Masatoshi Nohara

Ezetimibe ameliorates atherogenic lipids profiles, insulin resistance and hepatocyte growth factor in obese patients with hypercholesterolemia

BackgroundEzetimibe ameliorates serum low-density lipoprotein cholesterol (LDL-c) and it has been approved for the treatment of hypercholesterolemia. However, the effects of ezetimibe on specific biomarkers have not been fully clarified in obese Japanese patients.MethodsA total of 101 patients (47 males and 54 females) were registered in this study during 2011 and 2012. All patients were over 20 years old, were obese [body mass index (BMI) ≥ 25kg/m2] and had hypercholesterolemia (LDL-c ≥ 120mg/dl). After excluding 10 subjects (7 who dropped out and 3 with missing data), 91 patients (39 males and 52 females) were analyzed. They were treated with 10 mg ezetimibe once a day for 24 weeks and were evaluated at 12 and 24 weeks.ResultsFollowing 12 weeks of ezetimibe therapy, BMI (p < 0.001), waist circumference (p < 0.001), total cholesterol (p < 0.001), LDL-c (p < 0.001), non high-density lipoprotein cholesterol [HDL-c] (p < 0.001), triglycerides (p < 0.05) and remnant-like particle cholesterol (RLP-c; p < 0.001) were significantly decreased. Following 24 weeks of ezetimibe therapy, BMI (p < 0.05), waist circumference (p < 0.001), total cholesterol (p < 0.001), LDL-c (p < 0.001), non HDL-c (p < 0.001), triglycerides (p < 0.05), RLP-c (p < 0.001), insulin (p < 0.05) and hepatocyte growth factor (HGF; p < 0.05) were significantly decreased. In contrast, HDL-c (p < 0.001) was significantly increased.ConclusionsEzetimibe ameliorated not only atherogenic lipid profiles but also anthropometric factors, insulin resistance and biomarkers such as HGF. Ezetimibe may have pleiotropic effects on obese patients with hypercholesterolemia.

Perianal alveolar rhabdomyosarcoma in a child

The long-term survival of alveolar rhabdomyosarcoma of the perianal region in a 13-month-old infant is described. Local excision with chemotherapy consisting of vincristine, actinomycin D, and cyclophosphamide over a period of two years has resulted in eight years of tumor-free survival with normal growth and development. Our case and review of the literature suggest that local excision with chemotherapy may be an appropriate treatment for Group I perianal rhabdomyosarcoma in children.

Angiogenesis of cultured endothelial cells of bovine coronary artery.

Endothelial cells of bovine coronary artery were isolated and cultivated and bovine clots were placed in the cultured endothelial cells (42 generations), followed by observation on the 14th day. Cultured endothelial cells not only covered the surface of each clot but also migrated in it to form oval or irregularly shaped intracytoplasmic vacuoles or sometimes intercellular vacuoles surrounded by 2 or 3 cells. Some of these vacuoles contained membranous materials. This vacuolization was considered to represent angiogenetic activity peculiar to endothelial cells.

Meningoencephalitis due to Serratia marcescens infection in neonates

Six autopsy cases of Serratia meningoencephalitis were reported. The symptoms of this infection become apparent at an early stage in neonates; the meningoencephalitis in these six cases was severe, with or without inflammatory lesions in other organs. Serratia marcescens was originally described as a nonpathogenic organism; however, it is believed that after entering the blood stream of neonates, it becomes pathogenic, especially to the central nervous system. Meningoencephalitis due to Serratia marcescens is very severe and takes a rapid and progressive course against which no antibiotics have been found effective. Prevention of this infection is therefore considered of crucial importance.

Effect of nilvadipine and angiotensin-converting enzyme inhibitors on quality of life in patients with essential hypertension: A comparative study

Multicenter, randomized, parallel-group, and open trials were performed in patients with mild-to-moderate essential hypertension to assess the impact of nilvadipine and angiotensin-converting enzyme (ACE) inhibitors on patient quality of life (QOL). After a baseline observation period, 79 patients were enrolled. QOL was evaluated at baseline and at weeks 24, 36, and 52 of treatment. Fourteen patients had withdrawn from the trial by week 24. QOL was assessed in 34 patients treated with nilvadipine and 31 patients treated with ACE inhibitors. Patients receiving nilvadipine reported improvements in headaches and head heaviness, shoulder stiffness, fatigue during work, general well-being, and leisure time enjoyment. Patients receiving ACE inhibitors noted improvements in headaches and head heaviness, shoulder stiffness, irritability, social relationships, and sleep. Nilvadipine was considered better than ACE inhibitors in improving shoulder stiffness and self-control, whereas ACE inhibitors were better than nilvadipine in improving shortness of breath, nocturia, and social relationships. Both nilvadipine and the ACE inhibitors produced similar falls in blood pressure; neither changed heart rate significantly during the treatment period. In conclusion, the two regimens were equally effective in lowering blood pressure with equally favorable effects on QOL.