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Nakamura K.,Clinical Data | Katai H.,National Cancer Center Hospital | Mizusawa J.,Clinical Data | Yoshikawa T.,Kanagawa Cancer Center | And 8 more authors.
Japanese Journal of Clinical Oncology | Year: 2013

A Phase III study was started in Japan to evaluate the non-inferiority of overall survival of laparoscopy-assisted distal gastrectomy with open distal gastrectomy in patients with clinical IA (T1N0) or IB [T1N1 or T2(MP)N0] gastric cancer. This study followed the previous Phase II study to confirm the safety of laparoscopy-assisted distal gastrectomy (JCOG0703) and began in March 2010. A total of 920 patients will be accrued from 33 institutions within 5 years. The primary endpoint is overall survival. The secondary endpoints are relapse-free survival, proportion of laparoscopy-assisted distal gastrectomy completion, proportion of conversion to open surgery, adverse events, short-term clinical outcomes, postoperative quality of life. Only a credentialed surgeon can be responsible for both open distal gastrectomy and laparoscopy-assisted distal gastrectomy. © 2012 The Author. Published by Oxford University Press. All rights reserved. Source

Nakajima K.,Kanazawa University | Nakata T.,Hakodate Goryoukaku Hospital
Journal of nuclear medicine : official publication, Society of Nuclear Medicine | Year: 2015

Cardiac neuroimaging with (123)I-metaiodobenzylguanidine ((123)I-MIBG) has been officially used in clinical practice in Japan since 1992. The nuclear cardiology guidelines of the Japanese Circulation Society, revised in 2010, recommended cardiac (123)I-MIBG imaging for the management of heart failure (HF) patients, particularly for the assessment of HF severity and prognosis of HF patients. Consensus in North American and European countries regarding incorporation into clinical practice, however, has not been established yet. This article summarizes 22 y of clinical applications in Japan of (123)I-MIBG imaging in the field of cardiology; these applications are reflected in cardiology guidelines, including recent methodologic advances. A standardized cardiac (123)I-MIBG parameter, the heart-to-mediastinum ratio (HMR), is the basis for clinical decision making and enables common use of parameters beyond differences in institutions and studies. Several clinical studies unanimously demonstrated its potent independent roles in prognosis evaluation and risk stratification irrespective of HF etiologies. An HMR of less than 1.6-1.8 and an accelerated washout rate are recognized as high-risk indicators of pump failure death, sudden cardiac death, and fatal arrhythmias and have independent and incremental prognostic values together with known clinical variables, such as left ventricular ejection fraction and brain natriuretic peptide. Another possible use of this imaging technique is the selection of therapeutic strategy, such as pharmacologic treatment and nonpharmacologic treatment with an implantable cardioverter-defibrillator or cardiac resynchronization device; however, this possibility remains to be investigated. Recent multiple-cohort database analyses definitively demonstrated that patients who were at low risk for lethal events and who were defined by an HMR of greater than 2.0 on (123)I-MIBG studies had a good long-term prognosis. Future investigations of cardiac (123)I-MIBG imaging will contribute to better risk stratification of low-risk and high-risk populations, to the establishment of cost-effective use of this imaging technique for the management of HF patients, and to worldwide acceptance of this imaging technique in clinical cardiology practice. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc. Source

Nakata T.,Hakodate Goryoukaku Hospital | Nakata T.,Sapporo Medical University
Journal of Nuclear Cardiology | Year: 2016

A high-speed, multi-slice coronary computed tomography (CT) imaging has emerged as a promising or clinically available multifunctional technique for the assessment of myocardial ischemia, viability, ischemia-induced cardiac dysfunction, and coronary atherosclerotic alterations in patients with suspected or known coronary artery disease. Despite several technical issues remain to be resolved, cardiac CT imaging will have a reality as a multifunctional modality for guiding physicians in better decision-making for favorable clinical outcomes in patients with suspected coronary artery disease, provided that this imaging technology can contribute to characterization and localization of high-risk coronary atherosclerosis in combination with the quantitative evaluation of functional myocardial ischemia. © 2016 American Society of Nuclear Cardiology Source

Matsuo S.,Kanazawa University | Nakajima K.,Kanazawa University | Nakata T.,Hakodate Goryoukaku Hospital
Circulation Journal | Year: 2016

Background: Although there are several known prognostic determinants in heart failure (HF), individual risk profiles can vary, in particular between ischemic and non-ischemic HF background. This study investigated the difference in prognostic efficacy of cardiac123I-meta-iodobenzylguanidine (MIBG) imaging between the 2 etiologies. Methods and Results: All 1,322 patients with HF were enrolled and followed up at most after 10 years. The HF patients were divided into 2 groups: an ischemic group (n=362) and non-ischemic group (n=960), and Cox proportional hazards model was used for data analysis. During 10 years of follow-up, 296 (22.4%) of 1,322 patients died; the mortality rates were 21.8% and 22.6% for the ischemic and non-ischemic groups, respectively. The ischemic group had greater prevalence of sudden death and lethal acute myocardial infarction, and the non-ischemic group had a higher rate of pump failure death. On multivariate Cox proportional hazards analysis using categorized variables, in the ischemic group, delayed heart-to-mediastinum ratio (HMR; P<0.0001), age (P=0.0002) and LVEF (P=0.03) were the independent significant predictors of lethal events. In the non-ischemic group, delayed HMR (P<0.0001), NYHA class (P<0.0001) and age (P<0.0001) were significant determinants of lethal outcome. Conclusions: Cardiac MIBG imaging has nearly identical prognostic value in both ischemic and non-ischemic HF, independent of cause of cardiac death. © 2016, Japanese Circulation Society. All rights reserved. Source

Sato S.,Hakodate Goryoukaku Hospital
Japanese Journal of Clinical Urology | Year: 2014

We investigated the need of a 24-hour creatinine clearance (24-hour Ccr) when we performed chemotherapy for urothelial carcinoma. From January 2006 to April 2009, 24 chemotherapy patients received total of 70 courses. We used a 24-hour Ccr, Cockcroft-Gault (C-G) equation and estimated GFR (eGFR) as evaluation methods of renal function. Our results demonstrated that A 24-hour Ccr was higher than C-G equation and eGFR in 70% and 90%, respectively. If both C-G equation and eGFR were more than 60 ml/min, a 24-hour Ccr was more than 60 ml/min in 95%. Therefore if both C-G equation and eGFR are more than 60 ml/min, we might omit a 24-hour Ccr. Source

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