1
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Sawano T, Takita M, Senoo Y, Nishikawa Y, Crump A, Tsubokura M. The responsibility of the Japanese media, the Fukushima accident and the use of personal data for research. QJM 2023; 116:625-627. [PMID: 31350887 PMCID: PMC10497179 DOI: 10.1093/qjmed/hcz193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Sawano
- From the Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima
| | - M Takita
- Department of Internal Medicine, Navitas Clinic, Shinjuku-ku, Tokyo
| | - Y Senoo
- Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Y Nishikawa
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - A Crump
- Kitasato University, Shirokane, Minato-Ku, Tokyo
| | - M Tsubokura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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Sawano T, Takita M, Senoo Y, Nishikawa Y, Crump A, Tsubokura M. Response to commentary by Kageura et al. QJM 2022; 114:903. [PMID: 33904570 DOI: 10.1093/qjmed/hcab082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Sawano
- From the Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1247, Japan
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima 972-8322, Japan
| | - M Takita
- Department of Internal Medicine, Navitas Clinic, Tachikawa, Tokyo 190-0023, Japan
| | - Y Senoo
- Comenius University, Bratislava 814 99, Slovakia
| | - Y Nishikawa
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima 976-0016, Japan
| | - A Crump
- Kitasato University, Minato-Ku, Tokyo 108-8641, Japan
| | - M Tsubokura
- From the Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1247, Japan
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Sawano T, Ito N, Ozaki A, Nishikawa Y, Nonaka S, Kobashi Y, Higuchi A, Tsubokura M. Evacuation of residents in a natural disaster during the COVID-19 era. QJM 2021; 114:445-446. [PMID: 33647970 PMCID: PMC7989190 DOI: 10.1093/qjmed/hcab044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- T Sawano
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, 57 Banchi, Jyobankamiyunaga-Yamachi, Iwaki, Fukushima 972-8322, Japan
- Address correspondence to Dr T. Sawano, Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima 975-0033, Japan.
| | - N Ito
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
| | - A Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, 57 Banchi, Jyobankamiyunaga-Yamachi, Iwaki, Fukushima 972-8322, Japan
| | - Y Nishikawa
- Department of Internal Medicine, Soma Central Hospital, 5-18, 3 Choume, Okinouchi, Soma, Fukushima 976-0016, Japan
| | - S Nonaka
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
| | - Y Kobashi
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
| | - A Higuchi
- Medical Governance Research Institute, 12-13, 2 Choume, Takanawa, Minato-ku, Tokyo 108-0074, Japan
| | - M Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
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Nishikawa Y, Suzuki C, Takahashi Y, Sawano T, Kinoshita H, Clero E, Laurier D, Phan G, Nakayama T, Tsubokura M. No significant association between stable iodine intake and thyroid dysfunction in children after the Fukushima Nuclear Disaster: an observational study. J Endocrinol Invest 2021; 44:1491-1500. [PMID: 33206361 PMCID: PMC8195967 DOI: 10.1007/s40618-020-01454-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/16/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Stable iodine prophylaxis helps prevent childhood thyroid cancer in nuclear emergencies; however, there is limited information on its effect on thyroid function. This study aimed to examine thyroid function and autoimmunity among children and adolescents that took stable iodine after the Fukushima Nuclear Disaster. METHODS For this observational study, data were obtained from children and adolescents that underwent thyroid cancer screening at Hirata Central Hospital from April 2012 to March 2018. Participant characteristics, including possible hypothyroidism and hyperthyroidism, were compared between the prophylaxis and no-prophylaxis groups. Multivariable logistic regression models were used to assess for possible hypothyroidism, autoantibodies positive, and hyperthyroidism. RESULTS A total of 1,225 participants with stable iodine prophylaxis and 3,946 without prophylaxis were enrolled. Of those participants, blood samples were available for 144 and 1,201 participants in the prophylaxis and no-prophylaxis groups, respectively. There were 17 (11.8%) and 146 cases (12.2%) of possible hypothyroidism or autoantibodies positive cases in the prophylaxis and no-prophylaxis groups, respectively, and there were no cases and 3 cases (0.2%) of possible hyperthyroidism in those two groups, respectively. Multivariable analysis for possible hypothyroidism revealed no association between stable iodine intake and possible hypothyroidism or autoantibodies positive [odds ratio 0.716 (95% confidence interval 0.399-1.284)] (p = 0.262). We did not perform multivariable analysis for hyperthyroidism due to the limited number of cases. CONCLUSION Significant adverse effects of stable iodine intake on thyroid function were not observed among children and adolescents 7 years after the Fukushima Nuclear Disaster.
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Affiliation(s)
- Y Nishikawa
- Department of Internal Medicine, Hirata Central Hospital, 4, Shimizu-uchi, Kami-Yomogida, Hirata-mura, Ishikawa-gun, Fukushima, 963-8202, Japan.
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - C Suzuki
- Department of Thyroid Surgery, Hirata Central Hospital, Shimizu-uchi, Kami-Yomogida, Hirata-mura, Ishikawa-gun, Fukushima, 963-8202, Japan
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Y Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - T Sawano
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1, Hikariga-oka, Fukushima City, 960-1295, Japan
| | - H Kinoshita
- The Institute for Humanistic Studies, Kamakura Women's University, 6-1-3, Ofuna, Kamakura, 247-0056, Japan
| | - E Clero
- Health and Environment Division, Institute for Radiological Protection and Nuclear Safety, 92262, Fontenay-aux-Roses, France
| | - D Laurier
- Health and Environment Division, Institute for Radiological Protection and Nuclear Safety, 92262, Fontenay-aux-Roses, France
| | - G Phan
- Health and Environment Division, Institute for Radiological Protection and Nuclear Safety, 92262, Fontenay-aux-Roses, France
| | - T Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - M Tsubokura
- Department of Internal Medicine, Hirata Central Hospital, 4, Shimizu-uchi, Kami-Yomogida, Hirata-mura, Ishikawa-gun, Fukushima, 963-8202, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1, Hikariga-oka, Fukushima City, 960-1295, Japan
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Sawano T, Kotera Y, Ozaki A, Murayama A, Tanimoto T, Sah R, Wang J. Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan. QJM 2020; 113:551-555. [PMID: 32573730 PMCID: PMC7454847 DOI: 10.1093/qjmed/hcaa209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Under the unique Japanese policy to restrict reverse transcriptase-polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors. AIM Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for coronavirus disease 2019 (COVID-19). DESIGN Cross-sectional study using regression and correlation analysis. METHODS We retrieved domestic laboratory-confirmed cases, deaths and the number of RT-PCR testing for COVID-19 from 15 January to 6 April 2020 in 47 prefectures in Japan, using publicly available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis. RESULTS The median prefectural-level incidence and number of RT-PCR testing per 100 000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (P < 0.001) and the number of RT-PCR testing (P = 0.03); and those for RT-PCR testing were the incidence (P = 0.025), available beds (P = 0.045) and cluster infections (P = 0.034). CONCLUSION Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic.
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Affiliation(s)
- T Sawano
- Department of Surgery, Sendai City Medical Center, Sendai, Miyagi, 983-0024, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1247, Japan
| | - Y Kotera
- Human Sciences Research Centre, University of Derby, Derby, DE22 1GB, UK
| | - A Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, 972-8322, Japan
- Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan
| | - A Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan
- Tohoku University School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - T Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan
| | - R Sah
- National Public Health Laboratory, Kathmandu 44600, Nepal
| | - J Wang
- School of Public Health, Fudan University, Shanghai, 200032, China
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Saito H, Tani Y, Ozaki A, Sawano T, Shimada Y, Yamamoto K, Tanimoto T. Financial ties between authors of the clinical practice guidelines and pharmaceutical companies: an example from Japan. Clin Microbiol Infect 2019; 25:1304-1306. [PMID: 31401175 DOI: 10.1016/j.cmi.2019.07.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/20/2019] [Accepted: 07/25/2019] [Indexed: 10/26/2022]
Affiliation(s)
- H Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
| | - Y Tani
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - A Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan; Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - T Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Y Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - K Yamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - T Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
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7
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Sawano T, Ozaki A, Hori A, Tsubokura M. Combating 'fake news' and social stigma after the Fukushima Daiichi Nuclear Power Plant incident-the importance of accurate longitudinal clinical data. QJM 2019; 112:479-481. [PMID: 30778551 DOI: 10.1093/qjmed/hcz049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - A Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - A Hori
- Hori Mental Clinic, Minamisoma, Fukushima, Japan
- Department of Disaster and Comprehensive Medicine, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - M Tsubokura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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8
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Ozaki A, Shimada Y, Yamamoto K, Hori A, Sawano T, Morita T, Leppold C, Tanimoto T, Tsubokura M. Death of the sole doctor at Takano Hospital 6 years after the Fukushima nuclear crisis-who is responsible for health care delivery in the Fukushima disaster zone? QJM 2018; 111:79-81. [PMID: 28339717 DOI: 10.1093/qjmed/hcx050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, Fukushima 975-0033
| | - Y Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima 975-0033
| | - K Yamamoto
- Department of Obstetrics and Gynecology, Minamisoma Municipal General Hospital, Fukushima 975-0033
| | - A Hori
- Hori Mental Clinic, Fukushima 979-2335
| | - T Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Fukushima 975-0033
| | - T Morita
- Department of Internal Medicine, Soma Central Hospital, Fukushima 976-0016, Japan
| | - C Leppold
- Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK
| | - T Tanimoto
- Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Fukushima 972-8322, Japan
| | - M Tsubokura
- Department of Internal Medicine, Soma Central Hospital, Fukushima 976-0016, Japan
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Takemura T, Takada A, Kishimoto T, Komura S, Kubo H, Matsuoka Y, Miuchi K, Miyamoto S, Mizumoto T, Mizumura Y, Motomura T, Nakamasu Y, Nakamura K, Oda M, Ohta K, Parker JD, Sawano T, Sonoda S, Tanimori T, Tomono D, Yoshikawa K. Development of the micro pixel chamber based on MEMS technology. EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201817402010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Micro pixel chambers (μ-PIC) are gaseous two-dimensional imaging detectors originally manufactured using printed circuit board (PCB) technology. They are used in MeV gamma-ray astronomy, medicalimaging, neutron imaging, the search for dark matter, and dose monitoring. The position resolution of the present μ-PIC is approximately 120 μm (RMS), however some applications require a fine position resolution of less than 100 μm. To this end, we have started to develop a μ-PIC based on micro electro mechanical system (MEMS) technology, which provides better manufacturing accuracy than PCB technology. Our simulation predicted the gains of MEMS μ-PICs to be twice those of PCB μ-PICs at the same anode voltage. We manufactured two MEMS μ-PICs and tested them to study their behavior. In these experiments, we successfully operated the fabricatedMEMS μ-PICs and we achieved a maximum gain of approximately 7×103 and collected their energy spectra under irradiation of X-rays from 55Fe. However, the measured gains of the MEMS μ-PICs were less than half of the values predicted in the simulations. We postulated that the gains of the MEMS μ-PICs are diminished by the effect of the silicon used as a semiconducting substrate.
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Ozaki A, Morita T, Nishikawa Y, Leppold C, Sawano T, Shimada Y. Tsunami in 2011 to the earthquake in 2016 in Fukushima-are we better prepared? QJM 2017; 110:543-544. [PMID: 28339600 DOI: 10.1093/qjmed/hcx031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, Fukushima 975-0033
| | - T Morita
- Department of Internal Medicine, Soma Central Hospital, Fukushima 976-0016, Japan
| | - Y Nishikawa
- Department of Internal Medicine, Soma Central Hospital, Fukushima 976-0016, Japan
| | - C Leppold
- Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK
| | - T Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Fukushima 975-0033
| | - Y Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima 975-0033, Japan
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11
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Affiliation(s)
| | - A Ozaki
- From the Department of Surgery
| | - Y Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan
| | - C Leppold
- Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK
| | - M Tsubokura
- Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033
| | | | - M Kami
- Medical Governance Research Institute, Minato-ku, Tokyo 108-0074, Japan
| | - H Ohira
- From the Department of Surgery
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12
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Ozaki A, Leppold C, Tsubokura M, Sawano T, Tsukada M, Ohira H. Abstract P3-10-14: Breast cancer provider delay after the 2011 triple disaster in Fukushima, Japan. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-10-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Timely diagnosis and treatment is an indispensable part of breast cancer management. Delay of this process, also known as provider delay, can result in a deteriorated prognosis of affected patients. Although it has been suggested that disasters can impact cancer care and extend provider delay, there is little information available on long-term trends of breast cancer provider delay in post-disaster settings.
So-so district of Fukushima prefecture, Japan, experienced an earthquake, tsunami and the Fukushima Daiichi Nuclear Power Plant Accident in 2011. So-so district has areas falling within the mandatory, voluntary and non-evacuation ordered zones. Due to a long-term shortage of medical staff and closure of medical institutions post-disaster, patients with breast cancer may have experienced longer provider delay in this area.
Objectives
To compare provider delay of breast cancer patients and elucidate contributing factors to delay pre- and post-disaster, in an area severely affected by Japan's 2011 triple disaster.
Methods
We retrospectively investigated data of newly diagnosed breast cancer patients who undertook first medical consultation at the two main cancer centers in the non-evacuation ordered zone of So-so district from 2005 to 2016. Sociodemographic and clinical information was collected from medical records. The main outcome measure was median (days) from first medical consultation to start of breast cancer-specific treatment, pre- and post-disaster, using Mann-Whitney U test. Multivariate linear regression was then conducted to identify any factors which contributed to extended provider delay before and after the disaster.
Results
A total of 157 pre-disaster patients and 121 post-disaster patients were included in the study. There was no significant difference in the interval of median days of first medical consultation to start of first treatment pre- and post-disaster (40 vs. 39, p=0.82). Although diagnosis was made in a shorter interval post-disaster compared to pre-disaster (11 vs. 14, p=0.01) with significantly smaller median number of biopsies (1 vs. 1, p=0.001), this post-disaster improvement in diagnostic process was offset by deferred start of treatment after diagnosis (26 vs. 22, p=0.008). Among the pre-disaster patients, cancer detection by breast cancer screening program (p<0.001), being engaged in full-time job (p<0.042), and number of biopsies before diagnosis (p=0.005) contributed to longer provider delay in multivariate regression. However, consultation from other medical providers (p=0.03) was the only factor which significantly contributed to extended delay post-disaster, after controlling for multiple variables.
Conclusion
There was no significant increase in provider delay among breast cancer patients post-disaster. However, a median interval of 39 days from first medical consultation to start of treatment is much longer than other high-income countries, and shows much room for improvement in future.Introduction
Timely diagnosis and treatment is an indispensable part of breast cancer management. Delay of this process, also known as provider delay, can result in a deteriorated prognosis of affected patients. Although it has been suggested that disasters can impact cancer care and extend provider delay, there is little information available on long-term trends of breast cancer provider delay in post-disaster settings.
So-so district of Fukushima prefecture, Japan, experienced an earthquake, tsunami and the Fukushima Daiichi Nuclear Power Plant Accident in 2011. So-so district has areas falling within the mandatory, voluntary and non-evacuation ordered zones. Due to a long-term shortage of medical staff and closure of medical institutions post-disaster, patients with breast cancer may have experienced longer provider delay in this area.
Objectives
To compare provider delay of breast cancer patients and elucidate contributing factors to delay pre- and post-disaster, in an area severely affected by Japan's 2011 triple disaster.
Methods
We retrospectively investigated data of newly diagnosed breast cancer patients who undertook first medical consultation at the two main cancer centers in the non-evacuation ordered zone of So-so district from 2005 to 2016. Sociodemographic and clinical information was collected from medical records. The main outcome measure was median (days) from first medical consultation to start of breast cancer-specific treatment, pre- and post-disaster, using Mann-Whitney U test. Multivariate linear regression was then conducted to identify any factors which contributed to extended provider delay before and after the disaster.
Results
A total of 157 pre-disaster patients and 121 post-disaster patients were included in the study. There was no significant difference in the interval of median days of first medical consultation to start of first treatment pre- and post-disaster (40 vs. 39, p=0.82). Although diagnosis was made in a shorter interval post-disaster compared to pre-disaster (11 vs. 14, p=0.01) with significantly smaller median number of biopsies (1 vs. 1, p=0.001), this post-disaster improvement in diagnostic process was offset by deferred start of treatment after diagnosis (26 vs. 22, p=0.008). Among the pre-disaster patients, cancer detection by breast cancer screening program (p<0.001), being engaged in full-time job (p<0.042), and number of biopsies before diagnosis (p=0.005) contributed to longer provider delay in multivariate regression. However, consultation from other medical providers (p=0.03) was the only factor which significantly contributed to extended delay post-disaster, after controlling for multiple variables.
Conclusion
There was no significant increase in provider delay among breast cancer patients post-disaster. However, a median interval of 39 days from first medical consultation to start of treatment is much longer than other high-income countries, and shows much room for improvement in future.
Citation Format: Ozaki A, Leppold C, Tsubokura M, Sawano T, Tsukada M, Ohira H. Breast cancer provider delay after the 2011 triple disaster in Fukushima, Japan [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-10-14.
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Affiliation(s)
- A Ozaki
- Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - C Leppold
- Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - M Tsubokura
- Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - T Sawano
- Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - M Tsukada
- Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - H Ohira
- Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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13
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Affiliation(s)
- A Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - T Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - M Tsukada
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - H Ohira
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - C Leppold
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - T Tanimoto
- Department of Internal Medicine, Jyoban Hospital of Tokiwakai Group, Iwaki, Fukushima, 972-8322, Japan.
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Tanimori T, Kubo H, Takada A, Iwaki S, Komura S, Kurosawa S, Matsuoka Y, Miuchi K, Miyamoto S, Mizumoto T, Mizumura Y, Nakamura K, Nakamura S, Oda M, Parker JD, Sawano T, Sonoda S, Takemura T, Tomono D, Ueno K. AN ELECTRON-TRACKING COMPTON TELESCOPE FOR A SURVEY OF THE DEEP UNIVERSE BY MeV GAMMA-RAYS. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/810/1/28] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Kabuki S, Sonoda S, Hatsukawa Y, Kimura H, Asai M, Hashimoto K, Komura S, Kubo H, Matsuoka Y, Mizumoto T, Nagai Y, Nakamura S, Sato T, Sawano T, Takada A, Toyoshima A, Tsukada K, Kunieda E, Tanimori T. SU-C-144-01: Imaging Study of An Electron-Tracking Compton Camera for Nuclear Medicine. Med Phys 2013. [DOI: 10.1118/1.4813990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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16
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Sawano T, Sawae Y, Murakami T. Effect of dose level ranged from 5Mrad to 100Mrad on the wear behaviour of cross-linked UHMWPE evaluated in the multi-directional pin-on-plate wear test. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)85172-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Kuroda M, Ohta T, Uchiyama I, Baba T, Yuzawa H, Kobayashi I, Cui L, Oguchi A, Aoki K, Nagai Y, Lian J, Ito T, Kanamori M, Matsumaru H, Maruyama A, Murakami H, Hosoyama A, Mizutani-Ui Y, Takahashi NK, Sawano T, Inoue R, Kaito C, Sekimizu K, Hirakawa H, Kuhara S, Goto S, Yabuzaki J, Kanehisa M, Yamashita A, Oshima K, Furuya K, Yoshino C, Shiba T, Hattori M, Ogasawara N, Hayashi H, Hiramatsu K. Whole genome sequencing of meticillin-resistant Staphylococcus aureus. Lancet 2001; 357:1225-40. [PMID: 11418146 DOI: 10.1016/s0140-6736(00)04403-2] [Citation(s) in RCA: 1413] [Impact Index Per Article: 61.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Staphylococcus aureus is one of the major causes of community-acquired and hospital-acquired infections. It produces numerous toxins including superantigens that cause unique disease entities such as toxic-shock syndrome and staphylococcal scarlet fever, and has acquired resistance to practically all antibiotics. Whole genome analysis is a necessary step towards future development of countermeasures against this organism. METHODS Whole genome sequences of two related S aureus strains (N315 and Mu50) were determined by shot-gun random sequencing. N315 is a meticillin-resistant S aureus (MRSA) strain isolated in 1982, and Mu50 is an MRSA strain with vancomycin resistance isolated in 1997. The open reading frames were identified by use of GAMBLER and GLIMMER programs, and annotation of each was done with a BLAST homology search, motif analysis, and protein localisation prediction. FINDINGS The Staphylococcus genome was composed of a complex mixture of genes, many of which seem to have been acquired by lateral gene transfer. Most of the antibiotic resistance genes were carried either by plasmids or by mobile genetic elements including a unique resistance island. Three classes of new pathogenicity islands were identified in the genome: a toxic-shock-syndrome toxin island family, exotoxin islands, and enterotoxin islands. In the latter two pathogenicity islands, clusters of exotoxin and enterotoxin genes were found closely linked with other gene clusters encoding putative pathogenic factors. The analysis also identified 70 candidates for new virulence factors. INTERPRETATION The remarkable ability of S aureus to acquire useful genes from various organisms was revealed through the observation of genome complexity and evidence of lateral gene transfer. Repeated duplication of genes encoding superantigens explains why S aureus is capable of infecting humans of diverse genetic backgrounds, eliciting severe immune reactions. Investigation of many newly identified gene products, including the 70 putative virulence factors, will greatly improve our understanding of the biology of staphylococci and the processes of infectious diseases caused by S aureus.
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Affiliation(s)
- M Kuroda
- Hiramatsu, Department of Bacteriology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
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18
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Sawano T, Kawashima T, Takase Y, Chikamori F, Shibuya S, Fukao K. Hepatic coma recovered after interventional obliteration for ileocecal-inferior vena cava shunt--report of one case. Wiad Lek 1998; 50 Suppl 1 Pt 1:296-7. [PMID: 9383349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We performed interventional angiography (IVA) in a patient with liver cirrhosis (LC) and hepatoma (HCC) who experienced repeated attacks of unconsciousness due to hyperammonemia caused by ileocecal-inferior vena cava (IC-IVC) shunt and succeeded in the treatment. We report the results below. The patient, 53-year-old male, underwent endoscopic injection sclerotherapy for esophageal varix due to LC followed by splenectomy for pancytopenia in 1986. He made good progress. However intraarterial anticancer therapy was conducted for HCC in 1994. From that time hepatic coma began to appear and its frequency gradually increased. Hepatic coma occurred once every 3 weeks from June 1996. He was thus admitted to our hospital. Hematobiochemical testes showed that ammonia level was 297 mcg/dl. Albumin 2.8d/dl, and Total-Bilirubin 10.78 mg/dl. Arterioportography from superior mesenteric artery showed most of portal blood flowed away from the liver though the ileocolic vein to IVC. We decided to conduct IVA for treatment. Specially, a 6Fr balloon catheter was inserted from the right inguinal region into a shunt to the portal vein though IVC by the Seldinger technique. The balloon was inflated in the shunt to close the shunt. Six ml of 5% ethanolamime oleate with iopamidol was injected because retrograde angiography showed that iopamidol was flowed out via testicular vein to IVC. The balloon catheter was retained for 24 hours. Angiography, conducted from the catheter again 24 hours later, showed that the shunt was occluded, blood ammonia level was 71 mcg/dl after occlusion. Hepatic coma was not observed after treatment. We encountered a very rare case who repeated hepatic comas due to IC-IVC shunt and recovered dramatically after IVA.
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Affiliation(s)
- T Sawano
- Department of Surgery, Tsukuba Soai Hospital
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Shibuya S, Takase Y, Chikamori F, Kawashima T, Sawano T. An improved endoscopic variceal ligation for esophageal and solitary gastric varices--three-O-band-shooter. Wiad Lek 1997; 50 Suppl 1 Pt 1:293-295. [PMID: 9383348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We have reported a 16.0 mm long new type of instrument with the inner diameter of inner cylinder of 10.3 mm for endoscopic variceal ligation which could shoot 3 elastic O bands continuously in short period of time without removing the endoscope. The suction volume of new instrument is larger than that of the Stiegmann's ligator. We performed endoscopic variceal ligation (EVL) in 17 cases of the esophageal varix and 8 cases of the solitary gastric varix. EVL was performed as prophylaxis as all the cases. The esophageal varices were eliminated in all the cases after ulcer formation. The procedure was performed one time in 15 cases and two times in the remaining 2 cases. Three patients died one to hepatic failure during the follow-up period between 4 and 16 months. Six and twelve months cumulative recurrence rates were 30% and 48% respectively. On the other hand all the gastric varices disappeared after one sitting of the treatment. There was one variceal recurrence during the follow-up period. Computed tomography and/or arterioportography performed before had showed patent gastro-renal shunt in five cases. No change in the shunt was observed after the treatment. No serious complications due to EVL was encountered in all the cases. Therefore, it is thought that this method can be used for the treatment of not only esophageal varices but also gastric varices.
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Affiliation(s)
- S Shibuya
- Department of Surgery, Tsukuba Memorial Hospital
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Sawano T, Tanaka M, Ohno K, Yoneda M, Ota Y, Terasaki H, Awaya S, Ozawa T. Mitochondrial DNA mutations associated with the 11778 mutation in Leber's disease. Biochem Mol Biol Int 1996; 38:693-700. [PMID: 8728098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
To clarify the characteristics of possible synergestic mitochondrial DNA (mtDNA) mutations associated with Leber's hereditary optic neuropathy (LHON), we analyzed the entire nucleotide sequences of mitochondrial genome of two Japanese patients from independent pedigrees harboring the 11778 mtDNA mutation, and compared their sequences with those of 47 disease and 6 normal controls. We have detected several unique mutations in the mtDNA in addition to the 11778 mutation. Two nucleotide substitutions, an A-to-G transition at position 856 in the 12S rRNA gene and an A-to-G transition at 14692 in the T psi C loop of the tRNA(Glu) gene, occurred at highly conserved sites among various species. These mutations in combination with the 11778 mutation might synergetically contribute to the pathogenesis of LHON.
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Affiliation(s)
- T Sawano
- Department of Ophthalmology, Faculty of Medicine, University of Nagoya, Japan
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Tsutsumi T, Kawakami A, Ozawa Y, Kawaguchi H, Fujii H, Sawano T, Asamoto H. [The efficacy and side effects of chemotherapy for primary lung cancer with cisplatin and etoposide]. Gan To Kagaku Ryoho 1991; 18:1003-6. [PMID: 1851407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We treated 34 primary lung cancer patients with chemotherapy of cisplatin and etoposide. There were 2 cases of CR (15%) and 8 cases of PR (61%) out of 13 cases of small cell lung cancer. No case of CR and one case of PR (5%) were obtained out of 21 cases of non-small cell cancer. Side effects were leukopenia, increase of BUN and creatinine, angina pectoris, supraventricular premature contraction, and renal failure. WBC reached nadir on day 15 on average. When we repeated this regimen, we encountered 3 cases of acute myocardial infarction, and it was useful for small cell lung cancer.
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Affiliation(s)
- T Tsutsumi
- Department of Respiratory Medicine, Kyoto National Hospital, Fushimi-ku, Japan
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Asamoto H, Kokura M, Kawakami A, Sasaki Y, Fujii H, Sawano T, Iso S, Ooishi T, Horiuchi Y, Ohara N. [Effect of azelastine on theophylline clearance in asthma patients]. Arerugi 1988; 37:1033-7. [PMID: 3214279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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23
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Kato Y, Kaneko K, Kondo T, Watanabe Y, Furuta T, Shimokata T, Sawano T, Kurokawa H, Kiriyama T, Sakurai M. [Investigation of exercise stress whole-body thallium-201 scintigraphy: comparison between supine and sitting bicycle ergometer stress testing in patients with ischemic heart disease]. Kaku Igaku 1988; 25:39-48. [PMID: 3373806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Kato Y, Kaneko K, Kondo T, Watanabe Y, Furuta T, Shimokata T, Sawano T, Kurokawa H, Kiriyama T, Sakurai M. [Estimation of fractional distribution of cardiac output by whole-body thallium-201 scintigraphy during supine and sitting ergometer stress testing in normal subjects]. Kaku Igaku 1987; 24:1749-56. [PMID: 3129605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Asamoto H, Kokura M, Kawakami A, Sawano T, Sasaki Y, Kohara N, Kitamura Y, Oishi T, Morishita H. Effect of famotidine on theophylline clearance in asthma and COPD patients. Arerugi 1987; 36:1012-7. [PMID: 2894822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Sawano T. [Cellular components of bronchoalveolar lavage fluids (BALF) of patients with pulmonary tuberculosis: cell subsets studies by monoclonal antibodies]. Bull Chest Dis Res Inst Kyoto Univ 1986; 19:80-92. [PMID: 3580584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Asamoto H, Hisa T, Sawano T, Sakai K, Kitamura S, Matsushita N, Kokura M, Satake H, Kawakami I. [CDDP-containing combination chemotherapy for advanced lung cancer]. Gan To Kagaku Ryoho 1984; 11:2544-9. [PMID: 6210053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The effect and toxicities of Cis-containing combination chemotherapy were tested in 28 patients with primary lung cancer. All patients were treated with 80 mg/m2 Cisplatinum on the first day and 750 mg ftorafur p.o. every day. In addition to these drugs, patients with squamous cell cancer were treated with continuous subcutaneous infusion of 4 mg/m2 Peplomycin for 5 days and one shot i.v. of 4 mg MMC. Patients with adeno- and large cell cancer were treated with 30 mg/m2 Adriamycin and 4 mg MMC, while patients with small cell cancer were given 150 mg/m2 VP-16 p.o. for 5 days. The following results were obtained. Of 22 evaluable patients, overall response rate was 50%. In each histologic type, response rate was 50% (5/10) for squamous cell carcinoma 50% (4/8) for adenocarcinoma 33% (1/3) for large cell carcinoma and 100% (1/1) for small cell carcinoma. No CR was obtained in this series. Main side effects due to Cisplatinum were nausea, vomiting, loss of appetite, mild leukopenia and thrombocytopenia, mild elevation of serum creatinine and BUN and alopecia, all of which were transient. Interstitial pneumonitis was observed in 40% of patients with squamous cell cancer. Two patients with adenocarcinoma died within 3 weeks after treatment due to embolism of the abdominal aorta and myocardial infarction probably caused by treatment with Adriamycin.
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Sawano T. [Immunological studies of T gamma cells (IgG Fc-receptors bearing T cells) in peripheral blood of patients with sarcoidosis]. Nihon Kyobu Shikkan Gakkai Zasshi 1984; 22:562-9. [PMID: 6239053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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