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Yonemura T, Yazawa R, Haranaka M, Kawakami K, Takanuma M, Kanzo T, Stefanidis D, Arai Y. Comparison of two biosimilarity studies of FKB327 with the adalimumab reference product: randomized phase 1 studies of single-blind, single-dose subcutaneous injection in healthy Japanese male participants. BMC Pharmacol Toxicol 2022; 23:6. [PMID: 34998419 PMCID: PMC8742919 DOI: 10.1186/s40360-021-00545-3] [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: 03/05/2021] [Accepted: 12/17/2021] [Indexed: 11/20/2022] Open
Abstract
Background FKB327 has been developed as a biosimilar of the adalimumab reference product (RP). We compared the pharmacokinetics (PK), safety, and immunogenicity of FKB327 with those of the adalimumab RP after a single dose by subcutaneous (SC) injection in Japanese male participants. Methods Two randomized, single-blind, single-dose studies were conducted in healthy Japanese male participants to compare PK characteristics between FKB327 and the RP. Study 1 included 130 participants who were randomized in a 1:1 ratio to receive a subcutaneous injection of 40 mg of either FKB327 or the RP into the abdomen. In Study 2, another 130 subjects were randomized in a 1:1 ratio to receive either drug as in Study 1, but the drug administration site was changed to the thigh. The primary PK endpoints of both studies were area under the concentration-time curve from time zero to the last measurable concentration (AUC0-t) and maximum serum concentration; area under the concentration-time curve from time zero to 360 h was also evaluated as one of the primary endpoints in Study 1. Biosimilarity in terms of pharmacokinetics was determined if the 90% confidence interval of the mean difference in geometric mean ratio of all primary PK parameters was within the prespecified equivalence criteria (0.80–1.25). Immunogenicity and safety were also evaluated as secondary endpoints. Results The serum concentration-time profiles were comparable between the FKB327 and the RP treatment groups in both studies. Primary PK parameters were within the prespecified bioequivalence range in Study 2, although AUC0-t was slightly outside the upper side of the range in Study 1. No differences in safety profile were observed in these studies. The incidence of anti-drug antibodies (ADAs) and impact of ADAs on PK profile were similar among the treatment groups in both studies. Conclusion Biosimilarity between FKB327 and the RP after a single 40-mg SC injection was confirmed in healthy Japanese male participants by modifying the study design. Trial registration jRCT2071200058 (https://jrct.niph.go.jp/en-latest-detail/jRCT2071200058, https://rctportal.niph.go.jp/en/detail?trial_id=jRCT2071200058) and jRCT2071200057 (https://jrct.niph.go.jp/en-latest-detail/jRCT2071200057, https://rctportal.niph.go.jp/en/detail?trial_id=jRCT2071200057). Retrospectively registered 25/11/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s40360-021-00545-3.
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Affiliation(s)
| | | | | | | | | | | | | | - Yasumasa Arai
- Fujifilm Kyowa Kirin Biologics Co., Ltd, Tokyo, Japan.
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2
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Yoshihara T, Ito K, Zaitsu M, Chung E, Aoyagi I, Kaji Y, Tsuru T, Yonemura T, Yamaguchi K, Nakayama S, Tanaka Y, Yurino N, Koyanagi H, Matsuki S, Urae R, Irie S. SARS-CoV-2 Seroprevalence among Healthcare Workers in General Hospitals and Clinics in Japan. Int J Environ Res Public Health 2021; 18:3786. [PMID: 33916399 PMCID: PMC8038556 DOI: 10.3390/ijerph18073786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/16/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has become a serious public health problem worldwide. In general, healthcare workers are considered to be at higher risk of COVID-19 infection. However, the prevalence of COVID-19 among healthcare workers in Japan is not well characterized. In this study, we aimed to examine the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies among 2160 healthcare workers in hospitals and clinics that are not designated to treat COVID-19 patients in Japan. The prevalence of SARS-CoV-2 immunoglobulin G was 1.2% in August and October 2020 (during and after the second wave of the pandemic in Japan), which is relatively higher than that in the general population in Japan (0.03-0.91%). Because of the higher risk of COVID-19 infection, healthcare workers should be the top priority for further social support and vaccination against SARS-CoV-2.
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Affiliation(s)
- Tatsuya Yoshihara
- Clinical Research Center, SOUSEIKAI Fukuoka Mirai Hospital, Kashiiteriha 3-5-1, Higashi-ku, Fukuoka 813-0017, Japan;
| | - Kazuya Ito
- SOUSEIKAI Clinical Epidemiological Research Center, Kashiiteriha 3-5-1, Higashi-ku, Fukuoka 813-0017, Japan;
- College of Healthcare Management, Takayanagi 960-4, Setaka-machi, Miyama 835-0018, Japan
| | - Masayoshi Zaitsu
- Department of Public Health, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan;
| | - Eunhee Chung
- SOUSEIKAI Global Clinical Research Center, Kashiiteriha 3-5-1, Higashi-ku, Fukuoka 813-0017, Japan;
| | - Izumi Aoyagi
- Department of Internal Medicine, SOUSEIKAI Fukuoka Mirai Hospital, Kashiiteriha 3-5-1, Higashi-ku, Fukuoka 813-0017, Japan;
| | - Yoshikazu Kaji
- SOUSEIKAI Hakata Clinic, 6-18 Tenyamachi, Hakata-ku, Fukuoka 812-0025, Japan;
| | - Tomomi Tsuru
- SOUSEIKAI PS Clinic, 6-18 Tenyamachi, Hakata-ku, Fukuoka 812-0025, Japan;
| | - Takuma Yonemura
- SOUSEIKAI Sumida Hospital, 1-29-1, Honjo, Sumida-ku, Tokyo 130-0004, Japan;
| | - Koji Yamaguchi
- SOUSEIKAI Nishikumamoto Hospital, 1012 Koga, Tomiaimachi, Minami-ku, Kumamoto 861-4157, Japan;
| | - Shinichi Nakayama
- SOUSEIKAI Miyata Hospital, 1636 Honjo, Miyawaka, Fukuoka 823-0003, Japan;
| | - Yosuke Tanaka
- SOUSEIKAI Kanenokuma Hospital, 3-24-16 Kanenokuma, Hakata-ku, Fukuoka 812-0863, Japan;
| | - Nobuo Yurino
- SOUSEIKAI Shinyoshizuka Hospital, 7-6-29, Yoshizuka, Hakata-ku, Fukuoka 812-0041, Japan;
| | - Hideki Koyanagi
- SOUSEIKAI Dodo Clinic, 1-31-13, Nakaikegami, Ota-ku, Tokyo 146-0081, Japan;
| | - Shunji Matsuki
- Clinical Research Center, SOUSEIKAI Fukuoka Mirai Hospital, Kashiiteriha 3-5-1, Higashi-ku, Fukuoka 813-0017, Japan;
| | - Ryuji Urae
- SOUSEIKAI, 3-5-1 Kashiiteriha, Higashi-ku, Fukuoka 813-0017, Japan; (R.U.); (S.I.)
| | - Shin Irie
- SOUSEIKAI, 3-5-1 Kashiiteriha, Higashi-ku, Fukuoka 813-0017, Japan; (R.U.); (S.I.)
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3
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Alten R, Kellner H, Boyce M, Yonemura T, Ito T, Genovese MC. Systematic analysis of injection-site pain and reactions caused by subcutaneous
administration of the adalimumab biosimilar FKB327 versus the adalimumab reference
product via different delivery methods. GaBI J 2020. [DOI: 10.5639/gabij.2020.0903.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction/Study objectives: FKB327 is a biosimilar of the adalimumab reference
product. Studies in healthy subjects and patients with rheumatoid arthritis demonstrated
biosimilarity between FKB327 and the reference product in safety profile, efficacy and
immunogenicity. FKB327 formulation excipients differ from the citrate-containing
formulation of the reference product, and injection-site pain differences have been
reported. The current analysis examines pooled data to assess the amount of
injection-site pain resulting from injecting FKB327 using a prefilled syringe,
autoinjector, or vial/syringe versus the reference product. Methods: Data from four
studies were pooled to compare injection-site pain upon subcutaneous administration of
FKB327 versus the reference product. Pooled data were analysed to compare FKB327 with
the reference product and to compare the autoinjector, pre-filled syringe and
vial/syringe. Results: Data were analysed from 2007 assessments in 1,001 subjects. A
linear mixed model of the injection-site pain visual analogue scale score across all
studies showed a 12.6-point lower pain score for FKB327 versus the reference product
(95% confidence interval, –14.3 to –10.8; p > 0.001). The autoinjector pain score was
4.4 points lower than the vial/syringe (95% confidence interval, –5.9 to –2.8; p >
0.001) and 1.7 points lower than the pre-filled syringe (95% confidence interval, –3.3
to –0.1; p = 0.035). No statistically significant differences were identified for
gender, age, body weight, needle gauge, or injection site. Conclusion: FKB327 showed
less injection-site pain compared with the reference product. No statistically
significant differences were seen in injection-site reactions or related adverse events
between FKB327 and the reference product or among FKB327 injection methods.
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4
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Inoue M, Yonemura T, de Solom R, Yamaji M, Aizawa M, Knirsch C, Pride MW, Jansen KU, Gruber W, Webber C. A phase 1 randomized study assessing safety and immunogenicity of two 3-dose regimens of a Clostridium difficile vaccine in healthy older Japanese adults. Vaccine 2019; 37:2600-2607. [PMID: 30962095 DOI: 10.1016/j.vaccine.2019.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/07/2019] [Accepted: 03/11/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Clostridium difficile infection (CDI) is a major global cause of nosocomial and community-acquired infections. Despite potentially severe or fatal complications and frequent recurrence, no preventive vaccine is currently available. This randomized, observer-blinded, placebo-controlled phase 1 study in older Japanese adults evaluated safety and immunogenicity of an investigational C difficile vaccine containing a mixture of genetically detoxified and chemically inactivated toxoids, A and B. METHODS Healthy Japanese adults aged 65 to 85 years were randomized in a 3:3:2 ratio to receive 100 or 200 μg of C difficile vaccine or placebo, respectively, at 0, 1, and 6 months (month regimen) or 1, 8, and 30 days (day regimen). The primary objective was safety evaluation. Vaccine immunogenicity, the secondary objective, was determined by assessing toxin A- and toxin B-specific neutralizing antibody levels in human sera. RESULTS Local reactions were reported by up to 33.3% of subjects per dose in the month regimen; percentages were generally higher in the 200-μg group. Such reactions were all mild or moderate in severity and generally transient. No adverse events in the month regimen led to subject withdrawal, and no serious adverse events were considered vaccine related. Further enrollment and dosing in the day regimen were discontinued after 3 subjects in the 100-μg group reported severe redness after dose 2. In the month regimen study arm, immune responses as measured by toxin-neutralizing antibody geometric mean concentrations, geometric mean fold rises, and proportions of subjects achieving prespecified fold rises were generally higher in the 200-μg group, peaked at month 7, and remained elevated at month 12. CONCLUSIONS The C difficile vaccine candidate was safe, well tolerated, and immunogenic when administered to healthy older Japanese adults at 0, 1, and 6 months. Results support continued development of the vaccine for the prevention of CDI. ClinicalTrials.gov identifier: NCT02725437.
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Affiliation(s)
- Megumi Inoue
- SOUSEIKAI PS Clinic, Fukuoka, Japan (former employee).
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5
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Yamada H, Yonemura T, Nemoto T, Ninomiya N, Irie S. Pharmacokinetics of Tenofovir Alafenamide, Tenofovir, and Emtricitabine Following Administration of Coformulated Emtricitabine/Tenofovir Alafenamide in Healthy Japanese Subjects. Clin Pharmacol Drug Dev 2018; 8:511-520. [PMID: 30325567 DOI: 10.1002/cpdd.623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022]
Abstract
A fixed-dose combination of tenofovir alafenamide (TAF) and emtricitabine (FTC) is available in 2 tablet strengths in Japan (FTC/TAF 200/10 mg and FTC/TAF 200/25 mg). These are used once daily in combination with other antiretroviral agents for the treatment of human immunodeficiency virus type 1 infection. The primary objective of this study was to investigate if there is any clinically relevant pharmacokinetic difference for TAF, tenofovir (TFV), and FTC between Japanese and non-Japanese with historical data. Three treatment groups were set in the study; FTC/TAF 200/10 mg in combination with darunavir (DRV) 800 mg + ritonavir (RTV) 100 mg (treatment A) or DRV/cobicistat (COBI) 800/150 mg (treatment B) and FTC/TAF 200/25 mg alone (treatment C). Especially for treatment C, it was designated for another purpose to evaluate the pharmacokinetic boosting effects of RTV and COBI on TAF bioavailability. As a result, the mean exposure of TAF among treatment groups was 125 to 154 ng/mL for Cmax and 119 to 179 ng·h/mL for AUCinf , which were comparable with the historical data in non-Japanese. The exposures of TFV and FTC were also consistent with the historical data. Therefore, no clinically relevant pharmacokinetic differences for TAF, TFV, and FTC were observed between Japanese and non-Japanese. Boosting effects of RTV and COBI on TAF bioavailability were slightly lower than we expected, less than a 2.5-fold increase, but it was within the range of exposures associated with efficacy and safety in phase 3 studies. Therefore, it was not considered clinically relevant.
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Affiliation(s)
- Hiroyuki Yamada
- Clinical Development Department, Pharmaceutical Division, Japan Tobacco Inc., Tokyo, Japan
| | | | - Takanori Nemoto
- Clinical Development Department, Pharmaceutical Division, Japan Tobacco Inc., Tokyo, Japan
| | - Noriko Ninomiya
- Clinical Development Department, Pharmaceutical Division, Japan Tobacco Inc., Tokyo, Japan
| | - Shin Irie
- SOUSEIKAI Sumida Hospital, Tokyo, Japan
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6
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Inoue M, Yonemura T, Baber J, Shoji Y, Aizawa M, Cooper D, Eiden J, Gruber WC, Jansen KU, Anderson AS, Gurtman A. Safety, tolerability, and immunogenicity of a novel 4-antigen Staphylococcus aureus vaccine (SA4Ag) in healthy Japanese adults. Hum Vaccin Immunother 2018; 14:2682-2691. [PMID: 30084709 PMCID: PMC6314418 DOI: 10.1080/21645515.2018.1496764] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/06/2018] [Accepted: 06/22/2018] [Indexed: 11/29/2022] Open
Abstract
A novel Staphylococcus aureus 4-antigen vaccine (SA4Ag) is under development, comprising capsular polysaccharide serotypes 5 and 8 (CP5 and CP8) conjugated to CRM197, recombinant protein clumping factor A (rmClfA), and recombinant manganese transporter protein C (MntC). We evaluated SA4Ag safety, tolerability, and immunogenicity in Japanese adults aged 20 to 64 and 65 to 85 years. A total of 136 healthy Japanese adults (68 per age group) were randomized 1:1 to receive single-dose SA4Ag or placebo intramuscularly (Day 1). Safety assessments included reactogenicity and adverse events. The ability of the vaccine to induce immune responses that are considered functional due to their ability to facilitate the killing of S. aureus or neutralize S. aureus virulence mechanisms was assessed using 5 different antigen-specific assays. SA4Ag was well tolerated in both age groups, with no safety concerns. At Day 29, > 85% of SA4Ag recipients in each age group achieved predefined thresholds for each antigen. Antibody geometric mean-fold rises from baseline to Day 29 in SA4Ag groups were: > 80 and > 30 for CP5 and CP8 (opsonophagocytic activity assay), > 10 for ClfA (fibrinogen-binding inhibition assay), and > 15 and > 7 for ClfA and MntC (competitive Luminex® immunoassay), respectively. Antibody titers decreased through Month 12 but remained well above baseline and placebo levels. SA4Ag had an acceptable safety profile and induced rapid and robust functional immune responses in both age groups. These results support ongoing development of SA4Ag for the prevention of invasive S. aureus disease in elective-surgery patients in Japan, North America, and Europe.
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Affiliation(s)
| | | | - James Baber
- Pfizer Vaccine Research and Development, Sydney, NSW, Australia
| | - Yasuko Shoji
- Pfizer Vaccine Research and Development, Tokyo, Japan
| | | | - David Cooper
- Pfizer Vaccine Research and Development, Pearl River, NY, USA
| | - Joseph Eiden
- Pfizer Vaccine Research and Development, Pearl River, NY, USA
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7
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Yonemura T, Okada N, Sagane K, Okamiya K, Ozaki H, Iida T, Yamada H, Yagura H. Effects of Milk or Apple Juice Ingestion on the Pharmacokinetics of Elvitegravir and Cobicistat in Healthy Japanese Male Volunteers: A Randomized, Single-Dose, Three-Way Crossover Study. Clin Pharmacol Drug Dev 2018; 7:737-743. [DOI: 10.1002/cpdd.425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/15/2017] [Accepted: 11/06/2017] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Hiroki Yagura
- Department of Pharmacy; National Hospital Organization Osaka National Hospital; Osaka Japan
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8
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Kobayashi A, Yonemura T, Kato M, Wakabayashi Y, Sawa H. A structural study on a nano-porous vapochromic Pt complex. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308086558] [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: 11/10/2022] Open
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9
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Abstract
BACKGROUND The growth pattern of early gastric carcinoma, as based on a volumetric analysis, reflects the biologic characteristics of a tumor. The penetrating growth (Pen) type tumor has an unfavorable prognosis, compared with the case of a superficially spreading (Super) type. The wild-type of the p53 protein plays an important role in cell growth regulation and apoptosis. The p21 protein, which is encoded by the WAF1/CIP1 gene, is a downstream target effector of wild-type p53 protein, and these proteins act as tumor suppressors in a negative cell-cycle regulation. METHODS In 133 Japanese patients with early gastric carcinoma with submucosal invasion, expressions of p53 and p21 proteins were studied immunohistochemically, and the relation between growth pattern and expressions was analyzed. RESULTS Early gastric carcinomas were grouped into the superficially spreading (Super) type 40 (30.1%) cases, expansively penetrating growth (Pen-A) type 28 (21.1%), infiltratively penetrating growth (Pen-B) type 20 (15.0%), small mucosal type 35 (26.3%), and mixed type 10 (7.5%). The Pen-A type tumors were characterized by the highest incidence of p53 expression and loss of p21 expression, and the rate of p53-positive and/or p21-negative cases was 71.4%. There were significant differences in the incidence of the p53 expression (50.0% vs.25.0%), the loss of p21 expression (53.6% vs. 27.5%), and the 5-year survival rate (83.2 %vs. 97.2%) between the Pen-A type and the Super type. CONCLUSIONS Thus, deregulation of the cell cycle by p53 and p21 in this study was shown to play an important role in progression of Pen-A type early gastric carcinoma.
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Affiliation(s)
- H Noda
- Department of Surgery, Saga Prefectural Hospital Koseikan, Saga, Japan
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10
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Tadamura E, Yoshibayashi M, Yonemura T, Kudoh T, Kubo S, Motooka M, Nohara R, Matsumori A, Sasayama S, Matsuda T, Tamaki N, Konishi J. Significant regional heterogeneity of coronary flow reserve in paediatric hypertrophic cardiomyopathy. Eur J Nucl Med 2000; 27:1340-8. [PMID: 11007516 DOI: 10.1007/s002590000300] [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: 10/27/2022]
Abstract
Previous studies have indicated that cardiac events in young patients with hypertrophic cardiomyopathy (HCM) are related to ischaemia rather than to arrhythmia. We measured coronary flow reserve in paediatric HCM and compared the values with those in adult HCM. We studied 12 patients with HCM including six paediatric (<20 years old; mean 13 years) and six adult patients (>20 years old: mean 62 years), and six healthy young adults (mean 29 years) as controls. Every patient underwent magnetic resonance imaging (MRI) for anatomical assessment. Myocardial blood flow at rest and after dipyridamole infusion was measured with dynamic nitrogen-13 ammonia positron emission tomography (PET). Partial volume effect was corrected for using the anatomical data obtained with MRI. In adult patients with HCM, coronary flow reserve in the hypertrophied septal region was not significantly different from that in the non-hypertrophied lateral wall (1.38+/-0.29 vs 1.77+/-0.39, respectively). In the paediatric patients, coronary flow reserve in the hypertrophied septal region was significantly lower than in the non-hypertrophied lateral wall (0.84+/-0.33 vs 2.74+/-0.90, respectively, P<0.01). In addition, coronary flow reserve in adult patients was lower than in control subjects both in the septal wall (1.38+/-0.29 vs 2.94+/-0.35, respectively, P<0.0001) and in the lateral wall (1.77+/-0.39 vs 2.85+/-0.69, respectively, P<0.05). In contrast, coronary flow reserve in paediatric patients was not significantly different from that in control subjects in the lateral wall (2.74+/-0.90 vs 2.85+/-0.69, respectively), while absolute reduction of myocardial blood flow was noted after pharmacological vasodilatation in the hypertrophied septal region. In conclusion, significant regional differences of coronary flow reserve were present in the paediatric patients with HCM. These results suggest that paediatric patients with HCM intrinsically have the potential to experience significant regional ischaemia even in the absence of coronary stenosis.
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Affiliation(s)
- E Tadamura
- Department of Nuclear Medicine, Kyoto University Graduate School of Medicine, Japan
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Abstract
Tacrolimus has been used as an immunosuppressive agent in the transplantation of all solid organs. Tacrolimus-induced hypertrophic cardiomyopathy has been reported to be an unusual but serious complication. To elucidate the effects of tacrolimus on myocardial hypertrophy, we studied the relationship between the blood levels of tacrolimus and cardiac wall thickening. Our findings demonstrated that tacrolimus-induced myocardial hypertrophy correlated with tacrolimus blood levels, and that myocardial hypertrophy induced by tacrolimus was reversible. However, no patients developed clinically significant symptoms related to myocardial hypertrophy.
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Affiliation(s)
- Y Nakata
- Department of Pediatrics, Kyoto University Faculty of Medicine, Kurashiki Central Hospital, Okayama, Japan
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12
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Yonemura T, Yoshibayashi M, Uemoto S, Inomata Y, Tanaka K, Furusho K. Intrapulmonary shunting in biliary atresia before and after living-related liver transplantation. Br J Surg 1999; 86:1139-43. [PMID: 10504366 DOI: 10.1046/j.1365-2168.1999.01207.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intrapulmonary shunting (IPS) is frequently observed and causes hypoxaemia in liver cirrhosis. This study investigated the prevalence, predictors of reversibility and the effect of living-related liver transplantation (LRLT) on IPS using contrast echocardiography in patients with end-stage biliary atresia. METHODS Fifty consecutive patients with biliary atresia were examined for IPS using contrast echocardiography before and after LRLT until IPS disappeared. The severity of IPS was classified into five grades according to the extent of contrast in the left ventricle (0, none; 1, trivial; 2, apparent; 3, complete but less than in right ventricle; 4, as dense as in right ventricle). RESULTS Thirty-two patients (grade 1, n = 15; grade 2, n = 7; grade 3, n = 4; grade 4, n = 6) had IPS before LRLT. Forty-four patients have survived for 9-26 months after LRLT. Among patients with grade 3 or 4 IPS (n = 8), there was a significant correlation between age at LRLT and the duration of IPS persistence after LRLT (P = 0.044). CONCLUSION IPS takes longer to disappear in older children than in younger ones, but always disappears eventually. LRLT is an effective treatment for biliary atresia with IPS. Presented to the 31st annual meeting of the Pacific Association of Pediatric Surgeons, Maui, Hawaii, June 1998
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Affiliation(s)
- T Yonemura
- Department of Paediatrics, Faculty of Medicine, Kyoto University, Japan
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13
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Egawa H, Kasahara M, Inomata Y, Uemoto S, Asonuma K, Fujita S, Kiuchi T, Hayashi M, Yonemura T, Yoshibayashi M, Adachi Y, Shapiro JA, Tanaka K. Long-term outcome of living related liver transplantation for patients with intrapulmonary shunting and strategy for complications. Transplantation 1999; 67:712-7. [PMID: 10096527 DOI: 10.1097/00007890-199903150-00012] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.3] [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: 11/26/2022]
Abstract
BACKGROUND In 320 living related liver transplantation performed between June 1990 and September 1997, there were 21 living related liver transplantation for patients with intrapulmonary shunting, manifested by digital clubbing, cyanosis, and dyspnea. We report the long-term outcome for more 6 months and our strategy to overcome complications in these recipients. PATIENTS A total of 21 patients (age range 2-33 years, 19 children and 2 adults, 6 males and 15 females) were classified into three grades according to shunt ratio calculated by TcMAA pulmonary scintigraphy; 5 in mild group (shunt ratio: less than 20%), 6 in moderated group (20%-40%), and 10 in severe group (more than 40%). The original underlying liver disease was biliary atresia in all patients. RESULTS Spearmen's correlation coefficient rank test revealed that shunt ratio correlated significantly with PaO2 in room air (P=0.0001), PaO2 in 100% oxygen (P=0.0004), hematocrit (P=0.0276), and period of dyspnea before transplantation (P=0.023). COMPLICATIONS Wound infection occurred in 80, 66, and 80%, and bile leakage in 20, 0, 40% in mild, moderate, and severe group, respectively. Patients who had portal vein thrombosis, and intracranial complication were classified as severe group and the incidence was 20 and 20%, respectively. The patient actuarial one year survival was 80, 66.7, and 48%, in mild, moderate, and severe group, respectively, although there was no significant difference. All patients who survived improved hepatopulmonary syndrome and the length of period required for the resolution was significantly correlated to the preoperative shunt ratio (P=0.023). COMMENTS Patients with severe shunting are susceptible to wound infection and bile leak. The trend of higher incidence of portal thrombosis and intracranial complications in the severe group was closely related high hematocrit. Secure surgical technique to reduce bile leak and delayed primary wound closure to reduce wound infection were found to be effective. Anticoagulant therapy by infusing heparin through the portal vein followed by coumadin could prevent fatal portal vein thrombosis without counter risk of fatal cerebral hemorrhage.
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Affiliation(s)
- H Egawa
- Department of Transplant Surgery, Faculty of Medicine, Kyoto University, Japan
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Yonemura T, Yasui T, Okamoto KI, Hidaka J. trans(S)-(S-Methyl-D-penicillaminato)(D-penicillaminesulfinato)cobalt(III) Monohydrate. Acta Crystallogr C 1996. [DOI: 10.1107/s0108270195015605] [Citation(s) in RCA: 2] [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: 11/10/2022] Open
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15
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Sakuragi T, Furukawa T, Yonemura T, Yoshida T, Irie K. [Thymoma associated with progressive systemic sclerosis--a case report]. Nihon Kyobu Geka Gakkai Zasshi 1995; 43:135-8. [PMID: 7884254] [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: 01/27/2023]
Abstract
A 59-year-old man was admitted to hospital with sclerodactyly and high grade fever. He complained of wrist joint pain and swelling of bilateral hands. Despite of administration of non steroid anti-inflammatory drug and steroid the symptoms were progressive and sclerodactyly spreaded to the forearm. Through the results of the laboratory examination, he was diagnosed as progressive systemic sclerosis (PSS). Chest CT scan showed an anterior mediastinal tumor, and histological examination revealed a spindle cell type thymoma with mild lymphocytic infiltration. During hospitalization, the pulse therapy of steroid was administrated. Progressive sclerodactyly and interstitial pneumonia were improved, but stiffness of hand and joint pain was not diminished. In expectation of improvement of the symptoms, mediastinal tumor was removed. Histological diagnosis was thymoma of epitherial type. After surgery, symptoms decreased and at last diminished, dosage of steroid could be tapered.
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Affiliation(s)
- T Sakuragi
- Department of Surgery, Saga Prefectural Hospital, Japan
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16
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Norita H, Ohteki H, Yoshitake K, Hisanou R, Todaka K, Yamada M, Yonemura T, Furukawa T, Ijima H. [Simultaneous operation of gastrectomy, cholecystectomy and coronary artery bypass grafting using right gastroepiploic artery]. Kyobu Geka 1993; 46:727-30. [PMID: 8371541] [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: 01/30/2023]
Abstract
We present a case who received the simultaneous surgical corrections of unstable angina, acute gastric ulcer, and cholelithiasis. A 72-year-old man was admitted to our hospital due to unstable angina. An emergency coronary angiography was performed and we found severe 2 vessels disease (RCA ostium and proximal LAD lesions). After the admission, the angina was poorly controlled and the surgical treatment had been considered. The patient developed sudden hematemesis due to the uncontrolled bleeding from gastric ulcer. Then the emergency operation was performed. Partial gastrectomy with preservation of RGEA and cholecystectomy were done followed by CABG to RCA with RGEA and to LAD with autologous saphenous vein. The postoperative course was uneventful and the patient is in good condition to date.
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Affiliation(s)
- H Norita
- Department of Cardiovascular Surgery, Saga Prefectural Hospital Kohseikan, Saga, Japan
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17
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Abstract
We examined the oxidative burst (hydrogen peroxide-dependent oxidative product formation) of polymorphonuclear leukocytes (PMNL) in the peripheral blood from the patients with various types of periodontal diseases including localized juvenile (LJP), generalized juvenile (GJP) and adult periodontitis (AP). Heparinized peripheral blood was obtained from 15 LJP, 13 GJP and 52 AP patients and from 30 healthy control subjects. The oxidative product (2',7'-dichlorofluorescein; DCF) formation of PMNL by stimulation with phorbol myristate acetate myristate acetate was evaluated by a rapid quantitative assay using flow cytometry. The results indicated that all patient groups contained variable populations with normal or increased DCF formation, while the control subjects exhibited DCF formation as a single population. No significant differences in average DCF formation were found among the three patient groups. Although individual patients gave various values, the average DCF formation of the three patient groups was much higher than that of the control group. Statistical analysis revealed a significant positive correlation between DCF formation and the clinical periodontal parameters on an individual basis. Furthermore, after initial periodontal treatment, DCF formation decreased to normal levels. These results suggest that the capacity of peripheral blood PMNL to mount oxidative burst reactions might reflect the inflammatory status of periodontal disease.
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Affiliation(s)
- S Kimura
- Department of Periodontics, Fukuoka Dental College, Japan
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18
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Kimura S, Yonemura T, Hiraga T, Okada H. Flow cytometric evaluation of phagocytosis by peripheral blood polymorphonuclear leucocytes in human periodontal diseases. Arch Oral Biol 1992; 37:495-501. [PMID: 1637264 DOI: 10.1016/0003-9969(92)90106-i] [Citation(s) in RCA: 18] [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: 12/28/2022]
Abstract
The complement-dependent phagocytic functions of polymorphonuclear leucocytes (PMNL) in peripheral blood from 15 patients with localized juvenile periodontitis (LJP), 13 with generalized juvenile periodontitis (GJP) and 52 with adult periodontitis (AP), and from 30 normal subjects as controls were measured by flow cytometry. Heparinized blood was collected and incubated with fluorescent microspheres, and erythrocytes were removed. By means of single-cell analysis the percentage of phagocytosing cells (% phagocytosis) and the mean number of microspheres phagocytosed by one PMNL (degree of phagocytosis; d-phagocytosis) were measured. Some but not all patients with LJP (53%) and GJP (46%) showed consistently low % phagocytosis and d-phagocytosis. On the other hand, only 6% of AP patients and no healthy subjects showed a reduction of PMNL phagocytosis. Phagocytosis was unchanged after initial periodontal treatment in all subjects, suggesting the depression of PMNL phagocytosis may not be a transient phenomenon associated with periodontal status. Furthermore, PMNLs from the LJP patients that showed depressed phagocytic function exhibited depressed phagocytic responses with either autologous or normal plasma, while control PMNLs with either normal or the patients' plasma showed normal responses. These results suggested that the depressed phagocytic responses in LJP patients could be due to cell-associated defect(s) on the PMNL.
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Affiliation(s)
- S Kimura
- Department of Periodontology and Endodontology, Osaka University Faculty of Dentistry, Japan
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19
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Kawami H, Shiramizu T, Mori Y, Yayama T, Yonemura T, Oka N, Inokuchi K. [A clinical case of ABO-incompatible living renal transplantation]. Nihon Geka Gakkai Zasshi 1990; 91:1044-7. [PMID: 2233659] [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: 12/30/2022]
Abstract
We successfully made ABO-incompatible renal transplantation, of which report is methodologically the first in Japan and probably the second in the world to our knowledge. Sixty year-old-female (mother) with B-blood type donated her right kidney to 36 years-old male (son) with O-blood type. Pretransplant removal of plasma isoagglutinin of the recipient through plasma exchange with albumin solution followed by hemodialysis with administration of fresh frozen B-type plasma effectively reduced the anti-BIgM-antibody titre of x256 to x8 and the anti-IgG-antibody titre of x512 to x16. Splenectomy was performed at the time of transplantation. On the 10th POD, the anti-B antibody titres were more decreased to IgM antibody x2 and IgG antibody x8. Patient is doing well without any sign of rejection as of 4 months postoperatively.
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Affiliation(s)
- H Kawami
- Department of Surgery, Saga Prefectural Hospital, Japan
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20
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Yonemura T. [Phagocytosis, intracellular killing and interleukin 1 production of polymorphonuclear leukocytes in human periodontal diseases]. Nihon Shishubyo Gakkai Kaishi 1989; 31:403-23. [PMID: 2637296 DOI: 10.2329/perio.31.403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The role of the polymorphonuclear leukocyte (PMNL) as a primary protective cell in periodontal diseases has been well recognized. Functional abnormalities of PMNL chemotaxis have been implicated in the pathogenesis of some types of periodontitis. However, no consistent correlation with other PMNL functions has been reported. In the present study, phagocytosis and intracellular killing (oxidative product formation) of the PMNL from the patients with various forms of periodontal disease were evaluated by flow cytometry. Moreover, interleukin 1 (IL-1) production by the PMNL was determined by means of the enzyme-linked immunosorbent assay (ELISA) with monoclonal antibodies against rIL-1 alpha and rIL-1 beta. In order to examine these functions of peripheral (p-PMNL) and/or gingival crevicular PMNL (g-PMNL), 15 patients with localized juvenile periodontitis (LJP), 13 patients with generalized juvenile periodontitis (GJP) and 52 patients with adult periodontitis (AP) served as subjects. About 50% of the patients in LJP and GJP group exhibited depressed p-PMNL phagocytosis. While only a minimal number of the AP patients and no healthy subjects showed any reduction of p-PMNL phagocytosis. The reduction of phagocytosis was not related to the clinical periodontal status, and no detectable improvement of p-PMNL phagocytosis could be observed after periodontal therapy. In addition, it was suggested that complement receptors on the p-PMNL might be closely related with the reduction. Compared to p-PMNL, g-PMNL from the same individual have a lower phagocytic capacity in all subjects. However, no significant difference in g-PMNL phagocytosis could be demonstrated among three patient groups. Incremental oxidative responses in p-PMNL were observed in LJP, GJP and AP patients without any significant difference being found among these three groups. The increased rate of oxidative product formation was related to the clinical periodontal status, and it followed that periodontal therapy had significant effect on the improvement of this p-PMNL function. In IL-1 production assay of PMNL, a significant amount of IL-1, especially IL-1 beta, was observed in g-PMNL, but not in p-PMNL. The g-PMNL of the patients was found to produce greater amounts of IL-1 alpha and IL-1 beta than did the healthy controls. In addition, IL-1 production of p-PMNL was induced by the stimulation with some pathogenic bacteria including Bacteroides gingivalis. These results suggest that impaired PMNL phagocytosis may contribute to the early onset of periodontal deterioration in some young patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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Kano T, Koga T, Souda K, Abe Y, Yonemura T, Oka N, Inokuchi K. The usefulness of CEA as an indicator for early detection and a guide to the treatment of recurrent gastric cancer. Jpn J Surg 1987; 17:269-75. [PMID: 3682435 DOI: 10.1007/bf02470699] [Citation(s) in RCA: 7] [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: 01/06/2023]
Abstract
The usefulness of carcinoembryonic antigen (CEA) as an indicator for recurrence and a guide to the treatment was evaluated from a retrospective analysis of 88 patients with recurrent gastric cancer. Sixty-two of these patients (70.5 per cent), 25 of whom had a preoperative positive assay, and 37 a negative assay, had elevated levels of CEA after disease progression. Averaged CEA level in patients with liver metastasis was significantly higher (872 ng/ml) than in those with peritoneal metastasis (68 ng/ml), with lymph node metastasis (103 ng/ml) or with local metastasis (93 ng/ml) (p less than 0.01). An elevation of CEA was found prior to the clinical manifestation of recurrence, and the average lead time was 4 months. In 25 patients with a lead time of more than 4 months, survival time after CEA elevation was 13.3 months, which was longer than the 6.5 months of 28 patients with less than 4 months. Thirty-seven of the 88 patients were treated after recurrence. The average survival period after the detection of recurrence was 9.4 months in patients with surgical treatments followed by chemotherapy, 5.9 months in those with chemotherapy alone and 3.8 months in those with surgery alone. The average survival period of 26 patients with positive CEA assays in recurrence was 5.1 months longer than of patients with negative assays. This fact suggested that early detection of recurrence followed by various treatments, in the elevated CEA group, contributes to favorable results.
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Affiliation(s)
- T Kano
- Department of Surgery, Saga Prefectural Hospital, Japan
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22
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Fukuhara H, Morita K, Yumitate J, Yonemura T, Ebisu S, Okada H. [Marginal periodontitis in outpatients and their etiologic factors]. Nihon Shishubyo Gakkai Kaishi 1987; 29:211-21. [PMID: 3506012 DOI: 10.2329/perio.29.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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23
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Toi M, Shiramizu T, Yonemura T, Ezaki T, Oka N, Yoshida T, Tsurumaru H. [Intraperitoneal cisplatin in peritoneal carcinomatosis patients]. Gan No Rinsho 1985; 31:522-6. [PMID: 4040582] [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: 01/08/2023]
Abstract
Cisplatin (100 mg) was given by intraperitoneal infusion to 23 patients with peritoneal carcinomatosis. Eighteen patients had gastric cancer, and five had colorectal cancer. The effects of this therapy were as follows. 1) In gastric cancer patients, the mean survival period was 11.0 months. The cumulative survival rate was superior at the level of statistical significance in comparison with controls. 2) The side effects of this agent given intraperitoneally were mild. In particular, nausea was slightly less than with intravesicular or intraarterial infusion.
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24
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Shiramizu T, Yoshida T, Yonemura T, Oka N, Ezaki T, Kodama H, Miyamoto Y, Kamoi I, Tsurumaru H. [Clinical study of cis-platinum in the chemotherapy for malignant gastrointestinal disease: arterial infusion and intraperitoneal administration]. Gan No Rinsho 1984; 30:1261-7. [PMID: 6541260] [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: 04/05/2023]
Abstract
We studied the antitumor effects and the side effects of CDDP in the main cancer chemotherapy for gastrointestinal cancer. CDDP (100mg) was administered through the hepatic artery, systemic vein and peritoneal cavity. The administration period was four weeks. In the cases of the hepatic arterial infusion, the size of metastatic liver tumors and CEA level decreased markedly. In those of the intraperitoneal administration, ascites decreased and performance status was well maintained. There was no bone marrow depression or nephropathy. Nausea and vomiting were the main side effects, being associated with 29 administrations (52%). Acute intrahepatic biliary stasis was found in the case of hepatic arterial administration of 300mg of CDDP.
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Shimbayashi K, Yonemura T, Deguchi N, Nakanishi M. Effect of caprylohydroxamic acid on rumen content of sheep and intestinal content of rat. Nihon Juigaku Zasshi 1973; 35:425-31. [PMID: 4800057 DOI: 10.1292/jvms1939.35.425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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26
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Shimbayashi K, Obara Y, Yonemura T, Deguchi N, Nakanishi M. Effect of caprylohydroxamic acid on ruminal urease. Nihon Juigaku Zasshi 1973; 35:327-34. [PMID: 4797147 DOI: 10.1292/jvms1939.35.327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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27
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Yonemura T. [Experience of a parent of a child with progressive muscular dystrophy]. Kango Gijutsu 1971; 17:82-3. [PMID: 5205330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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28
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Shimada N, Nakamura S, Hangai S, Yonemura T, Yamazato M. [2 cases of extravesical opening of the ureter]. Geka Chiryo 1967; 16:479-84. [PMID: 6072836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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29
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Ide Y, Shimbayashi K, Yonemura T. Effect of dietary conditions upon serum-and milk-urea nitrogen in cows. II. Effect of low energy diets. Nihon Juigaku Zasshi 1967; 29:33-9. [PMID: 5624098 DOI: 10.1292/jvms1939.29.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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30
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Ide Y, Shimbayashi K, Yonemura T. Effect of dietary conditions upon serum- and milk-urea nitrogen in cows. I. Serum- and milk-urea nitrogen as affected by protein intake. Nihon Juigaku Zasshi 1966; 28:321-7. [PMID: 6010002 DOI: 10.1292/jvms1939.28.321] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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31
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Shimbayashi K, Yonemura T. Influence of nutritional alteration on the plasma amino acids of the milking cow. I. Low protein diets associated with imbalance of inorganic substances. Natl Inst Anim Health Q (Tokyo) 1965; 5:202-212. [PMID: 5895824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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