Ayabe, Japan
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PubMed | Nara City Hospital, Murakami Memorial Hospital, Otsu City Hospital, Matsushita Memorial Hospital and 3 more.
Type: Journal Article | Journal: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society | Year: 2016

There are limited studies on incidence rates of metachronous neoplastic lesions after resecting large colorectal polyps. In the present study, we analyzed metachronous lesions after endoscopic resection of colorectal polyps 20mm in size.We retrospectively analyzed consecutive patients who underwent endoscopic resection of polyps from 2006 to 2013 at two affiliated hospitals. All patients underwent at least two total colonoscopies before follow up to ensure minimal missed polyps. Only patients who had follow-up colonoscopy annually after resection were recruited. We separated patients according to size of polyp resected; there were 239 patients in the 20-mm group and 330 patients in the <20-mm group. Clinical characteristics and cumulative rates of metachronous advanced adenoma and cancer in both groups were analyzed. Advanced adenoma was defined as a neoplastic lesion 10mm in size and adenoma with a villous component.Cumulative rate of development of metachronous advanced adenoma and cancer in the 20-mm group was significantly higher than in the <20-mm group (22.9% vs. 9.5%, P<0.001) at 36months. There was also more development of small polyps 5-9mm in the 20-mm group than in the <20-mm group (45.2% vs. 28.8%, P<0.001). With respect to metachronous lesions, there were more right-sided colonic lesions in the 20-mm group than in the <20-mm group (78.8% vs. 50.0%, P=0.015).High incidence rates of development of metachronous neoplastic lesions were detected after resection of colorectal polyps 20mm in size.


PubMed | Fukuchiyama City Hospital, Aiseikai Yamashina Hospital, Saiseikai Kyoto Hospital, Ayabe City Hospital and 3 more.
Type: Journal Article | Journal: Breast cancer (Tokyo, Japan) | Year: 2016

Docetaxel plus cyclophosphamide (TC) has recently been established as a standard adjuvant chemotherapy regimen for HER2-negative (HER2-) operable breast cancer. However, the efficacy and tolerability of TC as neoadjuvant chemotherapy (NAC) remain unclear. We, therefore, conducted a prospective study to evaluate the efficacy of TC NAC in HER2- primary breast cancer.Patients who were diagnosed with HER2-, N0-N1, invasive breast cancer between July 2011 and February 2014 and had tumors measuring 1-7cm were eligible. The subtypes were classified using a core-needle or vacuum-assisted breast biopsy. The efficacy and safety of NAC comprising TC (75mg/mFifty-two patients were enrolled. Of these, 94.2% (49/52) completed four cycles of TC. The overall pCR rate was 16.3% (8/49). The pCR rates for patients with luminal A-like breast cancer [estrogen receptor-positive (ER+), Ki67 index of <20%, and HER2-], luminal B-like breast cancer (ER+, Ki67 index of >20%, and HER2-), and triple-negative breast cancer [ER-negative (ER-) and HER2-] were 0% (0/12), 4.3% (1/23), and 50.0% (7/14), respectively. Almost all pCRs occurred in triple-negative breast cancer patients.The pCR rate of TC NAC was not very high despite the high completion rate. TC NAC was effective against the triple-negative subtype, resulting in a higher pCR rate. Therefore, our results indicated that TC NAC showed limited efficacy in luminal subtype breast cancer with the exception of the triple-negative subtype.


PubMed | Fukuchiyama City Hospital, Aiseikai Yamashina Hospital, Saiseikai Kyoto Hospital, Ayabe City Hospital and 3 more.
Type: Journal Article | Journal: Breast cancer (Tokyo, Japan) | Year: 2016

The standard primary systemic therapy for human epidermal growth factor receptor 2-positive (HER2+) breast cancer is anthracyclines and/or taxanes combined with trastuzumab, which demonstrates a high pathological complete response (pCR). A pCR is a predictive marker of prognosis. However, results slightly differ, depending on the hormone receptor status. The efficacy and tolerability of docetaxel, cyclophosphamide, and trastuzumab (HER-TC) as neoadjuvant chemotherapy (NAC) remain unclear. We performed a prospective multicenter study of HER-TC NAC for HER2+ primary breast cancer.Eligible patients had a clinical diagnosis of HER2+ invasive breast cancer greater than 1cm but less than 7cm and a tumor stage of N0 or N1. T hey were diagnosed between July 2011 and February 2014. For NAC, four cycles of HER-TC (6mg/kg loading dose, 8mg/kg, 75, and 600mg/mWe enrolled 42 patients. The completion rate for four cycles of HER-TC was 97.6% (41/42 patients). The overall pCR rate was 43.9% (18/41 patients). The pCR rate for patients with the luminal HER2 subtype [estrogen receptor (ER)-positive+, HER2+] and the HER2-enriched subtype (ER-, HER2+) was 40.0% (8/20 patients) and 47.6% (10/21 patients), respectively. A pCR was achieved with nearly the same probability for each subtype.Four cycles of HER-TC may be a NAC option for HER2-positive breast cancer.


Ohe C.,Kansai Medical University | Ohe C.,Saiseikai Nakatsu Hospital | Kuroda N.,Red Cross | Takasu K.,Hyogo Prefectural Amagasaki Hospital | And 7 more authors.
Medical Molecular Morphology | Year: 2012

Distinction of renal oncocytoma (RO) from chromophobe renal cell carcinoma (ChRCC) is important because their clinical behavior is different. As part of a search for the best available immunohistochemical markers to distinguish ChRCC from RO, we investigated the immunohistochemical profiles of these tumors. We selected 30 renal tumors consisting of ChRCC, typical variant (n = 14), ChRCC, eosinophilic variant (n = 6), and RO (n = 10). Their expression of cytokeratin (CK) 7, KAI1, epithelial-specific antigen (ESA), epithelial-related antigen (ERA), Claudin-7, and Claudin-8 was studied using an autostainer. Immunoreactivity was assessed based on a combined score of the extent and intensity of staining. Compared to RO, a significantly higher percentage of the total ChRCCs stained positive for CK7 (85% vs. 10%, respectively), KAI1 (90% vs. 10%), ESA (95% vs. 10%), ERA (95% vs. 10%), and Claudin-7 (95% vs. 20%) (P < 0.001). Additionally, there was a significant difference between the percentage of ChRCC eosinophilic variant (ChRCC-E) and RO that stained positive for KAI1 (100% vs. 10%, respectively), ESA (83% vs. 10%), and ERA (83% vs. 10%) (P < 0.001). We recommend immunohistochemical analysis of KAI1, ESA, and ERA to distinguish ChRCC-E from RO. © The Japanese Society for Clinical Molecular Morphology 2012.


Yamaguchi T.,Ayabe City Hospital | Kuroda N.,Red Cross | Imamura Y.,University of Fukui | Hes O.,Charles University | And 4 more authors.
Diagnostic Cytopathology | Year: 2010

In this article, we report a case of 76-year-old woman with a rare variant of chromophobe renal cell carcinoma (CRCC). Cytologically, renal tumor cells obtained from imprint cytology were isolated or arranged in small or monotonous population cells with abundant granular cytoplasm. Neoplastic cells showed regular and uniformly shaped small round to oval nuclei with smooth margin. Binucleation was occasionally seen. Immunocytochemically, the cytoplasm of almost all tumor cells was diffusely positive for vimentin and CK 7. Histologically, the cytoplasm was abundant granular eosinophilic and composed of solid cell sheets or pseudoacinar structures. Additionally, tumor cells showed infiltration into some small renal veins covered by a single layer of endothelial cells. These cytological and histological features entirely resembled those of renal oncocytoma. We performed the analysis of von Hippel-Lindau (VHL) gene mutation, 3p loss of heterozygosity (LOH), and fluorescence in situ hybridization (FISH) on chromosomes 7, 10, 13, 17, and 21. As a result, we confirmed monosomy of chromosomes 7, 10, 13, and 17, and these findings corresponded to the diagnosis of CRCC. Finally, we present a case of renal tumor morphologically resembling renal oncocytoma but genetically showing CRCC. We suggest that oncocytic variant of CRCC may actually exist. © 2009 Wiley-Liss, Inc.


Kuroda N.,Red Cross | Kanomata N.,Kawasaki Medical School | Yamaguchi T.,Ayabe City Hospital | Imamura Y.,University of Fukui | And 6 more authors.
Medical Molecular Morphology | Year: 2011

S100A1 is a calcium-binding protein and a member of the S100 family. Recently, S100A1 immunohistochemistry may be an available marker in the differential diagnosis between renal oncocytoma and chromophobe renal cell carcinoma (RCC). However, there are no reports on S100A1 expression in oncocytic papillary RCC that has been recently identified. In this article, we immunohistochemically examined the expression of S100A1 protein in 18 renal tumors including 4 renal oncocytoma, 10 chromophobe RCCs, and 4 oncocytic papillary RCCs. All the cases of renal oncocytoma and oncocytic papillary RCC showed a positive reaction for S100A1 with cytoplasmic pattern. In chromophobe RCC, 3 of 4 tumors with typical variant and 4 of 6 tumors in eosinophilic variant were completely negative for S100A1. Finally, S100A1 immunohistochemistry may be useful in distinguishing renal oncocytoma from chromophobe RCC, but it may be of no use in the differential diagnosis between renal oncocytoma and oncocytic papillary RCC. © 2011 The Japanese Society for Clinical Molecular Morphology.


PubMed | Nara City Hospital, Saiseikai Suita Hospital, Ayabe City Hospital, Kyoto Prefectural University of Medicine and 2 more.
Type: | Journal: Journal of cardiothoracic surgery | Year: 2015

Treatment protocols (including those for thoracic surgery) tend to be customized for individual hospitals. Procedural standardization is required to improve surgical tasks and patient outcomes. This study aimed to evaluate the effects of an initiative to standardize surgical tasks for efficient and safe performance.Hospitals associated with the Division of Chest Surgery of the Kyoto Prefectural University of Medicine held joint meetings involving their thoracic surgeons and operating room nurses between February 2011 and November 2012 to standardize surgical tasks. Operation times and blood loss were compared before and after standardization.The implementation rate of standardized surgical tasks was 97%. The pre-operative (from entry to the operating room until commencement of surgery) and post-operative (from conclusion of surgery until departure from the operating room) times were significantly decreased after the standardization. When compared according to operative group (all thoracic surgery, lung lobectomy, and partial lung resection), operation times were shorter for all three groups; in addition, the amount of blood loss was lower in all three groups after standardization. A post-standardization survey showed improved morale among the meeting participants.Interdisciplinary standardization of surgical tasks across institutions improved thoracic surgery tasks and surgical outcomes.


Yamaguchi T.,Ayabe City Hospital | Hirota E.,Ayabe City Hospital | Kuroda N.,Red Cross
Journal of Cytology | Year: 2015

There is only one report on cytological findings of oncocytic variant of chromophobe renal cell carcinoma (RCC). In this article, we report a new case with focus on cytological, and ultrastructural findings. A 60-year-old Japanese man was found to have a right renal tumor on medical checkup. In imprint cytological materials, the smears consisted of slightly discohesive clusters and isolated tumor cells with granular green colored cytoplasm on Papanicolaou staining. Nuclei were generally round and centrally located in the cytoplasm, but nuclear irregularity or perinuclear halo was absent. Ultrastructurally, the tumor was full of mitochondria with tubulovesicular cristae. Fluorescence in situ hybridization study using histological material showed multiple chromosomal losses including chromosomes 7, 10, 13, and 17. This finding supports the hypothesis that this variant may ultrastructurally show the nature of chromophobe RCC rather than renal oncocytoma. © 2015 Journal of Cytology | Indian Academy of Cytologists | Published by Wolters Kluwer - Medknow.


PubMed | Red Cross and Ayabe City Hospital
Type: Journal Article | Journal: Journal of cytology | Year: 2016

There is only one report on cytological findings of oncocytic variant of chromophobe renal cell carcinoma (RCC). In this article, we report a new case with focus on cytological, and ultrastructural findings. A 60-year-old Japanese man was found to have a right renal tumor on medical checkup. In imprint cytological materials, the smears consisted of slightly discohesive clusters and isolated tumor cells with granular green colored cytoplasm on Papanicolaou staining. Nuclei were generally round and centrally located in the cytoplasm, but nuclear irregularity or perinuclear halo was absent. Ultrastructurally, the tumor was full of mitochondria with tubulovesicular cristae. Fluorescence in situ hybridization study using histological material showed multiple chromosomal losses including chromosomes 7, 10, 13, and 17. This finding supports the hypothesis that this variant may ultrastructurally show the nature of chromophobe RCC rather than renal oncocytoma.

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