Fukuoka-shi, Japan
Fukuoka-shi, Japan

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PubMed | Fukuoka University, St Marys Hospital, Fukuoka Tokushukai Hospital and Imakiire General Hospital
Type: Journal Article | Journal: Asian cardiovascular & thoracic annals | Year: 2016

Because carcinomatous lymphangitis and carcinomatous pleuritis are the usual forms of metastasis associated with gastric cancer, resection of solitary pulmonary metastases arising from gastric cancer is rarely performed. To clarify the characteristics of pulmonary metastases from gastric cancer, we investigated patients who underwent resection of metastatic solitary lung tumors arising from gastric cancer.Between October 2003 and October 2012, 10 patients underwent pulmonary metastasectomy for metastatic gastric cancer at our institution. We retrospectively evaluated features of the primary gastric cancer and the clinicopathological features of the pulmonary metastases in these cases.70% of the patients had stage II disease. Lymphatic invasion was observed in all cases of primary gastric cancer. The method of pulmonary resection was partial resection in 5 cases, segmentectomy in 1, and lobectomy in 4. On histopathological examination, immunohistochemical staining was negative for thyroid transcription factor-1 and napsin A in all cases. Patients who underwent resection of pulmonary metastases arising from gastric cancer had a good prognosis: the 4-year survival rate was 75%.Carefully chosen patients have a good opportunity to obtain benefits from resection of pulmonary metastases arising from gastric cancer.


PubMed | Tokyo Women's Medical University, h Kumamoto Orthopaedic Hospital, University of Occupational and Environmental Health Japan, Chung Shan Medical University and 6 more.
Type: Clinical Trial, Phase II | Journal: Modern rheumatology | Year: 2015

This phase II, dose-ranging, double-blind, placebo-controlled, randomized study (NCT01463059) evaluated efficacy and safety of olokizumab (OKZ), a humanized anti-interleukin 6 monoclonal antibody, in Asian patients with moderately-to-severely active rheumatoid arthritis (RA) who had previously failed anti-TNF therapy.Patients were randomized to one of six treatment arms: placebo or OKZ (60mg/120mg/240mg every four weeks [Q4W]; or 60mg/120mg every two weeks [Q2W]); stratified by country and number of prior anti-TNFs. Primary efficacy variable was Week 12 change from baseline (CFB) in DAS28 CRP for 4-week cumulative dose groups of OKZ and placebo; secondary efficacy variables were Week 12 ACR20/ACR50/ACR70 response rates. Patients continued MTX treatment from baseline, without additional csDMARDs.Of 119 randomized patients, 88.2% completed the study. Greater improvements in DAS28(CRP) mean CFB at Week 12 were observed in all OKZ 4-week cumulative dose groups (60mg/120mg/240mg) versus placebo (p < 0.0001). Week 12 ACR20/ACR50 response rates were higher in all OKZ cumulative dose groups versus PBO (p < 0.05). Incidences of adverse events were similar across OKZ 4-week cumulative dose groups (76.9-84.4%) and placebo (82.8%) with no deaths.OKZ demonstrated improvements in efficacy variables versus placebo in Asian patients with moderately-to-severely active RA who had previously failed anti-TNF therapy. The safety profile was as expected for this class of drug.


PubMed | Kurume University, Fukuoka Tokushukai Hospital and Osaka City University
Type: Journal Article | Journal: European journal of radiology | Year: 2016

We examined whether fluorine-18 fluorodeoxyglucose (FDG) uptake is related to the mammalian target of rapamycin (mTOR) signal pathway and its related proteins in pancreatic cancer patients.We retrospectively studied 53 pancreatic cancer patients who underwent FDG positron emission tomography (PET) or FDG PET/CT, and complete curative surgical resection. The SUV max, the tumor to nontumor activity of pancreas [T/N (P)] ratio and the T/N of liver [T/N (L)] ratio were calculated. The expressions of glucose transporter-1(Glut-1) and mTOR pathway proteins in pancreas cell lines were examined by immune blots. Excised tumor tissue was analyzed by immunohistochemistry using monoclonal antibodies for Glut-1, epidermal growth factor receptor (EGFR), mTOR, p70S6kinase (p70S6) and S6 ribosomal protein (S6).The expressions of Glut-1, EGFR and p70S6 were significantly correlated with the SUV max, T/N (P) ratio and T/N (L) ratio. The expressions of mTOR and S6 were not correlated with all parameters. The expression of Glut-1 was positively correlated with the expressions of EGFR and p70S6, but not with mTOR or S6. S6 was positively correlated with p70S6.Glut-1, EGFR and p70S6 expressions are associated with the FDG uptake mechanism of pancreatic cancer. FDG uptake may predict the levels of EGFR and p70S6 expressions, and FDG uptake reflects glucose metabolism and cancer progression.


Chitose T.,Kumamoto University | Chitose T.,Social Insurance Omuta Tenryo Hospital | Sugiyama S.,Kumamoto University | Sugiyama S.,Jinnouchi Hospital | And 8 more authors.
Atherosclerosis | Year: 2014

Objective: Early statin therapy after acute coronary syndrome reduces atherothrombotic vascular events. This study aimed to compare the effects of hydrophilic and hydrophobic statins on myocardial salvage and left ventricular (LV) function in patients with ST-elevated myocardial infarction (STEMI). Methods: Seventy-five STEMI patients who had received emergency reperfusion therapy were enrolled and randomized into the hydrophilic statin group (rosuvastatin; 5mg/day, n=38) and hydrophobic statin group (atorvastatin; 10mg/day, n=37) for 6 months. LV ejection fraction (LVEF), and B-type natriuretic peptide (BNP) and co-enzyme Q10 (CoQ10) levels were measured at baseline and the end of treatment. The myocardial salvage index was assessed by single photon emission computed tomography with 123-I-β-methyl-iodophenylpentadecanoic acid (ischemic area-at-risk at onset of STEMI: AAR) and 201-thallium scintigraphy (area-at-infarction at 6 months: AAI) [myocardial salvage index=(AAR-AAI)×100/AAR (%)]. Results: Onset-to-balloon time and maximum creatine phosphokinase levels were comparable between the groups. After 6 months, rosuvastatin (-37.6%±17.2%) and atorvastatin (-32.4%±22.4%) equally reduced low-density lipoprotein-cholesterol (LDL-C) levels (. p=0.28). However, rosuvastatin (+3.1%±5.9%, p<0.05), but not atorvastatin (+1.6%±5.7%, p=0.15), improved LVEF. Rosuvastatin reduced BNP levels compared with atorvastatin (-53.3%±48.8% versus-13.8%±82.9%, p<0.05). The myocardial salvage index was significantly higher in the rosuvastatin group than the atorvastatin group (78.6%±29.1% versus 52.5%±38.0%, p<0.05). CoQ10/LDL-C levels at 6 months were increased in the rosuvastatin group (+23.5%, p<0.01) and percent changes in CoQ10/LDL-C were correlated with the myocardial salvage index (. r=0.56, p<0.01). Conclusion: Rosuvastatin shows better beneficial effects on myocardial salvage than atorvastatin in STEMI patients, including long-term cardiac function, associated with increasing CoQ10/LDL-C.Clinical trial registration: URL http://www.umin.ac.jp/ctr/index.htm Unique Identifier: UMIN000003893. © 2014 Elsevier Ireland Ltd.


Yamana I.,Fukuoka Tokushukai Hospital | Yamana I.,Fukuoka University | Kawamoto S.,Fukuoka Tokushukai Hospital | Inada K.,Fukuoka Tokushukai Hospital | And 3 more authors.
Surgery Today | Year: 2012

Purpose Previous authors have suggested that a diverticulum of the vermiform appendix has a higher risk of perforation than acute appendicitis. Therefore, this study compared appendiceal diverticulitis with acute appendicitis to explain the characteristics of appendiceal diverticulitis. Methods Data for this study came from a retrospective analysis at the Department of Surgery at Fukuoka Tokushukai Hospital from January 2005 to June 2008. Twelve cases of appendiceal diverticulitis and 378 cases of acute appendicitis were analyzed. Results The patients with appendiceal diverticulitis were older than those with acute appendicitis (42.7 ± 15.4 vs. 29.1 ± 17.7; p = 0.009). The white blood cell (WBC) level was lower (11332 ± 4658 vs. 14236 ± 3861; p = 0.011) and the CRP level was higher (8.65 ± 8.94 vs. 4.34 ± 6.34, p = 0.022) in those with appendiceal diverticulitis than in those with acute appendicitis. A preoperative diagnosis for appendiceal diverticulitis was made in 4 out of 12 (33.3%) by ultrasonography (US). The perforation rate was higher in appendiceal diverticulitis than that in acute appendicitis (33.3 vs. 9.8%; p = 0.009). Conclusions Appendiceal diverticulitis is more likely to perforate over the progression of the clinical course, which would mandate appendectomy when appendiceal diverticulitis is detected by US, even if the patient has no severe abdominal pain. © Springer 2012.


Hosaka S.,Fukuoka Tokushukai Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

A 59-year-old man realized a left lower abdominal pain and palpable mass about a month ago. He was admitted to our hospital because of the pain and high fever. Blood examinations revealed high levels of white blood cell count and CRP. Ultrasonography showed a wall thickness of the descending colon and 7 cm cystic mass with air around. Moreover, a 6 cm cystic mass was found an outside of the ascending colon. We first treated with antibiotics under the diagnosis of abscesses because of perforation of diverticulum. Colonoscopy revealed an obstructing tumor in descending colon and biopsy specimens of the tumor showed adenocarcinoma. The preoperative diagnosis of the right side tumor was unclear. We performed a partial resection of the descending colon, and the tumor outside of the ascending colon was resected. The pathological diagnosis of the tumors was both mucinous carcinoma of the colon. Mucinous carcinoma tends to be more found in the right side of the colon than in the left side. The rate of lymph node metastasis and dissemination is higher than that in differentiated adenocarcinoma. We report a rare case of mucinous carcinoma originated from the left side of the colon with a solitary dissemination in opposite side of the abdomen.


Yamashita K.,Fukuoka Tokushukai Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

We report a case of ruptured gastrointestinal stromal tumor (GIST) of the duodenum with intraabdominal bleeding. A 50-year-old man was admitted to our hospital because of sudden epigastralgia. Enhanced computed tomography (CT) showed a tumor measuring about 14 cm in diameter on the ventral side of the right kidney and intrapelvic fluid collection. We performed an emergency operation. At laparotomy, the tumor was originated from the 2nd portion of the duodenum without attaching to the retroperitoneum. We resected the tumor radically. Histopathologically, the tumor arose from the proper muscle layer of the duodenum, and was positive for c-kit and negative for CD34 and α-SMA on immunostaining. Then the tumor was diagnosed as GIST of the duodenum. Adjuvant therapy by imatinib 400 mg/day is now being done because this case is thought to be clinically malignant GIST.


Morokuma H.,Fukuoka Tokushukai Hospital | Katayama Y.,Fukuoka Tokushukai Hospital | Koga S.,Fukuoka Tokushukai Hospital | Ogura Y.,Fukuoka Tokushukai Hospital
Asian Cardiovascular and Thoracic Annals | Year: 2014

A 66-year-old man was referred in cardiogenic shock due to acute myocardial infarction. Echocardiography revealed severe mitral regurgitation with prolapse of the posterior mitral leaflet due to papillary muscle rupture. Emergency coronary angiography showed subtotal occlusion of the left circumflex coronary artery. A percutaneous coronary intervention was performed immediately. After inducing percutaneous cardiopulmonary support, emergency mitral valve replacement was carried out. The anterior and posterior papillary muscles attached to the posterior mitral leaflet were completely ruptured. Pathological findings showed massive necrosis. © 2013 The Author(s).


PubMed | Fukuoka Tokushukai Hospital
Type: Journal Article | Journal: Asian cardiovascular & thoracic annals | Year: 2016

A 66-year-old man was referred in cardiogenic shock due to acute myocardial infarction. Echocardiography revealed severe mitral regurgitation with prolapse of the posterior mitral leaflet due to papillary muscle rupture. Emergency coronary angiography showed subtotal occlusion of the left circumflex coronary artery. A percutaneous coronary intervention was performed immediately. After inducing percutaneous cardiopulmonary support, emergency mitral valve replacement was carried out. The anterior and posterior papillary muscles attached to the posterior mitral leaflet were completely ruptured. Pathological findings showed massive necrosis.


Morokuma H.,Fukuoka Tokushukai Hospital | Minato N.,Fukuoka Tokushukai Hospital | Kamohara K.,Fukuoka Tokushukai Hospital | Minematsu N.,Fukuoka Tokushukai Hospital
Annals of Thoracic and Cardiovascular Surgery | Year: 2010

Tricuspid valve infective endocarditis (TVIE) is rare in Japan, though many reports of it in intravenous drug users are found in other countries. We experienced 3 surgical cases of isolated TVIE in 2 nonintravenous drug users and 1 intravenous user, and we presented successful results. The surgical options for TVIE are vegetectomy and valvulectomy, valve repair, and valve replacement, which are controversial in regard to hemodynamic consequences in right-sided low-pressure system and long-term prognosis. We report the 3 surgical cases of isolated TVIE.

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