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Nishi-Tokyo-shi, Japan

Ohigashi S.,St. Lukes International Hospital
Nihon rinsho. Japanese journal of clinical medicine | Year: 2014

Incidence and mortality rates of colorectal cancer (CRC) are increasing gradually in Japan; the rapid increase in elderly population led to an increase in incidence rate in 50 years or older and mortality in 80 years or older. The mortality and morbidity for elderly patients with comorbidities after surgical treatment for CRC are extremely high. Also the 5-year-survival rate in elderly patients is significantly lower than that of non-elderly patients. Although reduction of lymphadenectomy or laparoscopic procedure is applied to elderly patients, an analysis of the validity is necessary. Because of high complication rates for surgeries in elderly patients, there is an immediate need to develop Japan's own accurate risk assessment such as comprehensive geriatric assessment.

Kojima Y.,Breast Center | Tsunoda H.,St. Lukes International Hospital
Breast Cancer | Year: 2011

Background: Triple-negative breast cancer is characterized as a cancer with a high malignancy potential and a poor prognosis. Therefore, early detection of this subtype of breast cancer is vital. In this paper, we describe the mammography and ultrasound findings of triple-negative breast cancer in a large population and investigate the specific features of this subtype. Methods: From January 2007 to April 2010, mammography and ultrasound findings of 88 patients with triplenegative breast cancer were retrospectively reviewed. In this cohort, 52 patients underwent neoadjuvant chemotherapy. We compared the pathological chemotherapy effects and radiological findings among these patients. Mammograms were reviewed according to the Japanese mammography guideline. Ultrasound findings were classified as masses, low echoic area, distortions, and calcifications. Noted features included shapes, patterns of internal echoes, posterior echoes, vascularity, and elasticity scores. Results: On mammography, triple-negative breast cancers frequently presented with a mass (62.4%). Masses with microlobulated margins were the most frequent (39.6%), indistinct (32.0%) and circumscribed (20.8%) were commonly observed, but spiculated margins were rare (4.7%). On ultrasound, cancers were more likely to present as a mass (92.5%), and less likely to show attenuating posterior echoes (8.8%). Of the 40 cases obtained via elasticity imaging, 35 (87.5%) lesions were scored as 4 or 5. There were no significant differences in the mammography or ultrasound findings between the chemotherapy effects. Conclusion: Mammography and ultrasound imaging together revealed that the morphological features of triplenegative breast cancer include a lobulated mass, with less attenuating posterior echoes, some vascularity, and low elasticity. © The Japanese Breast Cancer Society 2010.

Yamauchi H.,St. Lukes International Hospital | Ueno N.T.,University of Texas M. D. Anderson Cancer Center
Cancer | Year: 2010

Despite the introduction of multimodality treatment approaches, the prognosis of inflammatory breast cancer (IBC) is poor. Recent developments in molecular targeted therapy may be effective against IBC. The authors report the results of a literature review. Trastuzumab and lapatinib, which target human epidermal growth factor receptor 2 (HER-2), have demonstrated benefit in clinical trials for HER-2-positive breast cancers. WNT1-inducible signaling pathway protein 3, Ras homolog gene family member C guanosine triphosphatase, epidermal growth factor receptor (EGFR), and p27kip1 also have been studied as potential targets in IBC. Molecular targets in vasculolymphatic processes (angiogenesis, lymphangiogenesis, and vasculogenesis) have demonstrated greater potential in IBC than in non-IBC. Although loss of E-cadherin is a hallmark of epithelial-to-mesenchymal transition and may correlate with the promotion of metastasis, paradoxically, E-cadherin is overexpressed in IBC through an unknown mechanism. On the basis of dissecting the molecular mechanism of the aggressiveness of IBC, the authors currently are investigating whether EGFR may aid in developing innovative targeted therapies. © 2010 American Cancer Society.

To investigate the efficacy of subthreshold micropulse diode laser photocoagulation (SMDLP) combined with direct photocoagulation. Twenty one eyes of 20 patients with diabetic macular edema were treated with SMDLP and direct photocoagulation for microaneurysms within 1 month after SMDLP. The mean visual acuity in logMAR units and central macular thickness (CMT) were evaluated both before and after laser treatment by retrospective chart review and optical coherence tomography (OCT). The mean visual acuity did not change significantly at 3 and at 6 months. The mean CMT was significantly reduced at 3 and 6 months (3 months: p = 0.018, 6 months: p = 0.004). Visual acuity improved or maintained for 6 months in all of the patients (100%, 20 eyes of 20 patients). SMDLP combined with direct photocoagulation maintains visual acuity and improves diabetic macular edema for at least 6 months.

Social outcomes and quality of life (QOL) of childhood cancer survivors (CCSs) remain unknown in Japan. We investigated these outcomes in young adult CCSs compared to those of their siblings in Japan, and analyzed the association between social outcome and SF-36 health survey subscale scores. Between 2007 and 2009, we performed a cross-sectional survey using self-rating questionnaires. We estimated social outcomes and health-related QOL by performing the SF-36 in each group: CCSs with or without stem cell transplantation (SCT)/radiotherapy (RT) and their siblings. Adjusted odds ratios for outcomes of interest were estimated using logistic regression analysis. Questionnaires from 185 CCSs and 72 CCS's siblings were analyzed. There were no differences in educational attainment or annual income. The SF-36 subscale scores of CCSs with SCT and RT were significantly lower than those of siblings in physical functioning (PF) (p < 0.001 and 0.003, respectively) and general health (GH) (both p = 0.001). Lower PF scores correlated with recurrence (p = 0.041) and late effects (p = 0.010), and poor GH scores with late effects (p = 0.006). The CCSs had made efforts to attain educational/vocational goals; however, a significant proportion of CCSs who had experienced late effects remain at increased risk of experiencing diminished QOL.

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