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Gunma, Japan

Watanabe Y.,Kasugai Municipal Hospital | Itami N.,Nikko Memorial Hospital | Hashimoto N.,H N Medic | Kurosawa A.,Sumiyoshi Clinic Hospital | And 31 more authors.
Japanese Pharmacology and Therapeutics

Background: This study was designed to examine the clinical effects of C. E. R. A., a continuous erythropoietin receptor activator, administered intravenously (i. v.) at a dose level of 50 μg once every 2 weeks to EPO naïve renal anemia patients on hemodialysis. Methods: EPO naïve renal anemia patients were treated with C. E. R. A. i. v. at 50 μg once every 2 weeks during the correction period of anemia in order to attain the Hb levels of above 11 g/dL. The observation period established was 24 weeks, and the primary endpoint investigated was the percentage of patients who achieved the Hb levels of above 10 g/dL and the delta (Δ) Hb levels of 1 g/dL from baseline. Results: The Hb levels of renal anemia patients treated with C. E. R. A. were successfully corrected above 11 g/dL. The percentage of patients who attained Hb levels of above 10 g/ dL and the Δ Hb levels of above 1 g/dL from baseline was found to be 91.7%. It was shown from the present study, moreover, that the safety profiles of C. E. R. A. were similar to those of existing ESAs, erythropoiesis stimulating agents, and that the antibodies against C. E. R. A. were not detected in all the patients examined. Conclusions: This study has firstly disclosed that the administrations of C. E. R. A. i. v. at a dose level of 50 μg once every 2 weeks provided smooth as well as gradual increases of the Hb levels in patients with renal anemia on hemodialysis. Source

Tsuboi M.,Gunma University | Yamane A.,Gunma University | Horiguchi J.,Gunma University | Yokobori T.,Gunma University | And 8 more authors.
Breast Cancer

Background: The members of AID/APOBEC protein family possess cytidine deaminase activity that converts cytidine residue to uridine on DNA and RNA. Recent studies have shown the possible influence of APOBEC3B (A3B) as DNA mutators of breast cancer genome. However, the clinical significance of A3B expression in Japanese breast cancer has not been studied in detail. Methods: Ninety-three primary breast cancer tissues (74 estrogen-receptor (ER) positive, 3 ER and HER2 positive, 6 HER2 positive, and 10 triple negative) including 37 tumor-normal pairs were assessed for A3B mRNA expression using quantitative real-time RT-PCR. We analyzed the relation between A3B expression, mutation analysis of TP53 and PIK3CA by direct sequencing, polymorphic A3B deletion allele and human papillomavirus (HPV) infection in tumors. Results: A3B mRNA was overexpressed in tumors compared with normal tissue. Patients with high A3B expression were associated with subtype and progression of lymph node metastasis and pathological nuclear grade. However, the expression was not related to any other clinicopathological factors, including mutation of TP53 and PIK3CA, polymorphic A3B deletion allele, HPV infection and survival time. Conclusion: The expression of A3B in breast cancer was higher than in non-cancerous tissues and was related to the lymph node metastasis and nuclear grade, which are reliable aggressive phenotype markers in breast cancer. Evaluation of A3B expression in tumor may be a marker for breast cancer with malignant potential. © 2015 The Japanese Breast Cancer Society Source

Kojima M.,Dokkyo Medical University | Nakamura N.,Tokai University | Tsukamoto N.,Gunma University | Yokohama A.,Gunma University | And 5 more authors.

We present here seven cases of idiopathic multicentric Castleman's disease (MCD) showing effusion at the initial clinical presentation. This series includes a high proportion of middle-aged and elderly females (5/7). Various autoantibodies were detected in six cases. Anemia (Hb < 10 g/dl) was detected in four cases, leukocytosis (WBC > 10 × 109/l) in three and thrombycytopenia (<100 × 109/l) in five. Positivity for C-reactive protein or elevated erythrocyte sedimentation rate was recorded in all seven cases. Elevated serum IgG level (>2000 mg/dl) was recorded in only three cases. Elevated serum interleukin-6 level was recorded in all four cases examined. At the onset of disease, four cases were associated with idiopathic thrombocytic purpura. During the course of disease, one case each was diagnosed as systemic sclerosis + Sjögren's syndrome (SJS) and SJS. Histologically, five lesions exhibited a mixed type of Castleman's disease, and one case each exhibited a hyaline-vascular type and plasma cell type. The non-neoplastic nature of the B-lymphocytes was demonstrated by immunohistochemistry and polymerase chain reaction. There were no human herpes type-8 virus-positive cells in any of the seven lesions. Good responsiveness to glucocorticoid therapy has been seen in all six cases treated. From a therapeutic perspective, it is important to discriminate this subtype of MCD. Lupus (2011) 20, 44-50. © The Author(s), 2011. Source

Hosonuma K.,Toho Hospital | Sato K.,Gunma University | Yamazaki Y.,Gunma University | Hashizume H.,Gunma University | And 4 more authors.
American Journal of Gastroenterology

OBJECTIVES:The aim of this study was to assess the long-term prognosis, efficacy, and safety of combination therapy using ursodeoxycholic acid (UDCA) and bezafibrate (BF) for primary biliary cirrhosis (PBC) patients exhibiting dyslipidemia.METHODS:We performed a prospective, randomized, controlled, multicenter study to compare the long-term clinical results between combination therapy and UDCA monotherapy for patients refractory to UDCA monotherapy. Twenty-seven consecutive PBC patients were enrolled.RESULTS:The median treatment period in the UDCA and UDCA+BF groups was 107 and 110 months, respectively. The serum alkaline phosphatase (ALP) levels and the Mayo risk score in the combination therapy group (mean 290 IU/l and 0.91, respectively) were significantly lower than those in the UDCA monotherapy group (mean 461 IU/l and 1.42, respectively) at 8 years after the beginning of the study (P<0.05). The serum creatinine levels in the combination therapy group (mean 0.94 mg/dl) were significantly higher than those in the UDCA monotherapy group (mean 0.56 mg/dl) at 8 years after the beginning of the study (P<0.05). However, the survival rate was not significantly different between the groups. We observed dose reduction or discontinuation of the administration of BF, but not UDCA, due to renal dysfunction or muscle pain.CONCLUSIONS:Long-term combination therapy significantly improved the serum ALP levels and the Mayo risk score. However, the survival rate was not significantly different between the groups. In addition, long-term combination therapy significantly increased the serum creatinine levels. We should pay close attention to adverse events during this long-term combination therapy. © 2015 by the American College of Gastroenterology. Source

Matsumura M.,Toho Hospital | Sasaki H.,Toho Hospital | Sekizuka K.,Toho Hospital | Sano H.,Toho Hospital | And 7 more authors.
International Journal of Artificial Organs

Background: Intradialytic hypotension (IDH) is a common clinical trait in hemodialysis (HD) which is caused by poor biocompatibility of the dialyzer membrane. Aiming to improve IDH, vitamin E-bonded polysulfone dialyzer (VPS-H) was evaluated in a pilot study. Methods: Eight IDH patients on standard HD were switched from their conventional high-flux dialyzers to VPS-H, and intradialytic blood pressure (BP) was monitored regularly for 10 months. Results: The results showed that hypotension of systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) during the session were improved after changing the dialyzer. Notably, almost all the values recorded from 120 minutes into the session until the end of the treatment in the period between the second and tenth month after treatment were significantly different from the corresponding baseline values. Moreover, after 8 to 10 months, the SBP prior to a dialysis session was significantly reduced compared with baseline values. On the other hand, the pulse rate showed no difference throughout the study period. Conclusions: This study provides early evidence of the beneficial role that vitamin E-bonded dialyzers may have in preventing IDH. Larger controlled trials are needed to confirm this original finding. © 2010 Wichtig Editore. Source

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