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  • 1
    Online Resource
    Online Resource
    Creutzfeldt-Jakob Disease and Cadaveric Dura Mater Grafts in Japan: An Updated Analysis of Incubation Time
    S. Karger AG ; 2005
    In:  Neuroepidemiology Vol. 24, No. 1-2 ( 2005), p. 22-25
    Details
    In: Neuroepidemiology, S. Karger AG, Vol. 24, No. 1-2 ( 2005), p. 22-25
    Abstract: The incubation time for 76 patients with cadaveric dura mater-transmitted Creutzfeldt-Jakob disease reported in Japan by November 2001 was analyzed to clarify its distributional feature and the risk factors which affect the earlier onset of the disease. Cluster analysis indicated that cases could be divided into 3 clusters with respect to the incubation time, i.e., short (1.4–6.2 years), medium (7.0–11.9 years) and long (12.9–17.6 years). The incubation time in females was significantly shorter than those in males. Patients who were transplanted dura mater for facial spasms had a significantly shorter incubation time than those who received transplantation for other diseases including meningioma, aneurysm, or acoustic schwannoma. These results suggest that some host factors may have an influence on the incubation time of the disease.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    URL: Article
    DOI: 10.1159/000081045
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1483032-2
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  • 2
    Online Resource
    Online Resource
    Oxaliplatin-Free Interval as a Risk Factor for Hypersensitivity Reaction among Colorectal Cancer Patients Treated with FOLFOX
    S. Karger AG ; 2010
    In:  Oncology Vol. 79, No. 1-2 ( 2010), p. 136-143
    Details
    In: Oncology, S. Karger AG, Vol. 79, No. 1-2 ( 2010), p. 136-143
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Hypersensitivity reaction (HSR) and sensory neuropathy are major complications of oxaliplatin-based chemotherapy. Preplanned withdrawal of oxaliplatin after the first six cycles and reintroduction at the time of disease progression (stop-and-go strategy) may reduce neurotoxicity. However, the effect of an oxaliplatin-free interval on HSR occurrence remains poorly understood. 〈 i 〉 Patients and Methods: 〈 /i 〉 Data on patients with colorectal cancer who received FOLFOX (5-fluorouracil, leucovorin and oxaliplatin) treatment between June 2005 and June 2009 were retrieved from the prospective cohort database of the Outpatient Oncology Unit of the Kyoto University Hospital. Factor analysis was performed. 〈 i 〉 Results: 〈 /i 〉 Among patients who received six or fewer cycles of FOLFOX, the incidence of HSR was low (7/99, 7.1%). For patients who received more than six cycles, the incidence of HSR was higher among patients treated with stop-and-go FOLFOX than among patients treated with continuous FOLFOX (25/61, 41.0% vs. 13/63, 20.6%; p = 0.019). Interestingly, most cases of HSR during stop-and-go FOLFOX occurred during the second or third cycle of the reintroduction phase (21/25, 84%). Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (p = 0.016). 〈 i 〉 Conclusions: 〈 /i 〉 An oxaliplatin-free interval may increase the risk of HSR. Special vigilance is needed during the second and third cycles after reintroduction of oxaliplatin.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000320613
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 3
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    Online Resource
    Retrospective Evaluation of Sequential Outpatient Chemotherapy for Advanced Gastric Cancer
    S. Karger AG ; 2007
    In:  Chemotherapy Vol. 53, No. 3 ( 2007), p. 226-232
    Details
    In: Chemotherapy, S. Karger AG, Vol. 53, No. 3 ( 2007), p. 226-232
    Abstract: 〈 i 〉 Background/Aim: 〈 /i 〉 Due to the recent development of several promising chemotherapeutic agents, such as S-1, irinotecan (CPT-11) and paclitaxel, response rates for advanced gastric cancer to chemotherapy have improved. Thus far, however, the efficacy and survival benefits of sequential chemotherapy using these agents have not been evaluated. An additional benefit of outpatient sequential chemotherapy, that is, without hospitalization, would be its contribution to the maintenance of patients’ social activities. The aim of this study was to retrospectively evaluate sequential outpatient chemotherapy for advanced gastric cancer. 〈 i 〉 Patients and Methods: 〈 /i 〉 Patients with metastatic/recurrent gastric cancer treated with sequential outpatient chemotherapy were analyzed retrospectively. The sequential treatment consisted of S1-based chemotherapy as first-line therapy, low-dose CPT-11/CDDP as second-line therapy and weekly paclitaxel administration as third-line therapy. 〈 i 〉 Results: 〈 /i 〉 A series of 32 patients was enrolled in this study. During the sequential chemotherapy, all patients were treated at the outpatient ward of Kyoto University Hospital without hospitalization. The overall response rate was 37.5% and the median survival time was 523 days (95% confidence interval: 323–723 days). The progression-free survival for the three therapies was 135 days for S-1, 148 days for low-dose CPT-11/CDDP and 57 days for paclitaxel. Grade 4 neutropenia was observed in 1 patient (3.1%), and there were no treatment-related deaths. Univariate analysis showed that factors with significant impact on survival were pathological type (intestinal vs. diffuse), clinical response (responder vs. non-responder) and prior chemotherapy. Factors with p values 〈 0.1, including pathological type, clinical response, prior chemotherapy and age ( 〉 75 vs. ≤75 years), were evaluated by multivariate analysis, which disclosed that clinical response and patient age were significantly related to patient prognosis. 〈 i 〉 Conclusion: 〈 /i 〉 In terms of survival and maintenance of social activities of patients, outpatient sequential chemotherapy appears to be both feasible and effective for advanced gastric cancer. Although prospective analysis of sequential chemotherapy is difficult because of its complex treatment protocol, clinical trials to assess the survival benefits of second-line chemotherapy for advanced gastric cancer are clearly warranted.
    Type of Medium: Online Resource
    ISSN: 0009-3157 , 1421-9794
    URL: Article
    DOI: 10.1159/000100865
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1482111-4
    SSG: 15,3
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  • 4
    Online Resource
    Online Resource
    Digestive Disease Management in Japan: A Report on The 6th Diagnostic Pathology Summer Fest in 2012
    S. Karger AG ; 2013
    In:  Digestion Vol. 88, No. 3 ( 2013), p. 153-160
    Details
    In: Digestion, S. Karger AG, Vol. 88, No. 3 ( 2013), p. 153-160
    Abstract: The 6th Diagnostic Pathology Summer Fest, held in Tokyo on August 25-26, 2012, opened its gates for everyone in the medical profession. Basic pathology training can contribute to the improvement of algorithms for diagnosis and treatment. The 6th Summer Fest with the theme 〈 i 〉 ‘Pathology and Clinical Treatment of Gastrointestinal Diseases' 〈 /i 〉 was held at the Ito International Research Center, The University of Tokyo. On August 25, 〈 i 〉 ‘Treatment of Early Gastrointestinal Cancer and New Guidelines' 〈 /i 〉 was discussed in the first session, followed by 〈 i 〉 ‘Biopsy Diagnosis of Digestive Tract: Key Points of Pathological Diagnosis for Inflammation and Their Clinical Significance' 〈 /i 〉 in the second session. On August 26, cases were discussed in the third session, and issues on pathological diagnosis and classification of neuroendorcrine tumor in the fourth session. The summaries of speeches and discussions are introduced along with the statements of each speaker. This meeting was not a formal evidence-based consensus conference, and 20 experts gave talks on their areas of specialty. Discussion was focused on how the management strategy should be standardized on the algorithm of patient care.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000355330
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1482218-0
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  • 5
    Online Resource
    Online Resource
    Risk Factors of Dementia in Patients with Cerebral Vascular Diseases Based on Taiwan National Health Insurance Data
    S. Karger AG ; 2023
    In:  Dementia and Geriatric Cognitive Disorders Vol. 52, No. 3 ( 2023), p. 184-192
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 52, No. 3 ( 2023), p. 184-192
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Vascular factors have been shown to be associated with increased risk of dementia. However, clinical trials have so far been unsuccessful, suggesting new approaches are needed. The aim of this study was to use population-based real-world data to investigate risk factors and preventive factors for dementia, including the effects of traditional Chinese medicine (TCM). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This is a retrospective cohort study using LHID2000, a dataset randomly selected from Taiwan’s National Health Insurance Research Database. Subjects with occlusion and stenosis of precerebral and cerebral arteries, cerebral atherosclerosis without mention of cerebral infarction, and transient cerebral ischemia were included. Subjects with dementia at baseline were excluded. The primary endpoint was dementia. Data for demographic and clinical comorbid status and treatments administered at baseline in 2000 and at the end of follow-up in 2013 were included. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 4,207 subjects with cerebral vascular disease and no cognitive impairment were included, of whom 392 converted to dementia during an average 5.15-year (SD: 3.79) follow-up. Depression (adjusted HR: 1.54, 95% confidence interval [CI]: 1.13–2.09), osteoporosis (adjusted HR: 1.34, 95% CI: 1.04–1.74), and the use of enalapril (adjusted HR: 1.37, 95% CI: 1.09–1.73) were risk factors for dementia, while nitroglycerin (adjusted HR: 0.67, 95% CI: 0.53–0.85) was a protecting factor, in subjects with cerebrovascular diseases without mention of cerebral infarction. In total, statins were shown to be associated with decreased risk of dementia (HR: 0.73, 95% CI: 0.59–0.91); however, no one statin subtype or TCM had such an effect. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Depression, osteoporosis, and the use of enalapril were associated with a higher risk of dementia, while nitroglycerin might be a protecting factor for dementia, in subjects with cerebrovascular diseases without mention of cerebral infarction.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000530102
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482186-2
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  • 6
    Online Resource
    Online Resource
    Nitrosonifedipine, a Photodegradation Product of Nifedipine, Suppresses Pharmacologically Induced Aortic Aneurysm Formation
    S. Karger AG ; 2018
    In:  Pharmacology Vol. 102, No. 5-6 ( 2018), p. 287-299
    Details
    In: Pharmacology, S. Karger AG, Vol. 102, No. 5-6 ( 2018), p. 287-299
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 We have reported that nitrosonifedipine (NO-NIF), a photodegradation product of nifedipine, has strong antioxidant and endothelial protective effects, and can suppress several cardiovascular diseases in animal models. The objective of the present study was to investigate the effects of NO-NIF on aortic aneurysm formation. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The mice were infused with β-aminopropionitrile for 2 weeks and angiotensin II for 6 weeks to induce aortic aneurysm formation. The oxidative stress was measured by dihydroethidium staining and nitrotyrosine staining. The expressions of inflammation-related genes were assessed by quantitative real-time PCR and immunohistochemical staining. To clarify the mechanisms of how NO-NIF suppresses vascular cell adhesion molecule (VCAM)-1, endothelial cells were used in in vitro system. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 NO-NIF suppressed pharmacologically induced the aortic aneurysm formation and aortic expansion without blood pressure changes. NO-NIF suppressed elastin degradation and matrix metalloproteinase-2 mRNA expression. NO-NIF suppressed the reactive oxygen species-cyclophilin A positive feedback loop. Upregulated mRNA expressions of inflammation-related genes and endothelial VCAM-1 were suppressed by NO-NIF co-treatment in aortae. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 NO-NIF has the potential to be a new, nifedipine-derived therapeutic drug for suppressing aortic aneurysm formation by directly improving aortic structure with its strong ability to reduce oxidative stress and inflammation.
    Type of Medium: Online Resource
    ISSN: 0031-7012 , 1423-0313
    URL: Article
    DOI: 10.1159/000492577
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1483550-2
    SSG: 15,3
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  • 7
    Online Resource
    Online Resource
    The Baseline Ratio of Neutrophils to Lymphocytes Is Associated with Patient Prognosis in Advanced Gastric Cancer
    S. Karger AG ; 2007
    In:  Oncology Vol. 73, No. 3-4 ( 2007), p. 215-220
    Details
    In: Oncology, S. Karger AG, Vol. 73, No. 3-4 ( 2007), p. 215-220
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 In cancer patients, the balance between neutrophil (N) and lymphocyte (L) cell counts fluctuates with advancing disease. The objective of our study was to determine the prognostic implications of the N/L ratio in the peripheral blood of gastric cancer patients. 〈 i 〉 Methods: 〈 /i 〉 Study participants were identified from a prospective cohort of patients with advanced gastric cancer in Japan (n = 1,220). 〈 i 〉 Results: 〈 /i 〉 The median baseline N/L was 2.58 (range, 0.63–12.7). Univariate analysis revealed that patients with an N/L ≧2.5 (n = 644) had a significantly poorer prognosis than those with an N/L 〈 2.5 (n = 576; log rank test, p = 0.019 × 10 〈 sup 〉 –12 〈 /sup 〉 ). The median survival times for these two groups were 239 (95% confidence interval, CI, 217–251 days) and 363 days (95% CI, 334–406 days), respectively, while the 1-year survival rates were 30 (95% CI, 26–34%) and 50% (95% CI, 45–54%), respectively. A multivariate Cox model established a significant relationship between the N/L ratio and survival (adjusted hazard ratio = 1.52; 95% CI, 1.32–1.75; p = 0.077 × 10 〈 sup 〉 –8 〈 /sup 〉 ). 〈 i 〉 Conclusions: 〈 /i 〉 These results suggest that the N/L ratio is an independent prognostic factor in advanced gastric cancer. Measurement of this ratio may serve as a clinically accessible and useful biomarker for patient survival.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000127412
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 8
    Online Resource
    Online Resource
    Prognostic Factor Analysis for Plaque Psoriasis
    S. Karger AG ; 2005
    In:  Dermatology Vol. 211, No. 2 ( 2005), p. 103-106
    Details
    In: Dermatology, S. Karger AG, Vol. 211, No. 2 ( 2005), p. 103-106
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Little is known about the long-term prognostic factors which affect clinical outcomes after the diagnosis of psoriasis. 〈 i 〉 Objective: 〈 /i 〉 To identify the prognostic factors which predict long-term outcomes after diagnosis. 〈 i 〉 Methods: 〈 /i 〉 Patients’ clinical characteristics at diagnosis were associated with long-term prognosis using the logistic regression method for 169 psoriasis patients (median follow-up time 11.6 years). 〈 i 〉 Results: 〈 /i 〉 The factors age ≧40 [odds ratio 0.27, 95% confidence interval (CI) 0.10–0.72, p = 0.0091], male (odds ratio 2.67, 95% CI 1.02–7.00,p = 0.0459) and BMI ≧25 (odds ratio 2.74, 95% CI 1.01–7.42, p = 0.0480) had significant effects on long-term prognosis after diagnosis. A simple prognostic index based on these factors was proposed. 〈 i 〉 Conclusions: 〈 /i 〉 Three major prognostic factors were identified. The proposed index may be useful in the design of future clinical trials for psoriasis and in the selection of appropriate therapeutic approaches for individual patients.
    Type of Medium: Online Resource
    ISSN: 1018-8665 , 1421-9832
    URL: Article
    DOI: 10.1159/000086437
    RVK:
    XA 37700
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1482189-8
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  • 9
    Online Resource
    Online Resource
    Single-Agent Gemcitabine for Biliary Tract Cancers
    S. Karger AG ; 2006
    In:  Oncology Vol. 70, No. 5 ( 2006), p. 358-365
    Details
    In: Oncology, S. Karger AG, Vol. 70, No. 5 ( 2006), p. 358-365
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 The aim of this study was to investigate the outcomes of gemcitabine-treated patients with inoperable biliary tract cancers. 〈 i 〉 Methods: 〈 /i 〉 We conducted a retrospective study of consecutively treated 22 inoperable biliary tract cancer patients with gemcitabine (500–1,000 mg/m 〈 sup 〉 2 〈 /sup 〉 on days 1, 8, 15 every 4 weeks) as first-line, and 17 patients as second- or third-line treatment. 〈 i 〉 Results: 〈 /i 〉 The response rate of patients treated with gemcitabine as first-line and second- or third-line treatment was 5.3 and 28.5%, respectively. The median overall survival time in the first-, and second- or third-line treatment groups was 8.3 and 17.0 months, and the 1-year survival rate was 44.0 and 50.9%, respectively. The present study also suggests the possibility that the prognosis of patients with high levels of C-reactive protein and total bilirubin, or a low level of albumin might be worse. 〈 i 〉 Conclusions: 〈 /i 〉 Our results indicate that the treatment of inoperable biliary tract cancers with gemcitabine is feasible. There was no difference in the response rate and overall survival between biliary tract cancer patients in the first- and second- or third-line treatment groups. We also present the systematic review of literature of the recent treatment results of biliary tract cancers treated with gemcitabine.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000098109
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2006
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 10
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    Online Resource
    Rapid Formation of Cerebral Microbleeds after Carotid Artery Stenting
    S. Karger AG ; 2012
    In:  Cerebrovascular Diseases Extra Vol. 2, No. 1 ( 2012-3-14), p. 9-16
    Details
    In: Cerebrovascular Diseases Extra, S. Karger AG, Vol. 2, No. 1 ( 2012-3-14), p. 9-16
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Recent studies reported that cerebral microbleeds (CMBs), i.e. small areas of signal loss on T 〈 sub 〉 2 〈 /sub 〉 *-weighted gradient-echo (GE) imaging, could develop rapidly after acute ischemic stroke. We hypothesized that CMBs rapidly emerge after carotid artery stenting (CAS). 〈 i 〉 Objective: 〈 /i 〉 We investigated the frequency of and predisposing factors for CMBs after CAS. 〈 i 〉 Methods: 〈 /i 〉 We retrospectively examined MRI before and after CAS in 88 consecutive patients (average age: 71.7 ± 7.2 years, average rates of carotid stenosis: 72.6 ± 12.8%) who underwent CAS for carotid artery stenosis between March 1, 2009, and September 30, 2010. We defined new CMBs as signal losses that newly appeared on the follow-up GE. We examined the association of new CMBs with demographics, risk factors, and baseline MBs. 〈 i 〉 Results: 〈 /i 〉 Among 88 patients, 18 (20.5%) had CMBs initially, and 7 (8.0%) developed new CMBs right after CAS. New CMBs appeared on the same side of CAS in all of the 7 patients. New CMBs appeared significantly more frequently in the CMB-positive group than in the CMB-negative one (22% vs. 4%, p = 0.03) on the pre-CAS MRI. Multivariate analysis also revealed that the presence of CMBs before CAS was an independent predictor of new development of CMBs after CAS (odds ratio: 8.09, 95% confidence interval: 1.39–47.1). 〈 i 〉 Conclusion: 〈 /i 〉 CMBs can develop rapidly after CAS, especially in patients with pre-existing CMBs. Since the existence of CMBs prior to CAS suggests a latent vascular damage which is vulnerable to hemodynamic stress following CAS, particular attention should be paid to the prevention of intracerebral hemorrhage due to hyperperfusion after CAS.
    Type of Medium: Online Resource
    ISSN: 1664-5456
    URL: Article
    DOI: 10.1159/000337143
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
    detail.hit.zdb_id: 2651613-5
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