273 results match your criteria: "Itami City Hospital.[Affiliation]"

Objective: FREEDOM (Study 342; NCT03201900) assessed the long-term treatment effect of perampanel monotherapy in adolescent and adult patients (12-74 years of age) with untreated focal-onset seizures (FOS), with or without focal to bilateral tonic-clonic seizures (FBTCS).

Methods: In the Core Study, after a 4-week Pretreatment Phase, perampanel was up-titrated to 4 mg/day during a 6-week Titration Period followed by a 26-week Maintenance Period. Patients experiencing seizure(s) during the 4-mg/day Maintenance Period could have perampanel up-titrated to 8 mg/day over 4 weeks then could enter the 26-week 8-mg/day Maintenance Period.

View Article and Find Full Text PDF

There is insufficient evidence comparing the outcomes of tacrolimus-based remission induction therapy with infliximab in refractory ulcerative colitis (UC) and evidence regarding optimal strategies after tacrolimus-based remission induction therapy. We conducted a multi-institutional retrospective study of patients with UC treated with tacrolimus or infliximab between January 2010 and March 2019. The proportion of clinical remission at week 8 and cumulative colectomy-free rate were examined using propensity score matching analysis.

View Article and Find Full Text PDF

Background: We aimed to assess the outcomes of reduced port surgery using "marionette technique" in patients with primary spontaneous pneumothorax (PSP) compared to conventional three-port video-assisted thoracoscopic surgery( VATS).

Methods: Ninety patients were enrolled in this study from August 2015 to July 2021. The marionette technique was performed as follow.

View Article and Find Full Text PDF

Serum leucine-rich alpha-2 glycoprotein (LRG) can monitor disease activities during biologics treatment in patients with inflammatory bowel disease (IBD). It is unclear whether the pretreatment serum LRG level can predict clinical effectiveness including serum trough levels of ustekinumab in patients with IBD. This multicenter prospective cohort study included 184 patients (Crohn's disease, 104; ulcerative colitis, 80) who received ustekinumab (n = 119) or anti-tumor necrosis factor (n = 65) between January 2019 and March 2023.

View Article and Find Full Text PDF

The therapeutic effects of oral anticoagulant drugs for nonvalvular atrial fibrillation (NVAF) suggest that the three factor Xa (FXa) inhibitors may have distinct safety profiles, though this is not yet fully conclusive. This study investigated the current dosing of rivaroxaban, apixaban, and edoxaban by monitoring drug plasma concentration (PC) and coagulation activity from the viewpoint of the safety. This multicenter clinical study monitored the drug PC and two coagulation biomarkers (fibrinogen and fibrin monomer complex [FMC]) at peak and trough timing in 268 outpatients taking rivaroxaban (n = 72), apixaban (n = 71), and edoxaban (n = 125) for NVAF.

View Article and Find Full Text PDF

Aims: Whether rotation of a diverting loop ileostomy during rectal cancer surgery, for reducing the catastrophic effect of an anastomotic leakage, affects the incidence of small-bowel obstruction has not been fully investigated. The purpose of this study is to explore whether technical maneuvers in diverting loop ileostomy creation, including its rotation, are associated with increased incidence of small-bowel obstruction in rectal tumor surgery.

Methods: This multicenter prospective study was conducted by the Clinical Study Group of Osaka University, which comprises 24 major institutions.

View Article and Find Full Text PDF

Wilms' tumor protein 1 (WT1)-targeted immunotherapy has been used in patients with leukemia and solid tumors. However, the spontaneous WT1-specific immune response before WT1 peptide vaccination in patients with WT1-expressing tumors (PTs) remains unclear. Therefore, we investigated whether WT1-specific cytotoxic CD8 T-lymphocytes (CTLs) are clonally expanded in the peripheral blood outside of tumor sites.

View Article and Find Full Text PDF

Introduction: HER2 mutations are reported to occur in 2%-5% of all cases of non-small cell lung cancer (NSCLC). The clinical outcomes in patients with HER2-mutant NSCLC treated with immune checkpoint inhibitors (ICIs) plus platinum-based chemotherapy as 1st line treatment still remain unclear.

Methods: Using the large-scale clinico-genomic database of LC-SCRUM-Asia, the clinico-genomic characteristics and therapeutic outcomes of patients with HER2-mutant NSCLC were investigated.

View Article and Find Full Text PDF
Article Synopsis
  • SCLC has traditionally been viewed as a single entity, hindering advances in treatment; however, identifying genetic differences is key to improving patient outcomes.
  • A study analyzed over 1000 SCLC samples using genomic screening to identify five distinct genetic subgroups, which can respond differently to therapies, especially targeted treatments.
  • The findings indicate that while certain subgroups, like the NSCLC and MYC subgroups, have poorer survival rates with standard treatments, others may benefit from specialized therapies, highlighting the importance of personalized medicine in SCLC management.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the safety and efficacy of chemoimmunotherapy in patients with extensive-stage small-cell lung cancer (SCLC) who also had mild interstitial lung disease (ILD).
  • In a trial with 21 patients, a low incidence of pneumonitis was observed, with a severe pneumonitis-free rate of 95.2% and only two patients experiencing pneumonitis during treatment.
  • The findings suggest that chemoimmunotherapy could be a viable treatment option for these patients, with a median overall survival of 10.7 months.
View Article and Find Full Text PDF

Cogan syndrome (CS) is a rare chronic inflammatory disease characterized by ocular and inner ear inflammation. Well-known ocular manifestations include non-syphilitic interstitial keratitis (IK); however, some cases are not associated with IK. Inner ear symptoms include sensorineural hearing loss, rotatory vertigo, and tinnitus, which can become irreversible without timely treatment.

View Article and Find Full Text PDF
Article Synopsis
  • A phase 3 trial evaluated the effectiveness of adding a CTLA-4 inhibitor to standard platinum-based chemotherapy and PD-1/PD-L1 inhibitors for patients with advanced non-small-cell lung cancer, as no prior studies had focused on this combination's survival benefits.
  • Conducted across 48 hospitals in Japan, the trial involved patients aged 20+ with untreated NSCLC, but had to stop recruitment early due to a concerning number of treatment-related deaths in the nivolumab-ipilimumab group.
  • The final results indicated no significant difference in overall survival between those receiving pembrolizumab and those receiving nivolumab-ipilimumab, with median survival rates of 23.7 months and 20.5
View Article and Find Full Text PDF
Article Synopsis
  • Lung cancer treatment has advanced significantly in the last decade, but the cost of drugs has skyrocketed, especially in Japan where data on treatment regimens and costs is limited.
  • A survey of 60 Japanese centers revealed that a substantial number of patients with advanced lung cancer are receiving high-cost treatments, often over 500,000 Japanese yen per month, with a notable preference for immune checkpoint inhibitors (ICI).
  • The study highlights the disparity in treatment costs, showing that these high-priced therapies are widely used despite insufficient evidence for their effectiveness, urging physicians to consider treatment costs more carefully.
View Article and Find Full Text PDF

Background: The optimal subsequent treatment strategy for locally advanced non-small cell lung cancer (LA-NSCLC) after chemoradiotherapy (CRT) and consolidative durvalumab therapy remains unknown. We aimed to determine the optimal subsequent treatment strategy for this clinical population.

Materials And Methods: We retrospectively enrolled 523 consecutive patients with LA-NSCLC treated with CRT and analyzed the treatment outcomes of subsequent therapy after progression following CRT and consolidative durvalumab therapy.

View Article and Find Full Text PDF
Article Synopsis
  • This study analyzed pharmacokinetic (PK) data for atezolizumab, an immunotherapy drug, in Japanese patients with non-small cell lung cancer (NSCLC), focusing on a dosing regimen of 1200 mg every three weeks.
  • Researchers evaluated data from 262 patients, measuring plasma drug levels before the third treatment cycle and examining how these levels correlated with treatment effectiveness and the occurrence of adverse events (AEs).
  • Findings indicated that lower plasma levels of atezolizumab were linked to shorter overall survival, while higher drug concentrations were associated with increased AEs, suggesting the importance of monitoring PK levels for better treatment outcomes.
View Article and Find Full Text PDF

Background: We developed a machine learning (ML) model to predict the risk of lymph node metastasis (LNM) in patients with early gastric cancer (EGC) who did not meet the existing Japanese endoscopic curability criteria and compared its performance with that of the most common clinical risk scoring system, the eCura system.

Methods: We used data from 4,042 consecutive patients with EGC from 21 institutions who underwent endoscopic submucosal dissection (ESD) and/or surgery between 2010 and 2021. All resected EGCs were histologically confirmed not to satisfy the current Japanese endoscopic curability criteria.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the occurrence and impact of second primary malignancies (SPMs) in patients who underwent treatment for superficial esophageal squamous cell carcinoma (ESCC).
  • Out of 187 patients monitored over nearly 8 years, there was a 92.6% 5-year survival rate, but 14 patients died from SPMs, particularly from lung cancer, which had a high mortality rate.
  • The research highlights the need for comprehensive screening methods, including both esophagogastroduodenoscopy (EGD) and computed tomography, especially for patients showing certain risk factors like multiple Lugol-voiding lesions and metachronous ESCC.
View Article and Find Full Text PDF
Article Synopsis
  • Researchers developed an AI endoscopic ultrasonography (EUS) system to accurately assess the invasion depth of early gastric cancer (EGC) using a large dataset of EUS images.
  • The system was trained and validated using images from 11 institutions, demonstrating a strong performance with an area under the curve (AUC) of 0.870 in internal validation and 0.815 in external validation.
  • The AI's diagnostic accuracy was comparable to that of both expert and non-expert human evaluators, indicating its potential for reliable use in clinical settings.
View Article and Find Full Text PDF

Purpose: Post-operative infectious complication (IC) is a well-known negative prognostic factor, while showing neoadjuvant chemotherapy (NAC) may cancel out the negative influence of IC. This analysis compared the clinical impacts of IC according to the presence or absence of NAC in gastric cancer patients enrolled in the phase III clinical trial (JCOG0501) which compared upfront surgery (arm A) and NAC followed by surgery (arm B) in type 4 and large type 3 gastric cancer.

Methods: The subjects were 224 patients who underwent R0 resection out of 316 patients enrolled in JCOG0501.

View Article and Find Full Text PDF

Cancer (including pancreatic cancer) can develop following a infection within one year of tuberculosis infection. However, it is unclear whether tuberculosis infection increases the risk of developing adenosquamous carcinoma of the pancreas (ASCP), an extremely rare cancer with a poorer prognosis than pancreatic ductal adenocarcinoma (PDAC). Herein, we report a case of rapid growing ASCP discovered upon a resection for neck tuberculous lymphadenitis.

View Article and Find Full Text PDF

Background: Cementoblastoma is a rare odontogenic tumor characterized by the formation of osteocementum-like tissue on a tooth root directly by neoplastic cementoblasts. Although it is categorized as benign, it has a high potential for growth with a certain degree of recurrence risk. However, there are only a few studies describing the features of recurrent cementoblastoma.

View Article and Find Full Text PDF

Background And Aim: Perforation is one of the most important complications of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Several studies have examined risk factors for intraoperative and delayed perforations, but most were retrospective analyses with small numbers of patients.

Methods: This study represents a secondary analysis of a Japanese multicenter prospective cohort study.

View Article and Find Full Text PDF
Article Synopsis
  • Immune-related adverse events (irAEs) can influence the effectiveness of PD-L1 inhibitors in treating metastatic non-small cell lung cancer (NSCLC), but their impact on nonmetastatic NSCLC outcomes was previously unclear.
  • This study evaluated the relationship between irAEs and progression-free survival (PFS) in Stage III NSCLC patients undergoing treatment with the PACIFIC regimen, analyzing both mild and nonmild irAEs through robust statistical methods.
  • Findings indicated that patients with nonmild irAEs experienced poorer PFS compared to those with mild irAEs or none at all, suggesting that mild irAEs could indicate better survival outcomes while more severe reactions treated with steroids are linked to worse outcomes.
View Article and Find Full Text PDF

Objectives: The high rate of delayed bleeding after colorectal endoscopic submucosal dissection (ESD) in patients undergoing anticoagulant therapy remains a problem. Whether prophylactic clip closure reduces the rate of delayed bleeding in these patients is unclear. This study aimed to evaluate the efficacy of prophylactic clip closure in patients receiving anticoagulants.

View Article and Find Full Text PDF
Article Synopsis
  • A study was conducted to evaluate the effectiveness of endoscopic resection (ER) for elderly patients (≥75 years) with early gastric cancer (EGC), as previous evidence was limited.
  • The analysis involved 3,371 patients with 3,821 EGCs, highlighting key outcomes such as high rates of successful resections and low rates of complications, particularly for lesions within the established treatment guidelines.
  • The findings suggest that lesions of ≤3 cm and those classified as elderly-low have the potential to be new indicators for ER suitability, demonstrating favorable curative outcomes for elderly patients.
View Article and Find Full Text PDF