Kita Harima Medical Center

Kita Harima Medical Center

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PubMed | Kobe Minimally Invasive Cancer Center, Kita Harima Medical Center, Kobe University, Hyogo Cancer Center and Hyogo Prefectural Awaji Medical Center
Type: Journal Article | Journal: International journal of hematology | Year: 2016

To identify strategies for reducing emesis induced by the CHOP regimen, which includes high-dose steroids, we prospectively evaluated the efficacy of palonosetron in Japanese patients. Palonosetron was administered at a dose of 0.75mg via intravenous injection over 30min before chemotherapy on day 1. Patients kept diaries of chemotherapy-induced nausea and vomiting (CINV) incidence from the start of chemotherapy until 168h afterwards, in which they documented the occurrence and severity of nausea, vomiting, anorexia, and the use of rescue medication. The primary endpoint was the overall occurrence rate of nausea, vomiting, and anorexia; these rates were 56, 12, and 62%, respectively, including all grades. The rates and severity of symptoms tended to worsen 120-168h after completing oral prednisolone. We defined complete response (CR) as no vomiting and no use of rescue therapy. The CR rates of post palonosetron 0.75mg treatment in the acute (0-24h), delayed (24-168h), and overall phases (0-168h) were 86, 66, and 62%, respectively. Antiemetic strategies of CHOP regimen for day 6 and, thereafter, should be investigated.

PubMed | Red Cross, Oita University, Nippon Telegraph and Telephone, Waseda University and 5 more.
Type: Journal Article | Journal: Journal of gastroenterology | Year: 2015

Proton pump inhibitor (PPI) therapy, the first-line treatment for gastroesophageal reflux disease (GERD), is not always effective. This study aimed to examine the effect of pretreatment patient characteristics on response to PPI therapy.Japanese outpatients with symptomatic GERD scheduled to receive endoscopy and PPI therapy were enrolled in this multicenter prospective observational study. The patients characteristics, including GERD and dyspeptic symptoms, anxiety, depression, and quality of life, were assessed using questionnaires before and 2 and 4weeks after the start of PPI therapy. Factors affecting therapeutic response were examined by simple and multiple regression analyses using three patient-reported outcome measures as objective variables.Data from 182 patients were analyzed. In multiple regression analysis using the residual symptom rate as an objective variable, lower GERD symptom score (p<0.05), absence of erosive esophagitis (p<0.05), higher epigastric pain/burning symptom score (p<0.05), and higher depression subscale score (p<0.05) accompanied poorer therapeutic response. In analyses using the patients impression of therapy, lower GERD symptom score (p<0.05) and absence of erosive esophagitis (p<0.05) accompanied poorer therapeutic response. In analyses using the relative GERD symptom intensity evaluated using a numeric rating scale, lower GERD symptom score (p<0.05), higher epigastric pain/burning symptom score (p<0.1), and lower body mass index (p<0.05) accompanied poorer therapeutic response.Patients who complained of milder GERD symptoms before treatment were likely to have poorer response to PPI therapy. Association of absence of erosive esophagitis, severer epigastric pain/burning symptoms, lower body mass index, and severer depression with poorer therapeutic response was also suggested.

PubMed | Kobe Central Hospital, Kawasaki Hospital, Hirono Kogen Hospital, Hyogo Prefectural Awaji Medical Center and 7 more.
Type: Journal Article | Journal: International journal of oral and maxillofacial surgery | Year: 2016

This retrospective study was performed to investigate the influence of occlusal support and the presence, state, and position of mandibular third molars on the incidence of mandibular angle and condylar fractures. The following variables were investigated: age, sex, cause of fracture, presence and state (impaction, angulation, and the number of roots) of the mandibular third molars, site of the mandibular fracture, presence of occlusal support, duration of intermaxillary fixation, and postoperative complications. Various risk factors for mandibular angle and condylar fractures were investigated by univariate analysis. The risk of mandibular angle fracture was significantly higher in patients with occlusal support and mandibular third molars. The risk of condylar fracture was significantly higher in patients without occlusal support or mandibular third molars. The position and angulation of the mandibular third molars were not significant risk factors in mandibular angle and condylar fractures. This study demonstrated the influence of occlusal support and the presence of mandibular third molars on the incidence of mandibular angle and condylar fractures. The presence of occlusal support may be a more important factor affecting mandibular angle or condylar fractures than the position of the mandibular third molars.

Yokono K.,Kita Harima Medical Center
Nihon rinsho. Japanese journal of clinical medicine | Year: 2013

Both decreased insulin secretion and insulin resistance are two major factors of impaired glucose tolerance (IGT) in the elderly. Up to now, decreased lean body mass and relatively increased fat mass, so-called sarcopenia or sarcopenic obesity, contribute to insulin resistance in the elderly. However, recent reports indicate that muscle mitochondrial function is reduced in aging, and this age-associated decline in mitochondrial function contributes to insulin resistance in the elderly. In addition, exercise intervention to IGT in the elderly is more effective to reduce in the incidence of type 2 diabetes than in younger people. Exercise seems to improve insulin resistance through mitochondrial function by activating AMP-activated protein kinase(AMPK) and PPARgamma coactivator-1alpha (PGC-1alpha). Because cognitive impairment is a most crucial factor plunging into frailty in diabetic elderly, diabetic control would be very important in preventing cognitive decline as well as vascular events. However, comprehensive management of diabetes, including dyslipidemia and hypertension, might contribute to the prevention of declines in cognitive function in older diabetic patients.

Yamamoto K.,Kita Harima Medical Center | Teshima M.,Kita Harima Medical Center | Morita N.,Kita Harima Medical Center
Otolaryngology - Head and Neck Surgery (Japan) | Year: 2014

A 64-year-old woman complained of a swelling of the left buccal and cervical lymph node swelling. CT revealed the mass that destroyed the walls of left maxillary sinus except for the orbital floor. The mass was diagnosed as not malignanct on biopsy from the lesion that protruded into the oral cavity. However, as the possibility of malignancy was assumed, we removed the mass with Weber-Fergusson approach and the ligation of external carotid artery. The intraoperative frozen section showed no tumorous lesion, and the extended resection was not performed. The definitive diagnosis was a hematocele of the maxillary sinus, and there have been no signs of recurrence.

Takata M.,Kita harima Medical Center | Maniwa Y.,Kobe University
Japanese Journal of Lung Cancer | Year: 2016

Background. In female patients, choriocarcinoma most commonly occurs from the trophoblasts and is associated with gestation. Primary pulmonary choriocarcinomas are very rare. We herein report a case of pulmonary choriocarcinoma in which the primary tumor was barely distinguishable from a metastatic tumor. Case. A 36-year-old woman who underwent an induced abortion due to a partial hydatidiform mole between two normal pregnancies was referred to our hospital because of a well-defined mass shadow (26x21 mm) in the lower lobe of the right lung. She developed amenorrhea one month later, and a pregnancy test was positive. She was referred for a gynecological examination at our hospital on the suspicion of an extrauterine pregnancy after a sonographic examination did not reveal an embryo. Although a high serum level of human chorionic gonadotrophin (hCG) was found, a gynecological examination revealed no pelvic abnormalities. Tumor enlargement was found on a chest roentgenogram two months later (31x25 mm). Bronchofiberoscopy did reveal any malignancy. The high uptake of FDG in the tumor was observed on PET-CT. A malignant tumor was strongly suspected; thus, lower lobectomy of the right lung was performed. The tumor was microscopically and immunohistochemically diagnosed as a choriocarcinoma. The postoperative serum hCG level dropped to normal levels, and adjuvant chemotherapy consisting of methotrexate, etoposide and actinomycin D was administered three times. Recurrence has not been observed in the year after surgery. The tumor was first diagnosed as being metastasis from the hydatidiform mole. It was difficult to diagnose as a primary pulmonary choriocarcinoma because there were no other tumors in the lung, and there were no apparent primary lesions in the pelvic cavity. We clinically concluded that the tumor was derived from trophoblasts, because the low frequency of primary pulmonary choriocarcinoma as well as her history of pregnancy. Thus, the tumor was considered to have originated from the chorionic tissue in normal pregnancy, not from the hydatidiform mole, due to the normal serum hCG level after the abortion of the mole. © 2016 The Japan Lung Cancer Society.

PubMed | Aichi Gakuin University, Kobe University, Hyogo Prefectural Kakogawa Medical Center, Konan Kosei Hospital and 2 more.
Type: Journal Article | Journal: Journal of clinical and translational hepatology | Year: 2016

Wilson disease (WD) is an inherited disorder of copper metabolism, and an international group for the study of WD (IGSW) has proposed three phenotypes for its initial presentation: acute hepatic, chronic hepatic, and neurologic phenotypes. Characterization of the acute hepatic phenotype may improve our understanding of the disease.Clinical features of 10 WD patients with the acute hepatic phenotype and characteristics of chronic lesions remaining in survivors were assessed by the European Association for the Study of the Liver (EASL) guidelines.All six patients younger than 30 years had survived an acute episode of hemolytic anemia with residual liver disease of cirrhosis or chronic hepatitis. The acute episode was self-limiting in two of the four patients over the age of 30 years and progressed to acute liver failure in the other two patients. One of the two survivors had residual liver disease of chronic hepatitis, while the other had chronic hepatitis and neurologic disease. Neurologic disease remained in a patient who successfully received a liver transplantation. During acute episodes, serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) changed rapidly along with anemia. Liver-specific ALT levels were age-dependently correlated with hemoglobin (Hb) concentrations. Enzyme reduction was milder for AST than ALT, which resulted in a high AST/ALT ratio in the anemic stage. The anemic stage in two patients transformed to acute liver failure.All survivors of an acute episode of the acute hepatic phenotype had residual liver disease or both liver and neurologic diseases. The rapid changes in liver enzymes during the acute episode and the liver and neurologic diseases remaining in survivors may provide a better understanding of WD.

PubMed | Kita Harima Medical Center
Type: | Journal: BMC cancer | Year: 2014

Lung cancer cells have been reported to produce cytokines, resulting in systemic reactions. There have been few reports showing that these cytokines induced the formation of an inflammatory mass around lung cancers.We encountered a patient with a pleomorphic carcinoma of the lung. This tumor produced interleukin (IL)-8, granulocyte colony-stimulating factor and IL-6, which in turn recruited inflammatory cells, such as CD8 positive lymphocytes, around the tumor, resulting in a rapidly growing tumor shadow.18 F-fluoro-deoxy-glucose positron emission tomography, in addition to a conventional radiological approach such as computed tomography, may detect immunological responses around a tumor.

PubMed | Kita Harima Medical Center
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

We report a case of a large gastric gastrointestinal stromal tumor (GIST), which became resectable and achieved pathological complete response after neoadjuvant chemotherapy with imatinib mesylate. A 59-year-old man presented with left hypochondrial pain. Abdominal computed tomography (CT) revealed gastric GIST invading the spleen and the diaphragm. Administration of imatinib mesylate was initiated as neoadjuvant chemotherapy. Six months after neoadjuvant chemotherapy with imatinib mesylate, abdominal CT revealed a reduction in tumor size. We judged the tumor resectable and performed partial gastrectomy and splenectomy. Histologically, number of myofibroblasts increased, but no viable tumor cells were observed. Pathological complete response was obtained.

PubMed | Kita Harima Medical Center
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

A 47-year-old woman underwent colectomy for advanced colon cancer and thereafter received regorafenib therapy as fourth-line chemotherapy. On treatment day 12, the patient developed erythema multiforme (EM) induced by the regorafenib therapy. Immediately after regorafenib was withdrawn, the patient was treated with oral bepotastine and steroid ointment, which relieved the EM without progressing to Stevens-Johnson syndrome (SJS). Regorafenib is used for third- or fourth-line chemotherapy. Progression of regorafenib-induced EM to SJS may cause critical dysfunction among patients. Before administering regorafenib therapy, the patient should be made aware of this potential adverse effect and be advised to withdraw the treatment and visit the hospital immediately if symptoms of EM are observed.

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