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Nishi-Tokyo-shi, Japan

We report the case of an effectively treated 50-year-old woman with liver metastasis of left breast cancer. Her breast cancer (T2N0M0, Stage IIA) was resected in November 1998 (radical mastectomy+axillary lymph nodes dissection). After this operation, tamoxifen(TAM 20 mg daily) was administered. In February 2002, a solitary liver metastasis(S5, 4 cm in diameter) was found by computed tomography(CT) scan. Hepatic arterial infusion of docetaxel(DOC 20 mg weekly)was started. In March 2003, the solitary liver metastasis had become smaller and showed partial remission (PR), but DOC intravenous injection(iv) therapy(40 mg weekly) was started because lung metastases appeared. Therefore, epirubicin+ cyclophosphamide therapy, DOC ia therapy (120 mg triweekly), and anastrozole (1 mg daily) were continued. However, in March 2005, she refused chemotherapy. In January 2011, a CT scan showed progressive disease of multiple liver and lung metastases. Nab-paclitaxel(PTX) iv therapy(400 mg triweekly) and exemestane(25 mg daily) were administered. In March 2012, a CT scan showed PR of the metastatic breast cancer. She has continued to receive nab-PTX iv therapy as an outpatient.

Kurata N.,Kawaguchi Kogyo General Hospital | Kawashima Y.,Tsuchiura Kyodo General Hospital | Kishine Y.,Tsuchiura Kyodo General Hospital | Koda H.,Ohkubo Hospital | And 3 more authors.
Practica Oto-Rhino-Laryngologica | Year: 2012

We report the clinical course of 7 subjects with nasal extranodal natural killer/T-cell (NK/T) lymphoma (ENKL - 6 men and 1 woman, aged 34-71 years - ) treated between 2007 and 2010. Most had necrotic nasal cavity lesions that prevented an accurate pathological diagnosis. Definitive pathological diagnoses were obtained from 1 to 12 months after symptom onset (mean: 7.0±4.2 months). The mean time for taking biopsies was 2.6±1.7 months, and specimens required for diagnoses numbered 8.3±7.6. Subjects suspected of malignant lymphoma at initial biopsy required less time and fewer specimens for definitive diagnosis than those with a diagnosis suspected for other than malignant lymphoma. Based on Ann Arbor staging classification, 4 of the 7 were classified as stage I, 2 as stage II, and 1 as stage IV. One each in stages I and II attained remission, 2 in stage I are undergoing treatment, and one each in stages I and IV died during treatment. Early diagnosis is thus a critical factor in determining the prognosis of those with extranodal NK/T lymphoma. Our results suggest the importance of otolaryngologists to biopsy non necrotic tissues and to ensure clinical evaluation enabling prompt pathological diagnosis.

Kishimoto S.,Tokyo Medical and Dental University | Tsunoda A.,Tokyo Medical and Dental University | Koda H.,Ohkubo Hospital
Auris Nasus Larynx | Year: 2010

Objective: For the purpose of an en bloc resection with sufficient margins, a wide surgical field is necessary. We have reported on the application of a facial dismasking flap for removals of craniofacial lesions in order to provide a better surgical field with less morbidity. In this paper, we are introducing a new method, which is called the "nasal downward swing approach". Methods: This approach is a modification of the facial dismaking flap, which elevates the nasal bone along with the facial skin. Results: This approach offers an extremely wide surgical field on the facial front, especially the nasal cavity, while keeping scarring or facial paresis down to a bare minimum. Conclusion: This approach helps to preserve the entire shape of the nasal bone in particular, therefore, a good surgical option for pediatric patients. © 2009.

Tani S.,Jikei University School of Medicine | Hata Y.,Ohkubo Hospital | Tochigi S.,Jikei University School of Medicine | Ohashi H.,Jikei University School of Medicine | And 4 more authors.
Neurologia Medico-Chirurgica | Year: 2013

Spinal meningeal cysts in the sacrum (SMC) are known to be occasionally symptomatic with low back pain as well as leg pain, but no distinct prevalence of this pathological entity including asymptomatic lesions has been described. This prospective study investigated the prevalence of SMCs based on magnetic resonance (MR) myelography in 102 consecutive Japanese women with gynecological problems, who underwent pelvic conventional MR imaging. Ten of 102 patients were suspected of being positive for SMC (9.8%), but pseudo-positive findings were possible. A high probability of positive SMC was found in 7/102 (6.9%). MR myelography was better to detect SMCs than conventional MR imaging. Multiplicity and female preponderance may be other features of SMC. The speculated prevalence of SMCs in Japanese females ranged from 6.9% to 9.8%.

Hasegawa J.,Ohkubo Hospital | Hasegawa J.,Tokyo Womens Medical University | Honda K.,Tokyo Womens Medical University | Wakai S.,Ohkubo Hospital | And 5 more authors.
Transplantation Proceedings | Year: 2015

Objective We report a case of the clinical course and pathologic findings for a kidney transplant recipient with plasma cell-rich rejection (PCRR) accompanied by antibody-mediated rejection (ABMR). Methods A 29-year-old man with end-stage renal disease caused by lupus nephritis received an ABO-compatible living kidney transplant. Results Eighteen months after transplantation, the patient presented with proteinuria and increased serum creatinine. An episode biopsy revealed severe tubulointerstitial infiltration with plasma cells accompanied by peritubular capillaritis and positive findings on immunofluorescent C4d staining. Donor-specific antibodies were positive for DR52, and the patient was subsequently diagnosed with PCRR accompanied by ABMR. Treatment was initiated with high-dose steroids, intravenous immunoglobulin, gusperimus hydrochloride, muronmonab antibody CD3, and rituximab. However, ABMR persisted and allograft failure developed 20 months after onset. Conclusions We argue that PCRR accompanied by ABMR is a subtype of PCRR that can progress to allograft failure owing to persistent ABMR. © 2015 by Elsevier Inc. All rights reserved.

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