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Ōsaka, Japan

Yamamoto T.,Ishikiri Seiki Hospital
Osaka city medical journal

A 69-year-old Japanese woman underwent a curative operation for rectal cancer (T2, N0, M0, Dukes B, R0, and stage IIA of American Joint Committee on Cancer) 3 years ago. On subsequent routine follow-up, a right-side thyroid nodule and a regional lymph node of up to 1.5 cm in diameter was palpated. FDG-PET demonstrated high FDG accumulation in the right lobe of the thyroid gland, neck lymph nodes, and sacral periosteum. We diagnosed a local recurrence of rectal cancer and a primary thyroid cancer. We chose radiotherapy for the periosteal recurrence, and then right hemithyroidectomy with regional lymph node dissection for the thyroid tumor was performed. Pathological examination demonstrated mucinous carcinoma, the same as the previous surgical specimen from the rectum. She had been treated with postoperative chemotherapy and had been alive and well for 26 months with lung metastases. Although thyroid gland metastasis from colorectal cancer is rarely reported, physicians should consider the possibility of thyroid gland metastasis when performing routine follow-up examinations for recurrence of colorectal cancer. Source

Sato Y.,Kanazawa University | Kubo S.,Osaka City University | Takemura S.,Osaka City University | Sugawara Y.,University of Tokyo | And 7 more authors.
International Journal of Clinical and Experimental Pathology

Recently, cholangiocarcinoma has epidemically developed among young adult workers of a printing company in Japan. Exposure to organic solvents including 1,2-dichloropropane and/or dichloromethane is supposed to be associated with the carcinoma development. The metabolism of dichloromethane proceeds through a Theta-class glutathione S-transferase (GST) T1-1-catalyzed pathway, where its reactive intermediates have been implicated in genotoxicity and carcinogenicity. This study examined features of the carcinogenic process of the cholangiocarcinoma developed in the printing company. Surgically resected specimens of the cholangiocarcinoma cases were analyzed, where all cases were associated with precursor lesions such as biliary intraepithelial neoplasia (BilIN) and/or intraductal papillary neoplasm of the bile duct (IPNB). Immunohistochemical analysis confirmed constitutional expression of GST T1-1 in normal hepatobiliary tract. Immunostaining of γ-H2AX, a marker of DNA double strand break, showed that its expression was significantly increased in foci of BilIN, IPNB and invasive carcinoma as well as in non-neoplastic biliary epithelial cells of the printing company cases when compared to that of control groups. In the printing company cases, immunohistochemical expression of p53 was observed in non-neoplastic biliary epithelial cells and BilIN-1. Mutations of KRAS and GNAS were detected in foci of BilIN in one out of 3 cases of the printing company. These results revealed different carcinogenic process of the printing company cases, suggesting that the exposed organic solvents might act as a carcinogen for biliary epithelial cells by causing DNA damage, thereby contributing to the carcinoma development. Source

Yabe T.,Ishikiri Seiki Hospital | Ozawa T.,Osaka City University
Journal of Craniofacial Surgery

As a postoperative complication in nasoethmoid-orbital fractures, nasal depression often occurs. The cause of this is an overlooked left nasal septum fracture. By reducing and fixing the nasal septum, nasal depression could have been avoided. Kirschner wire is useful for the fixation of the nasal septum, and it is fixed with zygomatic bone or/and frontal process of the maxillary bone. Three cases of nasoethmoid-orbital fractures were treated with this method. Kirschner wire fixation of the nasal septum is a simple and an easy method and can avoid unnecessary bone graft. © 2011 by Mutaz B. Habal, MD. Source

Asai T.,Kansai Medical University | Kawashima A.,Ishikiri Seiki Hospital
Japanese Journal of Anesthesiology

Background : The i-gel, which has been introduced into clinical practice in Japan in 2010, has a potential role in maintaining a clear airway during general anesthesia. Methods : We retrospectively studied the efficacy of the i-gel in 120 patients who had undergone elective surgery under general anesthesia. Results : It was always possible to insert the i-gel at the first attempt. However, there was gasleak around the device in 5 patients, and the device was reinserted. It was possible to obtain adequate ventilation via the i-gel in 117 patients (97.5%) within two attempts at insertion. Insertion was judged easy in 106 patients, somewhat difficult in 12 patients, and difficult in 2 patients. The mean minimum airway pressure at which gas leaked around the device was 26.4cmH 2O, with no gasleak at the airway pressure of 30cmH 2O in 66 of 120 patients. In no patients, did any airway complications, such as airway obstruction, occur during positive pressure ventilation, during the return of spontaneous breathing around the end of surgery, and during emergence from anesthesia. After removal of the i-gel, there was no stain of blood on the device. Conclusions : We believe that the i-gel is useful in maintaining a clear airway during general anesthesia. Source

Yabe T.,Ishikiri Seiki Hospital
Japanese Journal of Plastic Surgery

The pocket principle is a method used to restore finger length after fingertip amputation. Good results were expected for fingertip amputations performed at subzone I or II according to Ishikawa classification of the amputation level. An abdominal subdermal or palmar subcutaneous pocket was used as the donor site, and there was no obvious difference between the two sites in terms of fingertip survival. For amputations performed at the abovementioned levels, the optimal pocketing period ranged from 10 to 14 days, and it took approximately 3 weeks for the graft to be epithelized by second intention. The extent of damage to. and volume of, the amputated fingertip; the pocketing period; the depth of de-epithelization; and the patient's age were all found to affect fingertip survival. Clinicians should be prudent about employing this method for subzone III or IV fingertip amputations because it can produce inconsistent results in such cases. Source

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