6 0 0 0 キャッスルマン病診療の参照ガイド
- 著者
- キャッスルマン病の疫学診療実態調査と患者団体支援体制の構築に関する調査研究班 吉崎 和幸 岡本 真一郎 川端 浩 水木 満佐央 川上 純 正木 康史 矢野 真吾 井出 眞 宇野 賀津子 八木 克巳 小島 俊行 水谷 実 徳嶺 進洋 西本 憲弘 藤原 寛 中塚 伸一 塩沢 和子 岩城 憲子 古賀 智裕
- 出版者
- 一般社団法人 日本血液学会
- 雑誌
- 臨床血液 (ISSN:04851439)
- 巻号頁・発行日
- vol.58, no.2, pp.97-107, 2017 (Released:2017-03-17)
- 参考文献数
- 75
キャッスルマン病は原因不明のリンパ増殖性疾患で,適切な治療を行わなければQOL低下や生命予後の短縮をきたす。しかしながら,その希少性のためにこれまで明確な診断基準や重症度分類が定まっていなかった。これに対して厚労科研・難治性疾患等政策研究事業の調査研究班では,本疾患の診断基準と病型分類,重症度分類の案を策定した。診断は,病理診断と臨床的な除外診断を併せて行う。組織型は硝子血管型,形質細胞型,および混合型に分類される。臨床的病型は,単中心性(限局型)と,HHV-8関連の多中心性,HHV-8陰性の特発性多中心性に分類した。重症度は主に臓器障害の程度により分類した。難治性とされる特発性多中心性キャッスルマン病は,重症度等に応じてprednisoloneやtocilizumabを用いて治療を行うこととした。今後,本疾患に関するエビデンスを集積し,本診断基準や重症度分類の妥当性を検証するとともに,質の高い診療ガイドラインを策定していく予定である。
1 0 0 0 成人急性骨髄性白血病の予後におけるCD7陽性の意義
- 著者
- 斎藤 健 薄井 紀子 土橋 史明 牧 信子 浅井 治 矢野 真吾 加藤 明徳 渡辺 浩 香取 美津冶 長峰 守 荻原 朝彦 山崎 博之 小林 直 田嶋 尚子 倉石 安庸
- 出版者
- 一般社団法人 日本血液学会
- 雑誌
- 臨床血液 (ISSN:04851439)
- 巻号頁・発行日
- vol.39, no.7, pp.481-486, 1998-07-30
- 参考文献数
- 17
- 被引用文献数
- 2
成人急性骨髄性白血病(AML)においてCD7が予後因子となり得るかを評価する目的で,CD7陽性(+) AMLとCD7陰性(-) AMLの治療成績の比較検討を行いその意義について検討した。対象症例は1989年9月より1996年1月までの6年4カ月の間に,当科に入院した15∼65歳の<i>de novo</i> AML症例63例である。63例中表面マーカー検索材料中の芽球が70%以下の9例,早期死亡例(1カ月以内)2例を除外した52例が評価可能症例であった。FAB分類ではM1: 10例,M2: 16例,M3: 11例,M4: 8例,M5: 5例,M6: 2例であった。評価可能症例中CD7+AML症例は10例で,FAB分類ではM1: 3例,M2: 6例,M3: 1例であった。CD7-症例42例中CRは33例(CR率:78.6%),無再発生存率は22.1%, 4年生存率は35.4%であったのに対し,CD7+例10例のCR率は60%(6例),無再発生存率は53.3%, 4年生存率は44.4%であった。CD7+AMLとCD7-AMLの間で性別,血液学的所見,肝脾腫,リンパ節腫大,中枢神経系浸潤の有無,CR率,4年無再発生存率に有意差を認めなかった。CD7陽性は単独では予後因子となり得ないと考えられた。
- 著者
- 伊藤 豊 矢野 真吾 渡辺 和夫 山中 悦二 相見 則郎 坂井 進一郎
- 出版者
- The Pharmaceutical Society of Japan
- 雑誌
- Chemical and Pharmaceutical Bulletin (ISSN:00092363)
- 巻号頁・発行日
- vol.38, no.6, pp.1702-1706, 1990-06-25 (Released:2008-03-31)
- 参考文献数
- 16
- 被引用文献数
- 10 18
We investigated the selectivities and structure requirements for alpha-1 and alpha-2 adrenoceptor blocking activities of yohimbine (YO) and its 12 related analogs, such as β-yohimbine (β-YO), dihydrocorynantheine (DHC) and (-)indoloquinolizidine ((-)IQ). The affinity of YO analogs to alpha-adrenoceptor was assessed by measuring their blockade of pressor responses to epinephrine in pithed rats. Among YO structure groups, the potency order was YO>DHC=β-YO>geissoschizine methylether>14β-hydroxy YO>14β-benzoyloxy YO (inactive). (-)IQ was slightly less potent than YO, but much stronger than (+)IQ. Among (±)IQ structure groups, the potency order was (±)IQ>(±)1, 12b-trans-1-hydroxy IQ»(±)1, 12b-cis-1-hydroxy IQ (imactive). (±)Borrerine was active, but (±)desmethylborrerine was inactive. The alpha-1 blocking activities of the four compounds YO, β-YO, DHC and (-)IQ, were assessed in experiments of pressor responses to methoxamine in pithed rats and contractile responses to methoxamine in the rat vas deferens. The potency order was (-)IQ>YO>DHC>β-YO. Furthermore, the alpha-2 blocking activities of the four analogs were assessed in experiments of pressor responses to clonidine and inhibition of electrically driven cardioacceleration by clonidine, in pithed rats. The potency order was YO>β-YO>(-)IQ>DHC. Based on the potency ratio between alpha-1 and alpha-2 blocking activities, DHC or YO was most selective for alpha-1 or alpha-2 subtype, respectively, among the four YO analogs. These results suggest that the A, B, C and D rings of YO analogs and their planarity are necessary for the affinity to alpha-adrenoceptors and that the predominant conformation of the carboxymethyl or hydroxy group on the E ring of YO structure determines the selectivity for alpha-1 and alpha-2 blocking activities.
- 著者
- 伊藤 豊 矢野 真吾 渡辺 和夫 山中 悦二 相見 則郎 坂井 進一郎
- 出版者
- 公益社団法人日本薬学会
- 雑誌
- Chem Pharm Bull (Tokyo) (ISSN:00092363)
- 巻号頁・発行日
- vol.38, pp.1702-1706, 1990
- 被引用文献数
- 2
We investigated the selectivities and structure requirements for alpha-1 and alpha-2 adrenoceptor blocking activities of yohimbine (YO) and its 12 related analogs, such as β-yohimbine (β-YO), dihydrocorynantheine (DHC) and (-)indoloquinolizidine ((-)IQ). The affinity of YO analogs to alpha-adrenoceptor was assessed by measuring their blockade of pressor responses to epinephrine in pithed rats. Among YO structure groups, the potency order was YO>DHC=β-YO>geissoschizine methylether>14β-hydroxy YO>14β-benzoyloxy YO (inactive). (-)IQ was slightly less potent than YO, but much stronger than (+)IQ. Among (±)IQ structure groups, the potency order was (±)IQ>(±)1,12b-trans-1-hydroxy IQ≫(±)1,12b-cis-1-hydroxy IQ (imactive). (±)Borrerine was active, but (±)desmethylborrerine was inactive. The alpha-1 blocking activities of the four compounds YO, β-YO, DHC and (-)IQ, were assessed in experiments of pressor responses to methoxamine in pithed rats and contractile responses to methoxamine in the rat vas deferens. The potency order was (-)IQ>YO>DHC>β-YO. Furthermore, the alpha-2 blocking activities of the four analogs were assessed in experiments of pressor responses to clonidine and inhibition of electrically driven cardioacceleration by clonidine, in pithed rats. The potency order was YO>β-YO>(-)IQ>DHC. Based on the potency ratio between alpha-1 and alpha-2 blocking activities, DHC or YO was most selective for alpha-1 or alpha-2 subtype, respectively, among the four YO analogs. These results suggest that the A, B, C and D rings of YO analogs and their planarity are necessary for the affinity to alpha-adrenoceptors and that the predominant conformation of the carboxymethyl or hydroxy group on the E ring of YO structure determines the selectivity for alpha-1 and alpha-2 blocking activities.
- 著者
- 伊藤 豊 矢野 真吾 渡辺 和夫 山中 悦二 相見 則郎 坂井 進一郎
- 出版者
- 公益社団法人 日本薬学会
- 雑誌
- CHEMICAL & PHARMACEUTICAL BULLETIN (ISSN:00092363)
- 巻号頁・発行日
- vol.38, no.6, pp.1702-1706, 1990
- 被引用文献数
- 18
We investigated the selectivities and structure requirements for alpha-1 and alpha-2 adrenoceptor blocking activities of yohimbine (YO) and its 12 related analogs, such as β-yohimbine (β-YO), dihydrocorynantheine (DHC) and (-)indoloquinolizidine ((-)IQ). The affinity of YO analogs to alpha-adrenoceptor was assessed by measuring their blockade of pressor responses to epinephrine in pithed rats. Among YO structure groups, the potency order was YO>DHC=β-YO>geissoschizine methylether>14β-hydroxy YO>14β-benzoyloxy YO (inactive). (-)IQ was slightly less potent than YO, but much stronger than (+)IQ. Among (±)IQ structure groups, the potency order was (±)IQ>(±)1, 12b-trans-1-hydroxy IQ»(±)1, 12b-cis-1-hydroxy IQ (imactive). (±)Borrerine was active, but (±)desmethylborrerine was inactive. The alpha-1 blocking activities of the four compounds YO, β-YO, DHC and (-)IQ, were assessed in experiments of pressor responses to methoxamine in pithed rats and contractile responses to methoxamine in the rat vas deferens. The potency order was (-)IQ>YO>DHC>β-YO. Furthermore, the alpha-2 blocking activities of the four analogs were assessed in experiments of pressor responses to clonidine and inhibition of electrically driven cardioacceleration by clonidine, in pithed rats. The potency order was YO>β-YO>(-)IQ>DHC. Based on the potency ratio between alpha-1 and alpha-2 blocking activities, DHC or YO was most selective for alpha-1 or alpha-2 subtype, respectively, among the four YO analogs. These results suggest that the A, B, C and D rings of YO analogs and their planarity are necessary for the affinity to alpha-adrenoceptors and that the predominant conformation of the carboxymethyl or hydroxy group on the E ring of YO structure determines the selectivity for alpha-1 and alpha-2 blocking activities.