11 + ADM therapy is very useful for improvement of QOL and life prolongation of patients with non-Hodgkin's lymphoma, which is refractory to conventional chemotherapies and is even disseminated.
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Affiliation(s)
- C Sakai
- Division of Hematology and Chemotherapy, Chiba Cancer Center Hospital
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30
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Kimura T, Andoh A, Fujiyama Y, Saotome T, Bamba T. A blockade of complement activation prevents rapid intestinal ischaemia-reperfusion injury by modulating mucosal mast cell degranulation in rats. Clin Exp Immunol 1998; 111:484-90. [PMID: 9528887 PMCID: PMC1904891 DOI: 10.1046/j.1365-2249.1998.00518.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [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: 02/07/2023] Open
Abstract
We attempted to define the putative role of complement activation in association with mucosal mast cell (MMC) degranulation in the pathogenesis of rapid intestinal ischaemia-reperfusion (I/R) injury. We prepared complement activity-depleted rats by the administration of the anti-complement agent K-76COOH and the serine-protease inhibitor FUT-175. Autoperfused segments of the jejunum were exposed to 60 min of ischaemia, followed by reperfusion for various time periods, and the epithelial permeability was assessed by the 51Cr-EDTA clearance rate. The number of MMC was immunohistochemically assessed. In control rats, the maximal increase in mucosal permeability was achieved by 30-45 min of reperfusion. This increase was significantly attenuated by the administration of either K-76COONa alone or in combination with FUT-175. In contrast, the administration of carboxypeptidase inhibitor (CPI), which prevents the inactivation of complement-derived anaphylatoxins such as C5a, significantly enhanced the increase in I/R-induced mucosal permeability. These findings were confirmed morphologically by light microscopy and scanning electron microscopy. In addition, the I/R-induced mucosal injury was accompanied by a marked decrease in the number of MMC, and administration of K-76COOH significantly inhibited this change. These results indicate that complement activation and the generation of complement-derived anaphylatoxins are key events in I/R-induced mucosal injury. It is likely that intestinal I/R-induced mucosal injury may be partially mediated by MMC activation associated with the complement activation.
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Affiliation(s)
- T Kimura
- Department of Internal Medicine, Shiga University of Medical Science, Seta-Tukinowa, Otsu, Japan
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Tagawa M, Goto S, Takenaga K, Takeshita A, Saotome T, Takenouchi T, Tsurumachi T, Gunji Y, Matsubara H, Sakiyama S. Reduced tumorigenicity of human gastric carcinoma cells engineered to produce IL-2 in SCID mice reconstituted with peripheral blood cells from cancer patients. Cancer Lett 1998; 123:87-93. [PMID: 9461023 DOI: 10.1016/s0304-3835(97)00411-4] [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: 02/06/2023]
Abstract
We have examined the validity of a humanized immune system with an animal model to assess cytokine gene therapy for cancer patients. For that purpose, we prepared hematologically-reconstituted severe combined immunodeficiency mice by transferring patient's peripheral blood cells containing CD34+ cells. These animals were inoculated subcutaneously with human gastric cancer lines transduced with cytokine genes. Tumorigenicity of interleukin-2-producing cells was significantly reduced in reconstituted but not in non-reconstituted mice, whereas that of wild-type and interleukin-6 producer cells was not affected irrespective of the reconstitution status. An inability to induce protective immunity in the reconstituted mice, which had rejected interleukin-2-producers, suggested that the effector cells mediating the antitumor response were non-T cells of donor origin. The experimental system presented in this study seems to be a feasible model to investigate applicable cytokines for patients.
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Affiliation(s)
- M Tagawa
- Division of Pathology, Chiba Cancer Center, Japan.
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Saotome T, Inoue H, Fujimiya M, Fujiyama Y, Bamba T. Morphological and immunocytochemical identification of periacinar fibroblast-like cells derived from human pancreatic acini. Pancreas 1997; 14:373-82. [PMID: 9163784 DOI: 10.1097/00006676-199705000-00008] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [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: 02/04/2023]
Abstract
Fibroblast-like cells in the periacinar region may play an important role in periacinar fibrosis. In the present study, we isolated and cultured periacinar fibroblast-like cells (PFCs) derived from human pancreatic acini and examined the characteristics of human PFCs morphologically and immunocytochemically. Immunocytochemical study of human PFCs showed that they were positively stained with antibodies against type I collagen/procollagen, type III collagen/procollagen, fibronectin, prolyl hydroxylase beta sub-unit, type IV collagen, laminin, alpha-smooth muscle actin, vimentin, and nonmuscle myosin. Electron microscopic study showed that human PFCs contained a number of microfilaments, forming dense bodies in the cytoplasm. These results indicated that human PFCs possess characteristics of myofibroblasts. Expression of alpha-smooth muscle actin, a marker of the myofibroblast-like phenotype, was increased with time in culture and was enhanced by treatment with transforming growth factor (TGF)-beta 1. Collagen synthesis in human PFCs was stimulated by TGF-beta 1 and the proliferation of human PFCs was stimulated by platelet-derived growth factor. These findings suggest that PFCs from human pancreas seem to be involved in periacinar fibrosis.
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Affiliation(s)
- T Saotome
- Department of Internal Medicine, Shiga University of Medical Science, Japan
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Kikuno K, Goto S, Iwasaki H, Saotome T, Takeshita A, Nagamura F, Watanabe J, Tsujimura H, Iseki T, Yonemitu H. [Two patients with acute promyelocytic leukemia whose relapse was noted by cytodiagnosis of middle ear discharge]. Rinsho Ketsueki 1996; 37:323-8. [PMID: 8847803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Patient 1 was a 36-year-old male and diagnosed as APL in April 1989, and treated with BHAC-DMP and BHAC-AMP. In January 1990, a diagnosis of exudative otitis media was made, but intractable. In June, left facial paralysis appeared and cytodiagnosis of the discharge from the middle ear confirmed leukemic cells. Otitis media and facial paralysis improved after high dose Ara-C, but developed again 5 months later. The condition improved after high dose Ara-C and irradiation of the temporal bones. In September 1992, he died of recurrence but no aggravation in facial paralysis or otitis media. Patient 2 was a 24-year-old female and diagnosed as APL in July 1989, and treated with BHAC-DMP. In May 1990, exudative otitis media was appeared. In July, recurrence was observed but improved by high dose Ara-C. In October, otitis media was aggravated again, and cytodiagnosis confirmed leukemic cell infiltration. She was treated with high dose Ara-C and irradiation of the temporal bones, then achieved complete remission. Maintenance therapy was continued until August 1992, she has been alive. When exudative otitis media developed during the course of leukemia, cytodiagnosis of the discharge from the middle ear should be performed. High dose Ara-C and irradiation of the temporal bone were effective.
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Affiliation(s)
- K Kikuno
- Department of Laboratory Medicine, Chiba University School of Medicine
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Sekine Y, Takei K, Nakano H, Saotome T, Hommura S. Survey of risk factors for expulsive choroidal hemorrhage: case reports. Substantiation of the risk factors and their incidence. Ophthalmologica 1996; 210:344-7. [PMID: 8887392 DOI: 10.1159/000310740] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To evaluate the interaction of risk factors for expulsive hemorrhage, we evaluated 3 cases of expulsive hemorrhage and 2 of acute intraoperative choroidal effusion that occurred at the University of Tsukuba Hospital over a 16-year-period and investigated the common findings in these 5 cases. We also selected randomly 500 cataractous cases operated at the University of Tsukuba Hospital and investigated the probabilities of risk factors for expulsive hemorrhage in these control cases. The 5 affected patients exhibited more than four risk factors of expulsive hemorrhage. The probability of more than four risk factors being involved in any cataract operation was approximately 0.33% (0.17 approximately 0.67%; 95% confidence interval). The incidence of expulsive hemorrhage at our hospital was approximately 0.2%, which is similar to the probability rate. Thus, we concluded that the development of expulsive hemorrhage was proved to be related to an accumulation of the risk factors for expulsive hemorrhage.
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Affiliation(s)
- Y Sekine
- Department of Ophthalmology, University of Tsukuba, Ibaraki-ken, Japan
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35
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Nagamura F, Goto S, Iseki T, Saotome T, Takeshita A, Kikuno K, Yonemitsu H, Yumoto N, Mikata A, Ohto M. [Molecular evidence for a single clonal origin in a patient with multiple myeloma and non-Hodgkin's lymphoma]. Rinsho Ketsueki 1995; 36:1182-7. [PMID: 8531328] [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: 01/31/2023]
Abstract
A 49-year old man was admitted in November 1989, because of anemia, abnormal shadowing on chest X ray and hyperproteinemia. Biclonal gammopathy (IgG kappa + IgA kappa) was shown in serum, and Bence Jones protein in urine. The bone marrow examination showed an increased number of abnormal plasma cells (15.7%) and no evidence of lymphoma, A diagnosis of multiple myeloma (MM) was made. In April 1990, while the patient was treated with the modified M2 regiman, swelling of the right cervical lymph node was observed. Lymph node biopsy revealed that he had non-Hodgkin's Lymphoma (:NHL, diffuse, mixed, B cell type). He was retreated with the CHOP regimen for both disease, but died of respiratory failure in October. 1991. To establish the clonal origin of this case of concominant MM and B-cell NHL, the immunoglobulin gene rearrangements in his lymph node and bone marrow were analyzed. Southern blot analysis with the JH probe and Ck probe showed one common band and one different band in the two samples. Our data suggest that two B-cell malignancies may have arisen from a single B-cell progenitor.
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Affiliation(s)
- F Nagamura
- First Department of Internal Medicine, Chiba University
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Takahashi M, Takeda K, Saotome T, Kobayashi N, Yagi S. [Change in cross-bridge activation rate constant (Kac) after six-minute walk in patients with heart failure]. J Cardiol 1994; 24:453-60. [PMID: 7823284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Cardiac adrenergic activity is increased in patients with congestive heart failure (CHF) and is excessively increased during mild exercise. Changes in cardiac adrenergic activity were examined in normal individuals and patients with CHF before and after mild exercise using the cross-bridge activation rate constant (Ka), which may represent the adrenergic activity related to the working left ventricular myocardium. Ten normal volunteers and 31 patients with stable CHF underwent echocardiography. The left ventricular ejection fraction (LVEF) was measured in all the CHF patients using left ventriculography or radionuclide cineangiography. The patients were classified into two groups: group 1 with an LVEF > or = 50% (n = 16) and group 2 with an LVEF < 50% (n = 15). The cause of CHF was old myocardial infarction in 25 patients and dilated cardiomyopathy in 6. All subjects exercised by walking for 6 min after resting in the supine position for 30 min. The blood pressure, electrocardiogram, phonocardiogram, and M-mode echocardiogram were recorded simultaneously before and after exercise. The values of Ka and Kac (Ka corrected for the individual heart rate) were calculated from the QS2 interval and the heart rate (HR) as follows: Ka = 3/QS2 interval, and Kac = Ka +0.0249 (66-HR). Before exercise, the HR was significantly higher in group 2, but the Kac value showed no significant difference between all three groups. The increase of HR with exercise (delta HR) and the Kac value after exercise were not significantly different between all three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Takahashi
- Department of Medicine, Dokkyo University School of Medicine, Tochigi
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Saotome T, Minoura S, Terashi K, Sato T, Echizen H, Ishizaki T. Labetalol in hypertension during the third trimester of pregnancy: its antihypertensive effect and pharmacokinetic-dynamic analysis. J Clin Pharmacol 1993; 33:979-88. [PMID: 8227470 DOI: 10.1002/j.1552-4604.1993.tb01933.x] [Citation(s) in RCA: 23] [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: 01/29/2023]
Abstract
The hypotensive effect, kinetics, and concentration-response relationship of labetalol, alpha beta- and alpha 1-adrenoceptor blocking drug, were studied in seven women with a moderate-to-severe hypertension (averaged diastolic blood pressure [DBP] of 100 to 120 mm Hg measured during a 1- to 2-day hospitalization period) during the third trimester of pregnancy who received the oral twice-daily doses of 150 to 450 mg. These dosages were individually selected by attaining a therapeutic goal of DBP < or = 100 mm Hg or systolic blood pressure (SBP)/DBP reduction of > 30/15 mm Hg, as compared with the pretreatment value, at any time during the 12-hour dosing interval for a 3- to 5-day dosage escalation period. Labetalol concentrations in plasma were measured by a high-performance liquid chromatography with fluorescence detection, and the plasma drug concentration-response relationship was analyzed by a sigmoidal Emax model. Labetalol decreased significantly (P < 0.05 to 0.01) the pretreatment SBP/DBP (166.3 +/- 5.2/110.3 +/- 3.0 mm Hg, mean +/- SEM) without any recognizable side-effects during the twice-daily dosing period in the mothers. Peaked concentrations occurred at 1 hour postdose in all patients. The elimination half-lives ranged from 4.3 to 6.9 hours, and the apparent oral clearance from 31.9 to 73.3 mL/min/kg. The pharmacodynamic parameters (Emax and EC50) analyzed by the Emax model revealed a 3- to 5-fold interindividual variability. The gestational ages at delivery ranged from 34 to 37 weeks, and the birth weights were < 2000 g in 6 of the 7 neonates. Four neonates developed respiratory distress syndrome after delivery, and one infant died of pulmonary hypoplasia 3 months later. The results indicate that 1) labetalol orally administered in a twice-daily regimen as done in this study is an effective antihypertensive drug in women with hypertension during late pregnancy, and 2) interindividual variability in the kinetic factor (e.g., oral clearance) as well as that in the pharmacodynamic factor (e.g., EC50) appear to be related to the overall variability in the hypotensive responsiveness to the drug. However, whether labetalol and/or hypertension per se would have been related to the fetal outcome remains unanswered from the present study.
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Affiliation(s)
- T Saotome
- Department of Obstetrics and Gynecology, National Medical Center, Tokyo, Japan
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Echizen H, Saotome T, Minoura S, Ishizaki T. Plasma protein binding of disopyramide in pregnant and postpartum women, and in neonates and their mothers. Eur J Pharmacol 1990. [DOI: 10.1016/0014-2999(90)93559-9] [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: 11/30/2022]
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Echizen H, Nakura M, Saotome T, Minoura S, Ishizaki T. Plasma protein binding of disopyramide in pregnant and postpartum women, and in neonates and their mothers. Br J Clin Pharmacol 1990; 29:423-30. [PMID: 2183867 PMCID: PMC1380112 DOI: 10.1111/j.1365-2125.1990.tb03660.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
1. The protein binding of disopyramide was measured in plasma obtained from nonpregnant women, pregnant women in the first, second, and third trimesters, matched pairs of mothers and neonates (cord plasma), and 1 month postpartum women (n = 6 or 8 of each). 2. Plasma samples spiked with 0.2-12.0 micrograms ml-1 of the drug were ultrafiltered and the free fractions were measured with a fluorescent polarization immunoassay. 3. The mean (+/- s.d.) percentages of free drug at a total concentration of 3.0 micrograms ml-1 observed in the third trimester (46 +/- 9%) and neonate (79 +/- 5%) groups were greater (P less than 0.05 or 0.01) than that in the non-pregnant group (34 +/- 7%). In contrast, the corresponding value observed in the postpartum group (23 +/- 8%) was less (P less than 0.05) than that in the non-pregnant group. In addition, there was a significant (P less than 0.01) difference in the mean percentage of free drug at 3.0 micrograms ml-1 in plasma from mothers (43 +/- 9%) and neonates (79 +/- 5%). 4. A multiple regression analysis indicated that alpha 1-acid glycoprotein (r = -0.88, P less than 0.01), rather than albumin (r = -0.008), dominated the binding of disopyramide within the therapeutic range of drug concentration. An analysis of the binding parameters of disopyramide suggested that alterations in binding were attributable to changes in the capacity rather than the affinity of binding.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Echizen
- Division of Geriatric Health and Nutrition, National Institute of Health and Nutrition, Tokyo, Japan
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Takei K, Saotome T, Nakano H, Hommura S, Nakajima Y. [Analysis of the components of the electrically evoked response (EER) of the visual system by topography and dipole-tracing]. Nippon Ganka Gakkai Zasshi 1989; 93:587-94. [PMID: 2801362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In order to examine the possibility of the clinical application of the electrically evoked response (EER) of the visual system, we analyzed the significance of the various components of the EER by means of topography and dipole-tracing. By applying a constant electric current of 1.0mA (duration 5msec) to each eye, three rhythmical waves were recorded within 200msec from the stimulation. The peaks of these waves were named N1, P1, N2, P2, N3, P3. Among those components of EER, we found P2 to be localized in the visual cortex, though the other components did not show any specific localization. The results indicated the significance of analyzing P2 in order to further investigate the possible clinical applications of EER.
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Yanagawa A, Iwayama T, Saotome T, Shoji Y, Takano K, Oka H, Nakagawa T, Mizushima Y. Selective transfer of cyclosporin to thoracic lymphatic systems by the application of lipid microspheres. J Microencapsul 1989; 6:161-4. [PMID: 2723958 DOI: 10.3109/02652048909098016] [Citation(s) in RCA: 26] [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: 01/02/2023]
Abstract
To overcome some of the disadvantages of present cyclosporin A (CsA) therapy, lipid microspheres incorporating CsA (lipo-CsA) were designed and their selective transfer to thoracic lymphatic systems was evaluated in vivo. It was found that concentrations of CsA in lymph-ducts were about 46 times higher after 2 h and 9-10 times higher after 3 h following oral administration of lipo-CsA, compared with those of conventional CsA. The concentrations in plasma produced by lipo-CsA were also higher than those produced by conventional CsA.
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Affiliation(s)
- A Yanagawa
- First Department of Internal Medicine, School of Medicine, St. Marianna University, Kanagawa-Pref, Japan
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Mizushima Y, Shoji Y, Saotome T, Yanagawa A, Nakagawa T. [Current problems and future perspectives in drug delivery systems for cancer therapy]. Gan To Kagaku Ryoho 1988; 15:1077-82. [PMID: 3291768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The current problems and future perspectives in DDS and targeting therapy for the treatment of cancer patients were reviewed on the basis of the following experimental data obtained in our laboratory. 1) IgG fractions isolated from the serum of a patient with systemic lupus erythematosus showed marked accumulation in cancer cells, indicating that certain serum IgGs may be useful as carriers of anticancer agents. 2) Lipid microspheres were also incorporated within cancer cells to enhance the anti-tumor activities of anti-cancer agents. In addition, this material may be applied for prevention of lymph node metastasis because of its lymphotrophic property. 3) Lipid microspheres including non-steroidal analgesics were quite effective for the management of cancerous pain, suggesting its efficacy as a DDS in this direction, besides its usefulness with anti-cancer agents.
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Affiliation(s)
- Y Mizushima
- 1st Dept. of Internal Medicine, St. Marianna University, School of Medicine
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