Clinical Usefulness of Corticotropin Releasing Hormone Testing in Subclinical Cushing’s Syndrome for Predicting Cortisol Replacement after Adrenalectomy

Masahiro Inoue,Hisamitsu Ide,Koji Kurihara,Tatsuro Koseki,Jingsong Yu,Toshiyuki China,Keisuke Saito,Shuji Isotani,Satoru Muto,Shigeo Horie 대한비뇨의학회 2012 Investigative and Clinical Urology Vol.53 No.6

Purpose: The purpose of this study was to investigate the clinical and hormonal features of patients with incidentally discovered adrenal adenomas in relation to corticotropin releasing hormone (CRH) testing and the clinical outcome of adrenalectomy. Materials and Methods: Twenty-three consecutive patients with incidentally detected adrenal adenomas were included in this retrospective study. All the patients underwent abdominal computed tomography scans and hormonal assays, including assessment of circadian rhythms of plasma cortisol and corticotropin (adrenocorticotropic hormone, ACTH), a corticotropin stimulation test, and low-dose and high-dose dexamethasone tests. The patients were reevaluated at regular intervals (6, 12, and 24 months) for a median period of 24 months. Subclinical Cushing’s syndrome (SCS) was diagnosed in patients with subtle hypercortisolism who did not present clinical signs of Cushing’s syndrome. Results: We calculated the responsive index (peak value of ACTH in CRH test/baseline value of ACTH in CRH test). Of 23 patients, 6 had Cushing’s syndrome, 8 had SCS, and 9 had a non-functioning tumor. All patients underwent laparoscopic adrenalectomy. Several patients (5 of 6 with Cushing’s syndrome and 2 of 8 with SCS) required cortisol replacement therapy after surgery. The remaining patients required no hormonal replacement after surgery. Those who required hormone replacement had a responsive index of less than 1.2. Those who did not need hormone replacement therapy had a responsive index of more than 2.0. Conclusions: In our limited experience, the responsive index of the CRH test might be a valuable tool for predicting the need for cortisol replacement after surgery in patients with SCS. Purpose: The purpose of this study was to investigate the clinical and hormonal features of patients with incidentally discovered adrenal adenomas in relation to corticotropin releasing hormone (CRH) testing and the clinical outcome of adrenalectomy. Materials and Methods: Twenty-three consecutive patients with incidentally detected adrenal adenomas were included in this retrospective study. All the patients underwent abdominal computed tomography scans and hormonal assays, including assessment of circadian rhythms of plasma cortisol and corticotropin (adrenocorticotropic hormone, ACTH), a corticotropin stimulation test, and low-dose and high-dose dexamethasone tests. The patients were reevaluated at regular intervals (6, 12, and 24 months) for a median period of 24 months. Subclinical Cushing’s syndrome (SCS) was diagnosed in patients with subtle hypercortisolism who did not present clinical signs of Cushing’s syndrome. Results: We calculated the responsive index (peak value of ACTH in CRH test/baseline value of ACTH in CRH test). Of 23 patients, 6 had Cushing’s syndrome, 8 had SCS, and 9 had a non-functioning tumor. All patients underwent laparoscopic adrenalectomy. Several patients (5 of 6 with Cushing’s syndrome and 2 of 8 with SCS) required cortisol replacement therapy after surgery. The remaining patients required no hormonal replacement after surgery. Those who required hormone replacement had a responsive index of less than 1.2. Those who did not need hormone replacement therapy had a responsive index of more than 2.0. Conclusions: In our limited experience, the responsive index of the CRH test might be a valuable tool for predicting the need for cortisol replacement after surgery in patients with SCS.

Efficacy of the pocket-creation method with a traction device in endoscopic submucosal dissection for residual or recurrent colorectal lesions

Daisuke Ide,Tomohiko Richard Ohya,Mitsuaki Ishioka,Yuri Enomoto,Eisuke Nakao,Yuki Mitsuyoshi,Junki Tokura,Keigo Suzuki,Seiichi Yakabi,Chihiro Yasue,Akiko Chino,Masahiro Igarashi,Akio Nakashima,Masayuk 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.5

Background/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions. Methods: We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 le- sions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events. Results: En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group. Conclusions: PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.

Evaluation of 131I (monoiodide) BSP for Clinical Studies

Ueda, Hideo,Iro, Masahiro,Kurata, Kunio,Yamada, Hideo,Iwase, Tohru,Migita, Tohru,Kameda, Haruo,Kato, Sadatake,Sato, Noboru,Ide, Kazuko,Wakebayashi, Takao 대한핵의학회 1971 핵의학 분자영상 Vol.5 No.1

"In 1925 Rosenthal and White introduced a bromosulfophthalein (BSP) dye retention test as a sensitive indicator of liver function. Even now it is regared as one of the most sensitive agents for the detection of non-icteric liver disease (liver cirrhosis, early stage of acute-hepatitis and hepatic tumor). BSP accumulates in the liver cells, conjugates with glutathione and is excreted into the bile. Therefore, a disorder in its excretion is due to a disturbance of one of these processes. Since bilirubin and BSP compete for uptake by the liver and increased serum bilirubin interferes with the colorimetric determination of BSP, it has been considered that BSP test is inappropriate for the differential diagnosis of jaundice conditions. It has been generally said that when jaundice is present, the BSP test is useless and should not be performed. In 1955, Taplin et al. labeled rose bengal, a dye similarly metabolized in the liver as BSP, with 131I and measured the hepatic excretion of this dye by external monitoring. Laster, Blahd et al. applied this method to the determination of the peripheral pool, succeeding in the diagnosis of chronic and subacute hepatic diseases without colorimetry. In 1968, Yamada, Taplin et al. suggested the possibility of differentiating so-called medical jaundice from surgical jaundice by scanning the subjects during 24 to 48 hours following intravenous injection of 131I-labeled rose bengal. As mentioned before, many authorities hold the opinion that BSP is not proper for the differential diagnosis of jaundice states. Some have tried to diagnose biliary tract obstruction by a malignant tumor by measuring BSP excretion into duodenal fluid and others by quantitating changes in serum levels of conjugated and free BSP. Furthermore, Burton et al. reported that in patients with extrahepatic obstructive jaundice, BSP retention was observed for 24 days after its administration. From a consideration of all these finding we came to a conclusion that the differential diagnosis of various jaundice states, (medical, surgical and constitutional) is possible by sequential scanning with radioisotope-labeled BSP, as with rose bengal, in accordance with procedures described by Yamada, Taplin et al. The evidence suggested that labeled BSP might make a more important contribution than rose bengal. "

오염된 고형물에서의 다이옥신과 PCB의 처리

( Dai Kojima ),( Hiroshi Nakai ),( Tetsuo Kobayashi ),( Kenichi Ushikoshi ),( Masahiro Ogura ),( Shoaki Ide ),( Takao Kawai ) 한국폐기물자원순환학회 2002 APLAS Vol.2002 No.2

대부분 소각잔류물이 매립된 매립지 침출수 처리시설부터 배출된 응집슬러지의 다이옥신은 열적 탈염소 과정(Hagenmaier method)에 의해서 다이옥신 농도가 380pg-TEQ/g에서 0.0031 pg- TEQ/g로 99.999%이상 분해되는 것을 bench-scale 실험을 통해서 확인되었다. 소각시설에서 배출된 배가스에 의해 다이옥신이 오염된 토양은 같은 공정으로 실험이 실시되었다. 이것 또한 6,800pg-TEQ/g에서 47pg-TEQ/g로 99% 이상 분해되는 것을 알 수 있었다. 이러한 실험을 통해 얻어진 분해상태를 기초를 하여, Hagenmaier method의 분해공정과 sodium particle 분산공정 (SP process) 의 조합은 PCBs로 오염된 토양을 제거하기 위해 full-scale 입증 실험을 실시하였다. 우선, Hagenmaier method를 통해서, PCBs 물질들은 26 mg/kg에서 0.0038 mg/kg로 다이옥신은 130pg - TEQ/g에서 0.22 pg-TEQ/g로 분해되어졌다. 열적 탈염화장치로부터 발생한 배가스 mist에 포함된 미량오염 물질은 가스 방지시설공정에 cleaning oil에 흡착되었다. 오염된 oil에 존재하는 PCBs와 다이옥신류는 SP 공정을 통해 각각 PCBs의 경우 9.8 mg/kg에서 0.056 mg/kg로, 다이옥신류의 경우 1.7 pg-TEQ/g에서 0.22 pg- TEQ/mg로 분해되었다. 이런 조합된 시스템은 오염된 토양에서의 PCBs의 경우 99.9%이상 다이옥신은 99.3%이상의 높은 분해능을 확인할 수 있었다. A bench-scale test had confirmed that dioxins in the coagulation sludge discharged from the leachate treatment plant in the landfill site where mainly incineration residue is dumped could be decomposed with the thermal dechlorination process (Hagenmaier method) from 380 to 0.0031 pg-TEQ/g, or by more than 99.999%. Soil contaminated with dioxins caused by exhaust gas from an incineration plant was tested with the same process. It was also confirmed that dioxins in the polluted soil could be decomposed from 6,800 to 47 pg-TEQ/g, or more than 99%. Based on the decomposing conditions obtained from these tests, the combined decomposition process of the Hagenmaier method and sodium particle dispersion process (SP process) was examined with a full-scale demonstration test to decontaminate soils polluted with PCBs. With the Hagenmaier method first, PCBs were decomposed from 26 mg/kg to less than 0.0038 mg/kg, and dioxins from 130 to less than 0.22 pg-TEQ/g. The trace contaminant contained in mist included in the gas exhausted from the thermal dechlorination equipment was then absorbed with gas cleaning oil in the gas cleaning unit. The PCBs and dioxins in this contaminated oil were decomposed with the sodium particle dispersion process respectively to 0.056 mg/kg and 0.22 pg-TEQ/g from 9.8 mg/kg and 1.7 pg-TEQ/g. This combined system was confirmed to have as high decomposability for decomposition of PCBs in contaminated soil as more than 99.9%, and dioxins as 99.3%.

THE TREATMENT OF DIOXINS AND PCBS IN POLLUTED SOLIDS

( Dai Kojima ),( Hiroshi Nakai ),( Tetsuo Kobayashi ),( Kenichi Ushikoshi ),( Masahiro Ogura ),( Shoaki Ide ),( Takao Kawai ) 한국폐기물자원순환학회 2002 APLAS Vol.2002 No.1

A bench-scale test had confirmed that dioxins in the coagulation sludge discharged from the leachate treatment plant in the landfill site where mainly incineration residue is dumped could be decomposed with the thermal dechlorination process (Hagenmaier method) from 380 to 0.0031 pg-TEQ/g, or by more than 99.999%. Soil contaminated with dioxins caused by exhaust gas from an incineration plant was tested with the same process. It was also confirmed that dioxins in the polluted soil could be decomposed from 6,800 to 47 pg-TEQ/g, or more than 99%. Based on the decomposing conditions obtained from these tests, the combined decomposition process of the Hagenmaier method and sodium particle dispersion process (SP process) was examined with a full-scale demonstration test to decontaminate soils polluted with PCBs. With the Hagenmaier method first, PCBs were decomposed from 26 mg/kg to less than 0.0038 mg/kg, and dioxins from 130 to less than 0.22 pg-TEQ/g. The trace contaminant contained in mist included in the gas exhausted from the thermal dechlorination equipment was then absorbed with gas cleaning oil in the gas cleaning unit. The PCBs and dioxins in this contaminated oil were decomposed with the sodium particle dispersion process respectively to 0.056 mg/kg and 0.22 pg-TEQ/mg from 9.8 mg/kg and 1.7 pg- TEQ/g. This combined system was confirmed to have as high decomposability for decomposition of PCBs in contaminated soil as more than 99.9%, and dioxins as 99.3%.

Oral Ingestion of AP Collagen Peptide Leads to Systemic Absorption of Gly-Pro-Hyp, Alleviating H2O2-Induced Dermal Fibroblast Aging

Minjung Chae,Chang Yong Moon,Sung-Hwan Lim,Yusuke Yamashita,Hiroaki Yamada,Masahiro Ide,Chan Woong Park,Jonghwa Roh,Wangi Kim 한국식품영양과학회 2023 Journal of medicinal food Vol.26 No.5

Collagen-derived dipeptides and tripeptides have various physiological activities. In this study, we compared the plasma kinetics of free Hyp, peptide-derived Hyp, Pro-Hyp, cyclo(Pro-Hyp), Hyp-Gly, Gly-Pro-Hyp, and Gly-Pro-Ala after ingestion of four different collagen samples: AP collagen peptide (APCP), general collagen peptide, collagen, and APCP and γ-aminobutyric acid (GABA) combination. Each peptide was measured by high-performance liquid chromatography and triple quadrupole mass spectrometer. We found that, among all the peptides that were analyzed, only Gly-Pro-Hyp was significantly increased after ingestion of APCP compared with that of general collagen peptides and collagen. In addition, ingestion of the APCP and GABA combination improved the absorption efficiency of Gly-Pro-Ala. Finally, we reveal that Gly-Pro-Hyp was effective for preventing H2O2-induced reduction in extracellular matrix (ECM)-related genes, COL1A, elastin, and fibronectin, in dermal fibroblasts. Taken together, APCP significantly enhances the absorption of Gly-Pro-Hyp, which might act as an ECM-associated signaling factor in dermal fibroblasts, and the APCP and GABA combination promotes Gly-Pro-Ala absorption. Clinical Trial Registration number: UMIN000047972.