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A 75-year-old woman with a left breast mass on breast cancer screening was referred to our hospital for detailed evaluation. Further examination revealed left breast cancer with metastases to the left axilla, left parasternal region, left supraclavicular fossa, mediastinum, and left hilar lymph nodes, as well as multiple lung metastases. Histopathological evaluation of a needle biopsy specimen revealed invasive ductal carcinoma(scirrhous type), and she was diagnosed with Stage Ⅳ human epidermal growth factor receptor 2(HER2)-positive breast cancer. Following diagnosis, treatment was initiated with trastuzumab, pertuzumab, and docetaxel; however, she developed hypersensitivity to docetaxel and received only trastuzumab and pertuzumab after the second course. We observed a complete response after 3 courses, and treatment was discontinued after 13 courses. She underwent regular evaluation after treatment discontinuation, and a complete response was maintained for 1 year and 6 months. We conclude that combination therapy comprising trastuzumab and pertuzumab was effective for Stage Ⅳ HER2-positive breast cancer and that a complete response could be maintained even after treatment discontinuation.

The use of smart devices in medical information systems is progressing. In addition, correspondence of communication functions in medical equipment is advancing. For this reason, and in order to establish the ubiquitous environment in hospitals, we developed an environment in which multiple wireless communications can be used.

In a hospital, we use a large number of medical equipment. In these use, I support the safe use by the alarm such as errors from medical equipment. There is the instrument notifying of alarm in communication, but there is the instrument by a sound and the light. For the medical safety management, confirmation of the alarm is important. We thought that stability was improved by integrating alarm from the instrument of the different type. Therefore, we thought that we integrated alarm from medical equipment. We decided to transmit an alarm signal from medical equipment by adding radio module program unit. The type of the radio used IEEE 802.15.4 (ZigBee) at a point of view of low power, International Standard, simple radio equipment. This system deals with only alarm information from medical equipment and does not handle the data. However, we understood that we were helpful very much even if it was only alarm information. We were able to in this way reduce the number of incidents.

In our hospital, we managed an electronic health record system and many section subsystems as a hospital information system. By the expansion of these information systems, a system becomes complicated, and maintenance and operative cost increased. Furthermore, the environment that is available to medical information is demanded anywhere anytime by expansion of the computerization. However, the expansion of the information use becomes necessary for the expansion such as the personal protection of information for security. We became rebuilding and the private cloud of the hospital information system by the virtualization technology to solve such a problem. As a result, we were able to perform a decrease in number of the servers which constituted a system, a decrease in network traffic, reduction of the operative cost.