Kure Medical Center and Chugoku Cancer Center

Kure, Japan

Kure Medical Center and Chugoku Cancer Center

Kure, Japan
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Kondo N.,Hiroshima University | Murakami Y.,Hiroshima University | Uemura K.,Hiroshima University | Sudo T.,Kure Medical Center and Chugoku Cancer Center | And 5 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2017

Purpose: To determine a recommended dose for a biweekly combination neoadjuvant chemotherapy including gemcitabine, nab-paclitaxel, and S-1 (GAS) for patients with locally advanced pancreatic ductal adenocarcinoma (LAPC). Methods: Patients with borderline resectable or unresectable LAPC without distant metastasis were eligible for this study. The planned dosages of gemcitabine (mg/m2, day 1), nab-paclitaxel (mg/m2, day 1), and S-1 (mg/day, days 1–7) were 800/100/60–100 at level 1, and 1000/125/60–100 at level 2. The treatment cycle was repeated every 2 weeks, and patients were assessed for resectability and response to the treatment after 6 cycles. This study was registered with UMIN Clinical Trial Registry (UMIN000016630). Results: We enrolled 16 patients with LAPC in this study. At dose level 1, one of 8 patients experienced dose-limiting toxicity (DLT). One of the next 8 patients also experienced DLT at dose level 2. Based on these results, level 2 was considered the recommended dose for this regimen. Pancreatectomy with curative intent could be performed in 13 of the 16 patients. R0 resection was performed in 12 of 13 patients. Conclusion: In conclusion, recommended doses for a biweekly GAS chemotherapy regimen were determined as nab-paclitaxel: 125 mg/m2, gemcitabine: 1000 mg/m2 on day 1, S-1: <1.25 m2, 60 mg; 1.25–1.5 m2, 80 mg; >1.5 m2, 100 mg twice a day on days 1–7. GAS chemotherapy showed good preliminary efficacy with mild toxicity in this study, and warrants a further phase 2 trial to investigate the efficacy of the GAS regimen for LAPC. © 2017, Springer-Verlag Berlin Heidelberg.


Hisaoka K.,Institute for Clinical Research | Hisaoka K.,Hiroshima University | Tsuchioka M.,Institute for Clinical Research | Yano R.,Institute for Clinical Research | And 8 more authors.
Journal of Biological Chemistry | Year: 2011

Recently, both clinical and animal studies demonstrated neuronal and glial plasticity to be important for the therapeutic action of antidepressants. Antidepressants increase glial cell line-derived neurotrophic factor (GDNF) production through monoamine-independent protein-tyrosine kinase, extracellular signal-regulated kinase (ERK), and cAMP responsive element-binding protein (CREB) activation in glial cells (Hisaoka, K., Takebayashi, M., Tsuchioka, M., Maeda, N., Nakata, Y., and Yamawaki, S. (2007) J. Pharmacol. Exp. Ther. 321, 148-157; Hisaoka, K., Maeda, N., Tsuchioka, M., and Takebayashi, M. (2008) Brain Res. 1196, 53-58). This study clarifies the type of tyrosine kinase and mechanism of antidepressant-induced GDNF production in C6 glioma cells and normal human astrocytes. The amitriptyline (a tricyclic antidepressant)-induced ERK activation was specifically and completely inhibited by fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitors and siRNA for FGFR1 and -2. Treatment with amitriptyline or several different classes of antidepressants, but not non-antidepressants, acutely increased the phosphorylation of FGFRs and FGFR substrate 2α (FRS2α). Amitriptyline-induced CREB phosphorylation and GDNF production were blocked by FGFR-tyrosine kinase inhibitors. Therefore, antidepressants activate the FGFR/FRS2α/ERK/CREB signaling cascade, thus resulting in GDNF production. Furthermore, we attempted to elucidate how antidepressants activate FGFR signaling. The effect of amitriptyline was inhibited by heparin, non-permeant FGF-2 neutralizing antibodies, and matrix metalloproteinase (MMP) inhibitors. Serotonin (5-HT) also increased GDNF production through FGFR2 (Tsuchioka, M., Takebayashi, M., Hisaoka, K., Maeda, N., and Nakata, Y. (2008) J. Neurochem. 106, 244-257); however, the effect of 5-HT was not inhibited by heparin and MMP inhibitors. These results suggest that amitriptyline-induced FGFR activation might occur through an extracellular pathway, in contrast to that of 5-HT. The current data show that amitriptyline-induced FGFR activation might occur by the MMP-dependent shedding of FGFR ligands, such as FGF-2, thus resulting in GDNF production. © 2011 by The American Society for Biochemistry and Molecular Biology, Inc.


Shibasaki C.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Takebayashi M.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Takebayashi M.,Kure Medical Center and Chugoku Cancer Center | Fujita Y.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Yamawaki S.,Hiroshima University
Neuropsychiatric Disease and Treatment | Year: 2015

Purpose: Electroconvulsive therapy (ECT) is an effective treatment for depression and schizophrenia. However, there is a high rate of relapse after an initial response to ECT, even with antidepressant or antipsychotic maintenance therapy. This study was carried out to examine the factors that influence the risk of relapse in schizophrenic patients after a response to ECT.Patients and methods: We retrospectively reviewed the records of 43 patients with schizophrenia who received and responded to an acute ECT course. We analyzed the associated clinical variables and relapse after response to the acute ECT. Relapse was defined as a Clinical Global Impressions Improvement score 6 or a psychiatric rehospitalization.Results: All patients were treated with neuroleptic medication after the acute ECT course. The relapse-free rate of all 43 patients at 1 year was 57.3%, and the median relapse-free period was 21.5 months. Multivariate analysis showed that the number of ECT sessions was associated with a significant increase in the risk of relapse (hazard ratio: 1.159; P=0.033). Patients who were treated with adjunctive mood stabilizers as maintenance pharmacotherapy after the response to the acute ECT course were at a lower risk of relapse than were those treated without mood stabilizers (hazard ratio: 0.257; P=0.047).Conclusion: Our study on the recurrence of schizophrenia after a response to an acute ECT course suggests that the number of ECT sessions might be related to the risk of relapse and that adjunctive mood stabilizers might be effective in preventing relapse. © 2015 Shibasaki et al.


PubMed | Kure Medical Center and Chugoku Cancer Center and Hiroshima City Asa Hospital
Type: | Journal: Journal of cardiothoracic surgery | Year: 2015

We report a case of a 58-year-old Japanese man with epithelioid-type MPM, with a left chest wall protruding tumor, who underwent extrapleural pneumonectomy and chest wall resection. Postsurgical pathology showed that surgical margins were free of mesothelioma cells. Positron emission tomography taken 5years after surgery showed no recurrence at any site, suggesting that long-term survival could be dependent on margin-free tumor resection or that specific MPM subgroups have lower malignant potential, leading to improved survival.


Tada M.,Kure Medical Center and Chugoku Cancer Center | Hirakawa H.,Kure Medical Center and Chugoku Cancer Center | Nishi Y.,Kure Medical Center and Chugoku Cancer Center | Watanabe T.,Kure Medical Center and Chugoku Cancer Center
Practica Oto-Rhino-Laryngologica | Year: 2015

A 3-year 8-month-old girl visited our clinic complaining of a feeling of fullness in the right ear. She had passed the newborn hearing screening (NHS) with the automated auditory brainstem response (automated ABR) test. CT imaging of the right temporal bone revealed internal auditory canal stenosis. MRI showed that the right cochlear nerve was thin, but continuous. No ABR was evoked even by 90 dB nHL of click stimuli to the right ear. Distortion product otoacoustic emission (DPOAE) response from the right ear was not clear. These results indicate that hearing impairment might appear after birth in patients with congenital unilateral internal auditory canal stenosis.


Hirakawa H.,Kure Medical Center and Chugoku Cancer Center | Nishi Y.,Kure Medical Center and Chugoku Cancer Center | Tada M.,Kure Medical Center and Chugoku Cancer Center | Watanabe T.,Kure Medical Center and Chugoku Cancer Center
Practica Otologica, Supplement | Year: 2015

Juvenile angiofibromas represent a rare vascular tumor of the deep part of the face occurring in adolescent males. This tumor typically arises from the sphenopalatine artery. The surgical approach for the tumor requires consideration for both complete removal of the tumor and preservation of the facial appearance. We applied the hemifacial degloving approach in a 12-year-old boy with a unilateral juvenile angiofibroma staged IIIA according to Radkowski (1996). We performed this approach twice on this patient because we had missed the residual tumor inside the base of the right pterygoid process at the first surgery. He has had no evidence of recurrence of the tumor and no surgical marks on the face over three years after the second surgery. Hemifacial degloving is a more suitable approach than midfacial degloving for exclusively unilateral tumors.


Handa Y.,Kure Medical Center and Chugoku Cancer Center | Harada H.,Kure Medical Center and Chugoku Cancer Center | Yamashita Y.,Kure Medical Center and Chugoku Cancer Center
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2015

A 70-years-old man was diagnosed as having primary lung adenocarcinoma (cT1aN0M0, cStage I A) in the left lingula. Because of poor pulmonary function [vital capacity (VC):1,840 ml, forced expiratory volume (FEV)1.0:790 ml],we thought he could not tolerate the surgery and should be treated by chemoradiation therapy. However,by his strong hope for surgical treatment,comprehensive pulmonary rehabilitation by nutritional therapy and physiotherapy of breathing was started and was continued for about 1 month. As the value of pulmonary function test was improved (VC:2,010 ml,FEV1.0:1,040 ml), we did left lingulectomy. Postoperative complications did not occur and the patient shows a favorable condition without respiratory failure 18 months postoperation.


Hirakawa H.,Kure Medical Center and Chugoku Cancer Center | Nishi Y.,Kure Medical Center and Chugoku Cancer Center | Tada M.,Kure Medical Center and Chugoku Cancer Center | Watanabe T.,Kure Medical Center and Chugoku Cancer Center
Practica Otologica, Supplement | Year: 2015

Concurrent superselective intra-arterial chemoradiotherapy (SIACRT), a combination of chemoradiotherapy (CRT) and superselective intra-arterial chemotherapy (SIAC), is a new therapeutic strategy for advanced squamous cell carcinomas (SCCs) of the head and neck. We have been applying SIACRT for SCC of the maxillary sinus and upper gingiva since 2008 and present herein the outcomes at our hospital. SIACRT was applied in 10 cases between 2009 and 2012, 7 males and 3 females with an age-range of 57 to 81. An intra-arterial micro-catheter was inserted into a feeding artery of the tumor super-selectively using Seldinger's method. Cisplatin (CDDP) was injected into the tumor intra-arterially through the catheter at a rate of 5 mg per minute. At the same time sodium thiosulfate (STS) was intravenously administered at 200- fold the dose of CDDP in a molar quantity to reduce the toxicity of the CDDP. Irradiation was started on the same day. Five-day-continuous intravenous administration of 5-fluorouracil (5FU) was started the next day. CDDP and 5FU were administered in the same way four weeks later. The total dose of irradiation was 50 to 60 Gy. In eight cases, the protocol was applied correctly, and these patients showed complete response (CR) and survived without disease for more than 15 months. In two cases, the patient dropped out of the protocol, resulting in partial response (PR). Of these cases, one refused the 2nd administration of SIAC and in the other two courses of SIAC followed by SIACRT were administered. In two of the eight CR cases, the application of SIACRT eliminated metastatic lymph node tumors.


PubMed | Kure Medical Center and Chugoku Cancer Center
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2015

A 70-years-old man was diagnosed as having primary lung adenocarcinoma (cT1aN0M0, cStage I A) in the left lingula. Because of poor pulmonary function [vital capacity (VC):1,840 ml, forced expiratory volume (FEV)1.0:790 ml],we thought he could not tolerate the surgery and should be treated by chemoradiation therapy. However,by his strong hope for surgical treatment,comprehensive pulmonary rehabilitation by nutritional therapy and physiotherapy of breathing was started and was continued for about 1 month. As the value of pulmonary function test was improved (VC:2,010 ml,FEV1.0:1,040 ml), we did left lingulectomy. Postoperative complications did not occur and the patient shows a favorable condition without respiratory failure 18 months postoperation.


PubMed | Kure Medical Center and Chugoku Cancer Center
Type: Journal Article | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016

We report a case of tracheal resection and primary anastomosis for adenoid cystic carcinoma using an extracorporeal membrane oxygenation (ECMO). A 45-year-old female was referred to our hospital because of a tracheal tumor that occupied most of the tracheal lumen. In case of airway obstruction by the tracheal tumor during anesthesia and operation, we decided to use ECMO before induction of general anesthesia. Under secure respiratory control using ECMO, tracheal resection and primary anastomosis was performed. Since histopathological examination revealed microscopically positive results at the surgical margin, postoperative adjuvant radiation therapy( 60 Gy/30 Fr) was conducted. Although a tracheal tumor is a relatively rare neoplasm, careful planning and a treatment strategy are necessary with special emphasis on the location and size of tumor. In this case, ECMO made a substantial contribution to secure respiratory control during surgery.

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