The Cost Burdan of Psoriasis Treated with Biologics in Akita Prefecture

Biologics have been dramatically effective in the treatment of psoriasis and have improved the quality of life of patients. However, to our knowledge, no comprehensive study has been implemented to explore the medical burden created by the administration of biologics. Consequently, we assessed the actual state of the cost burden of patients with psoriasis being treated with biologics in Akita University Hospital. Our results suggested that there were considerable differences in the co-payment of biologics up to the health insurance system. Future studies should carefully consider the cost of biologics from the perspective of the increase in medical expenses

Current Diagnostic and Therapeutic Approaches to Cytomegalovirus Infections in Ulcerative Colitis Patients Based on Clinical and Basic Research Data

Human cytomegalovirus (HCMV) is a ubiquitous herpesvirus (the human herpesvirus 5) and an opportunistic pathogen that primarily infects HIV-positive and other immuno-compromised patients. Retrospective studies in the field of inflammatory bowel disease (IBD) have suggested a relationship between a concomitant colonic HCMV infection and poor outcomes in patients with an ulcerative colitis (UC) due to the presence of HCMV in surgical specimens of patients with a toxic megacolon or a steroid-resistant UC. Therefore, gastroenterologists have focused on the contribution of HCMV infections in the exacerbation of UC. Numerous studies have addressed the benefits of treating colonic HCMV reactivation in UC using an antiviral treatment. However, its clinical relevance remains uncertain as only a few prospective studies have assessed the direct relationship between clinical outcomes and the viral load of HCMV in colonic tissues. HCMV reactivation can be triggered by inflammation according to fundamental research studies. Thus, optimal control of intestinal inflammation is essential for preventing an HCMV reactivation in the intestinal mucosa. Indeed, several reports have indicated the effectiveness of an anti-tumor necrosis factor-alpha (TNFα) treatment in patients with an active UC and concomitant HCMV infections. In this review, we describe the mechanism of HCMV reactivation in UC cases and discuss the current issues regarding diagnosis and treatment of HCMV infections in UC patients

SUPPRESSION OF SPONTANEOUS CARCINOGENESIS IN KERATINOCYTE-SPECIFIC PTEN-DEFICIENT MICE WITH SELECTIVE INHIBITION OF PI3K ISOFORMS

PTEN is a tumor suppressor gene that is mutated in many human sporadic cancers and in hereditary tumor susceptibility disorders such as Cowden disease. We have previously reported that keratinocyte-specific heterozygous Pten-deficient mice (K5CrePtenflox/+ mice) displayed enhanced susceptibility to carcinogenesis of the skin. Accordingly, to clarify whether the selective inhibition of phosphoinositide 3-kinase (PI3K) isoforms rescues the phenotypes of K5CrePtenflox/+ mice, we generated mice simultaneously lacking (PI3K) isoforms (p85α , p110α , p110δ or p110γ ) and Pten. Consequently, it was shown that heterozygous p110α deficiency (p110α +/−) and homozygous p110 deficiency (p110γ −/−) significantly rescued susceptibility to spontaneous carcinogenesis of the skin in K5CrePtenflox/+ mice. The present study sheds light on the possible role of p110α and p110γ in carcinogenesis of the skin ; thus providing new insights into a chemoprevention of squamous cell carcinoma

RESURFACING EFFECTS OF SHORT-PULSED CARBON DIOXIDE LASER FOR CUTANEOUS SQUAMOUS CELL CARCINOMA IN SITU

The carbon dioxide (CO2) laser in a short-pulsed mode is currently one of the most useful devices in dermatologic practice in the fields of oncology. To evaluate the safety and efficacy of the short-pulsed CO2 laser in the treatment of cutaneous squamous cell carcinoma (SCC) in situ, the clinical improvement of 40 cases SCC in situ treated with the laser was assessed by a retrospective study. Consequently, it was shown that (1) no clinical evidence of recurrences during the follow-up time (3 to 63 months) in 27 cases, (2) lesion recurrence occurred and additional treatments were required in 13 cases, and (3) hypertrophic scarring was complicated in 1 case. Our findings suggested that the short-pulsed CO2 laser can be considered a safe and effective treatment for patients with SCC in situ, offering excellent cosmetic results

Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study

Background Radial endobronchial ultrasonography (R-EBUS) has been used in conjunction with transbronchial lung cryobiopsy (TBLC) to diagnose diffuse parenchymal lung disease (DPLD) and to decrease the risk of bleeding complications. The diagnostic utility of different R-EBUS signs, however, remains unknown.Objectives This study aimed to determine whether different R-EBUS signs could be used to more accurately diagnose DPLD and whether bronchial bleeding could be prevented with use of R-EBUS during TBLC.Method Eighty-seven patients with DPLD were included in this multicentre prospective study, with 49 patients undergoing R-EBUS. R-EBUS signals were characterised as displaying either dense or blizzard signs. Pathological confidence of specimens obtained from TBLC was compared between patients with dense versus blizzard signs, and severity of bronchial bleeding was determined based on whether R-EBUS was performed or not.Results All patients with dense signs on R-EBUS showed consolidation on high-resolution CT (HRCT) imaging. Pathological confidence of lung specimens was significantly higher in patients with dense signs versus those with blizzard signs (p<0.01) and versus those who did not undergo R-EBUS (p<0.05). Patients who underwent TBLC with R-EBUS were more likely to experience no or mild bronchial bleeding than patients who did not undergo R-EBUS (p<0.01), with shorter procedure times (p<0.01).Conclusions The dense R-EBUS sign corresponded with consolidation on HRCT. High-quality lung specimens may be obtainable when the dense sign is observed on R-EBUS, and R-EBUS combined with TBLC may reduce risk of bronchial bleeding and shorten procedure times