Kanamecho Hospital

Tokyo, Japan

Kanamecho Hospital

Tokyo, Japan
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Matsusaki K.,Kanamecho Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2016

Massive ascites associated with cancerous peritonitis can result in severe respiratory discomfort and abdominal fullness. Additionally, it can significantly impair the activities of daily living of a patient, and relaxation is difficult to achieve, even with opioids. Frequent ascites drainage can cause rapid worsening of the patient's general condition, and a large amount of ascites can lead to discontinuation of anti-cancer treatment. Cell-free and concentrated ascites reinfusion therapy (CART) for refractory ascites was first covered by the insurance system in 1981. However, cancerous ascites includes many cellular components as well as mucus, and purification was a difficult process. Therefore, since the 1990s, CART disappeared from the field of cancer treatment. I have devised a Keisuke Matsusaki (KM)-CART system that has the ability to clean the filtration membrane. This system enables purification of massive cancerous ascites that may exceed 20 L. The general condition of the patients and their symptoms improve after use of KM-CART, making it possible to initiate or resume anti-cancer therapy. KM-CART helps remove unwanted components, such as cancer cells, cytokines, and vascular endothelial growth factors from the abdominal cavity through filtration of drained ascites. Therefore, the peritoneal environment can be improved, leading to enhancement of the efficacy of intraperitoneal chemotherapy. In addition, a large number of cancer cells and lymphocytes can be obtained with KM-CART, and it is possible to use these cells for customized cancer treatments, such as dendritic cell vaccine therapy, and to perform anti-cancer agent susceptibility testing. I believe that KM-CART is a good treatment approach for massive ascites associated with cancerous peritonitis.


Matsusaki K.,Hofu Institute of Gastroenterology | Ohta K.,International University of Health and Welfare | Yoshizawa A.,Kanamecho Hospital | Gyoda Y.,Kanamecho Hospital
International Journal of Clinical Oncology | Year: 2011

Background: We have actively carried out cell-free and concentrated ascites reinfusion therapy (CART) for refractory ascites. However, with conventional CART, the membrane becomes clogged after processing about 2 L of cancerous ascites fluid due to the fact that it is rich in cellular and mucous components; it is therefore difficult to process the entire volume of collected ascites. Methods: We developed KM-CART which includes a membrane cleaning function, and applied it in 73 cases of cancerous ascites, after its basic functions had been evaluated in 11 cases of refractory cancerous ascites. Results: On average, using KM-CART, 6.4 L (range 1.7-14.9 L) of ascites were filtrated and concentrated to 0.8 L (0.2-2.0 L) in 57 min (5-129 min); the membrane was cleaned an average of three times (range 0-10 times) and this enabled the processing of more ascites in a shorter period. In addition, the circuit and the handling were both markedly simple, and fever, which has been the most notable adverse effect with the conventional system, was not an issue. Conclusion: Since KM-CART was safe and is expected to improve the subjective symptoms and general condition of the patient, it is proposed that this novel system should actively be used not only for palliation but also as supplementary treatment for cancerous peritonitis. © 2011 Japan Society of Clinical Oncology.


Kitayama J.,University of Tokyo | Emoto S.,University of Tokyo | Yamaguchi H.,University of Tokyo | Ishigami H.,University of Tokyo | And 5 more authors.
Annals of Surgical Oncology | Year: 2015

Background: The frequency of intraperitoneal free tumor cells (IPTC) is considered to reflect the severity of peritoneal metastasis (PM). We quantified the relative number of IPTC against leukocytes in peritoneal fluid and evaluated its clinical relevance in gastric cancer (GC) patients, particularly those with PM. Methods: Cells recovered from ascites or peritoneal lavage fluid were immunostained with monoclonal antibodies (mAb) to CD45 and CD326 (EpCAM). Using flow cytometry (FACS), CD326(+) and CD45(+) cells were classified as either tumor cells (T) or leukocytes (L) and the T/L ratio (TLR) was calculated in a total of 506 samples obtained from 300 patients with GC and 33 patients with liver cirrhosis (LC). Results: Median (M) of the TLR of the initial samples obtained from 199 patients with PM(+) GC was 1.32 % (0–1,868.44 %), which was significantly higher than that in patients with PM(−) GC (M = 0 %, 0–0.35 %; n = 101) or LC (M = 0 %, 0–0.031 %; n = 33). In 104 PM(+) patients who received combination chemotherapy including intraperitoneal paclitaxel, the TLR was repeatedly measured in peritoneal fluid obtained from the port. In these patients, the TLR showed a strong correlation with clinical features as well as cytological findings and carcinoembryonic antigen messenger RNA status. Finally, the median survival time of the 11 patients with initial TLR > 10 % was significantly shorter than that of the 52 patients with TLR < 10 % (271 vs. 627 days; p = 0.0002). Conclusion: The TLR excellently reflected tumor burden in the peritoneal cavity, and could be a reliable biomarker to determine the outcome, as well as the effectiveness, of chemotherapy in patients with PM(+) GC. © 2014, Society of Surgical Oncology.


Kitayama J.,University of Tokyo | Emoto S.,University of Tokyo | Yamaguchi H.,University of Tokyo | Ishigami H.,University of Tokyo | And 5 more authors.
Cytometry Part B - Clinical Cytometry | Year: 2014

Background Peritoneal metastasis (PM) is the most life-threatening type of metastasis in abdominal malignancy. To improve the diagnostic accuracy of cytologic detection (CY) of free tumor cells (FTC) in the peritoneal cavity, we tried to quantify the FTC to leukocyte ratio using flow cytometry in patients with peritoneal metastasis. Methods Cells were recovered from ascites or peritoneal lavages from 106 patients who underwent abdominal surgery and additional 89 samples which were obtained from peritoneal catheter or access port in patients with PM (+) gastric cancer. The cells were immunostained with monoclonal antibodies to CD45 and to CD326 (EpCAM). Using flow cytometry, CD326 (+) and CD45 (+) cells were classified as either tumor cells (T) or leukocytes (L) and the T/L ratio (TLR) was calculated. Results In 106 samples obtained by laparotomy, Median (M) of the TLR of PM (+) patients was 1.39% (0-807.87%) which was significantly higher than PM (-) patients (M=0%, 0-2.14%, P < 0.001). In PM (+) patients, 86 CY (+) samples showed higher TLR than 61 CY (-) samples (M=2.81%, 0.02-1868.44% vs. M=0%, 0-3.45%, p<0.0001). In all of the 24 patients who were monitored for TLR before and after intraperitoneal (IP) chemotherapy, the TLR was reduced which was more dramatic than the results of the change in cytology. Conclusions TLR measured with FACS is an excellent reflection of the tumor spread in the peritoneal cavity and could be a reliable diagnostic biomarker to determine the severity of PM as well as effectiveness of IP chemotherapy. © 2013 International Clinical Cytometry Society © 2013 International Clinical Cytometry Society.


Hyodo I.,University of Tsukuba | Morita T.,Seirei Mikatabara Hospital | Adachi I.,Shizuoka Cancer Center | Shima Y.,Tsukuba Medical Center | And 2 more authors.
Japanese Journal of Clinical Oncology | Year: 2010

Objective: To develop a predicting tool for survival of terminally ill cancer patients. Methods: This prospective, multicenter study was composed of two cohorts of samples: development and test. In the development sample of terminally ill cancer patients, 32 candidate predictors were studied to develop a new tool, Japan Palliative Oncology Study Prognostic Index using the Cox proportional hazard model. Then the test sample was studied to validate Japan Palliative Oncology Study-Prognostic Index and compared it with the conventional predicting tools, such as palliative prognostic score and simplified palliative prognostic index. Results: Five significant predictors, physician's clinical prediction of survival, consciousness, pleural effusion, white blood cell count and lymphocyte % were derived from the analysis of 201 patients, and Japan Palliative Oncology Study-Prognostic Index was developed using these predictors. It could divide patients into three risk groups: low (A), intermediate (B) and high (C). Median survival times for Groups A, B and C were 51, 35 and 16 days, respectively. Survival probability for more than 30 days for Groups A, B and C in the development sample was 78%, 61% and 16%, respectively. Japan Palliative Oncology Study-Prognostic Index was studied in subsequent 208 patients for the test sample, and constant results (median survival times for Groups A, B and C; 67, 31 and 10 days, and survival probability for more than 30 days for Groups A, B and C; 81, 48 and 11%) were obtained. Palliative prognostic score can also predict three risk groups well, but simplified palliative prognostic index could not discriminate low risk from intermediate risk group. Conclusion: Japan Palliative Oncology Study-Prognostic Index, a tool to predict survival, has been developed. Its reliability should be confirmed further in the future study, comparing with palliative prognostic score. © The Author (2010). Published by Oxford University Press. All rights reserved.


Yoshizawa A.,Kanamecho Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

The cell-free and concentrated ascites reinfusion therapy(CART)is a useful palliative maneuver in a patient suffering from ascites. I think that home medical care cooperation is essential to diffuse at home CART.


Yoshizawa A.,Kanamecho Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

A promotion of home palliative care at our clinic has been built with many factors including a home medical care desired by patient's family, governance of the law, progress of medical measures and an improvement of medical cooperation.


Yoshizawa A.,Kanamecho Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

It is likely that home palliative care for head and neck cancer patients could be treatable at general hospitals or clinics whereas combined joint efforts by medical cooperation from specialists, who are specialized in understanding of the singularity and how to cope with the symptoms, are existed.


Yoshizawa T.,Kanamecho Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2010

We report the efficacy and safety of experimentally nebulized tiotropium use. We identified 19 elderly very severe COPD (GOLD stage IV) inpatients unable to use tiotropium in the Handihaler by themselves from January 2008 through May 2009. The contents of an 18 microg capsule of tiotropium were dissolved in 5 ml saline and nebulized via a nebulizer. Nebulized tiotropium improved the symptoms of all COPD patients, and the ADL scores of 12 COPD patients. All COPD patients tolerated nebulized tiotropium well, although mild dry mouth was reported by a single COPD patient. Tiotropium therapy for COPD patients is recommended in all GOLD stages. Our report showed that COPD patients (GOLD stage IV) who had difficulties using a tiotropium Handihaler benefitted from nebulized tiotropium. This helped them to continue their COPD therapy and was demonstrated to be an effective and well tolerated treatment option.


PubMed | Kanamecho Hospital
Type: | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

Tapentadol(TP)is a new strong opioid analgesicthat has both m-opioid receptor(MOR)effects and norepinephrine reuptake inhibitor(NRI)effects. In comparison with the existing strong opioid analgesics, the mechanism of action suitable for palliation of neuropathic pain is expected to be better for TP. The analgesic effect and side effects of this drug were tested in 10 cases of exacerbation of neuropathic pain at our hospital, and the sedative response rate was 70%. The main side effects were somnolence 44.4%, nausea 33.4%, and constipation 11.1%. The side effects on the digestive system were considered minimal. Although it is speculated that opioids would be useful as an outpatient treatment, few case reports are available regarding their use for cancer pain; therefore, further investigation is necessary. Generally, numerous social issues that would increase the likelihood of drug adherence failure must be addressed in order to expand the use of strong opioid analgesics such as TP. Both the patients and the healthcare worker should be involved when addressing these issues in Japan, and the measures should include instructions for appropriate reporting and for using such drugs.

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