Nihon Rinsho. Japanese Journal Of Clinical Medicine[JOURNAL]
Sun
200 papers
[Prognostic risk factors for recurrence after resection of colorectal liver metastases].
Yoshioka R, Hasegawa K, Arita J … +2 more , Sakamoto Y, Kokudo N
Nihon Rinsho · 2016 Nov · PMID 30550691
Surgical resection is the only potentially curative treatment for colorectal liver metastases (CLM). Although long-term survival after resection of CLM, with a 5-year overall survival of more than 50 %, has been reported...
Surgical resection is the only potentially curative treatment for colorectal liver metastases (CLM). Although long-term survival after resection of CLM, with a 5-year overall survival of more than 50 %, has been reported recently, high recurrence rate up to 80 % with a short interval after resection still remains the key problem of CLM treatment. Several clinicopa- thological prognostic risk factors after resection of CLM has been reported, such as short disease free interval, primary nodal status, number and size of CLM, preoperative serum carcinoembryonic antigen level, etc., and currently, RAS mutation status has been also con- sidered as the important prognostic factor. However, these factors do not preclude the surgical indication for CLM. Re-resection of the recurrence plays an important role for achieving the long-term survival.
[Evaluation of recurrence risk in colorectal cancer with the novel clinicopathological factors].
Kajiwara Y, Shinto E, Ueno H
Nihon Rinsho · 2016 Nov · PMID 30550690
Two novel histopathological parameters, i.e., poorly differentiated cluster(PDC) and des- moplastic reaction (DR), have increasingly been investigated as risk factors of recurrence in colorectal cancer patients. PDC is d...
Two novel histopathological parameters, i.e., poorly differentiated cluster(PDC) and des- moplastic reaction (DR), have increasingly been investigated as risk factors of recurrence in colorectal cancer patients. PDC is defined as cancer clusters composed of >5 cancer cells and lacking a gland-like structure. The grade of PDC is determined by the number of clusters within a microscopic field within a X 20 objective lens, whereas DR is pathologically classified into three groups on the basis of products of activated fibroblasts (i.e., keloid-like collagen and myxoid stroma). According to several recent studies, both PDC grade and DR grouping system are strong prognostic factors independent of conventional ones including the TNM stage in colorectal cancer.
[Risk of lymph node metastasis in colorectal T1 (SM) carcinoma].
Tanaka S, Asayama N, Tamaru Y … +2 more , Oka S, Chayama K
Nihon Rinsho · 2016 Nov · PMID 30550689
In this report, we reviewed risk factors for lymph node metastasis in colorectal T1 (SM) carcinoma in relation to the chronological trend of the management of T1 colorectal carci- noma after endoscopic treatment. Recentl...
In this report, we reviewed risk factors for lymph node metastasis in colorectal T1 (SM) carcinoma in relation to the chronological trend of the management of T1 colorectal carci- noma after endoscopic treatment. Recently according to the accumulation of many cases and detailed pathologic evaluation, after complete endoscopic en bloc resection, if below all conditions are satisfied in histological examination, 1) submucosal invasion depth: less than 1,000 pm, 2)histologic grade: favorable, 3)no vessel involvement and 4)budding grade: low, it shows very low risk of lymph node metastasis. Also, in this report, we assess the conditions for additional surgery after endoscopic resection based on the risk stratification of lymph node metastasis.
[Development of immune checkpoint inhibitor in colorectal cancer].
Kitano S
Nihon Rinsho · 2016 Nov · PMID 30550688
Nowadays immune checkpoint inhibitors such as anti-CTLA-4, PD-1 and PD -L1 anti- bodies, are most striking among the clinical development of immunotherapy. These mono- clonal antibodies restore and augment the anti-tumor...
Nowadays immune checkpoint inhibitors such as anti-CTLA-4, PD-1 and PD -L1 anti- bodies, are most striking among the clinical development of immunotherapy. These mono- clonal antibodies restore and augment the anti-tumor immune activities of cytotoxic T cells by mainly blocking immune checkpoint molecules on T cells or their ligands on antigen presenting and tumor cells. Based on preclinical data, many clinical trials have demonstrated the acceptable safety profiles and efficacies in a variety of cancers. Early phase clinical of mono therapies of immune checkpoint inhibitors had failed for colorectal cancer (CRC). How- ever, some pilot studies suggested anti -PD-1 antibody was very effective in CRC patients with microsatellite instability (MSI) -high. Now several clinical trials are investigating new agents, alone and in combination, for colorectal cancer patients with microsatellite stable (MSS). The current clinical development and TR research and future challenges in utilizing immune checkpoint inhibitors in CRC will be described.
[Integration of clinical information and molecular biology profile -Endeavor of SCRUM-Japan-].
Okamoto W, Yoshino T
Nihon Rinsho · 2016 Nov · PMID 30550687
In recent years, the cancer therapy based on the biomarker has been clinically introduced in colorectal cancer. Furthermore, the therapeutic development for the colorectal cancer patients corresponding to gene alteration...
In recent years, the cancer therapy based on the biomarker has been clinically introduced in colorectal cancer. Furthermore, the therapeutic development for the colorectal cancer patients corresponding to gene alteration, such as BRAF gene mutation and microsatellite instability(MSI), are underway. Although the development of the novel treatments according to biomarkers is urgent the fragmentation of the patient population by biomarker have caused various problems in the treatment development. To accelerate the development of therapeutic agents for small population, we conduct a nationwide genome screening project'SCRUM- Japan'.
[Mechanisms and clinical uses of miRNAs in colorectal cancer].
Ogawa Y, Mimori K
Nihon Rinsho · 2016 Nov · PMID 30550686
MicroRNAs(miRNAs) are key regulators involved in various tumors. Recently, it has become clear that aberrant miRNA expression has a functional role in the initiation and progression of colorectal cancer (CRC). Distinct m...
MicroRNAs(miRNAs) are key regulators involved in various tumors. Recently, it has become clear that aberrant miRNA expression has a functional role in the initiation and progression of colorectal cancer (CRC). Distinct miRNA expression profiles have cancer- specific patterns and are associated with diagnosis, prognosis and therapeutic outcome in CRC. Many studies have shown that the miRNA play an important role in carcinogenesis, invasion and metastasis by regulating multiple target gene expressions and should be early detection biomarkers and therapeutic targets for CRC. Here we review the mechanisms and clinical uses of representative miRNAs in colorectal cancer.
[Molecular subtypes of colorectal cancer].
Hata T, Konno M, Mizushima T
Nihon Rinsho · 2016 Nov · PMID 30550685
Cancer has a character of heterogeneity, which makes it difficult to determine treatment strategy and predict prognosis. To conquer this problem, comprehensive analyses have been actively performed for gene expression, a...
Cancer has a character of heterogeneity, which makes it difficult to determine treatment strategy and predict prognosis. To conquer this problem, comprehensive analyses have been actively performed for gene expression, and molecular subtypes of various types of cancer have been identified by many studies. In colorectal cancer(CRC), there are known to be other subtypes than gene expression, that is, chromosome instability(CIN), microsatellite instability (MSI), and CpG island methylator phenotype (CIMP). Classification of molecular subtypes by integrating these multiple biological properties would realize the effective tailor-made treatment, and improve CRC patient's prognosis. In this article, we overview the mechanisms of CRC carcinogenesis, and present the latest biological classification of subtypes in CRC.
[Epidemiology of colitis complicating cancer-postoperative cancer in ulcerative colitis and anorectal cancer in Crohn's disease].
Sugita A, Koganei K, Tatsumi K … +2 more , Futatsuki R, Kuroki H
Nihon Rinsho · 2016 Nov · PMID 30550684
Colitis complicating inflammatory bowel disease is gradually increasing in Japan. Although the postoperative cancer in ulcerative colitis is rare, careful postoperative follow up is nec- essary. Anorectal cancer includin...
Colitis complicating inflammatory bowel disease is gradually increasing in Japan. Although the postoperative cancer in ulcerative colitis is rare, careful postoperative follow up is nec- essary. Anorectal cancer including cancer of anal fistulae in Crohn's disease is the most common cancer in Japan and our original cancer surveillance program in which biopsy for anorectal lesion is performed for longstanding anal lesion (more than 10 years) is suggested to be effective for the detection of early cancer.
[Epidemiology of hereditary colorectal cancer].
Ishida H, Iwama T
Nihon Rinsho · 2016 Nov · PMID 30550683
Hereditary colorectal cancers comprise less than 5 % of all colorectal cancers and are defined as heritable conditions characterized by an apparently increased risk of colorectal cancer in individuals (mutant carriers in...
Hereditary colorectal cancers comprise less than 5 % of all colorectal cancers and are defined as heritable conditions characterized by an apparently increased risk of colorectal cancer in individuals (mutant carriers in the germline), compared with the risk in the general population. Among the various known hereditary colorectal cancers, Lynch syndrome is the most common, followed by familial adenomatous polyposis. Other rarer diseases have been described, such as MUTYH-associated polyposis, polymerase proofreading-associated polyposis, hamartomatous polyposis syndromes (Peutz-Jeghers syndrome, juvenile polyposis syndrome, and PTEN hamartomatous syndrome). The early-onset of colorectal cancer and the development of other malignant neoplasms in various organs are characteristics that are common to these diseases. We herein document the epidemiologic characteristics of these rare diseases.
[Colorectal cancer epidemiology in Japan: Mortality, incidence, survival].
Nishimoto H
Nihon Rinsho · 2016 Nov · PMID 30550682
The mortality, incidence, and survival rates for colorectal cancer in Japan are reviewed, with attention paid to changes over time and comparison with US statistics. The age-adjusted mortality rate gradually decreased in...
The mortality, incidence, and survival rates for colorectal cancer in Japan are reviewed, with attention paid to changes over time and comparison with US statistics. The age-adjusted mortality rate gradually decreased in Japan, 16.2 per 100,000 per year in 2014. In contrast, the age-adjusted incident rate is rather flat, 54.7 in 2012. The survival rate, dependent on stage of disease, improved to 69.2 % (2003-2005), as overall 5-year survival. In the desig- nated cancer care hospital, we compared the stage distribution between Japan and US, with stage 0, 14.7 % vs 5.8 %, and with stage IV, 13.3 %vs 19.2 %, the cancer and polyps earlier detected in Japan. The epidemiological colorectal cancer statistics in Japan and US are much different in each aspects.
[Colorectal cancer-the history and current status of clinical and research-].
Homma S, Yoshida T, Ichikawa N … +2 more , Kawamura H, Taketomi A
Nihon Rinsho · 2016 Nov · PMID 30550681
The history of clinical and research of colorectal cancer, beginning from surgery therapy, a variety of fields have evolved from there, the results have been stacked. Safety of the establishment and the usefulness of the...
The history of clinical and research of colorectal cancer, beginning from surgery therapy, a variety of fields have evolved from there, the results have been stacked. Safety of the establishment and the usefulness of the proof of the surgery, the development of diagnostic methods, advances in chemotherapy, the discovery of hereditary colon cancer, due to the development and application of basic research to support these, research and treatment results for colorectal cancer. It has been made great strides. Advances in establishment and chemotherapy safe surgical treatment, even for colorectal cancer has been considered to unresectable ever, it has become possible to perform a surgical treatment in combination with perioperative chemotherapy. In addition, even for recurrent colon cancer, by combining the surgery therapy sure to allow timing as well as chemotherapy, likely to be observed extension of further survival are coming out Occurrence for colorectal cancer, by the elucidation of the treatment mechanism, to expect that the study of the optimization of colon cancer treatment progresses.
[Molecular basis for the potential role of GRK2 in pathological disorders].
Hattori Y, Hattori K, Suzuki T
Nihon Rinsho · 2016 Oct · PMID 30551294
G protein-coupled receptor kinase 2(GRK2) is a ubiquitous member of the family of GRKs that are serine/threonine kinases originally discovered for their role in the process of desensitization of agonist-activated G prote...
G protein-coupled receptor kinase 2(GRK2) is a ubiquitous member of the family of GRKs that are serine/threonine kinases originally discovered for their role in the process of desensitization of agonist-activated G protein-coupled receptors (GPCRs). However, emerging evidence suggests that GRK2 can phosphorylate a large number of non-GPCR substrates and interact with a plethora of proteins involved in signaling and trafficking, suggesting that GRK2 would participate in the regulation of diverse cellular responses in a phosphorylation-dependent and -independent manner. Alternations in GRK2 levels and/or activity are demonstrated in an array of relevant cardiovascular, metabolic, inflammatory, or cancer pathologies. These changes are assumed to contribute to the onset and/or development of such pathologies. Thus, GRK2 may serve as a potentially interesting therapeutic target and those drugs targeted for GRK2 may constitute a novel therapeutic strategy for several intractable diseases, including sepsis.
[Mind-body inter-relationship of bronchial asthma].
Yoshihara K
Nihon Rinsho · 2016 Oct · PMID 30551293
The mind-body inter-relationship of bronchial asthma and its pathological mechanisms have been clarified by the knowledge obtained from basic research studies, such as epide- miological investigations, animal experiments...
The mind-body inter-relationship of bronchial asthma and its pathological mechanisms have been clarified by the knowledge obtained from basic research studies, such as epide- miological investigations, animal experiments, and brain imaging studies. It is important to take advantage of the knowledge obtained from these researches to clarify the pathology of bronchial asthma and to extend the results to the clinical sphere by developing effective treatments. In the clinical setting, the 'Japanese Guidelines for the Diagnosis and Treatment of Psychosomatic Diseases' is useful for the assessment and treatment of bronchial asthma accompanied by psychosomatic related problems. This report outlines the mind-body inter-relationship of bronchial asthma and the assessment & treatment of bronchial asthma accompanied by psychosomatic related problems.
[Current status and tasks of the patient education in asthma].
Takaku Y
Nihon Rinsho · 2016 Oct · PMID 30551292
With a chronic disease such as asthma, it is important for patients to be provided with education and skills in order to effectively manage their asthma. Although the principal knowl- edge may be the same, it should be a...
With a chronic disease such as asthma, it is important for patients to be provided with education and skills in order to effectively manage their asthma. Although the principal knowl- edge may be the same, it should be adjusted for individual patient and care should be taken so that patients can be socially and mentally active. The following items should be taught; namely the fact that asthma is a chronic disease that requires long-term management, dif- ferences between relievers and controllers, the usage of inhalers, self-monitoring of symp- toms with a diary and peak flow monitoring, a self-management plan (an action plan to show how to recognize and respond to worsening asthma), and avoidance of environmental allergens.
[Bronchial thermoplasty in the treatment of asthma].
Azagami S, Mineshita M
Nihon Rinsho · 2016 Oct · PMID 30551291
Bronchial thermoplasty(BT) is a novel therapeutic modality for adult patients with severe asthma. BT is a procedure of applying radio frequency thermal energy to the airways with the goal of ablating the airway smooth mu...
Bronchial thermoplasty(BT) is a novel therapeutic modality for adult patients with severe asthma. BT is a procedure of applying radio frequency thermal energy to the airways with the goal of ablating the airway smooth muscle and ameliorating airway hypersensitivity. BT improves asthma related quality of life and reduces the rate of asthma exacerbations compared with standard therapy. These benefits are reported to..persist for at least 5 years. BT was introduced in Japan on April 2015, and the number of treated asthma patients is increasing. In this article, we describe the methods, effectiveness, safety and the current status of BT in Japan.
[Treatment and managements of pediatric asthma].
Katsunuma T, Akashi K
Nihon Rinsho · 2016 Oct · PMID 30551290
In Japan, pediatric asthma is managed based on the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012). JPGL 2012 also recommends treat- ment and management aimed at complete control...
In Japan, pediatric asthma is managed based on the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012). JPGL 2012 also recommends treat- ment and management aimed at complete control through avoiding exacerbation factors and appropriate use of anti-inflammatory drugs. In this review, we describe an overview of the newer treatment options available for treatment and management of pediatric asthma and some topics.
[Definition, classification and differential diagnosis of childhood asthma].
Tokuyama K
Nihon Rinsho · 2016 Oct · PMID 30551289
The pathophysiology of childhood asthma has not been clarified compared to that of adults. Airway remodeling has been demonstrated even in younger children. On the other hand, high incidence of remission compared to that...
The pathophysiology of childhood asthma has not been clarified compared to that of adults. Airway remodeling has been demonstrated even in younger children. On the other hand, high incidence of remission compared to that in adults has been shown, suggesting a het- erogeneity of childhood asthma. The diagnosis of childhood asthma is difficult because air- ways of younger children is easy to close, causing wheezing. Thus, differential diagnosis is important. The phenotypes of asthma in younger children is mainly classified into mild episodic viral wheeze and multiple-trigger atopic wheeze.
[Understanding the common pathogenesis of asthma and COPD].
Konno S
Nihon Rinsho · 2016 Oct · PMID 30551288
Asthma and chronic obstructive pulmonary disease (COPD) are obstructive pulmonary diseases characterized by chronic airway inflammation. Historically, the pathogenesis of the two diseases has been independently studied i...
Asthma and chronic obstructive pulmonary disease (COPD) are obstructive pulmonary diseases characterized by chronic airway inflammation. Historically, the pathogenesis of the two diseases has been independently studied in mutually exclusive populations. However, the recent recognition of heterogeneity and of the importance of phenotypic classification in both diseases have highlighted the need to pay much attention to subjects with overlapping features of both asthma and COPD: those with asthma-COPD overlap syndrome (ACOS). In real clinical settings, particularly in the population with a high smoking rate, subjects with ACOS consist of a large percentage of those with obstructive lung disease. Until now, no evidence-based guidelines for the management of ACOS currently exist. Thus, future research is certainly needed to improve our understanding of ACOS and to achieve the best management strategies.
[Eosinophilic granulomatosis with polyangiitis (EGPA) and allergic bronchopulmonary mycosis (ABPM)].
Taniguchi M, Fukutomi Y
Nihon Rinsho · 2016 Oct · PMID 30551287
Eosinophilic granulomatosis with polyangiitis(EGPA) is characterized by ANCA-related small vessel vasculitis with granuloma formation and chronic eosinophilic airway inflammation including severe asthma and nasal polypos...
Eosinophilic granulomatosis with polyangiitis(EGPA) is characterized by ANCA-related small vessel vasculitis with granuloma formation and chronic eosinophilic airway inflammation including severe asthma and nasal polyposis. Allergic bronchopulmonary mycosis(ABPM) is characterized by asthma, central bronchiectasis, eosinophilic mucoid impaction, and fungal sensitization. The accurate diagnosis in early stages for these severe type of asthma is very important for good prognosis. Recent reports claimed that mepolizumab may be effective ad-on treatment for EGPA, and omalizumab is effective for ABPA.
[Eosinophilic otitis media and eosinophilic chronic -hinosinusitis].
Matsubara A, Takahata J, Kudo N … +2 more , Noro M, Miura T
Nihon Rinsho · 2016 Oct · PMID 30551286
In Japan, eosinophilic inflammations of upper airway, eosinophilic otitis media(EOM) and eosinophilic chronic rhinosinusitis(ECRS), have been paid attention as intractable disease in recent years. The most common charact...
In Japan, eosinophilic inflammations of upper airway, eosinophilic otitis media(EOM) and eosinophilic chronic rhinosinusitis(ECRS), have been paid attention as intractable disease in recent years. The most common characteristic of EOM is the presence of highly viscous middle ear effusion enriched eosinophils, and EOM carries a high risk of hearing loss. That of ECRS is the nasal polyps with eosinophil dominant infiltration, and ECRS has a high risk of impairment of smell. In the case of the treatment of bronchial asthma, it is necessary to be careful for nasal symp- toms and aural symptoms, since EOM and ECRS were associated with bronchial asthma at high rates.
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