Hirai K.,International Goodwill Hospital |
Hirai K.,Yokohama City University |
Takano Y.,Kitasato Institute Hospital |
Uchio E.,Fukuoka |
Kadonosono K.,Yokohama City University
Clinical Ophthalmology | Year: 2012
Purpose: To evaluate the therapeutic effects of atelocollagen absorbable punctal plugs. Method: Seventy-four eyes in 37 patients with dry eye disease (DED) underwent punctal plug occlusion using atelocollagen plugs and were followed up for 24 weeks. Subjective symptoms were evaluated using the ocular surface disease index (OSDI) questionnaire. Ocular surface disease parameters, including the Schirmer test, phenol red thread test, tear break-up time(TBUT), and fluorescein and Rose Bengal staining, were recorded before and 1, 4, 8, 16, and 24 weeks after treatment. Results: In comparison with the pretreatment data, the subjective symptoms and ocular surface disease parameters showed significant improvement after atelocollagen punctal occlusion. The average time of relapse was 17.4 ±5.1 weeks. No severe complications occurred, and none of the plugs had to be removed because of local discomfort or epiphora. Conclusion: Atelocollagen absorbable punctal plugs effectively improved ocular surface disorders in DED. These plugs are a safe and effective alternative in the treatment of DED. © 2012 Hirai et al, publisher and licensee Dove Medical Press Ltd.
Chiba K.,International Goodwill Hospital
BMJ case reports | Year: 2013
Double-lumen catheters are widely used to achieve temporary access to circulation in patients requiring acute haemodialysis (HD); however, several complications are associated with the insertion of these catheters. Arteriovenous fistula (AVF), a rare but significant complication of catheter insertion, has been reported in several cases. In this report, we describe a case of a right femoral AVF that caused calf pain 2 months after HD catheter removal. The right ankle-brachial index was 0.46, and the diagnosis of AVF was confirmed using colour Doppler ultrasound and three-dimensional CT. The fistula was managed by surgical vascular repair. The right ABI improved to 1.06, and the absence of fistula was confirmed using three-dimensional CT. Therefore, physicians and nursing staff should be aware of the potential of this complication and should perform clinical and medical examinations at the insertion and removal of temporary HD catheters.
Naito S.,Kyushu University |
Tsukamoto T.,Sapporo Medical University |
Murai M.,International Goodwill Hospital |
Fukino K.,Bayer Yakuhin Ltd |
Akaza H.,University of Tsukuba
BJU International | Year: 2011
Study Type - Therapy (Phase II non-randomized trial) Level of Evidence 2b What's known on the subject? and What does the study add? Interim result of this study had shown promising efficacy, with response rate of 14.7% and median PFS of 7.4 months, and good tolerability of sorafenib in previously-treated Japanese patients with metastatic RCC. Final result of the study adds: (1) the median overall survival of 25.3 months, which is longer than that in the global phase III study TARGET; (2) the response rate which elevated to 19.4% because of 6 late responders achieved after 9.2 months or longer of SD period; (3) lack of either unknown adverse events nor cumulative toxicity in the long-term use of sorafenib. OBJECTIVE • To explore the long-term efficacy and safety of sorafenib in Japanese patients with metastatic renal cell carcinoma (RCC) in a phase II trial. PATIENTS AND METHODS • In all, 131 Japanese patients with metastatic RCC who had received nephrectomy and failed at least one cytokine-containing systemic therapy received continuous sorafenib 400 mg twice daily, and the efficacy and safety parameters were evaluated in these patients, including objective response rate, progression-free survival and overall survival. RESULTS • Of the total, 129 patients were valid for intention-to-treat analyses and 131 patients were valid for safety analyses. • Twenty-five patients (19.4%) had confirmed partial response and 87 patients (67.4%) had stable disease as best overall response. The 25 patients included six late-responders who achieved response after 9.2 months or longer of stable disease. The objective response rate and disease control rate were 19.4% and 73.6%, respectively. • The median overall survival and median progression-free survival were 25.3 and 7.9 months, respectively. • Safety profile was consistent with those previously reported, with hand-foot skin reaction (58.0%), lipase elevation (57.3%) and diarrhoea (42.7%) as the most frequently observed drug-related adverse events. Neither unknown adverse event nor cumulative toxicity was observed over the long-term use of sorafenib. • Despite the dose discontinuation/interruption/reduction, the mean and median relative dose intensities were 86.4% and 97.4%, respectively. CONCLUSION • The final results of this trial showed that long-term use of sorafenib after cytokine treatment was well tolerated and provided new efficacy data, including late-response events and favourable overall survival in Japanese patients with metastatic RCC. © 2011 BAYER YAKUHIN, LTD. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.
Arima M.,International Goodwill Hospital |
Matsuda A.,International Goodwill Hospital |
Nitta M.,International Goodwill Hospital |
Yoshida K.,International Goodwill Hospital |
Shimizu M.,International Goodwill Hospital
Heart and Vessels | Year: 2012
A 73-year-old woman was admitted to our hospital with anterior acute myocardial infarction due to subacute thrombosis after coronary stenting with a zotarolimus- eluting stent (ZES), which is a newly developed drug-eluting stent that has been widely used since May 2009 in Japan. Five days before, she underwent implantation with a ZES in the left anterior descending artery due to stable angina pectoris. After stenting, the intravascular ultrasonography showed no malapposition from the proximal to the distal edge of the stent. She received aspirin 100 mg/day and clopidogrel 75 mg/day from 2 weeks before the stent was implanted. When we investigated the single nucleotide polymorphisms of CYP2C19 in this patient, both CYP2C19*2 and CYP2C19*3 were detected, and she was classified as a poor metabolizer. This report is the first to describe subacute stent thrombosis following the implantation of a newly developed ZES in a Japanese patient, which may be related to clopidogrel resistance. © 2011 Springer.
Wakui H.,Yokohama City University |
Dejima T.,Yokohama City University |
Dejima T.,International Goodwill Hospital |
Tamura K.,Yokohama City University |
And 10 more authors.
Cardiovascular Research | Year: 2013
Aims: Activation of tissue angiotensin II (Ang II) type 1 receptor (AT1R) plays an important role in the development of vascular remodelling. We have shown that the AT1R-associated protein (ATRAP/Agtrap), a specific binding protein of AT1R, functions as an endogenous inhibitor to prevent pathological activation of the tissue renin-angiotensin system. In this study, we investigated the effects of ATRAP on Ang II-induced vascular remodelling. Methods and results: Transgenic (Tg) mice with a pattern of aortic vascular-dominant overexpression of ATRAP were obtained, and Ang II or vehicle was continuously infused into Tg and wild-type (Wt) mice via an osmotic minipump for 14 days. Although blood pressure of Ang II-infused Tg mice was comparable with that of Ang II-infused Wt mice, the Ang II-mediated development of aortic vascular hypertrophy was partially inhibited in Tg mice compared with Wt mice. In addition, Ang II-mediated up-regulation of vascular Nox4 and p22 pox, NADPH oxidase components, and 4-HNE, a marker of reactive oxygen species (ROS) generation, was significantly suppressed in Tg mice, with a concomitant inhibition of activation of aortic vascular p38MAPKand JNKby Ang II. This protection afforded by vascular ATRAP against Ang II-induced activation of NADPH oxidase is supported by in vitro experimental data using adenoviral transfer of recombinant ATRAP. Conclusion: These results indicate that activation of aortic vascular ATRAP partially inhibits the Nox4/p22 phox-ROS-p38MAPK/JNK pathway and pathological aortic hypertrophy provokedby Ang II-mediated hypertension, thereby suggesting ATRAPasa novel receptor-binding modulator of vascular pathophysiology. © The Author 2013.
PubMed | Clinical Data, National Cancer Center Hospital, Keio University, The Surgical Center and 3 more.
Type: Journal Article | Journal: Japanese journal of clinical oncology | Year: 2016
It is important to examine variation in the treatment effects of patients with esophageal cancer in order to generalize treatment outcomes. We aimed to investigate the range of prognostic differences among hospitals in the treatment of locally advanced esophageal cancer. The JCOG0303 study compared the efficacy of radiotherapy plus low-dose cisplatin and 5-fluorouracil with that of high-dose cisplatin and 5-fluorouracil for unresectable esophageal cancer. Of 32 institutions participating in the JCOG0303 study, the 18 institutions that enrolled three or more patients were included in this study. We predicted the 1-year survival in each institution by using a mixed-effect model. We found that the predicted 1-year survival in the 18 institutions with three or more patients was a median of 60.9%, with a range of 60.9-60.9%. This study is the first to investigated heterogeneity of survival in patients who received definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma.
PubMed | International Goodwill Hospital, Yokohama City University, Yokohama Municipal Citizens Hospital and Johns Hopkins University
Type: Journal Article | Journal: Oncotarget | Year: 2016
Our recent retrospective study revealed a significantly reduced risk of bladder cancer (BC) recurrence in men who received androgen deprivation therapy (ADT) for their prostate cancer. However, whether androgen receptor (AR) signals contributed to the preventive effect of ADT remained unclear because ADT could reduce serum estrogens as well. The purpose of this study is to investigate the associations between the expression of AR/estrogen receptors (ERs) and BC recurrence in patients treated with ADT. We immunohistochemically stained 72 BCs and 42 corresponding normal urothelial tissues. AR/ER/ER were positive in 44(61%)/22(31%)/39(54%) tumors and 35(83%)/24(57%)/34(81%) corresponding normal urothelial tissues, respectively. There were no statistically significant correlations between AR/ER/ER expression and clinicopathological features of BC. With a median follow-up of 31.3 months, 12 (43%) of 28 patients with AR-negative tumor versus 11 (23%) of 44 patients with AR-positive tumor experienced BC recurrence. Thus, patients with AR-positive tumor had a significantly lower risk of BC recurrence (P=0.031), compared with those with AR-negative tumor. Meanwhile, the expression of ER/ER in tumors and that of AR/ER/ER in normal urothelial tissues were not significantly correlated with BC recurrence. A multivariate analysis revealed AR positivity in tumors as an independent prognosticator (hazard ratio: 0.27; 95% confidence interval: 0.11-0.67) for BC recurrence. These results indicate that ADT prevents BC recurrence via the AR pathway, but not via the ER/ER pathways.
PubMed | International Goodwill Hospital
Type: | Journal: SAGE open medical case reports | Year: 2016
Emerging concepts of reduced port surgery have gained considerable attention from laparoscopic surgeons, including the field of liver resection. To date, 86 cases of single-incision laparoscopic hepatectomy (SILH) have been reported, with commercially available access devices being used in most of these cases. We report herein a use of homemade transumbilical glove port for SILH.A 39-year-old woman represented giant hepatic hemangioma (9-cm in size) located at the left lateral segment (S2/3). Partial hepatectomy was performed by the glove method via single port access with conventional laparoscopic bipolar forceps, grasper and scissors without the need of any single-port specific devices.The operative time was 77 minutes, and intraoperative blood loss was 50 mL. The postoperative course was uneventful.Glove method not only has significant advantages in terms of cost, but also is superior in its versatility, allowing wider range of movements compared to conventional access devices. Taking in consideration its cost effectiveness and versatility, glove method may be a good option for SILH.
Ando N.,International Goodwill Hospital
Esophageal Squamous Cell Carcinoma: Diagnosis and Treatment | Year: 2015
Esophageal cancer causes an estimated 386,000 deaths worldwide and is the sixth most common cause of death for men. The background characteristics of esophageal cancer treatment are markedly different between Asian and Western countries, however. In tumor histology, squamous cell carcinoma associated with smoking and alcohol consumption is overwhelmingly prevalent in Asia, whereas adenocarcinoma associated with Barretts metaplasia is markedly prevalent in the West. In Asia, especially in Japan, the key persons who play important roles in the management of esophageal cancer patients are surgeons; in the West those roles are filled by medical and radiation oncologists as well as surgeons. The philosophy of surgeons regarding cancer surgery varies from locoregional to local tumor control, particularly in focusing on lymph node dissection. Physicians approach to surgical adjuvant therapy differs, therefore, between Asia and the West. Considering these EastWest differences in esophageal cancer treatment, the currently available results of Western evidence should not be considered directly applicable to esophageal cancer in Asia.In this book, the authors discuss theknowledge base in Japan in terms of treatment of esophageal squamous cell carcinoma. Since this volume contains a wide spectrum of current information and addresses topics surrounding the treatment of patients with esophageal squamous cell carcinoma, it is highly relevant to Asian physicians and researchers as well as to their counterparts in the West. © Springer Japan 2015.
PubMed | International Goodwill Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016
This study was aimed to assess the feasibility and short-term outcomes of adjuvant systemic chemotherapy with either S-1/oxaliplatin (SOX) or mFOLFOX6 (FOLFOX)after curative resection of distant metastases from colorectal cancer. We retrospectively examined 16 patients who underwent R0 resection of colorectal metastases, including the liver (n=6), lung (n=5), lymph node (n=3), and peritoneum (n=2), followed by chemotherapy with SOX (n=7) or FOLFOX (n=9) until disease progression. The mean recurrence-free survival was 13.2 months in the SOX group and 16.9 months in the FOLFOX group. The mean overall survival was 17.9 and 22.9 months, respectively. The number of given courses were 6.5 and 11.0, respectively. Although sensory neuropathy was observed in 38% of the patients, relative dose intensity was higher than 80%. Adjuvant chemotherapy with SOX or FOLFOX was feasible and effective. Further randomized prospective trials are warranted to confirm these results.