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Mori K.,Houju Memorial Hospital | Yamada K.,Kanazawa University | Konno T.,Kanazawa University | Inoue D.,Kanazawa University | And 6 more authors.
Internal Medicine | Year: 2015

We herein report the case of a 65-year-old man with pericardial involvement associated with autoimmune pancreatitis. Chest CT imaging showed pericardial thickening. The patient responded to corticosteroid therapy, and the pericardial thickening resolved. Multiple organs are involved in immunoglobulin G4 (IgG4)- related disease (IgG4-RD); however, only a few cases of IgG4-related chronic constrictive pericarditis have been reported. To our knowledge, this is the first reported case of IgG4-RD with pericardial involvement at an early stage. This case indicates that recognizing pericardial complications in autoimmune pancreatitis is important and that CT imaging may be useful for obtaining the diagnosis and providing follow-up of pericardial lesions in cases of IgG4-RD. © 2015 The Japanese Society of Internal Medicine.


Makino I.,Houju Memorial Hospital | Yoshimitsu Y.,Houju Memorial Hospital | Sakuma H.,Houju Memorial Hospital | Nakai M.,Houju Memorial Hospital | Ueda H.,Houju Memorial Hospital
Journal of Gastrointestinal and Liver Diseases | Year: 2010

Biliary cystic tumors are rare neoplasms occurring in the liver and less frequently in the extrahepatic biliary system. Recently, biliary cystic tumors in the liver are thought to be divided into a biliary mucinous cystic neoplasm and intraductal papillary neoplasm of the bile duct. We report a case of a large cystic tumor originating around the hepatic hilum which had luminal communication with the bile duct. A 74 year-old-woman underwent abdominal ultrasonography for a routine checkup. It revealed a large cystic tumor in the liver. CT scan and MRI showed a multilocular cystic tumor about 12 cm in diameter with a mural nodule occupying the medial and anterior segment of the liver. Intraoperative cholangiography showed a communication between the cystic tumor and the bile duct. Central bisegmentectomy of the liver and extrahepatic bile duct resection was performed. A papillary tumor existed in the common hepatic duct and was connected with the cystic tumor in the liver. The tumor was mostly composed of noninvasive papillary adenocarcinoma with adenoma components, and was associated with focal microinvasion of adenocarcinoma. Ovarian-like stroma was not observed. This lesion was diagnosed as a cystic variant of intraductal papillary neoplasm of the bile duct. The patient is alive with no recurrence for 18 months since the surgery.


Kawaguchi I.,Houju Memorial Hospital | Kawaguchi I.,Kanazawa University | Higashide T.,Kanazawa University | Ohkubo S.,Kanazawa University | And 2 more authors.
Japanese Journal of Ophthalmology | Year: 2012

Purpose: To compare the drug efficacy of four prostaglandin analogues (PGAs) by bilateral treatment in normal subjects. Methods: Three consecutive studies comparing latanoprost to three other PGAs (travoprost, tafluprost and bimatoprost) were performed in 24 healthy subjects. Each study was separated by a washout period of over 6 weeks. In each study, two drugs were randomly assigned to one eye of each subject. Study subjects instilled the assigned medication at 9:00 p.m. every day for 2 weeks. The same masked investigator measured intraocular pressure (IOP) at 9:00 a.m., 1:00 p.m. and 5:00 p.m. at baseline and repeated measurements on days 7 and 14. The differences in IOP reduction were compared between the drugs. Results: Mean diurnal IOP reduction with latanoprost on days 7 and 14 was similar to that with travoprost and tafluprost, but was significantly lower than that with bimatoprost. The association of the mean diurnal IOP reduction between latanoprost and bimatoprost on day 14 (r 2 = 0.25) was weak, in remarkable contrast to the strong association between latanoprost and travoprost (r 2 = 0.81) and between latanoprost and tafluprost (0.82). Conclusions: The short-term bilateral treatment revealed a different IOP-lowering efficacy of bimatoprost compared to other PGAs in healthy subjects. © Japanese Ophthalmological Society 2012.


Sagawa M.,Kanazawa Medical University | Maeda T.,Houju Memorial Hospital | Yoshimitsu Y.,Houju Memorial Hospital | Sakuma T.,Kanazawa Medical University
European Journal of Cardio-thoracic Surgery | Year: 2014

Two patients were admitted to our hospital due to giant bullae. During thoracoscopic surgery, saline-cooled radiofrequency coagulation devices were used to shrink the wall of the bulla. In each case, the volume of the bulla was gradually reduced and the boundary between the lung and bulla was clearly delineated. This method is considered to be useful for performing thoracoscopic surgery of giant bulla. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.


Yoshioka K.,Kanazawa University | Matsuda E.,Houju Memorial Hospital | Murakami H.,Kanazawa University | Tsuchiya H.,Kanazawa University
Asian Spine Journal | Year: 2015

We present a rare case of a patient who underwent complete microendoscopic excision of an osteoid osteoma, which induced radiculopathy without nerve root compression. A 20-year-old man presented severe right groin pain that was temporarily relieved by nonsteroidal anti-inflammatory drugs. A computed tomography (CT) scan showed typical features of a nidus located in the inferior cortex of the right L3 pedicle. We performed surgery using a posterior microendoscopic approach. We drilled vertically along the line of the cortex of the caudal pedicle using a high-speed drill. After identifying the tumor, en bloc resection of the nidus was achieved. Immediately after surgery, pain in the right groin disappeared. A CT scan showed that most of the right L3 pedicle remained. This minimally invasive technique preserves spinal structures, including the facet and pedicle, and is a viable option for the treatment of spinal osteoid osteomas located close to vital structures.


PubMed | Houju Memorial Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2014

A 49-year-old female patient presented with lower abdominal pain and constipation. Computed tomography revealed left breast cancer with lymph node metastases, a peritoneal metastasis, bilateral hydronephrosis, and ovarian metastasis. The giant ovarian metastasis occupied the pelvic cavity and was responsible for her symptoms of digestive obstruction. Both ovaries were resected as a palliative measure. Three cycles of weekly paclitaxel were successfully administered, leading to the disappearance of malignant ascites. Hence, reduction surgery for ovarian metastasis in the treatment of breast cancer increased the effectiveness of the chemotherapy by improving the patients general condition.


PubMed | Houju Memorial Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2014

A 66-year-old woman was admitted to our hospital for massive ascites of unknown origin. Peritoneal mesothelioma was suspected because of her history of asbestos exposure. Diagnostic laparoscopy with biopsy of the peritoneum and greater omentum was performed. Pathological examination with immunostaining provided a definite diagnosis of malignant peritoneal mesothelioma. The patient underwent early postoperative induction therapy with pemetrexed and carboplatin, which resulted in a reduction in ascites. Laparoscopic biopsy contributed to the definite diagnosis of malignant peritoneal mesothelioma, and thereby, early induction of chemotherapy.


PubMed | Houju Memorial Hospital and Kanazawa University
Type: | Journal: Journal of pharmaceutical health care and sciences | Year: 2016

Regorafenib and its metabolites may inhibit the activities of several CYP or UDP-glucuronosyltransferase isoforms, including that of CYP2C9. Therefore, pharmacological agents that are CYP2C9 substrates may show elevated circulating levels and enhanced drug efficacy when concurrently used with regorafenib. Previous studies showed that the area under the plasma concentration-time curve of warfarin, which is the substrate for CYP2C9, increased upon co-administration of regorafenib. However, there are no reports indicating that the anticoagulant effects of warfarin increased upon co-administration of regorafenib.We report a case of a 76-year-old man with liver metastasis of colon cancer. He was treated with regorafenib at a dosage of 120mg daily on days 1 to 21 every 4weeks as a third-line therapy. He had a history of acute myocardial infarction and had taken 2mg warfarin daily. Three weeks after the treatment began, PT/INR values markedly increased, although there was no hemorrhage. Administration of regorafenib and warfarin was discontinued, and then PT/INR rapidly decreased. Warfarin administration was restarted (0.5mg daily) and the dose was increased up to 1.5mg daily. The patients PT/INR values exhibited a tendency to increase when concurrently used with regorafenib, the dose of which was reduced to 80mg daily on days 1 to 14 every 3weeks at a physicians discretion.The clinical course of this patient suggested that PT/INR might increase during concurrent use of warfarin and regorafenib. Therefore, PT/INR should be periodically monitored during the concurrent use of warfarin and regorafenib.


PubMed | Kanazawa Medical University and Houju Memorial Hospital
Type: Journal Article | Journal: Oncology letters | Year: 2014

Neurotoxicity is one of the most frequent side-effects of oxaliplatin. Oxaliplatin-induced cumulative and dose-limiting neurotoxicity either results in dose reduction or decreases the patients quality of life. However, the symptoms of neurotoxicity often vary among patients. The current study presents the case of a male with rectal cancer, who was administered a cumulative oxaliplatin dose of >5,000 mg/m


PubMed | Houju Memorial Hospital and Kanazawa University
Type: Journal Article | Journal: Asian spine journal | Year: 2015

We present a rare case of a patient who underwent complete microendoscopic excision of an osteoid osteoma, which induced radiculopathy without nerve root compression. A 20-year-old man presented severe right groin pain that was temporarily relieved by nonsteroidal anti-inflammatory drugs. A computed tomography (CT) scan showed typical features of a nidus located in the inferior cortex of the right L3 pedicle. We performed surgery using a posterior microendoscopic approach. We drilled vertically along the line of the cortex of the caudal pedicle using a high-speed drill. After identifying the tumor, en bloc resection of the nidus was achieved. Immediately after surgery, pain in the right groin disappeared. A CT scan showed that most of the right L3 pedicle remained. This minimally invasive technique preserves spinal structures, including the facet and pedicle, and is a viable option for the treatment of spinal osteoid osteomas located close to vital structures.

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