Nikko Memorial Hospital

Hitachi, Japan

Nikko Memorial Hospital

Hitachi, Japan
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Cummings K.J.,Centers for Disease Control and Prevention | Nakano M.,Keio University | Omae K.,Keio University | Takeuchi K.,Occupational Respiratory Disease Center Toyama Rosai Hospital | And 12 more authors.
Chest | Year: 2012

Background: Reports of pulmonary fibrosis, emphysema, and, more recently, pulmonary alveolar proteinosis (PAP) in indium workers suggested that workplace exposure to indium compounds caused several different lung diseases. Methods: To better understand the pathogenesis and natural history of indium lung disease, a detailed, systematic, multidisciplinary analysis of clinical, histopathologic, radiologic, and epidemiologic data for all reported cases and workplaces was undertaken. Results: Ten men (median age, 35 years) who produced, used, or reclaimed indium compounds were diagnosed with interstitial lung disease 4-13 years after first exposure (n = 7) or PAP 1-2 years after first exposure (n = 3). Common pulmonary histopathologic features in these patients included intraalveolar exudate typical of alveolar proteinosis (n = 9), cholesterol clefts and granulomas (n = 10), and fibrosis (n = 9). Two patients with interstitial lung disease had pneumothoraces. Lung disease progressed following cessation of exposure in most patients and was fatal in two. Radiographic data revealed that two patients with PAP subsequently developed fibrosis and one also developed emphysematous changes. Epidemiologic investigations demonstrated the potential for exposure to respirable particles and an excess of lung abnormalities among coworkers. Conclusions: Occupational exposure to indium compounds was associated with PAP, cholesterol ester crystals and granulomas, pulmonary fibrosis, emphysema, and pneumothoraces. The available evidence suggests exposure to indium compounds causes a novel lung disease that may begin with PAP and progress to include fibrosis and emphysema, and, in some cases, premature death. Prospective studies are needed to better define the natural history and prognosis of this emerging lung disease and identify effective prevention strategies. © 2012 American College of Chest Physicians.

PubMed | Red Cross, Hiroshima University, Tokai University, Hyogo College of Medicine and 14 more.
Type: | Journal: International journal of clinical oncology | Year: 2017

Six months of adjuvant chemotherapy is regarded as the standard of care for patients with stage III colon cancer. However, whether longer treatment can improve prognosis has not been fully investigated. We conducted a phase III study comparing 6 and 12months of adjuvant capecitabine chemotherapy for stage III colon cancer, and report here the results of our preplanned safety analysis.Patients aged 20-79years with curatively resected stage III colon cancer were randomly assigned to receive 8 cycles (6months) or 16 cycles (12months) of capecitabine (2500mg/mA total of 1304 patients (642 and 636 in the 6-month and 12-month groups, respectively) were analyzed. The most common AE was hand-foot syndrome (HFS). HFS, leukocytopenia, neutropenia, and hyperbilirubinemia (any grade) occurred more frequently in the 12-month group than in the 6-month group. HFS was the only grade 3 AE to have a significantly higher incidence in the 12-month group (23 vs 17%, p=0.011). The completion rate for 8 cycles was 72% in both groups, while that for 16 cycles was 46% in the 12-month group. HFS was the most common AE requiring dose reduction and treatment discontinuation.Twelvemonths of adjuvant capecitabine demonstrated a higher cumulative incidence of HFS compared to the standard 6-month treatment period, while toxicities after 12months of capecitabine were clinically acceptable.UMIN-CTR, UMIN000001367.

Omae K.,Keio University | Nakano M.,Keio University | Tanaka A.,Kyushu University | Hirata M.,Kyushu University | And 2 more authors.
International Archives of Occupational and Environmental Health | Year: 2011

Purpose: The present review is aimed to introduce an new occupational lung disease, Indium Lung. Methods: We searched case reports and epidemiological studies concerning indium-related lung diseases and reviewed. Results: Up to March, 2010, 7 cases of interstitial pneumonia in Japanese indium-exposed workers, two cases of pulmonary alveolar proteinosis (PAP) in US indium-exposed workers, one case of PAP in a Chinese indium-exposed worker, and 4 cross-sectional surveys in Japan had been published. All cases and epidemiological studies in Japan indicate that exposure to hardly soluble indium compounds causes interstitial as well as emphysematous lung damages, which we call "Indium Lung". Based on the epidemiological studies, the Japan Society for Occupational Health proposed 3 μg/l of indium in serum as an occupational exposure limit based on biological monitoring to prevent significant increase of KL-6. Comments: Long-term follow-up of currently and formerly indium-exposed workers is essential not only to clarify the natural history of indium lung but also to trace the incidence of lung cancer. It is also necessary to elucidate the mechanism of indium lung and difference in clinical manifestations between Japanese and US cases. © 2010 Springer-Verlag.

Sato K.-I.,Nikko Memorial Hospital | Nishimura S.-I.,Nikko Memorial Hospital
Open Ophthalmology Journal | Year: 2013

We report the incidence of lacrimal passage impairment and specific features of corneal epitheliopathy as adverse effects of the oral anticancer drug S-1, and examine the relationship between the two pathologies. We conducted a retrospective chart review of 84 patients prescribed the anticancer drug S-1. The incidence of lacrimal passage impairment and corneal epitheliopathy was 8% and 6%, respectively. Three patients experienced both pathologies, demonstrating a moderate probability of both occurring in the same patient (kappa coefficient = 0.46). The findings show that lacrimal passage impairment and specific features of corneal epitheliopathy are likely to occur in the same individual as adverse effects of S-1. © Sato and Nishimura; Licensee Bentham Open.

Takada J.,Nikko Memorial Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

Even though skeletal muscle, making up about 40% of body weight, is the largest organ in the human body, metastasis from malignant lesions is rare. Among reports of metastasis, those involving the iliopsoas muscle are numerous but few reports involve resection. Reported here is one example we experienced where metastasis developed in the iliopsoas muscle following colectomy, resection was then made possible by radiotherapy and chemotherapy. The case involved a 71-year- old male in which a Hartmann procedure was performed for sigmoid colon cancer. The pathology was Type 3 (8 × 7 cm, adenocarcinoma( mod), ss or more, ly1, v1, n0, ow(-), aw or ew(+), stage II). Upon additional sampling, thermal degredation of neoplastic cells was shown and outpatient oral UFT was performed. Five years following surgery, lymphoadenopathy was noted in the area of the left iliac artery upon US and CT. PET showed a probable metastasis to the left iliopsoas muscle. Early esophageal and stomach cancer were diagnosed by GFT. The esophageal cancer was located 30-32 cm from the incisors, unstained, Borrmann type 1, penetrating deeper than the muscularis propria. Biopsy revealed a diagnosis of tubular adenocarcinoma. ESD was performed for the esophageal cancer and one month later, a total gastrectomy D1+β was performed. During surgery, the iliopsoas muscle tumor was determined to be large and impossible to resect. Radiotherapy of 10MV X-ray, 8 fields, 65-70 Gy/26 times for 6 . 5 weeks was performed for residual tumor but had no effect on tumor size. Fifteen courses of FOLFOX+bevacizumab were then performed. The tumor was markedly reduced in size, unidentifiable upon CT but showed slight uptake on PET and resection of the suspected residual tumor was performed. Histologically, atypical cells were shown in scarred muscle and connective tissue, however, degradation by chemotherapy was high. Residual tumor at resection margins was found, findings consistent with metastasis form sigmoid colon cancer. Taking into account the age and condition of the patient following surgery, chemotherapy was changed to S-1. Currently, 5 months after resection, there has been no recurrence.

Sato K.-I.,Nikko Memorial Hospital | Tabira K.,Nikko Memorial Hospital
Open Ophthalmology Journal | Year: 2012

For five consecutive eyes from five patients with liquefied aftercataract, Nd: YAG laser treatment significantly reduced high-order aberrations. Two eyes showing a reduction in positive spherical-like aberrations after treatment showed a postoperative myopic shift, while three eyes showing no change in spherical-like aberrations demonstrated hyperopic or only a slight myopic shift. © Sato and Tabira.

Nawa T.,Hitachi General Hospital | Nakagawa T.,Hitachi Health Care Center | Mizoue T.,International Clinical Research Center | Kusano S.,Hitachi Health Care Center | And 3 more authors.
Lung Cancer | Year: 2012

The effectiveness of lung cancer screening using low-dose chest computed tomography (CT) remains elusive. The present study examined the prognosis of patients with lung cancer detected on CT screening in Japanese men and women. Subjects were 210 patients with primary lung cancer identified on CT screening at two medical facilities in Hitachi, Japan, where a total of 61,914 CT screenings were performed among 25,385 screenees between 1998 and 2006. Prognostic status of these patients was sought by examining medical records at local hospitals, supplemented by vital status information from local government. The 5-year survival rate was estimated according to the characteristics of patients and lung nodule. A total of 203 (97%) patients underwent surgery. During a 5.7-year mean follow-up period, 19 patients died from lung cancer and 6 died from other causes. The estimated 5-year survival rate for all patients and for those on stage IA was 90% and 97%, respectively. Besides cancer stage, smoking and nodule appearance were independent predictors of a poor survival; multivariable-adjusted hazard ratio (95% confidence interval) was 4.7 (1.3, 16.5) for current and past smokers versus nonsmokers and 4.6 (1.6, 13.9) for solid nodule versus others. Even patients with solid shadow had a 5-year survival of 82% if the lesion was 20. mm or less in size. Results suggest that lung cancers detected on CT screening are mostly curative. The impact of CT screening on mortality at community level needs to be clarified by monitoring lung cancer deaths. © 2011 Elsevier Ireland Ltd.

Tei K.,Hokkaido University | Sakakibara N.,Nikko Memorial Hospital | Yamazaki Y.,Hokkaido University | Ohiro Y.,Hokkaido University | And 2 more authors.
Journal of Oral and Maxillofacial Surgery | Year: 2012

Purpose: The present study aimed to measure postsurgical swallowing function in patients 5 years after the surgical treatment of tongue carcinoma. Patients and Methods: Using a retrospective cohort study design, the investigators enrolled postsurgical patients treated for tongue carcinomas in Hokkaido University Hospital. The primary outcome variable was oropharyngeal swallow efficiency (OPSE) determined by videofluoroscopic evaluation, and OPSE at follow-up was compared with that at discharge. Other variables included current nutritional status (body mass index, serum albumin), dietary intake, self-rating of current swallowing function, and occurrence of pneumonia. Statistical analysis used the paired t test and the Spearman rank correlation. Results: Swallowing function was assessed in 20 patients (11 men and 9 women) who underwent the surgical treatment of tongue carcinomas; the median age was 70 years (range, 56 to 90 yrs). The mean OPSE values for liquid and paste at follow-up were 26.6 ± 21.2 and 21.9 ± 22.5, respectively. The mean values for the body mass index and serum albumin at presentation were 22.2 ± 3.4 kg/m2 and 4.5 ± 0.3 g/dL, respectively. All patients had a full oral intake of foods, with a mean self-rated value of 6.4 ± 2.5, a value acceptable to the patients. Pneumonia requiring hospitalization did not occur in these patients. Conclusions: The long-term follow-up of patients after the surgical treatment of tongue carcinomas showed acceptable levels of oral function and nutritional status despite objective measurements of poor swallowing efficiency assessed using videofluoroscopy. © 2012 American Association of Oral and Maxillofacial Surgeons.

PubMed | Nikko Memorial Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

This case involves a 76 year-old woman. A sigmoidectomy was performed for sigmoid colon cancer in August 2006. On histological examination, the cancer was shown to be tub2>tub1>por2, pSE, int, INF b, ly2, v0, pN0, p1 (Douglas), Stage . After surgery, 4 courses of FOLFOX and 8 courses of TS-1 plus CPT-11 were administered after UFT plus LV was performed. Because of suspected recurrence at the anastomotic site, a partial colectomy was performed in September 2010, and TS-1 was started after surgery. In March 2012, the carcinoembryonic antigen level had increased to 13.7 ng/mL. Irregular masses with spicula, 1315 mm and 1923 mm on the right and left sides, respectively, were observed on chest computed tomography, and lung metastasis was suspected. Left lower and partial right middle lobectomies were performed. After surgery, the tumor marker levels were normalized. Chemotherapy was not performed. Currently, at 2 years 8 months after resection of the lung metastases, no recurrence was observed. Long-term survival in cases of colon cancer with peritoneal dissemination is rare, but multidisciplinary treatment, including surgical treatment, showed the promising possibility of long-term survival.

PubMed | Tochigi Cancer Center Research Institute, Nikko Memorial Hospital and Sapporo Medical University
Type: | Journal: European journal of dermatology : EJD | Year: 2017

Muir-Torre syndrome (MTS) is characterized by sebaceous neoplasms with internal malignancies and regarded as a variant of hereditary nonpolyposis colorectal cancer (HNPCC). Pathogenic variations of MTS have been identified in the MSH2, MLH1, and MSH6 genes, with the majority of variations located in MSH2.To present an MTS patient who was the only individual with skin malignancies within a cancer-prone pedigree and to show the usefulness of RNA-based genetic analysis in the investigation of MTS.A 77-year-old man who had operated X-ray equipment at his workplace in his twenties was clinically diagnosed with MTS and investigated by RNA-based analysis, multiplex ligation-dependent probe amplification, and genomic DNA sequencing.The patient had suffered from sebaceous tumours, squamous cell carcinomas of the skin, and colon cancer. The patients family history was remarkable for visceral malignant diseases. Genetic analysis revealed homologous recombination between two Alu elements within intron 4 and 5 of the MLH1 gene. The rearrangement caused a 1,222-bp deletion, including the entire exon 5. Deletion of exon 5 has previously been reported only in two patients with HNPCC, and not in patients with MTS.For the genetic analysis of MTS, the possibility of rare copy number variations of MLH1, as well as MSH2 variations, should be considered. RNA-based screening using puromycin is recommended in order to identify such variations. It remains unclear why only the proband among the pedigree had skin malignancies, however, the skin carcinogenesis might have been related to occupational radiation exposure.

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