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Toyokawa, Japan

Iijima S.,Nagoya City University | Matsuura K.,Nagoya City University | Matsuura K.,U.S. National Institutes of Health | Watanabe T.,Nagoya City University | And 12 more authors.
PLoS ONE | Year: 2015

The levels of expression of interferon-stimulated genes (ISGs) in liver are associated with response to treatment with pegylated interferon (PEG-IFN) plus ribavirin (RBV). However, associations between the responses of ISGs to IFN-based therapy and treatment efficacy or interleukin-28B (IL28B) genotype have not yet been determined. Therefore, we investigated the early responses of ISGs and interferon-lambdas (IFN-λs) in peripheral blood mononuclear cells (PBMCs) during PEG-IFN/RBV plus NS3/4 protease inhibitor (PI) therapy. We prospectively enrolled 50 chronic hepatitis C patients with HCV genotype 1, and collected PBMCs at baseline, 8 and 24 h after the initial administration of PEG-IFN/RBV/PI. Levels of mRNAs for selected ISGs and IFN-λs were evaluated by real-time PCR. All 31 patients with a favorable IL28B genotype and 13 of 19 with an unfavorable genotype achieved sustained virological responses (SVR). Levels of mRNA for A20, SOCS1 , and SOCS3, known to suppress antiviral activity by interfering with the IFN signaling pathway, as well as IRF1 were significantly higher at 8 h in patients with an unfavorable IL28B genotype than in those with a favorable one (P = 0.007, 0.026, 0.0004, 0.0006, respectively), especially in the non-SVR group. Particularly, the fold-change of IRF1 at 8 h relative to baseline was significantly higher in non-SVR than in SVR cases with an unfavorable IL28B genotype (P = 0.035). In conclusion, levels of several mRNAs of genes suppressing antiviral activity in PBMCs during PEG-IFN/RBV/PI differed according to IL28B genotypes, paralleling treatment efficacy. © 2015 Iijima et al.

Asano S.,Toyokawa City Hospital
Clinical calcium | Year: 2013

Glucocorticoid-induced osteoporosis (GIOP) is known as a serious adverse side effect during long-term glucocorticoid treatment. Several clinical guidelines are available to whom and how we should start to treat GIOP. However, the assessment of the treatment of GIOP is still controversial. Accumulating evidences suggest us that both bone mineral density and bone turn over markers could reflect the effect of some pharmacological agents on bone metabolism. However, further studies would be required for precise assessment of the efficacy of drugs on fracture prevention in GIOP.

A 54-year-old female with chronic hepatitis C developed severe thrombocytopenia after a single administration of Peg-IFN alpha 2a subsequent to 48 weeks of Peg-IFN alpha-2b plus ribavirin therapy. The platelet count decreased from 11.3×10 4/mm 3 to 1.6×10 4/mm 3. Blood test and bone marrow aspiration examination indicated that an immunological mechanism was considered for the etiology of platelet decrease. Fifty mg of prednisolone was administered and the platelet count gradually increased to the normal range. This case is very instructive since severe thrombocytopenia did not occur during 48 weeks of Peg-IFN alpha-2b plus ribavirin therapy, but occurred after a single subcutaneous administration of Peg-IFN alpha-2a during a subsequent course. © 2010 The Japanese Society of Internal Medicine.

Shibayama M.,Aichi Spine Institute | Ito F.,Aichi Spine Institute | Miura Y.,Aichi Spine Institute | Nakamura S.,Aichi Spine Institute | And 2 more authors.
Journal of Bone and Joint Surgery - Series B | Year: 2011

Patients with Bertolotti's syndrome have characteristic lumbosacral anomalies and often have severe sciatica. We describe a patient with this syndrome in whom standard decompression of the affected nerve root failed, but endoscopic lumbosacral extraforaminal decompression relieved the symptoms. We suggest that the intractable sciatica in this syndrome could arise from impingement of the nerve root extraforaminally by compression caused by the enlarged transverse process. ©2011 British Editorial Society of Bone and Joint Surgery.

Shibayama M.,Toyokawa City Hospital | Nagahara M.,Toyokawa City Hospital | Kawase G.,Toyokawa City Hospital | Fujiwara K.,Toyokawa City Hospital | And 2 more authors.
Spine | Year: 2010

Study Design: Case series. Objective: To improve the isolation rate for pyogenic spondylodiscitis, we developed a new needle biopsy technique. Summary Of Background Data: The biggest problem in treating lumbar pyogenic spondylodiscitis is a low success rate in isolating a causative microorganism. The rates have been reported 42% to 64%. Methods: There are 3 steps: (A) Insert a 21-G needle as for discography, aspirate pus or fluid as specimen. (B) If step A fails, inject saline and collect fluid as reflux. (C) If step B fails, insert another needle into the disc, inject saline and collect reflux from the other needle. We applied this approach to 12 patients with a mean age of 64.3 years. Results: We were able to collect fluid samples in all cases and the culture was positive in 11 cases (91.6%). Staphylococcus aureus was the most frequently identified organism (41.7%). Conclusion: This simple method improved the isolation rate and should improve the treatment of lumbar pyogenic spondylodiscitis. © 2010 Lippincott Williams & Wilkins.

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