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1.
J Vasc Interv Radiol ; 35(6): 874-882, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38479451

ABSTRACT

PURPOSE: To evaluate the effectiveness and safety of pre-emptive transcatheter arterial embolization (P-TAE) for aortic side branches (ASBs) to prevent Type 2 endoleaks (EL2) before endovascular aneurysm repair (EVAR) using the Excluder stent-graft system (Excluder). MATERIALS AND METHODS: In this prospective, multicenter study, 80 patients (mean age, 79.1 years [SD ± 6.7]; 85.0% were men; mean aneurysmal sac diameter, 48.4 mm [SD ± 7.4]) meeting the eligibility criteria were prospectively enrolled from 9 hospitals. Before EVAR, P-TAE was performed to embolize the patent ASBs originating from the abdominal aortic aneurysm. Contrast-enhanced computed tomography (CT) was performed at 1 month and 6 months after EVAR. The primary endpoint was EL2 incidence at 6 months, and the secondary endpoints were aneurysmal sac diameter changes at 6 and 12 months, P-TAE outcomes, adverse events related to P-TAE, reintervention, and aneurysm-related mortality. RESULTS: All patients successfully underwent P-TAE without serious. Coil embolization was successful in 81.6% of ASBs. EL2 incidence at 6 months was identified in 18 of 70 (25.7%) patients. Aneurysmal sac diameter shrinkage (≥5 mm) was observed in 30.0% of patients at 6 months and in 40.9% at 12 months. Only 1 patient required reintervention for EL2 within 1 year of EVAR; aneurysm-related deaths were not observed. CONCLUSIONS: P-TAE for ASBs before EVAR using Excluder is a safe and effective strategy. It aids in achieving early aneurysmal sac shrinkage and reduces EL2 reintervention at 1 year after EVAR.


Subject(s)
Aortic Aneurysm, Abdominal , Blood Vessel Prosthesis Implantation , Blood Vessel Prosthesis , Computed Tomography Angiography , Embolization, Therapeutic , Endoleak , Endovascular Procedures , Prosthesis Design , Stents , Humans , Female , Male , Aged , Endovascular Procedures/adverse effects , Endovascular Procedures/instrumentation , Prospective Studies , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/surgery , Embolization, Therapeutic/adverse effects , Embolization, Therapeutic/instrumentation , Treatment Outcome , Aged, 80 and over , Endoleak/etiology , Endoleak/therapy , Endoleak/diagnostic imaging , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Time Factors , Aortography , Risk Factors , Japan , Endovascular Aneurysm Repair
2.
Kyobu Geka ; 77(2): 87-91, 2024 Feb.
Article in Japanese | MEDLINE | ID: mdl-38459856

ABSTRACT

A 66-year-old man. He had myocardial infarction due to occlusion of the left anterior descending branch, which was subsequently complicated by ventricular septal perforation. Ventricular septal perforation was repaired through right ventricle incision, applying double patches for closure, and injecting glue between the patches. The early postoperative course was good, but the infarcted left ventricular anterior wall remained because of the right ventriculotomy approach. A left ventricular aneurysm was demonstrated on postoperative follow-up echocardiography, which gradually enlarged to become giant. Since symptoms of heart failure such as respiratory distress appeared, left ventriculoplasty was performed 29 months after the perforation of the initial surgery. Since thinned left ventricular wall remains following right ventriculotomy approach, risk of postoperative left ventricular aneurysm should be taken into account.


Subject(s)
Cardiac Surgical Procedures , Heart Aneurysm , Myocardial Infarction , Ventricular Septal Rupture , Male , Humans , Aged , Ventricular Septal Rupture/diagnostic imaging , Ventricular Septal Rupture/etiology , Ventricular Septal Rupture/surgery , Myocardial Infarction/complications , Cardiac Surgical Procedures/adverse effects , Heart Ventricles/diagnostic imaging , Heart Ventricles/surgery , Heart Aneurysm/diagnostic imaging , Heart Aneurysm/etiology , Heart Aneurysm/surgery
3.
Kyobu Geka ; 69(10): 833-7, 2016 Sep.
Article in Japanese | MEDLINE | ID: mdl-27586313

ABSTRACT

A 77-year-old man with a history of stent implantation in the right common iliac artery(CIA) and the left external iliac artery(EIA) was admitted to our hospital for a rapid growth of an aneurysm( max 53 mm) at Th11 level of the descending aorta. Although thoracic endovascular aortic repair (TEVAR) was required, there were many problems about access rout. The infrarenal abdominal aorta and the left EIA were severely calcified, and the lumens of the right CIA stent(5.3 mm) and the left EIA stent( 4.3 mm) were small in size. Besides, the left CIA was short(13 mm). Therefore, TEVAR was performed by retrograde approach from the left internal iliac artery( IIA) with a tube graft conduit in the hybrid operation room. IIA is a useful option for an access rout in endovascular aortic repair.


Subject(s)
Aorta, Abdominal/surgery , Iliac Artery/surgery , Aged , Aorta, Abdominal/diagnostic imaging , Humans , Iliac Artery/diagnostic imaging , Imaging, Three-Dimensional , Male , Stents , Tomography, X-Ray Computed
4.
Kyobu Geka ; 68(7): 515-9, 2015 Jul.
Article in Japanese | MEDLINE | ID: mdl-26197826

ABSTRACT

A 74-year-old woman progressed to extensive aortic aneurysm after 2 years and 6 months from onset of type B dissection. A computed tomography scan revealed aortic aneurysm from ascending aorta to Th12 level of descending aorta. Her appearance was very frailty. Therefore, we performed 2-staged hybrid repair for this case. First, surgical total arch replacement with elephant trunk via median sternotomy was performed. On the 47th days after the 1st operation, thoracic endovascular aortic repair was performed. The spinal drainage was done for spinal cord protection. Postoperative course was uneventful without any complications. Considering a surgical stress, 2-staged hybrid repair using a stent graft was less-invasive than 1 staged graft replacement.


Subject(s)
Aortic Aneurysm, Thoracic/surgery , Aortic Aneurysm/surgery , Aged , Drainage , Female , Humans , Thoracic Surgical Procedures , Tomography, X-Ray Computed , Vascular Grafting , Wound Healing
5.
Kyobu Geka ; 68(7): 532-4, 2015 Jul.
Article in Japanese | MEDLINE | ID: mdl-26197830

ABSTRACT

A 64-years-old man had cor triatriatum (Lucas-Schmidt type I A) with severe mitral regurgitation and atrial fibrillation. We perfomed resection of the anomalous septum between the accessory chamber and left atrium, and conducted mitral annuloplasty and maze procedure. Arrhythmia were not encountered after surgery. The maze procedure and resection of the anomalous septum with mitral surgery proved to be effective for atrial fibrillation with cor triatriatum.


Subject(s)
Atrial Fibrillation/surgery , Cor Triatriatum/surgery , Mitral Valve Insufficiency/surgery , Atrial Fibrillation/complications , Cardiac Surgical Procedures , Cor Triatriatum/complications , Cor Triatriatum/diagnosis , Humans , Male , Middle Aged , Mitral Valve Insufficiency/complications , Tomography, X-Ray Computed
6.
Ann Vasc Dis ; 17(2): 171-174, 2024 Jun 25.
Article in English | MEDLINE | ID: mdl-38919318

ABSTRACT

A 79-year-old man underwent 1-debranched thoracic endovascular aortic repair (TEVAR) for a saccular aneurysm of the distal arch of the aorta. Computed tomography performed 3 years after surgery revealed a significant displacement of the distal side of the stent graft and severe deformity due to displacement of the aorta. There were no obvious findings after aortic dissection. Endovascular treatment was selected, and surgery was performed semiemergency. Additional TEVAR was performed to restore the aortic shape and displacement to its normal position.

7.
Diagn Interv Imaging ; 2024 Mar 18.
Article in English | MEDLINE | ID: mdl-38503637

ABSTRACT

PURPOSE: The purpose of the study was to evaluate the efficacy and safety of pre-emptive transcatheter arterial embolization (P-TAE) of aortic side branches to prevent type II endoleak in patients with abdominal aortic aneurysm after endovascular abdominal aneurysm repair (EVAR). MATERIALS AND METHODS: This multicenter, prospective, single-arm trial enrolled 100 patients with abdominal aortic aneurysm from nine hospitals between 2018 and 2021. There were 85 men and 15 women, with a mean age of 79.6 ± 6.0 (standard deviation) years (range: 65-97 years). P-TAE was attempted for patent aortic side branches, including the inferior mesenteric artery, lumbar arteries, and other branches. The primary endpoint was late type II endoleak incidence at 6 months post-repair. Secondary endpoints included changes in aneurysmal sac diameter at 6- and 12 months, complications, re-intervention, and aneurysm-related mortality. Aneurysm sac changes at 6- and 12 months was compared between the late and no-late type II endoleak groups. RESULTS: Coil embolization was successful in 80.9% (321/397) of patent aortic side branches, including 86.3% of the inferior mesenteric arteries, 80.3% of lumbar arteries, and 55.6% of other branches without severe adverse events. Late type II endoleak incidence at 6 months was 8.9% (8/90; 95% confidence interval: 3.9-16.8%). Aneurysm sac shrinkage > 5 mm was observed in 41.1% (37/90) and 55.3% (47/85) of the patients at 6- and 12-months post-EVAR, respectively. Patients with late type II endoleak had less aneurysm sac shrinkage than those without type II endoleak at 12 months (-0.2 mm vs. -6.0 mm; P = 0.040). No patients required re-intervention for type II endoleak, and no aneurysm-related mortalities occurred. CONCLUSION: P-TAE is safe and effective in preventing type II endoleak, leading to early sac shrinkage at 12 months following EVAR.

8.
Circulation ; 126(11 Suppl 1): S97-S101, 2012 Sep 11.
Article in English | MEDLINE | ID: mdl-22966000

ABSTRACT

BACKGROUND: Cardiac tamponade is associated with fatal outcomes for patients with acute type A aortic dissection, and the presence of cardiac tamponade should prompt urgent aortic repair. However, treatment of the patient with critical cardiac tamponade who cannot survive until surgery remains unclear. We analyzed our experience of controlled pericardial drainage (CPD) managing critical cardiac tamponade. METHODS AND RESULTS: Between September 2003 and May 2011, 175 patients with acute type A aortic dissection were treated surgically, including 43 (24.6%) who presented with cardiac tamponade on arrival. Eighteen patients, who did not respond to intravenous volume resuscitation, underwent CPD in the emergency department. An 8F pigtail drainage catheter was inserted percutaneously, and drainage volume was controlled by means of several cycles of intermittent drainage to maintain blood pressure at ≈90 mm Hg. After CPD, all of the patients were transferred to the operating room, and immediate aortic repair was performed. Systolic blood pressure before CPD was 64.3 ± 8.2 mm Hg and elevated significantly in all of the cases after CPD. Systolic blood pressure after CPD was 94.8 ± 10.5 mm Hg, and increase in systolic pressure was 30.5 ± 11.7 mm Hg. Total volume of aspirated pericardial effusion was 40.1 ± 30.6 mL, and 10 patients required only ≤30-mL aspiration volume. All of the patients underwent aortic repair successfully. In-hospital mortality was 16.7%; however, there was no complications or mortality related to CPD. CONCLUSIONS: Preoperative pericardial drainage with control of volume is a safe and effective procedure for acute type A aortic dissection complicated by critical cardiac tamponade. In our patient population, timely controlled pericardial drainage is warranted.


Subject(s)
Aortic Aneurysm/complications , Aortic Dissection/complications , Cardiac Tamponade/surgery , Pericardiocentesis/methods , Acute Disease , Aged , Aged, 80 and over , Aortic Dissection/classification , Aortic Dissection/surgery , Aortic Aneurysm/classification , Aortic Aneurysm/surgery , Aortic Rupture/etiology , Aortic Rupture/mortality , Blood Vessel Prosthesis Implantation , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/etiology , Catheters , Emergencies , Female , Humans , Hypertension/complications , Male , Middle Aged , Multiple Organ Failure/etiology , Multiple Organ Failure/mortality , Organ Size , Pericardiocentesis/instrumentation , Pneumonia/mortality , Postoperative Complications/etiology , Postoperative Complications/mortality , Treatment Outcome , Ultrasonography
9.
Kyobu Geka ; 66(6): 501-4, 2013 Jun.
Article in Japanese | MEDLINE | ID: mdl-23917058

ABSTRACT

Papillary muscle rupture associated with acute myocardial infarction (AMI) is well known, but it's incidence is rare. We report a case of mitral valve repair with artificial chordae for partial papillary muscle rupture after AMI. A 75-year-old man underwent percutaneous coronary intervention(PCI) for right coronary artery because of AMI about 2 months ago at another hospital, and suffered from dyspnea 1 week after PCI. He had emergency admission to our hospital for cardiac failure. Echo-cardiogram revealed severe mitral regurgitation due to posterior papillary muscle rupture. We performed mitral valve repair with neochorda implantation to left ventricular wall of papillary muscle rupture site and ring annuloplasty. Mitral regurgitation was well controlled on postoperative echo-cardiogram. He was discharged at 25th postoperative day with no morbidity.


Subject(s)
Heart Rupture, Post-Infarction/surgery , Mitral Valve/surgery , Papillary Muscles/pathology , Aged , Humans , Male , Mitral Valve Insufficiency/etiology
10.
Kyobu Geka ; 66(12): 1096-9, 2013 Nov.
Article in Japanese | MEDLINE | ID: mdl-24322320

ABSTRACT

The operative procedure of extensive aortic aneurysm with ischemic coronary artery disease is controversial. We report a case of arch and descending thoracic aortic aneurysm replacement with coronary artery bypass grafting(CABG)via left thoracotomy. A 70-year-old man followed up by hepatic disease was diagnosed with expanding aortic thoracic aneurysm at the other hospital. He had admission to our hospital for surgical intervention. Computed tomography(CT)revealed arch and descending thoracic aortic aneurysm, and coronary arteriography (CAG) revealed #7 90% and #13 75% stenosis. We performed arch and descending thoracic aortic aneurysm replacement with CABG via left thoracotomy. Replaced synthetic graft and bypass grafts were patent on the postoperative CT. He was discharged at 15th postoperative day with no morbidity.


Subject(s)
Aorta, Thoracic/surgery , Coronary Artery Bypass/methods , Thoracotomy/methods , Aged , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation , Coronary Stenosis/complications , Coronary Stenosis/surgery , Humans , Male
11.
Gan To Kagaku Ryoho ; 40(12): 2158-60, 2013 Nov.
Article in Japanese | MEDLINE | ID: mdl-24394045

ABSTRACT

Recurrent esophagus cancer has an extremely poor prognosis in spite of systemic chemotherapy. Herein, we report cases of long survival after recurrence owing to topical treatment. The first patient was a 75-year-old man. He was diagnosed with clinical stage IIA esophagus cancer and underwent subtotal esophagectomy. The pathological stage was IIIB. Liver metastases appeared in S8 and S5, 8 months after surgery. Systemic chemotherapy and transcatheter arterial chemoembolization were performed. He had kept CR but died due to brain metastasis 1 year and 4 months after the recurrence. The second patient was a 68-year-old man. He underwent esophagectomy for clinical stage IIIB esophagus cancer. The pathological stage was also IIIB. Five metastases were seen in the bilateral lobes of the liver 8 months after surgery. Transcatheter arterial chemoembolization and stereotactic irradiation were performed and he has been in complete remission for a year. Topical treatment may represent an important strategy for treating liver metastasis from esophagus cancer.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Embolization, Therapeutic , Esophageal Neoplasms/drug therapy , Liver Neoplasms/therapy , Aged , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/surgery , Combined Modality Therapy , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Esophagectomy , Humans , Liver Neoplasms/secondary , Male , Neoplasm Staging , Treatment Outcome
12.
R Soc Open Sci ; 10(3): 230039, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36998762

ABSTRACT

Bioluminescence, a phenomenon observed widely in organisms ranging from bacteria to metazoans, has a significant impact on the behaviour and ecology of organisms. Among bioluminescent organisms, Polycirrus, which has unique emission wavelengths, has received attention, and advanced studies such as RNA-Seq have been conducted, but they are limited to a few cases. In addition, accurate species identification is difficult due to lack of taxonomic organization. In this study, we conducted comprehensive taxonomic survey of Japanese Polycirrus based on multiple specimens from different locations and described as three new species: Polycirrus onibi sp. nov., P. ikeguchii sp. nov. and P. aoandon sp. nov. The three species can be distinguished from the known species based on the following characters: (i) arrangement of mid-ventral groove, (ii) arrangement of notochaetigerous segments, (iii) type of neurochaetae uncini, and (iv) arrangement of nephridial papillae. By linking the bioluminescence phenomenon with taxonomic knowledge, we established a foundation for future bioluminescent research development. We also provide a brief phylogenetic tree based on cytochrome c oxidase subunit I (COI) sequences to discuss the evolution of bioluminescence and the direction of future research.

13.
Circulation ; 124(11 Suppl): S163-7, 2011 Sep 13.
Article in English | MEDLINE | ID: mdl-21911807

ABSTRACT

BACKGROUND: Management of acute type A aortic dissection (AADA) complicated by coma remains controversial. We analyzed our experience in managing AADA complicated by coma to determine the relationship of duration of preoperative coma to postoperative neurological recovery. METHODS AND RESULTS: Between September 2003 and October 2010, 181 patients with AADA were treated, including 27 presenting with coma (Glasgow Coma Scale <11) on arrival. Twenty-one patients were repaired immediately (immediate group); time from onset of symptoms to operating room was <5 hours. For brain protection, deep hypothermia with antegrade cerebral perfusion was used, and postoperative therapeutic hypothermia with magnesium treatment was performed. Six patients initially were managed medically, and 3 of them were followed by eventual repair because time from onset was >5 hours (delayed group). The preoperative National Institutes of Health Stroke Scale score was 31.4 ± 6.6 in the immediate group and 28.3 ± 9.5 in the delayed group. Hospital mortality was 14% in the immediate group and 67% in the delayed group. Full recovery of consciousness was achieved in 86% of patients in the immediate group and in 17% in the delayed group. In immediate group, the postoperative National Institutes of Health Stroke Scale score significantly improved to 6.4 ± 8.4, cumulative survival rate was 71.8% in 3 years, and independence in daily activities was achieved in 52% (11/21). CONCLUSIONS: Aortic repair, if performed immediately from the onset of symptoms, showed satisfactory recovery of consciousness and neurological function in patients with AADA complicated by coma. In this patient population, immediate aortic repair is warranted.


Subject(s)
Aortic Aneurysm/complications , Aortic Aneurysm/surgery , Aortic Dissection/complications , Aortic Dissection/surgery , Cognition/physiology , Coma/etiology , Vascular Surgical Procedures/methods , Adult , Aged , Aged, 80 and over , Aortic Dissection/mortality , Aorta/surgery , Aortic Aneurysm/mortality , Consciousness/physiology , Female , Glasgow Coma Scale , Humans , Male , Middle Aged , Postoperative Period , Retrospective Studies , Survival Rate , Time Factors , Treatment Outcome
14.
Asian Cardiovasc Thorac Ann ; : 2184923211017096, 2021 May 11.
Article in English | MEDLINE | ID: mdl-33975466

ABSTRACT

For atrial septal defect closure via right minithoracotomy in an adult patient with infra-hepatic interruption of the inferior vena cava with azygos connection, an alternative venous cannulation strategy was applied. In addition to bicaval cannulations to the femoral vein and the internal jugular vein, a 20 Fr straight cannula draining the hepatic vein was added to the proximal IVC through the right atrium wall via a working port. A bloodless operative field in the right atrium was afforded with bicaval encircling. Preoperative imaging test of the continuity of the IVC was important planning cardiac surgery with peripheral cannulations.

15.
Sci Rep ; 11(1): 19097, 2021 09 27.
Article in English | MEDLINE | ID: mdl-34580316

ABSTRACT

Terebellidae worms have large numbers of tentacles responsible for various biological functions. Some Terebellidae worms whose tentacles emit light are found around the world, including exceptional violet-light-emitting Polycirrus spp. found in Europe and North America. However, there is no video-recorded observation of the luminous behavior of such unique species in nature, and the genetic information related to their ecology are lacking. Here, for the first time, we video-recorded the violet-light-emitting behavior of an undescribed Japanese worm in its natural habitat. The worm was designated as Polycirrus sp. ISK based on morphological observations, and the luminescence spectrum showed a peak at 444 nm, which is an exceptionally short wavelength for bioluminescence in a shallow coastal water environment. An analysis of differentially expressing genes based on separate RNA-Seq analysis for the tentacles and the rest of body revealed the specific expression of genes that are probably involved in innate immunity in the tentacles exposed to predators. We also found a Renilla luciferase homologous gene, but coelenterazine was not detected in the worm extract by analyses using a liquid chromatography and a recombinant Renilla luciferase. These results will promote an understanding of the ecology and luminescence mechanisms of luminous Polycirrus spp.

16.
Gen Thorac Cardiovasc Surg ; 67(2): 263-265, 2019 Feb.
Article in English | MEDLINE | ID: mdl-29455309

ABSTRACT

We report a rare case of right heart failure caused by distal aortic aneurysm. Although aortopulmonary fistula is a common complication of giant aortic arch aneurysm, right heart failure caused by mechanical pressure by aneurysm is very rare. A 79-year-old female patient presented dyspnea. Contrast computed tomography (CT) of the thorax delineated a 78 mm aortic arch aneurysm pressing the main to left pulmonary artery and a 40 mm pericardial effusion at maximum depth at posterior side. Echocardiography showed the acceleration flow from main to left pulmonary artery and moderate pulmonary hypertension. Left ventricular function, however, was preserved. We diagnosed right heart failure caused by giant aortic arch aneurysm and performed emergency aortic arch aneurysm replacement. After the operation, pulmonary artery pressure decreased and right heart failure improved.


Subject(s)
Aortic Aneurysm, Thoracic/complications , Heart Failure/etiology , Pulmonary Artery/physiopathology , Aged , Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/physiopathology , Aortic Aneurysm, Thoracic/surgery , Aortic Rupture/surgery , Dyspnea/diagnosis , Echocardiography , Female , Heart Failure/diagnostic imaging , Humans , Pericardial Effusion/etiology , Tomography, X-Ray Computed , Vascular Surgical Procedures
17.
Anticancer Res ; 36(8): 4299-306, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27466548

ABSTRACT

BACKGROUND: Regorafenib and TAS-102 are novel antitumor agents for patients with metastatic colorectal cancer (mCRC) whose disease has progressed after standard therapies. In randomized trials, regorafenib and TAS-102 prolonged survival in patients with mCRC. However, the appropriate selection of regorafenib or TAS-102 in treatment strategy has not yet been established. PATIENTS AND METHODS: We performed a retrospective analysis, between March 2013 and July 2015, on the efficacy and safety of regorafenib or TAS-102. RESULTS: Thirty-seven patients with mCRC treated with regorafenib or TAS-102 were included. Of these 37 patients, 23 first received regorafenib and 14 received TAS-102. The median progression-free survival and overall survival were 3.0 and 5.8 months, respectively, in the regorafenib group and 2.1 and 6.3 months, respectively, in the TAS-102 group. Drug-related adverse events (AEs) and grade ≥3 AEs were 23 (100%) and 10 (43.5%), respectively, in the regorafenib group and 13 (92.9%) and 2 (14.3%), respectively, in the TAS-102 group. The most frequent grade ≥3 AEs were hepatotoxicity (17.4%) and hand-foot syndrome (13.0%) in the regorafenib group, and neutropenia (14.3%) in the TAS-102 group. In subgroup analysis, the median overall survival was 11.5 months in patients receiving crossover treatment with regorafenib to TAS-102, and 7.6 months in those receiving crossover treatment with TAS-102 to regorafenib. CONCLUSION: Our results showed that regorafenib and TAS-102 have comparable efficacy but different toxicity profiles in patients with mCRC. Both are considered new salvage treatment options. Differences in the toxicity profiles between the two treatments will help in choosing regorafenib or TAS-102.


Subject(s)
Colorectal Neoplasms/drug therapy , Drug-Related Side Effects and Adverse Reactions/pathology , Phenylurea Compounds/administration & dosage , Pyridines/administration & dosage , Trifluridine/administration & dosage , Uracil/analogs & derivatives , Adult , Aged , Aged, 80 and over , Colorectal Neoplasms/pathology , Disease-Free Survival , Drug Combinations , Female , Humans , Male , Middle Aged , Neoplasm Metastasis , Phenylurea Compounds/adverse effects , Pyridines/adverse effects , Pyrrolidines , Randomized Controlled Trials as Topic , Thymine , Treatment Outcome , Trifluridine/adverse effects , Uracil/administration & dosage , Uracil/adverse effects
18.
Int J Oncol ; 27(1): 69-76, 2005 Jul.
Article in English | MEDLINE | ID: mdl-15942645

ABSTRACT

The cyclin-dependent kinase inhibitor p21cip1/waf1 negatively regulates the progression of cell cycle and the potential usefulness of p21cip1/waf1 gene is proposed in gene therapy. However, studies have demonstrated a protective role of p21cip1/waf1 against apoptosis and little is known about effects of ectopic expression of p21cip1/waf1 on differentiation of colon cancer cells. In the present study, we found diffuse p21cip1/waf1 expression in only a few clinical samples of colorectal cancer with wild-type p53 gene. To explore the role of p21cip1/waf1 in cell growth, apoptosis and differentiation, we constitutively overexpressed p21cip1/waf1 in HT29 colon carcinoma cells. Ectopic overexpression of p21cip1/waf1 was associated with inhibition of CDK2-associated kinase activity, indicating the functionality of the introduced p21cip1/waf1 gene. Overexpression of p21cip1/waf1 caused an appreciable growth inhibition in monolayer and soft agar cultures and it significantly reduced sodium butyrate- but not 5-fluorouracil-induced apoptosis. p21cip1/waf1 overexpressing cells exhibited marked decrease of intestinal differentiation when assayed with intestinal alkaline phosphatase. Our findings suggest that introduction of p21cip1/waf1 gene into colon cancer cells may be useful for inhibiting cell growth but caution should be taken regarding the increased resistance to certain apoptosis-inducing agents and dysregulation of endogenous p21cip1/waf1-mediated differentiation process.


Subject(s)
Apoptosis , Carcinoma/pathology , Cell Cycle Proteins/metabolism , Colonic Neoplasms/pathology , Gene Expression Regulation, Neoplastic , Agar/chemistry , Alkaline Phosphatase/metabolism , Blotting, Western , Butyrates/pharmacology , Carcinoma/metabolism , Cell Differentiation , Cell Line, Tumor , Cell Proliferation , Colonic Neoplasms/metabolism , Cyclin-Dependent Kinase Inhibitor p21 , DNA Mutational Analysis , Flow Cytometry , Fluorouracil/pharmacology , Humans , Inhibitory Concentration 50 , Isobutyrates , Mutation , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , Time Factors , Tumor Suppressor Protein p53/metabolism
19.
Gan To Kagaku Ryoho ; 30(11): 1791-3, 2003 Oct.
Article in Japanese | MEDLINE | ID: mdl-14619521

ABSTRACT

The immunocompetence and nutritional state of patients with advanced or recurrent gastric cancer is low, making it important to conduct chemotherapy while at the same time improving or maintaining their immunocompetence and nutritional state. To reduce the side effects but not the antitumor effect of TS-1, a 2-week regime of TS-1, and 1-week drug-free interval, in combination with the immunotherapeutic agent lentinan (LNT) was started in 5 patients with advanced or recurrent gastric cancer. Toxicity, efficacy, immunocompetence and nutritional state were investigated preliminarily to examine whether or not usefulness of lentinan could be evaluated. The IAP tended to decrease. TS-1 and lentinan combination immunochemotherapy was able to be carried out safely in patients with advanced recurrent gastric cancer. In order to examine the usefulness of combined LNT, it is thought to be necessary to perform a randomized trial using toxicity and not only efficacy but QOL and immunological and nutritional parameters as indicators.


Subject(s)
Adjuvants, Immunologic/administration & dosage , Antimetabolites, Antineoplastic/administration & dosage , Lentinan/administration & dosage , Neoplasm Recurrence, Local/drug therapy , Oxonic Acid/administration & dosage , Pyridines/administration & dosage , Stomach Neoplasms/drug therapy , Tegafur/administration & dosage , Adult , Aged , Drug Administration Schedule , Drug Combinations , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/immunology , Stomach Neoplasms/immunology
20.
Gan To Kagaku Ryoho ; 30(8): 1125-30, 2003 Aug.
Article in Japanese | MEDLINE | ID: mdl-12938267

ABSTRACT

The quality of life (QOL) of patients with advanced or recurrent gastric cancer is poor and their immunocompetence is low, making it important to conduct chemotherapy while at the same time improving their QOL and maintaining their immunocompetence. To improve QOL and increase compliance by reducing the side effects but not the antitumor effect of TS-1, a 2-week regime with 2-week administration of TS-1, and a 1-week drug-free interval in combination with the immunotherapeutic agent lentinan (LNT) was started in 5 patients with advanced or recurrent gastric cancer. Toxicity, efficacy, QOL, and immunological parameters were investigated preliminarily to examine whether or not usefulness of lentinan could be evaluated. QOL scores for appetite, nausea/vomiting, and abdominal pain/diarrhea showed improvement, although not in statistically significant values. The Th2 (CD4-positive, IL4-positive T cells) response in peripheral blood decreased significantly. TS-1 and lentinan combination immunotherapy was carried out safely with advanced recurrent gastric cancer. In order to examine the usefulness of LNT combined use, it was thought that a randomised trial using toxicity with not only efficacy but QOL and immunological parameters as indicators would be beneficial.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lentinan/administration & dosage , Silicates/administration & dosage , Stomach Neoplasms/drug therapy , Titanium/administration & dosage , Adult , Aged , Drug Administration Schedule , Female , Humans , Immunocompetence/drug effects , Male , Middle Aged , Neoplasm Recurrence, Local , Quality of Life
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