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Yasui H, Okita Y, Nakamura M, Sagawa T, Watanabe T, Kataoka K, Manaka D, Shiraishi K, Akazawa N, Okuno T, Shimura T, Shiozawa M, Sunakawa Y, Ota H, Kotaka M, Okuyama H, Takeuchi M, Ichikawa W, Fujii M, Tsuji A. Ramucirumab plus FOLFIRI as second-line treatment for patients with RAS wild-type metastatic colorectal cancer previously treated with anti-EGFR antibody: JACCRO CC-16. ESMO Open 2023; 8:101636. [PMID: 37703596 PMCID: PMC10594013 DOI: 10.1016/j.esmoop.2023.101636] [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: 04/14/2023] [Revised: 07/28/2023] [Accepted: 08/09/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Chemotherapy in combination with anti-epidermal growth factor receptor (EGFR) antibody is considered a first-line treatment regimen for RAS wild-type and left-sided metastatic colorectal cancer (mCRC), whereas second-line treatment regimens have not yet been established. Few studies have prospectively evaluated second-line treatment with anti-vascular endothelial growth factor antibody after first-line anti-EGFR antibody therapy for RAS wild-type mCRC. PATIENTS AND METHODS This non-randomized phase II trial investigated the clinical outcomes of second-line ramucirumab (RAM) plus fluorouracil, levofolinate, and irinotecan (FOLFIRI) after first-line anti-EGFR antibody in combination with doublet or triplet regimen in patients with RAS wild-type mCRC. The primary endpoint was the 6-month progression-free survival (PFS) rate. The secondary endpoints were PFS, overall survival (OS), objective response rate (ORR), rate of early tumor shrinkage (ETS), and safety. We hypothesized a threshold 6-month PFS rate of 30% and an expected 6-month PFS rate of 45%. Treatment was considered effective if the lower limit of the 90% confidence interval (CI) of the 6-month PFS rate was >0.30. RESULTS Ninety-two patients were enrolled in the study. The primary tumor was located on the left side in 86 (95.6%) patients. Twenty (22.0%) patients had received triplet plus cetuximab as previous therapy. Six-month PFS rate was 58.2% (90% CI 49.3% to 66.2%) with a median PFS of 7.0 months (95% CI 5.7-7.6 months). Median OS was 23.6 months (95% CI 16.5-26.3 months). The ORR and ETS rate were 10.7% and 16.9%, respectively, in 83 patients with measurable lesions. The 6-month PFS rate was comparable between patients previously treated with doublet and triplet regimens; however, median PFS was longer for the doublet regimen (7.4 versus 6.4 months, P = 0.036). CONCLUSIONS Our study demonstrated prospectively that RAM plus FOLFIRI is an effective second-line treatment after anti-EGFR antibody-containing first-line therapy in RAS wild-type and left-sided mCRC. Furthermore, the results were similar for patients who were previously treated with triplet regimen.
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Affiliation(s)
- H Yasui
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe
| | - Y Okita
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Kita-gun
| | - M Nakamura
- Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto
| | - T Sagawa
- Department of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, Sapporo
| | - T Watanabe
- Department of Surgery, Japanese Red Cross Society Himeji Hospital, Himeji
| | - K Kataoka
- Division of Lower GI, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya
| | - D Manaka
- Department of Surgery, Gastro-Intestinal Center, Kyoto Katsura Hospital, Kyoto
| | - K Shiraishi
- Department of Medical Oncology, National Hospital Organization Nagoya Medical Center, Nagoya
| | - N Akazawa
- Department of Gastroenterological Surgery, Sendai City Medical Center Sendai Open Hospital, Sendai
| | - T Okuno
- Department of Medical Oncology, Osaka Rosai Hospital, Sakai
| | - T Shimura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - M Shiozawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama
| | - Y Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - H Ota
- Department of Gastroenterological Surgery, Ikeda City Hospital, Ikeda
| | - M Kotaka
- Gastrointestinal Cancer Center, Sano Hospital, Kobe
| | - H Okuyama
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Kita-gun
| | - M Takeuchi
- Graduate School of Mathematical Sciences, The University of Tokyo, Meguro-ku
| | - W Ichikawa
- Division of Medical Oncology, Showa University Fujigaoka Hospital, Yokohama
| | - M Fujii
- Department of Digestive Surgery, Nihon University School of Medicine, Itabashi-ku, Japan
| | - A Tsuji
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Kita-gun.
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Kogiso T, Sagawa T, Taniai M, Shimada E, Inai K, Shinohara T, Tokushige K. Risk factors for Fontan-associated hepatocellular carcinoma. PLoS One 2022; 17:e0270230. [PMID: 35714161 PMCID: PMC9205474 DOI: 10.1371/journal.pone.0270230] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Aims The incidence of hepatocellular carcinoma (HCC) in patients with Fontan-associated liver disease (i.e., FALD-HCC) has increased over time. However, the risk factors for HCC development remain unclear. Here, we compared the levels of non-invasive markers to the survival rate of FALD-HCC patients. Methods From 2003 to 2021, 154 patients (66 men, 42.9%) developed liver disease after undergoing Fontan procedures. HCC was diagnosed in 15 (9.7%) (8 men, 53.3%) at a median age of 34 years (range, 21–45 years). We compared FALD-HCC and non-HCC cases; we generated marker level cutoffs using receiver operating characteristic curves. We sought to identify risk factors for HCC and mortality. Results The incidence of HCC was 4.9% in FALD patients within 20 years after the Fontan procedure. Compared with non-HCC patients, FALD-HCC patients exhibited higher incidences of polysplenia and esophageal varices. At the time of HCC development, the hyaluronic acid (HA) level (p = 0.04) and the fibrosis-4 index (p = 0.02) were significantly higher in FALD-HCC patients than in non-HCC patients; the total bilirubin (T-BIL) level (p = 0.07) and the model for end-stage liver disease score [excluding the international normalized ratio (MELD-XI)] (p = 0.06) tended to be higher in FALD-HCC patients. Within approximately 20 years of the Fontan procedure, 10 patients died (survival rate, 96.9%). Kaplan–Meier curve analysis indicated that patients with T-BIL levels ≥ 2.2 mg/dL, HA levels ≥ 55.5 ng/mL, and MELD-XI scores ≥ 18.7 were at high risk of HCC, a generally poor prognosis, and both polysplenia and esophageal varices. Multivariate Cox regression analyses indicated that the complication of polysplenia [Hazard ratio (HR): 10.915] and a higher MELD-XI score (HR: 1.148, both p < 0.01) were independent risk factors for FALD-HCC. Conclusions The complication of polysplenia and a MELD-XI score may predict HCC development and mortality in FALD patients.
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Affiliation(s)
- Tomomi Kogiso
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
- * E-mail:
| | - Takaomi Sagawa
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
| | - Makiko Taniai
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
| | - Eriko Shimada
- Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kei Inai
- Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
| | - Tokuko Shinohara
- Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
| | - Katsutoshi Tokushige
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
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Abstract
Hepatic hemangiomas are benign liver tumors, and most of them progress asymptomatically. We report a case of hepatic hemangioma considered the cause of fever. A 53-year-old woman had a fever of 40°C for about 3 months without infection. Hepatic hemangiomas with internal bleeding of 10 cm in size on liver S8/7 and S3/2 were observed. These were resected laparoscopically for diagnostic treatment. She was afebrile after the operation. The pathological diagnosis was hematoma inside cavernous hemangioma. It should be noted that a bleeding hepatic hemangioma may cause fever of unknown origin and be indicated for resection.
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Affiliation(s)
- Chihiro Yoshimizu
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Shunichi Ariizumi
- Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
| | - Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Goro Honda
- Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
| | - Hiroto Egawa
- Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
| | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
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Kogiso T, Sagawa T, Kodama K, Taniai M, Hashimoto E, Tokushige K. Outcomes of Japanese patients with non-alcoholic fatty liver disease according to genetic background and lifestyle-related diseases. Ann Hepatol 2021; 21:100260. [PMID: 32987175 DOI: 10.1016/j.aohep.2020.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/11/2020] [Accepted: 09/11/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Genetic background may be involved in the mechanisms of liver injury and the development of non-alcoholic fatty liver disease (NAFLD). However, its contributions to the long-term outcome of NAFLD have been unclear. METHODS We enrolled 314 Japanese patients with biopsy-confirmed NAFLD from 2000 to 2018 (161 men [51.3%]; median age, 53 [14-84] years; 114 with advanced fibrosis [37.5%]) in the patients without hepatocellular carcinoma at diagnosis. Genomic DNA was extracted from peripheral blood and single nucleotide polymorphisms (SNPs) were analyzed. Associations of mortality with patatin-like phospholipase 3 (PNPLA3) and aldehyde dehydrogenase 2 (ALDH2) were analyzed. Finally, a subgroup analysis according to lifestyle-related disease was performed. RESULTS During the median 7 years of follow-up, 20 patients (6.4%) died (13 liver-related [4.1%] and 7 non-liver-related deaths [2.2%]). Patients with ALDH2 (non-GG genotype) who had reduced alcohol metabolism tended to have a poor prognosis (p = 0.06). Patients carrying both risk SNPs of PNPLA3 (GG) and ALDH2 (non-GG) had a significantly poor prognosis (p = 0.01). In the subgroup analysis, patients with PNPLA3 (GG) who were non-diabetics (p = 0.06) or non-dyslipidemic (p = 0.03), with ALDH2 (non-GG) who were non-dyslipidemic (p = 0.01) or hypertensive (p = 0.03), also had a poor prognosis. The Cox analysis revealed that ALDH2 (non-GG) was associated with a poor prognosis (Hazard ratio: 4.568, 95% Confidence Interval: 1.294-16.131, p = 0.02) similar to the liver function tests. CONCLUSIONS Genetic background may affect NAFLD prognosis and ALDH2 SNP could predict the outcome.
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Affiliation(s)
- Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Kazuhisa Kodama
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Etsuko Hashimoto
- Seibu Railway Health Support Center, 1-11-2 Seibu Second Building 7th Floor, Kusunoki-dai, Tokorozawa-shi, Saitama, 359-0037, Japan
| | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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Kogiso T, Ogasawara Y, Sagawa T, Taniai M, Tokushige K. Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan. JGH Open 2021; 5:1298-1305. [PMID: 34816016 PMCID: PMC8593781 DOI: 10.1002/jgh3.12672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/07/2021] [Accepted: 10/16/2021] [Indexed: 11/28/2022]
Abstract
Background and Aim Acute kidney injury (AKI) is a life‐threatening complication of liver cirrhosis. Here, we evaluated the risk factors and characteristics of AKI in cirrhosis. Patients/Methods This was a single‐center retrospective study. A total of 199 Japanese patients with decompensated liver cirrhosis (104 men, median age 61 years) were enrolled and received tolvaptan orally. Survival rates and new onset of AKI were monitored, and risk factors were evaluated. Results Forty‐six patients (23.1%) suffered an AKI complication and exhibited significantly poorer survival (P < 0.01). The rates of hepatic encephalopathy (P < 0.01) and chronic kidney disease (CKD; P = 0.02) were significantly increased in patients with AKI. The rate of proton pump inhibitor (PPI)/H2 blocker treatment (P = 0.04) was significantly lower, whereas that of ascites drainage was significantly higher in the AKI cases (P < 0.01). The AKI risk was significantly increased in patients with hepatic encephalopathy (HR 4.18, 95% CI 1.618–10.771). In contrast, the incidence of AKI was significantly lower in patients with a higher serum albumin level (HR 0.36, 95% CI 0.142–0.914, P = 0.03). Treatment with PPI/H2 blockers (HR 0.30, 95% CI 0.126–0.711, P < 0.01) or kanamycin/rifaximin (HR 0.26, 95% CI 0.075–0.929, P = 0.04) was significantly associated with a reduced risk of AKI development. Conclusions AKI incidence was increased in patients with decreased liver function and was associated with poor survival. PPI/H2 blocker or kanamycin/rifaximin treatment may reduce the risk of AKI.
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Affiliation(s)
- Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University Shinjuku‐ku Tokyo Japan
| | - Yuri Ogasawara
- Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University Shinjuku‐ku Tokyo Japan
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University Shinjuku‐ku Tokyo Japan
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University Shinjuku‐ku Tokyo Japan
| | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University Shinjuku‐ku Tokyo Japan
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Arai S, Kogiso T, Ogasawara Y, Sagawa T, Taniai M, Tokushige K. Long-term outcome of Wilson's disease complicated by liver disease. JGH Open 2021; 5:793-800. [PMID: 34263074 PMCID: PMC8264237 DOI: 10.1002/jgh3.12589] [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] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 11/22/2022]
Abstract
Background and Aim Wilson's disease (WD) is a rare inherited disease that causes systemic copper accumulation. This study examined the long‐term course of WD patients with liver disease. Methods The 12 patients (9 female patients) enrolled in the study had a median age of 28 years (range: 19–57 years) at their first visit to our hospital. Clinical course and fibrosis markers were assessed in all patients. Results The median age at diagnosis was 24 years (range: 5–42 years). One patient had acute liver failure (ALF) and 11 patients had chronic liver disease (CLD, 5 with cirrhosis). The patients were followed‐up for >20 years. The patient with ALF underwent liver transplantation; the postoperative course during the subsequent 20 years was good. Of the six patients with CLD, liver cirrhosis developed in four patients with interrupted chelating therapy. Two of the patients with cirrhosis died; one of these two patients died at 21 years after liver transplantation. However, the remaining patients with continued treatment exhibited a favorable clinical course for 30 years and none developed hepatocellular carcinoma (HCC). The duration of chelation therapy was significantly negatively correlated (P < 0.05) with the fibrosis‐4 index or aspartate aminotransferase to platelet ratio index (APRI) score at the last visit; lower values were indicative of greater treatment success. Patients with an APRI score ≥1.5 had a significantly worse prognosis (P < 0.05). Conclusion Long‐term survival of patients with WD was achieved without worsened liver function or carcinogenesis with appropriate treatment. Treatment disruption should be avoided.
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Affiliation(s)
- Satoko Arai
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Tomomi Kogiso
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Yuri Ogasawara
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Takaomi Sagawa
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Makiko Taniai
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Katsutoshi Tokushige
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
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Ogasawara Y, Kogiso T, Kotera Y, Omori A, Konda N, Sugano E, Sagawa T, Taniai M, Harigai M, Egawa H, Yamamoto M, Tokushige K. The utility of liver transplantation to treat acute liver failure caused by adult-onset Still's disease: case reports. Clin J Gastroenterol 2021; 14:866-875. [PMID: 33797038 DOI: 10.1007/s12328-021-01398-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/19/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Adult-onset Still's disease (AOSD) is an inflammatory condition commonly complicated by mild liver dysfunction. However, severe liver failure is rarely reported. We report three cases of severe acute hepatic failure (ALF) associated with AOSD. We encountered three cases of acute liver failure (ALF) with encephalopathy. RESULTS Case 1 was a 75-year-old female, who was started on a steroid (prednisolone, PSL) to treat AOSD; this was gradually tapered. Two months later, severe ALF developed. She died despite an increase in the PSL dose and artificial liver support. Case 2 was a 26-year-old-female taking PSL 30 mg/day to treat subacute thyroiditis. PSL was tapered, and she received methyl PSL pulse therapy and artificial liver support, but this did not cure the ALF. Liver transplantation (LT) was performed 25 days later. Three years later, the same symptoms were observed and we diagnosed AOSD. Case 3 was a 56-year-old-female who met the AOSD criteria. PSL 50 mg/day was started and then tapered. Methyl PSL pulse therapy was prescribed to treat hemophagocytic syndrome, but she required LT on hospital day 13. CONCLUSION In AOSD cases, ALF is rarely complicated; urgent LT should be considered only for patients with AOSD-related severe ALF.
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Affiliation(s)
- Yuri Ogasawara
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Tomomi Kogiso
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Yoshihito Kotera
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Akiko Omori
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Naoko Konda
- Department of Rheumatology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Eri Sugano
- Department of Rheumatology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Takaomi Sagawa
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Makiko Taniai
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Masayoshi Harigai
- Department of Rheumatology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Hiroto Egawa
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Katsutoshi Tokushige
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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Sagawa T, Kogiso T, Ito T, Yasuda H, Katoh N, Yoshinaga T, Yazaki M, Kato T, Omori A, Kotera Y, Egawa H, Yamamoto M, Tokushige K. Hereditary Apolipoprotein A-1 Amyloidosis With Glu34Lys Mutation Treated by Liver Transplantation: A Case Report. Transplant Proc 2021; 53:1327-1332. [PMID: 33573822 DOI: 10.1016/j.transproceed.2020.11.012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/16/2020] [Indexed: 12/20/2022]
Abstract
Hereditary apolipoprotein A-1 (ApoA-1) amyloidosis is a rare disease characterized by progressive deposition of amyloid fibrils in the kidney, heart, and liver. We observed a 45-year-old male patient with liver failure. Liver dysfunction was detected at 30 years of age during an annual health check-up. At 35 years of age, renal dysfunction was also found. At 40 years of age, the pathologic findings of the liver revealed amyloid deposition. A testis biopsy specimen taken at 42 years of age to identify the cause of male infertility showed amyloid accumulation. At 43 years of age, the amyloid results and genetic profile led to a definitive diagnosis of hereditary ApoA-1 amyloidosis caused by Glu34Lys mutation. A family history was absent. Liver failure showed Budd-Chiari-like formation, including enlargement of the caudate lobe and liver congestion. Although the patient showed end-stage liver cirrhosis and renal failure, only liver transplant was performed considering the burden for a living donor. The enlarged liver (4.9 kg) showed amyloid deposition in parenchyma and the space of Disse. Amyloid also accumulated in the giant spleen. The APOA1 mutation Glu34Lys is extremely rare, and in this case hepatic failure was successfully treated by liver transplant to both replace organ function and reduce production of the amyloidogenic ApoA-1-variant protein. Careful observation for reaccumulation of amyloidosis in the organ is required.
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Affiliation(s)
- Takaomi Sagawa
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomomi Kogiso
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
| | - Taito Ito
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hideo Yasuda
- Hamamatsu University School of Medicine, Internal Medicine, Hamamatsu, Shizuoka, Japan
| | - Nagaaki Katoh
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Tsuneaki Yoshinaga
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Masahide Yazaki
- Department of Biomedical Laboratory Sciences, Shinshu University School of Health Sciences, Matsumoto, Nagano, Japan; Institute for Biomedical Sciences, Shinshu University, Matsumoto, Nagano, Japan
| | - Takaaki Kato
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Akiko Omori
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoshihito Kotera
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroto Egawa
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsutoshi Tokushige
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
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Kogiso T, Sagawa T, Kodama K, Taniai M, Hashimoto E, Tokushige K. Development and course of diabetes according to genetic factors and diabetes treatment among patients with nonalcoholic fatty liver disease. Nutrition 2020; 83:111080. [PMID: 33348109 DOI: 10.1016/j.nut.2020.111080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/23/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Many patients with nonalcoholic fatty liver disease (NAFLD) also have diabetes. However, the genetic factors associated with diabetes in NAFLD are unclear. In this study, we investigated the clinical course and risk factors of diabetes development. METHODS A total of 544 patients (275 men; 50.6%) with a median age of 53 y and biopsy-confirmed NAFLD enrolled in the study. Patatin-like phospholipase 3 and voltage-gated potassium channel KQT-like subfamily member 1 (KCNQ1) single nucleotide polymorphisms were identified in 287 cases. There were 272 patients without diabetes, and 64, 141, and 67 patients with diabetes not treated with an oral hypoglycemic agent, treated with an oral hypoglycemic agent, and treated with insulin, respectively. Changes in biochemical parameters and body weight over a 1-y period were determined in patients treated with incretin agents (n = 91), a sodium glucose cotransporter 2 inhibitor (n = 19), or both (n = 33). The prevalence and risk factors for diabetes development among patients with NAFLD were determined in nondiabetic patients. RESULTS Among patients with NAFLD, half of the patients had diabetes and the incidence was high in those with advanced fibrosis. Reduction in body weight was higher after sodium glucose cotransporter 2 inhibitor treatment (P = .050) and in KCNQ1 CC genotype patients (P < .05). Reduction in hemoglobin A1c level was significantly lower in patatin-like phospholipase 3 GG subjects (P < .05). De novo diabetes developed in 44 patients (10-y incidence: 17.9%), especially in obese (P = .046) and KCNQ1 CC genotype patients (P < .01). CONCLUSIONS Patient genetic background affected treatment response and incidence of diabetes in patients with NAFLD.
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Affiliation(s)
- Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
| | - Kazuhisa Kodama
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
| | | | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
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10
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Yatsuji S, Kotera Y, Kogiso T, Saito S, Omori A, Sagawa T, Taniai M, Shimizu K, Yamamoto M, Nakano M, Tokushige K. A case of hemorrhage of hepatocellular carcinoma resembling a hepatic cyst arising from non-cirrhotic steatohepatitis. Clin J Gastroenterol 2020; 14:218-223. [PMID: 32979153 DOI: 10.1007/s12328-020-01251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/16/2020] [Indexed: 11/24/2022]
Abstract
A 70-year-old female was found to have multiple hepatic cysts at her annual checkup. In the posterior segment of the right lobe of the liver, an 81 × 67 mm circular cystic lesion was detected by contrast-enhanced computed tomography (CT). Magnetic resonance imaging (MRI) of the cyst revealed a solid component. The cyst had a capsule-like structure and non-uniform fluid accumulation suggested bleeding. Since the lesion was enlarged and malignancy could not be ruled out, it was surgically resected. Histopathologically, reticular fibers of the liver were seen in necrotic tissue and the lesion was diagnosed as a bleeding hepatocellular carcinoma (HCC). The non-cancerous liver tissue showed non-cirrhotic steatohepatitis. This was an unusual presentation of HCC.
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Affiliation(s)
- Sho Yatsuji
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yoshihito Kotera
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Tomomi Kogiso
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Satomi Saito
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Akiko Omori
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Takaomi Sagawa
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Makiko Taniai
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kyoko Shimizu
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Masayuki Nakano
- Tokyo Central Pathology Laboratory, Hachioji, Tokyo, 192-0024, Japan
| | - Katsutoshi Tokushige
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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11
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Kogiso T, Sagawa T, Kodama K, Taniai M, Hashimoto E, Tokushige K. Long-term outcomes of non-alcoholic fatty liver disease and the risk factors for mortality and hepatocellular carcinoma in a Japanese population. J Gastroenterol Hepatol 2020; 35:1579-1589. [PMID: 31975453 DOI: 10.1111/jgh.14989] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/20/2019] [Accepted: 01/22/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIM The incidence of mortality and hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD) has been reported, but the long-term outcomes of Japanese patients with NAFLD are not fully evaluated. METHODS We enrolled 365 Japanese patients with biopsy-confirmed NAFLD (1990-2008) followed for ≥ 6 months: 185 males (50.7%); median age (54 years); advanced fibrosis 108 (29.8%); HCC, n = 26 (7.1%); diabetes, n = 191 (52.3%); dyslipidemia, n = 234 (64.1%); and hypertension, n = 193 (52.9%). We analyzed the survival and new-onset HCC rates for hepatic fibrosis as well as complications and the treatment of lifestyle-related diseases. RESULTS During the median 7.1-year follow-up, 44 patients (12.1%) died: n = 28 liver-related (10 years liver-related death, 9.4%) and n = 16 non-liver-related deaths (10 years non-liver-related death, 4.9%). Both incidence rates were significantly higher in the advanced fibrosis group. The incidence of HCC at 10 years was 20.1% in the advanced fibrosis group, and the mortality was increased in patients with higher age, history of HCC, lower seru\m level of albumin, higher level of γ-glutamyltransferase, and insulin treatment for diabetes. Risk factors for HCC onset were higher levels of aspartate aminotransferase and triglyceride and hypertension treatment. Platelet count < 11.5 × 104 /μL was revealed as a risk factor for death and HCC development. CONCLUSIONS The rates of both liver-related and non-liver-related deaths and HCC development were significantly prominent in the patients with advanced fibrosis. It is important to identify and treat NAFLD patients who have several risk factors and advanced fibrosis, which might be predicable simply by the platelet count.
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Affiliation(s)
- Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazuhisa Kodama
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
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12
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Sagawa T, Kogiso T, Sugiyama H, Hashimoto E, Yamamoto M, Tokushige K. Characteristics of hepatocellular carcinoma arising from Fontan-associated liver disease. Hepatol Res 2020; 50:853-862. [PMID: 32219953 DOI: 10.1111/hepr.13500] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/02/2020] [Accepted: 03/17/2020] [Indexed: 02/08/2023]
Abstract
AIM Hepatocellular carcinoma (HCC) can arise from Fontan-associated liver disease (FALD); this is known as FALD-HCC. The clinical features of FALD-HCC are unclear. Thus, we examined the incidence and clinical characteristics of FALD-HCC. METHODS From 1972 to 2019, 122 patients developed liver disease after undergoing Fontan procedures. HCC was diagnosed in 12 (9.8%) FALD patients. We compared FALD-HCC and non-HCC patients. RESULTS The incidence of HCC was 0.8% and 2.9% in FALD 10 and 20 years after the Fontan procedure, respectively. The median age of patients at diagnosis of HCC was 32.5 years (range 20.6-46.1 years), and seven of the 12 patients were men. Patients with FALD-HCC had a higher incidence of liver cirrhosis and polysplenia than non-HCC patients. Liver tumors were detected as single nodules in eight patients, and the median diameter was 47 mm (range 11-105 mm). HCC was treated by surgical resection in two patients, transcatheter arterial chemoembolization or chemotherapy in three patients, and proton beam therapy in four patients. Three patients could not be treated because of their poor condition. Four patients died of liver/cardiac failure and HCC, and HCC was controlled in three patients. The survival rate after 25 years was significantly lower in patients with FALD-HCC than non-HCC patients (68.6% vs. 97.9%, respectively; P < 0.01). CONCLUSIONS Of the 122 patients with FALD, 12 developed HCC 20 years after surgery. Because complications of HCC are associated with poor prognosis, constant surveillance for HCC should begin 10 years after surgery.
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Affiliation(s)
- Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisashi Sugiyama
- Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Masakazu Yamamoto
- Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
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13
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Horiuchi K, Kogiso T, Sagawa T, Ito T, Taniai M, Miura K, Hattori M, Morisada N, Hashimoto E, Tokushige K. Bardet-Biedl Syndrome Caused by Skipping of SCLT1 Complicated by Microvesicular Steatohepatitis. Intern Med 2020; 59:2719-2724. [PMID: 33132306 PMCID: PMC7691027 DOI: 10.2169/internalmedicine.5045-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We treated the case of a 22-year-old male patient with liver dysfunction. At 1 year of age, hepatic fibrosis was suspected. In addition, due to the presence of retinitis pigmentosa, renal failure, obesity, mental retardation, and hypogonadism, he was diagnosed with Bardet-Biedl syndrome (BBS). Skipping of exons 14 and 17 in the sodium channel and clathrin linker 1 (SCLT1) gene was observed. At 22 years of age, the liver enzyme levels were further elevated and a diagnosis of microvesicular steatohepatitis was made. Insulin resistance, a reduction of muscle mass, an impairment of the fatty acid metabolism, and hyperleptinemia in this syndrome may cause steatohepatitis.
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Affiliation(s)
- Kentaro Horiuchi
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Taito Ito
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Kenichiro Miura
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Japan
| | - Motoshi Hattori
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Japan
| | - Naoya Morisada
- Department of Pediatrics, Kobe University Graduate School of Medicine, Japan
| | | | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
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14
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Kogiso T, Sagawa T, Oda M, Yoshiko S, Kodama K, Taniai M, Tokushige K. Characteristics of acute hepatitis A virus infection before and after 2001: A hospital-based study in Tokyo, Japan. J Gastroenterol Hepatol 2019; 34:1836-1842. [PMID: 30861194 DOI: 10.1111/jgh.14655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 02/08/2019] [Accepted: 03/08/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM The incidence of acute hepatitis A [AH (A)] is decreasing because of improvements in hygiene; however, cases of sporadic severe hepatitis are still being reported. We assessed the epidemiology of AH (A) in Japan. METHODS This was a hospital-based retrospective study, in which 126 AH (A) patients (96 men [76%], median age 39 [range, 19-66] years) were enrolled. Patients diagnosed with AH (A) before 2001 (n = 79) and after 2001 (n = 47) were compared. RESULTS The incidence of AH (A) showed peaks in 1990, 1999, and 2018. After 2001, one patient had hepatitis B virus, four had human immunodeficiency virus, and three had syphilis coinfections. Before and after 2001, HAV was transmitted, respectively, by raw oysters (28% and 26%), overseas travel (19% and 28%), and sexual contact (0% and 19%) (P < 0.01). The frequencies of symptoms were appetite loss (51% and 32%), fever (63% and 81%), and diarrhea (3% and 13%) (all P < 0.05), respectively. On admission, the median levels of alanine aminotransferase (1455 and 3069 U/L) and γ-glutamyl transpeptidase (221 and 345 U/L) were significantly higher (P < 0.01), and the prothrombin time (77.5% and 65.9%) and platelet count (22.7 and 16.4 × 10/μL) were significantly lower after 2001 (P < 0.05). A time to normalization of the bilirubin level ≥ 30 days was associated with older age and a diagnosis of AH (A) after 2001. CONCLUSIONS Outbreaks and severe AH (A) cases due to sexual transmission have been reported recently. It is necessary to examine their sexual behavior and other sexual infection.
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Affiliation(s)
- Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Mayuko Oda
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Somura Yoshiko
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Kazuhisa Kodama
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
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15
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Kogiso T, Sagawa T, Kodama K, Taniai M, Tokushige K. Impact of continued administration of tolvaptan on cirrhotic patients with ascites. BMC Pharmacol Toxicol 2018; 19:87. [PMID: 30563565 PMCID: PMC6299627 DOI: 10.1186/s40360-018-0277-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022] Open
Abstract
Background The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites. We investigated the outcome of long-term treatment. Methods This was a single-center retrospective study. Overall, 170 cirrhotic patients (95 males, median age 63 years) were enrolled and received tolvaptan orally after hospitalization for ascites, which included treatment with conventional diuretics. We compared patients who withdrew tolvaptan treatment after < 1 year (n = 90) with patients who continued treatment for ≥1 year (n = 37). In continuously treated patients, the pretreatment and post-treatment (1 year) blood biochemistry values were assessed. Results Overall, 37 patients received treatment for ≥1 year and showed a higher response after tolvaptan therapy. The reduction in body weight was 2.0 (− 3.4–17.2) kg compared to discontinued cases, which had a body weight reduction of 1.1 (− 6.2–7.5) kg after 1 week. The group that received treatment for ≥1 year had a significantly lower rate of the complication gastroesophageal varices and also showed better liver function. In patients with continued treatment, serum levels of albumin was significantly higher without renal disturbance after 1 year of treatment. The prothrombin time/international normalized ratio and ammonia level were also significantly improved. Multivariate analyses showed that a change in body weight reduction and serum levels of albumin were predictive factors of continued administration. Conclusions Long-term tolvaptan treatment increased serum levels of albumin, decreased ammonia levels, and preserved renal function after 1 year of treatment. A reduction in body weight after 1 week was associated with a favorable outcome of tolvaptan therapy.
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Affiliation(s)
- Tomomi Kogiso
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Takaomi Sagawa
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kazuhisa Kodama
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Makiko Taniai
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Katsutoshi Tokushige
- Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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16
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Kogiso T, Sagawa T, Kodama K, Taniai M, Katagiri S, Egawa H, Yamamoto M, Tokushige K. Hepatocellular carcinoma after direct-acting antiviral drug treatment in patients with hepatitis C virus. JGH Open 2018; 3:52-60. [PMID: 30834341 PMCID: PMC6386743 DOI: 10.1002/jgh3.12105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/26/2018] [Accepted: 10/09/2018] [Indexed: 01/05/2023]
Abstract
Background and Aim Given the use of direct‐acting antivirals (DAAs) to treat hepatitis C virus (HCV), their effects on hepatocarcinogenesis should be determined. Methods This study enrolled 349 patients with HCV who underwent DAA treatment at our hospital between 2014 and 2018. Their median age was 65 years, and 184 were male; 301 cases were of HCV serotype 1, and 48 were of serotype 2. The DAA treatment was daclatasvir/asunaprevir in 107 cases, sofosbuvir (SOF)/ledipasvir in 147 cases, ritonavir‐boosted ombitasvir/paritaprevir in 28 cases, elbasvir/grazoprevir in 19 cases, and SOF/ribavirin in 48 cases. The patients’ histories included hepatocellular carcinoma (HCC) in 45 cases, liver transplant (LT) in 10 cases, and kidney transplant (KT) in 17 cases. Results Sustained virological responses occurred in 335 cases (96%). DAA treatment was initiated a median of 16.3 months after HCC treatment. After DAA treatment, 15 cases (33%) had recurrence of HCC after a median of 11.6 months, and 3 cases (1%) developed de novo HCC. Six LT patients and one KT patient had HCC; however, no HCC was observed after DAA. The incidence of HCC was significantly higher in patients with multiple HCC treatments in the Cox hazard model (hazard ratio 1.664, 95% confidence interval 1.134–2.441, P < 0.01). Surgical resection or LT reduced the risk of HCC. Conclusions DAA did not increase the rate of HCC, even in immunosuppressed patients. However, careful follow‐up for HCC recurrence is required in previously treated cases.
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Affiliation(s)
- Tomomi Kogiso
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Takaomi Sagawa
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Kazuhisa Kodama
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Makiko Taniai
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Satoshi Katagiri
- Department of Surgery Tokyo Women's Medical University, Yachiyo Medical Center Yachiyo Japan.,Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Hiroto Egawa
- Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
| | - Katsutoshi Tokushige
- Department of Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
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Kaerkitcha N, Sagawa T. Amplified polarization properties of electrospun nanofibers containing fluorescent dyes and helical polymer. Photochem Photobiol Sci 2018; 17:342-351. [DOI: 10.1039/c7pp00413c] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Well-aligned nanofibers containing cationic fluorescent dyes and anionic chiral polymers prepared via electrospinning exhibit an enhanced circular dichroism, which is mainly caused by linear dichroism and linear birefringence.
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Affiliation(s)
- N. Kaerkitcha
- Graduate School of Energy Science
- Kyoto University
- Kyoto 606-8501
- Japan
| | - T. Sagawa
- Graduate School of Energy Science
- Kyoto University
- Kyoto 606-8501
- Japan
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18
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Sato Y, Ohnuma H, Okamoto K, Miyamoto H, Hirakawa M, Uemura N, Kikuchi S, Sagawa T, Fujikawa K, Takahashi Y, Minami S, Okuda T, Takahashi M, Kato J, Takayama T. Phase II study of modified docetaxel, cisplatin and S-1 (mDCS) combination chemotherapy in patients with unresectable metastatic gastric cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Tsuji A, Eto T, Masuishi T, Satake H, Segawa Y, Tanioka H, Hara H, Kotaka M, Sagawa T, Watanabe T, Nakamura M, Takahashi T, Negoro Y, Manaka D, Fujita H, Suto T, Ichikawa W, Fujii M, Takeuchi M, Nakajima T. Phase II study of third-line cetuximab rechallenge in patients with metastatic wild-type K-RAS colorectal cancer who achieved a clinical benefit in response to first-line cetuximab plus chemotherapy (JACCRO CC-08). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.58] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Satake H, Nakamura M, Tsuji A, Sagawa T, Tamura F, Hatachi Y, Oguchi K, Takagane A, Kaji T, Sekikawa T, Furukawa M, Kochi M, Ichikawa W, Takeuchi M, Fujii M, Nakajima T. Phase II study to evaluate the efficacy of regorafenib in metastatic colorectal cancer patients by the assessment using FDG-PET/CT (JACCRO CC-12) metastatic colorectal cancer (JACCRO CC-12). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.72] [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: 11/12/2022] Open
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21
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Sagawa T, Kakizaki S, Tomizawa T, Nakayama T, Tanaka H, Tojima H, Sato K, Kusano M, Okamura S, Yamada M. Faecal lactoferrin is a useful biomarker for mucosal healing in patients with ulcerative colitis during granulocyte and monocyte adsorptive apheresis therapy. Colorectal Dis 2016; 18:696-702. [PMID: 26748553 DOI: 10.1111/codi.13258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/07/2015] [Indexed: 12/13/2022]
Abstract
AIM The study investigated the value of faecal lactoferrin as a follow-up biomarker for mucosal healing of ulcerative colitis during granulocyte and monocyte adsorptive apheresis (GMA) therapy. METHOD Patients with ulcerative colitis exhibiting a moderate or severe disease activity with a partial Mayo Score (pMS) of over 4 were enrolled in this study. The patients received 10 courses of GMA therapy. The pMS value and faecal lactoferrin level were monitored and compared with the findings of endoscopy until 12 months after the last dose of GMA therapy. RESULTS Twenty patients (male:female 11:9) were enrolled in this study. Twelve had total colitis, while six had left-sided involvement and two had distal proctitis. Thirteen (65.0%) responded to GMA therapy. The faecal lactoferrin levels were significantly decreased in patients who responded to GMA therapy (P < 0.05), whereas the levels did not change in non-responders. Moreover, the faecal lactoferrin levels correlated with the endoscopic findings (r = 0.792, P < 0.01) and pMS scores (r = 0.529, P < 0.01). The correlation coefficients between the faecal lactoferrin levels and mucosal findings were higher than those observed between the pMS score and mucosal findings. CONCLUSION The faecal lactoferrin level is a useful biomarker of the mucosal findings in ulcerative colitis. Although endoscopy is the gold standard, the faecal lactoferrin level can be used as a biomarker during GMA therapy in patients with ulcerative colitis.
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Affiliation(s)
- T Sagawa
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - S Kakizaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - T Tomizawa
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - T Nakayama
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - H Tanaka
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - H Tojima
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - K Sato
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - M Kusano
- Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital, Maebashi, Japan
| | - S Okamura
- Department of Health and Nutritional Science, Takasaki University of Health and Welfare, Takasaki, Japan
| | - M Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
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22
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Tobata H, Sagawa T. Specific excitonic interactions in the aggregates of hyaluronic acid and cyanine dyes with different lengths of methine group. Photochem Photobiol Sci 2016; 15:329-33. [PMID: 26815728 DOI: 10.1039/c5pp00343a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The absorption and circular dichroism (CD) spectra of three types of cyanine dyes with different lengths of methine group (3,3'-diethylthiadicarbocyanine iodide, DTDC; 3,3'-diethylthiacarbocyanine iodide, DTC; and 3,3'-diethylthiacyanine iodide, DTTHC) in an aqueous solution were compared with and without hyaluronic acid (HA), which has a helical structure. DTDC forms chiral H- and J-aggregates, whereas DTC and DTTHC are unable to form any aggregates. DTDC also forms H- and J-aggregates in the presence of sodium polyacrylate (PA) with a random-coil structure; however, the PA-DTDC aggregates exhibit no chirality. These results suggest that the chirality of HA-DTDC aggregates is induced by the helical structure of HA. In 2.4 vol% and 10 vol% methanol, HA-DTDC aggregates displayed different patterns of temperature dependence, whereas no aggregation was observed in 30 vol% methanol. The solubility of DTDC in a mixed solvent of water and methanol is generally improved by the addition of methanol, which prevents the aggregation of DTDC.
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Affiliation(s)
- H Tobata
- Graduate School of Energy Science, Kyoto University, Yoshida-Honmachi, Sakyo-Ku, Kyoto 606-8501, Japan.
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23
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Sato Y, Ohnuma H, Hirakawa M, Osuga T, Okagawa Y, Sagawa T, Takahashi Y, Takahashi M, Maeda M, Katsuki S, Hirayama M, Kikuchi S, Murase K, Takada K, Sato T, Miyanishi K, Kobune M, Takimoto R, Takayama T, Kato J. 2298 Docetaxel, cisplatin and S-1 (DCS) combination chemotherapy for gastric cancer patients with peritoneal metastasis: a multi-institute retrospective study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31214-x] [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: 11/26/2022]
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24
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Sato Y, Ohnuma H, Takayama T, Sagawa T, Hirakawa M, Sato Y, Takahashi Y, Takahashi M, Maeda M, Katsuki S, Hirayama M, Takada K, Hayashi T, Sato T, Miyanishi K, Kobune M, Takimoto R, Nobuoka T, Hirata K, Kato J. Treatment Strategy for Conversion Therapy Using Docetaxel/Cddp/S-1 (Dcs) or Dcs-Trastuzumab (Dcs-T) According to Her2 Status in Metastatic Gastric Cancer Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.41] [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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25
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Koski JV, Maisi VF, Sagawa T, Pekola JP. Experimental observation of the role of mutual information in the nonequilibrium dynamics of a Maxwell demon. Phys Rev Lett 2014; 113:030601. [PMID: 25083623 DOI: 10.1103/physrevlett.113.030601] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Indexed: 06/03/2023]
Abstract
We validate experimentally a fluctuation relation known as generalized Jarzynski equality governing the work distribution in a feedback-controlled system. The feedback control is performed on a single electron box analogously to the original Szilard engine. In the generalized Jarzynski equality, mutual information is treated on an equal footing with the thermodynamic work. Our measurements provide the first evidence of the role of mutual information in the fluctuation theorem and thermodynamics of irreversible processes.
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Affiliation(s)
- J V Koski
- Low Temperature Laboratory (OVLL), Aalto University, POB 13500, FI-00076 Aalto, Finland
| | - V F Maisi
- Low Temperature Laboratory (OVLL), Aalto University, POB 13500, FI-00076 Aalto, Finland and Centre for Metrology and Accreditation (MIKES), P.O. Box 9, 02151 Espoo, Finland
| | - T Sagawa
- Department of Basic Science, The University of Tokyo, Komaba 3-8-1, Meguro-ku, Tokyo 153-8902, Japan
| | - J P Pekola
- Low Temperature Laboratory (OVLL), Aalto University, POB 13500, FI-00076 Aalto, Finland
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26
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Fujii W, Ashihara E, Nagahara H, Kukida Y, Ishigaki R, Kasahara A, Sagawa T, Seno T, Yamamoto A, Kohno M, Oda R, Tokunaga D, Kubo T, Kawahito Y. OP0175 Monocarboxylate Transporter (MCT)-4, Associated with the Decrease of Synovial Fluid Ph, is A Novel Therapeutic Target of Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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27
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Kukida Y, Kida T, Inoue T, Isoda Y, Sagawa T, Ishigaki R, Kasahara A, Nakabayashi A, Fujioka K, Nagahara H, Fujii W, Murakami K, Seno T, Yamamoto A, Kohno M, Kawahito Y. AB0501 Retrospective Study of Multitarget Therapy with Combination of Mizoribine and Tacrolimus for Systemic Lupus Erythematosus with or without Nephritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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28
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Fukuoka H, Sagawa T, Inoue Y, Takahashi H, Ishijima A. Direct Imaging of Intracellular Signaling Components That Regulate Bacterial Chemotaxis. Sci Signal 2014; 7:ra32. [DOI: 10.1126/scisignal.2004963] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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29
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Ohnuma H, Sato Y, Takayama T, Sagawa T, Hirakawa M, Harada K, Nobuoka T, Hirata K, Sato Y, Takahashi Y, Katsuki S, Takahashi S, Hirayama M, Takahashi M, Maeda M, Sato T, Miyanishi K, Kobune M, Takimoto R, Kato J. A phase II study of neoadjuvant combination chemotherapy with docetaxel, cisplatin, and S-1 for locally advanced gastric cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4057] [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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30
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Boisnier E, Sagawa T, Komatsu T, Takagi N, Katayama M, Katayama T. A habitat association index to distinguish resident species along marine artificial reefs. COMMUNITY ECOL 2009. [DOI: 10.1556/comec.10.2009.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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31
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Ihara H, Takafuji M, Sakurai T, Tsukamoto H, Shundo A, Sagawa T, Nagaoka S. Facile Enantiomer Analysis by Combination of N‐Dansyl Amino Acid as Diastereomerizer and Molecular‐Shape Recognitive RP‐HPLC Using Comb‐Shaped Polymer‐Immobilized Silica. J LIQ CHROMATOGR R T 2009. [DOI: 10.1081/jlc-200028400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- H. Ihara
- a Institute for Materials Chemistry and Engineering , Kyushu University , Fukuoka , Japan
- b Department of Applied Chemistry , Kumamoto University , Kumamoto , Japan
| | - M. Takafuji
- b Department of Applied Chemistry , Kumamoto University , Kumamoto , Japan
| | - T. Sakurai
- b Department of Applied Chemistry , Kumamoto University , Kumamoto , Japan
| | - H. Tsukamoto
- b Department of Applied Chemistry , Kumamoto University , Kumamoto , Japan
| | - A. Shundo
- b Department of Applied Chemistry , Kumamoto University , Kumamoto , Japan
| | - T. Sagawa
- c Institute of Advanced Energy , Kyoto University , Uji , Japan
| | - S. Nagaoka
- d Kumamoto Industrial Research Institute , Kumamoto , Japan
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32
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Tanaka M, Sagawa T, Hashimoto M, Mizumoto Y, Yoshimoto H, Yamazaki R, Kasai T, Inoue M. The Culdotomy FourS Two U procedure for transvaginal access to the peritoneal cavity. Endoscopy 2009; 41:472-4. [PMID: 19418403 DOI: 10.1055/s-0029-1214593] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
A reliable method of transvaginal access is needed for natural orifice transluminal endoscopic surgery. We introduce a new culdotomy procedure, using a technique for the creation of space in the cul-de-sac, transvaginal ultrasound, and a newly developed umbrella Hakko needle. An artificially developed, saline-containing space in the cul-de-sac was punctured by an umbrella Hakko needle from the vagina under the guidance of ultrasound. The vaginal walls on both sides of the needle were incised with an electric scalpel. In five cases with benign gynecological tumors, culdotomy was successfully performed. Operating time was less than 10 minutes and blood loss was less than 10 mL. There were no culdotomy-associated complications. This procedure, named Culdotomy FourS Two U, is a simple, safe, and reliable method for entry into the cul-de-sac in transvaginal gynecological surgeries and may have future applications in transluminal endoscopic surgery through the vagina.
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Affiliation(s)
- M Tanaka
- Department of Obstetrics and Gynecology, Kanazawa University, School of Medicine, Ishikawa, Japan.
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33
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Watanabe N, Jintoku H, Sagawa T, Takafuji M, Sawada T, Ihara H. Self-assembling fullerene derivatives for energy transfer in molecular gel system. ACTA ACUST UNITED AC 2009. [DOI: 10.1088/1742-6596/159/1/012016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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34
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Sato Y, Takayama T, Takahari D, Sagawa T, Sato T, Abe S, Kogawa T, Nikaido T, Miyanishi K, Takahashi S, Kato J, Niitsu Y. Successful treatment for gastro-intestinal bleeding of Osler-Weber-Rendu disease by argon plasma coagulation using double-balloon enteroscopy. Endoscopy 2008; 40 Suppl 2:E228-9. [PMID: 18991211 DOI: 10.1055/s-2007-966562] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Y Sato
- Fourth Department of Internal Medicine, Sapporo Medical University, School of Medicine, Sapporo, Japan
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35
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Sato Y, Takayama T, Sagawa T, Tanaka S, Takahashi S, Takimoto R, Kato J, Ohnuma H, Takahashi Y, Niitsu Y. Phase II study of S-1, docetaxel and cisplatin combination chemotherapy in patients with unresectable metastatic gastric cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4537] [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: 11/20/2022] Open
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36
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Tanaka M, Sagawa T, Hashimoto M, Mizumoto Y, Yoshimoto H, Yamazaki R, Kasai T, Inoue M. Ultrasound-guided culdotomy for vaginal ovarian cystectomy using a renal balloon dilator catheter. Ultrasound Obstet Gynecol 2008; 31:342-345. [PMID: 18307175 DOI: 10.1002/uog.5272] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To evaluate the feasibility and utility of performing ultrasound-guided culdotomy using a renal balloon dilator catheter for transvaginal ovarian cystectomies. METHODS Culdotomy using transvaginal sonography and a Nephromax balloon dilator catheter was performed in 16 patients for the vaginal removal of benign ovarian cysts located in the cul-de-sac. Each ovarian cyst was punctured under transvaginal ultrasound guidance and the punctured site on the vaginal wall was enlarged with a dilator. The cyst was then enucleated through this vaginal wound. Preoperative characteristics of the patients, outcome, operating time, blood loss and complications of each culdotomy, and the histology of the cysts, were recorded and examined. RESULTS We used this method on 14 patients with unilateral ovarian cysts and two with bilateral cysts. Culdotomy was performed successfully in 15 cases (94%). The mean +/- SD operating time for culdotomy was 22 +/- 11 min, and blood loss during the procedure was less than 10 mL in all cases. There were no complications including rectal injury or febrile morbidity. CONCLUSIONS Culdotomy assisted by ultrasound imaging and a dilator is a safe, reliable and effective method for removal of benign ovarian cysts via a vaginal approach.
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Affiliation(s)
- M Tanaka
- Department of Obstetrics and Gynecology, School of Medicine, Kanazawa University, Japan.
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37
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Takayama T, Sato Y, Sagawa T, Okamoto T, Nagashima H, Takahashi Y, Ohnuma H, Kuroiwa G, Miyanishi K, Takimoto R, Matsunaga T, Kato J, Yamaguchi K, Hirata K, Niitsu Y. Phase I study of S-1, docetaxel and cisplatin combination chemotherapy in patients with unresectable metastatic gastric cancer. Br J Cancer 2007; 97:851-6. [PMID: 17848958 PMCID: PMC2360407 DOI: 10.1038/sj.bjc.6603957] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The aim of this dose escalation study was to determine the maximum-tolerated dose (MTD), dose-limiting toxicities (DLTs) and preliminary efficacy of docetaxel, S-1 and cisplatin combination chemotherapy in patients with unresectable metastatic gastric cancer. Seventeen patients received oral S-1 (40 mg m−2 bid) on days 1–14, intravenous cisplatin (60 mg m−2) and docetaxel (60, 70 or 80 mg m−2 depending on DLT) on day 8 every 3 weeks. The MTD of this combination was presumed to be docetaxel 70 mg m−2. At this dose level, 40% of the patients (two of five) developed grade 4 neutropenia and 20% (one of five) exhibited grade 3 nausea during the first course. Therefore, the recommended dose of docetaxel was defined as 60 mg m−2. The DLT was neutropenia. The response rate (RR) was 88.2% (15 of 17), consisting of one complete response and 14 partial responses. There were two stable diseases but no progressive disease. Of these 15 responders, four (23.5%) with high VEGF expression showed rapid tumour regression and achieved downstaging, leading to subsequent curative gastrectomy. Three of these have been disease free for about 3 years, suggesting a complete cure. In conclusion, this regimen was tolerable and showed a quite high RR, with an appreciable downstaging rate in metastatic gastric cancer.
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Affiliation(s)
- T Takayama
- Fourth Department of Internal Medicine, Sapporo Medical University, School of Medicine, Sapporo, Japan.
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38
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Chowdhury MAJ, Ihara H, Sagawa T, Hirayama C. RETENTION BEHAVIORS OF POLYCYCLIC AROMATIC HYDROCARBONS ON COMB-SHAPED POLYMER IMMOBILIZED-SILICA IN RPLC. J LIQ CHROMATOGR R T 2007. [DOI: 10.1081/jlc-100100488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- M. A. Jamil Chowdhury
- a Graduate School of Science and Technology, Kumamoto University , 2-39-1 Kurokami, Kumamoto, 860-8555, Japan
| | - H. Ihara
- a Graduate School of Science and Technology, Kumamoto University , 2-39-1 Kurokami, Kumamoto, 860-8555, Japan
| | - T. Sagawa
- b Department of Applied Chemistry & Biochemistry , Faculty of Engineering, Kumamoto University , 2-39-1 Kurokami, Kumamoto, 860-8555, Japan
| | - C. Hirayama
- b Department of Applied Chemistry & Biochemistry , Faculty of Engineering, Kumamoto University , 2-39-1 Kurokami, Kumamoto, 860-8555, Japan
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39
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Takayama T, Sato Y, Okamoto T, Sagawa T, Abe T, Ihara H, Nagashima H, Kato J, Niitsu Y. Phase I/II study of docetaxel, CDDP and S-1 in unresectable advanced gastric cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Y. Sato
- Sapporo Medcl Univ, Sapporo, Japan
| | | | | | - T. Abe
- Sapporo Medcl Univ, Sapporo, Japan
| | - H. Ihara
- Sapporo Medcl Univ, Sapporo, Japan
| | | | - J. Kato
- Sapporo Medcl Univ, Sapporo, Japan
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40
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Abstract
The incidence of endometrial cancer and ovarian cancer in Japan has been increasing in recent years. Results of epidemiologic studies suggest that the onset and multiplication of these cancers are associated with estrogen. Estrogens are metabolized by cytochrome P450 1A1 (CYP1A1) and converted into catecholestrogens, which are carcinogens. CYP1A1 has several polymorphisms, the major one being T6235C transition in the non-coding 3'-flanking region (MspI polymorphism), and another being A4889G transition in exon 7 (Ile/Val polymorphism). These polymorphisms can affect the metabolites of estrogens and contribute to the susceptibility to gynecological malignancy. In this study, to determine whether CYP1A1 polymorphism plays a role in the development of gynecological malignancy in the Japanese population, we assessed the association of CYP1A1 polymorphism in Japanese patients with gynecological malignancy in comparison to that in controls. The odds ratios (ORs) of Ile/Val polymorphism were 1.16 in ovarian cancer patients and 1.70 in endometrial cancer patients. The ORs of MspI polymorphism were 1.33 in ovarian cancer patients and 0.88 in endometrial cancer patients. No significant association was found between these CYP1A1 polymorphisms and gynecological malignancy. Although the frequency of CYP1A1 polymorphism in the Japanese population is higher than that in the Caucasian population, CYP1A1 polymorphism is not related to gynecological malignancies in Japanese population.
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Affiliation(s)
- T Sugawara
- Departments of Biochemistry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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41
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Sagawa T, Takayama T, Oku T, Hayashi T, Ota H, Okamoto T, Muramatsu H, Katsuki S, Sato Y, Kato J, Niitsu Y. Argon plasma coagulation for successful treatment of early gastric cancer with intramucosal invasion. Gut 2003; 52:334-9. [PMID: 12584212 PMCID: PMC1773547 DOI: 10.1136/gut.52.3.334] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND In recent years, there has been an increasing number of cases of early gastric cancer (T1, NX) with intramucosal invasion, which are untreatable by surgical or endoscopic mucosal resection (EMR) because of their high risk. Currently, no adequate treatment is available for such patients. AIM The main objective of this study was to evaluate whether argon plasma coagulation (APC) is an effective and safe modality for treating early gastric cancer untreatable by surgical resection or EMR. METHODS The study group comprised 20 men and seven women diagnosed with gastric cancer with intramucosal invasion who were considered poor candidates for surgical resection or EMR due to risk factors such as severe cardiac failure or thrombocytopenia. Irradiation conditions for APC treatment were determined using swine gastric mucosa. We used an argon gas flow of 2 l/min at a power setting of 60 W and a maximum irradiation time of 15 s/cm(2). The follow up period of the 27 patients ranged from 18 to 49 months (median 30 months). RESULTS All lesions were irradiated easily, including areas anatomically difficult for EMR such as the gastric cardia or the posterior wall of the upper gastric body. In 26 of 27 patients (96%) there was no evidence of recurrence during the follow up period (median 30 months). One patient showed recurrence six months after the treatment but was successfully retreated. No serious complications were found in any of the 27 patients but three patients (11%) experienced a feeling of abdominal fullness. INTERPRETATION APC is a safe and effective modality for treatment of early gastric cancer with intramucosal invasion untreatable by surgical resection or EMR. However, further observations are necessary to determine the long term prognosis of patients undergoing this treatment.
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Affiliation(s)
- T Sagawa
- Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
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42
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Abstract
The incidence of endometrial cancer and ovarian cancer in Japan has been increasing in recent years. Results of epidemiologic studies suggest that the onset and multiplication of these cancers are associated with estrogen. Estrogens are metabolized by cytochrome P450 1A1 (CYP1A1) and converted into catecholestrogens, which are carcinogens. CYP1A1 has several polymorphisms, the major one being T6235C transition in the non-coding 3′-flanking region (MspI polymorphism), and another being A4889G transition in exon 7 (Ile/Val polymorphism). These polymorphisms can affect the metabolites of estrogens and contribute to the susceptibility to gynecological malignancy. In this study, to determine whether CYP1A1 polymorphism plays a role in the development of gynecological malignancy in the Japanese population, we assessed the association of CYP1A1 polymorphism in Japanese patients with gynecological malignancy in comparison to that in controls. The odds ratios (ORs) of Ile/Val polymorphism were 1.16 in ovarian cancer patients and 1.70 in endometrial cancer patients. The ORs of MspI polymorphism were 1.33 in ovarian cancer patients and 0.88 in endometrial cancer patients. No significant association was found between these CYP1A1 polymorphisms and gynecological malignancy. Although the frequency of CYP1A1 polymorphism in the Japanese population is higher than that in the Caucasian population, CYP1A1 polymorphism is not related to gynecological malignancies in Japanese population.
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43
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Morikawa M, Yamada H, Kato EH, Shimada S, Ebina Y, Yamada T, Sagawa T, Kobashi G, Fujimoto S. NK cell activity and subsets in women with a history of spontaneous abortion. Cause, number of abortions, and subsequent pregnancy outcome. Gynecol Obstet Invest 2002; 52:163-7. [PMID: 11598357 DOI: 10.1159/000052966] [Citation(s) in RCA: 17] [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: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to assess the role of NK cells in nonpregnant women with a history of spontaneous abortion. STUDY DESIGN 113 nonpregnant women with a history of spontaneous abortion were assessed for peripheral NK cell activity and percentage of NK cell subsets, in relation to the cause of abortions, the number of spontaneous abortions, and subsequent pregnancy outcome (n = 56). RESULTS Neither NK cell activity nor subsets showed a significant difference in relation to the cause or number of spontaneous abortions. NK cell activity in nonpregnant women who later experienced subsequent abortion with normal chromosomes (n = 10) (mean +/- SD: 42.8 +/- 15.8%) was relatively higher than that in women with subsequent live birth (control, n = 39) (32.1 +/- 13.7%) (p = 0.099). NK cell activity in women who later experienced subsequent abortion with abnormal chromosomes (n = 7) (28.7 +/- 21.4%) was the same as the level in the control. CONCLUSION Peripheral NK cell activity or subsets during nonpregnant status were not related to the cause or number of previous spontaneous abortions. A relation between preconceptional NK cell activity and later experiencing abortion with normal chromosomes should be further studied.
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Affiliation(s)
- M Morikawa
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan
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44
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Yamada H, Hirayama Kato E, Tsuruga R, Ebina Y, Kobashi G, Sagawa T, Makita Z, Koike T, Fujimoto S. Insulin response patterns contribute to different perinatal risks in gestational diabetes. Gynecol Obstet Invest 2001; 51:103-9. [PMID: 11223703 DOI: 10.1159/000052903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to evaluate the insulin dynamics of patients with gestational diabetes mellitus (GDM) and to compare perinatal outcomes according to the insulin response patterns. Twenty-two out of 925 consecutive women examined were diagnosed as having GDM. One hundred and ten women who experienced a normal pregnancy were used as controls. Plasma glucose levels and insulin responses were evaluated by a 2-hour 75-gram oral glucose tolerance test (OGTT). Immunoreactive insulin (IRI), the area under the curve (AUC) of glucose (AUCg) and insulin (AUCi), and the insulinogenic index (II = DeltaIRI 30 min/DeltaBS 30 min) were measured. The GDM patients were divided into three subgroups, consisting of hyper-, normo- and hypoinsulinemic groups, according to the mean +/- 2 SD of the AUCi obtained from the controls. Clinical and laboratory findings were compared among the GDM subgroups and controls. The GDM patients showed impaired insulin secretion to glucose stimuli, with low plasma insulin levels (at 30 min) and reduced insulin/glucose ratios (at 30 and 60 min) early in the 75-gram OGTT. The II and AUCi/AUCg values of GDM patients were reduced as compared with those of controls. These reduced insulin responses were remarkable in hypo- and normoinsulinemic GDM patients, but were not detected in hyperinsulinemic GDM patients. The number of babies large for their gestational age in normo- and hypoinsulinemic GDM patients was significantly higher than that in hyperinsulinemic GDM patients or controls. Hyperinsulinemic GDM patients had a high frequency of pregnancy-induced hypertension (40%). The body mass index prior to pregnancy of hyperinsulinemic GDM patients was significantly higher than that of normoinsulinemic GDM patients or controls. It was demonstrated that not only insulin secretion, but also perinatal clinical characteristics, differed among the GDM subgroups. The heterogeneity of the disease was thus confirmed.
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MESH Headings
- Adult
- Analysis of Variance
- Area Under Curve
- Blood Glucose/analysis
- Diabetes, Gestational/diagnosis
- Diabetes, Gestational/drug therapy
- Diabetes, Gestational/physiopathology
- Female
- Glucose Tolerance Test
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/etiology
- Insulin/administration & dosage
- Insulin/blood
- Insulin Resistance/physiology
- Perinatal Care/methods
- Pregnancy
- Pregnancy Complications/diagnosis
- Pregnancy Complications/drug therapy
- Pregnancy Complications/physiopathology
- Pregnancy Outcome
- Pregnancy, High-Risk
- Probability
- Risk Factors
- Statistics, Nonparametric
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Affiliation(s)
- H Yamada
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
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Luo ML, Sakuragi N, Shimizu M, Seino K, Okamoto K, Kaneuchi M, Ebina Y, Okuyama K, Fujino T, Sagawa T, Fujimoto S. Prognostic significance of combined conventional and immunocytochemical cytology for peritoneal washings in endometrial carcinoma. Cancer 2001; 93:115-23. [PMID: 11309777 DOI: 10.1002/cncr.9017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Noncancerous cells simulating adenocarcinoma cells may interfere with the analysis of peritoneal cytology (PC) in patients with endometrial carcinoma. Immunocytochemistry (ICC) may improve the diagnosis of PC. METHODS PC slides from 115 patients with endometrial carcinoma were reviewed. Suspicious or positive cell clusters were recovered with a cell transfer method and were subjected to ICC for MOC-31, cytokeratin 5/6, and p53. Conventional Papanicolaou staining and ICC results were compared directly on the same cells. RESULTS By combined conventional and immunocytochemical PC (CONV-ICC-PC), cytodiagnosis was positive in 18 of 115 patients (15.7%) and suspicious in 3 of 115 patients (2.6%). According to a multivariate Cox regression analysis of patients with tumors confined to the uterus that included grade, myometrial invasion, cervical involvement, and CONV-ICC-PC, only CONV-ICC-PC was an independent prognostic factor (P < 0.05). A multivariate analysis for all of the patients studied that compared CONV-ICC-PC with staging variables revealed that only peritoneal metastasis (P < 0.0001) and lymph node metastasis (P < 0.01) were independent prognostic factors. When peritoneal metastases were excluded, CONV-ICC-PC (P < 0.01) and lymph node metastasis (P < 0.0025) were the independent prognostic factors. By cell transfer and p53 immunostaining in samples from 14 patients with malignant cells in their peritoneal washings, no deaths occurred among 5 patients with negative p53, whereas 5 of 9 patients with positive p53 died of disease at the time of data analysis. CONCLUSIONS MOC-31 immunostaining improves the diagnosis of PC in endometrial carcinoma. Positive PC is an important prognostic factor for patients with endometrial carcinoma confined to the uterus. The p53 positive cells in PC have possible prognostic significance.
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Affiliation(s)
- M L Luo
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan
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46
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Ohkubo K, Sawakuma K, Sagawa T. Influence of cross-linking monomer and hydrophobic styrene comonomer on stereoselective esterase activities of polymer catalyst imprinted with a transition-state analogue for hydrolysis of amino acid esters. POLYMER 2001. [DOI: 10.1016/s0032-3861(00)00453-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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47
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Sagawa T, Nishio M, Sagawa K, Kelly JE, Lokuta AJ, Tsai J, Kan E, Wasserstrom JA. Activation of purified cardiac ryanodine receptors by dihydropyridine agonists. Am J Physiol Heart Circ Physiol 2001; 280:H1201-7. [PMID: 11179064 DOI: 10.1152/ajpheart.2001.280.3.h1201] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Prior observations have raised the possibility that dihydropyridine (DHP) agonists directly affect the sarcoplasmic reticulum (SR) cardiac Ca(2+) release channel [i.e., ryanodine receptor (RyR)]. In single-channel recordings of purified canine cardiac RyR, both DHP agonists (-)-BAY K 8644 and (+)-SDZ202-791 increased the open probability of the RyR when added to the cytoplasmic face of the channel. Importantly, the DHP antagonists nifedipine and (-)-SDZ202-791 had no competitive blocking effects either alone or after channel activation with agonist. Thus there is a stereospecific effect of SDZ202-791, such that the agonist activates the channel, whereas the antagonist has little effect on channel activity. Further experiments showed that DHP agonists changed RyR activation by suppressing Ca(2+)-induced inactivation of the channel. We concluded that DHP agonists can also influence RyR single-channel activity directly at a unique allosteric site located on the cytoplasmic face of the channel. Similar results were obtained in human purified cardiac RyR. An implication of these data is that RyR activation by DHP agonists is likely to cause a loss of Ca(2+) from the SR and to contribute to the negative inotropic effects of these agents reported by other investigators. Our results support this notion that the negative inotropic effects of DHP agonists result in part from direct alteration in the activity of RyRs.
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Affiliation(s)
- T Sagawa
- Division of Cardiology, Department of Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA
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48
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Abstract
Chlamydia trachomatis (CT) infection in pregnant women is related to unfavorable obstetric outcomes such as prematurity, intrauterine growth retardation, and stillbirth. A 22-year-old woman underwent transabdominal amniocentesis at 16 weeks of gestation (GW). A CT antigen test using polymerase chain reaction in the amniotic fluid was found to be positive, though the patient had no symptom of infection. Beginning at 20 GW, clarithromycin was orally administered at a dose of 400 mg/day for 2 weeks. The CT antigen test in amniotic fluid at 28 GW turned to a negative result. A female baby was vaginally born at 38 GW by spontaneous labor. The CT antigen test of her gastric contents showed a negative result and anti-CT IgM in umbilical cord blood was negative. Neither respiratory distress, pneumonia, nor conjunctivitis was detected. To the best of our knowledge, this case is the first report showing the reversal of the intra-amniotic CT antigen status by antibiotic treatment.
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Affiliation(s)
- H Yoshida
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan
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49
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Yamamoto R, Azuma M, Wakui Y, Kishida T, Yamada H, Okuyama K, Sagawa T, Shimizu K, Satomura S, Fujimoto S. Alpha-fetoprotein microheterogeneity: a potential biochemical marker for Down's syndrome. Clin Chim Acta 2001; 304:137-41. [PMID: 11165209 DOI: 10.1016/s0009-8981(00)00381-8] [Citation(s) in RCA: 19] [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: 11/22/2022]
Abstract
Our purpose was to examine the utility of analyzing alpha-fetoprotein (AFP) microheterogeneity assessed by lectin affinity in Down's syndrome (DS) screening. Maternal sera and amniotic fluids were collected from 18 women who were carrying DS fetuses and 70 unaffected pregnancies around 16 weeks of gestation. The percentages of AFP which reacted with Lens culinaris agglutinin (AFP-L2,3) were determined by lectin affinity electrophoresis. AFP-L2,3 levels were significantly increased (P<0.0001) in both maternal serum and amniotic fluid from DS-affected versus unaffected pregnancies. The fractional areas under the receiver operating characteristic curves were 0.835 and 0.700 (P=0.106) for AFP-L3 and AFP MoM (multiples of the median) in maternal serum. No correlation was found between AFP-L3 and AFP MoM in maternal serum (r=0.006). Our data suggest that the measurement of AFP-L3 in maternal serum is a potential biochemical marker for DS.
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Affiliation(s)
- R Yamamoto
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo 060-8638, Japan.
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Takahashi T, Tokailin H, Suzuki S, Sagawa T, Shirotani I. Electronic band structure of black phosphorus studied by angle-resolved ultraviolet photoelectron spectroscopy. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0022-3719/18/4/013] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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