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1

2 no.645 vol.63 no ACP ACP f CODE CN1645

3

4 TRUTH SEEKING

5 ATM INDEX NATURE REVIEWS DRUG DISCOVERY, VOLUME12, DECEMBER (2013) 2014 Access to Medicine Index. Access to Medicine Foundation

6 3 CLINICIAN Ê16 NO. 645

7 CLINICIAN Ê16 NO

8 5 CLINICIAN Ê16 NO. 645

9 CLINICIAN Ê16 NO

10 7 CLINICIAN Ê16 NO. 645

11 CLINICIAN Ê16 NO

12 9 CLINICIAN Ê16 NO. 645

13 CLINICIAN Ê16 NO inph inph inph inph possible inph possible inph probable inph possible inph probable inph definite inph

14 11 CLINICIAN Ê16 NO. 645 inph Hirono N, et al:distinctive neurobehavioral features among neurodegenerative dementias. J Neuropsychiatry Clin Neurosci, 11, DESH inph

15 (2015) 2):an open-label randomised trial. Lancet Neurol, 14, idiopathic normal pressure hydrocephalus (SINPHONI- Kazui H, et al:lumboperitoneal shunt surgery for (2013) hydrocephalus after shunt surgery. J Neurol Sci, 328, symptoms in patients with idiopathic normal pressure Kazui H, et al : Predictors of the disappearance of triad Brain and Nerve Neurologia medico-chirurgica, 52, (2012) normal pressure hydrocephalus :second edition. Mori E, et al : Guidelines for management of idiopathic (2013) multiple hospitals. Int Psychogeriatr, 25, symptoms in patients with dementia : a cohort study in stay for the treatment of severe neuropsychiatric Sugiyama H, et al :Predictors of prolonged hospital (1999) CLINICIAN Ê16 NO

16 13 CLINICIAN Ê16 NO. 645

17 CLINICIAN Ê16 NO

18 CT DVD NST /ARB FAX 15 CLINICIAN Ê16 NO. 645

19 M M CT scan CT ECG CT CT ECG CLINICIAN Ê16 NO

20 17 CLINICIAN Ê16 NO. 645 Hand book,

21 CLINICIAN Ê16 NO inform inform

22 19 CLINICIAN Ê16 NO mg mg mg mg.. mmhg mmhg 180/110

23 CLINICIAN Ê16 NO Brose M, et al:sorafenib in radioactive iodinerefractory, locally advanced or metastatic differentiated thyroid cancer :a randomized, double-blind, phase 3 trial. Lancet, 384 (9940), (2014) Schlumberger M, et al :Lenvatinib versus placebo in radioiodine-refractory thyroid cancer. N Eng J Med, 372 (7), (2015) Team Nexavar

24 21 CLINICIAN Ê16 NO. 645 Advance Care Planning

25 CLINICIAN Ê16 NO

26 23 CLINICIAN Ê16 NO. 645

27 CLINICIAN Ê16 NO

28 25 CLINICIAN Ê16 NO. 645

29 CLINICIAN Ê16 NO

30 27 CLINICIAN Ê16 NO. 645

31 CLINICIAN Ê16 NO high resolution manometry

32 29 CLINICIAN Ê16 NO. 645

33 CLINICIAN Ê16 NO Yoshikawa H, et al:oral symptoms including dental erosion in gastroesophageal reflux disease are associated with decreased salivary flow volume and swallowing function. J Gastroenterol, 47, (2012) Adachi K, et al :Predominant nocturnal acid reflux in patients with Los Angeles grade C and D reflux esophagitis. J Gastroenterol Hepatol, 16, (2001) Mizuta A, et al:different sex-related influences of eating habits on the prevalence of reflux esophagitis in Japanese. J Gastroenterol Hepatol, 26, (2011)

34 31 CLINICIAN Ê16 NO. 645 Nutritional Support Team Inflammatory bowel disease

35 CLINICIAN Ê16 NO

36 33 CLINICIAN Ê16 NO. 645

37 CLINICIAN Ê16 NO IBD IBD IBD IBD IBD 2030

38 35 CLINICIAN Ê16 NO. 645

39 CLINICIAN Ê16 NO Treat to Target csdmard

40 37 CLINICIAN Ê16 NO. 645 csdmard csdmard MSW RA

41 CLINICIAN Ê16 NO

42 39 CLINICIAN Ê16 NO. 645

43 CLINICIAN Ê16 NO benefit pt-global-vas unmet medical needs

44 41 CLINICIAN Ê16 NO. 645

45 CLINICIAN Ê16 NO

46 43 CLINICIAN Ê16 NO

47 CLINICIAN Ê16 NO

48 45 CLINICIAN Ê16 NO. 645 Interdisciplinary

49 CLINICIAN Ê16 NO Barsky AJ, Borus JF:Functional somatic syndromes. Ann Intern Med, 130 (11), (1999) Del Fabbro E : Assessment and management of chemical coping in patients with cancer. JCO, 32, (2014)

50 47 CLINICIAN Ê16 NO. 645

51 CLINICIAN Ê16 NO

52 49 CLINICIAN Ê16 NO. 645

53 CLINICIAN Ê16 NO

54 51 CLINICIAN Ê16 NO. 645

55 CLINICIAN Ê16 NO

56 53 CLINICIAN Ê16 NO. 645

57 CLINICIAN Ê16 NO

58 55 CLINICIAN Ê16 NO. 645

59 CLINICIAN Ê16 NO

60 57 CLINICIAN Ê16 NO. 645

61 CLINICIAN Ê16 NO rt-pa Drip, Ship and Retrieve

62 59 CLINICIAN Ê16 NO. 645 mrs:modified Rankin Scale, FIM:Functional Independence Measure, BI:Barthel Index, NIHSS: National Institute of Health Stroke Scale, JCS:Japan Coma Scale

63 CLINICIAN Ê16 NO

64 61 CLINICIAN Ê16 NO. 645 No.

65 CLINICIAN Ê16 NO

66 63 CLINICIAN Ê16 NO. 645 Hurthle mci....., p<. Hurthle mci....., p<.

67 CLINICIAN Ê16 NO

68 65 CLINICIAN Ê16 NO

69 CLINICIAN Ê16 NO Brose MS, et al:sorafenib in radioactive iodinerefractory, locally advanced or metastatic differentiated thyroid cancer:a randomised, double-blind, phase 3 trial. Lancet, 384, (2014) Schlumberger M, et al:lenvatinib versus Placebo in Radioiodine-Refractory Thyroid Cancer. N Engl J Med, 372, (2015)

70 67 CLINICIAN Ê16 NO. 645

71 CLINICIAN Ê16 NO

72 69 CLINICIAN Ê16 NO. 645

73 ②超音波検査 US 数の年度別推移 㻝㻥㻥㻡 㻝㻝㻘㻤㻝㻞 㻝㻥㻥㻢 㻝㻟㻘㻢㻣㻡 㻝㻥㻥㻣 㻝㻠㻘㻤㻤㻝 㻝㻥㻥㻤 㻝㻢㻘㻞㻤㻡 㻝㻥㻥㻥 㻝㻣㻘㻡㻥㻢 㻞㻜㻜㻜 㻝㻤㻘㻝㻤㻢 㻞㻜㻜㻝 㻞㻜㻘㻜㻟㻞 㻞㻜㻜㻞 㻞㻜㻘㻢㻞㻢 㻞㻜㻜㻟 㻞㻞㻘㻡㻣㻡 㻞㻜㻜㻠 㻞㻟㻘㻣㻤㻠 㻞㻜㻜㻡 㻞㻠㻘㻥㻞㻝 㻞㻜㻜㻢 㻞㻠㻘㻝㻥㻜 㻞㻜㻜㻣 㻞㻡㻘㻝㻡㻠 㻞㻜㻜㻤 㻞㻠㻘㻢㻟㻡 㻞㻜㻜㻥 㻞㻠㻘㻥㻟㻣 㻞㻜㻝㻜 㻞㻠㻘㻝㻞㻣 㻞㻜㻝㻝 㻞㻠㻘㻥㻞㻣 㻞㻜㻝㻞 㻞㻠㻘㻜㻣㻝 㻞㻜㻝㻟 㻞㻠㻘㻝㻜㻠 㻞㻜㻝㻠 㻞㻞㻘㻞㻥㻣 年 2004年以降はプラトーである ③細胞診検査数の年度別推移 㻝㻥㻥㻡 㻥㻜㻜 㻝㻥㻥㻢 㻝㻘㻜㻞㻝 㻝㻥㻥㻣 㻝㻘㻝㻠㻢 㻝㻥㻥㻤 㻝㻘㻝㻞㻟 㻝㻥㻥㻥 㻝㻘㻞㻞㻠 㻞㻜㻜㻜 㻝㻘㻜㻢㻠 㻞㻜㻜㻝 㻝㻘㻝㻢㻝 㻞㻜㻜㻞 㻝㻘㻜㻡㻝 㻞㻜㻜㻟 㻝㻘㻝㻡㻝 㻞㻜㻜㻠 㻝㻘㻝㻟㻝 㻞㻜㻜㻡 㻝㻘㻞㻠㻞 㻞㻜㻜㻢 㻝㻘㻝㻞㻜 㻞㻜㻜㻣 㻝㻘㻜㻢㻢 㻞㻜㻜㻤 㻝㻘㻜㻣㻡 㻞㻜㻜㻥 㻝㻘㻜㻟㻜 㻞㻜㻝㻜 㻥㻟㻣 㻞㻜㻝㻝 㻝㻘㻜㻝㻜 㻞㻜㻝㻞 㻥㻟㻣 㻞㻜㻝㻟 㻤㻢㻟 㻞㻜㻝㻠 㻤㻝㻣 年 2005年をピークに減少傾向にある これは針生検 CNB やマンモトーム MMT 検査の 増加によるものである (72) CLINICIAN Ê16 NO

74 71 CLINICIAN Ê16 NO. 645 LH-

75 CLINICIAN Ê16 NO RH agonist tachyphylaxis

76 73 CLINICIAN Ê16 NO. 645

77 CLINICIAN Ê16 NO News letter News letter

78 75 CLINICIAN Ê16 NO. 645

79 CLINICIAN Ê16 NO

80 77 CLINICIAN Ê16 NO. 645

81 CLINICIAN Ê16 NO

82 79 CLINICIAN Ê16 NO. 645

83 CLINICIAN Ê16 NO

84 81 CLINICIAN Ê16 NO. 645

85 CLINICIAN Ê16 NO

86 83 CLINICIAN Ê16 NO

87 CLINICIAN Ê16 NO

88 85 CLINICIAN Ê16 NO % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

89 CLINICIAN Ê16 NO

90 87 CLINICIAN Ê16 NO. 645

91 CLINICIAN Ê16 NO End of Life care

92 89 CLINICIAN Ê16 NO. 645

93 CLINICIAN Ê16 NO Step 1 Step 5 Step 5

94 91 CLINICIAN Ê16 NO. 645

95 CLINICIAN Ê16 NO

96 93 CLINICIAN Ê16 NO. 645

97 CLINICIAN Ê16 NO

98 95 CLINICIAN Ê16 NO. 645

99 CLINICIAN Ê16 NO NHS End of Life Care Programme publication supported by NCPC :Advance Care Planning :A Guide for Health and Social Care Staff (2007) AdvanceCarePlanning.pdf

100 IBD 3I survey IBD RA RA RA conventional synthetic DMARDscsDMARDs 2015 SpA PsA JIA 97 CLINICIAN Ê16 NO. 645

101 CLINICIAN Ê16 NO Halichondrin B

102 99 CLINICIAN Ê16 NO. 645 VEHERI

103 CLINICIAN Ê16 NO

104 101 CLINICIAN Ê16 NO. 645 in vitro

105 CLINICIAN Ê16 NO Cortes J, et al : Eribulin monotherapy versus treatment of physician s choice in patients with metastatic breast cancer (EMBRACE) : a phase 3 open-label randomised study. Lancet, 377 (9769), (2011) Ali AM, Ueno T, et al :Determining circulating endothelial cells using CellSearch system during preoperative systemic chemotherapy in breast cancer patients. Eur J Cancer, 47 (15), (2011) Shaked Y, et al :Rapid chemotherapy-induced acute endothelial progenitor cell mobilization:implications for antiangiogenic drugs as chemosensitizing agents. Cancer Cell, 14 (3), (2008) Tozer GM, et al :Disrupting tumour blood vessels. Nat Rev Cancer, 5 (6), (2005) Funahashi Y, et al:eribulin mesylate reduces tumor microenvironment abnormality by vascular remodeling in preclinical human breast cancer models. Cancer Sci, 105 (10), (2014) Kajiyama H, et al:chemoresistance to paclitaxel induces epithelial-mesenchymal transition and enhances metastatic potential for epithelial ovarian carcinoma cells. Int J Oncol, 31 (2), (2007) Li QQ, et al:twist1-mediated adriamycin-induced epithelial-mesenchymal transition relates to multidrug resistance and invasive potential in breast cancer cells. Clin Cancer Res, 15 (8), (2009) Yoshida T, et al:eribulin mesilate suppresses experimental metastasis of breast cancer cells by reversing phenotype from epithelial-mesenchymal transition (EMT) to mesenchymal-epithelial transition

106 signaling. J Biol Chem, 284 (34), (2009) activation of urokinase receptor-dependent cell transition (EMT) induced in breast cancer cells by Jo M, et al:reversibility of epithelial-mesenchymal 305 (2008) 1alpha promotes metastasis. Nat Cell Biol, 10 (3), 295- Yang MH, et al :Direct regulation of TWIST by HIF- (MET) states. Br J Cancer, 110 (6), (2014) 103 CLINICIAN Ê16 NO. 645

107 CLINICIAN Ê16 NO response rate progression-free survival overall survival quality of life

108 105 CLINICIAN Ê16 NO. 645 luminal vascular endothelial growth factor P< log-rank P= positive study

109 CLINICIAN Ê16 NO survival post-progression post-progression survival P=0.03 log-rank

110 107 CLINICIAN Ê16 NO. 645 P=0.01 log-rank response evaluation criteria in solid tumours

111 CLINICIAN Ê16 NO Seah DS, et al :Use and duration of chemotherapy in patients with metastatic breast cancer according to tumor subtype and line of therapy. J Natl Compr Canc Netw, 12 (1), (2014) Miller K, et al:paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med, 357, (2007) Broglio KR, Berry DA:Detecting an overall survival benefit that is derived from progression-free survival. J Natl Cancer Inst, 101 (23), (2009) Cortes J, et al : Eribulin monotherapy versus treatment of physician s choice in patients with metastatic breast cancer (EMBRACE):a phase 3 open-label randomised study. Lancet, 377, (2011) Twelves C, et al :Efficacy of eribulin in women with metastatic breast cancer:a pooled analysis of two phase 3 studies. Breast Cancer Res Treat, 148 (3), (2014) Watanabe J:Eribulin monotherapy improved survivals in patients with ER-positive HER2-negative metastatic breast cancer in the real world:a single institutional review. SpringerPlus, 4, 625 (2015)

112 CLINICIAN Ê16 NO

113

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