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  • 1
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    Online Resource
    Pseudobulbar Dysarthria in the Initial Stage of Motor Neuron Disease with Dementia: A Clinicopathological Report of Two Autopsied Cases
    S. Karger AG ; 2013
    In:  European Neurology Vol. 69, No. 5 ( 2013), p. 270-274
    Details
    In: European Neurology, S. Karger AG, Vol. 69, No. 5 ( 2013), p. 270-274
    Abstract: We retrospectively analyzed the clinical features of two cases of neurodegenerative disease, whose initial symptoms were motor speech disorder and dementia, brought to autopsy. We compared the distributions of pathological findings with the clinical features. The main symptom of speech disorder was dysarthria, involving low pitch, slow rate, hypernasality and hoarseness. Other than these findings, effortful speech, sound prolongation and initial difficulty were observed. Moreover, repetition of multisyllables was severely impaired compared to monosyllables. Repetition and comprehension of words and sentences were not impaired. Neither atrophy nor fasciculation of the tongue was observed. Both cases showed rapid progression to mutism within a few years. Neuropathologically, frontal lobe degeneration including the precentral gyrus was observed. The bilateral pyramidal tracts also showed severe degeneration. However, the nucleus of the hypoglossal nerve showed only mild degeneration. These findings suggest upper motor neuron dominant motor neuron disease with dementia. We believe the results indicate a subgroup of motor neuron disease with dementia whose initial symptoms involve pseudobulbar palsy and dementia, and which shows rapid progression to mutism.
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    URL: Article
    DOI: 10.1159/000342220
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1482237-4
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  • 2
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    Online Resource
    Suppression of Allergic Diarrhea in Murine Ovalbumin-Induced Allergic Diarrhea Model by PG102, a Water-Soluble Extract Prepared from 〈i〉Actinidia arguta〈/i〉
    S. Karger AG ; 2009
    In:  International Archives of Allergy and Immunology Vol. 150, No. 2 ( 2009), p. 164-171
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 150, No. 2 ( 2009), p. 164-171
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Allergic reactions to food can involve diarrhea, vomiting, nausea and abnormal pain. PG102 has previously been shown to control various factors involved in allergy pathogenesis, including IgE and various Th1 and Th2 cytokines, in vivo as well as in vitro [Park EJ, et al.: J Allergy Clin Immunol 2005;116:1151–1157; Park EJ, et al.: J Invest Dermatol 2007;127:1154–1160]. These data indicate that PG102 might have antiallergic effects on allergic diarrhea. Here, we investigated whether PG102 could prevent allergic diarrhea in the murine ovalbumin (OVA)-induced allergic diarrhea model. 〈 i 〉 Methods: 〈 /i 〉 BALB/c mice were orally treated with PG102, dexamethasone or water for 9 days on a daily basis, followed by subcutaneous injection with OVA on day 0. Animals were orally administrated with OVA from day 7, 3 times a week, over a period of approximately 20 days. Incidence of diarrhea, serum, OVA-restimulated splenocytes and lamina propria lymphocytes were analyzed. 〈 i 〉 Results: 〈 /i 〉 Oral administration of PG102 could suppress the incidence of diarrhea in a murine allergic diarrhea model. The amelioration of allergic diarrhea by PG102 was accompanied with the inhibition of mast cell infiltration into the large intestine. The serum level of IgE, IL-6 and MCP-1 was decreased in PG102-treated mice. When splenocytes were isolated from respective groups and cultured in the presence of OVA, cells from PG102-administrated animals produced lesser amounts of IL-6 and MCP-1. 〈 i 〉 Conclusions: 〈 /i 〉 PG102 has the potential to be used as a preventive for food allergic diseases.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    URL: Article
    DOI: 10.1159/000218119
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1482722-0
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  • 3
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    Analyses of Intermediate-Stage Hepatocellular Carcinoma Patients Receiving Transarterial Chemoembolization prior to Designing Clinical Trials
    S. Karger AG ; 2020
    In:  Liver Cancer Vol. 9, No. 5 ( 2020), p. 596-612
    Details
    In: Liver Cancer, S. Karger AG, Vol. 9, No. 5 ( 2020), p. 596-612
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Intermediate-stage hepatocellular carcinoma (HCC) has a high frequency of recurrence and progression to advanced stage after transarterial chemoembolization (TACE), particularly in patients with high tumor burden. Promising new results from immune checkpoint inhibitors (ICIs) and ICI-based therapies are expected to replace TACE, especially in HCC patients with high tumor burden. 〈 b 〉 〈 i 〉 Aims: 〈 /i 〉 〈 /b 〉 The present study aimed to evaluate the effectiveness of TACE with a view to design clinical trials comparing TACE and ICIs. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We retrospectively identified intermediate-stage HCC patients undergoing TACE from our database and subdivided patients into low- and high-burden groups based on three subclassification models using the diameter of the maximum tumor and the number of tumors. Clinical outcomes were compared between low- and high-burden intermediate-stage HCC. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 1,161 newly diagnosed HCC patients, 316 were diagnosed with intermediate-stage disease and underwent TACE. The median overall survival from high-burden intermediate-stage disease was not significantly different by clinical course, reaching high tumor burden in all subclassification models. The prognosis of high-burden patients after initial TACE was poor compared with low-burden patients for two models (except for the up-to-seven criteria). In all three models, high-burden patients showed a poor durable response rate (DRR) both ≥3 months and ≥6 months and poor prognosis after TACE. Moreover, patients with confirmed durable response ≥3 months and ≥6 months showed better survival outcomes for high-burden intermediate-stage HCC. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Our results demonstrate the basis for selecting a population that would not benefit from TACE and setting DRR ≥3 months or ≥6 months as alternative endpoints when designing clinical trials comparing TACE and ICIs.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000508809
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2666925-0
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  • 4
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    Online Resource
    Caloric Nystagmus in Three Dimensions under Otolithic Control in Rhesus Monkeys
    S. Karger AG ; 1990
    In:  ORL Vol. 52, No. 4 ( 1990), p. 218-225
    Details
    In: ORL, S. Karger AG, Vol. 52, No. 4 ( 1990), p. 218-225
    Type of Medium: Online Resource
    ISSN: 1423-0275 , 0301-1569
    URL: Article
    DOI: 10.1159/000276139
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1990
    detail.hit.zdb_id: 1483533-2
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  • 5
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    Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma
    S. Karger AG ; 2021
    In:  Liver Cancer Vol. 10, No. 5 ( 2021), p. 473-484
    Details
    In: Liver Cancer, S. Karger AG, Vol. 10, No. 5 ( 2021), p. 473-484
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 There is no standard posttreatment for patients with advanced hepatocellular carcinoma (HCC) in whom lenvatinib therapy has failed. This study aimed to investigate rates of migration to posttreatment after lenvatinib and to explore candidates for second-line agents in the patients with failed lenvatinib therapy. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We retrospectively collected data on patients with advanced HCC who received lenvatinib as the first-line agent in 7 institutions. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Overall survival and progression-free survival (PFS) of 178 patients who received lenvatinib as the first-line agent were 13.3 months (95% confidence interval [CI], 11.5–15.2) and 6.7 months (95% CI, 5.6–7.8), respectively. Sixty-nine of 151 patients (45.7%) who discontinued lenvatinib moved on to posttreatment. The migration rates from lenvatinib to the second-line agent and from the second-line agent to the third-line agent were 41.7 and 44.4%, respectively. Based on multivariate analysis, response to lenvatinib (complete or partial response according to modified RECIST) and discontinuation of lenvatinib due to radiological progression, as well as male were associated with a significantly higher probability of migration to posttreatment after lenvatinib. On the other hand, alpha-fetoprotein levels of 400 ng/mL or higher was correlated with a significantly lower probability of migration to posttreatment after lenvatinib. Of 63 patients who received second-line systemic therapy, 53 (84.2%) were administered sorafenib. PFS, objective response rate (ORR), and disease control rate (DCR) for sorafenib treatment were 1.8 months (95% CI, 0.6–3.0), 1.8%, and 20.8%, respectively. According to the Cox regression hazard model, Child-Pugh class B significantly contributed to shorter PFS. PFS, ORR, and DCR of 22 patients who received regorafenib after lenvatinib in any lines were 3.2 months (range, 1.5–4.9 months), 13.6%, and 36.3%, respectively. Similarly, PFS, ORR, and DCR of 17 patients who received regorafenib after lenvatinib in the third-line (after sorafenib) were 3.8 months (range, 1.1–6.5 months), 17.6%, and 41.2%, respectively. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Sorafenib may not be a candidate for use as a posttreatment agent after lenvatinib, according to the results of the present study. Regorafenib has the potential to become an appropriate posttreatment agent after lenvatinib.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000515552
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2666925-0
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  • 6
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    A Case of Pulmonary Metastasis of Breast Cancer 23 Years after Surgery Accompanied with Non-Tuberculous Mycobacterium Infection
    S. Karger AG ; 2020
    In:  Case Reports in Oncology Vol. 13, No. 3 ( 2020-11-25), p. 1357-1363
    Details
    In: Case Reports in Oncology, S. Karger AG, Vol. 13, No. 3 ( 2020-11-25), p. 1357-1363
    Abstract: Recurrence of oestrogen receptor (ER)-positive breast cancer rarely occurs postoperatively after a long period. Breast cancer cells survive and settle in distant organs in a dormant state, a phenomenon known as “tumour dormancy.” Here, we present a 66-year-old woman with recurrence of ER-positive breast cancer in the left lung 23 years after surgery accompanied with non-tuberculous mycobacterium infection (NTM). At the age of 43 years, the patient underwent a right mastectomy and adjuvant hormonotherapy to completely cure breast cancer. Twenty-three years after the operation, when the patient was 66 years old, computed tomography presented nodular shadows in the lower lobes bilaterally with bronchiectasis and ill-defined satellite tree-in-bud nodules. 〈 i 〉 Mycobacterium intracellulare 〈 /i 〉 was detected in cultured bronchoalveolar lavage fluid obtained from the left lower lobe by bronchoscopy. Rifampicin, ethambutol, and clarithromycin were started, which resulted in shrinkage of the nodule in the right lower lobe and satellite nodules; however, the nodule in the left lower lobe increased in size gradually. Wedge resection of the left lower lobe containing the nodule by video-assisted thoracoscopic surgery was performed, which demonstrated that the nodule was adenocarcinoma in intraoperative pathological diagnosis; therefore, a left lower lobectomy and mediastinal lymph node dissection were performed. The tumour was revealed to be consistent with recurrence of previous breast cancer according to its morphology and immunohistochemical staining. Furthermore, caseous epithelioid cell granulomas existed in the periphery of the tumour. It is reported that inflammatory cytokines induce reawakening of dormant oestrogen-dependent breast cancer and, in our case, NTM infection might have stimulated the dormant tumour cells in the lower lobe.
    Type of Medium: Online Resource
    ISSN: 1662-6575
    URL: Article
    DOI: 10.1159/000511072
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2458961-5
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  • 7
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    Controlling Major Portal Vein Invasion Progression during Lenvatinib Treatment by Carbon-Ion Radiotherapy in Patients with Advanced Hepatocellular Carcinoma
    S. Karger AG ; 2021
    In:  Case Reports in Oncology Vol. 14, No. 2 ( 2021-7-15), p. 1103-1110
    Details
    In: Case Reports in Oncology, S. Karger AG, Vol. 14, No. 2 ( 2021-7-15), p. 1103-1110
    Abstract: Macrovascular invasion (MVI), including portal vein tumor thrombosis (PVTT), is strongly associated with poor prognosis in patients with hepatocellular carcinoma (HCC). While recommended standard treatment for patients with advanced HCC is systemic therapy, various treatment approaches, including resection, transarterial chemoembolization, and radiation, have been empirically suggested to improve prognosis by eliminating or controlling MVI. Herein, we report our experience of a case with advanced HCC where MVI was controlled by carbon-ion radiotherapy (CIRT) while on systemic therapy, resulting in a prolonged survival. A female patient with HCC in her early 60s had multiple intrahepatic lesions (maximum 60 mm in diameter) with PVTT. The PVTT of this patient had reached the main trunk of the portal vein despite the use of lenvatinib. The other intrahepatic lesions of the patient, except PVTT, had been controlled by lenvatinib. Therefore, hoping to control PVTT, we attempted CIRT. The patient resumed lenvatinib therapy after the irradiation. During lenvatinib re-treatment, no evident progression of PVTT was observed in the patient.
    Type of Medium: Online Resource
    ISSN: 1662-6575
    URL: Article
    DOI: 10.1159/000517440
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
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  • 8
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    Potentiation of Potassium Currents by Beta-Adrenoceptor Agonists in Human Urinary Bladder Smooth Muscle Cells: A Possible Electrical Mechanism of Relaxation
    S. Karger AG ; 2008
    In:  Pharmacology Vol. 81, No. 3 ( 2008), p. 251-258
    Details
    In: Pharmacology, S. Karger AG, Vol. 81, No. 3 ( 2008), p. 251-258
    Abstract: We examined the effects of β-adrenoceptor agonists on the membrane currents of smooth muscle cells from the human urinary bladder using a whole-cell patch clamp to investigate the involvement of Ca 〈 sup 〉 2+ 〈 /sup 〉 -activated K 〈 sup 〉 + 〈 /sup 〉 (K 〈 sub 〉 Ca 〈 /sub 〉 ) channels in relaxation by β-adrenergic agonists. With 0.05 mmol/l EGTA in the patch pipette, depolarizing pulses evoked outward rectifying currents. Isoproterenol (1 µmol/l) significantly increased the membrane currents by 75% at +80 mV with 0.05 mmol/l EGTA pipette solution. BRL 37344 (1 µmol/l) significantly increased the membrane currents by 44% at +80 mV. Iberiotoxin (100 nmol/l) significantly decreased the membrane currents by 60% at +80 mV. In the presence of iberiotoxin, the potentiation of the outward currents by isoproterenol was greatly suppressed and, in the presence of iberiotoxin and apamin (1 µmol/l), the potentiation by isoproterenol was totally abolished. On the other hand, with 5 mmol/l EGTA pipette solution, depolarizing pulses evoked smaller outward currents. Isoproterenol (1 µmol/l) did not change the membrane currents with 5 mmol/l EGTA pipette solution. The real-time PCR analysis revealed the expression of β 〈 sub 〉 2 〈 /sub 〉 -adrenoceptors in the cells. These results suggest that Ca 〈 sup 〉 2+ 〈 /sup 〉 -activated and iberiotoxin- and apamin-sensitive currents via both large-conductance and small-conductance K 〈 sub 〉 Ca 〈 /sub 〉 channels could be increased by stimulation of β 〈 sub 〉 2 〈 /sub 〉 -adrenoceptors.
    Type of Medium: Online Resource
    ISSN: 0031-7012 , 1423-0313
    URL: Article
    DOI: 10.1159/000114719
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1483550-2
    SSG: 15,3
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  • 9
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    Biliary Peritonitis Caused by Spontaneous Bile Duct Rupture in the Left Triangular Ligament of the Liver after Endoscopic Sphincterotomy for Choledocholithiasis
    S. Karger AG ; 2021
    In:  Case Reports in Gastroenterology Vol. 15, No. 1 ( 2021-1-25), p. 53-61
    Details
    In: Case Reports in Gastroenterology, S. Karger AG, Vol. 15, No. 1 ( 2021-1-25), p. 53-61
    Abstract: Spontaneous bile duct rupture is a rare condition in adults, with only 70 cases reported. Increased bile duct wall pressure may lead to rupture and biliary peritonitis. In this patient, the bile duct ruptured in the hepatic left triangular ligament. A 91-year-old man underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis and endoscopic retrograde biliary drainage (ERBD) placement. One week later, removal of the ERBD and common bile duct stones and an endoscopic sphincterotomy (EST) were performed. Four days later, the patient had abdominal pain, increased inflammatory reaction, and jaundice. Abdominal computed tomography showed ascites, bile duct dilatation and fluid collection under the liver (10 cm in diameter). Emergency surgery was performed to drain the fluid. On laparotomy, encapsulated biliary ascites was seen. To search for the site of the leak, after cholecystectomy, a tube (C-tube) was inserted into the common bile duct via cystic duct stump. Because of uncontrollable bleeding, after packing with surgical gauze, the operation was temporarily stopped. The next day, reoperation was performed. Intraoperative cholangiography with contrast dye revealed the perforation site in the left triangular ligament and a partial resection was performed. Bile excretion from the C-tube was subsequently observed, but the patient’s jaundice did not improve. Although endoscopic retrograde cholangiopancreatography revealed that the EST site was normal, ERBD was placed again, and the jaundice gradually improved. Although EST was performed in this case, biliary peritonitis resulting from spontaneous bile duct rupture occurred. This case was very informative because biliary perforation may occur even after EST.
    Type of Medium: Online Resource
    ISSN: 1662-0631
    URL: Article
    DOI: 10.1159/000510932
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2440540-1
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  • 10
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    Evolution of Survival Impact of Molecular Target Agents in Patients with Advanced Hepatocellular Carcinoma
    S. Karger AG ; 2022
    In:  Liver Cancer Vol. 11, No. 1 ( 2022), p. 48-60
    Details
    In: Liver Cancer, S. Karger AG, Vol. 11, No. 1 ( 2022), p. 48-60
    Abstract: 〈 b 〉 〈 i 〉 Background and Aims: 〈 /i 〉 〈 /b 〉 The prognosis of patients with advanced hepatocellular carcinoma (HCC) is expected to improve as multiple molecular target agents (MTAs) are now available. However, the impact of the availability of sequential MTAs has not been fully verified yet. 〈 b 〉 〈 i 〉 Approach and Results: 〈 /i 〉 〈 /b 〉 We retrospectively collected the data on the whole clinical course of 877 patients who received any MTAs as first-line systemic therapy for advanced HCC between June 2009 and March 2019. The study population was divided into 3 groups according to the date of first-line MTA administration (period 1: 2009–2012, 〈 i 〉 n 〈 /i 〉 = 267; period 2: 2013–2016, 〈 i 〉 n 〈 /i 〉 = 352; period 3: 2017–2019, 〈 i 〉 n 〈 /i 〉 = 258). Then, we compared the number of MTAs used, overall survival (OS), and MTA treatment duration among the 3 groups. Analysis was also performed separately for advanced-stage and nonadvanced-stage HCC. The proportion of patients who received multiple MTAs was remarkably increased over time (1.1%, 10.2%, and 42.6% in periods 1, 2, and 3, respectively, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). The median OS times were prolonged to 10.4, 11.3, and 15.2 months in periods 1, 2, and 3, respectively ( 〈 i 〉 p 〈 /i 〉 = 0.016). Similarly, the MTA treatment durations were extended (2.7, 3.2, and 6.6 months in periods 1, 2, and 3, respectively; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). We confirmed that the correlation between OS and MTA treatment duration was strengthened (period 1: 0.395, period 2: 0.505, and period 3: 0.667). All these trends were pronounced in the patients with advanced-stage HCC but limited in the patients with nonadvanced-stage HCC. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The availability of multiple MTAs had steadily improved the prognosis of patients with advanced HCC patients, particularly advanced-stage HCC patients.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000519868
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 2666925-0
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