PubMed Health⌕ Search

Biomedical subjects

Hiroki Nakayama

Publications and source records attributed to Hiroki Nakayama.

10 recordsLinked to original sources
PubMed2005

[A dose escalation study of concurrent chemoradiation therapy with nedaplatin for cervical cancer].

Doses of nedaplatin (CDGP) were established for concurrent chemoradiation therapy (CCRT) for cervical cancer, and a collaborative dose escalation study involving 8 hospitals was conducted to investigate the safety and efficacy of this therapy. Radiotherapy was performed according to the standard treatment described in the Regulations of Cervical Carcinoma Treatment. CDGP at 80 mg/m2 as Level 1 or at 90 mg/m2 as Level 2 was administered on Days 1 and 29 of treatment. Dose-limiting toxicity (DLT) was observed in 1 of 6.patients receiving 80 mg/m2 of CDGP and in all 2 patients receiving 90 mg/m2 of CDGP; therefore, Level 2 was regarded as the maximum tolerated dose (MTD), and Level 1 as the recommended dose. DLT signs consisted of delayed improvement in the leukocyte count in 2 patients and anorexia in 1 patient, suggesting that delayed improvement in the leukocyte count is the main DLT of this combination therapy. The main side effects were digestive disorders such as nausea and anorexia and bone marrow suppression, such as leukopenia, neutropenia, and thrombopenia. Side effects in the Level 1 group were more mild than in the Level 2 group. The efficacy was PR or better in all patients. The CR rates were 60% (6/10) in the Level 1 group and 50% (1/2) in the Level 2 group; there was no marked difference between the two groups. These results suggest that CCRT involving administration of CDGP at 80 mg/m2 on Days 1 and 29 is safe and effective.

Adult↗
PubMed2004

Down-regulation of members of glycolipid-enriched membrane raft gene family, MAL and BENE, in cervical squamous cell cancers.

Persistent human papillomavirus infections cause infected epithelial cells to lose cellular polarity leading to cell transformation. Glycolipid-enriched membrane (GEM) rafts are implicated in polarized sorting of apical membrane proteins in epithelial cells and even in signal transduction. The MAL and BENE are essential component of the GEM raft's machinery for apical sorting of membrane proteins. In this study we demonstrated down-regulation of MAL and BENE mRNA in over two-thirds of primary cervical squamous cell cancers (14 and 15 of 20 cases, for MAL and BENE, respectively) when compared to corresponding non-cancerous uterine squamous cells. Allelic loss or hyper-methylation was not accompanied by MAL or BENE mRNA down-expression in human primary cervical cancers in microsatellite allelic analysis and HpaII-PCR-based methylation analysis of the MAL and BENE genomic region. In addition, we note down-regulation of these genes in established cervical cancer cell lines. These results suggest that down-regulation of MAL and BENE genes, which are essential components of the cellular polarized sorting system, play an important role in human cervical squamous cell cancer development.

Carrier Proteins↗
PubMed2004

[Laser conization].

Explore the source record for details and available documents.

Blood Loss, Surgical↗
PubMed2004

[Sentinel node navigation surgery in uterine cancer].

The Clinical test of sentinel nodes (SNs) in uterine cancer began recently, especially endometrial cancer. In relation to cervical cancer, the detection rate of SN ranged anywhere between 15% to 100% and likewise the sensitivity rate varied from 66% to 100%. Due to these inconclusive results, the data cannot be reliably used for clinical study purposes. Meanwhile, it should be noted that endometrial cancer research has just begun. The tracer used for detection can be roughly classified into an isotope method and a dye method. The isotope method shows a better detection rate, but it can supplemented by using together with the dye method. In Japan, the most commonly reported radiopharmaceutical agent is technetium-99m-labeled phytic acid isotope and 1% isosulfan blue as the dye. In conducting cervical cancer studies, there are many reports of utilizing technetium-99m-labeled phytic acid isotope, injected into 4 different areas of the cervix. Regarding research conducted for endometrial cancer, experiments range from direct injection into the uterine body, injections into the cervix, and hysteroscopic injection. Due to ambiguity in the results, additional clinical testing is required to gather more data.

Female↗
PubMed2003

Brief psychotic disorder associated with bereavement in a patient with terminal-stage uterine cervical cancer: a case report and review of the literature.

We report here a terminally ill patient with uterine cervical cancer who developed a brief psychotic disorder after bereavement following the loss of three close friends also suffering from gynecological cancer. A 49-year-old housewife, who was diagnosed as having uterine cervical cancer and was receiving palliative care was referred for psychiatric consultation because of an abrupt onset of delusions, bizarre behavior, disorganized speech, and catatonic behavior. On psychiatric examination, she showed delusional thought and catatonic behavior. Laboratory data were unremarkable, as was brain MRI. She had no history of psychiatric illness or drug or alcohol abuse. After receiving haloperidol, psychiatric symptoms disappeared, and she returned to the previous level of functioning after 3 days. The patient explained that the death of three of her friend due to gynecological cancer was shocking event for her. She focused her attention on her own fears of dying from the same disease. Brief psychotic disorder in cancer patients is rare in the literature. However, our report of brief psychotic disorder associated with bereavement may highlight possible precipitating factors, which have not been adequately emphasized in the literature to date. From a clinical perspective, it would be informative for liaison psychiatrists to inquire about the patient's experience of loss of significant others with the same disease. This may provide useful information helpful to understanding the patient's conception of the disease process. Cancer patients' bereaving friends who had cancer is not rare in clinical settings. Therefore, medical staff should be mindful of interpersonal relationships between patients and bereavement arising from these relationships.

Bereavement↗
PubMed2003

Pelvic insufficiency fractures in postmenopausal woman with advanced cervical cancer treated by radiotherapy.

PURPOSE: To assess the predisposing factors and clinical characteristics of pelvic insufficiency fractures (PIF) in postmenopausal women with pelvic irradiation. MATERIAL AND METHODS: A total 335 postmenopausal patients with cervical cancer of the intact uterus treated with radiation therapy between 1983 and 1998 were reviewed. Total external dose was delivered between 45 and 50.4 Gy with parallel opposed anteroposterior portals. Total brachytherapy dose at point A was delivered between 10 and 36 Gy. PIF were diagnosed by bone scintigraphy and confirmed by computed tomography. The cumulative incidence of symptomatic PIF was estimated by actuarial methods. Potential risk factors (age, weight, type II diabetes, delivery, menopause, total external dose, total brachytherapy dose) were assessed. RESULTS: Fifty-seven (17.0%) of 335 patients were diagnosed as having PIF. Forty-seven patients were symptomatic and ten were asymptomatic. Parameters carrying a significant association with PIF were body weight 49 kg or below (P=0.044) in stepwise logistic regression analysis. The cumulative incidence of symptomatic PIF at 5 years was 17.9% calculated by the Kaplan-Meier method. A body weight of 49 kg or below and more than three deliveries were identified as having a significant effect on symptomatic PIF in univariate analysis (P=0.021, P=0.003, log-rank test) and Cox life table regression analysis (P=0.038, P=0.013). Five patients required narcotic agents and eight patients required hospital admission. CONCLUSIONS: We should consider reducing the dose contribution to the sacrum and sacroilac joints, without underdosing the tumor, especially in postmenopausal women with many deliveries or low body weight.

Aged↗