Background/Aim: Surgical resection is recommended for nonfunctional pancreatic neuroendocrine neoplasms (NF-pNENs). However, metastasis is rare in patients with small lesions with histological grade ...1 (G1); thus, observation is an optional treatment approach for small NF-pNENs. Texture analysis (TA) is an imaging analysis mode for quantification of heterogeneity by extracting quantitative parameters from images. We retrospectively evaluated the utility of TA in predicting histological grade of resected NF-pNENs in a multicenter retrospective study. Patients and Methods: The utility of TA in preoperative prediction of grade were evaluated with 29 patients treated by pancreatectomy for NF-pNEN who underwent preoperative dynamic computed tomography scan between January 1, 2013 and December 31, 2020 at three hospitals affiliated with the Jikei University School of Medicine. TA was performed with dedicated software for medical imaging processing for determining histological tumor grade using dynamic computed tomography images. Results: Histological tumor grades based on the 2017 World Health Organization Classification for Pancreatic Neuroendocrine Neoplasms were grade 1, 2 and 3 in 18, 10 and one patient, respectively. Preoperative grades by TA were 1 and 2/3 in 15 and 14 patients, respectively. The sensitivity, specificity and area under the curve for TA-oriented grade 1 lesions were 1.00, 0.889 and 0.965 (95% confidence interval=0.901-1.000), respectively. Conclusion: TA is useful for predicting grade 2/3 NF-pNEN and can provide a safe option for observation for patients with small grade 1 lesions.
The S6472 is a 4:6 mixture of 2 types of granules of cefaclor (CCL) coated with different films; one type of granules is soluble at low pH's and absorbed in the stomach while the other type is ...soluble at high pH's and absorbed in the intestine. The difference in absorption sites makes it possible to maintain blood concentrations of the drug at clinically efficient levels for a longer period of time compared with ordinary CCL. The efficacy, safety and usefulness of S6472 in the treatment of bacterial pneumonia was compared with those of ordinary CCL and of amoxicillin (AMPC) by the blind method. The patients entered in this trial were those who had bacterial pneumonia or lung abscess and were 16 years or above of age. The S6472 was given orally for 14 days at a daily dose of 1,500 mg (750 mg each after breakfast and supper), CCL was given at a daily dose of 1,500 mg (500 mg each after every meal), and AMPC at 2,000 mg (500 mg each after every meal and at the bedtime). To make the study blind, placeboes were matched with the test drug so that patients in every treatment group took 4 doses per day. Out of a total of 195 patients thus treated, 179 patients (55 in S6472 group, 62 in CCL group and 62 in AMPC group) were adopted for the evaluation by committee members while 185 patients (58 in S6472 group, 63 in CCL group and 64 in AMPC group) by controllers. When clinical results of the 3 treatment groups were compared, no statistically significant differences were observed in efficacy rates (cure rates), incidences of side effects nor abnormal findings of laboratory tests. From these results of this trial, it is concluded that oral administration of 750 mg of S6472 twice a day (1,500 mg per day) is as effective and useful as that of 500 mg of ordinary CCL 3 times a day (1,500 mg per day) or 500 mg of AMPC 4 times a day (2,000 mg per day) in the treatment of bacterial pneumonia or lung abscess.
Clinical efficacy and safety of S6472 (long active cefaclor (CCL)) and CCL were compared by a double-blind study using 248 patients with bacterial bronchitis. Patients were orally administered with ...either 375 mg of S6472 2 times or 250 mg of CCL 3 times daily for 7 days, and the following results were obtained. Clinical efficacy judged by a committee: The efficacy rates on acute bronchitis were 87.2% for S6472 and 82.6% for CCL, and the efficacy rates on chronic bronchitis were 70.3% for S 6472 and 64.7% for CCL. There was no significant difference between the 2 drugs in clinical efficacy. Clinical efficacy judged by doctors in charge: Results of the clinical efficacy judged by doctors in charge were similar to the efficacy judged by the committee. Bacteriological efficacy judged by the committee: Eradication rate for the S6472 group was 71.1% (32 of 45 patients) and that for the CCL group was 67.4% (29 of 43 patients). There was no significant difference between the 2 drugs in the bacteriological efficacy. Side effects and abnormal laboratory findings: Side effects were observed in 5 cases (4.2%) in the S6472 group and in 5 cases (4.0%) in the CCL group. These side effects, however, were not serious, and no remarkable abnormal laboratory values were observed. There was no significant difference between the 2 drugs in the incidence of side effects or abnormal laboratory findings. Clinical utility: When the clinical utility was expressed by the utility rate (very useful and useful), it was 79.5% in the S6472 group (117 patients) and 76.2% in the CCL group (122 patients) (judged by the committee). When the utility was judged by doctors in charge, it was 73.3% in S6472 group (120 patients) and 71.4% in CCL group (126 patients). From the above results, it has been concluded that S6472 taken twice daily is equivalent to CCL in effectiveness on bacterial bronchitis.
Efficacy, safety and usefulness of cefixime (CFIX), a new oral cephem, in the treatment of bacterial pneumonia, were evaluated by the double-blind comparative method using amoxicillin (AMPC) as a ...reference drug. Patients with bacterial pneumonia, aged 16 or older, were treated by oral administration of either 200mg of CFIX twice a day or of 500mg of AMPC four times a day for 14 days. Out of a total of 222 patients thus treated, 172 patients (82 with CFIX: 90 with AMPC) were used for comparative evaluation of clinical efficacy, 208 patients (100 with CFIX: 108 with AMPC) for that of safety, and 170 patients (82 with CFIX: 88 with AMPC) for that of usefulness. There were no significant differences in characteristics of the patients between the two treatment groups, except that susceptibility to AMPC of the causative organisms which had been isolated from the patients belonging to the AMPC treatment group was significantly lower than that of the patients treated with CFIX. Rate of cure was 73.5% in the patients treated with CFIX, and 78.6% in those treated with AMPC. When patients with viral or mycoplasmal pneumonia were included in the evaluation, a slight degree of decline in the cure rates was observed, i. e. 70.7% with CFIX and 73.3% in the AMPC-treatment groups. Thus, there was no difference in efficacy rates between the two treatment groups. Decrease in amount of purulent sputum on the fourth and 15 th days of the treatment was more marked in the CFIX treatment group than in the AMPC group and was statistically significant. Bacteriological effects were examined in a total of 41 of the bacteriologically documented cases (20 patients treated with CFIX: 21 with AMPC). Rate of eradication of the causative organisms was 100% in the CFIX group and 81% in the AMPC group. Side effects observed were mainly due to functional disturbances of gastrointestinal tracts including nausea, epigastric pain, diarrhea and so forth. Incidences were 2.0% in the CFIX group and 6.4, in the AMPC group. Abnormalities in laboratory findings, mainly a slight degree of elevation in serum transaminases, were detected both during and after the treatment. These incidences were 17.2% in the CFIX grout and 24.7% in the AMPC group. This difference between the two treatment groups in the incidence of abnormal laboratory findings was not statistically significant. Taking efficacy and safety into consideration, the usefulness of both drugs in the treatment of bacterial pneumonia or lung abscess is estimated as follows: CFIX was evaluated to be very useful or useful in 72.1% of the patients treated with it, and AMPC in 77.9% of the patients so treated. From the results mentioned above, it is concluded that CFIX is one of oral cephems with high utility in the treatment of bacterial pneumonia or lung abscess, when administered in a twice daily dosage of 200mg.
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