研究者詳細 - 樋之津　史郎

論文 - 樋之津　史郎

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[Meta-analysis and evidence based medicine].

Hinotsu S, Akaza H

Gan to kagaku ryoho. Cancer & chemotherapy 29 ( 10 ) 1705 - 1710 2002年10月 [査読有り]

PubMed

[Urology].

Hinotsu S, Akaza H

Gan to kagaku ryoho. Cancer & chemotherapy 29 ( 9 ) 1549 - 1569 2002年09月 [査読有り]

PubMed

[Intravesical instillation of doxorubicin or epirubicin for chemoprophylaxis of superficial bladder cancer--the fifth study of the Japanese Urological Cancer Research Group for Adriamycin/Farumorubicin].

Hinotsu S, Akaza H, Isaka S, Kagawa S, Koiso K, Kotake T, Machida T, Matsumura Y, Niijima T, Obata K, Ohashi Y, Ohe H, Shimazaki J, Tashiro K, Japanese Urological Cancer Research Group for Adriamycin, Farumorubicin

Gan to kagaku ryoho. Cancer & chemotherapy 29 ( 1 ) 73 - 80 2002年01月 [査読有り]

PubMed

Comparison of losartan with ACE inhibitors and dihydropyridine calcium channel antagonists - A pilot study of prescription-event monitoring in Japan

K Samizo, E Kawabe, S Hinotsu, T Sato, S Kageyama, C Hamada, Y Ohashi, K Kubota

DRUG SAFETY ( ADIS INTERNATIONAL LTD ) 25 ( 11 ) 811 - 821 2002年 [査読有り]

Introduction: Two pilot studies for prescription-event monitoring in Japan (J-PEM) were launched in 1997 and 1998. Here we present data regarding adverse events that were reported in the second pilot J-PEM study where losartan was compared with ACE inhibitors and dihydropyridine calcium channel antagonists. Study design: We conducted a cohort study with a concurrent control. Methods/patient group: Study subjects prescribed losartan, an ACE inhibitor or a calcium channel antagonist were identified from prescriptions in hospital or community pharmacies. Events and other information were collected from doctors and pharmacists by mailed questionnaires. Events were coded and analysed using the Medical Dictionary for Regulatory Activities (MedDRA) terminology. Crude event rates were calculated and compared between patients treated with losartan and those receiving control drugs. When the difference was statistically significant, the event was further examined in several ways, including follow-up studies and by comparison with the data of the UK PEM study on losartan. Results: Pharmacists were sent 4344 questionnaires and returned 3591 (83%), while doctors were sent 3517 questionnaires and returned 1380 (39%). In the doctors' data, the adverse event rate for losartan treatment was greater than that for ACE inhibitors and/or calcium channel antagonists for the following seven events: headache, palpitations, anaemia, insomnia, feeling abnormal, increased blood pressure and asthma. Most of these are known adverse drug reactions (ADRs) of losartan except for two events: increased blood pressure and asthma. In pharmacists' data, the event rate for losartan was significantly greater than that for control drugs for the following ten events: hot flushes, abnormal hepatic function, oedema, peripheral swelling, decreased blood pressure, increased blood pressure, rhinitis, contact dermatitis, dry skin and heat rash. The first five events were known ADRs of losartan but the other five were not. When the two sets of data were combined, the rate of an additional event, increased blood creatinine phosphokinase, which is a known ADR of losartan, was significantly greater than that for the control drugs. The six events that were not documented as ADRs for losartan were not judged to be ADRs based on the results of follow-up studies and comparison with the UK PEM study on losartan. The crude rate of cough with losartan treatment was similar to that with calcium channel antagonists, but was significantly less than that with ACE inhibitors. Conclusion: No novel safety problems were found in this observational cohort study on losartan. The rates of some known ADRs differed significantly between patients treated with losartan and those in the control groups.

DOI PubMed

Pilot study of prescription-event monitoring in Japan comparing troglitazone with alternative oral hypoglycemics

K Kubota, E Kawabe, S Hinotsu, C Hamada, Y Ohashi, K Kurokawa

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY ( SPRINGER-VERLAG ) 56 ( 11 ) 831 - 838 2001年01月 [査読有り]

Objective: To examine adverse events reported in a pilot study of the prescription-event monitoring in Japan (J-PEM) scheme, comparing troglitazone with other oral hypoglycemics. Methods: We used a cohort study with a concurrent control in which information was gathered from both doctors and pharmacists. Crude event rates were calculated and compared between troglitazone (T) and alternative oral hypoglycemics (control drugs, C) using the likelihood ratio test. When the difference was statistically significant, possible confounding mechanisms were examined using Poisson regression analysis. Results: Of 3115 patient codes registered, pharmacists were sent 2078 questionnaires and returned 1814 (87%), while doctors were sent 1858 questionnaires and returned 671 (36%). The difference in crude rates was statistically significant in 11 events (seven where T > C and four where C > T) reported by pharmacists and ten events (three where T > C and seven where C > T) reported by doctors. Among those, in two events, "weight increased" (T > C) and "abnormal hepatic function" (T > C), significant differences were observed in data from both doctors and pharmacists. Regression analysis revealed that the difference in crude rates for "nausea" (T > C) was possibly due to an uneven distribution of genders and that for "weight increased" (T > C) was possibly due to an uneven distribution of compliance. Patients with hepatic function abnormalities associated with troglitazone could be divided into two subtypes: one with a slight increase in serum lactate dehydrogenase concentration only and the other with elevated serum alanine aminotransferase. Conclusions: Comparison of the event rates between troglitazone and control drugs, followed by regression analysis, revealed several features of adverse events associated with drugs, including possible confounding mechanisms. Troglitazone-induced hepatic function abnormalities may be divided into two subtypes.

Development of molecular targeting drugs for the treatment of cancer-therapeutic potential and issues to be addressed in global development

H. Akaza, K. Aiba, S. Isonishi, O. Ogawa, M. Shibuya, S. Sone, T. Tsuruo, S. Noguchi, S. Hinotsu, S. Kono, O. Mikami, G. Blackledge, B. Vose, D. Stribling

Gan to kagaku ryoho. Cancer & chemotherapy 27 ( 11 ) 1681 - 1693 2000年

A survey of cancer treatment in a sample of hospitals > 100 beds conducted in 1998 compared with experience in the US showed that good progress has been achieved in Japan in the screening and early treatment of gastric cancer, and that the prognosis for breast cancer is better than in the West. Although in the past, the cytotoxic therapies available to physicians in Japan vs the West have been different, recent acceleration of regulatory review will result in a convergence of treatment paradigms and some improvement in acute response in many tumour types. However, world wide there is a need for new improved therapies in all cancers evaluated. Particular needs are in the management of NSCLC, advanced disease and cancers which form micrometastases. The eventual hope is that cancer can be turned from a lethal disease into a chronic disease where patients maintain a good QOL. Apart from anti hormonal therapies, the usual approach has been to kill the cancerous cells. However, the new approaches to intervening in the growth and migration of cancerous cells or the host tissue response by molecular targeting offer the promise of achieving a step change in therapy. Although EGF tyrosine Kinase inhibitors such as ZD 1839 have been shown to cause a conventional tumour response in NSCLC, many of these new approaches are unlikely to show a short term response even if they have the capacity to affect tumour development and increase disease free survival. Some compounds will require combination therapy with a conventional cytotoxic or radiotherapy to show their full benefit. For conventional cytotoxics, the usual approach to development has been to select the maximum tolerated dose and then evaluate the efficacy in advanced disease. However, for the new approaches which will not have such severe dose limiting toxicities, it will be necessary to select a surrogate marker of the intended biological effect to select the optimal biological dose (OBD) and dose regimen in phase I/II studies for further evaluation in phase II or III studies which are designed to show the expected patient benefit. The tumour target, the stage of the disease and the possible need for concomitant therapy will also have to be considered according to the mechanism of action of the product.

PubMed

Argyrophilic nucleolar organizer region in proliferating cell has a predictive value for local recurrence in superficial bladder tumor

M Tomobe, T Shimazui, K Uchida, S Hinotsu, H Akaza

JOURNAL OF UROLOGY ( LIPPINCOTT WILLIAMS & WILKINS ) 162 ( 1 ) 63 - 68 1999年07月 [査読有り]

Purpose: It has been shown in many carcinomas that the proliferation rate and number of argyrophilic nucleolar organizer regions (AgNOR) are associated with tumor aggressiveness. However, in bladder tumor the significance of the correlation between the number of AgNOR and tumor behavior remains controversial. Therefore, it would be helpful if a new technique could be developed that would allow for more accurate AgNOR counting in association with tumor behavior. We established the simultaneous staining technique of AgNOR with Ki-67 labeling to reveal the significance of AgNOR count in superficial bladder tumor. Materials and Methods: A total of 50 paraffin sections of superficial bladder tumor were stained with AgNOR and Ki-67 (MIB-1). The numbers of AgNORs in proliferating (MIB-1 positive) or resting (MIB-1 negative) cells were counted from a total of 100 nuclei. Correlations between MIB-1 associated AgNOR count and clinicopathological parameters were statistically analyzed. Results: The AgNOR count in proliferating cells was significantly higher than that in resting cells (p <0.01), and the count significantly increased with tumor grade (p <0.01). Based on recurrence-free survival analyses the local recurrence rate was significantly higher in patients with high proliferating cell NOR but not for those with resting or whole cells. However, no AgNOR score helped to select patients at high risk for disease progression. Conclusions: Proliferating cell NOR had a predictive value for local recurrence in patients with superficial bladder tumor.

Intravesical chemotherapy and immunotherapy for superficial tumors: Basic mechanism of action and future direction

H. Akaza, K. H. Kurth, R. Williams, S. Hinotsu, M. A.S. Jewett, K. Naito, K. Okada, P. F. Schellhammer, R. F. Van Velthoven, J. A. Witjes

Urologic Oncology ( Elsevier Inc. ) 4 ( 4-5 ) 121 - 129 1999年 [査読有り]

DOI

Early detection and prevention of cancers in various therapeutic areas. Discussion

H. Akaza, T. Tsuruo, T. Tsukamoto, S. Noguchi, H. Moriwaki, S. Isonishi, N. Masuda, S. Hinotsu, A. F. Nash, M. von Euler, J. Wildin, D. Stribling

Gan to kagaku ryoho. Cancer & chemotherapy 26 ( 11 ) 1585 - 1597 1999年

As illustrated by prostate cancer screening provides an opportunity for early intervention and treatment. However the screening test needs to detect patients with cancer with a low rate of false positives and at a stage which can be treated. Recently the concept of treating patients at high risk of developing breast cancer or suffering a recurrence has been highlighted by the western studies with Nolvadex (tamoxifen). Thus roundtable discussion (held in Tokyo) discussed the different strategies in Japan compared to US & Europe for screening & early intervention/prevention of cancer for breast, prostate, bladder, liver, lung, gynaecological & GI cancers. The range of strategies for cancer screening, how it is funded, whether it is appropriately targeted and whether there is any evidence for a beneficial effect on morbidity or mortality & future prospects for improved sensitivity through new methodology or markers were discussed. Although the relative rates of cancer vary between Japan & the West, the same factors seem to influence cancer development & the data on intervention were seen to be valid. The changing patterns of cancer in Japan suggest a clear opportunity for reducing, the incidence of cancer through lifestyle modification. For some cancers, e.g. cervical & bladder where there is a clear link between abnormal cytology & development cancer true prevention is already practiced. In other cases, preventive treatment is limited by the efficacy of available therapies. As far as drug treatment is concerned, funding of healthcare in Japan does not recognise the concept of prevention although there is, in practice, no barrier to the use of interventions where there is a clear link between biochemical/histological markers & development of cancer.

PubMed

医学統計学の実際 : がん治療研究・薬理実験を対象として

大橋靖雄, 樋之津史郎

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 88 ( 2 ) 74 - 74 1997年

DOI CiNii

Comparison of clinical effects between granisetron alone and combination of granisetron and methylprednisolone against the nausea and vomiting induced by CDDP chemotherapy comparative study by the cross-over trial

K. Uchida, H. Akaza, T. Shimazui, K. Kikuchi, F. Manabe, A. Iwasaki, S. Ishikawa, R. Noguchi, M. Otani, K. Hattori, F. Kondo, Y. Nishijima, K. Sato, K. Koiso, S. Hinotsu

Japanese Journal of Cancer and Chemotherapy 23 ( 1 ) 81 - 86 1996年 [査読有り]

A cross over clinical trial was carried out to compare the antiemetic effort and safety between granisetron alone (40 μg/kg) and the combination of granisetron and methylprednisolone (MP: 10 mg/kg) in urological cancer patients treated with cisplatin. Forty-eight courses were given with granisetron alone and 47 courses with both granisetron and MP. The antiemetic effect of nausea and vomiting was evaluated in the acute emetic phase, during the 24 hours following the CDDP administration, and in the delayed emetic phase, 2 to 7 days after the administration. Combination therapy of granisetron and MP demonstrated a greatest antiemetic effect during the 72 hours following the CDDP administration than by granisetron alone. But there was no significant difference in antiemetic effect between combination therapy and granisetron alone after the 3rd day. Combination therapy also demonstrated more efficacy in complete antiemetic effect, with no emesis and less than moderate nausea, than by granisetron alone. Both treatments showed no side effects and were safe.

PubMed

An overview of clinical trials in endocrine therapy for cancer

S. Hinotsu, Y. Ohasi, H. Akaza

Japanese Journal of Cancer and Chemotherapy 23 ( 6 ) 689 - 694 1996年 [査読有り]

To obtain information for published clinical trials in endocrine therapy for cancer in Japan, a computerized literature search of MEDLINE, EMBASE and IGAKU-CHUO-ZASSHI (CD-ROM) was done. We found four articles on randomized trials for prostate cancer and two for breast cancer. In order to obtain information for ongoing randomized phase III trials in endocrine therapy for cancer in the United States and Europe, a search of PDQ (Physician's Data Query) was done. In PDQ, 13 active trials started after January 1990 in endocrine therapy for breast cancer and six active trials started after January 1990 in endocrine therapy for prostate cancer were registered. Out of 13 trials for breast cancer, projected sample sizes were over 1,000 in eight trials, and QOL was selected as an end point in six trials. Out of six trials for prostate cancer, projected sample sizes were over 500 in three trials, and QOL or sexual function was selected as an end point in three trials.

PubMed

精巣腫瘍導入化学療法における肺障害の検討

河合弘二, 樋之津史郎, 宮永直人, 菊池孝治, 内田克紀, 武島仁, 赤座英之

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 87 ( 2 ) 508 - 508 1996年

DOI CiNii

シスプラチン併用全身および動注化学療法時の悪心・嘔吐に対する制吐剤投与法の検討

内田克紀, 佐々木明, 菊池孝治, 赤座英之, 小磯謙吉, 石川悟, 野口良輔, 大谷幹伸, 樋之津史郎, 服部一紀, 近藤福次, 岩崎明郎, 真鍋文雄

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 86 ( 3 ) 824 - 824 1995年

DOI CiNii

日本泌尿器科学会雑誌掲載論文中に使用された統計学的手法の解析

樋之津史郎, 大橋靖雄

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 86 ( 3 ) 831 - 831 1995年

DOI CiNii

Bellini duct carcinoma accompanied by hemorrhagic renal cyst: A case report and review of the literature

N. Sekido, S. Hinotsu, K. Kawai, K. Matsuki, H. Akaza, K. Koiso

Nishinihon Journal of Urology 57 ( 4 ) 515 - 518 1995年

A 51-year-old female, who had undergone close follow-up for a right hemorrhagic renal cyst one year earlier, was admitted to our hospital in order to undergo examination of a newly developing tumor adjacent to the cyst, which had been found on ultrasonography and computed tomography. Aortography showed the downward displacement of the lower renal artery, but did not reveal any tumor vessels. Dark red fluid was aspirated from the cyst and the LDH level in the fluid was found to be very high (3042 U/ml). Urine cytological study resulted in class IV. Since small renal cell carcinoma was highly suspected according to these results, we performed right radical nephrectomy. According to the pathological findings, this tumor was not a renal cell carcinoma originating from the proximal tubules, but was a Bellini duct carcinoma originating from the collecting duct. Moreover, renal hilar lymph-node metastasis was present. She was treated with α-interferon and Tegafur postoperatively, but 4 months after surgery there was evidence of metastasis in the liver. She received chemotherapy of the M-VAC regimen, but after 1 cycle of this therapy, multiple liver metastases and retroperitoneal lymph node metastases were noted. We herein describe a case report and review the literature.

Fournier's gangrene detected at an early stage: A case report

N. Sekido, S. Hinotsu, H. Akaza, K. Koiso

Nishinihon Journal of Urology 56 ( 10 ) 1199 - 1202 1994年

A 25-year-old male was admitted to our hospital complaining of pyrexia, sore throat and left hemiscrotal pain. On physical examination, a part of the left hemiscrotum showed slight redness, mild swelling and a small ulcerative lesion. Hematological study revealed marked inflammatory reaction. Intensive antibiotic chemotherapy and deep stab incision through the center of the lesion was conducted under the diagnosis of early-stage Fournier's gangrene. He rapidly recovered and the scrotal wound healed very quickly, without spreading any further across the scrotum. We conclude that early-stage Fournier's gangrene can be treated with intensive antibiotic chemotherapy and minimal debridement.

Intravesical ultrasound tomography with miniature probe for bladder cancer

K. Hattori, S. Hinotsu, T. Shimazui, K. Uchida, H. Akaza, K. Koiso

Japanese Journal of Medical Ultrasonics 20 ( 10 ) 1 - 5 1993年

軟性膀胱鏡と Nd : YAGレーザーを用いた表在性膀胱腫瘍の外来治療 : 第80回日本泌尿器科学会総会

石川悟, 佐々木明, 笠谷俊也, 樋之津史郎, 鶴田敦, 小磯謙吉

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 84 ( 1 ) 105 - 106 1993年

DOI CiNii

Use of ND:YAG laser and flexible cystoscope in outpatient treatment of recurrent superficial bladder tumors

Satoru Ishikawa, Akira Sasaki, Atsushi Tsuruta, Shiro Hinotsu, Kenkichi Koiso

Japanese Journal of Urology 84 ( 4 ) 707 - 710 1993年 [査読有り]

Nd:YAG laser irradiation and flexible cystoscopy were used in the outpatient management of 16 cases (21 sessions) with superficial bladder tumors. Irradiation of tumors was accomplished in all cases except 3 in which the visual field was affected by bleeding after the cup biopsy of tumors. Tumors at the bladder neck were easily irradiated through the flexible cystoscope. No tumor recurred at or near the previously irradiated site. This method provided a safe and cost-effective means to treat superficial bladder tumors in selected cases. © 1993, THE JAPANESE UROLOGICAL ASSOCIATION. All rights reserved.

DOI PubMed

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