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Ashizawa K.,Ibaraki Prefectural Central Hospital and Cancer Center
Otolaryngology - Head and Neck Surgery (Tokyo) | Year: 2010

A 59-year-old man presenting with dysphagia showed trismus and stiffness of the cervical muscles after 6 days, and was then diagnosed as tetanus. Another 69-year-old man presented with trismus after a hand injury. A clinical diagnosis of tetanus was made. In both cases, respiratory care involving endotracheal intubation and anti-tetanus immunoglobulin injection and administration of penicillin G were performed, resulting in cure without any sequelae.

Moriwaki T.,University of Tsukuba | Bando H.,National Cancer Center Hospital East | Takashima A.,National Cancer Center Hospital | Yamazaki K.,Shizuoka Cancer Center | And 12 more authors.
Medical Oncology | Year: 2012

The efficacy of bevacizumab combined with infusional 5-fluorouracil/ leucovorin (5-FU/LV) plus irinotecan (FOLFIRI) as the second-line treatment for metastatic colorectal cancer (mCRC) has not been fully clarified, although bevacizumab combined with infusional 5-FU/LV plus oxaliplatin (FOLFOX) in the second-line setting has demonstrated a survival benefit. We investigated the efficacy of bevacizumab plus FOLFIRI in mCRC patients who failed oxaliplatin-containing regimens without bevacizumab. Patients who received bevacizumab plus FOLFIRI or bevacizumab plus FOLFOX as second-line chemotherapy between July 2007 and March 2008 were registered (trial registration: UMIN000001547). Patient background data and progression-free survival (PFS), overall survival (OS), response, and bevacizumab-related adverse events were prospectively collected every 6 months. A total of 195 patients were enrolled from 26 institutions. Among them, 115 patients received bevacizumab plus FOLFIRI after failure of oxaliplatin and fluoropyrimidine (FOLFIRI+BV after OX/FU group), and 45 patients received bevacizumab plus FOLFOX after failure of irinotecan and fluoropyrimidine (FOLFOX+BV after IRI/FU group). Median PFS was 8.3 months (95% confidence interval [CI], 6.7-9.9) for the FOLFIRI+BV after OX/FU group and 7.8 months (95% CI, 5.8-9.7) for the FOLFOX+BV after IRI/FU group. Median OS was 21.6 months (95% CI, 17.6-25.6) and 16.5 months (95% CI, 11.8-21.2), respectively. Overall response rates were 25 and 29%, respectively. The most common grade ≥3 bevacizumab-related adverse events were hypertension (5.0%) and bleeding (3.8%). FOLFIRI+BV after OX/FU showed comparable efficacy to FOLFOX+BV after IRI/FU. © 2011 Springer Science+Business Media, LLC.

Higuchi K.,Kitasato University | Tanabe S.,Kitasato University | Shimada K.,Showa University | Hosaka H.,Gunma Prefectural Cancer Center | And 13 more authors.
European Journal of Cancer | Year: 2014

Purpose We compared biweekly irinotecan plus cisplatin (BIRIP) with irinotecan alone as the second-line chemotherapy (SLC) for advanced gastric cancer (AGC). Methods Patients with metastatic or recurrent gastric cancer refractory to S-1-based first-line chemotherapy were randomly assigned to receive BIRIP (irinotecan 60 mg/m2 plus cisplatin 30 mg/m 2, every 2 weeks) or irinotecan alone (irinotecan 150 mg/m 2, every 2 weeks). The primary end-point was to show the superiority of BIRIP to irinotecan in terms of progression free survival (PFS). Results 130 patients were enrolled. PFS was significantly longer in the BIRIP group (3.8 months [95% confidence interval (CI) 3.0-4.7]) than in the irinotecan group (2.8 months [2.1-3.3]; hazard ratio 0.68, 95% CI 0.47-0.98; P = 0.0398). Median overall survival was 10.7 months in the BIRIP group and 10.1 months in the irinotecan group (HR 1.00, 95% CI 0.69-1.44, P = 0.9823). The objective response rate was 22% in the BIRIP group and 16% in the irinotecan group (P = 0.4975). However, the disease control rate was significantly better in the BIRIP group (75%) than in the irinotecan group (54%, P = 0.0162). The incidences of grade 3 or worse adverse events did not differ between the two groups. Any grade elevation of serum creatinine was more common in the BIRIP group (25% versus 8%, P = 0.009), but any grade diarrhoea (17% versus 42%, P = 0.002) was more common in the irinotecan group. Conclusion BIRIP significantly prolonged PFS as compared with irinotecan alone and was tolerated as SLC, but did not demonstrate the survival benefit in this trial. © 2014 Elsevier Ltd. All rights reserved.

Tani K.,Ibaraki Prefectural Central Hospital and Cancer Center
Otolaryngology - Head and Neck Surgery (Tokyo) | Year: 2010

We reported two cases of a foreign body in the hypopharynx and esophagus, removed by an external neck incision. The first case was a 50-year-old female who complained of a sore throat after eating a fish. CT scan revealed a fish bone in her hypopharynx. The foreign body was removed by lateral neck incision. The second case was a 70-year-old male, who presented with anterior neck swelling after swallowing of a fish. CT scan revealed a fish bone in his esophagus, and an abscess formation was detected. The foreign body was removed following transcervical drainage of the abscess.

Murata S.,University of Tsukuba | Mukai H.Y.,Janssen Pharmaceutical | Kojima H.,Ibaraki Prefectural Central Hospital and Cancer Center
Journal of Thrombosis and Haemostasis | Year: 2010

Background: The pro-apoptotic BH3-only protein Bim is recognized as a pivotal regulator of apoptosis induced by the depletion of cytokines. In the present study, we examined the role of Bim in megakaryopoiesis. Methods: Megakaryocyte (MK) progenitors obtained from bim knockout (KO) mice were analyzed in vitro for liability to apoptosis after the depletion of cytokines, ability to differentiate into MKs and proliferation/cell cycle progression in response to thrombopoietin (TPO). The production of platelets in vitro was evaluated by assaying the formation of proplatelets in MKs. Megakaryopoiesis in vivo was observed in a mouse model of thrombocytopenia induced by injecting fluorouracil (5-FU). Results: Bim-deficient CD34-/c-kit+/Sca-1+/Lineage- stem cells and MKs were highly resistant to apoptosis induced by cytokine depletion, suggesting that Bim is involved in the apoptotic process in both stem cells and MKs. As bim KO mice exhibited splenomegaly and thrombocytopenia, splenectomized mice were used for experiments in vivo. Platelet recovery after 5-FU-induced thrombocytopenia was significantly delayed in bim KO mice. Corresponding with this, numbers of MKs in the recovery phase bone marrow were significantly reduced in bim KO mice. Culture of c-kit+/Lineage- progenitors with TPO revealed that Bim-deficient cells poorly proliferate and differentiate into CD41+ cells in comparison with wild-type (WT) cells. However, once differentiated into MKs, these cells matured normally. Furthermore, cell cycle analyses demonstrated that transition from the G1 to the S phase was delayed in Bim-deficient stem cells. Conclusions: In the present study, we demonstrated that Bim plays a pivotal role in the regulation of cell cycle progression in hepatopoietic progenitors during megakaryopiesis. © 2010 International Society on Thrombosis and Haemostasis.

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