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Biomedical subjects

H Shigematsu

Publications and source records attributed to H Shigematsu.

At least 19 recordsLinked to original sources
PubMed2026

Eribulin versus taxane as first-line chemotherapy combined with dual HER2 blockade in patients with HER2-positive locally advanced or metastatic breast cancer: final survival outcomes of the JBCRG-M06/EMERALD study.

BACKGROUND: The phase III JBCRG-M06/EMERALD study was the first to show noninferior progression-free survival (PFS) of eribulin to taxane, combined with dual human epidermal growth factor receptor 2 (HER2) blockade (trastuzumab plus pertuzumab), as a first-line treatment for HER2-positive locally advanced breast cancer or metastatic breast cancer (LABC/MBC). We report final survival outcomes and biomarker analyses of the EMERALD trial. PATIENTS AND METHODS: Patients with HER2-positive LABC/MBC were randomly assigned 1:1 to either eribulin or physician-choice taxane (docetaxel or paclitaxel), both combined with trastuzumab plus pertuzumab, as first-line chemotherapy. PFS and overall survival (OS) were assessed through 30 June 2023 for PFS and 31 December 2024 for OS. Survival outcomes were compared between the eribulin and taxane groups and according to circulating tumor DNA (ctDNA) detection of PIK3CA mutations (PIK3CAm+; E542K, E545K, H1047R, and N345K single nucleotide variants) or HER2 amplification (HER2 amp+; ERBB2 copy number >2.5). RESULTS: Median OS was 78.5 months [95% confidence interval (CI) 64.3-not reached (NR)] for eribulin and was NR for taxane, with a hazard ratio of 1.25 (95% CI 0.92-1.71, log-rank P = 0.19). The 60-month OS rates were 59.7% and 65.2% for eribulin and taxane, respectively. Median OS and 60-month OS rates were numerically lower in ctDNA PIK3CAm+ patients, and greater in ctDNA HER2 amp+ patients for all patients and with stratification by treatment group. There were no statistical interactions between treatment group with either ctDNA PIK3CAm or ctDNA HER2 amp status. Similar patterns were observed for PFS. CONCLUSION: Final survival analysis revealed that median OS exceeded 6 years with eribulin or physician-choice taxane, combined with trastuzumab plus pertuzumab, as first-line chemotherapy for HER2-positive LABC/MBC, with no significant differences between the two groups. ctDNA PIK3CAm+ status was a poor prognostic factor. ctDNA HER2 amp+ was associated with longer survival.

Aged↗
PubMed1995

The influence of surgical insults on restenosis after transluminal balloon angioplasty.

The influences of atherogenic response on restenosis after transluminal balloon angioplasty and the anastomosis of arterial reconstruction were investigated. Iliac transluminal balloon angioplasty was performed on 81 consecutive patients at 86 sites, between January, 1987 and December, 1992. A balloon angioplasty alone was performed in 58 patients at 60 sites, while distal revascularization was performed in 23 patients on 26 limbs, in association with the angioplasty. An improvement in the inflow of the distal grafts was achieved in 22 of these 23 patients in 26 limbs. The combined distal revascularization included 21 femoropopliteal bypasses, 3 femorofemoral bypasses, and 2 thromboendarterectomies at the profunda femoris arteries. A reduction in the luminal diameter after the balloon angioplasty was determined by means of follow-up arteriograms which showed no obvious progression of the restenosis at the angioplasty sites even when neointimal hyperplasia had developed at the anastomosis of the arterial reconstruction. The accumulative graft patency rate of the combined distal revascularization did not differ significantly from that of femoropopliteal reconstructions alone during the same study period. This study demonstrated that concomitant surgical insults do not have a detrimental effect on restenoses at angioplasty sites.

Aged↗
PubMed1995

Conversion of glomerular histology from a mesangiopathic to a membranopathic pattern in serum sickness nephritis with prolonged sensitization.

In order to examine the effect of prolonged sensitization on glomerular injury, serum sickness nephritis was induced in Fischer rats by administration of egg albumin (EA). Animals were divided into A, B and C groups with 4-week, 6-week and 8-week sensitization, respectively. The experimental results were as follows: Both group A (4 weeks) and group B (6 weeks) showed mesangial immune complex deposition with proliferation (mesangiopathic pattern), but in the latter both the size and the amount of the deposits were larger than those in the former; while group C (8 weeks) demonstrated predominant distribution of deposition along the capillary walls (membranopathic pattern). It is suggested that such conversion of deposition from mesangiopathic to membranopathic pattern after prolonged repeated sensitization may be the result of the change of the host immune response to antigen, and/or the character of the antibody.

Animals↗
PubMed1995

Self-induced photogenic seizures in a child with severe myoclonic epilepsy in infancy: optical investigations and treatments.

In a 2-year-old patient with severe myoclonic epilepsy in infancy, we studied self-induced photogenic seizures using optical filters and blue-tinted contact lenses. The patient induced absences and/or myoclonic jerks by two kinds of behaviors: flickering hand movement (FHM) and forced eye closure (FEC). The placebo inhibitory effect on FHM by a blank goggle frame indicated that acquisition of learning affected the frequency of FHMs per se. Optical studies suggested that the degree of absorption from approximately 600-700 nm might determine the inhibitory effect of filters on FHM. Investigations using contact lenses showed that blue-tinted lenses gradually reduced photosensitivity and inhibited FHMs.

Child, Preschool↗
PubMed1995

Nonphotosensitive video game-induced partial seizures.

We report a 9-year-old boy with a ring 20 chromosome anomaly whose complex partial seizures (CPS), presumably of frontal lobe origin, were often induced by playing video games. Neither photosensitivity nor pattern sensitivity was observed. An intensive video-EEG investigation showed that video games as well as mental calculation elicited rhythmic runs of bilateral high-voltage slow waves, which eventually evolved into ictal discharges. This case suggests that higher brain functions can be involved in seizure induction.

Brain↗
PubMed1994

Computer-aided 3-dimensional visualization of abdominal aortic aneurysms from CT images.

A new method for elucidating the process of abdominal aortic aneurysm enlargement is presented herein. First, 3-dimensional (3-D) reconstructed images were used to precisely evaluate the size of an aneurysm, after which reconstruction and a volume analysis of images were performed with a personal computer system using serial computed tomographic films. The evolution of an aneurysm was examined by the detailed reconstruction, and an estimation of size was achieved by accurately measuring the figure reconstructed from the angle perpendicular to the axis of the contour. In quantifying the enlargement of an aneurysm, an exact evaluation of volume changes and morphological changes can be performed using the 3-D reconstruction method from the film series obtained at follow-up studies. The volume analysis proved especially useful for evaluating the axial expansion of aneurysms with stable maximum diameters.

Aortic Aneurysm, Abdominal↗
PubMed1994

Nonanastomotic aneurysm formation in a Dacron arterial graft: report of a case.

Dacron prostheses are the most widely used grafts in replacement procedures for abdominal aortic aneurysms, having been proven as the most reliable substitute for arterial replacement. However, we present herein the rare case of an 82-year-old woman in whom nonanastomotic aneurysm formation occurred in the graft as a complication associated with a Dacron prosthesis. The patient presented with a pulsatile mass in the right inguinal region. She had undergone surgery 13 years earlier for an abdominal aortic aneurysm, at which time an aortobifemoral graft reconstruction had been performed with a double-velour knitted Dacron prosthesis. The pulsatile mass was found to be a nonanastomotic aneurysm of the right limb of the bifurcated graft with an intact distal anastomosis. In this case, the development of the graft aneurysm seemed to result from deterioration of the Dacron prosthesis itself due to mechanical fatigue caused by the inguinal band.

Aged↗
PubMed1994

Perioperative changes in coagulative and fibrinolytic function during surgical treatment of abdominal aortic aneurysm and arteriosclerosis obliterans.

To determine the factors which influence perioperative coagulative and fibrinolytic function, we studied 41 patients who underwent surgical repair of unruptured abdominal aortic aneurysm (AAA) and 30 patients who underwent arterial reconstruction for arteriosclerosis obliterans (ASO). In patients with AAA, the levels of fibrin/fibrinogen degradation products (FDP) (11.4 +/- 20.1 micrograms/ml), thrombin-antithrombin III complex (TAT) (22.0 +/- 21.8 micrograms/l), plasmin-alpha 2 plasmin inhibitor complex (PIC) (2.6 +/- 2.9 micrograms/ml) and d-dimer of cross-linked fibrin degradation products (D-D) (8.4 +/- 10.8 micrograms/ml) were elevated, particularly when the AAAs had a large mural thrombus surface area or were accompanied by aneurysm of the iliac or femoral artery. In arterial aneurysms, blood coagulability and secondary fibrinolytic activity were believed to be enhanced. In patients with ASO, the level of TAT (17.2 +/- 24.8 micrograms/l) was so elevated that they were considered to show chronic hypercoagulability. Among the ASO patients with aorto-iliac lesions, those with concomitant graft occlusion or anastomotic aneurysm had significantly elevated levels of TAT. Proximal arterial occlusion or accompanying aneurysm in the ASO patients was associated with increased levels of PIC and D-D. Postoperative fluctuations in conventional hematological variables did not differ significantly among the surgical procedures. Conventional markers showed a transient decrease due to consumption during surgery, and a subsequent recovery or an actual increase within several days after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

An objective assessment of intermittent claudication by near-infrared spectroscopy.

Changes in tissue oxygenation in the calf muscle were measured by near-infrared spectroscopy (NIRS) in 62 patients who complained of intermittent claudication in the calf during a treadmill test. Three distinctive patterns of oxygenated and deoxygenated haemoglobin were observed. None of the type 0 cases were severe (i.e., unable to walk for more than 5 minutes), while 37 and 82% of the type 1 and type 2 cases were severe, respectively. The mean maximum walking distance of type 1 was significantly longer than that of type 2 (179 +/- 70 m and 109 +/- 46 m, respectively; p < 0.005), while the mean ankle-brachial pressure index at rest of type 1 was not significantly different from that of type 2 (0.68 +/- 0.19 and 0.61 +/- 0.23, respectively). Our results indicate that NIRS can be used to accurately assess the severity of intermittent claudication.

Adult↗
PubMed1994

The importance of cellular adhesion for mesangial cell proliferation in serum sickness nephritis of the rat: a co-culture study of glomerular macrophages and mesangial cells.

The role of cell-cell contact on activating mesangial cell proliferation by nephritic macrophage was investigated. Nephritic glomerular macrophages were obtained from serum sickness nephritis (SSN) rat kidneys at 14 days after the cessation of sensitization, when proliferating cells were most increased in the glomeruli in the course of the SSN. The effect of the nephritic macrophages on mesangial cell proliferation was greater than that of control by co-culture allowing cellular contact. However, nephritic macrophages did not enhance mesangial cell proliferation by co-culture without direct contact even though the nephritic macrophages were activated with lipopolysaccharides. Conditioned medium from co-culture of the nephritic macrophages and mesangial cells did not enhance mesangial cell proliferation. Anti-intercellular adhesion molecules (ICAM)-1 antibody inhibited mesangial cell proliferation by direct co-culture dose-dependently. From these results, cellular contact was important for stimulation of mesangial cell proliferation by macrophages and ICAM-1 participated in these interactions.

Animals↗
PubMed1994

[Susceptibility to macrolides against Mycoplasma pneumoniae isolated during 7 years].

The efficacies of macrolide antibiotics, rokitamycin, leukomycin, josamycin and erythromycin were investigated against 63 strains of M. pneumoniae included FH strain which were isolated from clinical specimens obtained in 1986-1987, 1991, 1992-1993. Values of MICs and MBCs of these antibiotics were evaluated by two methods, broth dilution method and M. pneumoniae L cell infection system. In broth dilution method, MIC50 and MBC50 of rokitamycin were 0.0063-0.025 microgram/ml and 0.025-0.2 microgram/ml respectively. The ratios of MBC50/MIC50 were 1-32. MIC50 of leukomycin, josamycin and erythromycin were 0.0063-0.05 micrograms/ml, 0.0025-0.05 microgram/ml, and 0.0125-0.05 microgram/ml respectively. MBC50 of these drugs were 0.0125-50 micrograms/ml, 25-50 micrograms/ml, and 25-50 micrograms/ml respectively. The ratios of MIC50/MBC50 were 2-800, 500-2000, 500-4000. MIC50 of rokitamycin and leukomycin to the isolates during period from 1992-1993 were higher as compare to those of isolates during 1986 to 1991. On the other hand, rokitamycin markedly reduced the numbers of CFU in the growth phase when added at the concentrations of 16 and 4 times the MIC, but the other macrolides were reduced slightly CFU at the concentrations of 4 times, the MIC. In L cell infectious system, MIC50 and MBC50 of rokitamycin were 0.005-0.0125 microgram/ml and 0.05-0.1 microgram/ml respectively. The ratios of MBC50/MIC50 were 1-2 Ratios of leukomycin, josamycin, and erythromycin were 0.05-0.1 microgram/ml, 0.05-0.2 microgram/ml and 0.050-0.1 microgram/ml respectively. The MBC50 of these drugs were 0.2-0.4 micrograms/ml, 0.8-1.6 microgram/ml, 0.8-1.6 microgram/ml. Ratios of MBC50/MIC50 were 2-8, 4-32, 8-32.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1994

[Anesthetic management of a patient with Freeman-Sheldon syndrome].

The Freeman-Sheldon syndrome is a rare congenital myopathy and dysplasia that results in deformity of the face, hands, and feet. We describe here some problems in general anesthesia from the anesthetic management point of view. An 8-year-old girl with Freeman-Sheldon syndrome underwent surgery under general anesthesia for the correction of lip deformity and microstomia. Patients with this syndrome may present anesthetic problems involving difficulties in endotracheal intubation due to microstomia, micrognathia and neck rigidity, as well as postoperative respiratory complications and problems that relate to myogenetic morphology and myofunctional abnormalities. Preoperatively, we analyzed X-ray cephalograms to evaluate the difficulty of endotracheal intubation. Fiberscopic endotracheal intubation was performed; the time required was 55 minutes. On recovery from anesthesia and after becoming fully responsive, she was extubated in the operating room without any complications. Postoperative recovery was uneventful. Patients with Freeman-Sheldon syndrome should be managed by good preanesthetic preparation, and attention should be paid to postoperative respiratory complications due to the use of muscle relaxants and to securing intravenous access.

Abnormalities, Multiple↗
PubMed1994

Significance of first renal biopsy histology for therapeutic selection in IgA nephropathy.

Histological differences were analyzed in the first renal biopsy specimen of IgA nephropathy of patients treated with or without the use of steroids, using samples supplied from multi-institutional sources. The application of acuteness and chronicity index indicated that the occurrence of acute intra- and/or extra-capillary lesions was significantly high in progressive cases. Though in present study the dosage or duration of steroids was different in each case, steroids appeared to have been selected preferentially for histologically active cases. Since steroids are used clinically in acute inflammatory disease like SLE, and have been experimentally demonstrated to be effective in suppressing the extent of acute inflammation, effective usage of steroids is recommended in attempts to treat IgA nephritis with high acuteness index scores. The high acuteness index seems appropriate for the selection of steroids for IgA nephropathy.

Adult↗
PubMed1994

The significance of tubulointerstitial nephritis in IgA nephritis.

The occurrence of significant tubulointerstitial nephritis (TIN) was observed in 6 (18.3%) of 32 patients with IgA nephritis registered in 1991. T lymphocytes and macrophages in the interstitium were seen to invade the tubulus through injured tubular basement membrane (TBM), then were seen in the intercellular spaces of tubular cells which showed degeneration, single cell necrosis or detachment. Thus some tubular components were seen destroyed and had disappeared resulting in interstitial fibrosis, and others showed a regeneration process forming a renewed TBM on the innerside of the original TBM. However the recurrence of cellular inflammation was again observed in these regenerated tubuli. Thus the progression of nephron loss by TIN was seen to be independent of the glomerular changes and TIN is considered to be one of the important factors in predicting the prognosis of IgA nephritis.

Adolescent↗