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1.
Dig Dis Sci ; 2020 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-32036515

RESUMO

BACKGROUND: Self-expandable metal stents (SEMSs) are widely used in patients with distal malignant biliary obstruction. A SEMS that can avoid occlusion as much as possible is desirable. AIMS: The aim of this multicenter single-arm prospective study was to assess the clinical effectiveness and safety of a novel fully covered braided SEMS. METHODS: We enrolled consecutive patients with distal malignant biliary obstruction between February 2016 and November 2017 at ten tertiary-care medical centers. RESULTS: We included 79 patients with a median age of 76 years; 47 (59.5%) patients were men. The technical and clinical success rate was 98.7% and 93.6%, respectively. Recurrent biliary obstruction occurred in 14 patients (17.9%); stent ingrowth, overgrowth, migration, and other occurred in five (6.4%), four (5.1%), four (5.1%), and one (1.3%) patients, respectively. All reinterventions in patients with recurrent biliary obstruction were successful via the transpapillary approach. Adverse events occurred in 15 patients (19.2%); cholangitis, pancreatitis, and others occurred in ten (12.8%), three (3.8%), and two (2.6%) patients, respectively. The stent patency probability at 6 months was 48.5%. Median time to stent patency was 171 days, median time to recurrent biliary obstruction was 536 days, and median survival time was 195 days. CONCLUSIONS: We confirmed the utility and safety of a novel fully covered braided SEMS with low axial force and high radial force in patients with malignance biliary obstruction. This novel SEMS is recommended in patients with distal malignant biliary obstruction.

2.
Dig Endosc ; 31(5): 575-582, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30908711

RESUMO

BACKGROUND AND AIM: Endoscopic ultrasound-guided biliary drainage (EUS-BD) can be carried out by two different approaches: choledochoduodenostomy (CDS) and hepaticogastrostomy (HGS). We compared the efficacy and safety of these approaches in malignant distal biliary obstruction (MDBO) patients using a prospective, randomized clinical trial. METHODS: Patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography were randomly selected for either CDS or HGS. The procedures were carried out at nine tertiary centers from September 2013 to March 2016. Primary endpoint was technical success rate, and the noninferiority of HGS to CDS was examined with a one-sided significance level of 5%, where the noninferiority margin was set at 15%. Secondary endpoints were clinical success, adverse events (AE), stent patency, survival time, and overall technical success including alternative EUS-BD procedures. RESULTS: Forty-seven patients (HGS, 24; CDS, 23) were enrolled. Technical success rates were 87.5% and 82.6% in the HGS and CDS groups, respectively, where the lower limit of the 90% confidence interval of the risk difference was -12.2% (P = 0.0278). Clinical success rates were 100% and 94.7% in the HGS and CDS groups, respectively (P = 0.475). Overall AE rate, stent patency, and survival time did not differ between the groups. Overall technical success rates were 100% and 95.7% in the HGS and CDS groups, respectively (P = 0.983). CONCLUSIONS: This study suggests that HGS is not inferior to CDS in terms of technical success. When one procedure is particularly challenging, readily switching to the other could increase technical success.


Assuntos
Colestase/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Endossonografia , Adulto , Idoso , Idoso de 80 Anos ou mais , Colangiopancreatografia Retrógrada Endoscópica , Coledocostomia , Colestase/patologia , Duodenostomia , Feminino , Gastrostomia , Humanos , Japão , Fígado/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Stents
3.
Sci Rep ; 8(1): 5095, 2018 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-29572522

RESUMO

The number of patients with dysphagia is rapidly increasing due to the ageing of the population. Therefore, the importance of objectively assessing swallowing function has received increasing attention. Videofluoroscopy and videoendoscopy are the standard clinical examinations for dysphagia, but these techniques are not suitable for daily use because of their invasiveness. Here, we aimed to develop a novel, non-invasive method for measuring swallowing function using a motion tracking system, the Kinect v2 sensor. Five males and five females with normal swallowing function participated in this study. We defined three mouth-related parameters and two larynx-related parameters and recorded data from 2.5 seconds before to 2.5 seconds after swallowing onset. Changes in mouth-related parameters were observed before swallowing and reached peak values at the time of swallowing. In contrast, larynx-related parameters showed little change before swallowing and reached peak values immediately after swallowing. This simple swallow tracking system (SSTS) successfully quantified the swallowing process from the oral phase to the laryngeal phase. This SSTS is non-invasive, wireless, easy to set up, and simultaneously measures the dynamics of swallowing from the mouth to the larynx. We propose the SSTS for use as a novel and non-invasive swallowing assessment tool in the clinic.


Assuntos
Deglutição , Tecnologia sem Fio , Adolescente , Adulto , Transtornos de Deglutição/diagnóstico , Feminino , Humanos , Larix/fisiologia , Masculino , Movimento (Física) , Boca/fisiologia , Tecnologia sem Fio/instrumentação , Adulto Jovem
4.
Sci Rep ; 7(1): 14262, 2017 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-29079768

RESUMO

High gamma band (>50 Hz) activity is a key oscillatory phenomenon of brain activation. However, there has not been a non-invasive method established to detect language-related high gamma band activity. We used a 160-channel whole-head magnetoencephalography (MEG) system equipped with superconducting quantum interference device (SQUID) gradiometers to non-invasively investigate neuromagnetic activities during silent reading and verb generation tasks in 15 healthy participants. Individual data were divided into alpha (8-13 Hz), beta (13-25 Hz), low gamma (25-50 Hz), and high gamma (50-100 Hz) bands and analysed with the beamformer method. The time window was consecutively moved. Group analysis was performed to delineate common areas of brain activation. In the verb generation task, transient power increases in the high gamma band appeared in the left middle frontal gyrus (MFG) at the 550-750 ms post-stimulus window. We set a virtual sensor on the left MFG for time-frequency analysis, and high gamma event-related synchronization (ERS) induced by a verb generation task was demonstrated at 650 ms. In contrast, ERS in the high gamma band was not detected in the silent reading task. Thus, our study successfully non-invasively measured language-related prefrontal high gamma band activity.


Assuntos
Mapeamento Encefálico , Idioma , Magnetoencefalografia , Córtex Pré-Frontal/fisiologia , Adulto , Feminino , Humanos , Masculino , Razão Sinal-Ruído , Adulto Jovem
5.
J Am Soc Mass Spectrom ; 27(7): 1219-26, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27098411

RESUMO

We propose detecting a fragment ion (Ph2As(+)) using counter-flow introduction atmospheric pressure chemical ionization ion trap mass spectrometry for sensitive air monitoring of chemical warfare vomiting agents diphenylchloroarsine (DA) and diphenylcyanoarsine (DC). The liquid sample containing of DA, DC, and bis(diphenylarsine)oxide (BDPAO) was heated in a dry air line, and the generated vapor was mixed into the humidified air flowing through the sampling line of a mass spectrometer. Humidity effect on the air monitoring was investigated by varying the humidity of the analyzed air sample. Evidence of the in-line conversion of DA and DC to diphenylarsine hydroxide (DPAH) and then BDPAO was obtained by comparing the chronograms of various ions from the beginning of heating. Multiple-stage mass spectrometry revealed that the protonated molecule (MH(+)) of DA, DC, DPAH, and BDPAO could produce Ph2As(+) through their in-source fragmentation. Among the signals of the ions that were investigated, the Ph2As(+) signal was the most intense and increased to reach a plateau with the increased air humidity, whereas the MH(+) signal of DA decreased. It was suggested that DA and DC were converted in-line into BDPAO, which was a major source of Ph2As(+). Graphical Abstract ᅟ.

6.
J Stroke Cerebrovasc Dis ; 25(3): e25-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26725128

RESUMO

Delayed symptomatic vasospasm after clipping surgery for unruptured aneurysm is rarely reported. We report a case of a 62-year-old woman who presented with symptomatic vasospasm 11 days after clipping surgery for an unruptured aneurysm. We could not predict the existence of vasospasm until ischemic symptoms developed. We retrospectively found mild vasospasm in the computed tomography angiogram taken 8 days after the operation. The patient complained of a prolonged unexpected headache 1 week after the operation. We should recognize prolonged unexpected headache as a warning sign of vasospasm.


Assuntos
Aneurisma Roto/cirurgia , Aneurisma Intracraniano/cirurgia , Procedimentos Neurocirúrgicos/efeitos adversos , Instrumentos Cirúrgicos/efeitos adversos , Vasoespasmo Intracraniano/etiologia , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico por imagem , Feminino , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Angiografia por Ressonância Magnética , Pessoa de Meia-Idade , Vasoespasmo Intracraniano/diagnóstico por imagem
7.
J Med Case Rep ; 9: 244, 2015 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-26514430

RESUMO

INTRODUCTION: Superior ophthalmic vein thrombosis is a rare entity, but is associated with significant morbidities. We describe a case in which superior ophthalmic vein thrombosis occurred shortly after severe facial trauma. CASE PRESENTATION: A 77-year-old Japanese man was transferred to our tertiary hospital after a motor vehicle accident. Le Fort III facial bone fractures and a minor cerebral contusion were detected. Follow-up computed tomography scans detected dilatation of his left superior ophthalmic vein on day 3 and thrombosis on day 12; however, no causative carotid cavernous fistula was observed. As he did not present with any symptoms other than slight conjunctival congestion, a conservative management strategy was adopted along with anticoagulant therapy against deep venous thrombosis. The superior ophthalmic vein thrombosis resolved spontaneously and the conjunctival congestion also improved. CONCLUSIONS: Superior ophthalmic vein thrombosis should be taken into consideration and managed properly after severe facial injuries, and further investigation of its cause is necessary to prevent morbidities.


Assuntos
Anticoagulantes/uso terapêutico , Traumatismos Faciais/complicações , Órbita/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico , Varfarina/uso terapêutico , Idoso , Traumatismos Faciais/diagnóstico por imagem , Humanos , Masculino , Tomografia Computadorizada por Raios X
9.
Anal Chem ; 87(2): 1314-22, 2015 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-25553788

RESUMO

A new method enabling sensitive real-time air monitoring of highly reactive chemical warfare agents, namely, mustard gas (HD) and Lewisite 1 (L1), by detecting ions of their in-line reaction products instead of intact agents, is proposed. The method is based on corona discharge-initiated atmospheric pressure chemical ionization coupled with ion trap tandem mass spectrometry (MS(n)) via counterflow ion introduction. Therefore, it allows for highly sensitive and specific real-time detection of a broad range of airborne compounds. In-line chemical reactions, ionization reactions, and ion fragmentations of these agents were investigated. Mustard gas is oxygenated in small quantity by reactive oxygen species generated in the corona discharge. With increasing air humidity, the MS(2) signal intensity of protonated molecules of mono-oxygenated HD decreases but exceeds that of dominantly existing intact HD. This result can be explained in view of proton affinity. Lewisite 1 is hydrolyzed and oxidized. As the humidity increases from zero, the signal of the final product, namely, didechlorinated, dihydroxylated, and mono-oxygenated L1, quickly increases and reaches a plateau, giving the highest MS(2) and MS(3) signals among those of L1 and its reaction products. The addition of minimal moisture gives the highest signal intensity, even under low humidity. The method was demonstrated to provide sufficient analytical performance to meet the requirements concerning hygienic management and counter-terrorism. It will be the first practical method, in view of sensitivity and specificity, for real-time air monitoring of HD and L1 without sample pretreatment.

10.
Anal Chem ; 86(9): 4316-26, 2014 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-24678766

RESUMO

A highly sensitive and specific real-time field-deployable detection technology, based on counterflow air introduction atmospheric pressure chemical ionization, has been developed for a wide range of chemical warfare agents (CWAs) comprising gaseous (two blood agents, three choking agents), volatile (six nerve gases and one precursor agent, five blister agents), and nonvolatile (three lachrymators, three vomiting agents) agents in air. The approach can afford effective chemical ionization, in both positive and negative ion modes, for ion trap multiple-stage mass spectrometry (MS(n)). The volatile and nonvolatile CWAs tested provided characteristic ions, which were fragmented into MS(3) product ions in positive and negative ion modes. Portions of the fragment ions were assigned by laboratory hybrid mass spectrometry (MS) composed of linear ion trap and high-resolution mass spectrometers. Gaseous agents were detected by MS or MS(2) in negative ion mode. The limits of detection for a 1 s measurement were typically at or below the microgram per cubic meter level except for chloropicrin (submilligram per cubic meter). Matrix effects by gasoline vapor resulted in minimal false-positive signals for all the CWAs and some signal suppression in the case of mustard gas. The moisture level did influence the measurement of the CWAs.


Assuntos
Poluentes Atmosféricos/análise , Substâncias para a Guerra Química/análise , Espectrometria de Massas em Tandem/métodos , Pressão Atmosférica , Limite de Detecção
11.
Gan To Kagaku Ryoho ; 39(13): 2541-4, 2012 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-23235175

RESUMO

A 74-year-old man was referred to our hospital because of abdominal distension. Upper gastrointestinal endoscopy revealed advanced gastric cancer and early gastric cancer. HER2-positive and AFP-producing gastric cancer with peritonitis carcinomatosa showing no indication for operation was diagnosed by histopathological and radiological examinations. He was treated with trastuzumab, docetaxel, and S-1 combination chemotherapy. At the end of the second course of therapy, the primary lesion was remarkably decreased in size and was associated with a significant decrease in serum AFP level. No serious adverse events occurred except for grade 3-4 leukopenia and neutropenia. We carried out eight courses of chemotherapy. Trastuzumab, docetaxel, and S-1 combination chemotherapy promise to be one of the effective treatments for HER2-positive and AFP-producing gastric cancer that have no indication for radical cure excision.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Gástricas/tratamento farmacológico , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Docetaxel , Combinação de Medicamentos , Humanos , Masculino , Ácido Oxônico/administração & dosagem , Receptor ErbB-2/análise , Neoplasias Gástricas/química , Neoplasias Gástricas/metabolismo , Taxoides/administração & dosagem , Tegafur/administração & dosagem , Trastuzumab , alfa-Fetoproteínas/biossíntese
12.
Hepatol Res ; 42(10): 966-73, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22548706

RESUMO

AIM: Little is known about the appropriate use of peginterferon-α-2b (PEG IFN-α-2b) or ribavirin (RBV) in genotype 1 chronic hepatitis C (CH-C) patients with complete early virological response (cEVR). Female patients, especially the older, are known to experience inferior treatment outcomes. METHOD: A total of 150 CH-C patients with cEVR treated for 48 weeks (n = 104) or 52-64 weeks (n = 46) with PEG IFN-α-2b and RBV combination therapy were retrospectively analyzed to evaluate the benefits of extended treatment. RESULTS: In the 48-week group, patients without a sustained virological response (SVR) were more often female (P = 0.004) and had received a significantly lower total RBV dose (P = 0.003) than those with SVR. The SVR rate in these female patients was similar to males with hepatitis C virus (HCV) RNA negativity at treatment week 8 (P = 0.413); however, it was lower than that in males with HCV RNA negativity at treatment week 12 (P = 0.005). In the 52-64-week group, although the total RBV dose (mg/kg) after treatment week 48 was less in females than in males (P = 0.027), the SVR rate in females was equivalent to that in males (P = 0.604). CONCLUSION: Genotype 1 CH-C patients treated with PEG IFN-α-2b and RBV combination therapy without SVR were more often female and had received a lower total RBV dose than males. The smaller SVR rate in female patients with cEVR compared to males may be overcome by extending treatment even if the RBV dose is lowered due to anemia.

13.
Hepatol Res ; 41(12): 1145-52, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21951359

RESUMO

AIM: Hepatic steatosis is one of the factors limiting the virological response to interferon-based antiviral therapy for chronic hepatitis C (CH-C) patients infected with genotype 1, while contradictory results have been reported for genotype 2. We aimed to clarify the effect of hepatic steatosis on therapeutic outcome and cumulative positivity of serum HCV RNA in CH-C patients infected with genotype 2 treated by peginterferon (PEG-IFN)α2b and ribavirin (RBV) combination therapy. METHODS: A total of 74 treatment-naïve non-cirrhotic CH-C patients infected with genotype 2 who received PEG-IFNα2b and RBV according to the standard regimen were divided into hepatic steatosis 0-10% and >10% groups. The clinical backgrounds, sustained virological response (SVR) rates and cumulative positivity of serum HCV RNA were compared between the two groups. RESULTS: Among the 74 patients, 61 (82.4%) had hepatic steatosis 0-10% and 13 (17.6%) had hepatic steatosis >10%. Scores of homeostasis model assessment-insulin resistance and hepatic fibrosis were higher in patients with hepatic steatosis >10% than hepatic steatosis 0-10% (P = 0.040 and 0.042, respectively). Non-SVR was more frequent in patients with hepatic steatosis >10% than hepatic steatosis 0-10% (P = 0.003). Cumulative positivity of serum HCV RNA was significantly higher in patients with hepatic steatosis >10% than hepatic steatosis 0-10% (P = 0.004). CONCLUSIONS: In CH-C patients infected with genotype 2 treated by PEG-IFNα2b and RBV combination therapy, hepatic steatosis >10% was associated with increased insulin resistance, advanced hepatic fibrosis and higher cumulative positivity of serum HCV RNA, which lead to a higher risk of non-SVR.

14.
Hepatol Res ; 41(2): 126-32, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21269382

RESUMO

AIM: We advocate a simple formula which can conveniently predict the outcome of Peg-interferon (IFN) alpha2b and ribavirin (RBV) combination therapy for genotype 1 chronic hepatitis C (CH-C) with high viral load. METHODS: A total of 338 (group A: 230, Group B: 108) genotype 1 CH-C patients treated with Peg-IFN alfa-2b and RBV were enrolled. Clinical parameters differing significantly between sustained virological responders (SVRs) and non-SVRs in group A were categorized, then a simple formula to predict SVR was constructed and re-evaluated in group B. Another formula containing hepatitis C virus amino acid mutations/substitutions also was constructed. RESULTS: In group A, gender and HCV RNA load <1000 KIU were significant predictors of SVR by multivariate logistic regression analysis. A simple formula was constructed (formula A): male gender (point 2) + HCV RNA load <1000 KIU (3) + platelet counts ≥15 × 10(4) /mm(3) (1) + age <60 (1). In group A, score (0-1) predicted SVR rate 23.8% (2-4): 48.1% and (5-7): 70.2%. According to this formula, score (0-1) predicted SVR rate 7.1% (2-4): 38.6%, and (5-7): 70.3% in group B. Information on HCV amino acid mutations/substitutions seemed to add some accuracy. CONCLUSIONS: This simple formula can be used to roughly determine, at the patients' first/second visit, the probability of response to Peg-IFN alpha2b and RBV combination therapy for genotype 1 CH-C with high viral load.

15.
Gan To Kagaku Ryoho ; 36(7): 1183-6, 2009 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-19620814

RESUMO

The patient was a 79-year-old male. In December 2002, US findings suggested hepatocellular carcinoma, and he was admitted. Liver biopsy led to a diagnosis of well-differentiated hepatocellular carcinoma. Radio frequency ablation (RFA) was performed. Then, regional relapse was detected, and treatment was repeated. However, follow-up with periodic imaging was continued based on the patient's wishes. RFA was completed in December 2005, and TAI in February 2006. In December 2007, abdominal swelling occurred. CT revealed pleural effusion/ascites and nodular tumor in the adipose tissue of the parietal peritoneum and mesentery around the liver. The patient died due to rapid deterioration. Autopsy revealed a tumor involving the liver surface to the peritoneum, suggesting cancerous peritonitis. Histopathologically, liver cancer showed sarcoma-like changes, directly infiltrating the liver surface to the peritoneum. Hepatocellular carcinoma with sarcoma-like changes and peritoneal dissemination is rare. In the present case, it was possible to compare imaging changes with autopsy findings. We report this patient and review the literature.


Assuntos
Carcinoma Hepatocelular/terapia , Ablação por Cateter , Quimioembolização Terapêutica , Neoplasias Hepáticas/terapia , Idoso , Autopsia , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/patologia , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Masculino , Peritônio/patologia , Radiografia
16.
J Mass Spectrom ; 44(9): 1300-7, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19565470

RESUMO

A novel approach to the analysis of ecstasy tablets by direct mass spectrometry coupled with thermal desorption (TD) and counter-flow introduction atmospheric pressure chemical ionization (CFI-APCI) is described. Analytes were thermally desorbed with a metal block heater and introduced to a CFI-APCI source with ambient air by a diaphragm pump. Water in the air was sufficient to act as the reactive reagent responsible for the generation of ions in the positive corona discharge. TD-CFI-APCI required neither a nebulizing gas nor solvent flow and the accompanying laborious optimizations. Ions generated were sent in the direction opposite to the air flow by an electric field and introduced into an ion trap mass spectrometer. The major ions corresponding to the protonated molecules ([M + H](+)) were observed with several fragment ions in full scan mass spectrometry (MS) mode. Collision-induced dissociation of protonated molecules gave characteristic product-ion mass spectra and provided identification of the analytes within 5 s. The method required neither sample pretreatment nor a chromatographic separation step. The effectiveness of the combination of TD and CFI-APCI was demonstrated by application to the direct mass spectrometric analysis of ecstasy tablets and legal pharmaceutical products.


Assuntos
3,4-Metilenodioxianfetamina/análise , Espectrometria de Massas/instrumentação , N-Metil-3,4-Metilenodioxianfetamina/análise , 3,4-Metilenodioxianfetamina/química , Acetaminofen/análise , Acetaminofen/química , Diazepam/análise , Diazepam/química , Difenidramina/análise , Difenidramina/química , Espectrometria de Massas/métodos , Microquímica , Estrutura Molecular , N-Metil-3,4-Metilenodioxianfetamina/química , Preparações Farmacêuticas/química , Fenetilaminas/química , Detecção do Abuso de Substâncias/métodos , Comprimidos/química , Espectrometria de Massas em Tandem , Volatilização
17.
J Gastroenterol ; 44(9): 952-63, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19517057

RESUMO

BACKGROUND: Chronic hepatitis C (CHC) genotype 1b patients with high viral load are resistant to peginterferon (PEG-IFN) and ribavirin (RBV) combination therapy, especially older and female patients. METHODS: To elucidate the factors affecting early and sustained viral responses (EVR and SVR), 409 genotype 1b patients CHC with high viral loads who had received 48 weeks of PEG-IFN/RBV therapy were enrolled. The amino acid (aa) sequences of the HCV core at positions 70 and 91 and of the interferon sensitivity determining region (ISDR) were analyzed. Host factors, viral factors, and treatment-related factors were subjected to multivariate analysis. RESULTS: Male gender, low HCV RNA load, high platelet count, two or more aa mutations of ISDR, and wild type of core aa 70 were independent predictive factors for SVR. In patients with over 80% adherences to both PEG-IFN and RBV, male gender, mild fibrosis stage, and wild type of core aa 70 were independent predictors for SVR. CONCLUSIONS: Independent predictive factors for SVR were: no aa substitution at core aa 70, two or more aa mutations in the ISDR, low viral load, high values of platelet count, mild liver fibrosis and male gender.


Assuntos
Antivirais/farmacologia , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , Proteínas não Estruturais Virais/genética , Adolescente , Adulto , Idoso , Sequência de Aminoácidos , Substituição de Aminoácidos , Farmacorresistência Viral , Quimioterapia Combinada , Feminino , Genótipo , Hepacivirus/genética , Hepatite C Crônica/genética , Humanos , Interferon alfa-2 , Interferon-alfa/farmacologia , Japão , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Análise Multivariada , Mutação , Polietilenoglicóis/farmacologia , Proteínas Recombinantes , Estudos Retrospectivos , Ribavirina/farmacologia , Fatores de Risco , Fatores Sexuais , Carga Viral , Adulto Jovem
18.
Zoolog Sci ; 25(2): 220-4, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18533754

RESUMO

Primary males that function as males throughout their lives are often found among protogynous fishes such as wrasses and parrotfishes. However, the issue of whether the sexuality of primary males involves gonochorism or hermaphroditism remains uncertain. To clarify this, we implanted estradiol-17beta (E2) into the body cavities of primary males of two protogynous wrasses, Halichoeres poecilopterus and Halichoeres tenuispinis. At 51-63 days after implantation, primary males with E2 treatment in both wrasses were observed to develop ovarian tissues. These results suggest that primary males of Halichoeres wrasses potentially have the ability to change sex and that estradiol-17beta is related to gonadal transitions in primary males.


Assuntos
Ovário/fisiologia , Perciformes/fisiologia , Diferenciação Sexual/fisiologia , Testículo/fisiologia , Animais , Feminino , Masculino
19.
Gan To Kagaku Ryoho ; 35(3): 503-6, 2008 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-18347405

RESUMO

A 70-year-old female was admitted to our hospital with high fever about 5 days before this writing, along with anemia and hyperglycemia. Upper gastrointestinal series and endoscopy revealed type 1 gastric cancer in the greater curvature. CT and MRI showed multiple liver metastasis in the right lobe. Distal partial gastrectomy with lymphadenectomy and cannulation of hepatic artery was performed. The pathological findings revealed moderately-differentiated adenocarcinoma, T2, N0, H1, M0, stage IV. The postoperative chemotherapy with S-1 (80 mg/day) was administered for 4 weeks followed by 1 week rest and CDDP (50 mg) administered once every 4 weeks by arterial infusion. Two months after operation the tumor marker values have become normal, and CT can hardly detect the metastatic liver tumors. At 8 months after operation, CT and MRI revealed complete disappearance of these tumors. Then, 12 months after operation, FDG-PET revealed no accumulation. Now, at 18 months, the CR stage has been maintained. Combined use of peroral S-1 and CDDP by arterial infusion is effective for multiple liver metastasis after gastrectomy in gastric cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Ácido Oxônico/uso terapêutico , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Tegafur/uso terapêutico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Cisplatino/administração & dosagem , Combinação de Medicamentos , Feminino , Gastrectomia , Humanos , Infusões Intra-Arteriais , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Excisão de Linfonodo , Ácido Oxônico/administração & dosagem , Tomografia por Emissão de Pósitrons , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia , Tegafur/administração & dosagem , Tomografia Computadorizada por Raios X
20.
Hepatol Res ; 38(1): 27-36, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18039201

RESUMO

AIM: We aimed to identify the candidates for antiviral therapy, among patients who are hepatitis C virus (HCV) carriers with normal serum aminotransferase (ALT), focused on the inhibition of hepatocellular carcinoma (HCC). METHODS: Four hundred and sixty-four HCV carriers with normal serum ALT and 129 HCV carriers with persistently normal ALT (PNALT) and platelet (PLT) counts >/=150 000/muL who received liver biopsies were enrolled. HCV carriers with normal serum ALT were divided into four groups according to their ALT levels (/=150 000/muL or <150 000/muL). RESULTS: In 129 HCV carriers with PNALT, the rate of progression of fibrosis stage was 0.05/year and no HCC was detected during the follow up for 10 years. Approximately 20% of patients with ALT /=150 000/muLwere at stage F2-3; however, approximately 50% of patients with ALT /=31 U/L when we focus on the inhibition of the development of HCC.

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