Tomoyuki Tsuzuki

National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan

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Publications (39)216.05 Total impact


  • No preview · Article · May 2014 · Gastrointestinal Endoscopy
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    ABSTRACT: Objectives: A phase II study was performed to investigate the safety and efficacy of concurrent chemoradiotherapy (CCRT) combined with an orally active fluoropyrimidine, S-1, plus cisplatin for locally advanced esophageal cancer (LAEC). Methods: CCRT comprised 2 courses, a 30-Gy radiotherapy over 3 weeks plus daily oral S-1 (80 mg/m(2)/day) for 2 weeks and a 24-hour cisplatin infusion (70 mg/m(2)) on day 8, and an identical course administered after a 2-week break. Results: One hundred and sixteen patients, 12 with stage II, 71 with stage III, and 33 with stage IVa LAEC participated, and 106 of them (91.4%) completed the CCRT course. The most serious toxicity was myelosuppression: grade 3 and 4 neutropenia occurred in 28.4 and 9.5% of patients, respectively. Nonhematologic toxicity was moderate. Complete response rates in patients with stage II, III, and IVa LAEC were 91.7, 67.6, and 36.4%, respectively. The overall median survival time was 2.3 years and that of patients with stage II, III, and IVa cancer was 7.0, 2.6, and 1.3 years, respectively. Conclusions: CCRT combined with S-1 plus cisplatin showed promising safety and efficacy. Potentially, this combination therapy could become a baseline medication for patients with LAEC.
    No preview · Article · May 2013 · Oncology
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    ABSTRACT: Case 1 was 80-year-old female, treated with pulmonary aspergillosis. She was admitted the treatment of HBs antigenpositive hep atop athy. On October 16,2011, laboratory test showed following: AST 193 U/1, ALT 180 U/L HBe antigen 1579 S/CO, HBe antibody 0, HBV DNA 7.9 log copies/ml, HBc antibody 10.18 S/CO, IgM-HBc antibody 0.76 S/CO and HBV genotype B. Case 2 was 74-year-old male, treated with Parkinson's disease. He was admitted f;:) r the treatment of HBs antigen-positive hep atop athy. On January 20, 2012, laboratory test showed following: AST 134 U/1, ALT 188 U/L HBe antigen 1.82 S/CO, HBe antibody 0, HBV DNA>9.0 log copies/ml, HBc antibody 9.38 S/CO, IgM-HBc antibody 0.19 S/CO and Genotype C. In both two cases HBc antibody and HBs antibody were not tested for the past years. But, we considered that HBV reactivation occurred and administered Entecavir. The reason of HBV reactivation was not unknown.
    No preview · Article · Feb 2013
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    ABSTRACT: Background TH-302 is a hypoxia targeted prodrug with a hypoxia-triggered 2-nitroimidazole component designed to release the DNA alkylator, bromo-isophosphoramide mustard (Br-IPM), when reduced in severe hypoxia. A randomized Phase 2B study (NCT01144455) was conducted to assess the benefit of G + T to standard dose G as first-line therapy of PAC.
    Full-text · Conference Paper · Sep 2012
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    ABSTRACT: At Nagoya Medical Center, 10 patients co-infected with HIV and HCV received peginterferon α (PEG-IFNα) plus ribavirin therapy. Three of the cases were HCV genotype 1b, 2 cases were HCV 3b, and 1 case each were 2b, 2c, 3a, 4a and 6n. Nine patients received anti HIV therapy from the beginning. In 5 of these patients, anti HIV therapy was modified when PEG-IFNα plus ribavirin treatment was started. Of the above, 7 patients completed the protocol. No patients had severe adverse effects. Sustained virological response was achieved in 1 of 4 (25%) of the patients with genotypes 1 or 4, and in 5 of 6 (83%) of the patients with other genotypes. PEG-IFNα plus ribavirin therapy is considered a safe and efficacious treatment for patients co-infected with HIV and HCV.
    No preview · Article · Jul 2012 · Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology
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    ABSTRACT: We investigated the efficacy and long-term prognosis of Ieukocytapheresis therapy with 1.5 l of blood processing (1.5 l LCAP therapy) for ulcerative colitis (UC). A total of 10 UC patients with moderate or greater severity were treated with 1.5 l LCAP therapy. Of the 10 patients, 8 (80%) achieved clinical improvement and endoscopic improvement was noted in 6 out of 7 patients (85.7%). Dose reduction or withdrawal of steroids was possible in 6 out of the 8 patients (75%). The 2 steroid-naive patients achieved remission and had a favorable clinical course. As to long-term prognosis, 5 patients relapsed (mean 12.2± 11.5 months) and 3 maintained remission (mean 47.7±34.4 months). The patients who had achieved and maintained remission had lower Matts' grade (1.67±0.58) after 1.5 l LCAP therapy, mucosal regeneration on observation with a narrow band imaging,improved mucosal edema on examination with endoscopic ultrasonography, and slight infiltration of inflammatory cells on examination of biopsy specimens. No side effect was observed. Therefore, 1.5 l LCAP therapy is a safe and effective therapy, and provided good long-term prognosis in patients who had achieved mucosal regeneration and improvement of mucosal edema.
    No preview · Article · May 2012
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    ABSTRACT: Objectives: To carry out a phase II multi-center study on the efficacy and safety of triple combination therapy with paclitaxel, S-1, and cisplatin in patients with unresectable/metastatic gastric cancer. Methods: A total of 63 patients from 8 institutions were included in this study. Paclitaxel (160 mg/m2) was administered by infusion for 3 h on the first day. S-1 (70 mg/m2/day) was administered orally for 14 consecutive days from the first day. Cisplatin (60 mg/m2) was administered intravenously over 24 h on day 14 of every 28-day cycle. Results: All 63 patients were assessed for clinical efficacy and safety. A total of 259 cycles of treatment were administered (median 4, range 1–10). Grade 3–4 toxicities included neutropenia in 30.2%, thrombocytopenia in 12.7%, and anemia in 11.1%. There was no grade 3–4 non-hematological toxicity or treatment-related death. Complete response was observed in 6 patients and partial response in 34 patients. The overall response rate was 63.5%. The median progression-free survival and response duration were 8.0 and 8.8 months, respectively, and median survival time was 15 months. Conclusions: Triple combination therapy with paclitaxel, S-1, and cisplatin showed promising safety and efficacy profiles with the potential to become a standard regimen for unresectable/metastatic gastric cancer.
    No preview · Article · Jun 2011 · Oncology
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    ABSTRACT: Twelve chronic hepatitis C patients (six men and six women; average age 60.3 years) with genotype 1b and high viral load who were not cured by previous interferon (IFN) therapy received double filtration plasmapheresis (DFPP) and peginterferon plus ribavirin (PEG IFN • Rib) combination therapy. In the previous IFN therapy, there were three non-responders (NR) to IFN monotherapy, two NRs to IFNα2b • Rib, two relapsers (Rel) and five NRs to PEG IFNa2b • Rib. Viral load reduction by DFPP was 1.8 ± 1.2 (range: 0.1-4.8) log IU/ml. The mutations of the interferon sensitivity determining region (ISDR) and HCV core amino acid (aa) did not affect the viral load reduction by DFPP. The viral load reduction rate of NRs to a previous IFN monotherapy was significantly higher than that of the patients who previously received Rib combination therapy (p<0.05). Three (100%) of the patients who previously received IFN monotherapy showed a sustained viral response (SVR). The patients who previously received IFNα2b 'Rib did not become HCV RNA-negative. Among the patients who previously received PEG IFNα2b 'Rib, two Rels showed SVR but five NRs did not showed SVR. Two Rels became HCV RNA-negative after the present treatment at an earlier stage than the previous PEG IFNα2b • Rib. Finally, five of all the patients (41.7%) and two of 9 (22.2%) who previously received Rib combination therapy showed SVR. The rates of patients showing SVR in the cases of ISDR mutation≧, ISDR mutation of 0 or 1 and either a core aa70or aa91 mutant ISDR mutation of 0 or 1 and both a core aa70 and aa91 mutant were 2/2 (100%), 2/6 (33%) and 1/4 (25%), respectively. The indication of DFPP + PEG IFN • Rib for the retreatment of chronic hepatitis C of genotype 1 and a high viral load was suggested for NRs to a previous IFN monotherapy or Rels to a previous PEG IFN • Rib.
    No preview · Article · Jan 2011 · Kanzo
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    ABSTRACT: On November 9, 2009, a 34-year-old male was admitted to our hospital for the treatment of HBs antigen -positive hepatopathy. He was positive for HBV DNA, but negative for IgM HBc antibody, HBc antibody and HIV antibody. On December 10, laboratory test showed following: the increase in transaminase levels(AST 754 IU/ml and ALT 1486 IU/ml), HBs antigen 92997 S/N, HBe antigen 1272 S/CO, HBe antibody 0 % INH, IgM HBc antibody 28 S/CO, HBc antibody 4.41 S/CO and HBV DNA 8.6 Log copies/ml. Liver biopsy revealed chronic hepatitis. The HBV genotype was type A. Therefore, we concluded that his HB virus-related acute hepatitis was already chronic. Interferon a at 600 MU/day was administrated for 2 weeks and continued at 300 MU twice for 22 weeks, 24 weeks in total. He became negative for HBs antigen in March 2010 and positive for HBs antibody in April 2010. We considered that the administration of interferon might be effective for acute HBV genotype A infection to prevent it from being a chronic condition.
    No preview · Article · Jan 2011

  • No preview · Article · Apr 2009 · Gastrointestinal Endoscopy
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    ABSTRACT: Standard leukocytapheresis (LCAP) protocols recommend the processing of a 3 L blood volume. In this study, we evaluated the clinical effects of LCAP with 1.5 L of blood processing (1.5L-LCAP) in patients with active ulcerative colitis (UC). Ten patients with moderate to severe UC were enrolled. Their clinical and endoscopic responses, the kinetics of the peripheral blood counts and cytokine responses were evaluated. Clinical and endoscopic effects were assessed using the clinical activity index described by Rachmilewitz, and by Matts' endoscopic classification, respectively. The 1.5L-LCAP induced clinical remission in 8 out of 10 patients (80%). Endoscopic improvement was noted in 6 out of 7 patients (85.7%). Prednisolone (PSL) was used in 8 patients; the PSL dose could be reduced in 6 patients, and weaning was possible in one patient. Adverse effects were not observed during 1.5L-LCAP therapy. During the 1.5L-LCAP session, the leukocyte count reached the minimum at 1.0 L of blood processing, but promptly increased after completion of the session, and reached a maximum after 30 min. Interleukin (IL)-1beta-induced IL-8 and IL-6 secretion by peripheral blood mononuclear cells were both significantly reduced by 1.5L-LCAP therapy. 1.5L-LCAP was clinically effective for active UC patients. Cellular responses induced by 1.5L-LCAP were similar to those induced by a standard LCAP session.
    No preview · Article · Nov 2008 · Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
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    ABSTRACT: With the goal of establishing efficient leukocytapheresis (LCAP) for the treatment of ulcerative colitis (UC), in order to mainly remove the leukocytes that are attributable to inflammation and minimize removal of leukocytes supplied in an anti-inflammatory manner, we performed 1.5 L blood-processing- volume LCAP to treat 7 cases of moderate or severe UC and assessed its clinical efficacy and blood cell dynamics in peripheral blood. There was a clinical response in 5 (71.4%) of the 7 cases, and it was possible to reduce the dose of steroids or discontinue them in 4 (80%) of the 5 cases in which they were being used before LCAP. The changes in leukocyte count in peripheral blood showed a reduction from 7,971 (3,400-12,800)/μL before LCAP to a minimum value of 3,443 (1,300-6,300)/μL after 1. 5 L processing, and the maximum value 30 minutes after the completion of processing was 12,900 (6,200-17,100)/μL. Similar trends were also observed in regard to granulocytes, monocytes, and lymphocytes. There were no adverse effects. By removing the minimum number of leukocytes necessary, 1. 5 L blood-processing-volume LCAP allows treatment in approximately half the time and with approximately half the processing volume in comparison with the LCAP that is usually performed. It is also a safe and effective treatment clinically, and it appears to be an efficient method for treating UC patients.
    No preview · Article · Sep 2007
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    ABSTRACT: The objective of this study was to determine the dose-limiting toxicity (DLT), the maximum tolerated dose (MTD), the recommended dose (RD) and the preliminary antitumor activity of S-1, oral dihydropyrimidine dehydrogenase inhibitory fluoropyrimide, in combination with cisplatin and paclitaxel for advanced gastric cancer. Paclitaxel was administered on day 1. A fixed dose of S-1 (70 mg/m2/day) was orally administered for 14 consecutive days from day 1 and a 24-h infusion of a fixed dose of cisplatin (60 mg/m2) was administered on day 14 of every 28-day cycle. Four dose escalation levels of paclitaxcel were studied (120, 140, 160 and 180 mg/m2). Twenty patients were enrolled. The toxicities were generally mild no grade 4 hematological toxicity or grade 3 non-hematological toxicity were observed. Level 4 was considered as the MTD because of a treatment delay of more than 2 weeks in 3 out of 6 patients. The RD of paclitaxcel was 160 mg/m2. The overall response rate was 75%. A triple combination chemotherapy consisting of S-1, cisplatin and paclitaxel showed a tolerable level of adverse reactions and favorable antitumor activity.
    Full-text · Article · Mar 2006 · Anticancer research
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    ABSTRACT: To determine the role of interleukin (IL)-17 in gastric ulcerogenesis. Thirty-six gastric ulcer (GU) patients and 29 non-ulcer (NU) patients were enrolled in this study. Mucosal biopsy samples were obtained from the gastric antrum and GU site during endoscopy. Samples were used in in situ stimulation for 48 h in the presence of 10 microg/mL phytohemagglutinin-P (PHA), histological examination, and Helicobacter pylori (H pylori) culture. IL-17 and IL-8 protein levels in culture supernatants were assayed by ELISA. IL-17 mRNA expression was analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR). H pylori cagA and vacA status was assessed by reverse hybridization using a line probe assay (LiPA). IL-8 levels in culture supernatants were assayed after AGS cells were co-cultured with H pylori strain 26,695 or recombinant human (rh) IL-17. All 36 GU patients and 15 of 29 NU patients were found to be H pylori-positive, while 14 NU patients were H pylori-negative. All 51 H pylori strains from both GU and NU patients were cagA- and vacAs1/m1-positive. Antral mucosal tissues from H pylori-positive patients contained significantly (H pylori-positive NU patients: median 467 pg/mg/protein, range 53-2,499; H pylori-negative NU patients: median 104 pg/mg/protein, range 16-312, P< 0.0005) higher levels of IL-17 than those from uninfected patients. IL-17 levels at the ulcer site were significantly (ulcer site: median 1,356 pg/mg/protein, range 121-1,3730; antrum: median 761 pg/mg/protein, range 24-7,620, P< 0.005) higher than those at distant sites in the antrum. Biopsies from H pylori-positive GU and NU patients showed IL-17 mRNA expression in all samples whereas those from the antrum of the H pylori-negative controls showed no detectable expression. A significant correlation was seen between IL-17 and IL-8 levels at each biopsy site (ulcer: r = 0.62, P< 0.0001; antrum: r = 0.61, P< 0.0001) in GU patients. RhIL-17 and H pylori strain 26,695 each stimulated IL-8 production from AGS cells. IL-17 may play an important role in the inflammatory response to H pylori colonization, and may ultimately influence the outcome of H pylori-associated diseases that arise within the context of gastritis.
    Full-text · Article · Nov 2005 · World Journal of Gastroenterology
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    ABSTRACT: The long-term benefit of Helicobacter pylori eradication treatment that includes metronidazole on peptic ulcer disease in Japan is unclear. We investigated the rate of H. pylori re-infection and ulcer relapse after H. pylori eradication. A total of 266 patients with endoscopically confirmed peptic ulcer disease and H. pylori infection were treated with triple therapy of omeprazole 40 mg (20 mg b.i.d.), clarithromycin 800 mg (400 mg b.i.d.), and tinidazole 1000 mg (500 mg b.i.d.) for 7 days. Endoscopy with gastric biopsy was performed before and 1 month, 6 months, 1.5 years, and 3.5 years after therapy. H. pylori status was determined by H. pylori culture, rapid urease test, and histopathology. 13C-urea breath test was done at 6 months after eradication therapy. Treatment was deemed successful when all tests were negative at 6 months after therapy by endoscopic biopsy. Successful H. pylori eradication was achieved in 262/266 (98.5%) patients with peptic ulcer. Total relapse of peptic ulcer occurred in 8/262 (3%) patients after eradication, with 3/262 (1.1%) occurring within 1.5 years after treatment and 5/262 (1.9%) within 3.5 years. All relapsed patients were found to be H. pylori-positive at the time of relapse. Of the 262 patients who experienced eradication, 20 (7.6%) were subsequently re-infected, six (2.3%) within 1.5 years and 14 (5.3%) within 3.5 years. Triple therapy with omeprazole, clarithromycin, and tinidazole (OCT) is useful for H. pylori eradication in Japan, but there is an appreciable re-infection rate in this population.
    No preview · Article · Nov 2005 · Helicobacter
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    ABSTRACT: Background: Assessment of the response of esophageal cancer to chemoradiotherapy is difficult. We investigated the value of a transendoscopic miniature ultrasonic probe (USP) in assessing response to chemoradiotherapy in patients with locally advanced esophageal cancer. Methods: A total of 33 patients were entered in this prospective study. Response to treatment was evaluated according to World Health Organization criteria. According to the sonographic image, complete response (CR) of the primary lesion was divided into two subcategories: confirmed CR (cCR) and unconfirmed CR (uCR). Results: Initial sonographic criteria for evaluating tumor depth and lymph nodes in the 33 patients before therapy showed two cases of T2N0, four of T3N0, 15 of T3N1, four of T4N0, and eight of T4N1. Following chemoradiotherapy, CR was obtained in 18 (54.5%): seven cCR and 11 uCR. Eleven were partial response (PR) (33.3%), while three were stable disease (SD) and one was progressive disease (PD). High frequency USP (20 MHz) was able to detect tumor disappearance and restoration of the esophageal wall. One-year survival rates among CR (cCR + uCR), PR and SD + PD were 100%, 70% and 0%, respectively. A significant difference in survival was evident among CR, PR and SD + PD (P < 0.001). Three-year survival rates between cCR and uCR were 100% and 40%, respectively. A significant difference in survival was evident between cCR and uCR (P < 0.001). In seven cases of uCR, local recurrence and distant metastasis appeared within 1 year, and five died of disease progression. Not one cCR case has relapsed. Conclusion: USP, which can be accomplished with a standard endoscopy, including biopsy, in one procedure, is a useful method for objectively assessing the response to chemoradiotherapy in patients with locally advanced esophageal cancer.
    No preview · Article · Mar 2005 · Digestive Endoscopy
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    ABSTRACT: We investigated the possible roles of the interleukin (IL)-15 and IL-15 receptor (IL-15R) system in a heightened state of B-cell activation and differentiation in intestinal mucosa with inflammatory bowel disease (IBD). The expression of IL-15 and IL-15Ralpha mRNA and protein in inflamed colonic mucosal tissues with IBD, and in control tissues was examined by reverse transcriptase-polymerase chain reaction and immunohistological methods. The effects of recombinant (r)IL-15 on the expression of IL-15Ralpha on lamina propria B cells and the production of immunoglobulin G (IgG) were analyzed in vitro, using lamina propria mononuclear cells (LPMCs) isolated from control tissues. The intensity of IL-15 and IL-15Ralpha mRNA was greater in the mucosal tissues of patients with IBD, especially in those of patients with ulcerative colitis (UC), than in control tissues. Compared to control tissues, mononuclear cells positive for IL-15Ralpha protein were observed in greater proportions in tissue sections from patients with IBD, especially in those from patients with UC, where IL-15Ralpha protein was localized to CD20-positive B cells to a significant degree. There were increases in the proportions of IL-15Ralpha-positive B cells and IgG-producing cells in rIL-15- or rCD40L-stimulated cultures of LPMCs, with stimulatory effects being greater in the presence of their combination. These data suggest that the IL-15 and IL-15R system may play important roles in the activation and differentiation of lamina propria B cells in patients with IBD, especially in those with UC.
    No preview · Article · Mar 2005 · Journal of Gastroenterology
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    ABSTRACT: The aim of this multicentric trial was to determine the clinical toxicities and antitumor effects of a chemotherapy regimen of S-1 combined with cisplatin in patients with inoperable locally or metastatic advanced gastric cancer. Forty-two patients were entered into the study. S-1 (80 mg/m2) was administered orally daily for 14 consecutive days and 24-h infusion of cisplatin (70 mg/m2) was administered on day 8 of every 28-day cycle. The overall response rate was 50% and complete response rate was 5%. The most common adverse event was leucopenia, which occurred with grade 3 in 7 patients (16.6%) and grade 4 in 2 patients (4.8%). Non-hematological adverse events were generally mild. The median survival time was 342 days. The 2-year survival rate was 22.9%. This combination chemotherapy is active, convenient and well tolerated in patients with high-grade advanced gastric cancer.
    Full-text · Article · Mar 2005 · Anticancer research
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    ABSTRACT: The association between Helicobacter pylori infection and idiopathic thrombocytopenic purpura (ITP) has been reported widely. We investigated the prevalence of H. pylori infection, its virulence profile and the effectiveness of its eradication in patients with ITP. Twenty patients with ITP, 20 with peptic ulcer (10 gastric ulcer (GU), 10 duodenal ulcer (DU)) and 20 with NUD were studied. The virulence profile of the strains was assessed by genotyping for cagA, vacA, iceA, and hpyIIIR/hrgA and by assaying for IL-8 and DNA fragmentation after incubation with AGS cells. Infected patients and two uninfected ITP patients received triple therapy and platelets were counted before and 1 month, 6 months, 1 year, and 2 years after eradication therapy. H. pylori infection was found in 17 ITP (85%), 20 ulcer (100%) and 13 NUD (65%) patients. Biopsies and strains were collected from five ITP, 20 ulcer and 13 NUD patients. The ITP patients had a pangastritis or corpus-predominant gastritis pattern. All H. pylori isolates, from ITP, ulcer and NUD patients, were cagA(+) and vacA s1/m1, and did not differ in levels of IL-8 induction or DNA fragmentation. Fifteen ITP (88%) and 17 ulcer (85%) patients had successful eradication of H. pylori. Ten of these 15 (67%) H. pylori-eradicated ITP patients had platelet recovery. There was no significant change in platelet count in the two ITP patients in whom eradication failed or in the two originally H. pylori-uninfected ITP patients, or in the treated ulcer patients. Age at onset of ITP was the main determinant of platelet recovery: 100% of patients diagnosed after the age of 60 recovered compared with only 22% of those diagnosed before 50. H. pylori-infected ITP patients have a corpus-predominant pattern of gastritis but the virulence profile of their strains does not differ from that of ulcer or NUD patients. Eradication of H. pylori infection is a good therapeutic option for some patients with chronic ITP, especially for those who develop ITP in older age.
    No preview · Article · Nov 2004 · Helicobacter
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    ABSTRACT: A 51-year-old man was hospitalized for evaluation of dysphagia and bloody stool. Gastrointestinal endoscopy showed esophageal cancer invading the gastric fundus. A metastatic lesion was demonstrated in the sigmoid colon. The patient agreed to have concurrent chemoradiotherapy for the primary lesion, followed by additional chemotherapy. The first course included 30 Gy of radiotherapy given over 3 weeks, together with daily oral administration of S-1 (80 mg/m2 per day) for 2 weeks, and a 24-h infusion of cisplatin (70 mg/m2) on day 8. After a second course of chemoradiotherapy, four additional courses of chemotherapy with S-1 and cisplatin were administered, at 4-week intervals. After the additional chemotherapy, gastroscopy and colonoscopy showed disappearance of both the primary and the metastatic lesions. One year after his initial hospitalization, no recurrence of either the primary or the metastatic tumor lesions is evident.
    No preview · Article · Nov 2004 · International Journal of Clinical Oncology

Publication Stats

323 Citations
216.05 Total Impact Points

Institutions

  • 2004-2013
    • National Hospital Organization Nagoya Medical Center
      Nagoya, Aichi, Japan
  • 2000
    • Nagoya University
      Nagoya, Aichi, Japan