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Hayashi H.,University of Fukui | Tokuriki S.,University of Fukui | Okuno T.,University of Fukui | Shigematsu Y.,University of Fukui | And 4 more authors.
Pediatrics International | Year: 2014

Amino acid formulas and hydrolyzed formulas given to infants in Japan with milk allergies theoretically contain little, if any, biotin and carnitine. We assessed biotin and carnitine insufficiency in six infants with milk allergy who were fed amino acid formulas and/or hydrolyzed formulas, by measuring urine 3-hydroxyisovaleric acid (3-HIA) and serum free carnitine (C0), respectively. All patients presented with elevated urine 3-HIA and lowered serum C0 compared with post-menstrual age-matched infants who were fed breast milk or standard infant formulas. Supplementation with biotin and l-carnitine immediately improved the insufficiency. Care should be taken to avoid biotin and carnitine deficiency in allergic infants fed amino acid or hydrolyzed formulas. © 2014 Japan Pediatric Society.

Isozaki Y.,Chiba Prefectural Sawara Hospital | Takayama W.,Chiba Prefectural Sawara Hospital | Nishimori T.,Chiba Prefectural Sawara Hospital | Koh T.,Chiba Prefectural Sawara Hospital | And 3 more authors.
Japanese Journal of Gastroenterological Surgery | Year: 2012

A 67-year-old man presented complaining of tarry stool. His hemoglobin level was 3.8 g/dl. Upper gastrointestinal endoscopy revealed a 7 cm submucosal tumor with a deep ulcer near the papilla of Vater. Contrast-enhanced CT showed the tumor was the origin of the marked bleeding. Melena from the tumor continued after admission, and we were requested to stop the bleeding immediately. Abdominal angiography revealed the tumor was supplied from the anterior and posterior superior pancreaticoduode-nal arteries, inferior pancreaticoduodenal artery, and middle colonic artery. Portal vein flow was enhanced in the early phase, indicating an AV shunt. Selective transarterial embolization (TAE) was performed through all the pancreaticoduodenal arteries except for the colonic artery. The TAE was effective. After 9 days, pylorus preserving-pancreaticoduodenectomy with partial colonic resection was performed. Based on the histopathological findings, a final diagnosis of duodenal gastrointestinal tumor was made. He lost about 600 g blood volume during the operation, which was similar to conventional operations. Although few articles reported TAE from primary gastrointestinal stromal tumors, TAE may be useful to avoid of emergency operation, and reduce intraoperative bleeding during the operation. © 2012 The Japanese Society of Gastroenterological Surgery.

Kakuta S.,Chiba Prefectural Sawara Hospital | Takayama W.,Chiba Prefectural Sawara Hospital | Kou T.,Chiba Prefectural Sawara Hospital | Satou M.,Chiba Prefectural Sawara Hospital | Sugaya M.,Chiba Prefectural Sawara Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

We report a case of descending colon adenocarcinoma with neuroendocrine differentiation that was effectively treated with FOLFIRI plus bevacizumab. A 70-year-old man underwent a colonoscopy and was found to have a type 2 tumor of the descending colon. A well-to-moderately differentiated adenocarcinoma was diagnosed by biopsy. A preoperative CT scan showed paraaortic lymph node and liver metastasis, and that the tumor was directly invading the spleen. The patient underwent a left hemicolectomy with resection of the pancreas tail, spleen, and diaphragm. The pathological diagnosis was adenocarcinoma with less than 30% neuroendocrine differentiation in the primary tumor and almost 100% neuroendocrine differentiation in the metastatic lymph nodes. After surgery, FOLFIRI plus bevacizumab treatment was initiated. After 33 treatment cycles, the paraaortic lymph node and liver metastasis disappeared and the patient has remained progression-free to date. Adenocarcinoma with neuroendocrine differentiation of the colon is rare and an effective chemotherapy has not yet been established. We report this case with a review of the literature.

Nonaka H.,Chiba Prefectural Sawara Hospital | Tsuchiya K.,Chiba Prefectural Sawara Hospital | Kitazaki H.,Chiba Prefectural Sawara Hospital | Yoneda M.,Chiba Prefectural Sawara Hospital | Arai G.,Chiba Prefectural Sawara Hospital
Chiba Medical Journal | Year: 2013

Bisphosphonates, which possess powerful bone resorption inhibition effect, are widely used as the first choice in the treatment and prevention of osteoporosis. Recently, femoral fractures have been shown to occur in patients who underwent long-term bisphosphonate therapy. These fractures, which extend from below the trochanter to the diaphyseal femur, are called atypical femoral fractures (AFF). We examined the cases of surgeries performed at our hospital for AFF occurring because of long-term bisphosphonate use in terms of the following: cause of fracture, bisphosphonate type, administration period, prodromes, marrow ossification, and bone density. The subjects were 5 patients (6 limbs). All the subjects had been using bisphosphonates for 5 years or more and had fractures due to slight injuries. Many patients presented with marked ossification at the fracture site, which required a special approach during surgery. The postoperative outcomes were favorable in all cases. Caution should be exercised when treating osteoporosis patients, especially when prescribing long-term bisphosphonate therapy. Further, drug withdrawal or change of drugs need to be considered for patients who have been taking the drug for 5 years or more.

Yanagibashi H.,Chiba Prefectural Sawara Hospital | Takayama W.,Chiba Prefectural Sawara Hospital | Yoneyama Y.,Chiba Prefectural Sawara Hospital | Kakuta S.,Chiba Prefectural Sawara Hospital | And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2015

A 62-year-old man was admitted to our hospital because of appetite loss. Computed tomography (CT) revealed thickness of the gastric wall, multiple liver tumors, and lung nodes. Upper gastrointestinal endoscopy revealed an easy bleeding type 2 tumor at the gastric antrum. We performed distal gastrectomy to control bleeding from the gastric tumor. Histological findings from the gastric lesion indicated primary gastric choriocarcinoma (PCG). Combination chemotherapy using hepatic arterial infusion chemotherapy for synchronous liver metastases and S-1 was administered for 5 months after the operation. CT revealed that the liver metastases decreased remarkably. On the other hand, lung metastases increased. Irinotecan and cisplatin were administered. Liver metastases did not increase, as observed using imaging studies. The patient died 17 months after the operation for cachexia. PCG is a highly aggressive tumor that is often associated with liver metastasis. It is important to control liver metastasis from PCG.

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