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Kunihara E.,JA Onomichi General Hospital
Nippon Ganka Gakkai zasshi | Year: 2012

Using an ultrasound biomicroscope (UBM) and an endoscope just after birth, We observed the morphological changes in the anterior segment in a case of anterior segment dysgenesis. The patient was a 9-day-old baby girl born with central opacity and high intraocular pressure. The central cornea was thin and the opacity was ring-shaped. Corneal vascularization was associated with the increase in the central corneal opacity, and finally progressed to fatty degeneration. Just after birth, UBM showed a double anterior chamber in one part of the cornea. The space in the cornea was filled with solid material, and the corneal thickness worsened. Surgical endoscopy showed a red membrane on the inner side of the cornea. The red color faded with time. We reasoned that an immature corneal stroma developed after birth, and that this secondary stroma filled the space between the retrocorneal membrane and the corneal stroma. We also reasoned that the red membrane of the posterior cornea might be caused by bleeding from the corneal neovascular vessels, or that the vascular membrane of the posterior cornea encouraged proliferation of collagen fibers. Later on the vessels and bleeding regressed. Source


Yoshino T.,JA Onomichi General Hospital
Hinyokika kiyo. Acta urologica Japonica | Year: 2012

We report a case of metachronous bilateral testicular tumors. A 36-year-old man was admitted to our hospital with the chief complaint of painless left scrotal swelling. He had undergone right high orchiectomy for testicular seminoma, stage I, one year earlier. This time, ultrasonography demonstrated two hypoechoic mass and microlithiasis of the left testis. Abdominal and chest computed tomography revealed no lymph adenopathy and no metastasis. The preoperative diagnosis was stage I testicular tumor and subsequently left high orchiectomy was performed. Histopathological examination revealed typical seminoma. To our knowledge, including the present case, 191 cases of metachronous bilateral testicular tumors have been reported in Japan. Contralateral testicular tumor was observed at a mean age of 37.3 years and the mean interval of time between the initial testicular tumor and contralateral one was 73.0 months Approximately fifty percent of metachronous bilateral testicular tumors previously reported have recurred after five years or more from the initial surgery. In the testicular tumor, long-term follow-up and self examination of the contralateral testis are of great importance. Source


Yamaguchi K.,University of Kitakyushu | Okusaka T.,National Cancer Center | Shimizu K.,Tokyo Womens Medical University | Furuse J.,Kyorin University | And 3 more authors.
Japanese journal of clinical oncology | Year: 2014

Clinical practice guidelines for pancreatic cancer based on evidence-based medicine (2006) were published by the Japan Pancreas Society (Committee for revision of clinical guidelines for pancreatic cancer) in March 2009 in Japanese, revised to Clinical Practice Guidelines for Pancreatic Cancer based on evidence-based medicine (2009) in July 2009 in Japanese and further revised to Clinical Practice Guidelines for Pancreatic Cancer (2013) in October 2013 in Japanese. These guidelines were established according to evidence-based medicine. A total of 629 papers were collected from among 4612 reports concerning pancreatic cancer listed in PubMed and Igakuchuo Zasshi between May 2007 and January 2011. This new set of guidelines was written by members of the Committee for the Revision of Clinical Practice Guidelines for Pancreatic Cancer in the Japan Pancreas Society. The guidelines provide an algorithm for the diagnosis (Fig. 1) and treatment (Fig. 2) of pancreatic cancer and address six subjects (Diagnosis, Surgery, Adjuvant therapy, Radiation therapy, Chemotherapy and stent therapy), with 35 clinical questions and 57 recommendations. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com. Source


Yoshino T.,JA Onomichi General Hospital | Ohara S.,Hiroshima University | Moriyama H.,JA Onomichi General Hospital
Journal of Medical Case Reports | Year: 2013

Introduction. Amyloidosis is characterized by extracellular deposition of abnormal insoluble fibrils, which cause structural and functional disorders. Amyloidosis is classified into primary and secondary disease. We report a case of localized amyloidosis of the urinary bladder. In the English literature, this is the first case effectively treated with occlusive dressing therapy using dimethyl sulfoxide. Case presentation. A 58-year-old Japanese woman was introduced to our department with asymptomatic gross hematuria. Cystoscopy revealed a gently raised nodule at the right lateral wall. Histopathological findings of this lesion revealed extensive amorphous eosinophilic deposits that stained positive with Congo red and Dylon. The patient was diagnosed with primary localized amyloidosis of the urinary bladder. To treat residual amyloidosis of the bladder, we performed occlusive dressing therapy using dimethyl sulfoxide. After treatment, cystoscopy and magnetic resonance imaging showed no relapse of the mass-like lesion of the bladder wall. Conclusions: Occlusive dressing therapy using dimethyl sulfoxide is efficacious and tolerable for amyloidosis of the urinary bladder. The maneuver of occlusive dressing therapy was simpler and easier than that of intravesical instillation, and occlusive dressing therapy was advantageous in that the patient could perform the therapy herself every day. However, invasive surgical management including cystectomy should be considered if conservative management is inefficacious. © 2013 Yoshino et al.; licensee BioMed Central Ltd. Source


Yoshino T.,JA Onomichi General Hospital | Moriyama H.,JA Onomichi General Hospital | Sanda N.,Chuden Hospital
Urologia Internationalis | Year: 2013

IgG4-related sclerosing disease is a novel clinicopathological entity characterized by fibrosis, extensive infiltration of IgG4-positive plasma cells, and serum IgG4 elevation. This disorder includes a variety of diseases, such as autoimmune pancreatitis, retroperitoneal fibrosis, sialadenitis, thyroiditis, inflammatory abdominal aneurysm, tubulointerstitial nephritis, and inflammatory pseudotumor [World J Gastroenterol 2008;14:3948-3955]. A 71-year-old man visited our hospital with the complaint of left flank pain and gross hematuria. Computed tomography (CT) revealed left hydronephrosis and a thick retroperitoneal soft tissue mass around the ureteropelvic junction, suspicious of renal pelvic cancer. Urine cytology using a urine sample from the left renal pelvis was negative. On laboratory examination, serum levels of IgG and IgG4 were found to be elevated. The patient refused tumor biopsy. Therefore, he was treated with corticosteroid therapy on the basis of a clinical diagnosis with IgG4-related retroperitoneal fibrosis. Regression of the retroperitoneal mass as well as improvement of left hydronephrosis and decrease in serum IgG4 levels were accomplished. These effects strongly suggested that the present case was an IgG4-related retroperitoneal fibrosis. However, in this instance, since we could not completely rule out malignancies by biopsy, careful follow-up was necessary with these points in mind. Copyright © 2012 S. Karger AG, Basel. Source

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