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Tazawa K.,Itoigawa General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

A 94-year-old female patient presenting with vomiting and hematemesis, was transferred to our hospital. On a chest computed tomography (CT) image, mediastinal emphysema was seen with a little amount of bilateral pleural effusion, therefore, a diagnosis of spontaneous esophageal rupture was made. It took 6 hours to make a definite diagnosis of this disease, and conservative therapies were done including administration of antibiotics and proton-pump inhibitor. The patient was able to drink water on 4th hospital day, and was discharged on 19th hospital day. At about 2 months after the onset, a gastrointestinal fiberscope showed just only scar at the lower thoracic esophagus. Source


Tachino H.,University of Toyama | Shojaku H.,University of Toyama | Nishida H.,University of Toyama | Watanabe Y.,University of Toyama | And 4 more authors.
Practica Otologica, Supplement | Year: 2012

We report a case of sinonasal rhabdomyosarcoma in an elderly 74-year-old man who complained of double vision and exophthalmos of the left eye. Computed tomography of the paranasal sinus confirmed findings of opacification of the left maxillary and ethmoidal sinuses extending into the orbit. Immunohistochemical examination of the excised tissue of the sinonasal tumor revealed the alveolar type of the rhabdomyosarcoma. Partial remission of the tumor was acquired in response to standard chemoradiotherapy for the rhabdomyosarcoma. However, the patient died due to multiple metastases 16 months after the onset of the disease. Sinonasal rhabdomyosarcoma with a high proliferative index (immunoexpression of MIB-1) has a poor prognosis. Source


Omura T.,University of Toyama | Shimada Y.,University of Toyama | Nagata T.,University of Toyama | Okumura T.,University of Toyama | And 6 more authors.
Oncology Reports | Year: 2014

S-1 has been recommended as adjuvant chemotherapy in patients after curative surgery for gastric cancer. However, some patients suffer recurrence even after S-1 adjuvant chemotherapy. The present study was conducted to find a predictive marker of the efficacy of S-1 adjuvant chemotherapy. We examined the microRNA (miRNA) expression of 35 patients who underwent S-1 adjuvant chemotherapy after curative surgery (R0) for pathological stage II or III gastric cancer. miRNAs were extracted from formalin-fixed, paraffin-embedded specimens for analysis and miRNA expression was examined using miRNA oligo chips. Fifteen patients relapsed and 20 did not over 5 years. Five miRNAs (miR-92b, 422a, 4732-5p, 4758-3p and 221) were highly expressed according to the tumor/normal (T/N) ratio in the patients who relapsed but not in those who did not relapse (P-value <0.05) by microarray analysis. If tumors showed high expression of 4 miRNAs (miR-92b, 422a, 4732-5p and 4758-3p) their positive predictive value of relapse was 93.8% and negative predictive value was 92.3%. In this case, their disease-free survival rate and overall survival rate were very poor. Our findings indicate that miR-92b, miR-422a, miR-4732-5p and miR-4758-3p are closely associated with relapse following S-1 adjuvant chemotherapy in gastric cancer. Source


Sato T.,Itoigawa General Hospital | Kameyama T.,University of Toyama | Inoue H.,University of Toyama
Journal of Diabetes and its Complications | Year: 2014

Background HbA1c level represents mean blood glycemic control. 1,5-Anhydro-d-glucitol (1,5-AG) level reflects glycemic fluctuations, a strong risk factor for the development of macroangiopathy. The present study investigated the relationship between serum 1,5-AG levels and macroangiopathy in patients with type 2 diabetes. Methods A total of 115 consecutive patients with type 2 diabetes, aged 45-79 years, were included. HbA1c, 1,5-AG, and lipid profile were measured. Carotid maximum intima-media thickness (IMT) and plaque score (PS) were determined by carotid sonography. An 1,5-AG level < 14.2 μg/mL was used as a predictor of a post-challenge 2-h blood glucose level > 200 mg/dL. Patients were divided into four groups: A (n = 32), HbA1c≥6.5% and 1,5-AG < 14.2 μg/mL; B (n = 23), HbA1c ≥ 6.5% and 1,5-AG ≥ 14.2 μg/mL; C (n = 24), HbA1c < 6.5% and 1,5-AG < 14.2 μg/mL; and D (n = 36), HbA1c < 6.5% and 1,5-AG ≥ 14.2 μg/mL. Results HbA1c level had significant positive correlation with IMT and PS. 1,5-AG level had a significant negative correlation with PS. PS was significantly higher in group C than in group D, but similar to that in group B. In multivariate analysis, HbA1c (β = 0.27, p = 0.03) and 1,5-AG (β = - 0.24, P = 0.04) were independent determinants of PS. Conclusions 1,5-AG level might provide additional information to identify macroangiopathy of patients with type 2 diabetes, especially in those with excellent HbA1c levels. © 2014 Elsevier Inc. Source


Tazawa K.,Itoigawa General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

We report a case of left traumatic diaphragmatic hernia in the postoperative state of the lung cancer. A 68-year-old man underwent video-assisted partial resection of the left lung for lung cancer. One year after the operation, he experienced an accident of falling from a tree. Chest radiograph and chest computed tomography revealed the stomach herniating into the left thoracic cavity. An emergent operation was performed by the abdominal approach. The stomach was returned into the abdominal cavity, and the hiatus in the central tendon of the left diaphragm was primarily sutured. The postoperative course was uneventful. Source

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