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Tenri, Japan

Nakatani S.,Osaka University | Akaishi M.,Kitasato University | Asanuma T.,Osaka University | Hashimoto S.,National Cerebral and Cardiovascular Center | And 7 more authors.
Journal of Echocardiography | Year: 2015

Echocardiography plays a pivotal role as an imaging modality in modern cardiology practice. Information derived from echocardiography is definitely helpful for patient care. The Japanese Society of Echocardiography has promoted echocardiography in routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure this, we believe that equipment in good condition and a comfortable environment are important for both patient and examiner. Here, the Guideline Preparation Committee of the Japanese Society of Echocardiography has established brief guidance for the routine use of echocardiography equipment. © 2015 Japanese Society of Echocardiography

Chang S.,Tenri Yorozu Hospital | Matsuura N.,Kagawa University | Tarumi S.,Kagawa University | Ishikawa S.,Kagawa University | And 2 more authors.
Japanese Journal of Lung Cancer | Year: 2012

Background. Bevacizumab in combination chemotherapy has improved tumor regression rate in the treatment of advanced non-squamous non-small cell lung cancer (NSCLC). Case. A 78-year-old man was given a diagnosis of primary lung cancer in the left upper lobe with a left adrenal metastasis (adenocarcinoma, cT2aN0M1b, stage IV) and received 4 cycles of bevacizumab combination chemotherapy. After chemotherapy, 75% tumor reduction rate (partial response) was achieved and tumor marker values normalized. Therefore, left upper lobectomy and left adrenalectomy were performed. In the primary tumor Ef. 2 (viable cancer cells seen in less than one-third of the tumor) was observed, with Ef. 3 in the previous metastatic tumor (no viable cancer cells in histological observation). He has been well with no evidence of recurrence for 12 months after operation. Conclusion. Induction chemotherapy in combination with bevacizumab may increase the indications for current unresectable advanced NSCLC, based on careful case selection. © 2012 The Japan Lung Cancer Society.

Sugiura J.,Fukuoka Childrens Hospital | Nakano T.,Fukuoka Childrens Hospital | Oda S.,Fukuoka Childrens Hospital | Usui A.,Nagoya University | And 2 more authors.
European Journal of Cardio-thoracic Surgery | Year: 2014

OBJECTIVES: Tricuspid regurgitation (TR) remains a significant risk factor affecting the survival of patients with hypoplastic left heart syndrome (HLHS). We performed this study to investigate differences in the clinical course based on the timing of the development of TR and the effects of tricuspid valve surgery (TVS). METHODS: One hundred and five patients of classic HLHS underwent staged operations from May 1991 to July 2010. Forty-four patients (41.9%) exhibited moderate or greater TR during the follow-up. We defined the early TR group (30 patients, around the first palliative surgery) and the late TR group (14 patients, the later period) based on the timing of the appearance of moderate or greater TR. We performed TVS when moderate or greater TR was detected in 28 patients. The follow-up period was 5.5 ± 5.1 (plus/minus values are means ± SD) years (range: 0.01-14.6 years) after the first palliative surgery and 4.9 ± 4.4 years (range: 0.01-13.3 years) after TVS. RESULTS: The early TR group exhibited poorer survival than the late TR group (42.9 vs 92.9% at 5 years, P = 0.003). However, in the early TR group, the TVS significantly improved survival compared with that observed in the non-TVS cases (52.1 vs 23.3% at 5 years, P = 0.046). The right ventricular ejection fraction (RVEF) significantly decreased (62.7 ± 11.4→57.2 ± 12.6% (plus/minus values are means ± SD), P = 0.040) and the right ventricular end-diastolic diameter (RVDd) became significantly enlarged (27.7 ± 7.6→36.7 ± 3.4 mm, P < 0.001) in association with deterioration of the TR degree. TVS significantly improved the degree of TR (2.5 ± 0.5→1.5 ± 0.9°, P < 0.001) and RVDd (37.7 ± 7.4→30.4 ± 5.0 mm, P = 0.007); however, the RVEF was not improved 1 month after surgery (54.4 ± 12.1→54.3 ± 12.4%, P = 0.931) or at the latest follow-up (53.7 ± 14.9%, P = 0.836). CONCLUSIONS: The survival of HLHS patients who develop moderate or greater TR around the time of the first palliative surgery is worse than that of HLHS patients who develop moderate or greater TR at a later time. In this study, TVS for early TR improved survival and decreased right ventricular dimensions during the 4.9-year follow-up period. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Nakamura S.,Kansai Medical University | Kaneko S.,Kansai Medical University | Shinde A.,Tenri Yorozu Hospital | Morita J.-I.,Kansai Medical University | And 3 more authors.
Neuromuscular Disorders | Year: 2013

Three very elderly (over 80. years old) patients having generalized myasthenia gravis without thymoma were treated with cyclosporin A and followed for up to 24. months. Cyclosporin A therapy quickly improved myasthenia gravis symptoms in all cases, which allowed a rapid reduction in the prednisolone dose and improvement of prednisolone-related hyperglycemia and hypertension. Combination therapy with prednisolone and low-dose cyclosporin A not only improved the clinical symptoms of the very elderly myasthenia gravis patients but also resulted in a rapid reduction in prednisolone dosage and prednisolone-related side effects. Attention should be paid to cyclosporin A-related renal dysfunction. © 2012 Elsevier B.V.

Hatano E.,Kyoto University | Okuno M.,Kyoto University | Nakamura K.,Kyoto University | Ishii T.,Kyoto University | And 21 more authors.
Journal of Hepato-Biliary-Pancreatic Sciences | Year: 2015

Background: Patients with colorectal liver metastasis (CRLM) might be down-staged by chemotherapy from an initially unresectable stage to a resectable stage. Because the tumor response to preoperative chemotherapy has been correlated with resection rate, the improved efficacy from the concept that only the patients without K-ras mutations receive an anti-EGFR antibody might be expected to increase the conversion rate. The purpose of this study is to evaluate the conversion rate from unresectable CRLM to complete resection. Methods: We conducted a multi-institutional phase II trial for unresectable CRLM. Patients received mFOLFOX6 with either bevacizumab (bev) or cetuximab (cet) based on K-ras status (UMIN000004310). Planned treatment was for six cycles during which tumors were assessed for resectability every three cycles. Patients whose disease was unresectable after six cycles switched their chemotherapy regimen from mFOLFOX6 to FOLFIRI. The primary endpoint was R0 resection rate. Results: Thirty-five patients with unresectable CRLM were enrolled. A total of 22/12 patients with K-ras wild-type/mutant (wt/mt) were treated with mFOLFOX6 plus cet/bev, respectively. The overall response rate was 64.7% (wt/mt; 77.3%/41.7%, P = 0.04). In 20 patients (58.8%), hepatectomy was performed according to protocol treatment, and the conversion rate was 72.7%/33.3% in wt/mt patients, respectively (P = 0.03). Finally, 23 patients (67.6%) underwent hepatectomy, and the conversion rate was 77.2%/50.0% in wt/mt patients (P = 0.09). The overall R0 resection rate was 47.1% (wt/mt; 50.0%/41.7%, P = 0.36). Conclusions: This prospective study showed that combined chemotherapy based on K-ras status can facilitate conversion to resection in patients with unresectable CRLM. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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