Dokkyo Medical University Repository / 獨協医科大学リポジトリ
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Ovariectomy-Induced Dry Skin Increases IL-31-Induced Scratching Behavior in Mice
Get PDFDry skin and type 2 cytokines, IL-4/IL-13 and IL-31, have been reported to be involved in pruritus in skin diseases such as atopic dermatitis. IL-31 directly induces pruritus, but IL-4/IL-13 themselves have little or no potential to induce pruritus, whereas IL-4/IL-13 potentiate nerve activation by subthreshold doses of pruritogens such as histamine and IL-31 in vitro, and are involved in alloknesis in dry skin mouse models induced by ovariectomy and artificial barrier disruption. In this study, we investigated whether ovariectomy-induced dry skin with permeability barrier dysfunction enhances IL-31-induced pruritus in mice. Levels of spontaneous scratching behavior were higher than in ovariectomized mice than in sham-operated mice probably due to barrier disruption that could be accelerated by hair shaving. Levels of scratching behavior induced by intradermal administration of IL-31, regardless of single or repeated administration, were increased in ovariectomized mice compared to in sham-operated mice. Pre-intradermal administration of neutralizing antibodies against IL-4/IL-13 did not attenuate the level of IL-31-induced scratching behavior in ovariectomized mice. Our results show that the dry skin induced by ovariectomy is an itchy condition prone to pruritus, and this is the first report showing that the dry skin enhances the potential of IL-31 to induce pruritus in vivo.journal articl
Current Situation of Food Allergy among Elementary and Junior High School Children in Tochigi Prefecture, Japan
Get PDFBackground: Food allergy (FA) is a public health concern with escalating prevalence, particularly among children. It is a phenomenon characterized by immunological reactions to specific foods. Recognizing the prevalent dietary allergens is crucial for public health and clinical interventions.
Objective: This study aimed to assess the current landscape of FA among elementary and junior high school students in Oyama and Tochigi cities, Japan. The investigation focused on prevalence, manifestations, and associated factors.
Method: An online survey was conducted among parents of children aged 6 to 15 years, distributed with the collaboration of education councils in Oyama City and Tochigi City. Data collection included demographics, allergy history, and current symptoms. Statistical analyses were performed using IBM SPSS Statistics Version 28.0.0.0.
Results: Analysis of 2036 valid responses revealed significant differences in symptom prevalence between age groups and genders. Notably, 6-10 years old boys exhibited a higher symptom prevalence than 11-15 years old boys, while 11-15 years old girls displayed a higher symptom prevalence than younger girls. The prevalence of current FA showed statistical significance between boys of different age groups.
Conclusion: This study provides nuanced insights into the FA situation, emphasizing age-specific patterns and triggers. The sustained prevalence of FA underscores the need for ongoing research and targeted interventions to mitigate its impact on children. The findings contribute to understanding FA epidemiology, informing future investigations and interventions in pediatric food allergies.journal articl
Early Experience of Liver Resection Following Atezolizumab and Bevacizumab Therapy for Hepatocellular Carcinoma with Vascular Invasion
Get PDFThe effectiveness of surgical resection for hepatocellular carcinoma (HCC) with vascular invasion (VI) remains controversial, and the multidisciplinary treatment combining chemotherapy and surgical resection may improve the prognosis of these patients. Recently, atezolizumab and bevacizumab (AB) therapy has shown favorable survival benefits and tumor responses for HCC. In this study, we analyzed HCC patients with VI treated with liver resection following AB therapy to evaluate the safety and efficacy of this multidisciplinary treatment.
A retrospective analysis was performed of 76 HCC patients who received AB therapy as initial treatment at Dokkyo Medical University Saitama Medical Center between 2020 and 2023. Seventeen patients with VI were divided into two groups: receiving hepatectomy (ABH group) and not (AB group).
The response rate was significantly higher in the ABH group (ABH: 71.4% vs. AB: 10%, p = 0.035). There was no difference in adverse events between the two groups. In the ABH group, the median operative time was 398 (229-533) minutes, and the median blood loss was 315 (130-590) ml. There were no complications of Clavien-Dindo ≥IIIa. R0 resection was achieved in six patients, and pathological complete remission was seen in three. One patient had hepatic recurrence at ten months postoperatively, but the others survived without recurrence.
The surgical resection following AB therapy can be performed safely for HCC with VI. In addition, the pathological examination showed favorable results for this treatment. A prospective study should be conducted to confirm the safety and efficacy of this treatment.journal articl
Therapeutic Outcome of Chemoradiotherapy with Dose-reduced Nedaplatin and 5-Fluorouracil in Older Esophageal Cancer Patients Aged 80 or More
Get PDFBackground: There is no standard treatment modality for older patients with esophageal cancer, especially those aged ≥ 80 years. At our institution, a decreased dose of nedaplatin plus 5-fluorouracil (NF) was usually used as a regimen of definitive chemoradiotherapy (CRT) for older adult patients. Therefore, this study aimed to analyze the feasibility and effectiveness of definitive CRT with NF (NF-RT) in older adult patients aged 80 years.
Methods: Twenty-eight patients who underwent NF-RT were retrospectively analyzed for therapeutic outcomes and compared with 19 patients who underwent esophagectomy.
Results: Although the NF dose was restricted to 26 (92.9%) patients, 25 patients (89.3%) received a total of 60 Gy of irradiation. The rates of complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were 75.0%, 14.3%, 3.6%, and 3.6%, respectively. Adverse events greater than grade III occurred in 25.0% of the patients. Regarding esophagectomy, preventive lymphadenectomy was contraindicated. The 1-, 2-, and 5-year overall survival of the NF-RT and surgery groups were 74.7%, 67.0%, and 50.0% and 68.4%, 42.1%, and 18.9% (P = 0.0605); 1-, 2-, and 5-year disease-free survival were 79.6%, 75.2%, and 64.4% and 51.0%, 43.7%, and 43.7% (P = 0.0928); and the disease-specific survival were 87.4%, 83.0%, and 72.3% and 72.2%, 60.0%, and 42.0% (P = 0.0832), respectively.
Conclusions: The therapeutic outcome of NF-RT in older patients with esophageal cancer aged ≥ 80 years was favorable. Thus, we think that this is an useful therapeutic modality.journal articl
Influence of Sex Differences on the Onset of Alcoholic Early Chronic Pancreatitis and the Rate of Alcohol Abstinence/Reduction
Get PDFAim and Background: Alcohol is the main cause of chronic pancreatitis (CP) / early CP (ECP), but patient characteristics reportedly differ depending on sex. This study was designed to clarify the influence of sex differences on the onset of alcoholic ECP.
Methods: We extracted 98 cases diagnosed as definite or probable ECP from our hospital records of April 2018-March 2022 and retrospectively examined their clinical characteristics.
Results: Of the 98 cases, there were 25 cases of definite ECP and 73 cases of probable ECP. Continuous heavy drinking of alcohol equivalent of pure ethanol (EtOH) in 55 patients diagnosed with alcoholic ECP was 82 ± 28 g for men and 61 ± 26 g for women: significantly more frequent for men (P = 0.041). When lifestyle guidance was given to alcoholic ECP patients, the non-abstinence/reduction rate was 17% for men and 54% for women (P = 0.018), with women being less likely than men to be unable to quit or reduce alcohol consumption.
Conclusions: The onset of alcoholic ECP is likely to be affected by sex differences. Lifestyle guidance related to drinking must be individualized, with consideration of a person's sex and lifestyle background.journal articl
Role of Pediatric Allergy Educators
Get PDF小児アレルギーエデュケーター（以下，PAE：pediatric allergy educator）は，2009年から開始された日本小児臨床アレルギー学会が認定するアレルギー専門メディカルスタッフの認定制度である．PAEの役割は，患者・家族のアドヒアランスを高め，できるだけ症状のない状態にコントロールし，QOLを向上・維持できるように患者教育を行うことである．2023年11月現在，607名のPAEがアレルギー疾患医療拠点病院を含む専門病院，総合病院，クリニック，調剤薬局，大学などの教育施設で活躍しており，その活動範囲は医療機関内に留まらず，地域のアレルギー関連イベント，保育所や学校関係，他団体との共同活動へと広がっている．
一方，PAEとして求められるレベルを確保すること，PAEの資格を習得するまでに費用が掛かること，患者教育に保険点数が付かないこと等もPAE取得者が増えない要因であろう．アレルギー疾患をもつ患者や家族が適切な治療と患者教育を受けられるように，PAE活動のやりがいや教育効果を社会に伝えていくことは有効な啓発手段と考えられる．journal articl
