著者
井上 晴洋 塩飽 洋生 岩切 勝彦 鬼丸 学 小林 泰俊 南 ひとみ 佐藤 裕樹 北野 正剛 岩切 龍一 小村 伸朗 村上 和成 深見 悟生 藤本 一眞 田尻 久雄
出版者
一般社団法人 日本消化器内視鏡学会
雑誌
日本消化器内視鏡学会雑誌 (ISSN:03871207)
巻号頁・発行日
vol.60, no.6, pp.1249-1271, 2018 (Released:2018-06-20)
参考文献数
143

日本消化器内視鏡学会は,新たに科学的な手法で作成した基本的な指針として,「POEM診療ガイドライン」を作成した.POEM(Peroral endoscopic myotomy)は,食道アカラシアおよび類縁疾患に対して本邦で開発された新しい内視鏡的治療法であり,国内外で急速に普及しつつある.したがって,本診療ガイドラインの作成が強く望まれた.しかしながら,この分野においてこれまでに発表された論文はエビデンスレベルの低いものが多く,また長期成績はまだ出ていないため,専門家のコンセンサスに基づき推奨の強さを決定しなければならなかった.主として,トレーニング,適応,検査法,前処置,麻酔,方法,成績,有効性,偶発症,他治療との比較などの項目について,現時点での指針をまとめた.
著者
後藤 茂 岩男 裕二郎 岩男 淳一郎 唐原 和秀 北野 正剛
出版者
一般社団法人 日本温泉気候物理医学会
雑誌
日本温泉気候物理医学会雑誌 (ISSN:00290343)
巻号頁・発行日
vol.71, no.4, pp.221-228, 2008 (Released:2010-04-30)
参考文献数
22

A case reportA 70-year-old male with small bowel adenocarcinoma involving retroperitoneal invasion had undergone chemotherapy after non-curative operation. However, this patient had to discontinue the first and second lines of chemotherapies within one month due to serious side effects of anti-cancer agents. Subsequently, the patient complained of severe low-back pain and there was evidence of local recurrence around the resected small intestine. Therefore, phototherapy was applied three times a week to relieve the low-back pain while the patient underwent the third line of chemotherapy. It was interesting to note that these combination therapies coincidentally ameliorated the various side effects caused by anti-cancer drugs. For one year during the third line of chemotherapy, the patient had to temporarily discontinue chemotherapy only two times when phototherapy was not available for one week due to consecutive national holidays in May and November. The quality of life of this patient was well maintained, and he only needed to be hospitalized for the last two months before he died.Epidemiological studies have shown a high incidence of cancer in people less exposed to solar rays. The sunshine “vitamin” 1 alpha, 25-dihydroxy vitamin D3 (1, 25(OH)2D3) is involved in these epidemiological studies based on the evidence that 1, 25(OH)2D3 is an antiproliferative agent that may inhibit proliferation of cancer cells in vitro and development in animals. To elucidate the synergetic effect of phototherapy in combination with chemotherapy, we assayed serum levels of 1, 25(OH)2D3 in this patient compared with those of end-stage cancer patients undergoing chemotherapy alone. Serum levels of 1, 25(OH)2D3 in this patient after receiving the combination therapies were higher than those in other cancer patients treated with chemotherapy alone.Our results indicate that phototherapy may be a good complementary therapy with chemotherapy for cancer patients.