Himeji, Japan
Himeji, Japan

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Haruma T.,Okayama University of Science | Ogawa C.,Okayama University of Science | Nishida T.,Okayama University of Science | Kusumoto T.,Okayama University of Science | And 4 more authors.
Acta Medica Okayama | Year: 2015

Pure ovarian choriocarcinoma is an extremely rare malignancy that can be gestational or non-gestational in origin. Silver-Russell syndrome (SRS) is a rare congenital developmental disorder characterized by pre- and postnatal growth failure, relative macrocephaly, a triangular face, hemihypotrophy, and fifth-finger clinodactyly. We report a rare case of pure ovarian choriocarcinoma occurring in a 19-year-old woman with SRS. Following surgery, multiple chemotherapy courses were effective and she was free of disease at the 10-month follow-up. © 2015.


Ota S.,Himeji St Marys Hospital | Hiramatsu Y.,Red Cross | Kondo E.,Okayama University | Kasahara A.,Himeji St Marys Hospital | And 5 more authors.
Acta Medica Okayama | Year: 2014

Leukocytosis is occasionally seen in patients with presumptive but undiagnosed myeloproliferative disorders (MPD). A 74-year-old woman was admitted to our hospital for tarry stools, anemia, and marked peripheral leukocytosis of 1.4×105/μL. Gastroenteroscopy revealed an acute gastric and duodenal mucosal lesion that was treated successfully via endoscopic hemoclipping. Bone marrow aspiration revealed marked megakaryocyte proliferation with atypia of naked nuclei and marrow hypercellularity (90% cellularity). A fluorescence in situ hybridization test could not detect the BCR-ABL fusion gene. Bone marrow aspiration later revealed further abnormalities of megakaryocytes. The patient died from cerebral bleeding. The present case fulfilled 2 of the 3 major criteria of primary myelofibrosis according to the World Health Organization 2008 classification:namely, megakaryocytic hyperplasia with hypercellular marrow and granulocytic hyperplasia. However, the megakaryocytic abnormality was not strictly compatible with the criteria. Instead, we considered prefibrotic primary myelofibrosis as a possibility, although myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) was technically the correct diagnosis. The present case shows that MPN diagnosis remains difficult and suggests that other cases of peripheral leukocytosis with diagnosed MDS/MPN-U might include similar findings. © 2014 by Okayama University Medical School.


Kanezaki M.,Himeji Dokkyo University | Ogawa T.,Himeji St Marys Hospital | Izumi T.,Health Sciences University of Hokkaido
Tohoku Journal of Experimental Medicine | Year: 2015

Contraction of the genioglossus affects either tongue protrusion strength or dilating forces of the upper airway. The upper airway in patients with obstructive sleep apnea (OSA) is thought to collapse during sleep, at least in part because of a sleep related reduction in genioglossus muscle activity. Thus, although tongue protrusion strength by genioglossus activity during sleep contributes to the maintenance of airway patency in patients with OSA, the relationship between tongue protrusion strength in the arousal state and obstructive sleep apnea has not been fully elucidated. Conventional method of tongue protrusion strength cannot be used to evaluate in edentulous subjects and/or subjects with the decreased biting force. In this study, employing a novel measurement method that does not require biting a transducer, we investigated relationships between the tongue protrusion strength and polysomnographic findings. We enrolled twenty normal subjects and 26 subjects with OSA. All subjects completed the measurement of tongue protrusion strength. Each subject with OSA was evaluated by full polysomnography. The degree of tongue protrusion strength was assessed by maximum voluntary contraction against the tongue depressor connected with a strain gauge dynamometer. The tongue protrusion strength was negatively correlated with obstructive apnea time, apnea index (AI) and the percent of sleep stage 2 (r = −0.61, p < 0.0001, r = −0.41 p = 0.03 and r = −0.39 p = 0.04, respectively). Tongue protrusion strength measured in the arousal state is predictive of the airway patency during sleep in OSA. © 2015 Tohoku University Medical Press


Mizuno S.,Himeji St Marys Hospital | Ota S.,Himeji St Marys Hospital | Tanaka T.,Okayama University | Shiomi K.,Himeji St Marys Hospital | And 2 more authors.
Acta Medica Okayama | Year: 2014

Primary tracheal malignant lymphoma is a rare disease; only 30 cases have been reported to date. A 73-year-old Japanese man with a history of asbestos exposure was undergoing biannual chest computed tomography (CT) twice a year as a routine procedure for those previously exposed to asbestos. He had been smoking since the age of 32. In September 2010, chest CT during this regular checkup revealed a polypoid lesion in his trachea and pleural plaques, which were suspected to be caused by asbestos. Bronchoscopy performed in October revealed a polypoid lesion with granules and nodules in the trachea. A diagnosis of non-Hodgkin lymphoma (NHL) and extranodal marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) was confirmed by histological analysis of the biopsy specimens. To our knowledge, this is the first case of primary tracheal lymphoma associated with a history of asbestos exposure. Several reports have documented no correlation between asbestos and malignant lymphoma. In addition, the correlation between smoking and NHL is weak. Although we cannot exclude the possibility of a simple coincidence of asbestos, smoking, and tracheal lymphoma, this case suggests that asbestos and smoking might have multiplicative effects in the development or progression of tracheal lymphoma. © 2013 by Okayama University Medical School.


Nagura I.,Kobe University | Fujioka H.,Kobe University | Kurosaka M.,Kobe University | Mori H.,Himeji St Marys Hospital | And 4 more authors.
Journal of Foot and Ankle Surgery | Year: 2012

Calcaneal avulsion fractures are not uncommon, and they are probably more likely in patients with osteoporosis. Closed manipulation for this type of fracture often fails to achieve acceptable reduction, and open reduction and internal fixation are usually required. However, open reduction and internal fixation with either a lag screw or Steinmann pins do not provide satisfactory fixation in patients with diabetes and elderly patients because of the presence of porotic bone. Levi described a tension band fixation system used to treat a calcaneal avulsion fracture using a simple technique performed with a transverse Kirschner wire through the os calcaneus, securing a figure-of-8 metal tension band wiring to the fragment. We report the successful treatment of 3 patients with calcaneal avulsion fractures using a modified tension band wiring technique, resulting in satisfactory recovery. Re-displacement of the fragment during the initial follow-up period was not reported, and bony union was achieved in all patients. We believe this technique is a useful surgical option for the treatment of calcaneal avulsion fractures. © 2012 American College of Foot and Ankle Surgeons.


Ota S.,Himeji St Marys Hospital | Kasahara A.,Himeji St Marys Hospital | Mizuno S.,Himeji St Marys Hospital | Uchikoga O.,Himeji St Marys Hospital | And 7 more authors.
Internal Medicine | Year: 2013

Case 1. The laboratory findings of a hematological analysis of a 53-year-old woman with palpitations and dyspnea revealed the following: red blood cell (RBC) count: 9.4×105/μL with 60.0‰ reticulocytes; Hb: 3.7 g/ dL; mean corpuscular volume (MCV): 124.5 fL; white blood cell (WBC) count: 2,800/μL with 10.0% myeloblasts. Case 2. Similarly, a 42-year-old man with dizziness had a RBC count of 1.63×106/μL with 24.0% reticulocytes, an Hb level of 6.0 g/dL, an MCV of 120.2 fL and a WBC count of 3,100/μL with 4.0% myeloblasts. Bone marrow aspirates in both patients confirmed a diagnosis of acute erythroid leukemia (AEL), which can present as marked macrocytic anemia with an MCV in excess of 120 fL and hemolysis. © 2013 The Japanese Society of Internal Medicine.


Takahashi M.,Himeji St Marys Hospital | Takahara H.,Himeji St Marys Hospital | Wakabayashi T.,Himeji St Marys Hospital
Japanese Journal of Anesthesiology | Year: 2016

We experienced two cases of end-of-life cancer patients with perineal pain, whose pain was relieved by 5 ml absolute ethanol caudal block. Although the first injection was ineffective, the second injection resulted in significant relief of pain in both cases. Although the indication should be carefully considered, alcohol caudal block is an analgesic method worth considering for the end-of-life cancer patients complaining of perineal pain.


PubMed | Himeji St Marys Hospital
Type: Case Reports | Journal: Acta medica Okayama | Year: 2014

Primary tracheal malignant lymphoma is a rare disease; only 30 cases have been reported to date. A 73-year-old Japanese man with a history of asbestos exposure was undergoing biannual chest computed tomography (CT) twice a year as a routine procedure for those previously exposed to asbestos. He had been smoking since the age of 32. In September 2010, chest CT during this regular checkup revealed a polypoid lesion in his trachea and pleural plaques, which were suspected to be caused by asbestos. Bronchoscopy performed in October revealed a polypoid lesion with granules and nodules in the trachea. A diagnosis of non-Hodgkin lymphoma (NHL) and extranodal marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) was confirmed by histological analysis of the biopsy specimens. To our knowledge, this is the first case of primary tracheal lymphoma associated with a history of asbestos exposure. Several reports have documented no correlation between asbestos and malignant lymphoma. In addition, the correlation between smoking and NHL is weak. Although we cannot exclude the possibility of a simple coincidence of asbestos, smoking, and tracheal lymphoma, this case suggests that asbestos and smoking might have multiplicative effects in the development or progression of tracheal lymphoma.


PubMed | Himeji St Marys Hospital
Type: | Journal: Case reports in medicine | Year: 2015

There are few reports of a transverse colon inguinal hernia; furthermore, an inguinal hernia perforating the scrotum is rare. Here we report the case of a 79-year-old man who died after developing an incarcerated colon inguinal hernia that perforated the scrotum and exhibited an air-fluid level. The patient was referred to our hospital in November 2011 with a complaint of inability to move. Physical examination revealed an abnormally enlarged left scrotum and cold extremities. He reported a history of gastric cancer that was surgically treated more than 30 years ago. His white blood cell count and C-reactive protein level were elevated. Abdominal and inguinal computed tomography revealed that his transverse colon was incarcerated in the left inguinal canal. Free air and air-fluid level were observed around the transverse colon, suggestive of a perforation. The patient and his family refused any surgical intervention; therefore, he was treated with sultamicillin tosilate hydrate and cefotiam hydrochloride. However, he succumbed to panperitonitis 19 days after admission. The findings from this case indicate that the transverse colon can perforate into an inguinal hernia sac.

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