Yoshihiro Kawade

035 The mechanisms of stress-induced erectile dysfunction; a focus on regulators of contraction and relaxation in the corpus cavernosum by using a rat model of water immersion-restraint stress

application of sildenafil-np may represent a significant improvement because of potentially lowered doses for efficacy, improved safety profile, speed of efficacy and the potential to treat patients that are refractory to existing treatments. This new data shows a statistically improved erectile function when sildenafil-np is topically applied on the corpora (local) but no improvement when applied to the abdomen(distal) suggesting the lack of systemic effect on local application. Disclosure: Work supported by industry: no.

The consciousness survey and the effect of educational intervention of Advance Care Planning (ACP) including post-mortem to elderly residents living in old New Town of big city

AIM Awareness reform aims to enable survival in an aging society, and ultimately, improve healthcare. An ideal way to achieve this is by implementing Advance directive (Ad) and Advance Care Planning (ACP), which do not usually include postmortem events. This study aims to create opportunities for Ad and ACP to include the postmortem period as a trigger for this awareness reform. METHODS We conducted an Ad/ACP enlightenment lecture, and a questionnaire survey pre- and post-lecture for the elderly in old New Town, which is known for its aging society. The questionnaire comprised 38 multiple-choice questions covering 6 themes assuming an advanced state of dementia. RESULTS There were 35 participants (7 men and 22 women) aged 40-89 years. Several people left during the lecture, making it difficult to capture the precise transformation effect with regard to changing of mind. However, the effect of enlightenment was identified as a result of the consciousness survey. A statistically significant change in consciousness occurred in response to social contribution after death. Furthermore, notably more people wanted emergency transportation compared to those wanting resuscitation and extension of life. CONCLUSIONS The medical treatment desired might vary over time. Even the desire for life extension may differ significantly among individuals. This survey indicated a divergent view between the general public and medical staff, regarding a series of medical actions. We must persistently promote opportunities for enlightenment in cooperation with the general public (i.e., the communities and families we serve).

Hepatitis B infection reported with cancer chemotherapy: analyzing the US FDA Adverse Event Reporting System

We conducted data mining using the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database on spontaneously reported adverse events to evaluate the association between anticancer drug therapy and hepatitis B infection. Reports of hepatitis B infection were retrieved from the FAERS database. The reporting odds ratio (ROR) was used to estimate the association between hepatitis B infection and various anticancer agents and drug combinations. We detected statistically significant risk signals of hepatitis B for 33 of 64 anticancer agents by ROR (26 cytotoxicity drugs and seven molecular‐targeted drugs). We focused on molecular‐targeted drugs and assessed the risk of hepatitis B from specific anticancer drug combinations. The frequency of hepatitis B infection was significantly high for drugs such as rituximab, bortezomib, imatinib, and everolimus. The addition of cyclophosphamide, doxorubicin, and fludarabine to drug combinations additively enhanced the frequency of hepatitis B infection. There were no reports on hepatitis B infection associated with trastuzumab or azacitidine monotherapy. However, trastuzumab‐containing regimens (e.g., combinations with docetaxel or paclitaxel) were correlated with the incidence of hepatitis B infection, similar to azacitidine monotherapy. Our findings suggest that the concomitant use of anticancer drugs, such as trastuzumab, taxane, and azacitidine, may contribute to the risk of hepatitis B infection. The unique signals detected from the public database might provide clues to eliminate the threat of HBV in oncology.

Determination of methylmalonyl coenzyme A by ultra high-performance liquid chromatography tandem mass spectrometry for measuring propionyl coenzyme A carboxylase activity in patients with propionic acidemia

Propionic acidemia (PA) is an inherited metabolic disease caused by low activity of propionyl coenzyme A (CoA) carboxylase (PCC), which metabolizes propionyl-CoA into methylmalonyl-CoA. Although many patients with PA have been identified by tandem mass spectrometry since the test was first included in neonatal mass screening in the 1990s, the disease severity varies. Thus, determining the specific level of PCC activity is considered to be helpful to grasp the severity of PA. We developed a new PCC assay method by the determination of methylmalonyl-CoA, which is formed by an enzyme reaction using peripheral lymphocytes, based on ultra high-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). With methylmalonyl-CoA concentrations of 0.05, 0.5, and 5μmol/L, the intra-assay coefficients of variation (CVs) were 8.2%, 8.7%, and 5.1%, respectively, and the inter-assay CVs were 13.6%, 10.5%, and 5.9%, respectively. The PCC activities of 20 healthy individuals and 6 PA patients were investigated with this assay. Methylmalonyl-CoA was not detected in one PA patient with a severe form of the disease, but the remaining PA patients with mild disease showed residual activities (3.3-7.8%). These results demonstrate that determination of PCC activity with this assay would be useful to distinguish between mild and severe cases of PA to help choose an appropriate treatment plan.