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Shimobayashi T.,Kenseikai Nara Coloproctology Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

The current treatment plan for squamous cell anal canal carcinoma using chemoradiotherapy (CRT) is becoming more standardized. We use CRT rather than surgery to select the appropriate treatment. We experienced 4 patients treated with abdominoperineal resection(APR), of which 1 underwent adjuvant CRT. We also experienced 3 patients treated with radiotherapy(RT) and 2 treated with CRT. A patient treated with RT underwent APR because of radiation colitis. RT and CRT are advantageous for quality of life and are expected to be effective for controlling the disease. We hope that the standard treatment plan for anal cancer in Japan will be determined on the basis of histological features.


Nakamura S.,Nara Medical University | Sho M.,Nara Medical University | Koyama F.,Nara Medical University | Ueda T.,Nara Medical University | And 7 more authors.
Scandinavian Journal of Gastroenterology | Year: 2015

Background. The prevalence of inflammatory bowel disease (IBD) is increasing. Since patients usually need long-term treatment and suffer from reduced quality of life, there is a need to develop new therapeutic strategy. The aim of this study was to investigate the therapeutic potential of erythropoietin (EPO) for the treatment of IBD. Methods. Murine colitis was induced by 3.0% Dextran Sulfate Sodium (DSS). Recombinant human EPO (rhEPO) was given to evaluate the anti-inflammatory and regenerative effects on intestinal inflammation. The effect of rhEPO on human colon epithelial cells was also evaluated. Immunohistochemical analysis of EPO receptor was performed in human IBD tissues. Results. While about 62% of control mice with severe colitis induced by 5-day DSS died, 85% of mice treated with rhEPO survived. Histological analysis confirmed that EPO treatment reduced the colonic inflammation. Furthermore, EPO treatment significantly downregulated the local expressions of IFN-γ, TNF-α and E-selectin in the colon, suggesting that the effect was associated with inhibiting local immune activation. In a 4-day DSS-induced colitis model, rhEPO significantly improved the recovery of body weight loss compared to controls. Furthermore, proliferating cell nuclear antigen expression was significantly upregulated in the colon tissue from mice treated with rhEPO compared to controls. In addition, rhEPO increased the growth of cultured human colon epithelial cells in a dose-dependent manner. Furthermore, EPO-receptor expression was confirmed in human IBD colon tissues. Conclusion. Three major functions of EPO, hematopoiesis, anti-inflammation and regeneration, may produce significant effects on intestinal inflammation, therefore suggesting that rhEPO might be useful for IBD. © Informa Healthcare.


Iwakoshi M.,Kensekai Dongo Hospital | Kuge H.,Kenseikai Nara Coloproctology Center | Terada M.,Kensekai Dongo Hospital | Kanazawa H.,Kensekai Dongo Hospital | And 4 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2013

In 2010, a newly-created medical fee was established for "Cancer Patient Rehabilitation." We acquired the facility criteria for cancer rehabilitation in August 2011. In December 2005, we started a preventive rehabilitation program to provide comprehensive respiratory physical therapy. Maintenance rehabilitation, palliative rehabilitation and home visiting rehabilitation have been increasing recently. All our staff hope to provide safer, improved skills cancer medical care for all patients by using better rehabilitation skills.


Yamaguchi T.,Kenseikai Nara Coloproctology Center | Inatsugi N.,Kenseikai Nara Coloproctology Center | Yoshikawa S.,Kenseikai Nara Coloproctology Center | Masuda T.,Kenseikai Nara Coloproctology Center | And 7 more authors.
Gastroenterological Endoscopy | Year: 2011

In patients with longstanding ulcerative colitis (UC), the risk of developing colorectal cancer (CRC) increases steadily and cancer surveillance is widely recommended. We herein report on four cases of early CRC associated with UC, and in every case we could detect the lesions endoscopically and perform the operation successfully. The type IV like pit pattern, called the neoplastic pit pattern of ulcerative colitis (NPUC), was a particularly important indicator to recognize CRC and dysplasia. However, in many cases, to detect flat neoplastic lesions is still difficult in spite of remarkable progress in endoscopic techniques : therefore, further studies are necessary for accurate diagnosis of the lesions. In surveillance colonoscopy, when we can acquire an exact method of finding the lesions, surveillance by targeted biopsies will be more efficient than by non-targeted random biopsies.


Yamaoka K.,Kenseikai Nara Coloproctology Center | Inatsugi N.,Kenseikai Nara Coloproctology Center | Yoshikawa S.,Kenseikai Nara Coloproctology Center | Masuda T.,Kenseikai Nara Coloproctology Center | And 14 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2010

A woman in her fifties underwent a right hemicolectomy (D3) for cancer of the ascending colon in October 2007, definitively and pathologically diagnosed as papillary adenocarcinoma invading to the subserosa, and no metastasis was detected to lymph node. But 13 months after the surgery, she was found to have a mass near the anastomosis by an abdominal CT scan. Colonoscopy showed an evaluating lesion with ulcer in the anal side of the anastomosis. We tried to resect the metastasis, but it was not resectable because of the invasion to the pancreas. The mFOLFOX regimen was effective. After the chemotherapy (6 courses), we decided to perform a radical resection. We conducted pancreatoduodenectomy in May 2009. She is still alive 12 months after surgery.

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