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  • 1
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2019
    In:  Neuro-Oncology Advances Vol. 1, No. Supplement_2 ( 2019-12-16), p. ii31-ii31
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 1, No. Supplement_2 ( 2019-12-16), p. ii31-ii31
    Abstract: Despite aggressive treatment with surgery and chemo-radiation therapy, it is difficult to cure patients with glioblastoma (GBM). The end-of-life (EOL) phase of patients with GBM, and related problems, have not yet been adequately studied. Most cancer patients died in the hospital (84%) in 2017, but the Japanese government has recommended palliative home-care and the number of deaths at home has recently been increasing. This study explores the current situation of EOL care for GBM patients in our hospital. METHODS We retrospectively examined the clinical course and EOL phase of 166 consecutive patients who were treated in our hospital between 2010 and 2017. RESULT In total, 107 patients died; 28 (26%) at home, 25 (23%) in hospice care, 9(9%) in nursing homes, 21(20%) in long-term care hospitals (LTCH), 13(12%) in our hospital, and 11(10%) in other neurosurgical hospitals. The median survival time and length of EOL phase for patients who died at home were 596 and 77 days; 469 and 103 days in hospice care; 528 days and 149 days in LTCH; 388 days and 52 days in our hospital; 802 and 91 days in other neurosurgical hospital; and 565 days and 55 days in nursing homes, respectively. The KPS of patients who transferred to LTCH or was started palliative care in other neurological hospital was 60. That of other patients was 50.The patients who died at home entered deep coma in the last 3.5 days (n=24) of life and could not take oral feeds for 7 days (n=26). CONCLUSION According to cancer patient study, the home-based palliative time of longer prognosis group were 59 days. EOL phase of GBM may be longer than other cancer. We must consider the problems of the EOL phase and improve the quality of EOL care.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 3009682-0
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  • 2
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2019
    In:  Neuro-Oncology Vol. 21, No. Supplement_6 ( 2019-11-11), p. vi206-vi207
    In: Neuro-Oncology, Oxford University Press (OUP), Vol. 21, No. Supplement_6 ( 2019-11-11), p. vi206-vi207
    Abstract: Despite aggressive treatment with surgery and chemo-radiation therapy, it is difficult to cure patients with glioblastoma (GBM). The end-of-life (EOL) phase of patients with GBM, and related problems, have not yet been adequately studied. Unlike in other countries, most cancer patients died in the hospital (84%) in 2017, but the Japanese government has recommended palliative home care and the number of deaths at home has recently been increasing. This study explores the current situation of EOL care for GBM patients in Japan. METHODS We retrospectively examined the clinical course and EOL phase of 166 consecutive patients who were treated in our hospital between 2010 and 2017. RESULT: In total, 107 patients died; 27 (25.7%) at home, 24 (22.8%) in hospice care, 8 (7.6%) in nursing homes, 46 (43.9%) in hospitals (long-term care hospitals [LTCH; 19.8%], our hospital [13.3%] , and other neurosurgical hospitals [10.4%]). According to our previous research, in 2001–2005, 6% of GBM patients died at home, 3% in hospice case, and 91% in the hospital. The KPSof patients who started palliative home care or transferred to another hospital was 50–60. The median survival time and length of EOL phase for patients who died at home were 498 and 76.5 days; 395 and 103 days in hospice care; 533 days and 149 days in LTCH; 374 days and 52 days in our hospital; 338 and 75.5 days in other neurosurgical hospital; and 557 days and 37 days in nursing homes, respectively. CONCLUSION The number of GBM patients who died at home in Japan is increasing, and we must consider the problems of the EOL phase and improve the quality of EOL care.
    Type of Medium: Online Resource
    ISSN: 1522-8517 , 1523-5866
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2094060-9
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  • 3
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2019
    In:  Neuro-Oncology Advances Vol. 1, No. Supplement_2 ( 2019-12-16), p. ii44-ii45
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 1, No. Supplement_2 ( 2019-12-16), p. ii44-ii45
    Abstract: In 2018,Optune (TTF) became available covered by public insurance for patients with glioblastoma,based on the effectiveness of the US EF-14 study (TTF + TMZ (temozolomide) vs. TMZ). There are problems such as use of at least 18 hours a day,behavior restrictions,expensive medical expenses,etc. From the initial use experience of optune in our hospital,we examined the problems of effectiveness and treatment of TTF. METHOD We examined patient approval rate of TTF use and treatment problems in patients with glioblastoma who started treatment in our department from 2017.11 when TTF became covered by insurance. RESULT There were 41 patients with primary glioblastoma during the study period (male: female = 25: 16,median age 60 years (22–77)). There are 10 patients with KPS & lt;70 that are not TTF indications (male: female = 7: 3,median age 45.5 (29–64),consent rate 38.5%). For 26 people (63% of the total) excluding 5 patients who participated in clinical trial,we explained that TTF indications,clinical trial results,adverse events,wearing rate should be 75% or more,and that full shaving is required. 10 people wanted to undergo TTF treatment. The consent rate of women is lower than that of men (46.7% vs. 27.3%),there was a tendency to take TTF treatment in young patients. Average wear rates of 5 patients who continued for more than 6 months were 55%,76%,84%,85%,91%,respectively. Use of TTF for 6 months or longer with residual tumor was CR 1 case,PR 1 case,SD 2 cases. Our department policy is to continue for 12 months. One person ends in 12 months,the other continues to use TTF. So far,no adverse events caused by TTF have been observed,though,there were complaints about the weight of the equipment,feeling of binding,restrictions on bathing,etc.,and one person stopped using it in the fifth month. DISCUSSION The consent rate for TTF use was about 40% as expected,and 80% of patients with an average wearing rate of 75% or more. TTF can generally continue once the patient is convinced and begins to use,but seems to be severely restricted in behavior in patients with paralysis. There is no profound data on TTF in Japan,and it is necessary to collect data at multiple facilities and clarify the effectiveness and safety in the future.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 3009682-0
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  • 4
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2017
    In:  Interactive CardioVascular and Thoracic Surgery Vol. 25, No. 6 ( 2017-12-01), p. 950-957
    In: Interactive CardioVascular and Thoracic Surgery, Oxford University Press (OUP), Vol. 25, No. 6 ( 2017-12-01), p. 950-957
    Type of Medium: Online Resource
    ISSN: 1569-9293 , 1569-9285
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2096257-5
    detail.hit.zdb_id: 3167862-2
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  • 5
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2010
    In:  Journal of Pharmacy and Pharmacology Vol. 60, No. 4 ( 2010-02-18), p. 461-465
    In: Journal of Pharmacy and Pharmacology, Oxford University Press (OUP), Vol. 60, No. 4 ( 2010-02-18), p. 461-465
    Abstract: Conscious young adult male rats were given total parenteral nutrition (TPN) with or without soybean fat for 4 days. Those given fat-free TPN developed severe fatty liver, with hyperglycaemia, hyperinsulinaemia, and hypotriglyceridaemia. These disorders were clearly improved by supplementing TPN with soybean fat, in an amount equivalent to 20% of total calories, and correspondingly reducing glucose. Insulin resistance also developed over a 4-day infusion of fat-free TPN in mature rats. Even after overnight fasting after stopping the TPN infusion, the levels of serum glucose and insulin were higher in the fat-free TPN group than in the control group, and intravenous glucose tolerance test results indicated insulin resistance in the fat-free TPN group. The HOMA-IR index of insulin resistance was significantly improved by supplementation with soybean fat. In conclusion, fat-free TPN infusion induced hyperglycaemia and hyperinsulinaemia, leading to fatty liver and insulin resistance. TPN with glucose should be supplemented with soybean fat emulsion as replacement for part of the glucose calories.
    Type of Medium: Online Resource
    ISSN: 0022-3573 , 2042-7158
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2010
    detail.hit.zdb_id: 2041988-0
    detail.hit.zdb_id: 2050532-2
    SSG: 15,3
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  • 6
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2013
    In:  European Journal of Cardio-Thoracic Surgery Vol. 43, No. 1 ( 2013-1), p. 176-181
    In: European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), Vol. 43, No. 1 ( 2013-1), p. 176-181
    Type of Medium: Online Resource
    ISSN: 1873-734X , 1010-7940
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2013
    detail.hit.zdb_id: 1500330-9
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  • 7
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  European Journal of Cardio-Thoracic Surgery Vol. 58, No. 1 ( 2020-07-01), p. 138-144
    In: European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), Vol. 58, No. 1 ( 2020-07-01), p. 138-144
    Abstract: OBJECTIVES Valve repair for aortic insufficiency (AI) requires a tailored surgical approach determined by the leaflet and aortic disease. In this study, we used a repair-oriented system for the classification of AI, and we elucidated long-term outcomes of aortic root reimplantation with this classification system. METHODS From 1999 to 2018, a total of 197 patients underwent elective reimplantation (mean age: 52.7 ± 17.7 years; 80% male). The aortic valve was tricuspid in 143 patients, bicuspid in 51 patients and quadricuspid in 3 patients. A total of 93 patients had type I AI (aortic dilatation), 57 patients had type II AI (cusp prolapse) and 47 patients had type III AI (restrictive). In total, 104 of the 264 patients (39%) had more than 1 identified mechanism. RESULTS In-hospital mortality was 0.5% (1/197). Mid-term follow-up (mean follow-up duration: 5.5 years) revealed a late mortality rate of 4.2% (9/197). Aortic valve reoperation was performed on 16 patients (8.0%). Rates of freedom from aortic valve replacement and freedom from aortic valve-related events at 10 years of follow-up were 87.0 ± 4.0% and 60.6 ± 6.0%, respectively; patients with type Ib AI (98.3 ± 1.7%; 80.7 ± 7.5%) had better outcomes than patients with type III AI (59.6 ± 15.6%; 42.2 ± 13.1%, P = 0.01). In patients with types II and III AI who had bicuspid aortic valves, rates of freedom from aortic valve-related events at 5 years of follow-up were 95.2 ± 4.7% and 71.7 ± 9.1%, respectively (P = 0.03). CONCLUSIONS This repair-oriented system for classifying AI could help to predict the durable aortic valve repair techniques. Patient selection according to the classification is particularly important for long-term durability. Clinical trial registration number B190050.
    Type of Medium: Online Resource
    ISSN: 1010-7940 , 1873-734X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1500330-9
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  • 8
    In: Journal of Biochemistry, Oxford University Press (OUP), Vol. 159, No. 2 ( 2016-02), p. 181-190
    Type of Medium: Online Resource
    ISSN: 0021-924X , 1756-2651
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2016
    detail.hit.zdb_id: 2009977-0
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  • 9
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2014
    In:  European Journal of Cardio-Thoracic Surgery Vol. 46, No. 6 ( 2014-12), p. 974-980
    In: European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), Vol. 46, No. 6 ( 2014-12), p. 974-980
    Type of Medium: Online Resource
    ISSN: 1873-734X , 1010-7940
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2014
    detail.hit.zdb_id: 1500330-9
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