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Nishi-Tokyo-shi, Japan

Watanabe Y.,Kinki University | Hoshiai H.,Kinki University | Nakanishi T.,Aichi Cancer Center | Kawamura N.,Osaka City General Hospital | And 6 more authors.
Anticancer Research | Year: 2011

Aim: To evaluate the efficacy and toxicities of cisplatin and daily oral etoposide in patients with recurrent cervical cancer. Patients and Methods: Treatment was initiated with oral etoposide 25 mg/day for 21 consecutive days, with intravenous cisplatin at 50 mg/m2, on day 1, every 4 weeks, then the etoposide dose was increased to 50 mg/day. Results: Thirty patients were enrolled in this study. Twenty-seven (90.0%) patients had a history of prior treatment (cisplatin with concurrent chemoradiotherapy in 15, radiation therapy in 3, chemotherapy in 1, and both radiation therapy and chemotherapy in 9), and 22 (73.3%) patients had a treatment-free interval of less than 6 months. NCI-CTC grade 314 hematologic toxicities were leukopenia in 19 (63.3%), neutropenia in 17 (58.6%), anemia in 15 (50.0%) and thrombocytopenia in 6 (20.0%). Four patients developed febrile neutropenia. NCI-CTC grade 3 nonhematologic toxicities consisted of nausea/vomiting in 2 (6.7%), anorexia in 4 (13.3%) and fatigue in 2 (6.7%). The overall response rate was 16.7% including one complete response. The median progression-free survival period and overall survival period were 4.5 and 9.7 months, respectively. Conclusion: Combination chemotherapy consisting of oral etoposide and intravenous cisplatin is safe and effective for recurrent cervical cancer. Source


Inoue O.,Keio University | Hamatani T.,Keio University | Susumu N.,Keio University | Yamagami W.,Keio University | And 7 more authors.
Reproductive Biology and Endocrinology | Year: 2016

Background: Patients hoping to preserve their fertility receive conservative treatment with high-dose medroxyprogesterone acetate (MPA) for well-differentiated endometrioid adenocarcinoma (EC) or atypical endometrial hyperplasia (AEH). Such treatment generally involves frequent intrauterine operations, including dilation and curettage (D&C) and endometrial biopsy (EMB), which could result in endometritis, endometrial thinning, or intrauterine adhesion. In turn, any of these outcomes could adversely affect implantation and pregnancy development. The current study thus aimed to identify factors that might affect pregnancy following conservative treatment by MPA. Methods: We compared a pregnancy group (45 patients) with a non-pregnancy group (53 patients) of MPA-treated patients to evaluate the factors affecting clinical pregnancy establishment. We undertook a multivariate logistic regression analysis based on factors shown by univariate analysis to be significantly different between the groups. Univariate analysis identified number of D&C, endometrial thickness, duration of MPA administration, age of pregnancy permission (the age at which a patient was first allowed to attempt pregnancy after disappearance of the lesion), period of disappearance of lesions, and recurrence as independent variables. Results: The odds ratios (95 % confidence interval) of multivariate analysis for disease recurrence, endometrial thickness during ovulation, and age of pregnancy permission were 0.283 (0.102-0.785), 1.677 (1.251-2.248), and 0.889 (0.792-0.998), respectively. There was no significant difference in the other independent variables between groups. Conclusions: We identified three factors considered to affect pregnancy establishment following conservative treatment with MPA: recurrence, endometrial thickness during ovulation, and the age of the pregnancy permission. Introduction of infertility treatment including assisted reproductive technology (ART) soon after achieving tumor disappearance by MPA would therefore be beneficial for patients with disease recurrence, thin endometrium, or a higher age of pregnancy permission. © 2016 Inoue et al. Source


Iwanaka T.,University of Tokyo | Kawashima H.,University of Tokyo | Tanabe Y.,Tokyo Medical College | Aoki T.,Tokyo Medical College
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2011

The management of long-gap pure esophageal atresia (LGEA) remains controversial. An 8-month-old girl with LGEA underwent a laparoscopic and thoracoscopic gastric pull-up and esophago-esophagostomy in the right thorax combined with intrathoracic fundoplication. She was positioned supine, and three 5-mm ports were placed in the standard locations for laparoscopic Nissen fundoplication. The gastrostomy was taken down and an additional 5-mm port was inserted at the gastrostomy site. Laparoscopic gastric mobilization was performed; the short gastric and left gastric vessels were divided using harmonic shears, and the whole stomach and distal esophageal stump maintained their vascular supply via the right gastric and gastroepiploic arteries. The hiatus was enlarged by radial incisions at both cruras, and the mobilized whole stomach and distal esophageal stump were pushed up into the right thorax through the hiatus. The patient was placed in a modified prone position and three 5-mm ports were inserted into the right thorax. Via thoracoscopy, the upper esophageal pouch was dissected bluntly, and an esophago-esophagostomy was performed using interrupted 4-0 absorbable sutures and was wrapped by a 360-degree gastric fundoplication. The patient was positioned supine again, and a Heinecke-Mikulicz pyloroplasty and gastropexy were also performed laparoscopically. The patient has mild respiratory distress that requires bronchodilators; however, she is eating baby food well without vomiting. Postoperative intrathoracic gastrofiberscopy showed a well-functioning antireflux valve, and her parents are also satisfied with the cosmetic appearance of the seven small wounds. Our new procedure is feasible and is an excellent option in selected patients with LGEA. © 2011 Mary Ann Liebert, Inc. Source


Osada T.,Tokyo Medical University | Osada T.,Tokyo Therapeutic Institute | Osada T.,Tokyo Medical College | Iwane H.,Tokyo Medical College | And 14 more authors.
Acta Physiologica | Year: 2012

Aim: To examine the blood flow (BF) response in the lower abdomen (LAB) in recovery following upright cycling exercise at three levels of relative maximum pulmonary oxygen consumption and the relationship of BF LAB to heart rate (HR) and target intensity. Methods: For 11 healthy subjects, BF (Doppler ultrasound) in the upper abdominal aorta (Ao) above the coeliac trunk and in the right femoral artery (RFA) was measured repeatedly for 720s after the end of cycling exercises at target intensities of 30%, 50% and 85%, respectively. Blood flow in the lower abdomen (BF LAB) can be measured by subtracting bilateral BF FAs (≈twofolds of BF RFA) from BF Ao. Change in BF LAB (or BF LAB volume) at any point was evaluated by difference between change in BF Ao and in BF FAs. Heart rate and blood pressure were also measured. Results: At 85%, significant reduction in BF LAB by approx. 89% was shown at 90s and remained until 360s. At 50%, reduction in BF LAB by approx. 33% was found at 90s although it returned to pre-exercise value at 120s. On the contrary at 30%, BF LAB showed a light increase (<20%) below 70bpm of HR. There was a close negative relationship (P<0.05) between change in BF LAB and recovery HR, as well as between change in BF LAB volume and both recovery HR and %. Conclusion: This study suggests that the lower abdominal BF in recovery may be influenced by sympathetic-vagus control, and dynamics of BF LAB may be closely related to the level of relative exercise intensities. © 2011 The Authors. Acta Physiologica © 2011 Scandinavian Physiological Society. Source


Takahashi E.,Sasaki Foundation | Koshiishi H.,Tokyo Cosmopolitan Ohtsuka Hospital | Sakaniwa N.,Raspiratory Disease Center | Okunaka T.,Raspiratory Disease Center | And 4 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014

In case of central type lung cancer, it happens that tumors tend to grow at many foci of bronchial tree, sometimes simultaneously and sometimes not. And these patients with such abnormalities often suffer from pulmonary emphysema or chronic bronchitis because of heavy smoking habits. So it is important to choose the treatment which preserve the pulmonary function in these cases. Today among several kinds of treatments, photodynamic therapy (PDT) is the definite method to maintain lung function. We report here a case of multiple central type lung cancer treated successfully by PDT. Source

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