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Mino, Japan

Yamamoto T.,Minoh City Hospital
Clinical calcium | Year: 2013

FGF23 related rickets/osteomalacia was mainly composed of XLH, ADHR, ARHR1, ARHR2 and tumor induced rickets/osteomalacia. Although the mechanism for increasing serum FGF23 levels was different from disease to disease, therapies for these patients were basically the same ; pharmacological doses of active vitamin D and phosphate administration. It is noted that phosphate therapy is associated with the occurrence of secondary hyperparathyroidism and nephrocalcinosis. Moreover, recent evidences indicated that these combination therapies increased serum FGF23 levels. On the basis of these data, it is suggested that appropriate doses of active vitamin D and phosphate are to be selected according to the data of serum PTH, ALP and the amount of urinary excretion of calcium. For the children, the recovery of growth velocity is also an important factor for deciding the suitable doses of the therapies. Source

Yamamoto T.,Minoh City Hospital
Clinical calcium | Year: 2010

Vitamin D related osteomalacia consisted of vitamin D deficient and resistant forms. Vitamin D deficiency was frequently suggested as a complication of osteoporosis. Vitamin D was synthesized in the skin from pro vitamin D by sunlight. And the elderly residents in the nursing home who do not want to come outside frequently are at high risk. Also, the people taking anti-convulsant are the case, because the medications promoted the catabolism of vitamin D through the induction of an enzyme linked to cytochrome P450. Since the effect of bisphosphonate was reported to be decreased in vitamin D deficiency, we have to keep in mind for adding native or active vitamin D for the target people of osteoporosis. Source

Doi T.,Minoh City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

Superior sulcus tumor( SST) is a rare type of lung cancer. Treatment usually consists of surgical resection after chemoradiotherapy. We report a case of a woman in her fifties who underwent carbon ion radiotherapy for SST. The patient complained of left shoulder pain, and imaging studies revealed a 5.2×3.5-cm local solid tumor at the apex of the left lung, invasion to the ribs, and no lymph node swelling. The level of tumor marker, carcinoembryonic antigen (CEA), was 5.7 ng/mL. Needle biopsy specimen revealed adenocarcinoma. The diagnosis was SST, T3N0M0, stage IIB. We did not detect Horner syndrome. Carbon ion radiotherapy at 66 Gy equivalent dose per 10 fractions was administered to the SST site. Subsequently, the tumor size decreased to 4.5×1.9-cm. The adverse effect was Grade 1 skin and pulmonary toxicity. Six months later, Grade 2 left shoulder connective tissue toxicity was observed; it was difficult to differentiate this from tumor recurrence. After 2.5 years from radiotherapy, the patient is free from recurrence. Carbon ion radiotherapy is effective and safe and can be considered as an important treatment option for SST. Source

Oshima S.,Minoh City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

Case 1 involved a 74-year-old man. After transcatheter arterial chemoembolization( TACE) for hepatocellular carcinoma (HCC), abdominal computed tomography (CT) revealed a gas-containing lesion in the liver. The patient was diagnosed as having a gas-containing liver abscess, necessitating emergency drainage under laparotomy. Blood culture revealed Clostridium perfringens. He was discharged on day 63 after surgery. Case 2 involved a 70-year-old man who was admitted to our hospital for obstructive jaundice caused by HCC. He was treated with TACE after endoscopic retrograde biliary tract drainage (ERBD). On the second day, he was diagnosed as having a ruptured gas-containing liver abscess with massive hemolysis, necessitating emergency drainage under laparotomy. He died the next day after surgery. The clinical course of liver abscess caused by Clostridium perfringens can be fulminant and fatal with massive hemolysis. Source

Kanayama S.,Minoh City Hospital
International ophthalmology | Year: 2011

To report clinical and histopathologic findings in a case of a failed AlphaCor artificial cornea explanted due to corneal stromal melting. We describe the case of a 77-year-old man who received multiple penetrating keratoplasties (PKPs) and subsequent placement of an AlphaCor artificial cornea. Examination showed total corneal infiltration as well as an AlphaCor that was partially dehisced from the host cornea. After explantation, the implant and adjacent host tissue underwent hematoxylin and eosin staining and high-resolution scanning electron microscopy (HR-SEM). Histopathologic analysis of the specimens revealed infiltration of the skirt pores by reactive corneal fibroblasts. Although the AlphaCor implant is an established method of treating multiple failed PKPs, in this case, HR-SEM imaging strongly suggests that the strength of the interface between the implant and corneal tissue is highly dependent on collagen deposition between the pores found in the implant skirt. Collagen deposition then increases the mechanical strength of the cornea-skirt interface. Source

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