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Effect of an extract of Ganoderma lucidum in men with lower urinary tract symptoms： a double-blind, placebo-controlled randomized and dose-ranging study

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Asian Journal of Andrology 2008年第4期10卷 651-658页

作者： masanori noguchi Tatsuyuki Kakuma Katsuro Tomiyasu Yoshiko Kurita Hiroko Kukihara Fumiko Konishi Shoichiro Kumamoto Kuniyoshi Shimizu Ryuichiro Kondo Kei Matsuoka Departments of Urology Kurume University School of Medicine Kurume 830-0011 Japan Departments of Bio-statistics Kurume University School of Medicine Kurume 830-0011 Japan Research Laboratories Chlorella Industry Chikugo 833-0056 Japan Department of Forest and Forest Products Science Faculty of Agriculture Kyushu University Fukuoka 812-8582 Japan

Aim： To conduct a double-blind, placebo-controlled randomized and dose-ranging study to evaluate the safety and efficacy of the extract of Ganoderma lucidum （G. lucidum） in men with lower urinary tract symptoms （LUTS）. Methods： We enrolled male volunteers （〉 50 years） with an International Prostate Symptom Score （IPSS; questions 1-7）〉 5 and a prostate-specific antigen （PSA） value 〈 4 ng/mL. Volunteers were randomized into groups of placebo （n = 12）, G. lucidum of 0.6 mg （n = 12）, 6 mg （n = 12） or 60 mg （n = 14）, administered once daily. Efficacy was measured as a change from baseline in IPSS and the peak urine flow rate （Qmax）. Prostate volume and residual urine were estimated by ultrasonography, and blood tests, including PSA levels, were measured at baseline and at the end of the treatment. Results： The overall administration was well tolerated, with no major adverse effects. Statistical significances in the magnitude of changes between the experimental groups were observed at weeks 4 and 8. No changes were observed with respect to Qmax, residual urine, prostate volume or PSA levels. Conclusion： The extract of G. lucidum was well tolerated and an improvement in IPSS was observed. The recommended dose of the extract of G. lucidum is 6 mg in men with LUTS.

关键词： lower urinary tract symptoms phytotherapy outcome randomized trial

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Randomized clinical trial of an ethanol extract of Ganoderma lucidum in men with lower urinary tract symptoms

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Asian Journal of Andrology 2008年第5期10卷 777-785页

作者： masanori noguchi Tatsuyuki Kakuma Katsuro Tomiyasu Akira Yamada Kyogo Itoh Fumiko Konishi Shoichiro Kumamoto Kuniyoshi Shimizu Ryuichiro Kondo Kei Matsuoka Departments of Urology Kurume University School of Medicine Kurume 830-0011 Japan Departments of Bio-statistics Kurume University School of Medicine Kurume 830-0011 Japan Departments of Immunology Kurume University School of Medicine Kurume 830-0011 Japan Research Laboratories Chlorella Industry Co Ltd Chikugo 833-0056 Japan Department of Forest and Forest Products Science Faculty of Agriculture Kyushu University Fukuoka 812-8582 Japan

Aim： To evaluate the safety and efficacy of an extract of Ganoderma lucidum that shows the strongest 5α-reductase inhibitory activity among the extracts of 19 edible and medicinal mushrooms by a double-blind, placebo-controlled, randomized and dose-ranging study in men with lower urinary tract symptoms （LUTS）. Methods： In this trial, we randomly assigned 88 men over the age of 49 years who had slight-to-moderate LUTS to 12 weeks of treatment with G. lucidum extract （6 mg once a day） or placebo. The primary outcome measures were changes in the International Prostate Symptom Score （IPSS） and variables of uroflowmetry. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, laboratory values and the reported adverse effects. Results： G. lucidum was effective and significantly superior to placebo for improving total IPSS with 2.1 points decreasing at the end of treatment （mean difference, -1.18 points; 95% confidence interval, -1.74 to -0.62; P 〈 0.0001）. No changes were observed with respect to quality of life scores, peak urinary flow, mean urinary flow, residual urine, prostate volume, serum prostate-specific antigen or testosterone levels. Overall treatment was well tolerated with no severe adverse effects. Conclusion： The extract of G. lucidum was well tolerated and improved IPSS scores. These results encouraged a further, large-scale evaluation of phytotherapy for a long duration using the extract of G. lucidum on men with LUTS.

关键词： lower urinary tract symptoms phytotherapy outcome randomized trial Ganoderma lucidum

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Coincidence between malignant perivascular epithelioid cell tumor arising in the gastric serosa and lung adenocarcinoma

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World Journal of Gastroenterology 2015年第4期21卷 1349-1356页

作者： Sohsuke Yamada Atsunori Nabeshima Hirotsugu noguchi Aya Nawata Hisae Nishii Xin Guo Ke-Yong Wang masanori Hisaoka Toshiyuki Nakayama Department of Pathology and Cell Biology School of MedicineUniversity of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Urology School of MedicineUniversity of Occupational and Environmental HealthKitakyushu807-8555Japan Bio-information Research Center School of MedicineUniversity of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Pathology and Oncology School of MedicineUniversity of Occupational and Environ-mental HealthKitakyushu 807-8555Japan

A 4-mo history of both epigastralgia and back pain was presented in a 39-year-old male. Computed tomography showed right lung nodule and abdominal mass attached to the gastric wall, measuring approximately 30 mm and 70 mm in diameter. Since biopsy samples from the lung and abdomen revealed poorly differentiated adenocarcinoma and malignant tumor, clinicians first interpreted the abdominal mass as metastatic carcinoma, and a right lower lobectomy with following resection of the mass was performed. Gross examination of both lesions displayed gray-whitish to yellow-whitish cut surfaces with hemorrhagic and necrotic foci, and the mass attached to the serosa of the lesser curvature on the gastric body. On microscopic examination, the lung tumor was composed of a proliferation of highly atypical epithelial cells having abundant eosinophilic cytoplasm, predominantly arranged in an acinar or solid growth pattern with vessel permeation, while the abdominal tumor consisted of sheets or nests with markedly atypical epithelioid cells having pleomorphic nuclei and abundant eosinophilic to clear cytoplasm focally in a radial perivascular or infiltrative growth pattern. Immunohistochemically, the latter cells were positive for HMB45 or α-smooth muscle actin, but the former ones not. Therefore, we finally made a diagnosis of malignant perivascular epithelioid cell tumor(PEComa) arising in the gastric serosa, combined with primary lung adenocarcinoma. Furthermore, small papillary car-cinoma of the thyroid gland was identified. The current case describes the coincidence of malignant PEComa with other carcinomas, posing a challenge in distinction from metastatic tumor disease.

关键词： Perivascular epithelioid cell tumor Malignant Gast

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Serum angiotensin-converting enzyme level for evaluating significant fibrosis in chronic hepatitis B

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World Journal of Gastroenterology 2017年第36期23卷 6705-6714页

作者： Ryuichi noguchi Kosuke Kaji Tadashi Namisaki Kei Moriya Mitsuteru Kitade Kosuke Takeda Hideto Kawaratani Yasushi Okura Yosuke Aihara masanori Furukawa Akira Mitoro Hitoshi Yoshiji Third Department of Internal Medicine Nara Medical University

AIM To evaluate the diagnostic performance of angiotensinconverting enzyme(ACE)on significant liver fibrosis in patients with chronic hepatitis B(CHB). METHODS In total,100 patients with CHB who underwent liver biopsy in our hospital were enrolled,and 70 patients except for 30 patients with hypertension,fatty liver or habitual alcoholic consumption were *** compared histological liver fibrosis and serum ACE levels and evaluated the predictive potential to diagnose significant liver fibrosis by comparison with several biochemical marker-based indexes such as the aspartate aminotransferase(AST)-to-platelet ratio index(APRI),the fibrosis index based on four factors(FIB-4),the Mac-2 binding protein glycosylation isomer(M2BPGi)level and the number of platelets(Plt). RESULTS Serum ACE levels showed moderately positive correlation with liver fibrotic stages(R2=0.181).Patients with significant,advanced fibrosis and cirrhosis(F2-4)had significantly higher serum ACE levels than those with early-stage fibrosis and cirrhosis(F0-1).For significant fibrosis(≥F2),the 12.8 U/L cut-off value of ACE showed 91.7%sensitivity and 75.0%*** receiver-operating characteristic(ROC)curves analysis revealed that the area under the curve(AUC)value of ACE was 0.871,which was higher than that of APRI,FIB-4,M2BPGi and Plt. CONCLUSION The serum ACE level could be a novel noninvasive,easy,accurate,and inexpensive marker of significant fibrosis stage in patients with CHB.

关键词： Angiotensin-converting enzyme Hepatitis B virus Liver fibrosis Noninvasive fibrosis marker Aspartate aminotransferase-to-platelet ratio index Fibrosis index based on four factors Mac-2 binding protein glycosylation isomer

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Dual therapy for third-line Helicobacter pylori eradication and urea breath test prediction

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World Journal of Gastroenterology 2012年第21期18卷 2735-2738页

作者： Toshihiro Nishizawa Hidekazu Suzuki Takama Maekawa Naohiko Harada Tatsuya Toyokawa Toshio Kuwai masanori Ohara Takahiro Suzuki Masahiro Kawanishi Kenji noguchi Toshiyuki Yoshio Shinji Katsushima Hideo Tsuruta Eiji Masuda Munehiro Tanaka Shunsuke Katayama Norio Kawamura Yuko Nishizawa Toshifumi Hibi Masahiko Takahashi Division of Gastroenterology National Hospital Organization Tokyo Medical CenterTokyo 1528902 Japan Division of Gastroenterology and Hepatology Department of Internal Medicine Keio University School of MedicineTokyo 1608582 Japan Division of Gastroenterology National Hospital Organization Kyoto Medical CenterKyoto 6128555 Japan Division of Gastroenterology National Kyushu Medical CenterFukuoka 8108563 Japan Division of Gastroenterology National Hospital Organization Fukuyama Medical CenterFukuyama 7208520 Japan Division of Gastroenterology National Hospital Organization Kure Medical CenterKure 7370023 Japan Division of Gastroenterology National Hospital Organization Hakodate Medical CenterHakodate 0418512 Japan Division of Gastroenterology National Hospital Organization Maizuru Medical CenterMaizuru 6258502 Japan Division of Gastroenterology National Hospital Organization Higashihiroshima Medical CenterHigashihiroshima 7390041 Japan Division of Gastroenterology National Hospital Organization Sendai Medical CenterSendai 9838520 Japan Division of Gastroenterology National Hospital Organization Osaka Medical CenterOsaka 5400006 Japan Division of Gastroenterology National Hospital Organization Ureshino Medical CenterUreshino 8430393 Japan Division of Gastroenterology National Hospital Organization Osaka Minami Medical CenterKawachinagano 5868521 Japan Division of Gastroenterology National Hospital Organization Fukuoka Higashi Medical CenterKoga 8113195 Japan Division of Gastroenterology National Hospital Organization Yonago Medical CenterYonago 6838518 Japan Division of Gastroenterology National Hospital Organization Disaster Medical CenterTachikawa 1900014 Japan Pharmaceutical Department National Center for Global Health and MedicineTokyo 1658655 Japan

We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy. In patients with failure of first-line treatment with a proton pump inhibitor (PPI)- AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen, a third-line eradication regimen with rabeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk. Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy. A total of 46 patients were included; however, two were lost to followup. The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%,respectively. The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil, respectively. The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P = 0.019). A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%. Adverse effects were reported in 18.2% of the patients, mainly diarrhea and stomatitis. Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.

关键词： Helicobacter pylori Amoxicillin Dual therapy Eradication Urea breath test

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