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Maeda H.,Cancer Treatment Center | Okamoto K.,Cancer Treatment Center | Sakamoto J.,Tokai Central Hospital | Usui T.,Tano Hospital | And 4 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2015

This report describes a case of recurrent gastric cancer successfully treated with S-1 oral administration. A 77-year old female patient underwent distal gastrectomy for gastric cancer, followed by adjuvant chemotherapy with tegafur-uracil (UFT). However, 1 year after surgical resection, recurrence in the lymph node of the hepatic hilum was diagnosed by abdominal computed tomography. The patient was treated with S-1 alone after refusing intravenous infusion chemotherapy. Three months after treatment, the size of the target lesion decreased significantly, and a complete response was seen on imaging examination during the 2 years of chemotherapy treatment. One year and 5 months after the discontinuation of chemotherapy, recurrence was noted again. Although supportive care was eventually provided to the patient, S-1 oral administration was resumed that resulted in tumor growth control for >6 months. In this patient, S-1 treatment was effective in tumor growth suppression without deteriorating the patient's quality of life (QOL). Further studies are needed to identify patients for whom S-1 therapy is optimal treatment.

Kida K.,Kochi Medical School | Tadokoro N.,Kochi Medical School | Kumon M.,Kochi Medical School | Ikeuchi M.,Kochi Medical School | And 2 more authors.
Archives of Orthopaedic and Trauma Surgery | Year: 2014

Purpose: To determine if cantilever transforaminal lumbar interbody fusion (C-TLIF) using the crescent-shaped titanium interbody spacer (IBS) favors acquisition of segmental and lumbar lordosis even for degenerative spondylolisthesis (DS) on a long-term basis. Methods: We analyzed 23 consecutive patients who underwent C-TLIF with pedicle screw instrumentations fixed with compression for a single-level DS. Measurements on the lateral radiographs taken preoperatively, 2 weeks postoperatively and at final follow-up included disc angle (DA), segmental angle (SA), lumbar lordosis (LL), disc height (%DH) and slip rate (%slip). Results: There was a good functional recovery with 100 % fusion rate at the mean follow-up of 62 months. Segmental lordosis (DA and SA) and %DH initially increased, but subsequently decreased with the subsidence of the interbody spacer, resulting in a significant increase (p = 0.046) only in SA from 13.2 ± 5.5 preoperatively to 14.7 ± 6.4 at the final follow-up. Changes of LL and %slip were more consistent without correction loss finally showing an increase of LL by 3.6 (p = 0.005) and a slip reduction by 6.7 % (p < 0.001). Conclusions: Despite the inherent limitation of placing the IBS against the anterior endplate of the upper vertebra in the presence of DS, the C-TLIF helped significantly restore segmental as well as lumbar lordosis on a long-term basis, which would be of benefit in preventing hypolordosis-induced back pain and the adjacent level disc disease. © 2014 Springer-Verlag Berlin Heidelberg.

Toda G.,Sempo Tokyo Takanawa Hospital | Ishibashi H.,Clinical Research Center and Clinical Laboratory | Onishi S.,Kubokawa Hospital | Okanoue T.,Saiseikai Suita Hospital | And 11 more authors.
Acta Hepatologica Japonica | Year: 2011

The safety and efficacy of treatment with ursodeoxycholic acid (UDCA) of the patients with primary biliary cirrhosis (PBC) were investigated by following 1462 and 1327 patients, respectively, for 3 to 5 years after the start of treatment. No serious adverse events related to UDCA treatment occurred in the patients investigated and the start of treatment induced the significant fall of serum alkaline phosphatase (Al-P), γGTP, AST, ALT and total bilirubin concentration (T-Bil), which was sustained throughout the investigation period, indicating that the prolonged UDCA treatment was safe and effective in the improvement of liver function tests. In the final visit, however, little or no improvement of Al-P, γGTP, AST, ALT and T-Bil was noticed in some of the patients treated. The stratification of the patients according to the daily dose of UDCA revealed that in each of the liver function tests, the frequency of those who showed little or no improvement decreased with the increase in the dose, suggesting that the increase in the dose improved the liver function tests in these patients. Twenty three patients died of liver-related causes or received liver transplantation. Multivariate Cox regression analysis indicated that the base line T-Bil greater than 1.2 mg/dl, advanced histological stage and decrease less than 30% of base line level in T-Bil or AST at 6 months after the start of treatment were the predictors for liver-related death or liver transplantation. The response of T-Bil or AST to UDCA treatment is useful to identify the patients who need additional treatment for improvement of prognosis. © 2011 The Japan Society of Hepatology.

Akutagawa T.,Kochi Medical School Hospital | Tani T.,Kubokawa Hospital | Kida K.,Kubokawa Hospital | Tadokoro N.,Kochi Medical School | And 3 more authors.
Spinal Cord | Year: 2016

Study design:A case-control investigation.Objectives:The objective of this study was to quantitatively study impaired ability to appropriately adjust pinch strength while holding a small object in patients with cervical spondylotic myelopathy (CSM).Setting:Kochi Medical School Hospital, Japan.Methods:The subjects consisted of 19 CSM patients who had frequent episodes of failing to grasp and hold small objects in their daily life (Group A), 13 CSM patients who did not experience such episodes (Group B) and 16 healthy subjects (Control Group). We continuously measured the dynamic internal pressure of a pneumatic rubber object called a blower pinched by the subject, following two different sets of instructions: (1) pinching with eyes open and with the minimal strength required to prevent dropping; and (2) maintaining a constant pinch strength at given levels with eyes closed.Results:Compared with the other two groups, Group A subjects used a significantly (P<0.01) greater pinch strength to avoid dropping the blower held with eyes open and showed a significantly (P<0.01) greater deviation in pinch strength from the baseline values with eyes closed. These tendencies in Group A showed a significant correlation with the tactile perception threshold of the digits (P<0.01) but not with impairment of rapid repetitive movements of the digits that reflects spasticity.Conclusion:Our technique applied to CSM patients helps assess functional integrity primarily, if not exclusively, of the fasciculus cuneatus mediating the feedback signals from proprioceptive and cutaneous receptors in the digits, which are otherwise difficult to evaluate quantitatively. © 2016 International Spinal Cord Society All rights reserved.

Nakatani H.,Kubokawa Hospital | Akimori T.,Hatakenmin Hospital | Takezaki Y.,Kochi University | Hanazaki K.,Kochi University
Journal of Medical Investigation | Year: 2010

Human carcinosarcomas of esophagus are uncommon malignant neoplasms that are composed both carcinomatous and sarcomatous components. We established a novel cell line, HN-Eso-1, from the metastatic esophageal spindle cell carcinoma (so-called carci-nosarcoma). In this study, we estimated the vascular endothelial growth factors (VEGFs) and VEGF receptors (VEGFRs). Reverse transcription polymerase chain reaction (RT-PCR) studies revealed that VEGF-A,-C,-D and VEGFR-1,-2 were upregulated. Cisplatin reduced the cell viability of HN-Eso-1 cells and VEGF attenuated its effect. These results suggest that expression of VEGF-A, VEGF-C, VEGF-D, VEGFR-1, and VEGFR-2 are involved in the cell's autocrine system and that VEGF protected these cells from the anti-tumor agent.

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