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Maintenance time of sedative effects after an intravenous infusion of diazepam: A guide for endoscopy using diazepam

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World Journal of Gastroenterology 2008年第33期14卷 5197-5203页

作者： Mitsushige Sugimoto Takahisa Furuta akiko nakamura Naohito Shirai Mutsuhiro Ikuma Shingen Misaka Shinya Uchida Hiroshi Watanabe Kyoichi Ohashi Takashi Ishizaki Akira Hishida First Department of Medicine Hamamatsu University School of Medicine1-20-1 Handayama Higashi-ku Hamamatsu 431-3192 Japan Center for Clinical Research Hamamatsu University School of Medicine1-20-1 Handayama Higashi-ku Hamamatsu 431-3192 Japan Department of Gastroenterology Enshu General Hospital1-1-1 Tyuou Naka-ku Hamamatsu 430-0929 Japan Department of Pharmacoki-netics and Pharmacodynamics School of Pharmaceutics Sciences University of Shizuoka52-1 Yada Suruga-ku Shizuoka 422-8526 Japan Department of Clinical Pharmacology and Therapeutics Hamamatsu University School of Medicine1-20-1 Handayama Higashi-ku Hamamatsu 431-3192 Japan Department of Clinical Pharmacology and Therapeutics Oita University1-1 Idaigaoka Hazama Yufu 879-5593 Japan

AIM: To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450 (CYP ) 2C19 genotypes after an infusion regimen of diazepam commonly used forgastrointestinal endoscopy in Japan. METHODS: Fifteen healthy Japanese volunteers consisting of three different CYP2C19 genotype groups underwent a critical ? icker fusion test, an eye movement analysis and a postural sway test as a test for physical sedative effects, and a visual analog scale (VAS) symptom assessment method as a test for mental sedative effects during the 336 h period after the intravenous infusion of diazepam (5 mg). RESULTS: The physical sedative effects assessed by the critical flicker test continued for 1 h (t values of 5 min, 30 min and 60 min later: 4.35, 5.00 and 3.19, respectively) and those by the moving radial area of a postural sway test continued for 3 h (t values of 5 h, 30 h, 60 min and 3 h later: -4.05, -3.42, -2.17 and -2.58, respectively), which changed significantly compared with the baseline level before infusion (P < 0.05). On the other hand, the mental sedative effects by the VAS method improved within 1 h. The CYP2C19 genotype-dependent differences in the postinfusion sedative effects were not observed in any of the four psychomotor function tests. CONCLUSION: With the psychomotor tests, the objective sedative effects of diazepam continued for 1 h to 3 h irrespective of CYP2C19 genotype status and the subjective sedative symptoms improved within 1 h. Up to 3 h of clinical care appears to be required after the infusion of diazepam, although patients feel subjectively improved.

关键词： Diazepam Sedation cytochrome P450(CYP) 2C19 Endoscopy Complication Critical flicker fusion test Eye movement analysis Postural sway test Visual analog scale

Effects of adacolumn selective leukocytapheresis on plasma cytokines during active disease in patients with active ulcerative colitis

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World Journal of Gastroenterology 2006年第21期12卷 3393-3399页

作者： Hiroyuki Hanai Takayuki Iida Masami Yamada Yoshihiko Sato Ken Takeuchi Tatsuo Tanaka Kenji Kondo Masataka Kikuyama Yasuhiko Maruyama Yasushi Iwaoka akiko nakamura Kazuhisa Hirayama Abby R Saniabadi Fumitoshi Watanabe Hamamatsu South Hospital Center for Gastroenterology and IBD Research Department Endoscopic and Photodynamic Medicine Hamamatsu UniversityHamamatsuJapan Hamamatsu Medical Centre Hamamatsu Japan Seirei General Hospital Hamamatsu Japan Department Endoscopic and Photodynamic Medicine Hamamatsu University HamamatsuJapan Hamamatsu Rosai Hospital Hamamatsu Japan Fujueda General Hospital Fujieda Japan Hamamatsu Insurance Hospital Hamamatsu Japan Immunoresearch Laboratories Takasaki Japan Yasuhiko Maruyama Fujueda General Hospital FujiedaJapan

AIM： To investigate the relationship between ulcerative colitis （UC） clinical activity index （CAI） and circulating levels of IL-1ra, IL-10, IL-6 and IL-18. METHODS： Blood levels of IL-1ra, IL-10, IL-6 and IL-18 were measured in 31 patients with active UC, the mean CAI was 11.1, ranging from 5-25; and 12 healthy individuals as controls. Patients were given granulocyte and monocyte adsorptive apheresis （GMA） with Adacolumn. Leucocytes which bear the FcyR and complement receptors were adsorbed to the column leucocytapheresis carriers. Each patient could receive up to 11 GMA sessions over 8 wk. RESULTS： We found strong correlations between CAI and IL-10 （r = 0.827, P 〈 0.001）, IL-6 （r = 0.785, P 〈 0.001） and IL-18 （r = 0.791, P 〈 0.001）. IL-1ra was not correlated with CAI. Following GMA therapy, 24 of the 31 patients achieved remission and the levels of all 4 cytokines fell to the levels in healthy controls. Further, blood levels of IL-1ra and IL-10 increased at the column outflow and inflow at 60 min suggesting release from leucocytes that adhered to the carriers. CONCLUSION： Elevated blood levels of IL-6 and IL-18 together with peripheral blood granulocytes and monocytes/macrophages in patients with active UC show activative behaviour and increased survival time can be proinflammatory and the targets of GMA therapy.

关键词： Interleukin-1 receptor antagonist Interleukin-6 Interleukin-10 Interleukin-18 Ulcerative colitis

Clinical Utility of Molecular Diagnosis of Blood Stream Infections in Allogeneic Hematopoietic Stem Cell Transplantation Recipients with Hematologic Malignancies

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Advances in Microbiology 2019年第12期9卷 971-982页

作者： Atsushi Fujieda Kazunori Nakase akiko nakamura Kohshi Ohishi Yuka Sugimoto Fumihiko Monma Masahiro Masuya Naoyuki Katayama Department of Hematology and Oncology Mie University Hospital Tsu Japan Cancer Center Mie University Hospital Tsu Japan Central Clinical Laboratories Mie University Hospital Tsu Japan Transfusion Service Mie University Hospital Tsu Japan

Blood stream infections (BSIs) are a serious problem in patients with hematologic malignancies receiving allogeneic hematopoietic stem cell transplantation (ASCT). We evaluated the clinical utility of molecular diagnosis for the management of BSIs in such patients. We prospectively performed a polymerase chain reaction (PCR) analysis of microbial DNA in blood samples from 10 consecutive patients with hematological malignancies at least once a week for one month after ASCT. In total, 51 and 54 samples were analyzed by bacterial and fungal PCR assays, respectively. Bacteria were detected in 24 samples from 8 patients by PCR, but in only 2 samples from one patient by blood culture. Notably, the bacteria detected in at least half of the 24 samples were considered to have originated from the oral cavity. Fungi were detected in 5 samples from 3 patients by PCR, but not by blood culture. Most cases with positive PCR results were manageable with empirical antimicrobial therapy without disclosure of DNA data. Our DNA analyses did not directly contribute to management of BSIs, but did provide valuable microbiological evidence for the patients. Additionally, oral management appears to require a critical re-evaluation to reduce the occurrence of BSIs in ASCT recipients.

关键词： Allogeneic Hematopoietic Stem Cell Transplantation Blood Stream Infection PCR Analysis

Designing an Online Geospatial System for Forest Resource Management

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Journal of Geographic Information System 2014年第3期6卷 185-208页

作者： Peter G. Oduor Michael Armstrong Larry Kotchman Michael Kangas Buddhika Maddurapperuma Kelsey Forward Pubudu Wijeyaratne Xiana Santos akiko nakamura Krystal Leidholm California Department of Fish & Game Washburn USA Department of Computer Science North Dakota State University Fargo USA Department of Forestry Mississippi State University Starkville USA Department of Geosciences North Dakota State University Fargo USA East View Geospatial Minneapolis USA Environmental & Conservation Science Program North Dakota State University Fargo USA IT Systems Vulnerability Sanford Health Fargo Fargo USA North Dakota Forest Service Bottineau USA North Dakota Forest Service North Dakota State University Fargo USA Wenck Associates North Dakota Fargo USA

Geographic and Geospatial information systems (GISs) have especially benefited from increased development of their inherent capabilities and improved deployment. These systems offer a wide range of services, for example, user-friendly forms that interact with the geospatial components for locational information and geographic extents. An online distributed platform was designed for forest resource management with map elements residing on a GIS platform. This system is accessible on non-authenticated browsers optimized for desktops;whereas the online resource management forms are also accessible on mobile platforms. The system was primarily designed to aid foresters in implementing resource management plans or track threats to forest resource. Baseline data from the system can be easily visualized and mapped. Other data from the systemcan provide input for stochastic analyses especially with respect to forest resource management.

关键词： ArcGIS Server Wildland Fire Forest Stewardship North Dakota

Efficacy of tolvaptan in an infant with syndrome of inappropriate antidiuretic hormone secretion associated with holoprosencephaly:A case report

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World Journal of Clinical Cases 2023年第26期11卷 6262-6267页

作者： Mari Mori Satoru Takeshita Nami nakamura Yuki Mizuno akiko Tomita Mineyoshi Aoyama Hiroki Kakita Yasumasa Yamada Department of Perinatal and Neonatal Medicine Aichi Medical UniversityNagakute 480-1195Japan Department of Pathobiology Nagoya City University Graduate School of Pharmaceutical SciencesNagoya 467-8603Japan Department of Pediatrics Aichi Medical UniversityNagakute 480-1195Japan Department of Pharmacy Aichi Medical UniversityNagakute 480-1195Japan

BACKGROUND Holoprosencephaly(HPE)is a congenital malformation with various degrees of incomplete separation of the cerebral hemispheres due to differentiation disorders of the *** HPE with diabetes insipidus due to associated pituitary dysfunction has been reported,HPE with the syndrome of inappropriate antidiuretic hormone secretion(SIADH)is very ***,a vasopressin V2 receptor antagonist,is effective in adults with ***,there is no report of its efficacy in infants with *** purpose of this report is to demonstrate that tolvaptan is effective for SIADH in infants and that administration of tolvaptan eliminates the need for restriction of water intake and sodium *** SUMMARY A 2414-g female infant was born at 38 wk by normal vaginal *** anomalies and head magnetic resonance imaging indicated semilobar *** birth,she had hyponatremia due to SIADH and was treated using water and sodium ***,she developed an exaggerated response to the fluid restrictions,resulting in large fluctuations in serum sodium *** administration of tolvaptan improved the fluctuations in serum sodium levels without the need for adjustment of water or sodium *** sodium was maintained within the normal range after discontinuation of tolvaptan at 80 d of *** were no side effects,such as hypernatremia or liver dysfunction,during the administration of *** This is the first report on the safety and efficacy of tolvaptan in an infant with SIADH associated with HPE.

关键词： Tolvaptan Holoprosencephaly Antidiuretic hormone Syndrome of inappropriate secretion of antidiuretic hormone Hyponatremia Case report

Neoadjuvant chemotherapy for locally advanced cervical cancer

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Chinese Journal of Cancer Research 2016年第2期28卷 235-240页

作者： Takashi Iwata Azumi Miyauchi Yukako Suga Hiroshi Nishio Masaru nakamura akiko Ohno Nobumaru Hirao Tohru Morisada Kyoko Tanaka Hiroki Ueyama Hidemichi Watari Daisuke Aoki Department of Obstetrics and Gynecology Keio University School of Medicine Department of Obstetrics and Gynecology Hokkaido University Graduate School of Medicine

Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials （RCTs） have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy （CCRT） has markedly improved the outcome of radiotherapy （RT）, and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.

关键词： Neoadjuvant chemotherapy (NAC) cervical cancer

Genetic Polymorphisms in ADH1B and ALDH2 Are Associated with Colorectal Tumors in Japan: A Case-Control Study

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Journal of Cancer Therapy 2015年第12期6卷 1054-1062页

作者： akiko Shiotani Hideki Ishikawa Michihiro Mutoh Tatsuya Takeshita Tomiyo nakamura Kanehisa Morimoto Toshiyuki Sakai Keiji Wakabayashi Nariaki Matsuura Department of Molecular Pathology Osaka University Graduate School of Medicine & Health Science Osaka Japan Department of Molecular-Targeting Cancer Prevention Kyoto Prefectural University of Medicine Kyoto Japan Epidemiology and Prevention Division Research Center for Cancer Prevention and Screening National Cancer Center Tokyo Japan Department of Public Health Wakayama Medical University School of Medicine Wakayama Japan Department of Food Nutrition Faculty of Agriculture Ryukoku University Shiga Japan Department of Hygiene and Preventive Medicine Osaka University Graduate School of Medicine Osaka Japan Graduate Division of Nutritional and Environmental Sciences University of Shizuoka Shizuoka Japan

Background: Unlike with esophageal cancer, acetaldehyde levels and genetic polymorphisms in alcohol dehydrogenase have not yet been shown to be contributing factors for colorectal cancer (CRC). This study aimed to clarify the mechanism of CRC development related to alcohol consumption and to the presence of genetic polymorphisms in the alcohol dehydrogenase, ADH1B and aldehyde dehydrogenase, ALDH2. Methods: This was a case-control study (221 cases and 179 controls) in patients with adenomas and intramucosal tumors who underwent endoscopic removal of all tumors. The amount of alcohol consumption was determined using a self-recorded questionnaire, and the tumor information was obtained from colonoscopy results. Blood samples were taken to analyze the following polymorphisms: ALDH2 Glu504Lys and ADH1B His48Arg. Results: The polymorphisms in ADH1B and ALDH2 had little influence on the development of colorectal adenoma or intramucosal cancer. Patients with ALDH2 (Glu/Glu) were more tolerant of alcohol than those with ALDH2 (Glu/Lys and Lys/Lys). Next, we examined certain combinations of the ADH1B genotypes. In the ALDH2 (Glu/Glu) group, an increased risk (OR = 3.4;95% CI 1.4 - 8.4;P = 0.009) was observed among moderate/heavy drinkers with ADH1B (His/His). In the ALDH2 (Glu/Lys and Lys/Lys) group, an increased risk (OR = 4.2;95% CI 1.1 - 16.7;P = 0.041) was found among moderate/heavy drinkers with ADH1B (Arg/His and Arg/Arg). Conclusions: ADH1B and ALDH2 activity may be involved in the development of CRC.

关键词： Genetic Polymorphisms Colorectal Tumor Alcohol Intake Alcohol Dehydrogenase-1B Aldehyde Dehydrogenase-2