1.Attenuated Allergenic Activity of Ovomucoid After Electrolysis.
Allergy, Asthma & Immunology Research 2015;7(6):599-604
Ovomucoid (OMC) is the most prominent allergen causing hen's egg allergy, containing disulfide (S-S) bonds that may be responsible for its allergic action. As S-S bonds may be reduced during electrolysis, this study was undertaken to evaluate modulation of the allergic action of OMC after electrolysis. Electrolysis was carried out for 1% OMC containing 1% sodium chloride for 30 minutes with a voltage difference of 90 V, 0.23 A (30 mA/cm2). Protein assays, amino acid measurement, and mass spectrometry in untreated OMC and OMC on both the anode and cathode sides after electrolysis were performed. Moreover, 21 patients with IgE-mediated hen's egg allergy were evaluated by using the skin prick test (SPT) for untreated OMC and OMC after electrolysis. The allergic action of OMC was reduced after electrolysis on both the anode and cathode sides when evaluated by the SPT. The modifications of OMC on electrolysis caused the loss of 2 distinct peptide fragments (57E-63K and 123H-128R) as seen on matrix-associated laser desorption/ionization time-of-flight mass spectrometry. The total free SH groups in OMC were increased on the cathode side. Although the regions of S-S broken bonds were not determined in this study, the change in S-S bonds in OMC on both the anode and cathode sides may reduce the allergenic activity.
Egg Hypersensitivity
;
Electrodes
;
Electrolysis*
;
Humans
;
Mass Spectrometry
;
Ovomucin*
;
Peptide Fragments
;
Skin
;
Sodium Chloride
2.Comparison of the Effects of a Brand-name Drug and Its Generic Drug on the Quality of Life of Alzheimer's Disease Patients.
Mikio SAKAKIBARA ; Mitsuhiko KIDO ; Jun KURIBAYASHI ; Hiroshi OKADA ; Ataru IGARASHI ; Hiroyuki KAMEI ; Toshitaka NABESHIMA
Clinical Psychopharmacology and Neuroscience 2015;13(2):174-179
OBJECTIVE: The pharmacological effects of generic (GE) donepezil are the same as Aricept, its brand-name counterpart. However, little is known as to whether these two drugs provide the same quality of life (QOL). The study subjects were patients with Alzheimer's disease who were taking donepezil hydrochloride tablets, and were selected by visiting either the local pharmacies or the patients' homes. We chose the brand-name drug Aricept and its GE form donepezil to investigate, from a long-term caregiver's perspective, the influence of both drugs on the patients' QOL. METHODS: An EuroQol-5 Dimension (EQ-5D) was used to assess the QOL of patients with Alzheimer's disease, before and after various Aricept and/or donepezil regimens. Patients were divided into four groups: first time users of Aricept (n=43), first time users of GE donepezil (n=45), users refilling previous prescriptions of Aricept (n=51), and users switching from Aricept to GE donepezil (n=51). RESULTS: The average change in the EQ-5D utility indices rose significantly in the patients starting a new regimen of Aricept and its GE drug. The patients continuing an existing regimen of Aricept showed no significant differences, even after Aricept was switched to a GE drug. CONCLUSION: The QOL of patients starting a new regimen of Aricept and its GE drug improved. The QOL was maintained upon switching to the GE drug form.
Alzheimer Disease*
;
Drugs, Generic
;
Humans
;
Pharmacies
;
Prescriptions
;
Quality of Life*
;
Tablets
3.Preoperative independent prognostic factors in patientswith borderline resectable pancreatic adenocarcinoma following curative resection: Neutrophil-lymphocyteratio and platelet-lymphocyte ratio
Sadaki Asari ; Hirochika Toyama ; Ippei Matsumoto ; Tadahiro Goto ; Jun Ishida ; Yoshihide Nanno ; Azusa Ueta ; Tetsuo Ajiki ; Masahiro Kido ; Takumi Fukumoto ; Yonson Ku
Innovation 2014;8(4):110-111
Background: Borderline resectable pancreatic adenocarcinoma (BR-PAC) is
defined as locally advanced tumor of the pancreas without metastasis that is,
although potentially resectable (R), at high risk for positive resection margin
following surgery. The therapeutic strategy has remained unestablished because
BR-PAC is biologically a heterogeneous subset in which the preoperative
prognostic factors are undetermined. Recently, several prognostic factors related
to systemic inflammation have been explored in various kinds of cancers: the
combination of serum C-reactive protein (CRP) and albumin as the modified
Glasgow prognostic factor; a combination of CRP and white blood cell count
in the prognostic index; a combination of albumin and lymphocyte counts in
Onodera’s prognostic nutritional index; the neutrophil-lymphocyte ratio (NLR);
and the platelet-lymphocyte ratio (PLR). Although these prognostic factors have
been explored in some small cohort studies of PAC patients, the results still remain
controversial especially because PAC patients with diverse clinical stages were
included in the cohorts. It has never been reported whether or not the systemic
inflammatory response is validated as a predictive risk factor in cohorts of only
advanced BR-PAC patients.
Method: Between January 2003 and June 2012 at Kobe University Hospital,
136 consecutive pancreatic adenocarcinoma (PAC) patients who underwent
surgical curative resection were retrospectively studied. Prior to surgery, the PAC
patients were stratified into R- and BR-PAC patients according to the National
Comprehensive Cancer Network guidelines. To evaluate the independent
prognostic significance of NLR and PLR, univariate and multivariate Cox
proportional-hazard models were applied.
Results: The median survival in PAC patients with preoperative NLR > 3 (n=45)
and NLR < 3 (n=91) was 17.5 months and 31.1 months, respectively (P=0.0037).
However, the median survival in PAC patients with PLR > 225 (n=32) and PLR
< 225 (n=104) was 21.8 months and 26.2 months, showing no significant
difference in overall survival between the two groups (P=0.2526). The median
survival in the R-PAC patients with NLR > 3 (n=38) and NLR < 3 (n=70) was 18.1
months and 33.1 months, respectively (P=0.0138). However, the median survival
in the R-PAC patients with PLR > 225 (n=27) and PLR < 225 (n=81) was 24.1
months and 25.8 months, showing no significant difference in overall survival
between the two groups (P=0.6533). The median survival in BR-PAC patients
with preoperative NLR > 3 (n=7) and NLR < 3 (n=21) was 14.8 months and 27.2
months, respectively (P=0.0068). In addition, median survival in BR-PAC patients
with preoperative PLR > 225 (n=5) and PLR < 225 (n=23) was 14.8 months and
26.2 months, respectively (P=0.0050). Preoperative NLR > 3 (HR=21.437, 95%
CI=4.119-142.980; P=0.0002) and PLR > 225 (HR=30.993, 95% CI=3.844-
384.831; P=0.0009) were the only independent prognostic factors in BR-PAC
patients.
Conclusion: Preoperative NLR and PLR offer independent prognostic information
regarding overall survival in BR-PAC patients following curative resection. The
workup is only to obtain a blood sample of 3 mL from PAC patients immediately
before treatment. In the near future, these factors associated with the systemic
inflammatory response may have the potential to become criteria for BRPAC
candidates to undergo neoadjuvant chemotherapy and/or neoadjuvant
chemoradiation followed by surgical resection
4. Preoperative independent prognostic factors in patientswith borderline resectable pancreatic adenocarcinoma following curative resection: Neutrophil-lymphocyteratio and platelet-lymphocyte ratio
Sadaki ASARI ; Hirochika TOYAMA ; Ippei MATSUMOTO ; Tadahiro GOTO ; Jun ISHIDA ; Yoshihide NANNO ; Azusa UETA ; Tetsuo AJIKI ; Masahiro KIDO ; Takumi FUKUMOTO ; Yonson KU
Innovation 2014;8(4):110-111
Background: Borderline resectable pancreatic adenocarcinoma (BR-PAC) isdefined as locally advanced tumor of the pancreas without metastasis that is,although potentially resectable (R), at high risk for positive resection marginfollowing surgery. The therapeutic strategy has remained unestablished becauseBR-PAC is biologically a heterogeneous subset in which the preoperativeprognostic factors are undetermined. Recently, several prognostic factors relatedto systemic inflammation have been explored in various kinds of cancers: thecombination of serum C-reactive protein (CRP) and albumin as the modifiedGlasgow prognostic factor; a combination of CRP and white blood cell countin the prognostic index; a combination of albumin and lymphocyte counts inOnodera’s prognostic nutritional index; the neutrophil-lymphocyte ratio (NLR);and the platelet-lymphocyte ratio (PLR). Although these prognostic factors havebeen explored in some small cohort studies of PAC patients, the results still remaincontroversial especially because PAC patients with diverse clinical stages wereincluded in the cohorts. It has never been reported whether or not the systemicinflammatory response is validated as a predictive risk factor in cohorts of onlyadvanced BR-PAC patients.Method: Between January 2003 and June 2012 at Kobe University Hospital,136 consecutive pancreatic adenocarcinoma (PAC) patients who underwentsurgical curative resection were retrospectively studied. Prior to surgery, the PACpatients were stratified into R- and BR-PAC patients according to the NationalComprehensive Cancer Network guidelines. To evaluate the independentprognostic significance of NLR and PLR, univariate and multivariate Coxproportional-hazard models were applied.Results: The median survival in PAC patients with preoperative NLR > 3 (n=45)and NLR < 3 (n=91) was 17.5 months and 31.1 months, respectively (P=0.0037).However, the median survival in PAC patients with PLR > 225 (n=32) and PLR< 225 (n=104) was 21.8 months and 26.2 months, showing no significantdifference in overall survival between the two groups (P=0.2526). The mediansurvival in the R-PAC patients with NLR > 3 (n=38) and NLR < 3 (n=70) was 18.1months and 33.1 months, respectively (P=0.0138). However, the median survivalin the R-PAC patients with PLR > 225 (n=27) and PLR < 225 (n=81) was 24.1months and 25.8 months, showing no significant difference in overall survivalbetween the two groups (P=0.6533). The median survival in BR-PAC patientswith preoperative NLR > 3 (n=7) and NLR < 3 (n=21) was 14.8 months and 27.2months, respectively (P=0.0068). In addition, median survival in BR-PAC patientswith preoperative PLR > 225 (n=5) and PLR < 225 (n=23) was 14.8 months and26.2 months, respectively (P=0.0050). Preoperative NLR > 3 (HR=21.437, 95%CI=4.119-142.980; P=0.0002) and PLR > 225 (HR=30.993, 95% CI=3.844-384.831; P=0.0009) were the only independent prognostic factors in BR-PACpatients.Conclusion: Preoperative NLR and PLR offer independent prognostic informationregarding overall survival in BR-PAC patients following curative resection. Theworkup is only to obtain a blood sample of 3 mL from PAC patients immediatelybefore treatment. In the near future, these factors associated with the systemicinflammatory response may have the potential to become criteria for BRPACcandidates to undergo neoadjuvant chemotherapy and/or neoadjuvantchemoradiation followed by surgical resection
5.Necessity of pharyngeal anesthesia during transoral gastrointestinal endoscopy: a randomized clinical trial
Tomoyuki HAYASHI ; Yoshiro ASAHINA ; Yasuhito TAKEDA ; Masaki MIYAZAWA ; Hajime TAKATORI ; Hidenori KIDO ; Jun SEISHIMA ; Noriho IIDA ; Kazuya KITAMURA ; Takeshi TERASHIMA ; Sakae MIYAGI ; Tadashi TOYAMA ; Eishiro MIZUKOSHI ; Taro YAMASHITA
Clinical Endoscopy 2023;56(5):594-603
Background/Aims:
The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimed to compare the observation ability with and without pharyngeal anesthesia under midazolam sedation.
Methods:
This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinal endoscopy under intravenous midazolam sedation. Patients were randomly allocated to pharyngeal anesthesia: PA+ or PA– groups (250 patients/group). The endoscopists obtained 10 images of the oropharynx and hypopharynx. The primary outcome was the non-inferiority of the PA– group in terms of the pharyngeal observation success rate.
Results:
The pharyngeal observation success rates in the pharyngeal anesthesia with and without (PA+ and PA–) groups were 84.0% and 72.0%, respectively. The PA– group was inferior (p=0.707, non-inferiority) to the PA+ group in terms of observable parts (8.33 vs. 8.86, p=0.006), time (67.2 vs. 58.2 seconds, p=0.001), and pain (1.21±2.37 vs. 0.68±1.78, p=0.004, 0–10 point visual analog scale). Suitable quality images of the posterior wall of the oropharynx, vocal fold, and pyriform sinus were inferior in the PA– group. Subgroup analysis showed a higher sedation level (Ramsay score ≥5) with almost no differences in the pharyngeal observation success rate between the groups.
Conclusions
Non-pharyngeal anesthesia showed no non-inferiority in pharyngeal observation ability. Pharyngeal anesthesia may improve pharyngeal observation ability in the hypopharynx and reduce pain. However, deeper anesthesia may reduce this difference.