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Kishiwada, Japan

Okuno M.,Kishiwada City Hospital
General thoracic and cardiovascular surgery | Year: 2010

A 39-year-old woman who had experienced slight chest discomfort for a few months was referred to our hospital with an abnormal shadow on a regular checkup chest X-ray film. A computed tomography scan revealed a large well-defined mass in close relationship to the great vessels of the anterior mediastinum. Magnetic resonance imaging showed the anterior mediastinal mass, which was about 25 cm in diameter, expanding to the left pleural cavity with heterogeneous intensity. Because of the size and location of the mass, a combination of anterolateral thoracotomy and partial longitudinal median sternotomy--so-called hemiclamshell incision--was chosen, allowing excellent visualization and complete dissection of the giant tumor. The final histopathology of the resected specimen confirmed well-differentiated liposarcoma.

Kitai T.,Kishiwada City Hospital
Gastroenterology Research and Practice | Year: 2012

Pseudomyxoma peritonei (PMP) is a rare clinical condition, where copious mucinous ascites accumulate in the peritoneal cavity due to dissemination of mucin-producing tumor. Because of this disseminating, yet nonmetastasizing, behavior, PMP attracts much interest from surgical oncologists in that aggressive locoregional therapy can give the opportunity of long survival and even cure. Although extra-abdominal metastasis is exceptionally rare, the lung is the most likely site in such a case. In this paper, the clinical findings and treatment of eleven cases with pulmonary metastasis from PMP were reviewed, including ten cases in the literature and one case which we experienced. The clinical features of PMP cases with pulmonary metastasis were similar to cases without pulmonary metastasis. The histological type was low-grade mucinous neoplasm in most cases. Pulmonary lesions were resected in seven cases in which abdominal lesions were controlled by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy or another therapeutic modality. Disease-free state was maintained in five cases at the end of the follow-up period. However, it should be noted that rapid progression after resection was seen in two cases, suggesting that biological features may have changed by surgical intervention. Copyright © 2012 Toshiyuki Kitai.

Tsujino K.,Kinki Central Hospital | Tsujino K.,Osaka University | Kurata T.,Kinki University | Yamamoto S.,National Hospital Organization Kinki chuo Chest Medical Center | And 7 more authors.
Journal of Thoracic Oncology | Year: 2013

Introduction: The purpose of this study was to evaluate whether consolidation chemotherapy (CCT) after concurrent chemo-radiotherapy is beneficial for patients with locally advanced non-small-cell lung cancer (LA-NSCLC). Methods: We systematically searched PubMed for phase II/III trials published before December 31, 2011, examining survival of LA-NSCLC treated with concurrent chemo-radiotherapy. Median overall survival and other study characteristics were collected from each study and pooled. We extracted log-transformed hazards and standard errors under the assumption that survival follows an exponential distribution, and computed a pooled median overall survival and a 95% confidence interval (CI) using random-effects model. Collected trial arms were categorized as having CCT or not having it, CCT+ and CCT-, respectively. Results: Forty-one studies were identified including seven phase III studies and 34 phase II studies with 45 arms (CCT+: 25; CCT-: 20). Clinical data were comparable for clinical stage, performance status, cancer histology, sex, and median age between the two groups. There was no statistical difference in pooled mOS between CCT+ (19.0 month; 95% CI, 17.3-21.0) and CCT-(17.9 month; 95% CI, 16.1-19.9). Predicted hazard ratio of CCT+ to CCT-was 0.94 (95% CI, 0.81-1.09; p = 0.40). There were no differences between the two groups with regard to grade 3-5 toxicities in pneumonitis, esophagitis, and neutropenia. These models estimated that addition of CCT could not lead to significant survival prolongation or risk reduction in death for LA-NSCLC patients. Conclusion: The pooled analysis based on a publication basis failed to provide evidence that CCT yields significant survival benefit for LA-NSCLC. © 2013 by the International Association for the Study of Lung Cancer.

Shibutani T.,Kishiwada City Hospital
Kaku igaku. The Japanese journal of nuclear medicine | Year: 2013

Working group on JJ1017 nuclear medicine domain extension code in the Japanese Society of Nuclear Medicine has created nuclear medicine extension codes keeping the integrity with JJ1017. The objective of this study was to investigate the usefulness of nuclear medicine extension codes in real clinical settings. Nuclear medicine examinations of each institution were extracted from the examination master table and then the target subset of examinations to be coded with JJ1017 were identified. For this subset, working process was conducted, during which the followings compared conformity rate, application rate of representative frequently code set and compliance rate of nuclear medicine extension codes. Without using representative frequently code set, it was difficult to invent the same code for the same examination. By using the representative frequently code set, the same code expression could be invented for the same examination. Furthermore, using nuclear medicine extension codes additionally, these which could not be appropriately coded with representative frequently code set alone. Nuclear medicine extension codes keeping the integrity with JJ1017, was proved to be useful to improve the accuracy of coding.

Satsu T.,Kishiwada City Hospital | Onoe M.,Kishiwada City Hospital
PACE - Pacing and Clinical Electrophysiology | Year: 2010

Background: Although infection is a serious complication of pacemaker implantation, optimal treatment of infections related to pacemaker systems is poorly defined. Methods: We describe a man in his 60s, an octogenarian, and two nonagenarian females who were treated for an infected permanent pacemaker. All of these patients developed inflammation that presented as local symptoms and purulent collection in the pockets of their implanted pacemakers. After fenestration of the pacemaker pockets, they were treated with vacuum-assisted wound closure (VAC). Results: Infection was eradicated in all the patients without the need for aggressive surgery. The open wound was re-sutured without complete removal of the pacemaker system in two patients. After removing the infected generator from the other two patients, the open wounds healed with or without re-suture. The mean duration of VAC was 19.5 days. The postoperative course of all of the patients was uneventful, and they remained completely asymptomatic after VAC, with no evidence of recurrent infection for 5- 15 months after discharge. Conclusions: When the risk of total system explantation is high, less-invasive VAC might serve as the option for treating an infected pacemaker. (PACE 2010; 426-430) © 2009 Wiley Periodicals, Inc.

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