Iwamuro M.,Okayama University of Science |
Tanaka S.,Iwakuni Clinical Center |
Shiode J.,Okayama Saiseikai General Hospital |
Imagawa A.,Mitoyo General Hospital |
And 9 more authors.
Internal Medicine | Year: 2014
Objective: To analyze the clinical characteristics of patients with gastrointestinal bezoars and their response to therapy. Patients: We retrospectively reviewed the cases of 19 patients diagnosed with gastrointestinal bezoars at the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences or one of 15 collaborating institutions between December 2004 and August 2013. We investigated the epidemiology and etiology of the gastrointestinal bezoars by determining the gender, age at diagnosis, medical history, symptoms, complications, modalities used for diagnosis, treatments, outcomes and bezoar location, color and contents. Results: There were 17 patients with gastric bezoars and two patients with small intestinal bezoars. All patients were 62 years of age or older, except for one case of a trichobezoar in a 10-year-old patient. Some of the patients had a history of surgery of any part of the gastrointestinal tract (n=5) and/or diabetes mellitus (n=2). The two patients with small intestinal bezoars required surgical removal in order to relieve ileus. Approximately one-half of the patients with gastric bezoars had ulcerations in the stomach (9/17 patients, 52.9%) and/or gastrointestinal bleeding (8/17, 47.1%). Endoscopic fragmentation was performed in 10 patients, whereas bezoar dissolution was achieved with a gastroprokinetic agent (n=1) and without any treatment (n=3) in the remaining cases. Conclusion: As previously reported, elderly individuals with a positive history of surgery and/or diabetes mellitus were observed in this bezoar patient series. Gastric ulcers and gastrointestinal bleeding were frequently observed. The majority of patients underwent endoscopic fragmentation, while spontaneous resolution of the gastric bezoar was observed in several cases. © 2014 The Japanese Society of Internal Medicine.
Iwamuro M.,Onomichi Municipal Hospital |
Kawai Y.,Onomichi Municipal Hospital |
Takata K.,Okayama University of Science |
Okada H.,Okayama University |
Yamamoto K.,Onomichi Municipal Hospital
Case Reports in Gastroenterology | Year: 2013
Among duodenal tumors, lymphangioma is relatively infrequent. In this case report, we describe the case of a 65-year-old Japanese man with duodenal lymphangioma diagnosed by esophagogastroduodenoscopy. Endoscopically, the tumor appeared as a soft submucosal tumor with white spots. When the white spots were grasped by biopsy forceps, milky liquid exuded from the tumor. Additionally, observation by a magnifying endoscope with narrow-band imaging revealed elongated microvessels on the surface. We speculated that this feature was formed because the duodenal villi were dilated and the microvessels were stretched due to the retention of chyle. These endoscopic findings are key features in the diagnosis of duodenal lymphangioma. Copyright © 2013 S. Karger AG, Basel.
PubMed | Onomichi Municipal Hospital, Okayama University of Science and Okayama University
Type: | Journal: Ecancermedicalscience | Year: 2015
A 60-year-old Japanese man presented to our hospital for further investigation of an elevated serum anti-p53 antibody level. He was diagnosed with colon cancer and the tumour was surgically resected. Histological diagnosis of advanced colon cancer without lymph node involvement or distant metastasis was made. It was noteworthy that both serum carcinoembryonic antigen (CEA) and a fecal occult blood test that were performed preoperatively were non-diagnostic. This case highlights the potential usefulness of serum anti-p53 antibody tests for detection of colorectal cancers. Moreover, sequential changes in the anti-p53 antibody levels after curative resection were observed.
Three-Arm Randomized Trial of Sodium Alginate for Preventing Radiation-Induced Esophagitis in Locally Advanced Non-Small Cell Lung Cancer Receiving Concurrent Chemoradiotherapy: The OLCSG1401 Study Protocol
PubMed | Okayama University of Science, Red Cross, National Hospital Organization Shikoku Cancer Center, Chugoku Central Hospital and 7 more.
Type: | Journal: Clinical lung cancer | Year: 2016
Concurrent chemoradiotherapy (CRT) is the standard of care for locally advanced non-small cell lung cancer (LA-NSCLC). However, this intensive therapy often causes severe esophagitis, which could deteriorate a patients quality of life (QOL), leading to poor treatment compliance. Sodium alginate, approved in Japan for gastritis, is sufficiently highly viscous to remain in the esophageal mucosa, providing a protective effect in the esophagus. To investigate whether this compound has a preventive effect against severe esophagitis in patients receiving concurrent CRT, we plan a 3-arm randomized trial of sodium alginate with 2 different schedules versus water. The primary endpoint is set as the proportion of patients with grade 3 esophagitis using the Common Terminology Criteria for Adverse Events, version 4.0. With stratification by institute, performance status, and percentage of the esophageal volume receiving >35 Gy, the patients will be randomly assigned to 1 of the following groups: sodium alginate initiated concomitantly with CRT (group A), sodium alginate initiated soon after the development of extremely mild esophagitis during CRT (group B), or water administered throughout CRT (group C). Assuming that the proportion of grade 3 esophagitis would be 8% in groups A and B and 27% in group C, the required sample size would be 200 patients, with 70% power and 5% . The secondary endpoints include QOL, the frequency of additional prescriptions of analgesics, treatment response, and survival. The results of the present study will clarify whether sodium alginate can prevent esophagitis in patients with LA-NSCLC undergoing CRT.
PubMed | Onomichi Municipal Hospital, Okayama University of Science and Okayama University
Type: Journal Article | Journal: International journal of colorectal disease | Year: 2016
The purpose of this study was to determine the prevalence of lymphoid hyperplasia in the lower gastrointestinal tract and its role in patients undergoing colonoscopic examinations, particularly focusing on any allergic predisposition.A database search performed at the Department of Gastroenterology at Onomichi Municipal Hospital identified seven patients with lymphoid hyperplasia in the large intestine (i.e., cecum, colon, and/or rectum). Data regarding the endoscopic, biological, and pathological examinations performed and the allergic histories for each patient were retrospectively reviewed from the clinical records.Median age of the patients (four males, three females) was 50 years. Lymphoid hyperplasia was seen in the cecum (n=5), ascending colon (n=2), and transverse colon (n=1). Six patients (85.7%) had one of the allergic airway diseases: allergic rhinoconjunctivitis for pollen (n=3), bronchial asthma (n=1), infantile asthma (n=1), or allergic bronchitis (n=1). Drug allergy (n=3) and urticaria (n=2) were also found. All seven patients had one or more allergic diseases; however, none had a history of food allergy. Blood tests for allergens revealed that six patients (85.7%) had positive reactions to inherent allergens, whereas only one patient had a positive reaction to food allergens.Our results indicate that lymphoid hyperplasia in the large intestine may be associated with allergic airway diseases rather than with food allergies; thus, its presence may be useful to detect patients with underlying airway hyperreactivity.
Murakami T.,Onomichi Municipal Hospital |
Murakami T.,Red Cross |
Makihata K.,Makihata Clinic |
Takigawa N.,Kawasaki Medical School
Japanese Journal of Lung Cancer | Year: 2016
Objective. Pemetrexed is an effective agent for the treatment of non-squamous non-small cell lung cancer; however, the effectiveness of pemetrexed rechallenge chemotherapy remains to be proven. We administered pemetrexed rechallenge chemotherapy when disease progression was observed in advanced lung cancer patients in whom disease control had been achieved with initial pemetrexed treatment. Methods. We retrospectively reviewed five patients with advanced lung adenocarcinoma who had received pemetrexed rechallenge chemotherapy between January 2010 and December 2014. Results. All of the patients (median age, 64 years; range, 61-76) had stage IV lung adenocarcinoma. Four patients responded to the initial pemetrexed-based chemotherapy and stable disease was achieved in one patient. The median interval from the end of initial pemetrexed-based chemotherapy to pemetrexed rechallenge chemotherapy was 14.5 months (range, 11.8-17.4 months). Three patients achieved a partial response, and the median progression free survival period was 7.2 months (95% confidence interval, 3.8-10.6 months) with pemetrexed rechallenge chemotherapy. Conclusion. Pemetrexed rechallenge chemotherapy may be useful for selected patients. © 2016 The Japan Lung Cancer Society.
Kawamata O.,Onomichi Municipal Hospital
Japanese Journal of Lung Cancer | Year: 2010
Background. Diffuse malignant pleural mesothelioma (MPM) has a poor prognosis and there is no consensus on standard therapy. Furthermore, it is difficult to make a definitive diagnosis of MPM. In the present case, chemotherapy was performed after diagnosis by thoracoscopic biopsy. Six years after diagnosis extra-pleural pneumonectomy was performed. Case. A 54-year-old man had pleural effusion pointed out in a medical examination in early, 2001. MPM was diagnosed by pleural needle biopsy at another hospital. However, a diagnosis of MPM was not confirmed by another physician, and the patient was referred to our hospital in 2002. We performed thoracoscopic pleural biopsy in March, 2003, which resulted in a diagnosis of epithelial-type MPM (T1bN0M0 stage IB). We administered chemotherapy, after which we performed extra-pleural pneumonectomy. We confirmed recurrence by additional examination in the postoperative first year, but he is still alive at the time of writing. Conclusion. In order to obtain long-term survival by chemotherapy in such cases, careful consideration of the possibility of early-stage MPM is essential. © 2010 The Japan Lung Cancer Society.
Orimi S.,Onomichi Municipal Hospital |
Mizuno K.,Onomichi Municipal Hospital |
Narahara M.,Onomichi Municipal Hospital |
Umakosi H.,Onomichi Municipal Hospital |
And 2 more authors.
Therapeutic Apheresis and Dialysis | Year: 2011
We examined appropriate flow rates for high collection rates of Total Protein (TP) and Albumin (Alb) and a change of IL-6 concentrations in the cell-free and concentrated ascites reinfusion therapy (CART) process. No significant changes were observed in IL-6 concentration in the ascites storage test and the circulatory stimulation test. However, it was confirmed that the quantity of IL-6 in the ascites decreased by means of filtration and concentration. In some cases, it quickly reached high concentration rates at a higher flow rate (200mL/min) setting, but clogging or pressure increase has occurred in the hollow fiber filter. Therefore, it was concluded that a low flow rate (50mL/min) setting was best and provides safer conditions for filtration and concentration in order to collect TP and Alb effectively and reuse it as autologous protein, which is the primary objective of CART. © 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis.
Nozaki K.,Onomichi Municipal Hospital |
Horikawa Y.,Onomichi Municipal Hospital |
Oeda T.,Onomichi Municipal Hospital
Nishinihon Journal of Urology | Year: 2014
We investigated the clinical outcomes of endoscopic therapy with the holmium: YAG (Ho: YAG) laser for upper urinary tract calculi. This study included 65 patients (35 men and 30 women) who underwent transurethral lithotripsy (TUL) or percutaneous nephrolithotripsy (PNL) between September 2010 and September 2012. The median age of the patients was 66 years (range, 21-92 years). One patient had bilateral stones and 11 patients had multiple stones. Twenty-one stones were located in the renal pelvis, 9 in the ureteropelvic junction, 13 in the proximal ureter, 10 in the middle ureter, and 24 in the distal ureter. The median stone size was 9 mm (range, 4~63 mm) for renal stones and 6 mm (range, 3-13 mm) for ureteral stones. As one patient had bilateral stones, 66 treatments were performed. Thirty-four patients were treated by TUL with rigid ureteroscopy, 27 by TUL with flexible ureteroscopy, and 5 by PNL. The stone-free rate was 95.5%, and no difference was found with regard to the efficacy of fragmentation among the various types of stone. No intraoperative complications were identified. Seven patients (10.6%) developed macrohaematuria and seven patients (10. 6%) had acute pyelonephritis as postoperative complications, however, all cases were cured conservatively. The Ho: YAG laser is an excellent modality, which can treat upper urinary tract calculi both safely and effectively.
PubMed | Onomichi Municipal Hospital
Type: Comparative Study | Journal: Acta medica Okayama | Year: 2013
The pathogenetic roles of the coracoacromial arch in the development of rotator cuff tears are still controversial. This study compared the anteroposterior coverage of the humeral head by the coracoacromial arch between shoulders with and without full-thickness rotator cuff tears. Forty-two shoulders from 21 embalmed cadaveric specimens were macroscopically examined. Specimens were divided into 2 groups:shoulders with full-thickness cuff tears (tear group) and those with intact cuff tendons (normal group). The coverage angle of each component of the coracoacromial arch was measured using true lateral photographs. We also measured the angle of the total arc of the coracoacromial arch, as well as the angle of the anterior acromial projection. These data were compared between the tear group and the normal group. Although no significant differences were observed in the total arc of the coracoacromial arch between the groups, the tear group had significantly less coverage by the coracoacromial ligament than did the normal group (p0.05). Moreover, greater anterior acromial projection was observed in the tear group (p0.05). These results suggest that greater coverage of the bony structures on the rotator cuff may correlate with the development of rotator cuff tears.