Entity

Time filter

Source Type

Sapporo, Japan

There has been an increase in cancer patient referrals to our palliative care team during a cancer treatment. In order to help an end-of-life stage homecare cancer patient who becomes being depressed and the family being felt restlessness, a fine-tuned response, an early stage of revelation of the disease and treatment are essential to have a long lasting homecare environment. Based on the Basic Plan to Promote Cancer Control Programs, our hospital established a cancer consulting support center and a palliative cancer care team in June 2009, and staffed them with multidisciplinary personnel. With medical staffs involved as a team, we considered a shared decision making repeatedly in compliance with in-patient's wishes for home care. One of the problems we have experienced was that a patient would take a long time for a decision making due to the state of mental depression, even if the patient had an ability to think and evaluate oneself. For a medicinal treatment of cancer patient with the state of depression, steroid, interferon, hypertension drug, female hormone pill, anti-histamine medicine and anti-fungus agent will cause frequent side effects, but they are easy to get rid of the symptoms. It appears that 5-percent of the patients who had steroid administered 10 days ago have a tendency to have a high manifested risk in 40mg/day PURRE- DONIZORO/Japan calculated. In case of medication related depression, the symptom can be rather controlled quickly by a decrease in the amount of medication. On the other hand, there is a possibility that side effects may appear before anti-depression comes to effects in case of an ordinary depression case. And it takes 2-4 weeks for the medicine to be effective. Therefore, amid the cancer patient is being in the state of depression, a decision to transfer the patient for home care environment should be delayed. This is why we ought to investigate it as one of the problems in palliative care. In conclusion, due to a patient's inability to make own decision, or for a home care period to be not shortened, or we fail to make a right timing to for sending the patient to home, a careful daily observation and a fine-tuned response are desired for a sign of depression with the cancer patient. Source


Takayanagi H.,Sapporo Medical Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2010

It has been 2 years since the 2007 Cancer Control Act(Table 1)and the Basic Plan to Promote Cancer Control was implemented, which aimed at a reduction of burden for all cancer patients and their families and to improve a quality of life. The Basic Plan to Promote Cancer Control requires an active engagement, such as alleviation of physical symptoms and mental/psychological problems for not only in the terminal phase of a patient but also from an early phase of treatment. Specifically, our primary aim was to relive the mind of patient's family by providing information on cancer prevention, education, and things that matter most to the family were handled through training of medical staff, palliative care, consultation and care support, and other related services. Pursuant to the guidelines, our hospital established a Palliative Care Team and Cancer Consultation Support Center 2 years ago as our palliative care consultation arms to offer a team medicine. Source


During a cancer therapy, a fine-tuned response is necessary for a patient to stay home with family for a longer period of time. Especially the patient is near the end of life. Based on the Basic Plan to Promote Cancer Control programs, our hospital established a cancer consulting support center and a palliative care team in June 2009, and staffed them with multidisciplinary personnel. With medical staffs involved as a team, we considered a shared decision making repeatedly in compliance with inpatient 's wishes for home care. One of the problems the author experienced frequently was that a patient would take a long time for a decision making due to the state of mental depression. Hence, we simply couldn't send him home, or we would fail to make a right timing for sending him home. Due to a patient's inability to make own decision, a home care period could not be shortened, so that a careful daily observation is desired to keep an eye for signs of depression and to provide appropriate responses. Source


Jansen J.H.W.,Erasmus Medical Center | Eijken M.,Erasmus Medical Center | Jahr H.,Erasmus Medical Center | Chiba H.,Sapporo Medical Center | And 3 more authors.
Journal of Orthopaedic Research | Year: 2010

Wnt signaling is important for bone formation and osteoblastic differentiation. Recent findings indicate a stimulating role of Wnt signaling in bone mechanotransduction. However, negative effects of Wnt signaling on osteoblast differentiation and mineralization have been described as well. We conducted in vitro stretch experiments using human pre-osteoblasts to study short- and long-term effects of mechanical loading on Wnt/β-catenin signaling. As the extracellular regulated kinase (ERK) pathway is known to be involved in mechanotransduction in osteoblasts, we also evaluated its role in Wnt/β-catenin signaling. Stretch experiments up to 21 days (using stretch episodes of 15 min, alternated with 90 min rest) resulted in higher mineralization compared to static control cultures. We found that 15 min of stretch initially increased nuclear β-catenin, but ultimately resulted in significant decrease at 12 and 40 h after stretch. Downregulation of Wnt-responsive element activity 16 h after stretch, using a luciferase construct, further supported these findings. The presence of the ERK inhibitor U0126 did not alter the stretch-induced decrease of β-catenin levels. Our data indicate a biphasic effect of mechanical loading on β-catenin in mineralizing human differentiating osteoblasts, which is independent of the ERK pathway. The osteogenic potential of our loading regime was confirmed by an increase in osteogenic differentiation markers such as alkaline phosphatase activity and calcium deposition after 3 weeks of culture. We conjecture that the biphasic aspect of Wnt/β-catenin signaling with a strong decrease up to 40 h after the stretch induction, is important for the anabolic effects of mechanical stretch on bone. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. Source


Oba M.S.,Yokohama City University | Imoto S.,Kyorin University | Toh U.,Kurume University | Wada N.,National Cancer Center Hospital East | And 8 more authors.
Japanese Journal of Clinical Oncology | Year: 2014

Sentinel node biopsy is a standard procedure in clinically node-negative breast cancer patients. It has eliminated unnecessary axillary lymph node dissection in more than half of the early breast cancers. However, one of the unresolved issues in sentinel node biopsy is how to manage axilla surgery for sentinel node-positive patients and clinically node-negative patients.To evaluate the outcome of no axillary lymph node dissection in sentinel node-positive breast cancer, a prospective cohort study registering early breast cancer patients with positive sentinel nodes has been conducted (UMIN 000011782). Patients with 1-3 positive micrometastases or macrometastases in sentinel lymph nodes are eligible for the study. The primary endpoint is the recurrence rate of regional lymph nodes in patients treated with sentinel node biopsy. Patients treated with sentinel node biopsy followed by axillary lymph node dissection are also registered simultaneously to compare the prognosis. The propensity score matching is used to make the distributions of baseline risk factors comparable. © The Author 2014. Published by Oxford University Press. All rights reserved. Source

Discover hidden collaborations