Efficacy and Safety of a Traditional Herbal Medicine, Hochu-ekki-to in the Long-term Management of Kikyo (Delicate Constitution) Patients with Atopic Dermatitis: A 6-month, Multicenter, Double-blind, Randomized, Placebo-controlled Study

Hochu-ekki-to is a traditional herbal (Kampo) medicine that has been shown to be effective for patients with Kikyo (delicate, easily fatigable, or hypersensitive) constitution. Previous case reports have suggested that this herbal drug was effective for a certain subgroup of patients with atopic dermatitis (AD). We aimed to evaluate the efficacy and safety of Hochu-ekki-to in the long-term management of Kikyo patients with AD. In this multicenter, double blind, randomized, placebo-controlled study, 91 Kikyo patients with AD were enrolled. Kikyo condition was evaluated by a questionnaire scoring system. All patients continued their ordinary treatments (topical steroids, topical tacrolimus, emollients or oral antihistamines) before and after their protocol entry. Hochu-ekki-to or placebo was orally administered twice daily for 24 weeks. The skin severity scores, total equivalent amount (TEA) of topical agents used for AD treatment, prominent efficacy (cases with skin severity score = 0 at the end of the study) rate and aggravated rate (more than 50% increase of TEA of topical agents from the beginning of the study) were monitored and evaluated. Seventy-seven out of 91 enrolled patients completed the 24-week treatment course (Hochu-ekki-to: n = 37, placebo: n = 40). The TEA of topical agents (steroids and/or tacrolimus) was significantly (P < 0.05) lower in the Hochu-ekki-to group than in the placebo group, although the overall skin severity scores were not statistically different. The prominent efficacy rate was 19% (7 of 37) in the Hochu-ekki-to group and 5% (2 of 40) in the placebo group (P = 0.06). The aggravated rate was significantly (P < 0.05) lower in the Hochu-ekki-to group (3%; 1 of 37) than in the placebo group (18%; 7 of 39). Only mild adverse events such as nausea and diarrhea were noted in both groups without statistical difference. This placebo-controlled study demonstrates that Hochu-ekki-to is a useful adjunct to conventional treatments for AD patients with Kikyo constitution. Use of Hochu-ekki-to significantly reduces the dose of topical steroids and/or tacrolimus used for AD treatment without aggravating AD

急性心筋梗塞にて突然死したFibromuscular Dysplasiaの1例

We have recently encountered a patient presenting an sudden cardiac death secondary to acute myocardial infarction as a complication of fibromuscular dysplasia (FMD) involving the coronary artery. A 30 years old woman, who had a 6 year history of hyperthyroidism, was carried to our hospital because of sudden cardiac arrest. With no vital signs at arrival, advanced life support make her heart beat and gave a stable hemodynamic condition, which allowed us to make a diagnosis of acute broad anterior myocardial infarction with electrocardiography, echocardiography and serum CK-MB isoenzyme. Her brain activity did not recovered. She died on day 6 of hospitalization. Postmortem examination confirmed a broad anterior wall infarction of a histologic age of several days. Histologic examination also revealed intimal fibrous thickening with an increase of smooth muscle cells and elastic fibers in the right coronary and the anterior descending branch of the left coronary arteries, as well as the vertebral, bronchial, intra-renal and superior mesenteric arteries. Whereas no complete obstruction in the coronary artery was found at autopsy, it seems likely that the intracoronary luminal narrowing induced by fibromuscular hyperplasia might have precipitated a myocardial ischemic insult which caused the sudden cardiac death. Although FMD of the coronary artery has been rare in literature, it is necessary to consider FMD in the differential diagnosis of identifiable causes of sudden death, particularly in the young generation

Efficacy of Prednisolone in Generated Myotubes Derived From Fibroblasts of Duchenne Muscular Dystrophy Patients

Duchenne muscular dystrophy (DMD) is a recessive X-linked form of muscular dystrophy characterized by progressive muscle degeneration. This disease is caused by the mutation or deletion of the dystrophin gene. Currently, there are no effective treatments and glucocorticoid administration is a standard care for DMD. However, the mechanism underlying prednisolone effects, which leads to increased walking, as well as decreased muscle wastage, is poorly understood. Our purpose in this study is to investigate the mechanisms of the efficacy of prednisolone for this disease. We converted fibroblasts of normal human cell line and a DMD patient sample to myotubes by MyoD transduction using a retroviral vector. In myotubes from the MyoD-transduced fibroblasts of the DMD patient, the myotube area was decreased and its apoptosis was increased. Furthermore, we confirmed that prednisolone could rescue these pathologies. Prednisolone increased the expression of not utrophin but laminin by down-regulation of MMP-2 mRNA. These results suggest that the up-regulation of laminin may be one of the mechanisms of the efficacy of prednisolone for DMD

Surface Control Process of AlGaN for Suppression of Gate Leakage Currents in AlGaN/GaN Heterostructure Field Effect Transistors

We proposed a surface control process for suppressing the tunneling leakage of Schottky gates on AlGaN/GaN heterostructures. For the recovery of nitrogen-vacancy-related defects and reduction in the amount of oxygen impurities at the AlGaN surface, the process consisted of nitrogen radical treatment, the deposition of an ultrathin Al layer, UHV annealing and finally the removal of the Al layer. Ni/Au Schottky gates fabricated on processed AlGaN surfaces showed pronounced reduction in leakage current and a clear temperature dependence of I-V characteristics, indicating the effective suppression of tunneling leakage in current transport through AlGaN Schottky interfaces

Large reduction of leakage currents in AlGaN Schottky diodes by a surface control process and its mechanism

Leakage currents in AlGaN Schottky diodes were investigated systematically by using a rigorous computer simulation based on the thin surface barrier model taking account of unintentionally doped surface donors. The leakage currents in AlGaN Schottky diodes have stronger bias dependence and smaller temperature dependences as compared with those of GaN diodes. It was shown that these features were associated with shallow oxygen donors located near the AlGaN surface. Then, an attempt was made to remove oxygen and suppress leakage currents by a surface control process using an ultrathin Al layer and subsequent annealing. An in situ x-ray photoelectron spectroscopy analysis indicated the formation of Al2O3 layer during the surface control process, suggesting efficient gettering of oxygen from the surface. C-V analysis directly indicated the reduction of shallow donors by the surface control process. A remarkable reduction of reverse leakage currents of four to five orders of magnitude took place in large area AlGaN Schottky diodes after the application of the surface control process. This process also reduced leakage currents of the gate of the heterostructure field effect transistor device by more than one order of magnitude and increased temperature dependences of current. ©2006 American Vacuum Societ