Shimonoseki, Japan
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Nosaka S.,Iwakuni Minami Hospital | Morita K.,Shimonoseki Medical Center | Murayama M.,Iwakuni Minami Hospital
Japanese Journal of Chest Diseases | Year: 2016

We herein describe a 74-year-old man with stage IV lung adenocarcinoma (T2aN2M1b) who was treated with a combination of paclitaxel, carboplatin, and bevacizumab (BEV) as fourth-line chemotherapy. A history of pre-existing hypertension controlled by nifedipine was noted. On day 4 of the first cycle, he experienced episodes of severe chest pain and visited our hospital. Computed tomography with contrast enhancement detected aortic dissection (Stanford B, DeBakey III b). Subsequently, the false lumen was thrombosed and his chest pain disappeared, and wethus treated the patient medically by addition of a new antihypertensive drug. Because the possibility of this event being an adverse effect associated with BEV administration could not be ruled out BEV was withdrawn. To our knowledge, only two cases of aortic dissection has been described in patients treated with BEV therapy. BEV is an antiangiogenic agent targeting the vascular endothelial growth factor pathway. Since aortic dissection is a life-threatening, acute event clinicians must be aware of this complication, and aggressive monitoring of blood pressure is hence highly recommended.


Ito H.,Yamaguchi University | Oga A.,Yamaguchi University | Ikemoto K.,Yamaguchi University | Furuya T.,Yamaguchi University | And 7 more authors.
Cytometry Part A | Year: 2014

Fluorescence in situ hybridization (FISH) with centromeric probes is a method used to detect chromosomal instability (CIN), a hallmark of most cancers. However, no studies thus far have investigated the relationship between centromeric FISH signals and the cell cycle in cancer cells. In this study, the chromosome content in each cell cycle phase was evaluated with respect to the number of centromeric FISH signals in two breast cancer cell lines and eight surgically resected breast cancer specimens using image cytometry. Variations in chromosome number were detected at each phase of the cell cycle but were not associated with proliferative capacity in the cell lines. Furthermore, the chromosome doubling frequency differed in each cell line and clinical specimen. These results reveal two aspects of centromeric FISH signal variation in breast cancers that exhibit CIN, and suggest that chromosome doubling is a remarkable occurrence that may increase the heterogeneity of tumors. © 2014 International Society for Advancement of Cytometry.


Kondo J.,Shimonoseki Medical Center | Nishimura T.,Shimonoseki Medical Center | Nagashima Y.,Shimonoseki Medical Center | Okada T.,Shimonoseki Medical Center | And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014

Laparoscopic surgery for colorectal cancer has the advantage of being less invasive and delivering better cosmetic appearance. Although single-incision laparoscopic surgery produces excellent cosmetic results, it is considered very difficult to perform. We performed reduced port surgery (single-incision plus one or 2 ports) on 42 patients in our institute. The operation time, number of dissected lymph nodes, morbidity rates, and length of hospital stay after the operation were not inferior to those in conventional laparoscopic surgery. The estimated blood loss in reduced port surgery was less than in conventional laparoscopic surgery. In conclusion, the procedure of reduced port surgery should be further standardized to make it safer and more feasible, and to provide a favorable cosmetic result for selected patients.


Nishimura T.,Shimonoseki Medical Center | Sakata K.,Shimonoseki Medical Center | Kondo J.,Shimonoseki Medical Center | Nagashima Y.,Shimonoseki Medical Center | And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014

Introduction: The hemi-double stapling method (HDS) is typically used for extracorporeal Billroth-I anastomosis. We used HDS for reduced-port surgery. Laparoscopic HDS is used for intracorporeal Billroth-I anastomosis after laparoscopic distal gastrectomy. We performed reduced-port laparoscopic distal gastrectomy for gastric cancer. Methods: Reduced-port laparoscopic distal gastrectomy was performed using the multi-trocar method with 5 mm and 3 mm ports. Laparoscopic HDS was performed using an umbilical incision and a left upper abdominal incision. A total of 17 patients underwent reduced-port laparoscopic distal gastrectomy. A D1 + or D1 lymph node dissection was performed, and laparoscopic HDS was used for reconstruction. Results: The patients had no short-term complications. Conclusions: Laparoscopic HDS and reduced-port laparoscopic distal gastrectomy are safe and feasible procedures.


Kondo J.,Shimonoseki Medical Center | Maeda Y.,Shimonoseki Medical Center | Nagashima Y.,Shimonoseki Medical Center | Nishimura T.,Shimonoseki Medical Center | And 3 more authors.
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

A 74-year-old woman presented to our emergency department with a chief complaint of appetite loss, and already diagnosed dehydration and heart failure. After hospitalization, the signs of heart failure were improved with liquid supplementation and electrolyte revision. At admission, computed tomography incidentally detected a rectal tumor. She underwent colonography, which revealed a huge villous tumor in the rectum. Based on the result of the initial biopsy, it was classified as a group 4 tumor, but additional biopsy of specimens obtained from 6 places led to a diagnosis of group 5 tumor. Then, we performed laparoscopic super-low anterior resection and made an ileal stoma. The electrolyte imbalance was improved and did not recur after the operation. In this case, the electrolyte imbalance caused by the huge villous tumor was electrolyte depletion syndrome (EDS).


Ito K.,Shimonoseki Medical Center | Sasaki K.,Shimonoseki Medical Center | Yamaguchi S.,Shimonoseki Medical Center | Hiroyoshi T.,Shimonoseki Medical Center | Yamatogi S.,Shimonoseki Medical Center
Japanese Journal of Clinical Radiology | Year: 2016

We present an 89 year-old female with infected renal artery aneurism-duodenal fistula caused by urinary infection. The patient was admitted with melena. Two days later, she presented with hematemesis and computed tomography revealed a right renal artery aneurysm adjacent to the duodenum. Emergency angiography demonstrated renal artery aneurism-duodenal fistula. E ndovascular embolization using NBCA was performed. Complete embolization of the aneurysm was achieved. The postoperative course was uneventful. © 2016, Kanehara Shuppan Co. Ltd. All rights reserved.


PubMed | Shimonoseki Medical Center
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

A 74-year-old woman presented to our emergency department with a chief complaint of appetite loss, and already diagnosed dehydration and heart failure. After hospitalization, the signs of heart failure were improved with liquid supplementation and electrolyte revision. At admission, computed tomography incidentally detected a rectal tumor. She underwent colonography, which revealed a huge villous tumor in the rectum. Based on the result of the initial biopsy, it was classified as a group 4 tumor, but additional biopsy of specimens obtained from 6 places led to a diagnosis of group 5 tumor. Then, we performed laparoscopic super-low anterior resection and made an ileal stoma. The electrolyte imbalance was improved and did not recur after the operation. In this case, the electrolyte imbalance caused by the huge villous tumor was electrolyte depletion syndrome (EDS).


PubMed | Tokyo Women's Medical University, University of Chicago, Ogori Dai ichi General Hospital, Kanmon Medical Center and 7 more.
Type: Journal Article | Journal: Cancer science | Year: 2016

We previously conducted a phase I clinical trial combining the HLA-A*2402-restricted KIF20A-derived peptide vaccine with gemcitabine for advanced pancreatic cancer (PC) and confirmed its safety and immunogenicity in cancer patients. In this study, we conducted a multicenter, single-armed, phase II trial using two antiangiogenic cancer vaccines targeting VEGFR1 and VEGFR2 in addition to the KIF20A peptide. We attempted to evaluate the clinical benefit of the cancer vaccination in combination with gemcitabine. Chemotherapy nave PC patients were enrolled to evaluate primarily the 1-year survival rate, and secondarily overall survival (OS), progression free survival (PFS), response rate (RR), disease control rate (DCR) and the peptide-specific immune responses. All enrolled patients received therapy without the HLA-A information, and the HLA genotypes were used for classification of the patients. Between June 2012 and May 2013, a total of 68 patients were enrolled. No severe systemic adverse effects of Grade 3 or higher related to these three peptides were observed. The 1-year survival rates between the HLA-A*2402-matched and -unmatched groups were not significantly different. In the HLA-A*2402 matched group, patients showing peptide-specific CTL induction for KIF20A or VEGFR1 showed a better prognosis compared to those without such induction (P = 0.023, P = 0.009, respectively). In the HLA-A*2402-matched group, the patients who showed a strong injection site reaction had a better survival rate (P = 0.017) compared to those with a weak or no injection site reaction. This phase II study demonstrated that this therapeutic peptide cocktail might be effective in patients who demonstrate peptide-specific immune reactions although predictive biomarkers are needed for patient selection in its further clinical application.


PubMed | Osaka National Hospital, National Hospital Organization Kobe Medical Center, Sapporo Geka Kinen Hospital, Mine City Hospital and 16 more.
Type: | Journal: European journal of cancer (Oxford, England : 1990) | Year: 2016

Lentinan (LNT) is a purified -1, 3-glucan that augments immune responses. The present study was conducted to assess the efficacy of LNT in combination with S-1 as a first-line treatment for unresectable or recurrent gastric cancer.Eligible patients were randomly assigned to receive S-1 alone or S-1 plus LNT. The primary end-point was overall survival (OS). Secondary end-points were time-to-treatment failure (TTF), overall response rate (ORR), safety, quality of life (QOL), and biomarker. The percentages of LNT-binding monocytes in peripheral blood prior to treatment were analysed for the biomarker assessment.One hundred and fifty-four and 155 patients were randomly assigned to receive S-1 alone or S-1 plus LNT, respectively. The median OS was 13.8 and 9.9 months (P=0.208), the median TTF was 4.3 and 2.6months (P<0.001), the ORR was 22.3% and 18.7% for the S-1 and S-1 plus LNT groups, respectively. The incidences of haematologic and non-haematologic adverse events were similar, and no significant changes in QOL scores were observed during the treatment in both groups. In a subpopulation of patients with LNT-binding monocytes 2%, patients who received more than two cycles of chemotherapy showed a longer survival time in the S-1 plus LNT group.OS did not improve and TTF was significantly worse in the S-1 plus LNT group as compared with the S-1-only group. This study showed no efficacy of LNT when combined with S-1 treatment in patients with unresectable or recurrent gastric cancer.UMIN 000000574.


PubMed | Red Cross, Shuto General Hospital, Tokuyama Medical Association Hospital, Saiseikai Shimonoseki General Hospital and 12 more.
Type: Journal Article | Journal: International journal of clinical oncology | Year: 2016

The standard of care for treatment of localized muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC). The patients condition may affect management of MIBC, especially for elderly patients with more comorbid conditions and lower performance status. We retrospectively evaluated the association between clinicopathological data and outcomes for patients with bladder cancer (BCa) treated by RC. We particularly focused on elderly patients (age 75 years) with BCa.We enrolled 254 patients with BCa who underwent RC and urinary diversion with or without pelvic lymph node dissection. We assessed perioperative complications and clinicopathological data affecting overall survival (OS) after RC.The incidence of complications was 34.3 %, and that of severe complications (Grade 3-5) was 16.5 %. The elderly group experienced more severe complications (P = 0.042). Median follow-up was 43.0 months (range 1.0-155.6). Five-year OS after RC was 62.7 %. OS after RC was no different for patients aged 75 and <75 years (P = 0.983). Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status (ECOG PS) and hemoglobin (Hb) concentration were associated with all-cause mortality. Hb concentration of <12.6 g/dl was an independent predictor of a poor prognosis among elderly patients after RC for BCa. ECOG PS >1 tended to affect OS after RC in this group.ECOG PS and preoperative Hb concentration were useful for prediction of clinical outcome after RC for elderly patients. This information may aid decision-making in the treatment of elderly patients with MIBC.

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