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Kure, Japan

Nishikawa K.,Osaka General Medical Center | Iwase K.,Osaka General Medical Center | Aono T.,Osaka General Medical Center | Nomura M.,Osaka General Medical Center | And 6 more authors.
Esophagus | Year: 2010

Background: This study was designed to conduct a retrospective analysis of late toxicity following chemoradiotherapy (CRT) for esophageal carcinoma. Methods: The 49 first-onset esophageal carcinoma cases who allowed evaluation of late toxicity were the subjects. The incidence, severity, and background factors were analyzed for late toxicity (pneumonitis, pleural effusion, pericardial effusion). Performance status (PS) was 0/1/2/3 in 8/32/7/2 cases, respectively. The tumor-occupied site was Ce/Ut/Mt/Lt in 10/15/12/12 cases, respectively. T was 1/2/3/4 in 6/7/14/22 cases, and cStage was I/II/III/IVa/IVb in 6/9/8/23/3 cases, respectively. The radiation dose was <60 Gy/≥60 Gy in 12/37 cases. Concomitant chemotherapy was absent/present in 7/42 cases. Logistic regression analysis was conducted. Results: Pneumonitis was seen in 19 cases (39%), and its severity was grade 1/2/3 in 10/5/4 cases, respectively. Pleural effusion was noted in 15 cases (31%), and its severity was grade 1/2/3 in 9/5/1 cases, respectively. Pericardial effusion was seen in 10 cases (20%), and severity was grade 1/3 in 8/2 cases, respectively. In cases complicated by severe pneumonitis, a PS ≥ 2 was identified as an associated background factor. The tumor-occupied area (Mt/Lt) was identified as a background factor associated with severe pleural effusion. Age (≥75 years) was identified as a factor associated with pericardial effusion. Conclusions: Particular care is needed for a possible severe course of pneumonitis in cases with a PS ≥ 2, the likelihood of severe pleural effusion in cases with Mt/Lt cancer, and the likelihood of pericardial effusion in elderly patients. Measures to reduce late toxicity following chemoradiotherapy for esophageal carcinoma are desirable. © Japan Esophageal Society and Springer 2010. Source


Kajiwara K.,Hiroshima City Hospital | Kakizawa H.,Hiroshima University | Takeuchi N.,Chugoku Cancer Center | Toyota N.,Chugoku Cancer Center | And 9 more authors.
Japanese Journal of Radiology | Year: 2011

Purpose: To lower the rate of cutaneous complications after transcatheter arterial treatment for hepatocellular carcinoma (HCC) via the internal mammary artery (IMA) we retrospectively assessed the complications. Materials and methods: We reviewed cutaneous complications in 14 patients with 18 HCCs who had undergone 17 treatment procedures via the IMA, including selective transcatheter arterial infusion chemotherapy with Lipiodol (Lip-TAI) (n = 3), selective Lip-TAI + transcatheter arterial embolization (TAE) (n = 3), nonselective Lip-TAI (n = 1), nonselective Lip-TAI + TAE (n = 5), and nonselective TAE (n = 5). The filling and nonfilling of subcutaneous vessels with Lipiodol was examined on postoperative computed tomography (CT) scans. Results: Skin rash (n = 3) and ulceration (n = 1) occurred after 4 of 17 (24%) procedures: two of three selective Lip-TAI procedures and two of five nonselective Lip-TAI + TAE procedures. The doses of chemotherapeutic agents for tumor sizes in selective Lip-TAI procedures were higher than those in selective Lip-TAI + TAE procedures. Cutaneous complications were encountered after two of three procedures with filling but not after any of eight procedures without filling. Conclusion: A lower dose of chemotherapeutic agents may be less risky when undertaking a selective procedure via the IMA for HCC. If nonselective, TAE alone may be less risky. Postoperative CT may be helpful for predicting cutaneous complications. © 2011 Japan Radiological Society. Source


Endo T.,Chugoku Cancer Center | Onoe T.,Institute for Clinical Research | Onoe T.,Hiroshima University | Yamamoto N.,Chugoku Cancer Center | And 8 more authors.
Experimental and Clinical Cardiology | Year: 2014

Background: The quantification of severity has been recommended for evaluation of valvular heart disease by echocardiography. For accurate quantification, it is necessary to assess the mitral annulus area (MAA) to calculate mitral stroke volume (SV). Therefore, we evaluated the accuracy of three methods using 2D and Doppler echocardiography in normal adults. Methods: Twenty-five patients without any abnormal cardiac findings were included. The diameters of the MA in the four-chamber (4Ch), two-chamber (2Ch), commissure-commissure (CC) and anterior-posterior (LAX) axis were measured to calculate MAA in single-plane 4Ch method, biplane 4Ch-2Ch, and CC-LAX method. Mitral stroke volume (SV) was calculated from MAA values and compared with left ventricular SV (LVSV) to evaluate the accuracy of these methods. Results: The MAAs in the CC-LAX method were smaller than other methods. In correlation analysis, the relationship between mitral SV and LVSV in the CC-LAX method was closest to identical correlation and the percentage error values of the calculated mitral SV in the CC-LAX method were significantly smaller than other methods. Conclusion: The CC-LAX method is the most accurate for assessing MAA and mitral SV among three methods using 2D and Doppler echocardiography. Source


Oshita J.,Chugoku Cancer Center | Ohba S.,Chugoku Cancer Center | Itou Y.,Chugoku Cancer Center | Sakoda E.,Chugoku Cancer Center | Ishihara S.,Chugoku Cancer Center
Neurological Surgery | Year: 2011

A 25-year-old man presented with right hemiparesis and was admitted to the local hospital. CT scan revealed an intracerebral hematoma in the left motor cortex. He was treated conservatively, the hematoma passed without increase and his right hemiparesis improved gradually. The cause of hemorrhage was examined at the local hospital without resolution. He came to our hospital for further examination. Angiography revealed pial arteriovenous fistulas near the hematoma. The fistulas were fed by small branches of the left anterior cerebral artery and drained into an abnormal cortical vein. Left parietal craniotomy was performed. A red dilated cortical vein existed under the thickened, cloudy arachnoid membrane. Retrograde observation of the red vein showed some small branches connected directly to the red vein at the central sulcus. There was no nidus. The color of the red vein changed to blue after disconnection of the fistulas by electrocoagulation. The dilated cortical vein was resected. Postoperative angiography revealed the disappearance of the fistulas. He was discharged without any new neurological deficits. Intracranial pial arteriovenous fistulas are rare cerebrovascular lesions. As symptomatic patients managed conservatively have a poor prognosis, radical treatment should be undertaken as soon as possible. Source


Watanabe R.,Chugoku Cancer Center | Toyota N.,Chugoku Cancer Center | Hieda M.,Chugoku Cancer Center | Akiyama N.,Chugoku Cancer Center | Kohno H.,Chugoku Cancer Center
Japanese Journal of Clinical Radiology | Year: 2012

We report the case of a woman in her 70s with a mesocaval shunt and liver cirrhosis due to autoimmune hepatitis. Percutaneous transcatheter embolization of the shunt was performed via a portal vein using coils and 50% glucose solution. Blood ammonia level decreased to the normal level and clinical symptoms of hepatic encephalopathy disappeared. Transcatheter embolization is minimally invasive and may be an effective treatment for hepatic encephalopathy with mesocaval shunt. Source

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