Kumamoto Municipal Hospital

Kumamoto-shi, Japan

Kumamoto Municipal Hospital

Kumamoto-shi, Japan
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Osaki A.,Hiroshima University | Osaki A.,Saitama University | Mitsuyama S.,Kitakyushu Municipal Medical Center | Kurebayashi J.-I.,Kawasaki Medical School | And 5 more authors.
Oncology Letters | Year: 2010

The study present the results of the dose-setting study of concomitant weekly administration of paclitaxel and tegafur·uracil (UFT) for metastatic breast cancer. Eligible patients who entered the study underwent two or more courses of weekly paclitaxel + UFTtherapy as the protocol therapy. The initial dose (level 1) was paclitaxel, 80 mg/m 2 and UFT, 400 mg/day. At level 2, paclitaxel remained the same, but UFTwas increased to 600 mg/day. At level 3, only paclitaxel was increased to 90 mg/m 2. Twelve patients were enrolled in this study between September 2000 and September 2002. Three patients were assigned to level 1. Grade 3 liver dysfunction (increased aspartate aminotransferase and alanine aminotransferase) was noted in one patient and grade 4 neutropenia was noted in one patient, showing that dose-limiting toxicity was detected in 2/3 patients. In accordance with the protocol, UFT was fixed at 400 mg/day and paclitaxel was decreased to 60 mg/m 2 at level -1, and then increased to 70 mg/m 2 at level 0. The overall effective rate after completion of two courses was 33% (3/9) including one case of complete response and two cases of partial responses. The remaining patients presented with stable diseases and no patient had progressive disease. In this study, weekly paclitaxel with concomitant UFTwas administered. The recommended doses of paclitaxel and UFTwere determined to be 70 mg/m 2 and 400 mg/day, respectively. As the toxicity profile shows, the highest toxicity level of this regimen was neutropenia and liver dysfunction, and dose-limiting toxicity was neutropenia.

Katsuya H.,Fukuoka University | Ishitsuka K.,Fukuoka University | Utsunomiya A.,Imamura Bun in Hospital | Hanada S.,National Hospital Organization Kagoshima Medical Center | And 82 more authors.
Blood | Year: 2015

Adult T-cell leukemia/lymphoma (ATL) is amalignancy ofmature T lymphocytes caused by human T-lymphotropic virus type I. Intensive combination chemotherapy and allogeneic hematopoietic stemcell transplantation have been introduced since the previous Japanese nationwide survey was performed in the late 1980s. In this study, we delineated the current features andmanagement of ATL in Japan. The clinical data were collected retrospectively fromthemedical records of patientsdiagnosedwithATLbetween 2000 and2009, anda total of 1665 patients' records were submitted to the central office from 84 institutions in Japan. Seventy-one patients were excluded; 895, 355, 187, and 157 patients with acute, lymphoma, chronic, andsmoldering types, respectively, remained. Themedian survival timeswere 8.3, 10.6, 31.5, and 55.0 months, and 4-year overall survival (OS) rates were 11%, 16%, 36%, and 52%, respectively, for acute, lymphoma, chronic, and smoldering types. The number of patients with allogeneic hematopoietic stemcell transplantation was 227, and their median survival timeandOSat 4 years after allogeneic hematopoietic stemcell transplantationwas 5.9 months and 26%, respectively. This study revealed that the prognoses of the patients with acute and lymphoma types were still unsatisfactory, despite the recent progress in treatmentmodalities, but an improvement of 4-year OS was observed in comparisonwith the previous survey. Of note, one-quarter of patients who could undergo transplantation experienced long survival. It is also noted that the prognosis of the smoldering type was worse than expected. © 2015 by The American Society of Hematology.

Kawada K.,Kagawa University | Itoh S.,Kagawa University | Itani Y.,Kanagawa Childrens Medical Center | Kitajima H.,Research Institute for Maternal and Child Health | And 5 more authors.
Japanese Journal of Clinical Pharmacology and Therapeutics | Year: 2011

Aims : A new phenobarbital preparation for injection containing no additives (NOBELBAR®) was developed in Japan for safer use in neonates with seizures. This study was conducted to evaluate the clinical efficacy and safety of NOBELBAR® for the treatment of neonatal seizures. Methods : This investigator-initiated clinical trial was an open-label, uncontrolled, multicenter study, conducted in compliance with the good clinical practice. Phenobarbital was initially administered intravenously at a loading dose of 20 mg/kg. An additional dose of 20 mg/kg was given if the seizures did not resolve. The primary efficacy was evaluated 30 minutes after the administration of the loading dose. Infants who responded to the loading administration received maintenance therapy with 2.5 to 5 mg/kg intravenous phenobarbital once daily for 6 days. Results : NOBELBAR® was administered to 10 neonates with seizures. The primary efficacy was evaluated as complete response in all patients. Adverse events were reported in 9 of the 10 patients (90%), most of which were mild. Plasma phenobarbital concentrations ranged from 18.7 to 45.3 μg/mL. Conclusion : The study demonstrated that NOBELBAR® was effective for the control of neonatal seizures, and plasma drug concentrations were maintained within the therapeutic range. Approved for manufacturing and marketing was obtained based on the results of this study and other relevant data (Clinical Trials. number, UMIN-C000000410, JMA-II A00002.).

Sagara Y.,Hakuaikai Sagara Hospital | Kamada Y.,Nahanishi Clinic | Yamamoto Y.,Kumamoto University | Tanaka M.,Social Insurance Kurume Daiichi Hospital | And 4 more authors.
Breast Cancer | Year: 2012

Background: The development of molecular-targeted agents has improved the recovery rate for cancer. In Japan, trastuzumab has been approved as an adjuvant treatment for human epidermal growth factor receptor-2 (HER2)-positive breast cancer; therefore, accurate management of HER2 testing has become more important. In addition, proper patient selection is required from the viewpoint of health care economics. Methods: The current situation of HER2 testing in patients with infiltrating breast cancer from April 2008 to March 2009 was evaluated in 49 institutions (50 departments) treating breast cancer in the Kyushu-Okinawa region. Results: In a total of 5286 samples, HER2-positive ratio was 14.2%, which may reasonably reflect the current state of HER2 testing for breast cancer in the Kyushu-Okinawa region. There was a moderate discrepancy in HER2-positive ratio between institutions. Immunohistochemistry (IHC) analysis was outsourced in 15 institutions, and fluorescence in situ hybridization (FISH) analysis was outsourced in 23 institutions. The ratio of retesting by FISH analysis for samples judged as 2+ on IHC was 86.1%. There was no correlation between HER2-positive ratio and the number of HER2 tests at the institution. However, a high percentage of HER2 IHC 0-1+ results and a low percentage of HER2 2+ and 3+ results at the institution were significantly correlated with a high percentage of HER2 FISH-positive results for HER2 IHC 2+ cases. Conclusions: There is a moderate discrepancy in HER2-positive ratio between institutions. Institutions with a high percentage of HER2 IHC 0-1+ and a low percentage of HER2 2+ and 3+ may have more false negative cases. These institutions should perform internal accuracy evaluations in order to maintain proper diagnostic judgment. © 2011 The Japanese Breast Cancer Society.

Yamaguchi R.,Kurume University | Mitsuyama S.,Kitakyushu Municipal Medical Center | Tanaka M.,Social Insurance Kurume Daiichi Hospital | Sagara Y.,Sagara Hospital | And 5 more authors.
Journal of Clinical Pathology | Year: 2011

Appropriate testing for HER2 provides an important basis for selecting suitable treatment for cancer patients and avoiding overtreatment and/or undertreatment. Although a number of new technologies are emerging, immunohistochemistry (IHC), fluorescence in situ hybridisation (FISH) and chromogenic in situ hybridisation (CISH) are the only tests approved by the US Food and Drug Administration to determine HER2 status and decide which patients will receive treatment with trastuzumab or lapatinib. Despite the high concordance between the tests, accuracy of results can be adversely affected by a variety of biological, technological and methodological factors. In this review, the authors discuss practical considerations in the detection of HER2 status from a pathological prospective. First, the biology of HER2 in breast cancer is described; second, the advantages and disadvantages of the three Food and Drug Administration approved assays (IHC, FISH and CISH) are discussed; and, finally, the review addresses potential pitfalls and ways to improve the accuracy of testing HER2-positive status, including standardisation and compliance with recommended procedures for steps in the testing (for example, sample handling and formalin fixation) processes. Copyright Article author (or their employer) 2011.

Egashira S.,Kumamoto Municipal Hospital | Kidou M.,Kumamoto Municipal Hospital | Kaguchi A.,Kumamoto Municipal Hospital | Higo J.,Kumamoto Municipal Hospital | Ihn H.,Kumamoto University
Nishinihon Journal of Dermatology | Year: 2015

We describe a 49-year-old woman with amicrobial pustulosis associated with autoimmune disease. She had noticed eruptions of the intertriginous folds and scalp beginning 7-8 years earlier. Six months before her admission, she was diagnosed as having systemic lupus erythematosus (SLE). She was admitted to our hospital because the eruption had spread, without any worsening of her SLE symptoms. The eruption, which involved the scalp, reticular folds, flexural and anogenital areas, and the trunk and buttocks, consisted of coalesced pustules forming large, crusting plaques. We started to treat the patient with cimetidine and ascorbic acid, and an improvement was obtained over the course of two weeks. The present case suggests the effectiveness of cimetidine and ascorbic acid treatment as a safe alternative to corticosteroids. © 2015, Western Division of Japanese Dermatological Association. All rights reserved.

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