Search

OBJECTIVE Due to the occurrence of severe adverse drug reactions to regorafenib, a drug used in cancer therapy, the identification of a predictive marker(s) is needed to increase the therapeutic applicability of this compound. We therefore investigated whether polymorphisms in the ABCG2 and SLCO1B genes are associated with adverse drug reactions to regorafenib. METHODS For these analyses, 37 Japanese cancer patients were treated with regorafenib, genotyped for polymorphisms in ABCG2 and SLCO1B, and evaluated for drug-related adverse drug reactions. RESULTS There was no association between the ABCG2 421C>A variant and adverse drug reactions to regorafenib. After treatment, the incidences of increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as well as increased total bilirubin (grade ≥ 2) were 8%, 4%, and 12%, and 42%, 25%, and 25% among SLCO1B1*1b carriers and non-carriers, respectively. There were no significant associations between elevated ALT and bilirubin and the SLCO1B1*1b allele. However, there were significantly lower incidences of increased AST (8% vs. 42%) and anemia (16% vs. 50%) in SLCO1B1*1b carriers than in non-carriers. CONCLUSIONS The absence of SLCO1B1*1b allele appears to be associated with the development of adverse drug reactions to regorafenib; however, further studies involving larger test groups and other populations are needed to confirm these findings. .

これまで, リンパ浮腫への有効な治療法がなく, がん治療後の続発性リンパ浮腫に悩む患者が相当数いた. われわれは, 慢性的に経過しているリンパ浮腫患者に, フェルディー式の医療徒手リンパドレナージ (ML) 手技を含む複合的リンパ療法を行っている. この療法によって, 浮腫の改善と, それに伴うADLの改善が見られた. さらにボディーイメージの改善によって社会参加を取り戻しQOLの向上をもたらすことが出来た2事例を紹介する. 認定資格者によるML手技の適用と共に, 圧迫療法としての弾性包帯と弾性圧迫衣の活用, さらに自ら運動療法に取り組む過程で, セルフケア管理が出来るようになることを目指している. 継続的に自己管理が出来るようになると, 繰り返す蜂窩識炎を回避して, 家族と共に生活の質を維持していくことが可能である.

【背景・目的】他病院でがん診断または治療を受けているにもかかわらず, 主治医の診療情報提供書を持たず, 自らすすんで大学病院を受診した患者の動機を明らかにした.【対象と方法】総合診療部を受診したがん患者52名から受診動機を聴取し, 内容分析を行った.【結果】患者の大学病院受診の動機は, 1) 現在の診断・治療の妥当性についての相談 (30.8%), 2) 新たな症状が出現したことへの不安 (30.8%), 3) 病状が改善しないことによる不安 (19.2%), 4) 高度医療への希望・期待 (9.6%), 5) 経過観察を希望 (9.6%) の5カテゴリーにまとめられた.【結語】患者は, 現在の治療・病状に対する不安, 新たな症状が出現したことによる不安が多く, 大学病院に対し最先端の高度医療提供への期待があることが明らかになった.

The purpose of this study is to clarify the relation between vectorcardiographic configuration and hemodynamic factors of atrial septal defect (herein after refered to as ASD) Many authors made vectorcardiographic studies in ASD to date. The vectorcardiograms in ASD are known to show a unique configuration of counter clockwise rotation and terminal bunching on horizontal plane. However, the qunatitative analysis of the foregoing is rather complicated, in that, each instantaneous vector has no specific tendency as to magnitude and direction. Therefore, the condition of ASD derived from vectorcardiogram has always been qualitatively. It is now important to realize how much information of hemodynamics will be brought out from vectorcardiographiq parameters. Instead of the instantaneous QRS SE vector, the sequential composite QRS SE vector was used as vectorcardiographic parameter. The advantage of this method are: 1) to be able to effectively adopt as the parameter the terminal bunching vector having prolonged duration time. 2) to be able to comprehend as a whole each instantaneous QRS sE vector which may vary from time to time. For the prediction of the severeness in ASD from vectorcardiogram, the author made a comparison between sequential composite QRS sE vectors and hemodynamic factors using multivariate analysis. Method A total of 27 cases, 15 males, 12 females, ranging from 14 to 62 years of age with ASD (ostium secundum) were studied. Chest X-ray, phonocardiography and right ventricular catheterization were used to establish and comfirm the diagnosis of ASD. The three planar projections of vectorcardiogram were photographied on 60 × 60 mm X-ray films simultaneously by three channel vectorcardiography useing the Frank system. The method of morphological observations and quantetative analysis are as follow.