PubMed | Red Cross, Okitama Public General Hospital, Kushiro Rosai Hospital, Fukushima Medical University and 11 more.
Type: Clinical Trial | Journal: European journal of clinical pharmacology | Year: 2016
Dasatinib is a novel, oral, multi-targeted kinase inhibitor of breakpoint cluster region-abelson (BCR-ABL) and Src family kinases. The study investigated pharmacokinetic (PK) and pharmacodynamic (PD) analyses of dasatinib in 51 newly diagnosed, chronic phase, chronic myeloid leukemia patients.The dasatinib concentration required to inhibit 50 % of the CrkL (CT10 regulator of kinase like) phosphorylation in bone marrow CD34+ cells (half maximal (50 %) inhibitory concentration (IC50)CD34+cells) was calculated from each patients dose-response curve using flow cytometry. PK parameters were obtained from the population pharmacokinetic analysis of dasatinib concentrations in plasma on day 28 after administration.Early molecular responses were not significantly associated with PK or PD (IC50 CD34+cells) parameters. However, the PK/PD parameter-time above IC50 CD34+cells-significantly correlated with BCR-ABL transcript level at 3 months (correlation coefficient (CC) = -0.292, P = 0.0375) and the reduction of BCR-ABL level at 1 or 3 months (CC = -0.404, P = 0.00328 and CC = -0.356, P = 0.0104, respectively). Patients with more than 12.6 h at time above IC50 CD34+cells achieved a molecular response of 3.0 log reduction at 3 months and those more than 12.8 h achieved a deep molecular response less than 4.0 log reduction at 6 months at a significantly high rate (P = 0.013, odds ratio = 4.8 and P = 0.024, odds ratio = 4.3, respectively).These results suggest that the anti-leukemic activity of dasatinib exhibits in a time-dependent manner and that exposure for more than 12.8 h at time above IC50 CD34+cells could significantly improve prognosis.
PubMed | Tohoku University, Nihonkai General Hospital and Kanagawa Cancer Center Research Institute
Type: Journal Article | Journal: Journal of surgical oncology | Year: 2016
We evaluated the capacity of clinicopathological factors to predict recurrence in stage II/III colorectal cancer (CRC) patients after curative resection.We retrospectively examined 386 stage II/III CRC patients who underwent curative resections between April 2008 and August 2013. We assessed the predictive power of pre- and postoperative tumor marker levels, lymphatic and venous invasion, and infiltrative growth patterns using Coxs proportional hazards model.Of 206 stage II and 180 stage III patients, 26 (13%) and 46 (26%) patients, respectively, developed recurrences with median follow-up times of 51 and 45 months, respectively. Independent risk factors for recurrence were lymphatic invasion (hazard ratio [HR], 5.99; P=0.0006) and infiltrative growth patterns (HR, 4.02; P=0.017) in stage II patients; and elevated preoperative carcinoembryonic antigen levels (HR, 3.22; P=0.004), elevated postoperative carbohydrate antigen 19-9 levels (HR, 5.08; P=0.005), and infiltrative growth patterns (HR, 3.19; P=0.037) in stage III patients.High-recurrence risk can be identified in stage II/III CRC patients by assessing perioperative serum tumor marker levels, lymphatic invasion, and infiltrative growth patterns. Intensive follow-up for patients with these risk factors may help detect recurrences promptly and improve survival. J. Surg. Oncol. 2016;114:368-374. 2016 Wiley Periodicals, Inc.
Hamada A.,Nihonkai General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012
A 63-year-old man with a left rib tumor, which had been diagnosed as a giant cell tumor 2 years previously, had been followed up at another hospital after embolization of a feeding artery of the tumor. He was admitted to the emergency room of our hospital with complaints of breathing difficulties. A chest computed tomography (CT) revealed a left chest wall tumor, about 11 cm in size, originating from the 8th rib and a massive left hemothorax. Emergency operation was performed to releave hemorrhagic shock. Bleeding from the tumor was confirmed at thoracotomy. Tumor was removed with combined resection of the adjacent chest wall and diaphragm. His postoperative course was uneventful and he was discharged on the 8th postoperative day.
Uchida T.,Nihonkai General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012
A rare case of left ventricular outflow tract (LVOT) pseudoaneurysm complicated with prosthetic valve endocarditis was reported herein. A 78-year-old male previously underwent aortic valve replacement (AVR) with a bioprosthesis. Four years after the initial operation, he presented with prolonged high fever and bloody sputum. Multi-detector row computed tomography (MDCT) clearly showed LVOT pseudoaneurysm originating from a subvalvular fibrous region. The patient underwent re-AVR and repair of pseudoaneurysm. The postoperative course was uneventful, and the patient recovered good condition.
Shiono S.,Yamagata Prefectural Central Hospital |
Kanauchi N.,Nihonkai General Hospital |
Yanagawa N.,Yamagata Prefectural Central Hospital |
Abiko M.,Yamagata Prefectural Central Hospital |
Sato T.,Yamagata Prefectural Central Hospital
General Thoracic and Cardiovascular Surgery | Year: 2014
Objective: For recurrent lung cancer, postoperative follow-up methods have not been adequately assessed, and no evidence-based postoperative surveillance methods currently exist. Herein, we evaluated postoperative lung cancer recurrence and the personalized postoperative surveillance periods and methods used. Methods: Follow-up after surgery consisted of a regular outpatient clinic check-up, including physical examination, history, blood tests, and chest X-ray, which were conducted three or four times per year for 5 years. During the follow-up period, annual chest and brain computed tomography scanning was performed. Between May 2004 and December 2011, 547 lung cancer patients underwent complete resection in our institution. We retrospectively reviewed their prospectively collected data. Results: We selected 106 patients (19.4 %) who had a postoperative recurrence. Multivariate analysis showed that advanced stage (stage II-IV; p < 0.01) and lymphovascular invasion positivity (LVI; p = 0.01) were independent risk factors for earlier recurrence. Overall, 90.8 % of patients with advanced-stage disease and LVI positivity experienced a relapse within 2 years after surgery, compared to 55.1 % of patients who did not have these factors (p < 0.01). Multivariate analysis showed that recurrence with symptoms (p < 0.01) and shorter time to recurrence (<24 months; p < 0.01) were independent prognostic factors after recurrence. Conclusions: Although this study was retrospective and included some biases, patients with advanced-stage lung cancer and LVI positivity should be intensively followed up. Personalized follow-up programs should be considered for lung cancer patients who have undergone resection. © 2013 The Japanese Association for Thoracic Surgery.
Nawata Y.,Nihonkai General Hospital |
Homma K.,Nihonkai General Hospital |
Suzuki Y.,Nihonkai General Hospital
Digestive Endoscopy | Year: 2014
Background and Aim Colorectal endoscopic submucosal dissection (ESD) is widely carried out, but is still considered difficult. In 2010, a tumor size of ≥50 mm and less experience in colorectal ESD were reported as independent risk factors for complications such as perforation, delayed perforation and postoperative bleeding. In order to overcome such difficulties, we developed a scissors-type grasping device and reported the treatment results of a multicenter study. The aim of the present study was to investigate therapeutic outcomes of colorectal ESD of different tumor sizes. Methods Group A (134 tumors): tumor size <50 mm, and Group B (16 tumors): tumors ≥50 mm. All tumors were removed by ESD. We retrospectively evaluated the clinicopathological features of the tumors and the treatment results. Results Age, sex, tumor location and histopathological diagnosis were not different between the two groups. Laterally spreading tumor non-granular type was more often observed in Group A (64/134, 47.8%) than in Group B (0/16, 0%). Procedure time was significantly longer in Group B (Group A: 38 min; Group B: 86 min, P < 0.01). However, procedure speed was significantly faster in Group B (Group A: 0.21 cm2/min; Group B: 0.37 cm2/min, P < 0.01). No complications were observed in either group. The en bloc resection rate, en bloc R0 resection rate, and en bloc curative resection rate were similar between the groups with no significant differences. Conclusions Procedure speed for Group B was faster than that for Group A. Group B was treated as safely as Group A. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.
Kato H.,Nihonkai General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011
A 75-year-old woman who had undergone a hysterectomy for uterine leiomyosarcoma 15 years before was noted to have a lung tumor on chest radiography. Chest computed tomography (CT) showed a tumor mass, 3.5 cm in size, in her left lung (S10). CT-needle aspiration biopsy revealed sarcoma We performed a left lower lobectomy, as there was no distant metastasis. The histopathological diagnosis was a metastasis of uterine leiomyosarcoma. The disease-free interval for this case was 15 years, which was. to our knowledge, the longest among previous reports of pulmonary metastasis of uterine leiomyosarcoma.
PubMed | Nihonkai General Hospital, Yamagata Prefectural Shinjo Hospital and Yamagata University
Type: | Journal: Scandinavian journal of urology | Year: 2017
Urolithiasis is a common urological problem, and its incidence has been increasing worldwide, including in Japan. Relationships between stone etiology and rise in ambient temperature have been reported, but it remains unclear how age and gender affect these relationships.A retrospective examination was conducted of the medical archives of 1005 patients (aged 15 years) with acute renal colic diagnosed with urolithiasis upon image examination who consecutively visited emergency departments in three hospitals. The patients were categorized into six groups according to age:younger than 30, 30-39, 40-49, 50-59, 60-69, and 70 years and older. The net difference and fold increase in the number of patients in summer (July to September) versus in winter (December to February) were calculated.Overall, the actual number of the patients varied according to the temperature rise throughout the year and among the age groups. Net increases in the number of patients were observed in all age groups for both genders, apart from 30-39-year-old women. The age group of 50-59 years considerably outnumbered all other groups. A significant statistical correlation was detected between the fold increase and male aging using Spearmans rank correlation analysis (=0.94, p=0.017), but not in females (=-0.03, p=1).These results support a positive association between ambient temperature rise and increase in the incidence of renal colic due to urolithiasis in Japan, and indicate that aging and gender affect the association differently.
PubMed | Kitamurayama Municipal Hospital, Nihonkai General Hospital and Yamagata University
Type: Journal Article | Journal: Neurological research | Year: 2016
Complicated aortic arch plaques (CAP) and their progression are important for recurrent ischemic stroke (IS) and its prognosis. We investigated the effects and clinical benefits of rosuvastatin therapy on this pathophysiology. The purpose of this study was to investigate whether rosuvastatin prevention of aortic arch plaque progression improved the prognosis of IS patients.Ninety-seven consecutive acute cerebral embolism patients were retrospectively surveyed. All had transesophageal echocardiography (TEE) to assess the presence or absence of CAP, defined as aortic wall thickness4mm or plaque ulceration. Patients received conventional antithrombotic therapy as clinically indicated. All patients with CAP were recommended to receive 5mg rosuvastatin/day, administered by their attending physicians; not all physicians followed this recommendation. Six-month follow-up TEEs were performed in patients with CAP who received rosuvastatin. Major adverse cerebrovascular events (MACEs) comprised recurrent IS and death.CAP was detected in 39 patients (40%), and MACEs in 15. Multivariate regression analysis showed that patients with CAP not taking rosuvastatin was an independent risk factor for MACEs (odds ratio=18.044; 95% confidential interval=2.089-155.846, p<0.01). When patients were divided into three groups: those with CAP taking rosuvastatin, those with CAP not taking rosuvastatin, and those without CAP, Kaplan-Meier analysis demonstrated that patients with CAP not taking rosuvastatin had significantly more MACEs than those in the other two groups (long-rank test; Rosuvastatin therapy prevented aortic arch plaque progression in IS patients with CAP, and may also have long-term clinical benefits.
Homma K.,Nihonkai General Hospital |
Otaki Y.,Nihonkai General Hospital |
Sugawara M.,Nihonkai General Hospital |
Kobayashi M.,Yokkaichi Municipal Hospital
Digestive Endoscopy | Year: 2012
Background and Aim: Secure manipulation of forceps in endoscopic submucosal dissection (ESD) for colorectal tumors is sometimes hindered by the characteristics of that organ. SB knife Jr, which are scissor forceps using a mono-pole high frequency, were developed to avoid the difficulty of ESD operation in the colorectum. The aim of the present study was to examine the effectiveness of the SB knife Jr in colorectal ESD in 11 hospitals, mostly in northeastern Japan. Materials: One hundred and two colorectal tumors (49 non-granular laterally spreading tumor [LST] lesions, 39 granular LST lesions and 14 other lesions) that were resected by ESD operations using SB knife Jr between October 2009 and March 2010. Results: All tumors (102/102) were resected en bloc and could be observed in detail. The mean size of the resected pieces was 40.3 mm. The mean operation time was 54.2 min. Of the complications, one case of micro-perforation occurred during the manipulation of submucosal dissection, and this case was treated with clips in that operation. The rates of resection carried out only with SB knife Jr were 74.5% (76/102). Conclusion: The novel ESD using SB knife Jr in the colorectum offers a breakthrough in resection techniques for not only expert endoscopists but also general endoscopists. © 2012 Japan Gastroenterological Endoscopy Society.