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Sukeda A.,Clinical Pathology Laboratories | Mori T.,Clinical Pathology Laboratories | Suzuki S.,National Cancer Center Central Hospital | Ochiai A.,Clinical Pathology Laboratories
BMJ Case Reports | Year: 2014

Adenocarcinoma of the pigmented ciliary epithelium is an exceptionally rare eye tumour, with only a few cases reported to date. We encountered such a case in a 50-year-old woman who reported seeing floaters in her right eye. Fundus examination and MRI revealed an elevated lesion located in the ciliary body compressing the lens. The ciliary body was resected under the diagnosis of ciliary adenoma. On histological examination, the tumour exhibited epithelial features with glandular formation and moderate nuclear pleomorphism. The tumour invaded the subepithelial stroma of the ciliary body. Immunohistochemical findings were positive for cytokeratin OSCAR, AE1/AE3, CK7, EMA, S100, Melan A, HMB45, and microphthalmia-associated transcription factor. Copyright 2014 BMJ Publishing Group. All rights reserved. Source

Taniguchi C.,Nagoya Medical Center | Hibino F.,Nagoya Medical Center | Kawaguchi E.,Nagoya Medical Center | Maruguchi M.,National Cancer Center Central Hospital | And 7 more authors.
Journal of Epidemiology | Year: 2011

Background: We investigated the perceptions and practices regarding tobacco intervention among nurses, as improvement of such practices is important for the management of patients who smoke. Methods: Self-administered questionnaires were delivered by hospital administrative sections for nursing staff to 2676 nurses who were working in 3 cancer hospitals and 3 general hospitals. Of these, 2215 (82.8%) responded. Results: Most nurses strongly agreed that cancer patients who had preoperative or early-clinical-stage cancer but continued to smoke should be offered a tobacco use intervention. In contrast, they felt less need to provide tobacco use intervention to patients with incurable cancer who smoked. Most nurses felt that although they assessed and documented the tobacco status of cancer patients, they were not successful in providing cessation advice, assessing patient readiness to quit, and providing individualized information on the harmful effects of tobacco use. In multivariate analysis, nurses who received instruction on smoking cessation programs during nursing school were more likely to give cessation advice (odds ratio, 1.61; 95% confidence interval, 1.15-2.26), assess readiness to quit (1.73, 1.09-2.75), and offer individualized explanations of the harmful effects of tobacco (1.94, 1.39-2.69), as compared with nurses who had not received such instruction. Conclusions: The perceptions of Japanese nurses regarding tobacco intervention for cancer patients differed greatly by patient treatment status and prognosis. The findings highlight the importance of offering appropriate instruction on smoking cessation to students in nursing schools in Japan. © 2011 by the Japan Epidemiological Association. Source

Gotoda T.,Nihon University | Uedo N.,Japan National Cardiovascular Center Research Institute | Yoshinaga S.,National Cancer Center Central Hospital | Tanuma T.,Center for Gastroenterology | And 8 more authors.
Digestive Endoscopy | Year: 2016

Endoscopic diagnosis of gastrointestinal tumors consists of the following processes: (i) detection; (ii) differential diagnosis; and (iii) quantitative diagnosis (size and depth) of a lesion. Although detection is the first step to make a diagnosis of the tumor, the lesion can be overlooked if an endoscopist has no knowledge of what an early-stage 'superficial lesion' looks like. In recent years, image-enhanced endoscopy has become common, but white-light endoscopy (WLI) is still the first step for detection and characterization of lesions in general clinical practice. Settings and practice of routine esophagogastroduodenoscopy (EGD) such as use of antispasmodics, number of endoscopic images taken, and observational procedure are customarily decided in each facility in each country and are not well standardized. Therefore, in the present article, we attempted to outline currently available evidence and actual Japanese practice on gastric cancer screening using WLI, and provide tips for detecting EGC during routine EGD which could become the basis of future research. © 2016 Japan Gastroenterological Endoscopy Society. Source

Precise assessment of retroperitoneal invasion is clinically important to allow the achievement of negative margin resections. The clinical records of 132 patients who underwent macroscopic curative pancreaticoduodenectomy for invasive ductal carcinoma of the pancreas between 2004 and 2008 were retrospectively examined. The clinicopathological factors, including retroperitoneal fat infiltration classified into four groups by multidetector-row computed tomography (MDCT), were analyzed. The relationship between the grade of retroperitoneal fat infiltration and surgical outcomes, as well as various histopathological factors, was also investigated. The 5 year survival rate was 55.6 % for grade 0 infiltration (n = 8), 38.7 % for grade 1 (n = 54), 16.4 % for grade 2 (n = 49), and 0 % for grade 3 (n = 21). There were significant differences in survival in each group. Extrapancreatic nerve invasion and the surgical margin status were significantly associated with retroperitoneal fat infiltration demonstrated on MDCT. According to the grading classification among the 43 patients with pathological portal vein invasion, the 5 year survival rate was 45.9 % for patients with grade 1, which was significantly better survival that those with grade 2 (P = 0.007). The grading criteria for retroperitoneal fat infiltration may be useful as a predictor of survival after pancreaticoduodenectomy for pancreatic head carcinoma. Pancreaticoduodenectomy with portal vein resection could provide favorable survival in patients with grade 1 retroperitoneal fat infiltration, even if histopathological portal vein invasion is present. Source

Ban D.,University of Tokyo | Shimada K.,National Cancer Center Central Hospital | Konishi M.,National Cancer Center Hospital East | Saiura A.,Cancer Institute Hospital | And 2 more authors.
World Journal of Surgery | Year: 2012

Background: The pancreatic fistula rate following distal pancreatectomy ranges widely, from 13.3 to 64.0 %. The optimal closure method of the pancreatic remnant remains controversial, especially regarding whether to use a stapler. Methods: All patients who underwent distal pancreatectomy in five Japanese hospitals from January 2001 to June 2009 were included in this study. All relevant, anonymized medical records were entered into an electronic case report form. Complications and pancreatic fistulas were classified according to the Clavien-Dindo classification and the International Study Group of Pancreatic Surgery grading system, respectively. Results: Of the 388 patients, stapler closure and nonstapler closure were used after distal pancreatectomy in 224 patients (57.7 %) and 164 patients (42.3 %), respectively. Clinically relevant pancreatic fistulas (grades B and C) occurred in 47 patients (21.0 %) treated by stapler closure, which was a significantly lower rate than that for the 83 patients (50.6 %) treated by nonstapler closure. There were no surgical mortalities or in-hospital deaths. The distribution of postoperative complications was grade 1, 30.7 % (n = 119); grade 2, 40.2 % (n = 156); grade 3a, 0.1 % (n = 5); grade 3b, 0.3 % (n = 1); grade 4a, 0.3 % (n = 1). In the multivariate analysis, diabetes mellitus, previous laparotomy, operating time, and method of stump closure were found to be independently associated with the development of a clinical pancreatic fistula. Conclusions: Stapler closure is a safe, efficient alternative to standard suture closure techniques because the clinical fistula rate is significantly lower. © Société Internationale de Chirurgie 2012. Source

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