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Biomedical subjects

Takashi Matsushima

Publications and source records attributed to Takashi Matsushima.

9 recordsLinked to original sources
PubMed2005

Impact of daily high-dose IFNalpha-2b plus ribavirin combination therapy on reduction of ALT levels in patients with chronic hepatitis C with genotype 1 and high HCV RNA levels.

The possibility of delaying progression to hepatocellular carcinoma in chronic hepatitis C patients with genotype 1 and high viral titers with baseline ALT levels of >/=50IU/L was examined by administration of IFN plus ribavirin combination therapy using ALT normalization as index and IFN monotherapy as control. The rate of sustained ALT normalization (ALT normal at 24 weeks after the end of treatment) was 28.1% with combination therapy and 10.5% with IFN monotherapy (P=0.001). Furthermore, the number of patients with sustained viral response (SVR) and with sustained ALT normalization in non-SVR patients was also significantly higher in the combination therapy versus monotherapy group. Mean ALT values during treatment and for 6 months after the end of treatment were significantly lower with combination therapy versus monotherapy even in virological nonresponders, as well as significantly lower during the post-treatment observation period in patients who relapsed after the end of treatment. Since increase in the rate of sustained ALT normalization and SVR were successfully achieved, inhibition of progression to hepatocellular carcinoma should be studied with long-term IFN and ribavirin combination therapy.

Journal Article↗
PubMed2004

Prediction of treatment outcome with daily high-dose IFN alpha-2b plus ribavirin in patients with chronic hepatitis C with genotype 1b and high HCV RNA levels: relationship of baseline viral levels and viral dynamics during and after therapy.

Data on 334 patients with HCV genotype 1b and high viral levels were extracted from two multicenter double-blind studies conducted in Japan comparing IFN alpha-2b plus ribavirin (n = 209) with IFN alpha-2b alone (n = 125) for 24 weeks. HCV RNA assay was conducted before and 4, 12, and 24 weeks after the start and 4, 12, and 24 weeks after the end of treatment. Both sustained viral response (SVR) rate and relapse rate after the end of treatment were analyzed in relation to baseline viral levels and the time of first disappearance of virus. In the combination treatment group, the percentage of patients who were HCV RNA-negative within 4 weeks decreased with increase in baseline viral levels (i.e. 42%, 15%, and 11% were HCV RNA-negative in the groups exhibiting <500, 500 to <850, and >/=850kcopies/mL, respectively). In the IFN monotherapy group, the response rates were lower at 13%, 15%, and 1%, respectively. Disappearance of virus within 12 weeks after the start of combination treatment was indicative of higher probability of SVR. The risk of relapse was more highly correlated with the timing of initial viral disappearance than with baseline HCV levels; it was 4.8 and 10.3 times higher in patients who became HCV-negative at 4-12 and 13-24 weeks compared with in those who were HCV-negative within 4 weeks.

Journal Article↗
PubMed2004

A case report: change in fetal heart rate pattern on spontaneous uterine rupture at 35 weeks gestation after laparoscopically assisted myomectomy.

A 31-year-old nulligravid woman who underwent laparoscopically assisted myomectomy 5 months before becoming pregnant suffered uterine rupture at 35 weeks gestation. A 50 g intramuscular myomatous node had been removed laparoscopically. Early signs of rupture included sudden onset of severe abdominal tenderness and frequent uterine contractions despite reassuring FHR tracing. Variable deceleration was observed as late as 7.5 hours after onset. Emergency cesarean section was performed due to increasing severity of tenderness, revealing complete uterine rupture at the fundus site without extrusion of the fetus or placenta. A male neonate (2,860 g) was delivered without asphyxia and an Apgar score of 8. Total volume of hemorrhage was approximately 50 ml. The ruptured uterine wall was repaired by suturing in 2 layers. The present case indicates that sudden onset of abdominal tenderness in pregnant women with a history of laparoscopic myomectomy may suggest uterine rupture even in the presence of reassuring FHR. This is a rare case, as non-reassuring FHR patterns generally appear in the late stages of uterine rupture.

Adult↗
PubMed2003

Hepatitis C virus genotypes and hepatic fibrosis regulate 24-h decline of serum hepatitis C virus RNA during interferon therapy in patients with chronic hepatitis C.

BACKGROUND AND AIMS: Recently, hepatitis C virus (HCV) dynamics during interferon (IFN) therapy have been studied in detail. We examined factors that regulate the viral kinetics and the relationship between the viral kinetics and clinical effect of IFN therapy. METHODS: Eighty-eight patients with chronic hepatitis C entered this study. All patients had been treated with 3 MU of IFN-beta twice a day for the first 2-4 weeks, then IFN-alpha for the next 20-22 weeks (three injections per week). The levels of serum HCV RNA were determined by Amplicor HCV Monitor version 1.0, before and 24 h after the first injection of IFN; then the decline of HCV was calculated. Liver inflammation and fibrosis were scored as 0 (none), 1 (mild), 2 (moderate) or 3 (severe) using biopsy specimens. RESULTS: The decline of serum HCV RNA was 1.42 +/- 0.65 log copies/mL in genotype 1b and 1.83 +/- 0.72 in genotype 2a or 2b (P < 0.01). By a logistic regression model, genotype (1b, 2a or 2b) and hepatic fibrosis (0 or 1, 2 or 3) associated with 24-h decline of serum HCV RNA, independently. As the predictor of IFN therapy, the decline of serum HCV RNA and serum HCV RNA levels before IFN therapy were the independent significant factors (P < 0.001). CONCLUSIONS: The decline of serum HCV RNA during the first 24 h of IFN therapy was regulated by genotypes and hepatic fibrosis. The decline of serum HCV RNA and initial HCV load were independent factors that can be the predictor of the subsequent sustained viral response to IFN therapy.

Adult↗
PubMed2002

Serum HCV RNA levels during early phase of recombinant interferon alfa-2a (Roferon A) therapy for chronic hepatitis C and efficacy of short-term therapy with earlier loss of viremia.

We conducted a prospective, controlled, multicenter trial to assess if earlier changes of serum HCV RNA levels were predictable for long-term effect, and if a short-term therapy was effective in such patients. All 377 chronic hepatitis C (CH-C) patients were treated with interferon (IFN) daily 9 MU for 4 weeks. Patients positive for HCV RNA at week 1 were treated with IFN three times weekly for additional 22 weeks (group A), while those negative for HCV RNA were randomized into either regimens; three times weekly for another 22 (group B) or 12 weeks (group C). When complete responders (CR) were defined as the subjects showing sustained loss of viremia with therapy, CR rates were 17.7% (25/141) for group A, 80.0% (36/45) for group B and 61.0% (36/59) for group C, respectively. Group B showed a significantly higher CR rate than group C, indicating that a 16-week treatment period was inadequate. Patients with CR showed a rapid decrease in virus levels by day 2 after starting therapy. The CR ratio in patients with HCV RNA levels of <1.0 Kcopy/ml by day 2 was 64.6% (82/127), while the ratio without <1.0 Kcopy/ml was 12.7% (15/118). CR ratio in patients who became negative by week 2 was 65.7%, whereas only 2.9% after week 2. The results indicate that the determination of HCV RNA levels at day 2 and the qualitative assay at week 2 with IFN are useful in predicting the therapeutic effect.

Journal Article↗
PubMed2002

Assessment of fallopian tube cytology for the diagnosis of endometriosis and hydrosalpinx.

Fallopian tube cytology has been used as a useful tool in the diagnosis of infertility. In this study, we developed an intra-fallopian tube cell collection method with the simultaneous use of a laparoscope and hysteroscope, and examined its safety and applicability for the diagnoses of endometriosis and hydrosalpinx. Fallopian tube cells were collected at laparoscopy and hysteroscopy from 20 volunteer patients who visited the infertility clinic. There were 10 patients with normal fallopian tubes (Group 1), 7 with pelvic endometriosis (Group 2), and 3 with hydrosalpinx (Group 3). The collected cells were fixed onto glass slides using an auto-smear method, stained by the Papanicolaou method and subjected to detailed cytomorphological examinations. In each case, an adequate number of cells with well-preserved morphology for a reliable evaluation was obtained. Cells from normal fallopian tubes were mainly fallopian tube epithelial cells including ciliated columnar cells and secretory cells. The number of inflammatory cells was quite low. A characteristic feature in cases with pelvic endometriosis was the presence of a large number of macrophages, some of which showed hemosiderin phagocytosis. In contrast, cases with hydrosalpinx showed an extremely low cellular component. No complications were found in any of the patients. Our study indicates that the present intra-fallopian tube cell collection method using a laparoscope and hysteroscope is a reliable and safe method that can be applied to the diagnosis of endometriosis, hydrosalpinx, as well as pelvic infertility.

Cytological Techniques↗