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Cho Y.,Hokkaido University | Iizuka S.,Tenshi Hospital | Hatae Y.,Megumino Hospital | Kobayashi K.,Sapporo Hokuyu Hospital | And 3 more authors.
Hemoglobin | Year: 2012

We undertook a 25-year observation of a female patient with an unstable variant, Hb Nottingham or β98(FG5)Val→Gly, GTG>GGG. The proband was diagnosed with Hb Nottingham at the age of 9 years. Splenectomy was performed in order to successfully aid her height growth due to chronic anemia at the age of 11, although anemia improvement was transient. She experienced pregnancy/delivery twice, at age 23 and 26, respectively. During both pregnancies, a large number of nucleated red blood cells (NRBCs) appeared in her peripheral blood. No developmental delay of the fetus was noted in either pregnancy, and she gave birth without any maternal complications or perinatal problems. Both babies were diagnosed with Hb Nottingham. To the best of our knowledge, this is the first report of a long-term observation of a proband with Hb Nottingham, including her pregnancy/delivery and the neonatal course of her children with the same disorder. © 2012 Informa Healthcare USA, Inc.

Hori J.I.,Asahikawa University | Kitahara K.,Asahikawa University | Tamaki G.,Asahikawa University | Motoya T.,Asahikawa University | And 4 more authors.
Japanese Journal of Clinical Urology | Year: 2012

From 1989 to 2011, we have experienced 59 patients with germ cell tumors. Of these, 10 patients were defined as poor prognosis category by IGCCC. We presented clinical characteristics of these 10 patients. Median age of the 10 patients was 35 years. Median follow up time was 88 months. Clinical stage was IIIB2 in 2 patients and IIIC in 8 according to Japanese Urological Association Staging System. Six patients underwent salvage surgery after normalization of tumor marker. All 3 cases with pathological findings of fibrosis or necrosis were alive with or without evidence of disease. Five-year overall and disease-specific survival was 80%. Although our treatment outcome of poor prognosis germ cell tumors was good, we must consider new strategy including early introduction of salvage chemotherapy when half-life of tumor marker is unsatisfactory and high dose chemotherapy as a salvage setting.

Toda G.,Sempo Tokyo Takanawa Hospital | Ishibashi H.,Clinical Research Center and Clinical Laboratory | Onishi S.,Kubokawa Hospital | Okanoue T.,Saiseikai Suita Hospital | And 11 more authors.
Acta Hepatologica Japonica | Year: 2011

The safety and efficacy of treatment with ursodeoxycholic acid (UDCA) of the patients with primary biliary cirrhosis (PBC) were investigated by following 1462 and 1327 patients, respectively, for 3 to 5 years after the start of treatment. No serious adverse events related to UDCA treatment occurred in the patients investigated and the start of treatment induced the significant fall of serum alkaline phosphatase (Al-P), γGTP, AST, ALT and total bilirubin concentration (T-Bil), which was sustained throughout the investigation period, indicating that the prolonged UDCA treatment was safe and effective in the improvement of liver function tests. In the final visit, however, little or no improvement of Al-P, γGTP, AST, ALT and T-Bil was noticed in some of the patients treated. The stratification of the patients according to the daily dose of UDCA revealed that in each of the liver function tests, the frequency of those who showed little or no improvement decreased with the increase in the dose, suggesting that the increase in the dose improved the liver function tests in these patients. Twenty three patients died of liver-related causes or received liver transplantation. Multivariate Cox regression analysis indicated that the base line T-Bil greater than 1.2 mg/dl, advanced histological stage and decrease less than 30% of base line level in T-Bil or AST at 6 months after the start of treatment were the predictors for liver-related death or liver transplantation. The response of T-Bil or AST to UDCA treatment is useful to identify the patients who need additional treatment for improvement of prognosis. © 2011 The Japan Society of Hepatology.

Iuchi H.,Megumino Hospital | Watabe Y.,Megumino Hospital | Hashimoto H.,Megumino Hospital | Kitahara K.,JR Sapporo Hospital | And 2 more authors.
Nishinihon Journal of Urology | Year: 2012

A 68-year-old man was referred to our outpatient clinic with left renal cell cancer and bladder cancer. He had undergone combination therapy comprising chemotherapy plus radiation therapy following radical orchiectomy for testicular cancer at the age of 48 years. The right testis could be felt within the scrotum, however the left testis could not Blood tests showed no abnormality in regard to testicular tumor markers. Urine cytology was class V. Computed tomography revealed a 3.0 × 3.4 cm mass in the left kidney and a 4.5 × 1.5 cm mass in the left wall of the bladder. We made it a priority to treat the bladder cancer which was strongly suspected to be invasive cancer. At first the patient underwent radical cystectomy. Then left partial nephrectomy was carried out. Our case would appear to be the 24th case of triple primary urogenital cancer in Japan that consisted of left testicular cancer, left renal cancer and bladder cancer. Our case was also thought to be a case of secondary cancer that developed following treatment for testicular cancer.

Kang J.-H.,Center for Gastroenterology | Kang J.-H.,Hokkaido Study Group of Hepatitis E | Matsui T.,Center for Gastroenterology | Saga A.,Aiiku Hospital | And 14 more authors.
Acta Hepatologica Japonica | Year: 2010

We encountered a series of sporadic cases of hepatitis E (n=8) from late September to middle of October 2009 in Sapporo and its suburbs. Surprisingly, HEV sequences from these patients segregated to a very compact cluster, suggesting a single-source epidemic. Moreover, they are closely related to the "Sapporo strain" or the "Kitami/Abashiri strain" which is known to have caused severe hepatitis in Kitami and Abashiri area, far from Sapporo, several years before. Advanced livestock marketing and food-distribution system might have caused the spread of this HEV strain. © 2010 The Japan Society of Hepatology.

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