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SN-38, an active metabolite of irinotecan, is reabsorbed by the intestinal tract during excretion, causing diarrhoea and neutropenia. In addition, the association between blood levels of SN-38 and neutropenia has been reported previously, and the rapid excretion of SN-38 from the intestinal tract is considered to prevent neutropenia. Oral alkalization drugs are used as prophylactic agents for suppressing SN-38 reabsorption. The relationship between oral alkalization drugs and neutropenia, however, has not been well studied. The aim of this study was to investigate the relationship between oral alkalization drugs and neutropenia in irinotecan-treated patients. Patients with cervical or ovarian cancer were administered irinotecan and investigated by medical chart reviews to determine whether oral alkalization drugs were effective at ameliorating irinotecan-induced neutropenia. The drug combination in the oral alkalization drugs—ursodeoxycholic acid, magnesium oxide, and sodium hydrogen carbonate—significantly improved neutrophil counts and reduced dose intensity compared with those of non-users. In the large-scale Japanese Adverse Drug Event Report database, the reporting odds ratio of irinotecan-induced neutropenia was significantly lower when irinotecan had been given in combination with oral alkalization drugs. These data indicate that oral alkalization drugs may reduce the frequency of neutropenia caused by irinotecan administration, making it possible to increase the dose safely.

In recent years, the Internet of Things (IoT) has attracted attention according to the development of sensing technology and wireless communication technology. IoT devices are interconnected to realize a specific service with sensors and actuation functions over several communication methods. Internet Protocol (IP) exists as a basic communication technology for realizing an IoT system. Since IPv4 is a mainstream protocol on the Internet, the lack of compatibility between IPv4 and IPv6 should be great issues to realize IoT services. Additionally, recent networks employ the Network Address Port Translation (NAPT) technology to protect a network and to reduce the number of required IPv4 global addresses. The introduction of NAPT causes an accessibility issue due to the blocking of incoming packets. As a new issue, the mobility of IoT devices also becomes a concern about seamless communication because a change of IP address causes a disconnection of transport layer sessions. As a technique for solving these problems, the authors have developed CYber PHysical Overlay Network over Internet Communication (CYPHONIC) that supports accessibility and seamless mobility over the Internet. Since high-performance IoT devices typically implement the full IP stack, both IPv4 and IPv6 can be supported. Therefore, CYPHONIC can provide inter-connectivity among IoT devices. On the contrary, resource-constrained IoT devices with a low power operation support only the limited IP stack such as IPv6 over Low power Wireless Personal Area (6LowPAN). This paper proposes a new interconnectivity mechanism between IP networks and 6LowPAN by extending CYPHONIC. Therefore, the proposed mechanism can provide interconnectivity among 6LowPAN devices and IP devices to collaborate on a service. The proposed system introduces a gateway device for connecting between IP networks and 6LowPAN. Additionally, it also extends the signaling process of CYPHONIC to support 6LowPAN based IoT devices. Since the object of this paper is confirming the feasibility of the proposed mechanism, we have designed the implementation with Thread protocol that support 6LowPAN.