Japanese guidance for use of biologics for psoriasis (the 2019 version).

As the first biologics for psoriasis in Japan, infliximab and adalimumab, anti-tumor necrosis factor-α antibodies, became available in the field of dermatology in 2010, followed by ustekinumab, an anti-interleukin (IL)-12/IL-23p40 antibody, which was launched in Japan in 2011. Since 2015, three IL-17 inhibitors of secukinumab and ixekizumab, anti-IL-17A antibodies, and brodalumab, an anti-IL-17 receptor antibody, and two anti-IL-23p19 antibodies of guselkumab and risankizumab, have also been launched. It is important for physicians to select appropriate biologic therapy for each psoriatic patient after due consideration of disease factors, treatment factors and patient background factors, sharing such information with patients.

[Evaluation of Moisturizing Effect of Heparinoid Ointment (Hirudoid Soft Ointment) Diluted by White Petrolatum (Propeto)].

Steroid ointments are frequently mixed with moisturizer. It was reported that steroid ointments mixed with moisturizer increase permeability. There are only few studies done on the permeability of the moisturizer.

Does migraine-associated vertigo share a common pathophysiology with Meniere's disease? Study with vestibular-evoked myogenic potential.

To clarify if migraine-associated vertigo (MAV) and Meniere's disease (MD) share a common pathophysiology, vestibular-evoked myogenic potentials (VEMP) were measured in 11 patients with MAV, 11 with unilateral MD and eight healthy subjects. As acoustic stimuli, tone bursts (TB; 250, 500, 1000 and 2000 Hz) were presented. In healthy subjects, 500-Hz TB evoked the largest amplitude.

INSIG2 gene rs7566605 polymorphism is associated with severe obesity in Japanese.

The single nucleotide polymorphism (SNP) rs7566605 in the upstream region of the insulin-induced gene 2 (INSIG2) is associated with the obesity phenotype in many Caucasian populations. In Japanese, this association with the obesity phenotype is not clear. To investigate the relationship between rs7566605 and obesity in Japanese, we genotyped rs7566605 from severely obese subjects [n = 908, body mass index (BMI) > or = 30 kg/m2] and normal-weight control subjects (n = 1495, BMI < 25 kg/m2).

Vestibular drop attack secondary to Meniere's disease results from unstable otolithic function.

Conclusion: The otolithic organs of patients with vestibular drop attack (VDA) secondary to Meniere's disease were damaged but the damage was not complete. In other words, the otolithic functions of patients with VDA were unstable.

Objective: To evaluate otolithic function using vestibular evoked myogenic potential (VEMP) in patients with VDA secondary to Meniere's disease.

Does acute dysfunction of the saccular afferents affect the subjective visual horizontal in patients with vestibular neurolabyrinthitis?

Conclusions: The results of a series of studies including the present study suggest that acute dysfunction of the utricular afferents accompanied by acute dysfunction of the saccular afferents might require more time for the compensation of the otolith-ocular system than acute utricular dysfunction that was not accompanied by acute saccular dysfunction. Perhaps the inputs from the saccule also have some contribution to the subjective visual horizontal (SVH).

Objective: To clarify if acute dysfunction of the saccular afferents affects the SVH.

Variations in the FTO gene are associated with severe obesity in the Japanese.

Variations in the fat-mass and obesity-associated gene (FTO) are associated with the obesity phenotype in many Caucasian populations. This association with the obesity phenotype is not clear in the Japanese. To investigate the relationship between the FTO gene and obesity in the Japanese, we genotyped single nucleotide polymorphisms (SNPs) in the FTO genes from severely obese subjects [n = 927, body mass index (BMI) > or = 30 kg/m2] and normal-weight control subjects (n = 1,527, BMI < 25 kg/m2).

Subjective visual horizontal in patients with posterior canal benign paroxysmal positional vertigo.

Conclusion: Patients with posterior canal benign paroxysmal positional vertigo (p-BPPV) could have mild excitation in the vestibular system on the affected side.

Objective: p-BPPV is considered to be caused by small particles dislodged from the utricular macula. While subjective visual horizontal (SVH) mainly reflects utricular function, there is less documentation on SVH in patients with p-BPPV.

Tone burst-galvanic ratio of vestibular evoked myogenic potential amplitudes: a new parameter of vestibular evoked myogenic potential?

Objective: To clarify whether the ratio of tone burst vestibular evoked myogenic potential (VEMP) amplitude to galvanic (electric) VEMP amplitude can be a useful indicator of peripheral vestibular disorders, especially labyrinthine disorders.

Methods: Twelve healthy volunteers and 12 patients with endolymphatic hydrops (EH) were enrolled in this study. VEMP was recorded using 500 Hz short tone bursts (135dBSPL, rise/fall time 1 ms, plateau time 2 ms) and galvanic stimulation (3 mA, 1 ms).

Utility of coronary MR angiography in children with Kawasaki disease.

Objective: Although coronary arterial lesions due to Kawasaki disease (KD) should be evaluated as early as possible after the acute phase, conventional X-ray coronary angiography poses high risks for young children with the disease. The use of noninvasive MR coronary angiography is desirable, although it is difficult to produce clear images in young children. We developed a method to improve the quality of MR coronary angiography in young children.

Magnetic resonance coronary angiography to evaluate coronary arterial lesions in patients with Kawasaki disease.

We evaluated the efficiency of non-invasive magnetic resonance coronary angiography in detecting coronary arterial lesions in 106 patients, aged from 4 months to 37 years, with a median of 13 years, with Kawasaki disease. Non-contrast enhanced, free-breathing magnetic resonance coronary angiographic studies using both the steady-state free precession technique, namely bright blood imaging, and navigator-echo proton density weighted black blood imaging, so-called black blood imaging, were performed in all the patients. Conventional X-ray coronary angiography was performed in 70 patients with coronary arterial lesions.

Intratympanic injection of dexamethasone as an alternative treatment of steroid-dependent sensorineural hearing loss associated with aortitis syndrome.

We report a 44-year-old Japanese woman who presented with fluctuating hearing loss. She suffered from aortitis syndrome (AS) since she was 30-year-old and took daily tablets of prednisolone (10mg). Pure tone audiometry showed bilateral high-tone sensorineural hearing loss.

A case of severe dyspnea caused by relapsing polychondritis.

Relapsing polychondritis (RP) is a multi-systemic rheumatic disease characterized by widespread and potentially destructive inflammatory lesion of the cartilage. The rarity of the disease and the lack of pathognomonic laboratory findings sometimes cause delay in diagnosis. We report a 72-year-old woman with RP.

Mucosa-associated lymphoid tissue lymphoma presented as diffuse swelling of the parotid gland.

Mucosa-associated lymphoid tissue (MALT) lymphoma is a distinct subtype of lymphoma. Parotid MALT lymphoma is a rare tumor that is hard to diagnose by fine-needle aspiration cytology. Therefore, partial parotidectomy is often required for a pathological diagnosis.

VEMP recording by binaural simultaneous stimulation in subjects with vestibulo-cochlear disorders.

To reduce the testing time of vestibular evoked myogenic potentials (VEMP) and the physical efforts of subjects, we studied if VEMP recording by binaural simultaneous stimulation in patients with vestibulo-cochlear disorders can be applicable as a screening test. Twenty-eight patients with vestibulo-cochlear disorders (12 men and 16 women, 22 to 77 years of age) were enrolled in this study. Patients were presented with binaural or monaural click (95 dBnHL) stimulation to record VEMPs.

Sound-evoked neurogenic responses with short latency of vestibular origin.

Objective: In ABR recording, a large negative deflection with a latency of 3 ms (N3) has been recorded in patients with peripheral profound deafness. It has been suggested that N3 might be of vestibular origin. So far, N3 has been recorded only in patients with peripheral profound deafness.

Immunohistochemical study of apparently intact coronary artery in a child after Kawasaki disease.

Background: Coronary arterial lesions (CAL) due to Kawasaki disease (KD) often show progressive intimal hyperplasia even many years after the disease. However, most patients have no CAL after the acute phase, and it is an important issue whether or not coronary arteries without CAL have significant intimal hyperplasia, and whether or not there is the potential for this to progress to stenosis and/or atherosclerosis.

Methods: The authors examined formalin-fixed specimens of the coronary arteries immunohistochemically, using antibodies against vascular growth factors (GFs), the receptors of transforming growth factor-beta (TbetaRs) and inducible nitric oxid synthesis (iNOS) in a KD patient without CAL, and also in four control patients: two with CAL due to KD and two without a history of KD.

Disappearance of click-evoked potentials on the neck of the guinea pig by pharmacological and surgical destruction of the peripheral vestibular afferent system.

In order to establish an animal model of acoustically evoked vestibulo-collic reflex, the so-called vestibular evoked myogenic potential in humans, potentials evoked by loud clicks on the neck of the guinea pig were recorded using subjects whose peripheral vestibular endorgans or vestibular afferents had been damaged. Four normal control guinea pigs, four guinea pigs that received an intramuscular injection of gentamicin for 20 days (90 mg/kg/day) and five guinea pigs whose vestibular nerves were surgically sectioned were used in this study. Under general anesthesia with an intraperitoneal injection of pentobarbital sodium (40 mg/kg), auditory brainstem responses (ABRs) were recorded.

Small intestinal metastasis from renal cell carcinoma exhibiting rare findings.

Small intestinal metastasis from renal cell carcinoma (RCC) has only rarely been described. We report two patients who developed small bowel metastases from RCC showing different clinicopathological characteristics. Both patients underwent hemilateral nephrectomy for RCC and developed lung metastases metachronously or simultaneously.

[Effect of admixture of betamethasone butyrate propionate ointment on preservative efficacy].

Twenty percent of dermatologists have experienced a separation of water or deterioration of topical corticosteroids mixed with commercially available ointments and/or creams. However, few investigations of this deterioration of admixtures have been reported. To assess the effects of preservatives in preventing microbial contamination of these admixtures, we attempted to investigate the concentration of preservative agents in admixtures and the microbial contamination of these admixtures with a topical corticosteroid ointment (Antebate).

[Evaluation of the permeability of corticosteroid in hairless mouse and hairless micropig skin from admixture of commercially available corticosteroid ointments and/or creams].

Yucatan hairless micropig (YHMP) skin has been shown to have histology and physiologic properties similar to human skin. To assess the relationship between the permeability of corticosteroid ointments and five types of commonly used admixtures of corticosteroid through hairless mice (HM) or YHMP skin and the clinical effects in humans, we conduct by in vitro experiments using HM and YHMP skin. The permeability of corticosteroid in admixtures with urea or heparinoid ointments across HM or YHMP skin was 1.

[Effect of grapefruit pulp on the pharmacokinetics of the dihydropyridine calcium antagonists nifedipine and nisoldipine].

The effect of the intake of 200 g of grapefruit pulp (corresponding to one grapefruit) on the pharmacokinetics of the calcium antagonists nifedipine (NF) and nisoldipine (NS) were investigated in 8 healthy Japanese male volunteers. A crossover design was used for the study: group I did not ingest any grapefruit (control group); group II ingested grapefruit 1 h after drug administration; and group III ingested grapefruit 1 h before drug administration. The intake of grapefruit pulp increased the plasma concentrations of both NF and NS, an effect that has previously been reported with grapefruit juice.

Dihydropyrimidine dehydrogenase expression in preoperative biopsy and surgically resected specimens of gastric carcinoma.

Purpose: 5-Fluorouracil (5-FU) is most commonly used to treat patients with gastrointestinal neoplasms, including gastric carcinoma. Dihydroxypyrimidine dehydrogenase (DPD), an enzyme involved in metabolism of 5-FU, is a key factor determining the sensitivity of the tumors to 5-FU. Particularly when preoperative chemotherapy based on 5-FU is attempted, it is critical to know in advance how much DPD the tumor expresses.

[Effect of admixture of commercially available corticosteroid ointments and/or creams on vasoconstrictor activity].

A commonly used admixture of commercially available ointments and/or creams was selected from the prescribed sheets in our hospital, and questionnaire to dermatologists. To assess the relationship between permeability of corticosteroid through murine skin and clinical effects in human, we attempted to investigate the vasoconstrictor activity of these admixtures of topical corticosteroid by double-blind controlled study. Test samples were occluded at random on the back of 20 healthy volunteers for 4 hours.

Involvement of CYP2B6 in n-demethylation of ketamine in human liver microsomes.

Ketamine is metabolized by cytochrome P450 (CYP) leading to production of pharmacologically active products and contributing to drug excretion. We identified the CYP enzymes involved in the N-demethylation of ketamine enantiomers using pooled human liver microsomes and microsomes from human B-lymphoblastoid cells that expressed CYP enzymes. The kinetic data in human liver microsomes for the (R)- and (S)-ketamine N-demethylase activities could be analyzed as two-enzyme systems.