Shin yamanote Hospital

Tokyo, Japan

Shin yamanote Hospital

Tokyo, Japan

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Namikawa K.,Sapporo Medical University | Ouchi K.,Kawasaki Medical School | Kimura M.,Shin Yamanote Hospital
Journal of Travel Medicine | Year: 2010

Background. There is concern that Japanese travelers are poorly protected against travel-associated infectious diseases including vaccine-preventable infections. This prompted us to study Japanese travelers for measures taken to reduce their risk of acquiring an infectious disease and their immunization uptake. Methods. During April 2007 to May 2008, a questionnaire study was conducted using the European Travel Health Advisory Board (ETHAB) protocol and targeting Japanese group tour clients as well as individual travelers to developing countries. Results. A total of 302 returned questionnaires were analyzed. While the majority (87.4%) sought general information on their destination, few (38.7%) sought the travel health information. Very few (2.0%) got the health information from travel medicine specialists. More than half were either unaware of the risks or thought there was no risk of hepatitis A, hepatitis B, and typhoid fever in their destination. Only half (50.7%) thought vaccines provided sufficient protection and very few (13.6%) believed that vaccines were safe. For most of the vaccine-preventable diseases, only fewer than 10% had received the vaccines. Conclusions. There is a need for specialized travel health services in Japan and health professionals should be encouraged to expand these services. Japanese travelers should be made aware of the importance of seeking pre-travel health advice and information on the health risks at their destination. Travel health professionals should provide a balanced view of the risks and benefits of immunization, and misperceptions about immunization should be addressed. © 2010 International Society of Travel Medicine.

Teramoto T.,Teikyo University | Kawamori R.,Juntendo University | Miyazaki S.,Shin yamanote Hospital | Teramukai S.,Kyoto Prefectural University of Medicine | And 3 more authors.
Journal of Atherosclerosis and Thrombosis | Year: 2015

Aim: The aim of this analysis was to investigate the relationships between dyslipidemia, achieved blood pressure (BP) values and the lipid levels, as well as the control of four cardiovascular risk factors (BP, low-density lipoprotein: LDL cholesterol, hemoglobin A1c: HbA1c and smoking) and the incidence of cardiovascular disease (CVD), in Japanese patients receiving antihypertensive therapy. Methods: A total of 13,052 patients with no history of CVD were included in this subanalysis of the prospective observational OMEGA study in Japanese hypertensive patients treated with olmesartan. Multivariable Cox regression models were used to evaluate the relationship with the risk of CVD. Results: The incidence of CVD during the 36-month study period was 5.59/1,000 patient-years among the patients with dyslipidemia (n=6,297) and 5.57/1,000 patient-years among the patients without dyslipidemia (n= 6,755), with no significant differences between the two groups. Higher achieved BP values tended to be associated with an increased CVD risk in both the patients with and without dyslipidemia. In addition, the risk of CVD tended to be higher in the patients with an achieved LDL cholesterol level of ≥120 mg/dL than in those with an LDL level of ≥120 mg/dL (trend p=0.0005) and in the patients with an achieved high-density lipoprotein cholesterol level of≥60 mg/dL than in those with an HDL level of ≥60 mg/dL (trend p=0.0017). Furthermore, the risk of CVD was higher among the patients with fewer controlled risk factors than among those with control of all four risk factors (trend p<0.0001). Conclusions: In order to prevent CVD in olmesartan-treated hypertensive patients with no history of CVD, it is important to control both the lipid and BP levels and aim for comprehensive risk factor control. © Journal of Atherosclerosis and Thrombosis. All right received.

Tongu M.,The University of Shimane | Tongu M.,Shin Yamanote Hospital | Harashima N.,The University of Shimane | Tamada K.,Yamaguchi University | And 2 more authors.
Cancer Science | Year: 2015

Immunomodulating monoclonal antibodies (mAb) can evoke antitumor T-cell responses, which are attenuated by regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSC). Treatment with cyclophosphamide (CP) and gemcitabine (GEM) can mitigate the immunosuppression by Treg and MDSC, respectively. In the current study, we examined the antitumor effects of a combination of local injection with anti-CD137 mAb and intermittent low-dose chemotherapy using CP and GEM in subcutaneously established CT26 colon carcinoma. Although a significant antitumor effect was observed when local anti-CD137 mAb therapy (5 μg) was started early in the tumor-bearing stage (day 10), no therapeutic efficacy was observed when the mAb therapy was started at a later tumor-bearing stage (day 17). Analyses of the tumor-infiltrating immune cells revealed that the number of Gr-1high/low CD11b+ MDSC started to increase 13 days after tumor inoculation, whereas injection with low-dose (50 mg/kg) CP and GEM mitigated this increase. In addition, although intermittent injections with low-dose CP and GEM on days 10 and 18 suppressed tumor growth significantly, additional local injections of anti-CD137 mAb on days 19, 21, and 23 further augmented the therapeutic efficacy. Cytotoxic T lymphocytes reactive to CT26 and a tumor antigen peptide were induced successfully from the spleen cells of tumor-cured or tumor-stable mice. In a bilateral tumor inoculation model, this combination therapy achieved systemic therapeutic effects and suppressed the growth of mAb-untreated tumors. These results suggest that intermittent immunochemotherapy using CP and GEM could retain the therapeutic potential of anti-CD137 mAb that is normally impaired during the late tumor-bearing stage. Intermittent chemotherapy and anti-CD137 antibody therapy. © 2014 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.

Kimura M.,Shin Yamanote Hospital | Koga M.,Tokyo Medical University | Kikuchi T.,Tokyo Medical University | Miura T.,Tokyo Medical University | And 2 more authors.
Parasitology International | Year: 2012

Malaria remains an important health risk among travelers to tropical/subtropical regions. However, in Japan, only 2 antimalarials are licensed for clinical use - oral quinine and mefloquine. The Research Group on Chemotherapy of Tropical Diseases introduced atovaquone-proguanil in 1999, and reported on its excellent antimalarial efficacy and safety for treating non-immune patients with uncomplicated Plasmodium falciparum malaria (20 adult and 3 pediatric cases) in 2006. In the present study, additional cases of malaria were analyzed to confirm the efficacy and safety of this antimalarial drug. Fourteen adult and 2 pediatric cases of P. falciparum malaria and 13 adult cases and 1 pediatric case of P. vivax/. ovale malaria were successfully treated with atovaquone-proguanil, including 3 P. falciparum cases in which the antecedent treatment failed. Two patients with P. vivax malaria were treated twice due to primaquine treatment failure as opposed to atovaquone-proguanil treatment failure. Except for 1 patient with P. falciparum malaria who developed a moderate liver function disturbance, no significant adverse effects were observed. Despite the intrinsic limitations of this study, which was not a formal clinical trial, the data showed that atovaquone-proguanil was an effective and well-tolerated therapeutic option; licensure of this drug in Japan could greatly contribute to individually appropriate treatment options. © 2012 Elsevier Ireland Ltd.

Mori Y.,Jikei University School of Medicine | Taniguchi Y.,Shin Yamanote Hospital | Matsuura K.,Jikei University School of Medicine | Sezaki K.,The Surgical Center | And 2 more authors.
Diabetes Technology and Therapeutics | Year: 2011

Background: This study was performed to examine the efficacy of sitagliptin, a dipeptidyl peptidase-4 inhibitor, in Japanese patients with type 2 diabetes using continuous glucose monitoring (CGM) of 24-h glycemic changes. Subjects and Methods: The study was a prospective open-label pilot study in patients with type 2 diabetes who were admitted to our hospital and treated with sitagliptin alone or concomitantly with another oral hypoglycemic drug. CGM was performed for 2 days before sitagliptin administration and for another 2 days after administration. The average 24-h blood glucose level, SD of the 24-h blood glucose level, 24-h glycemic fluctuation range, mean amplitude of glycemic excursions (MAGE), and hyperglycemic and hypoglycemic time periods were compared before and after administration. Results: Sitagliptin administration alone and with a concomitant drug decreased the average 24-h blood glucose level, SD of the 24-h blood glucose level, 24-h glycemic fluctuation range, MAGE, and hyperglycemic time, compared with these parameters before administration. There were significant correlations between the average 24-h blood glucose level before administration and the decrease in the average 24-h blood glucose level after administration and between MAGE before administration and the decrease in MAGE after administration. Conclusions: Sitagliptin decreased the average glycemic level and also improved 24-h glycemic fluctuation, including postprandial hyperglycemia. © 2011, Mary Ann Liebert, Inc.

Kinoshita A.,Himeji Dokkyo University | Yamada H.,International University of Health and Welfare | Kotaki H.,International University of Health and Welfare | Kimura M.,Shin Yamanote Hospital
Malaria Journal | Year: 2010

Background. Concern over the potential cardiotoxicity of anti-malarial drugs inducing a prolonged electrocardiographic QT interval has resulted in the almost complete withdrawal from the market of one anti-malarial drug - halofantrine. The effects on the QT interval of four anti-malarial drugs were examined, using the guinea pig heart. Methods. The guinea pig heart was isolated, mounted on a Langendorff apparatus, and was then perfused with pyruvate-added Klebs-Henseleit solutions containing graded concentrations of the four agents such as quinidine (0.15 - 1.2 M), quinine (0.3 - 2.4 M), halofantrine (0.1 - 2.0 M) and mefloquine (0.1 - 2.0 M). The heart rate-corrected QaTc intervals were measured to evaluate drug-induced QT prolongation effects. Results. Quinidine, quinine, and halofantrine prolonged the QaTc interval in a dose-dependent manner, whereas no such effect was found with mefloquine. The EC50values for the QaTc prolongation effects, the concentration that gives a half-maximum effect, were quinidine < quinine halofantrine. Conclusions. In this study, an isolated, perfused guinea pig heart system was constructed to assess the cardiotoxic potential of anti-malarial drugs. This isolated perfused guinea pig heart system could be used to test newly developed anti-malarial drugs for their inherent QT lengthening potential. More information is required on the potential variation in unbound drug concentrations in humans, and their role in cardiotoxicity. © 2010 Kinoshita et al; licensee BioMed Central Ltd.

Kikuchi T.,Tokyo Medical University | Koga M.,Tokyo Medical University | Shimizu S.,Tokyo Medical University | Miura T.,Tokyo Medical University | And 2 more authors.
Parasitology International | Year: 2013

The clinical management of amebiasis is a growing concern, particularly among human immunodeficiency virus (HIV)-infected individuals who are predisposed to severe illness. Treatment with a luminal amebicide is strongly recommended following acute-stage treatment with a nitroimidazole. In 2004, the Japanese Research Group on Chemotherapy of Tropical Diseases introduced paromomycin, which was not nationally licensed, and offered it to a number of patients. From 2004 to 2011, 143 case records of amebiasis (123 with amebic colitis, 16 with amebic liver abscess, and 4 with both) in which patients were treated with paromomycin, mainly 1500. mg/day for 9 or 10. days following metronidazole treatment, were submitted. Among 123 evaluable cases, 23 (18.7%) experienced possible adverse effects, the most common being diarrhea (17/123, 13.8%) and other gastrointestinal problems that were resolved after the completion or discontinuation of treatment. In addition, single cases of bloody stools associated with Clostridium difficile colitis, skin rash, and the elevation of liver enzymes were also reported, although the causal relationship was not clear. HIV infection did not appear to increase the incidence of adverse drug effects. Each of the 11 asymptomatic or mildly symptomatic amebic colitis cases became negative for stool cysts after paromomycin treatment. Paromomycin was shown to be safe and well tolerated, as well as effective in a special subset of amebic colitis cases. © 2013 Elsevier Ireland Ltd.

PubMed | Shin Yamanote Hospital and Osaka Prefecture University
Type: Journal Article | Journal: Biotechnology letters | Year: 2016

To examine the potential of exosomes derived from the tumor cells, which had been genetically modified to express a Mycobacterium tuberculosis antigen, as a cancer vaccine aimed at overcoming the weak immunogenicity of tumor antigens.We transfected B16 melanoma cells with a plasmid encoding the M. tuberculosis antigen, early secretory antigenic target-6 (ESAT-6). The secreted exosomes bearing both tumor-associated antigens and the pathogenic antigen (or their epitopes) were collected. When the exosomes were injected into foot pads of mice, they significantly (p<0.05) evoked cellular immunity against both ESAT-6, and B16 tumor cells. Intra-tumoral injection of the exosomes significantly suppressed (p<0.001) tumor growth in syngeneic B16 tumor-bearing mice, while the exosomes derived from the non-transfected B16 cells showed no effect on tumor growth, although both exosomes should have similar tumor antigens.Exosomes bearing both tumor antigens and the M. tuberculosis antigen (or their epitopes) have a high potential as a candidate for cancer vaccine to overcome the immune escape by tumor cells.

Furuta T.,Tokyo Medical University | Kimura M.,Shin Yamanote Hospital | Watanabe N.,Jikei University School of Medicine
American Journal of Tropical Medicine and Hygiene | Year: 2010

In cerebral malaria, the binding of parasitized erythrocytes to the cerebral endothelium and the consequent angiogenic dysregulation play a key role in pathogenesis. Because vascular endothelial growth factor (VEGF) is widely regarded as a potent stimulator of angiogenesis, edema, inflammation, and vascular remodeling, the plasma levels of VEGF and the soluble form of the VEGF receptor (sVEGFR)-1 and -2 in uncomplicated malaria patients and healthy adults were measured by enzyme-linked immunosorbent assay (ELISA) to examine their roles in malaria. The results showed that VEGF and sVEGFR-2 levels were significantly elevated in malaria patients compared with healthy adults. Moreover, it was confirmed that malarial parasite antigens induced VEGF secretion from the human mast cell lines HMC-1 or KU812 cell. This is the first report to suggest that the interaction of VEGF and sVEGFR-2 is involved in the host immune response to malarial infection and that malarial parasites induce VEGF secretion from human mast cells. © 2010 by The American Society of Tropical Medicine and Hygiene.

Ito T.,Shin Yamanote Hospital | Eriguchi M.,Shin Yamanote Hospital | Koyama Y.,Shin Yamanote Hospital
MRS Communications | Year: 2015

Poly(acrylic acid) (PAA) and poly(vinylpyrrolidone) (PVP) are both highly safe synthetic polymers approved as pharmaceutical excipients. When their aqueous solutions are mixed, insoluble rigid complex is precipitated. On the other hand, if the dried PAA film was immersed in aqueous PVP solution, swollen PAA/PVP soft hydrogel was obtained. Heated drying of the gel afforded a transparent water-swellable film. The swellable PAA/PVP complex film exhibited favorable properties in medical use. If the film was put on a bleeding site, it swelled, and stuck to a hemorrhaging spot, and efficiently arrested bleeding. It could also prevent the adhesion formation by injured intestines. Copyright © Materials Research Society 2015.

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