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Sakai, Japan

Toyokawa T.,Osaka City General Hospital | Yamashita Y.,Osaka City General Hospital | Yamamoto A.,Osaka City General Hospital | Shimizu S.,Osaka City General Hospital | And 2 more authors.
Japanese Journal of Gastroenterological Surgery | Year: 2015

Imatinib has shown dramatic clinical effects on patients with advanced GIST; however, the impact of surgical intervention associated with imatinib treatment has not been clearly defined. Between 1993 and 2012, 23 patients were given diagnoses of metastatic/recurrent GIST in our institution. Among them, we retrospectively investigated the clinicopathological features and outcomes of 9 patients who underwent complete resection. Complete resection for 9 patients with metastatic/recurrent GIST was performed 14 times. The median follow-up time was 77 months (range, 38-109 months), and all 6 patients who underwent complete resection with imatinib treatment are still alive. All 7 patients who did not receive adjuvant chemotherapy relapsed, and their relapse-free survival time was 394 days. Complete resection with imatinib treatment may improve the prognosis of patients with metastatic/recurrent GIST. Imatinib treatment should be immediately resumed after surgery, even if complete resection is performed. Source

Kashiwagi S.,Baba Memorial Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

We report two resected cases of extragastric gastric cancer growth with gastrocolic fistula whose prognoses were fairly good with surgery and chemotherapy. CASE 1: A 45-year-old man was admitted to a nearby clinic complaining of fever and abdominal pain. Endoscopy revealed gastric mucosa-associated white moss under tumor-like lesions to the mucous cancer biopsy results. The patient underwent surgery; the transverse colon had adhered to the posterior wall of the stomach, so a distal gastrectomy and a partial resection of the transverse colon were performed. He enjoyed a good QOL for 56 months after the surgery. CASE 2: A 69-year-old man. An upper GI examination revealed a protrusion at the posterior wall of the stomach, and the barium leaked from the lesion to the colon. Diagnosis of stomach cancer surgery took place. He died 20 months after the surgery. Source

Mashimo M.,Baba Memorial Hospital | Arakawa T.,Osaka City University
Journal of Japanese Society of Gastroenterology | Year: 2010

We present 3 patients with Crohn disease (CD) of the duodenum with progressive symptoms. A 31-year-old man with Crohn ileocolitis presented epigastralgia. A 32-year-old man with Crohn ileocolitis presented upper GI bleeding. In both patients, endoscopy revealed duodenal stenosis. A 33-year-old man was given a diagnosis of CD by gastroduodenal endoscopy. They received an infliximab infusion and had symptomatic relief and macroscopic healings without any adverse effects. Several treatments for upper GI lesions of the CD patients have been tried, but there is no high-quality level evidence-based data to guide the medical management of gastroduodenal CD. Our experience with 3 patients suggests that infliximab is a safe and effective treatment for duodenal CD and it may be appropriate for early use to avoid surgery or balloon dilatation. Source

Nakanishi K.,Baba Memorial Hospital | Fukuda S.,University of Occupational and Environmental Health Japan | Tanaka A.,Wakayama Medical University | Otsuka K.,Ishikiriseiki Hospital | And 3 more authors.
Circulation Journal | Year: 2015

Background: Chronic kidney disease (CKD) is strongly associated with coronary artery disease (CAD), although the underlying pathophysiological mechanism remains unclear. Epicardial adipose tissue (EAT) has recently been recognized as an important source of various pro-inflammatory cytokines causing coronary atherosclerosis. This study investigated the relationship between CKD and EAT volume in association with high-risk plaque. Methods and Results: The study included 275 patients with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m2 who underwent multidetector computed tomography (MDCT) for the evaluation of CAD. Patients were classified, according to eGFR, into a CKD group (30≤eGFR<60 ml/min/1.73 m2) or a non-CKD group (eGFR ≥60 ml/min/1.73 m2). MDCT was used to assess coronary plaque morphology and EAT volume. One hundred and ten patients with CKD were more likely to be older, have higher prevalence of hypertension, lower serum HDL-C, higher serum CRP, and larger EAT volume, than those without CKD (all P<0.01). On multivariate analysis age, hypertension, and EAT volume were significantly associated with eGFR (all P<0.01). EAT volume was associated with the presence of high-risk plaque, independent of traditional CAD risk factors (P=0.003). Conclusions: Patients with CKD had significantly increased EAT volume, which could be associated with the presence of high-risk plaque. © 2016, Japanese Circulation Society. All rights reserved. Source

Nakanishi K.,Baba Memorial Hospital | Fukuda S.,University of Occupational and Environmental Health Japan | Yamashita H.,Baba Memorial Hospital | Kosaka M.,Baba Memorial Hospital | And 4 more authors.
JACC: Clinical Electrophysiology | Year: 2016

Objectives This study aimed to investigate the role of atrial natriuretic peptide (ANP) levels to predict left atrial (LA) reverse remodeling in atrial fibrillation (AF) patients. Background Although LA reverse remodeling after radiofrequency catheter ablation (RFCA) for AF was reported to be associated with favorable outcomes and improvement of LA and left ventricular function, the predictor has not been extensively evaluated. Methods This study included 104 consecutive patients who underwent RFCA for AF. All patients underwent multidetector computed tomography examination and laboratory tests, including measurement of ANP, plasma B-type natriuretic peptide (BNP), and high-sensitivity C-reactive protein (hs-CRP) levels before and 6 months after RFCA. The study population was divided according to the extent of the decrease in the LA volume index at follow-up; responders were defined as patients who exhibited a ≥15% decrease in the LA volume index. Results At follow-up, 49 patients (47%) were classified as responders. Pre-procedural serum ANP and BNP levels were significantly higher in the responders than in the nonresponders (both p < 0.01). In the responders, a significant decrease was observed in the log ANP, log BNP, and log hs-CRP levels from baseline to follow-up (all p < 0.01). Multivariate linear regression analysis revealed that log ANP levels before RFCA and maintenance of sinus rhythm during follow-up were independent predictors of LA reverse remodeling (both p < 0.01). Conclusions In this study, 47% of the patients exhibited LA reverse remodeling after RFCA for AF, with a concomitant improvement in serum ANP, BNP, and hs-CRP levels. The pre-procedural ANP level and maintenance of sinus rhythm were independently associated with LA reverse remodeling. © 2016 American College of Cardiology Foundation. Source

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