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Saito S.,Kumamoto University | Hayashi N.,Kumamoto University | Sato N.,Kumamoto University | Iwatsuki M.,Kumamoto University | And 15 more authors.
International Journal of Clinical Oncology | Year: 2013

Background: There has so far been little information on the clinical effect of bevacizumab against colorectal cancer in Japan. Hence, this study was conducted to retrospectively evaluate the safety and efficacy of bevacizumab in clinical practice. Methods: A total of 181 patients with metastatic colorectal cancer (mCRC) received bevacizumab in combination with chemotherapy at 18 hospitals in Kumamoto prefecture, Japan. We surveyed the medical records of all patients regarding the patient characteristics, objective tumor responses, and adverse events. We analyzed their overall survival and the survival benefit when continuing the administration of bevacizumab beyond disease progression (progressive disease; PD) in patients who received bevacizumab-containing 1st line therapy. Results: The response rate (RR) in all lines of therapy was 42 %. The 1st line patients showed significantly better survival in comparison to the patients who received further lines of treatment (P = 0.005). There were no significant differences in survival between the group with post-PD treatment with bevacizumab and the group with post-PD treatment without bevacizumab (P = 0.13). The most common grade 3 or greater adverse event associated with bevacizumab was hypertension (12.2 %). Especially, a high incidence of gastrointestinal (GI) perforation was shown in this study (4.4 %) and most of the patients with GI perforation had some risk factors for this complication. Conclusion: Although the survival benefit of bevacizumab in Japanese patients with mCRC was similar to that observed in previous clinical trials, this study showed a high incidence of GI perforation in comparison to previous studies. Therefore, the careful selection of patients with few risk factors for this complication is likely to lead to a greater benefit from bevacizumab treatment. © 2012 Japan Society of Clinical Oncology. Source


Ryoji B.,Prefectural University of Kumamoto | Hiromitsu M.,Prefectural University of Kumamoto | Kosei H.,Yatsushiro Social Insurance General Hospital
18th International Congress on Sound and Vibration 2011, ICSV 2011 | Year: 2011

Apraxia of speech is a speech disorder in which a person has trouble in saying what he or she wants to say correctly and consistently. It is not due to weakness, paralysis of the speech muscles (the muscles of the face, tongue, and lips) or aphasia. We recorded the utterances of a patient with apraxia of speech and analyzed them. The most remarkable characteristic of his speech is the incorrect use of "prosody" - that is, the varying rhythms, stresses, and inflections of speech that are used to help express meaning. His voice is very monotonous without word accent, and very slow and effortful. Accent in Japanese is pitch accent, and he cannot control the pitch of each word. But he raises his pitch at the end of an utterance, and he lowers it at the end of a discourse. Rising pitch indicates there is another utterance after this one, and lowering pitch indicates the discourse is over. Thus, he controls the utterance intonation and the discourse intonation. He cannot speak so rhythmically as healthy speakers, and he tends to speak while stamping his feet on the floor. It is said (Darley, 1975) [1] that apraxia of speech results from a disorder of the programme ability to make speech. We would emphasize that it involves a disorder of the ability to read the speech programme rather than an impairment of the programme itself. Source


Ichimori S.,Kumamoto University | Shimoda S.,Kumamoto University | Goto R.,Kumamoto University | Matsuo Y.,Saiseikai Kumamoto Hospital | And 8 more authors.
Journal of Diabetes Investigation | Year: 2012

Aims/Introduction: Several experimental studies have shown that ezetimibe improves steatosis and insulin resistance in the liver. This suggests that ezetimibe may improve glucose metabolism, as well as lipid metabolism, by inhibiting hepatic lipid accumulation. Therefore, we compared HbA1c levels after 3months ezetimibe treatment with baseline levels in patients with type 2 diabetes and examined the factors associated with reductions in HbA1c following ezetimibe administration. Materials and Methods: Lipid profiles, hepatic function, and HbA1c were assessed before and after 3months treatment with 10mg/day ezetimibe in 96 patients with type 2 diabetes and hypercholesterolemia. Regression analysis was used to investigate associations between metabolite levels and the percentage change in HbA1c. Results: Low-density lipoprotein-cholesterol was significantly lower after 3months treatment compared with baseline, and HbA1c decreased in approximately 50% of patients. Univariate linear regression analyses showed that changes in HbA1c were significantly associated with serum alanine aminotransferase (ALT), the aspartate aminotransferase (AST)/ALT ratio, and age. Two-tailed chi-square tests revealed that serum ALT ≥35IU/L and an AST/ALT ratio <1.0 were significantly associated with decreases in HbA1c following ezetimibe administration. Conclusions: The results of the present study indicate that ezetimibe may improve glucose metabolism. Serum ALT levels and the AST/ALT ratio were useful predictors of a glucose metabolism response to ezetimibe. This trial was registered with UMIN (no. UMIN000005307). © 2011 Asian Association for the Study of Diabetes and Blackwell Publishing Asia Pty Ltd. Source


Ikuta Y.,Kumamoto University | Takamori H.,Kumamoto University | Ikeda O.,Kumamoto University | Tanaka H.,Kumamoto University | And 10 more authors.
Journal of Gastroenterology | Year: 2010

Background: This study was designed to define the diagnostic advantage of computed tomography during arterial portography (CTAP) combined with computed tomography-assisted hepatic arteriography (CTHA) for the preoperative detection of liver metastases secondary to pancreatic cancer compared with that of multidetector computed tomography (MDCT). Methods: From January 2002 to December 2007, we retrospectively studied 197 consecutive patients with pancreatic cancer. MDCT was performed on 192 patients prior to preoperative visceral angiography; 153 patients underwent CTAP + CTHA at the time of preoperative angiography. Results: Liver metastases were identified in 39 patients by means of MDCT. Of the 153 patients who had no evidence of liver metastases on MDCT, 129 patients underwent CTAP + CTHA, and 53 of these 129 patients (41.1%) were diagnosed as having liver metastases that could not be detected by MDCT. These tumors missed by MDCT ranged from 3 to 15 mm in size. On CTAP + CTHA, a solitary nodule in the liver was detected in 11 patients, 2 nodules were detected in 6 patients, 3 lesions were detected in 2 patients, and ≧4 lesions were detected in 34 patients. The sensitivity and specificity of CTAP + CTHA versus MDCT were 94.2 versus 48.4% and 82.7 versus 97.9%, respectively. Conclusions: The combination of CTAP and CTHA is useful to confirm liver metastases and can potentially offer more accurate staging of pancreatic cancer compared with MDCT. © 2010 Springer. Source


Kuramoto M.,Yatsushiro Social Insurance General Hospital | Shimada S.,Yatsushiro Social Insurance General Hospital | Ikeshima S.,Yatsushiro Social Insurance General Hospital | Matsuo A.,Yatsushiro Social Insurance General Hospital | And 3 more authors.
Journal of Oncology | Year: 2012

Peritoneal metastasis, which often arises in patients with advanced gastric cancer, is well known as a miserable and ill-fated disease. Once peritoneal metastasis is formed, it is extremely difficult to defeat. We advocated EIPL (extensive intraoperative peritoneal lavage) as a useful and practical adjuvant surgical technique for those gastric cancer patients who are likely to suffer from peritoneal recurrence. In this paper, we review the effect of EIPL therapy on prevention of peritoneal recurrence on patients with peritoneal free cancer cells without overt peritoneal metastasis (CY+/P-) through the prospective randomized study, and we verified its potential as an optimal and standard prophylactic therapeutic strategy for peritoneal recurrence. Copyright © 2012 Masafumi Kuramoto et al. Source

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