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Okano H.,Kyoto Prefectural University of Medicine | Konishi H.,Kyoto Prefectural University of Medicine | Fukumoto K.,Kyoto Prefectural University of Medicine | Horie H.,Kyoto Prefectural University of Medicine | And 5 more authors.
Gastroenterological Endoscopy | Year: 2013

We examined the usefulness and safety of intragastric observation employing a small diameter rigid telescope (external diameter : 2.7 mm, Nisco Co., Ltd.), which can be inserted through the catheter lumen of a gastric fistula tube made by percutaneous endoscopic gastrostomy. While exchanging the catheter, fistula and intragastric observations were carried out with a rigid telescope E02700 (direct view type) or E02770 (oblique view type) to verify the optimal path and location of the catheter tip. Endoluminal visualization of the stomach as well as the fistula was possible in all 30 patients examined without any clinically significant adverse event. A direct view type telescope was more preferable for observing the fistula lumen and the bumper of the catheter with guidewire introduction, while an oblique view type telescope provided better visualization of the gastric mucosa around the bumper.


Takashima H.,Nagahama City Kohoku Hospital | Murakami Y.,Kyoto University | Imaeda K.,Nagahama City Kohoku Hospital | Kida N.,Nagahama City Kohoku Hospital | And 8 more authors.
Acta Hepatologica Japonica | Year: 2010

A 78-year-old man who had been treated for primary biliary cirrhosis (PBC) for approximately 10 years developed hepatocellular carcinoma (HCC). Serological findings suggested that he had a prior infection with HBV. The patient underwent resection of the S4 segment. Resected tumor tissue showed poorly differentiated HCC, and the adjacent liver tissue showed consistent with liver cirrhosis of PBC (Scheuer IV). To clarify the relation of prior infection with HBV, we performed Alu-PCR to detect viral- host junction, but we couldn't detect it. Since 1990, only 11 patients with HCC based on PBC underwent liver resection and this is the first case report investigating whether HBV-DNA integration occurs in HCC from PBC. © 2010 The Japan Society of Hepatology.


Kida N.,Nagahama City Kohoku Hospital | Takashima H.,Nagahama City Kohoku Hospital | Nishikawa T.,Nagahama City Kohoku Hospital | Tomikashi K.,Nagahama City Kohoku Hospital | And 6 more authors.
Acta Hepatologica Japonica | Year: 2011

Transarterial treatment procedures such as chemolipiodolization and chemoembolization are an important part of multimodal therapy for multiple hepatocellular carcinomas (HCC). We examined a 69-year-old man diagnosed with multiple HCC. Angiography revealed that the celiac artery had been occluded by a previous surgical procedure. We inserted a microcatheter through the superior mesenteric artery to the proper hepatic artery and performed chemoembolization. Five months later, reccurence in the form of several HCC tumors was observed in the anterior segment of right hepatic lobe, and the main trunk of the right hepatic artery was occluded because of the effects of transarterial chemoembolization. A new approach was therefore required to perform selective transarterial therapy, as opposed to the conventional approach. We therefore attempted to puncture A8 percutaneously under ultrasonographic guidance and achieved the desired therapeutic effects without critical complications. At present, this approach may lead to serious complications, such as bleeding from the hepatic artery. Hence, a good understanding of not only the overall clinical status but also the hemodynamic profile of the patient is essential before this treatment is performed. © 2011 The Japan Society of Hepatology.


Yasui K.,Kyoto Prefectural University of Medicine | Takashima H.,Nagahama City Kohoku Hospital | Miyagawa M.,Kameoka Municipal Hospital | Miyazawa K.,Nagahama City Kohoku Hospital | And 7 more authors.
Hepatology Research | Year: 2013

Aim: Miriplatin, a lipophilic platinum complex, is a novel intra-arterial chemotherapeutic agent for hepatocellular carcinoma (HCC). Little is known about platinum-DNA adduct levels in human HCC after administration of platinum-based drugs. We investigated whether miriplatin selectively accumulates and forms platinum-DNA adducts in human HCC tumors. Methods: Using inductively coupled plasma mass spectrometry, we determined the platinum concentrations and platinum-DNA adduct levels in paired HCC tumors and non-tumor liver tissues of four patients who received transcatheter arterial chemoembolization with miriplatin and subsequently underwent hepatic resection. Results: The mean (± standard deviation) platinum concentrations were 730±350μg/g (range, 400-1100) in HCC tumors and 16±9.2μg/g (range, 9.2-29) in non-tumor liver tissues. The concentrations were approximately 50-fold higher in HCC tumors than in non-tumor liver tissues. The mean platinum-DNA adduct levels were 54±16pg Pt/μg DNA (range, 37-69) in HCC tumors and 13±13pg Pt/μg DNA (range, 4.8-33) in non-tumor liver tissues. The adduct levels were roughly 7.6-fold higher in HCC tumors than in non-tumor liver tissues. There were no significant correlations between platinum concentrations and platinum-DNA adduct levels in HCC tumors. Conclusion: Our results quantitatively demonstrate that there is a selective accumulation of platinum and formation of platinum-DNA adducts in human HCC tumors after transarterial chemoembolization with miriplatin. No correlation was observed between platinum concentrations and platinum-DNA adduct levels. © 2012 The Japan Society of Hepatology.


Nagashima T.,Nagahama City Kohoku Hospital | Niiro M.,Nagahama City Kohoku Hospital | Hirayama K.,Nagahama City Kohoku Hospital | Date S.,Nagahama City Kohoku Hospital | And 2 more authors.
Acta Urologica Japonica | Year: 2012

We report a case of squamous differentiated prostate carcinoma that developed after combination endocrine therapy for adenocarcinoma of the prostate. The patient was a 68-year-old man who visited our hospital with microscopic hematuria. His serum prostate-specific antigen (PSA) level was 7.06 ng/ml. Transperineal needle biopsy was performed and histological examinations indicated moderately differentiated adenocarcinoma with a Gleason score of 4 + 4 = 8. Computed tomography showed swelling of left external iliac lymph node. The clinical stage was T3aN1M0. Six weeks after combination endocrine therapy using goserelin acetate and bicalutamide, the patient underwent radical prostatectomy and bilateral pelvic lymphadenectomy. Histopathological examination of the surgical specimen demonstrated squamous cell carcinoma of the prostate with very small areas of adenocarcinoma. The treatment measure was changed from endocrine therapy to combination chemotherapy consisting of docetaxel, cisplatin, and 5FU. Eighteen month has passed after the surgery without any evidence of distant metastasis.


PubMed | Nagahama City Kohoku Hospital
Type: Case Reports | Journal: Hinyokika kiyo. Acta urologica Japonica | Year: 2012

We report a case of squamous differentiated prostate carcinoma that developed after combination endocrine therapy for adenocarcinoma of the prostate. The patient was a 68-year-old man who visited our hospital with microscopic hematuria. His serum prostate-specific antigen (PSA) level was 7. 06 ng/ml. Transperineal needle biopsy was performed and histological examinations indicated moderately differentiated adenocarcinoma with a Gleason score of 4 + 4 = 8. Computed tomography showed swelling of left external iliac lymph node. The clinical stage was T3aN1M0. Six weeks after combination endocrine therapy using goserelin acetate and bicalutamide, the patient underwent radical prostatectomy and bilateral pelvic lymphadenectomy. Histopathological examination of the surgical specimen demonstrated squamous cell carcinoma of the prostate with very small areas of adenocarcinoma. The treatment measure was changed from endocrine therapy to combination chemotherapy consisting of docetaxel, cisplatin, and 5- FU. Eighteen month has passed after the surgery without any evidence of distant metastasis.

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