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Treatment of patients with multiple brain metastases by isolated radiosurgery:Toxicity and survival

World Journal of Clinical Oncology 2023年第10期14卷 400-408页

作者： AndréVinícius de Camargo Marcos Duarte de Mattos murilo kenji kawasaki Danilo Nascimento Salviano Gomes Allisson Bruno Barcelos Borges Vinicius de Lima Vazquez Raphael L C Araujo Department of Radiotherapy Barretos Cancer HospitalSão PauloBarretos 14784-400Brazil Department of Radiation Therapy Hospital DF Star Rede D´OrBrasília 70390-140Brazil Department of Surgery Barretos Cancer HospitalSão PauloBarretos 14784-400Brazil Department of Surgery Universidade Federal de São PauloSão Paulo 04024-002Brazil IEP Barretos Cancer HospitalSão PauloBarretos 14784-400Brazil

BACKGROUND Radiosurgery for multiple brain metastases has been more reported recently without using whole-brain ***,the sparsity of the data still claims more information about toxicity and survival and their association with both dosimetric and geometric aspects of this *** To assess the toxicity and survival outcome of radiosurgery in patients with multiple(four or more lesions)brain *** In a single institution,data were collected retrospectively from patients who underwent radiosurgery to treat brain metastases from diverse primary *** with 4-21 brain metastases were treated with a single fraction with a dose of 18 Gy or 20 *** clinical variables collected were relevant to toxicity,survival,treatment response,planning,and dosimetric *** Spearman’s rank correlation coefficients,Mann-Whitney test,Kruskal-Wallis test,and Log-RESULTS From August 2017 to February 2020,55 patients were *** was the most common complaint(38.2%).The median overall survival(OS)for patients with karnofsky performance status(KPS)>70 was 8.9 mo,and this was 3.6 mo for those with KPS≤70(P=0.047).Patients with treated lesions had a median progression-free survival of 7.6 *** were no differences in OS(19.7 vs 9.5 mo)or progression-free survival(10.6 vs 6.3 mo)based on prior *** was no correlation found between reported toxicities and planning,dosimetric,and geometric variables,implying that no additional significant toxicity risks appear to be added to the treatment of multiple(four or more)*** No associations were found between the evaluated toxicities and the planning dosimetric parameters,and no differences in survival rates were detected based on previous treatment status.

关键词： Radiosurgery Brain metastases Radiotherapy Survival Toxicity Cancer

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Pericardiocentesis with cisplatin for malignant pericardial effusion and tamponade

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World Journal of Gastroenterology 2010年第6期16卷 740-744页

作者： Takatsugu Oida kenji Mimatsu Hiso Kano Atsushi kawasaki Youichi Kuboi Nobutada Fukino Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

AIM:To evaluate the role and outcome of pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. METHODS:We retrospectively studied 7 patients who underwent pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal *** pericardiocentesis,we performed catheterization of the pericardial space under ultrasonogram *** etiology of the pericardial fluid was confirmed by cytological ***,cisplatin(10 mg in 20 mL normal saline) was instilled into the pericardial space. RESULTS:The mean total volume of the aspirated effusion fluid was 782±264 mL(range,400-1200 mL) . The drainage catheter was successfully removed in all patients,and the mean duration of pericardial drainagewas 7.7±2.7 d(range,5-13 d) .No fluid reaccumulation was *** survival time was 120±71 d(range,68-268 d) . CONCLUSION:Pericardiocentesis along with catheter drainage appears to be a safe and effective for pericardial malignant effusion and tamponade,and cisplatin instillation prevents recurrence.

关键词： Malignant pericardial effusion Cardiac tamponade Esophageal cancer Pericardiocentesis Cisplatin

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Post-gastrectomy spleen enlargement and esophageal varices: Distal vs total gastrectomy

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World Journal of Gastroenterology 2010年第22期16卷 2801-2805页

作者： Takatsugu Oida kenji Mimatsu Hisao Kano Atsushi kawasaki Youichi Kuboi Nobutada Fukino Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

AIM: To study the relationship between platelet count-to-spleen diameter ratio and post-gastrectomy esopha-geal varices (EVs) development in patients without liver cirrhosis or hepatitis. METHODS: We retrospectively studied 92 patients who underwent gastrectomy. They were divided into 2 groups on the basis of the surgical treatment: the distal gastrectomy (DG) group and total gastrectomy (TG) group. The incidence of EVs was determined and postoperative platelet counts, spleen diameters, and platelet count-to-spleen diameter ratios were com-pared between the 2 groups. RESULTS: EVs were not detected during the first 6 mo after surgery in either group; however, at 12 mo after surgery, EVs were detected in 2 patients (3%) in the DG group and in 1 patient (3.6%) in the TG group; their mean platelet count-to-spleen diameter ratio was 2628 ± 409, and 2604 ± 360, ***: Endoscopy should be performed to detect EVs when the platelet count-to-spleen diameter ratio is < 2600.

关键词： Spleen enlargement Esophageal varices Platelet count Distal gastrectomy Total gastrectomy

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Endoscopy-based early enterostomy closure for superior mesenteric arterial occlusion

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World Journal of Gastroenterology 2010年第8期16卷 992-996页

作者： Takatsugu Oida Hisao Kano kenji Mimatsu Atsushi kawasaki Youichi Kuboi Nobutada Fukino Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

AIM:To evaluate the efficacy of endoscopic examination of blood flow and edema in the remnant ***:We retrospectively studied 15 patients who underwent massive bowel resection with enterostomy for superior mesenteric arterial occlusion (SMAO); the patients were divided into a delayed closure group (D group) and an early closure group (E group).RESULTS:The mean duration from initial operation to enterostomy closure was significantly shorter in the E group (18.3 ± 2.1 d) than in the D group (34.3 ± 5.9 d) (P < 0.0001). The duration of hospitalization after surgery was significantly shorter in the E group (33 ± 2.2 d) than in the D group (51 ± 8.9 d) (P < 0.0002).CONCLUSION:Endoscopic examination of blood flow and edema in the remnant bowel is useful to assess the feasibility of early closure of enterostomy in SMAO cases.

关键词： Superior mesenteric arterial occlusion Closure of enterostomy Endoscopic inspection

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Impaction of a lithotripsy basket during endoscopic lithotomy of a common bile duct stone

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World Journal of Gastroenterology 2010年第22期16卷 2832-2834页

作者： Nobutada Fukino Takatsugu Oida Atsushi kawasaki kenji Mimatsu Youichi Kuboi Hisao Kano Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

The treatments for common bile duct (CBD) stones are being continually developed. Impaction of the lithotripsy basket during endoscopic removal of CBD stones was seen in 5.9% patients. We report the case of a 66-yearold woman who underwent surgery for the removal of an impacted biliary basket. She was admitted to our hospital with a complaint of right upper abdominal pain. Magnetic resonance cholangiopancreatography revealed a CBD stone (20 mm × 15 mm). We diagnosed her with choledocholithiasis and performed endoscopic retrograde cholangiopancreatography to remove the stone. However, unfortunately, the retrievable basket around the stone became impacted. An endotriptor along with forceps could not be used owing to the entrapment of the basket, and thus we performed urgent surgery. The basket containing the stone was removed through a longitudinal choledochotomy. The wires leading to the basket were cut, and the basket containing the stone was removed via the incision. A T-tube was inserted,and the choledochotomy was closed. The postoperative course was uneventful. In conclusion, if the diameter of a CBD stone is more than 20 mm, then the risk of basket impaction increases, and surgery may be necessary as the initial treatment of the CBD stone.

关键词： Common bile duct gallstones Impacted biliary basket Lithotripsy

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Pneumatosis cystoides intestinalis after fluorouracil chemotherapy for rectal cancer

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World Journal of Gastroenterology 2008年第20期14卷 3273-3275页

作者： kenji Mimatsu Takatsugu Oida Atsushi kawasaki Hisao Kano Youichi Kuboi Osamu Aramaki Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition characterized by intraluminal gas in the gastrointestinal tract. Several chemotherapeutic agents have been reported to be associated with PCI, although fluorouracil-related PCI is extremely rare. We report a case of a 76-year old man who received adjuvant chemotherapy for rectal cancer with fluorouracil (FU) and leucovorin (LV). After 1 cycle of the treatment, he presented with diarrhea and abdominal pain. Abdominal radiogram revealed the presence of free air under the diaphragm and intramural gas in the intestine. Laparotomy was performed, showing a suspected diagnosis of perforation in the gastrointestinal tract. Intraoperative findings revealed penumatosis of the intestine without evidence of perforation. He was treated supportively and his symptoms improved. In conclusion, we should consider the possibility of PCI occurring in patients with malignancies during chemotherapy treatment.

关键词： Pneumotosis cystoides intestinalis Chemotherapy Fluorouracil Colorectal cancer

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Clinical features in proven and probable invasive fungal disease in children and adolescents at a pediatric referral center: a 5-year experience

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World Journal of Pediatrics 2019年第3期15卷 270-275页

作者： kenji Kishimoto Masashi Kasai Noriko Kawamura Yusuke Ito Makiko Yoshida Daiichiro Hasegawa Keiichiro kawasaki Yoshiyuki Kosaka Department of Hematology and Oncology Children’s Cancer CenterKobe Children’s HospitalMinatojima—Minamimachi 1—6-7Chuo—kuKobe 650—0047 Japan Department of Infectious Disease Kobe Children’s Hospital KobeJapan Department of Clinical Laboratory Kobe Children’s HospitalKobeJapan Department of Diagnostic Pathology Kobe Children’s HospitalKobeJapan Department of Pediatrics Kita—Harima Medical Center KobeJapan

Background There is limited information concerning the overall epidemiology of invasive fungal disease (IFD) in *** aim of this study was to clarify the clinical features of IFD in a tertiary pediatric care *** Patients diagnosed with proven or probable IFD at our hospital between 2011 and 2015 were retrospectively *** and probable IFD were defined according to the European Organization for Research and Treatment of Cancer/Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group *** with possible IFD were *** The incidence of proven or probable IFD was 26 of 20,079 hospitalized patients (0.13%).The predominant underlying disease was malignancy (54%) and congenital anomaly (27%).The most common diagnosis was candidemia among the patients with proven IFD (8 of 13,62%).All the isolated pathogens in the candidemia patients were non-albicans Candida *** most common site of infection was the lungs in patients with probable IFD (11 of 13 patients,85%).In probable IFD episodes,positive β-D-glucan and galactomannan were found in 12 of 13 (92%) and 5 of 13 (38%) patients,*** but one patient (96%) received empirical antifungal *** patients underwent surgical resection of residual *** overall mortality was 23% and the attributable mortality of IFD was 12%.Conclusion Our results suggest the emergence of non-albicans Candida species as important pathogens in childhood IFD.

关键词： Children Invasive fungal disease Incidence Mortality

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JNK-Mediated FOXO Expression Plays a Critical Role in EGFR Tyrosine Kinase Inhibitor-Induced BIM Expression and Apoptosis

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Journal of Cancer Therapy 2012年第4期3卷 424-434页

作者： kenji Takeuchi Anh Ho Viet Katsumi kawasaki Kazuto Nishio Fumiaki Ito Department of Biochemistry Faculty of Pharmaceutical Sciences Setsunan University Osaka Japan Department of Genome Biology Kinki University School of Medicine Osaka Japan

BIM, a key proapoptotic member of the BCL-2 family of proteins, is essential for apoptosis triggered by tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR). However, the precise molecular mechanism by which EGFR-TKIs induce BIM expression has remained unclear. A previous study of ours showed that the activetion of c-Jun NH2-terminal kinase (JNK) is critical for the TKI-induced apoptosis in PC-9 cells, a gefitinib-sensitive human NSCLC cell line. In this study, we therefore examined the effect of JNK activation on BIM expression and further investigated the mechanism responsible for TKI-induced apoptosis in PC-9 cells. Northern blotting analysis revealed that the TKI AG1478 induced a substantial increase in the level of BIM mRNA. However, this TKI-induced increase was not observed in dominant-negative JNK overexpressing cell line J12A5 or in the TKI-resistant cell line HP-5R, in which JNK is not activated in response to AG1478. Therefore, JNK activation was correlated with the up-regulation of BIM expression. BIM is known to be a downstream target of forkhead box protein O (FOXO) transcription factors. Immunoblot analysis indicated that the levels of FOXO1, FOXO3a, and FOXO4 transcription factors increased after AG1478 treatment of PC-9 cells but that they were not increased in either J12A5 or HP-5R cells, indicating that FOXO was increased in PC-9 cells through JNK activation. FOXO1 knockdown in PC-9 cells decreased EGFR-TKI-induced BIM expression and apoptosis. These findings provide evidence that JNK activation and subsequent increased FOXO expression play a critical role in EGFR-TKI-induced BIM expression and apoptosis.

关键词： EGFR-TKI FOXO BIM JNK NSCLC

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Efficacy of Inchinkoto for Liver Cirrhosis in an Infant with Down Syndrome Complicated by Transient Myeloproliferative Disorder

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Open Journal of Pediatrics 2017年第1期7卷 26-31页

作者： Ryuta Washio Masaya Takahashi Sohsaku Yamanouchi Masato Hirabayashi kenji Mine Yukihiro Noda Eriko Kanda Atsushi Ohashi Hirohide kawasaki Kazunari Kaneko Department of Pediatrics Kansai Medical University Osaka Japan

Several patients with Down syndrome complicated by transient myeloproliferative disorder may develop liver cirrhosis for which no effective therapeutic agent exists. We report the infant with Down syndrome complicated by transient myeloproliferative disorder and liver cirrhosis who was successfully treated by Inchinkoto, the Japanese herbal medicine. In the present case, Inchinkoto appeared to prevent both histological and serological aggravation of liver cirrhosis. To the best of our knowledge, this is the first report of preventive effect of Inchinkoto on liver cirrhosis, and it can be a choice of treatment for infants with Down syndrome complicated by liver cirrhosis.

关键词： Inchinkoto Transient Myeloproliferative Disorder Down Syndrome Liver Fibrosis Japanese Herbal Medicine

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Usefulness of Enteral Nutritional Intake Containing Median-Chain Fatty Acids in Parkinson’s Disease Patients with Weight Loss: A Pilot Study

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Advances in Parkinson's Disease 2019年第1期8卷 1-7页

作者： Makoto Shiraishi kenji Isahaya Yasuhiro Hasegawa Department of Internal Medicine Division of Neurology St. Marianna University School of Medicine Kawasaki City Japan

Background: No solution has yet been found for the nutritional issues of Parkinson’s disease (PD) patients with weight loss, which affects their prognosis. The objective of the present study was to investigate whether a defined-formula diet rich in ω3 fatty acids improved nutrition through the effect of ghrelin in PD patients with weight loss. Method: Weight, serum total protein, albumin, lipids, serum ghrelin, serum acylghrelin, leptin, and the Unified Parkinson’s Disease Rating Scale were monitored for approximately 3 months in 11 subjects given a defined-formula diet rich in ω3 fatty acids for 3 months and 5 control subjects who received no such treatment. Results: No significant changes from baseline in serum ghrelin, acylghrelin, and leptin levels were noted after administration of the nutritional product. Meanwhile, compared with the control, changes from baseline in the levels of albumin and weight were significant after the nutritional therapy rich in ω3 fatty acids (P < 0.05). Conclusion: Administration of a medium-chain fatty acid-rich product has few effects on motor functions and activities of daily living in PD patients with weight loss, but it is expected to offer effective ghrelin-mediated nutritional improvement.

关键词： Parkinson’s Disease Weight Loss Ghrelin Leptin

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