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1.
Ann Oncol ; 31(9): 1198-1206, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32522691

RESUMEN

BACKGROUND: Acral melanoma (AM) is an epidemiologically and molecularly distinct entity that is underrepresented in clinical trials on immunotherapy in melanoma. We aimed to analyze the efficacy of anti-programmed cell death 1 (anti-PD-1) antibodies in advanced AM. PATIENTS AND METHODS: We retrospectively evaluated unresectable stage III or stage IV AM patients treated with an anti-PD-1 antibody in any line at 21 Japanese institutions between 2014 and 2018. The clinicobiologic characteristics, objective response rate (ORR, RECIST), survival estimated using Kaplan-Meier analysis, and toxicity (Common Terminology Criteria for Adverse Events 4.0.) were analyzed to estimate the efficacy of the anti-PD-1 antibodies. RESULTS: In total, 193 patients (nail apparatus, 70; palm and sole, 123) were included in the study. Anti-PD-1 antibody was used as first-line therapy in 143 patients (74.1%). Baseline lactate dehydrogenase (LDH) was within the normal concentration in 102 patients (52.8%). The ORR of all patients was 16.6% (complete response, 3.1%; partial response, 13.5%), and the median overall survival (OS) was 18.1 months. Normal LDH concentrations showed a significantly stronger association with better OS than abnormal concentrations (median OS 24.9 versus 10.7 months; P < 0.001). Although baseline characteristics were similar between the nail apparatus and the palm and sole groups, ORR was significantly lower in the nail apparatus group [6/70 patients (8.6%) versus 26/123 patients (21.1%); P = 0.026]. Moreover, the median OS in this group was significantly poorer (12.8 versus 22.3 months; P = 0.03). CONCLUSIONS: Anti-PD-1 antibodies have limited efficacy in AM patients. Notably, patients with nail apparatus melanoma had poorer response and survival, making nail apparatus melanoma a strong candidate for further research on the efficacy of novel combination therapies with immune checkpoint inhibitors.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Humanos , Japón , Melanoma/tratamiento farmacológico , Receptor de Muerte Celular Programada 1 , Estudios Retrospectivos , Neoplasias Cutáneas/tratamiento farmacológico
2.
Br J Dermatol ; 170(6): 1354-7, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24329551

RESUMEN

BACKGROUND: It is difficult to treat patients in the advanced stages of extramammary Paget disease (EMPD) because no effective treatment has yet been established. OBJECTIVE: To describe the experience of using combination chemotherapy (FECOM) in patients with metastatic EMPD. METHODS: Since we reported a case of metastatic EMPD that responded to FECOM, we have treated further patients with metastatic EMPD using FECOM at the National Cancer Center Hospital in Japan. FECOM consists of epirubicin 40 mg m(-2) , mitomycin C 3·5 mg m(-2) and vincristine 0·7 mg m(-2) on day 1, carboplatin 300 mg m(-2) on day 2 and 5-fluorouracil 350 mg m(-2) on days 2-6. To evaluate the efficacy of this combination therapy in patients with metastatic EMPD, data regarding patients given FECOM for the first-line treatment of metastatic EMPD were extracted retrospectively. RESULTS: Seven patients were eligible for this study. A partial response was noted in four evaluable patients (100%). The other three patients were not evaluable for clinical response. One of the three unevaluable patients showed a decrease in tumour size by 100%, the other two by about 20%. The median overall survival and progression-free survival were 9·4 months (7·6-17·3) and 6·5 months (2·6-7·9), respectively. The 1-year survival rate was 43% (three of seven). Three of the seven patients (43%) had grade 3 haematological toxicities. All treatment-related toxicities were reversible and there was no febrile neutropenia or treatment-related deaths. CONCLUSION: This study suggests that the combination chemotherapy FECOM may be a treatment option for patients with metastatic EMPD.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Ano/tratamiento farmacológico , Neoplasias de los Genitales Masculinos/tratamiento farmacológico , Enfermedad de Paget Extramamaria/tratamiento farmacológico , Neoplasias de la Vulva/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Neoplasias del Ano/cirugía , Neoplasias Óseas/secundario , Carboplatino/administración & dosificación , Terapia Combinada , Epirrubicina/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Neoplasias de los Genitales Masculinos/cirugía , Humanos , Neoplasias Hepáticas/secundario , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Persona de Mediana Edad , Mitomicina/administración & dosificación , Enfermedad de Paget Extramamaria/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Vincristina/administración & dosificación , Neoplasias de la Vulva/cirugía
3.
Br J Dermatol ; 168(6): 1259-66, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23360223

RESUMEN

BACKGROUND: Several recent studies have reported on the overexpression of human epidermal growth factor receptor (HER)2 in extramammary Paget disease (EMPD). However, there are only a few cases in which both overexpression and gene amplification of HER2 have been examined. OBJECTIVES: To evaluate the overexpression and gene amplification of HER2 using a standardized method with a large number of cases of EMPD. METHODS: Immunohistochemically, the overexpression of the HER2 protein was examined in 104 cases of EMPD, including 31 intraepithelial cases and 73 invasive cases (35 superficially invasive and 38 deeply invasive). When the HER2 protein was overexpressed or potentially overexpressed, further analysis of amplification of the gene encoding HER2, ERBB2, was undertaken using fluorescence in situ hybridization. RESULTS: The HER2 protein was overexpressed in 16 cases (15%) in total, and in 13 of 73 cases (18%) of invasive EMPD. The ERBB2 gene was amplified in all cases with a HER2 score of 3+. A HER2 score of 3+ or 2+, and ERBB2 amplification were significantly more frequent in the cases of deeply invasive EMPD than in intraepithelial/superficially invasive EMPD (24% vs. 6%/3%, P=0·012) and were correlated with a larger number of lymph-node metastases (P=0·047). Log-rank tests for survival curves showed that lymph-node metastasis and ERBB2 amplification were significant prognostic factors (P=0·0001 and P=0·043, respectively). However, by a multivariate analysis, only lymph-node status was a significant indicator of Paget-disease-specific survival (P=0·0001). CONCLUSIONS: A subset of EMPD, both intraepithelial and invasive, showed HER2 overexpression and gene amplification. These HER2 alterations were correlated with biologically aggressive EMPDs, i.e. those with deep invasion and lymph-node metastasis. Clinical trials of HER2-targeted therapy are awaited for improvement of the prognosis of patients with aggressive EMPD.


Asunto(s)
Amplificación de Genes , Regulación de la Expresión Génica/fisiología , Genes erbB-2/genética , Enfermedad de Paget Extramamaria/genética , Receptor ErbB-2/genética , Neoplasias Cutáneas/genética , Anciano , Anciano de 80 o más Años , Biomarcadores , Femenino , Amplificación de Genes/genética , Humanos , Hibridación Fluorescente in Situ/métodos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Enfermedad de Paget Extramamaria/inmunología , Receptor ErbB-2/inmunología , Índice de Severidad de la Enfermedad , Neoplasias Cutáneas/inmunología
4.
J Oral Rehabil ; 40(1): 33-42, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22943482

RESUMEN

The aim of this study was to compare the prognosis of separated and non-separated tooth autotransplantation of the upper first and second molars with complete root formation undertaken at dental clinics. The participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. This study analysed 35 separated teeth and 22 non-separated teeth of 47 participants ranging from 27 to 76 years of age (mean age: 55·0 years) after data screening and elimination. The cumulative post-transplantation survival rate at 10 years was 77·1% for separated teeth and 63·6% for non-separated teeth as calculated with the Kaplan-Meier method. There were no significant differences between separated teeth and non-separated teeth in a log rank test (P = 0·687). Separated-tooth autotransplantation can help fill narrow recipient sites and increase occlusal supporting zones, but the clinical success rate was only 48·6%. Although transplantation of teeth with complete root formation has limited prognosis, transplantation of upper first and second molars, whether separated or non-separated, is a viable option to replace missing teeth.


Asunto(s)
Arcada Parcialmente Edéntula/cirugía , Diente Molar/trasplante , Procedimientos Quirúrgicos Orales/métodos , Raíz del Diente/trasplante , Adulto , Anciano , Femenino , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Pronóstico , Trasplante Autólogo/métodos
5.
J Oral Rehabil ; 40(2): 112-8, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23134328

RESUMEN

The aim of this study was to investigate risk factors with age in the long-term prognosis of autotransplantation of teeth with complete root formation at dental clinics. Participating dentists were asked to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. The data were screened to exclude patients who were under 25 or 70 years of age and over, those who were smokers or whose smoking habits were unknown, those whose transplanted teeth had incomplete root formation or multiple roots and those with fewer than 25 present teeth post-operation. The participants in this study were 71 men (74 teeth) and 100 women (107 teeth) ranging from 25 to 69 years of age. Third molars were used as donor teeth in 89·0% of the cases. The participants were divided into three age groups of 25-39, 40-54 and 55-69. Survival analysis was conducted using the Kaplan-Meier method, and a log-rank test revealed that there were no significant differences in age groups for men or women. Cox regression analysis indicated that the survival of transplanted teeth was not influenced by age. However, although not statistically significant, the clinical success rate was lower in the 55-69-year-old group than that in the younger groups. These results indicate that if suitable donor teeth are available and the conditions are right, autotransplantation is a viable treatment for missing teeth regardless of the age of the patient.


Asunto(s)
Raíz del Diente/crecimiento & desarrollo , Diente/trasplante , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Tercer Molar/trasplante , Pronóstico , Modelos de Riesgos Proporcionales , Trasplante Autólogo
6.
J Oral Rehabil ; 40(5): 368-74, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23438017

RESUMEN

Gender-related risk factors in the survival of transplanted teeth with complete root formation have not yet been identified. The purpose of this study was to investigate gender differences in tooth autotransplantation at dental clinics. We asked participating dentists to provide information on transplantations they had undertaken from 1 January 1990 to 1931 December 2010. The data were screened to exclude patients who underwent more than one transplantation, smokers or those whose smoking habits were unknown, patients under 30 or who were 70 years old and over, cases where the transplanted teeth had incomplete root formation or multiple roots and those with fewer than 20 present teeth post-operation. We analysed 73 teeth of 73 males (mean age, 47.2 years) and 106 teeth of 106 females (mean age, 45.3 years) in this study. The cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method. The cumulative survival rate for males was 88.3% at the 5-year mark, 64.8% at 10 years and 48.6% at 15 years; for females, it was 97.2% at the 5-year mark, 85.9% at 10 years and 85.9% at 15 years. A log-rank test indicated the difference between males and females to be significant (P = 0.011). There was also a significant difference in the main causes for the loss of transplanted teeth: males lost more transplanted teeth due to attachment loss than females (P < 0.05). These results indicate that males require more attention during the autotransplantation process, particularly at the stage of pre-operation evaluation and that of follow-up maintenance.


Asunto(s)
Raíz del Diente/anatomía & histología , Diente/trasplante , Adulto , Anciano , Diente Premolar/patología , Diente Premolar/trasplante , Femenino , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Masculino , Persona de Mediana Edad , Diente Molar/patología , Diente Molar/trasplante , Odontogénesis/fisiología , Pérdida de la Inserción Periodontal/complicaciones , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Factores de Tiempo , Pérdida de Diente/etiología , Trasplante Autólogo , Resultado del Tratamiento
7.
J Oral Rehabil ; 39(11): 821-9, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22672336

RESUMEN

The aim of this study was to investigate the risk factors affecting long-term prognosis of autotransplantation of third molars with complete root formation in males at dental clinics. Participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. After data screening and elimination, participants of this study consisted of 183 teeth of 171 males ranging from 20 to 72 years of age (mean age, 44·8 years). The cumulative survival rate was 86·0% at the 5-year mark, 59·1% at 10 years and 28·0% at 15 years. The mean survival time was 134·5 months, as calculated by the Kaplan-Meier method. Single factor analysis using the log-rank test showed that the following factors had significant influence (P < 0·05) on survival of transplanted teeth: periodontal disease as the reason for recipient site tooth extraction, fewer than 25 present teeth and Eichner index Groups B1 to C. Cox regression analysis examined five factors: age, smoking habit, recipient site extraction caused by periodontal disease, fewer than 25 present teeth and Eichner index. This analysis showed that two of these factors were significant: fewer than 25 present teeth was 2·63 (95% CI, 1·03-6·69) and recipient site extraction caused by periodontal disease was 3·80 (95% CI, 1·61-9·01). The results of this study suggest that long-term survival of transplanted teeth in males is influenced not only by oral bacterium but also by occlusal status.


Asunto(s)
Tercer Molar/trasplante , Adulto , Factores de Edad , Anciano , Coronas , Pilares Dentales , Caries Dental/etiología , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/etiología , Periodontitis/complicaciones , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores de Riesgo , Tratamiento del Conducto Radicular , Resorción Radicular/etiología , Factores Sexuales , Fumar , Análisis de Supervivencia , Anquilosis del Diente/etiología , Extracción Dental , Fracturas de los Dientes/etiología , Raíz del Diente/lesiones , Alveolo Dental/cirugía , Trasplante Autólogo , Resultado del Tratamiento , Adulto Joven
8.
J Oral Rehabil ; 39(1): 37-43, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21793869

RESUMEN

The aim of this study was to investigate the usage of tooth autotransplantation in dental clinics which offer the treatment and evaluate its practicality. Participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. A total of 614 teeth from 552 patients (37 dentists) ranging in age from 17 to 79 (mean age: 44·1) were examined. Cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method, and log rank test was used for analysis of factors. The mean number of autotransplantation patients per clinic per year was 1·4. Upper third molars constituted 36·8% of donor teeth, while 37·1% were lower third molars. The lower first molar region was the most common recipient site at 32·6%, followed by the lower second molar region (28·0%). Prosthodontic treatment of transplanted teeth involved coverage with a single crown (72·5%) and abutment of bridge (18·9%). A total of 102 transplanted teeth were lost owing to complications such as attachment loss (54·9%) and root resorption (25·7%). The cumulative survival rate in cases where donor teeth had complete root formation was 90·1% at 5 years, 70·5% at 10 years and 55·6% at 15 years. The mean survival time was 165·6 months. Older age was a significant risk factor (P < 0·05) for survival. In cases where suitable donor teeth are available, autotransplantation of teeth may be a plausible treatment option for dealing with missing teeth in dental clinics.


Asunto(s)
Procedimientos Quirúrgicos Orales/estadística & datos numéricos , Diente/trasplante , Adolescente , Adulto , Anciano , Clínicas Odontológicas , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trasplante Autólogo/estadística & datos numéricos , Resultado del Tratamiento , Adulto Joven
9.
ESMO Open ; 6(6): 100325, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34839104

RESUMEN

BACKGROUND: Anti-programmed cell death protein 1 (PD-1) antibody monotherapy (PD1) has led to favorable responses in advanced non-acral cutaneous melanoma among Caucasian populations; however, recent studies suggest that this therapy has limited efficacy in mucosal melanoma (MCM). Thus, advanced MCM patients are candidates for PD1 plus anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) combination therapy (PD1 + CTLA4). Data on the efficacy of immunotherapy in MCM, however, are limited. We aimed to compare the efficacies of PD1 and PD1 + CTLA4 in Japanese advanced MCM patients. PATIENTS AND METHODS: We retrospectively assessed advanced MCM patients treated with PD1 or PD1 + CTLA4 at 24 Japanese institutions. Patient baseline characteristics, clinical responses (RECIST), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier analysis, and toxicity was assessed to estimate the efficacy and safety of PD1 and PD1 + CTLA4. RESULTS: Altogether, 329 patients with advanced MCM were included in this study. PD1 and PD1 + CTLA4 were used in 263 and 66 patients, respectively. Baseline characteristics were similar between both treatment groups, except for age (median age 71 versus 65 years; P < 0.001). No significant differences were observed between the PD1 and PD1 + CTLA4 groups with respect to objective response rate (26% versus 29%; P = 0.26) or PFS and OS (median PFS 5.9 months versus 6.8 months; P = 0.55, median OS 20.4 months versus 20.1 months; P = 0.55). Cox multivariate survival analysis revealed that PD1 + CTLA4 did not prolong PFS and OS (PFS: hazard ratio 0.83, 95% confidence interval 0.58-1.19, P = 0.30; OS: HR 0.89, 95% confidence interval 0.57-1.38, P = 0.59). The rate of ≥grade 3 immune-related adverse events was higher in the PD1 + CTLA4 group than in the PD1 group (53% versus 17%; P < 0.001). CONCLUSIONS: First-line PD1 + CTLA4 demonstrated comparable clinical efficacy to PD1 in Japanese MCM patients, but with a higher rate of immune-related adverse events.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Anciano , Antígeno CTLA-4 , Humanos , Inmunoterapia/métodos , Japón , Melanoma/tratamiento farmacológico , Estudios Retrospectivos
10.
Kyobu Geka ; 63(1): 35-40, 2010 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-20077830

RESUMEN

A 59-year old man complaining of right shoulder pain was diagnosed with Pancoast tumor. Chest computed tomography (CT) scan showed a right superior sulcus tumor, 5.8 cm in diameter, invading the middle-posterior compartment of thoracic inlet. Chest magnetic resonance imaging (MRI) sagittal section showed the possibility of infiltration to subclavian artery. The patient received preoperative concurrent chemoradiotyrapy (CCRT) [radiotherapy : 60 Gy/30 Fr, cisplatin and docetaxel], resulting in tumor regression (PR). The patient underwent right upper lobectomy and resection of the 1st- 2nd ribs and Th1 nerve via transmanubrial approach and high posterior thoracotomy. Pathological examination demonstrated a little live cancer cells and organization of necrotic tissue in the lung and inter costal region (Ef2). Transmanubrial osteomuscular sparing technique maintains an excellent exposure of thoracic inlet and cervical structures safely.


Asunto(s)
Neoplasias Pulmonares/terapia , Síndrome de Pancoast/terapia , Quimioterapia Adyuvante , Humanos , Masculino , Persona de Mediana Edad , Radioterapia Adyuvante , Toracotomía/métodos
11.
Kyobu Geka ; 62(9): 799-801, 2009 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-19670782

RESUMEN

A 62-years-old Japanese male, who had mediastinal tumor at the left thoracic inlet, was admitted to our hospital to receive surgical treatment. The tumor behind the left subclavian artery was guessed to be neurogenic benign tumor, though the involvement of the brachial plexus was unclear. We approached the tumor by means of left hemi-collar skin incision, resulting in performing safe operation with directly looking at the tumor that communicated with 1st intercostal nerve and inferior trunk of the left brachial plexus. Pathological diagnosis of the resected tumor was ganglioneuroma. Cervical approach by means of hemi-collar skin incision is thought to be available for surgical treatment of tumors at the thoracic inlet because of easy accessibility and less invasiveness than other approach with dividing bones, such as clavicle, sternum, or ribs.


Asunto(s)
Plexo Braquial , Ganglioneuroma/cirugía , Nervios Intercostales , Neoplasias Torácicas/cirugía , Humanos , Masculino , Persona de Mediana Edad
12.
Clin Transl Oncol ; 20(2): 169-175, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28674996

RESUMEN

BACKGROUND: Post-approval research or monitoring is important to determine real-world safety of new products; however, evidence is scant for vemurafenib in Japanese patients. In Japan, a unique system is officially obligated to investigate post-approval safety. Here we report the first adverse drug reaction (ADR) data from vemurafenib-treated Japanese patients with metastatic melanoma. Data were collected in an early post-marketing phase vigilance (EPPV) study. METHODS: ADRs were events for which a causal relationship with vemurafenib could not be ruled out or was unknown. ADR data were collected for patients treated with vemurafenib (960 mg bid) between 26 February and 25 August 2015. RESULTS: Among 95 patients, 46 patients had 118 ADRs (24 serious ADRs in 13 patients). The most common serious ADRs were hypersensitivity (n = 1; 3 events), arthralgia (n = 2; 2 events), pyrexia (n = 2; 2 events) and drug eruption (n = 2; 2 events). Seven patients had serious skin disorders or hypersensitivity, six of whom had prior anti-programmed cell death-1 (PD-1) antibodies 5-35 days before starting vemurafenib. ADR reports of serious skin disorders appeared to be collected more rapidly than previously reported. Cutaneous squamous cell carcinoma developed in only one patient. CONCLUSIONS: EPPV in Japanese vemurafenib-treated patients identified no new safety signals. The most serious skin and hypersensitivity ADRs occurred in patients with prior anti-PD-1 exposure. Cutaneous squamous cell carcinoma appeared to be rare in Japanese patients. Further research is needed to clarify whether prior treatment with anti-PD-1 agents or racial differences affect the characteristic profile of cutaneous ADRs in Japanese patients.


Asunto(s)
Indoles/efectos adversos , Melanoma/tratamiento farmacológico , Vigilancia de Productos Comercializados , Neoplasias Cutáneas/tratamiento farmacológico , Sulfonamidas/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Aprobación de Drogas , Industria Farmacéutica , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Pronóstico , Neoplasias Cutáneas/secundario , Vemurafenib , Adulto Joven
13.
Lung Cancer ; 104: 70-74, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-28213004

RESUMEN

OBJECTIVES: Malignant pleural effusion (MPE) has a poor prognosis. Most patients are treated with tube thoracostomy and sclerotherapy, although its success rate is around 64%. We have investigated intrapleural perfusion with hyperthermic chemotherapy (IPHC) using cisplatin in a study with a pharmacokinetic evaluation. METHODS: Patients with MPE, performance status of 0-1, possibility of good lung expansion and Cr<1.2mg/dL were treated with IPHC. The circuit was filled with 2000mL of normal saline containing cisplatin at a dose of 80mg/m2. Under video-assisted thoracoscopic surgery, the thoracic cavity was filled and perfused at a speed of approximately 1L/min at a temperature of 43°C for 1h. Perfusion solution and plasma samples were periodically collected, and concentrations of protein-unbound (free) platinum, which was the active derivative of cisplatin, and total platinum were determined by flameless atomic absorption spectrometry. RESULTS: Twenty patients with MPE (8 lung cancers, 7 mesotheliomas, and 5 others) were enrolled in this study. Rate of free platinum concentration relative to total platinum concentration in perfusion solution after 1hr IPHC at 43°C was 61.1±12.9%. Area under curve (AUC) of free platinum in the pleural space was calculated to be 26.3µg/mLxh, resulting in complete control of pleural effusion for 3 months after IHPC in all cases (95% confidence interval: 83-100%). While, absorption rate of total platinum from the pleural space was 33.8±17.0% (27.4±13.6mg/m2), and the maximum concentration of total platinum in serum was low, 0.66±0.31µg/mL, resulting in controllable side effects; grade 1 renal toxicity: 6 patients, grade 1 emesis: 7 patients. CONCLUSIONS: IPHC with cisplatin showed favorable pharmacokinetic profiles for an optional treatment to control malignant pleural effusion.


Asunto(s)
Cisplatino/farmacocinética , Hipertermia Inducida/métodos , Neoplasias Pulmonares/tratamiento farmacológico , Perfusión/métodos , Cavidad Pleural/efectos de los fármacos , Derrame Pleural Maligno/tratamiento farmacológico , Cirugía Torácica Asistida por Video/métodos , Adulto , Anciano , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Cisplatino/farmacología , Femenino , Humanos , Hipertermia Inducida/efectos adversos , Infusiones Intralesiones/efectos adversos , Infusiones Intralesiones/instrumentación , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Masculino , Mesotelioma/tratamiento farmacológico , Persona de Mediana Edad , Perfusión/efectos adversos , Platino (Metal)/uso terapéutico , Derrame Pleural Maligno/patología , Neoplasias Pleurales/tratamiento farmacológico , Estudios Prospectivos
14.
Artículo en Inglés | MEDLINE | ID: mdl-28096700

RESUMEN

By the recent introduction of molecular targeting drugs against BRAF mutation and immune checkpoint inhibitors, the prognosis of patients with melanoma in advanced stage is now improving, but still in the minority. Mucosal melanoma lacks the BRAF mutations, and hence conventional chemotherapeutic regimens must be improved. We have conventionally used dacarbazine (DTIC) for patients with metastatic mucosal melanoma. However, the efficacy of DTIC in patients with metastatic mucosal melanoma has been limited. Therefore, we explored other possibilities to improve the prognosis of patients suffering from metastatic mucosal melanoma. In this communication, we present a retrospective analysis of the sequential combination chemotherapy of DTIC with carboplatin and paclitaxel (CP) for metastatic mucosal melanoma of nasal cavity and paranasal sinuses. The objective response rate of seven patients is 14.3% by RECIST 1.1 and the overall survival (OS) is 12.5 months. These data indicate that the sequential combination chemotherapy of DTIC with CP could be an option for patients with metastatic mucosal melanoma of nasal cavity and paranasal sinuses who are currently ending into dismal prognosis.

15.
Cancer Res ; 54(7): 1672-7, 1994 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-8137280

RESUMEN

New sublines of Chinese hamster CHL cells stably expressing human NAT1 or NAT2 N-acetyltransferases or O-acetyltransferase of Salmonella typhimurium were established, and their sensitivities to carcinogenic nitroarenes and aromatic amines were compared using the in vitro micronucleus test. The subline expressing human NAT2 N-acetyltransferase exhibited the highest sensitivity to the clastogenicities of 1,8-dinitropyrene and 2-nitrofluorene. These results raise the possibility that human NAT2 N-acetyltransferase is involved in the metabolic activation of 1,8-dinitro-pyrene and 2-nitrofluorene. Since human NAT2 N-acetyltransferase exhibits a marked genetic polymorphism, the polymorphic status of human N-acetyltransferase could be a genetic predisposing factor to cancers caused by the nitroarenes. In contrast, the subline expressing O-acetyltransferase of S. typhimurium exhibited the highest sensitivity to the clastogenicity of 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) when the microsomes prepared from rat liver were present. This suggests that O-acetyltransferase of S. typhimurium has a higher ability to activate IQ than do the human acetyltransferases. Acetyltransferase enzymes of human enteric bacteria might contribute to the metabolic activation of IQ. The sublines could provide a new tool for investigation of the mechanism of metabolic activation and for assessment of cancer risk of nitroarenes and aromatic amines to humans.


Asunto(s)
Acetiltransferasas , Aciltransferasas/biosíntesis , Arilamina N-Acetiltransferasa/biosíntesis , Fluorenos/toxicidad , Pruebas de Micronúcleos , Mutágenos/toxicidad , Pirenos/toxicidad , Quinolinas/toxicidad , Salmonella typhimurium/enzimología , Animales , Secuencia de Bases , Biotransformación , Línea Celular , Supervivencia Celular/efectos de los fármacos , Cricetinae , Cricetulus , Fluorenos/metabolismo , Expresión Génica , Genes Bacterianos , Humanos , Cinética , Datos de Secuencia Molecular , Mutágenos/metabolismo , Oligodesoxirribonucleótidos , Plásmidos , Pirenos/metabolismo , Quinolinas/metabolismo , Transfección
16.
J Neurosci ; 19(19): 8409-18, 1999 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-10493742

RESUMEN

We have characterized two separate odorant receptor (OR) gene clusters to examine how olfactory neurons expressing closely linked and homologous OR genes project their axons to the olfactory bulb. Murine OR genes, MOR28, MOR10, and MOR83, share 75-95% similarities in the amino acid sequences and are tightly linked on chromosome 14. In situ hybridization has demonstrated that the three genes are expressed in the same zone, at the most dorsolateral and ventromedial portions of the olfactory epithelium, and are rarely expressed simultaneously in individual neurons. Furthermore, we have found that olfactory neurons expressing MOR28, MOR10, or MOR83 project their axons to very close but distinct subsets of glomeruli on the medial and lateral sides of the olfactory bulb. Similar results have been obtained with another murine OR gene cluster for A16 and MOR18 on chromosome 2, sharing 91% similarity in the amino acid sequences. These results may indicate an intriguing possibility that olfactory neurons expressing homologous OR genes within a cluster tend to converge their axons to proximal but distinct subsets of glomeruli. These lines of study will shed light on the molecular basis of topographical projection of olfactory neurons to the olfactory bulb.


Asunto(s)
Axones/fisiología , Mapeo Cromosómico , Regulación de la Expresión Génica , Familia de Multigenes , Bulbo Olfatorio/fisiología , Neuronas Receptoras Olfatorias/fisiología , Receptores Odorantes/genética , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Cartilla de ADN , Exones , Biblioteca de Genes , Ratones , Ratones Endogámicos BALB C , Datos de Secuencia Molecular , Mucosa Olfatoria/citología , Mucosa Olfatoria/fisiología , Neuronas Receptoras Olfatorias/citología , Alineación de Secuencia , Homología de Secuencia de Aminoácido , Homología de Secuencia de Ácido Nucleico
17.
Biochim Biophys Acta ; 1152(1): 192-6, 1993 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-8399300

RESUMEN

Two cDNA clones encoding rat mitochondrial adenine nucleotide translocator were isolated from libraries constructed from mRNAs of heart and liver. These two clones corresponded to the heart-skeletal muscle type (ANT1) and fibroblast type (ANT2), respectively. A genomic clone encoding rat ANT1 was also isolated and characterized.


Asunto(s)
ADN/aislamiento & purificación , Isoenzimas/genética , Mitocondrias Cardíacas/metabolismo , Mitocondrias Hepáticas/metabolismo , Translocasas Mitocondriales de ADP y ATP/genética , Secuencia de Aminoácidos , Animales , Clonación Molecular , ADN/química , Biblioteca de Genes , Isoenzimas/química , Masculino , Translocasas Mitocondriales de ADP y ATP/química , Datos de Secuencia Molecular , ARN Mensajero/química , Ratas , Ratas Sprague-Dawley , Ratas Wistar
18.
Biochim Biophys Acta ; 980(3): 315-8, 1989 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-2540838

RESUMEN

Amphiphilic compounds such as long-chain acyl carnitines accumulate in ischemic myocardium and potentially contribute to the myocardial damage. To characterize alterations in membrane molecular dynamics produced by palmitoylcarnitine, human erythrocytes were spin-labeled with 5-doxylstearic acid, and membrane fluidity was quantified by measuring the changes in the order parameter derived from ESR spectra. Palmitoylcarnitine induced triphasic alterations in membrane fluidity of human erythrocytes. The membrane fluidity increased for 5 min, then decreased in a concentration-dependent manner. At higher concentrations (100 and 150 microM) of palmitoylcarnitine, membrane fluidity increased again after 30 and 20 min of the incubation, respectively. Addition of 2.8 mM CaCl2 resulted in a significant decrease in membrane fluidity and enhanced the alterations in membrane fluidity caused by palmitoylcarnitine. The results suggest that alterations in molecular dynamics are one mechanism through which long-chain acyl carnitine could play an important role in ischemic injury.


Asunto(s)
Acetilcarnitina/farmacología , Carnitina/análogos & derivados , Membrana Eritrocítica/efectos de los fármacos , Fluidez de la Membrana/efectos de los fármacos , Adulto , Cloruro de Calcio/farmacología , Espectroscopía de Resonancia por Spin del Electrón , Humanos , Palmitoilcarnitina/farmacología
19.
Biochim Biophys Acta ; 1457(3): 263-72, 2000 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-10773170

RESUMEN

To understand the difference in metabolic flow in rat brown adipose tissue (BAT) from that in white adipose tissue (WAT) at the molecular level, we examined the steady-state transcript levels of 39 proteins in both adipose tissues with and without cold exposure by Northern blot analysis. In addition to the transcript levels of uncoupling protein isoforms, those of proteins involved in the transport and catabolism of fatty acids and glucose in BAT were elevated by cold exposure, suggesting the stimulation of utilization of fatty acids and glucose as fuels in BAT. As to these changes, the muscle-type subtypes were remarkable; and therefore, they were suggested to be responsible for the cold exposure-induced acceleration of energy expenditure in BAT. Furthermore, of the isoforms of beta-adrenergic receptor (beta-AR) and CCAAT enhancer binding protein (C/EBP), transcript levels of beta(1)-AR and C/EBPbeta in BAT were increased by the cold exposure. Possible roles of these proteins in energy metabolism in BAT were discussed.


Asunto(s)
Tejido Adiposo Pardo/metabolismo , Frío , Proteínas/genética , Animales , ADN Complementario , Ácidos Grasos/metabolismo , Glucosa/metabolismo , Masculino , Mitocondrias/metabolismo , Fosforilación Oxidativa , Ratas , Ratas Wistar , Triglicéridos/metabolismo
20.
Biochim Biophys Acta ; 1368(1): 129-36, 1998 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-9459591

RESUMEN

The steady state transcript levels of the four hexokinase (HK) isozymes and four glucose transporter (GLUT) isoforms were determined quantitatively by Northern analysis of RNA samples from rat tissues using synthetic fragments of the RNAs encoding the HK isozymes and GLUT isoforms. Results showed that the levels of HK isozyme transcripts were low in rat tissues, the level of that most highly expressed, the type I isozyme (HKI), in the brain being 0.025% of the total poly(A)+ RNA. A good correlation was found between the reported HK activities and the total amounts of transcripts encoding all HK isozymes in various tissues, showing that the HK activities in tissues can be estimated from the total amount of transcripts encoding HK isozymes. The proposed associated expressions of HK isozymes and GLUT isoforms in particular tissues were confirmed at their transcript levels. The steady state transcript levels of type II HK and the type 1 GLUT isoform in the malignant tumor cell line AH130 were also determined quantitatively.


Asunto(s)
Hexoquinasa/genética , Isoenzimas/genética , Proteínas de Transporte de Monosacáridos/metabolismo , ARN Mensajero/metabolismo , Animales , Electroforesis en Gel de Agar , ARN Mensajero/genética , ARN Mensajero/aislamiento & purificación , Ratas , Células Tumorales Cultivadas
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