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Maeda T.,Kasugai Municipal Hospital | Tatematsu M.,Aichi Cancer Center Hospital | Muro K.,Aichi Cancer Center Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2011

We retrospectively investigated the incidence of infusion reactions following cetuximab chemotherapy in 93 patients with colorectal cancer. Patients received chemotherapy treatment from September 2008 to February 2010 at Aichi Cancer Center Hospital. The initial cetuximab dose was 400 mg/m2, followed weekly by an additional 250 mg/m2; and biweekly by 500 mg/m2. Infusion reactions were observed in 12 patients (13%), with grade 1 reactions in 6 patients and grade 2 reactions in 6 patients. Eleven of the 12 patients (92%) experienced infusion reactions during the first treatment. Typical grade 1 adverse events were fever and chills, nausea, vomiting and pruritus. Non-steroidal anti-inflammatory drugs were given for fever and chills. Grade 2 adverse events included dyspnea and wheezing, eruption, facial flushing and convulsions. Steroids were given for these symptoms. Infusion reactions were observed in 3 of the 12 patients (25%) < 15 min after intravenous injection, 16-60 min after injection in 3 more patients (25%), and 61-120 min after injection in the remaining 6 patients (50%). Source


Iida O.,Cardiovascular Center | Nakamura M.,Toho University | Yamauchi Y.,Cardiovascular Center | Kawasaki D.,Hyogo College of Medicine | And 21 more authors.
Circulation: Cardiovascular Interventions | Year: 2013

Background-Recent technical advances have made endovascular treatment (EVT) an alternative first-line treatment for critical limb ischemia. Methods and Results-A prospective multicenter study was conducted to evaluate the clinical outcomes of 314 Japanese critical limb ischemia patients (mean age, 73±10 years) with infrainguinal arterial lesions who underwent EVT. Patients were enrolled from December 2009 to July 2011 and were followed-up for 12 months. The primary end point was amputation-free survival (AFS) at 12 months. Secondary end points were anatomic, clinical, and hemodynamic measures, including 12-month freedom from major adverse limb events. The 12-month AFS rate was 74%, with body mass index <18.5 (hazard ratio [HR], 2.22; P=0.008), heart failure (HR, 1.73; P=0.04), and wound infection (HR, 1.89; P=0.03) associated with a poor prognosis for AFS. The 12-month major adverse limb event-free rate was 88%, with hemodialysis (HR, 1.98; P=0.005), heart failure (HR, 1.69; P=0.02), and Rutherford classification 6 (HR, 2.25; P=0.002) associated with a poor prognosis for major adverse limb events. The median time for wound healing was 97 days, with body mass index <18.5 (HR, 0.54; P=0.03) and wound infection (HR, 0.60; P=0.04) being significant risk factors for unhealed wounds after EVT. At 12 months, 34% had undergone reintervention (bypass surgery, 2.6%; repeat EVT, 31.7%), and 73% were major adverse event-free. Conclusions-The high reintervention rate notwithstanding, EVT was an effective treatment for Japanese critical limb ischemia patients with infrainguinal disease, with satisfactory AFS and major adverse limb event-free rates. The results of this study will be helpful for the future evaluation of critical limb ischemia therapy. © 2013 American Heart Association, Inc. Source


Nozaki H.,Niigata University | Sekine Y.,Niigata University | Fukutake T.,Kameda Medical Center | Nishimoto Y.,Keio University | And 7 more authors.
Neurology | Year: 2015

Objectives: The objective of this study was to clarify the characteristic brain MRI findings for genetically diagnosed CARASIL (cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy). Methods: Seven patients with CARASIL carrying HTRA1 mutations (representing 6 Japanese families) were included in this study. Eighteen brain MRIs were reviewed and evaluated with a new rating scale based on scoring for abnormal hyperintense lesions and atrophy. Results: At the last follow-up MRI, all patients had hyperintense lesions on T2-weighted images of the frontal white matter, anterior temporal lobe, external capsules, and thalami. Patients with longer time from the onset of cognitive impairment had higher MRI severity score. The atrophy advanced, followed by white matter lesion progression. During the early stage, hyperintense lesions were observed in the frontal white matter, external capsule, and pons. During the late stage, the arc-shaped hyperintense lesion from the pons to the middle cerebellar peduncles, which we designated the "arc sign," became evident. The arc sign was a characteristic finding for CARASIL in the advanced stage. Conclusions: These characteristic MRI findings for CARASIL are useful for selecting patients for genetic testing. The rating scale correlates well with disease duration and might be useful for assessing disease progression. © © 2015 American Academy of Neurology. Source


Tsuda H.,Nagoya University | Kotani T.,Nagoya University | Sumigama S.,Nagoya University | Mano Y.,Nagoya University | And 6 more authors.
Early Human Development | Year: 2014

Background: Pregnancies with placenta previa are significantly associated with preterm delivery and cesarean section. Therefore particular attention should be paid to the incidence of neonatal respiratory disorders in pregnancies with placenta previa. Aims: The purpose of this study is to examine the relationship between placenta previa and neonatal respiratory disorders, including respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN), and to evaluate the impact of placenta previa on the amniotic lamellar body count (LBC) values. Methods: We analyzed the data from 186 registered elective cesarean cases without fetal or maternal complications at 36-38. weeks of gestation. Amniotic fluid samples were analyzed immediately without centrifugation, and the LBC was measured using a platelet channel on the Sysmex XE-2100. Results: RDS was present in four neonates (2.2%) and TTN in 12 neonates (6.5%). The rate of TTN was significantly higher and the LBC values were significantly lower in the placenta previa group than in the control group (P = 0.002 and P = 0.024). The adjusted odds ratio for neonatal TTN was 7.20 (95% confidence interval: 6.58-7.88) among females with placenta previa. In placenta previa, warning bleeding was a significant factor protecting against neonatal respiratory disorders (P = 0.046). Conclusions: Placenta previa in itself is a risk factor for neonatal TTN. When an elective cesarean section is performed in cases with uncomplicated placenta previa, special care should be taken to monitor for neonatal TTN even at 36-38. weeks of gestation. © 2013 Elsevier Ireland Ltd. Source


Shoji T.,Osaka City University | Masakane I.,Yabuki Shima Clinic | Watanabe Y.,Kasugai Municipal Hospital | Iseki K.,University of Ryukyus | Tsubakihara Y.,Osaka General Medical Center
Clinical Journal of the American Society of Nephrology | Year: 2011

Summary Background and objectives Dialysis patients show "reverse causality" between serum cholesterol and mortality. No previous studies clearly separated the risk of incident cardiovascular disease (CVD) and the risk of death or fatality after such events. We tested a hypothesis that dyslipidemia increases the risk of incident atherosclerotic CVD and that protein energy wasting (PEW) increases the risk of fatality after CVD events in hemodialysis patients. Design, setting, participants, & measurements This was an observational cohort study in 45,390 hemodialysis patients without previous history of myocardial infarction (MI), cerebral infarction (CI), or cerebral bleeding (CB) at the end of 2003, extracted from a nationwide dialysis registry in Japan. Outcome measures were new onsets of MI, CI, CB, and death in 1 year. Results The incidence rates of MI, CI, and CB were 1.43, 2.53, and 1.01 per 100 person-years, and death rates after these events were 0.23, 0.21, and 0.29 per 100 person-years, respectively. By multivariate logistic regression analysis, incident MI was positively associated with non-HDL cholesterol (non-HDL-C) and inversely with HDL cholesterol (HDL-C). Incident CI was positively associated with non-HDL-C, whereas CB was not significantly associated with these lipid parameters. Among the patients who had new MI, CI, and/or CB, death risk was not associated with HDL-C or non-HDL-C, but with higher age, lower body mass index, and higher C-reactive protein levels. Conclusions In this hemodialysis cohort, dyslipidemia was associated with increased risk of incident atherosclerotic CVD, and protein energy wasting/inflammation with increased risk of death after CVD events. © 2011 by the American Society of Nephrology. Source

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