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Miura Y.,National Hospital Organization Nishigunma Hospital
Arerugī = [Allergy] | Year: 2014

A 71-year-old man was referred to our hospital because of an intractable productive cough. Although he was treated for bronchial asthma, the symptom did not improve. Furthermore, since he developed progressive dyspnea and hypoxemia, he was admitted to our hospital. Marked eosinophilia in a blood test and sputum, poorly defined centrilobular nodules throughout the bilateral lung fields in a chest CT scan, and mixed ventilatory impairment in a spirometric test were revealed. Thoracoscopic lung biopsy and bronchoalveolar lavage were not conducted because of progressive respiratory failure. Therefore, we clinically diagnosed eosinophilic bronchiolitis, and immediately administered oral prednisolone (30 mg daily). His symptoms and examination findings rapidly improved. This case suggests that eosinophilic bronchiolitis should be taken into consideration for differential diagnoses of eosinophilic lung disease and obstructive lung disease, and marked eosinophilia in sputum may be one of the useful tools for diagnosis of this disease when invasive examinations are inadequate. Source


Suzuki J.,National Hospital Organization Nishigunma Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2011

A 25-year-old man was admitted with elevated fever, dyspnea, cough, dorsal chest pain, and multiple nodular shadows and pleural effusion found on chest X-ray films. There were multiple swollen superficial lymph nodes, and non-caseating epithelioid cell granulomas with Langhans giant cells were detected on a biopsy specimen of a right inguinal lymph node. Bronchoscopy findings demonstrated mucosal irregularity, telangiectasia and small nodules, and another biopsy specimen was similar to that of the inguinal lymph node. The number of lymphocytes and the CD4/CD8 ratio were elevated in his bronchoalveolar lavage fluid, and serum ACE and lysozymes levels were also elevated. These findings are compatible with sarcoidosis. Although his symptoms and pleural effusion improved with the administration of 30 mg/day prednisolone (PSL), these findings recurred after about 4 weeks. Therefore, we increased the PSL dose to 60 mg/day, and his symptoms, pleural effusions and laboratory data improved again. There were no signs of relapse after tapering and discontinuance of PSL. Source


Imai H.,Gunma University | Imai H.,Shizuoka Cancer Center | Kaira K.,Gunma University | Yoshino R.,National Hospital Organization Nishigunma Hospital | And 5 more authors.
Surgical Practice | Year: 2013

Aim: Invasive thymomas are rare tumours of the anterior mediastinum. These tumours' clinical features have been the subject of much controversy. Therefore, it is necessary to elucidate the optimal management of invasive thymomas. Patients and Methods: A total of 61 patients with invasive thymoma were retrospectively reviewed. Results: The study group comprised 38 males (62.3 per cent) and 23 females (37.7 per cent), with a median age of 55years (range: 28-79years). According to the Masaoka staging, 31 patients had stage II disease (50.8 per cent), 21 patients had stage III disease (34.4 per cent), four patients had stage IVa disease (6.6 per cent) and five patients had stage IVb disease (8.2 per cent). A statistically-significant difference in the survival rate was observed between stages II and III (P<0.001) and between III and IV (P<0.001). Complete resection was performed in 43 patients (70.5 per cent). Patients who underwent complete resection showed significantly better prognosis than those with incomplete resection (P<0.001) and inoperable/biopsy (P<0.001). After initial treatment, a total of 20 patients (32.8 per cent) relapsed. The recurrence rates in stages II, III and IV were 3.2 per cent, 66.7 per cent and 55.5 per cent, respectively. Treatment for recurrence was performed in all 20 patients. Conclusion: The outcome of invasive thymoma was correlated with the Masaoka stage and the extent of tumour resection. Salvage treatment for recurrent thymoma might give a moderate response rate and improve survival. A large-scale study is warranted for evaluating the role of the multimodality therapeutic approach in patients with invasive thymoma. © 2013 College of Surgeons of Hong Kong. Source


Isoda A.,National Hospital Organization Nishigunma Hospital | Kaira K.,Gunma University | Oriuchi N.,Gunma University | Tominaga H.,Fukushima Medical University | And 6 more authors.
Cancer Science | Year: 2014

L-type amino-acid transporter 1 (LAT1) plays a key role in cell growth and survival. To determine the prognostic significance of LAT1 in multiple myeloma (MM), we investigated the expression of LAT1 and its functional subunit, 4Fc heavy chain (CD98), on myeloma cells by immunohistochemistry in 100 newly diagnosed MM patients. High expression (moderate or strong staining intensity) of LAT1 and CD98 was detected in 56% and 45% of patients, respectively. The LAT1 expression score was positively correlated with Ki-67 index (r = 0.631, P < 0.001), and there was a statistically significant difference in Durie-Salmon stage between patients with high and low LAT1 expression (P = 0.03). In 43 patients treated with melphalan and prednisolone, the overall response rate was significantly higher in the high LAT1 expression group (60.0%) than in the low LAT1 expression group (17.6%) (P = 0.03). Multivariate analysis confirmed that high expression of LAT1 was a significant prognostic factor for predicting poor overall survival independently from the International Staging System (both P = 0.01). Here, we show that the overexpression of LAT1 is significantly associated with high proliferation and poor prognosis in newly diagnosed MM patients. Thus, LAT1 may be a promising pathological marker for identifying high-risk MM. © 2014 The Authors. Source


Imai H.,Shizuoka Cancer Center | Shukuya T.,Shizuoka Cancer Center | Shukuya T.,Juntendo University | Yoshino R.,National Hospital Organization Nishigunma Hospital | And 14 more authors.
Chemotherapy | Year: 2014

Background: There is no standard therapy for relapsed patients who have received postoperative platinum-based adjuvant chemotherapy for resected non-small-cell lung cancer (NSCLC). We investigated the efficacy and safety of platinum combination chemotherapy re-challenge for such patients. Methods: Medical records from 3 institutes from April 2005 to July 2012 were retrospectively reviewed. Patients who underwent complete surgical resection were eligible if they received postoperative adjuvant chemotherapy consisting of cisplatin plus vinorelbine once and then re-challenge with platinum combination chemotherapy. Results: Sixteen patients were enrolled in this study. After re-challenge with platinum combination chemotherapy, we observed an overall response rate of 31.2% (5/16) and a disease control rate of 81.2% (13/16). Median progression-free survival and overall survival from the start of the re-administration of platinum combination chemotherapy were 6.5 and 28.0 months, respectively. Frequently observed severe adverse events (≥grade 3) included neutropenia (31.2%), thrombocytopenia (31.2%), leukopenia (12.5%) and hyponatremia (12.5%). Frequently observed non-hematological toxicities (≥grade 2) were anorexia (37.5%) and nausea (37.5%). Conclusion: Re-challenge with platinum combination chemotherapy was effective and safe; therefore, this therapy should be considered as a treatment option for relapsed patients after postoperative cisplatin-based adjuvant chemotherapy for resected NSCLC. © 2014 S. Karger AG, Basel. Source

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