Ito T.,Kyushu University |
Sasano H.,Tohoku University |
Tanaka M.,Kyushu University |
Osamura R.Y.,Tokai University |
And 16 more authors.
Journal of Gastroenterology | Year: 2010
Background: There have been few epidemiological studies on gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Japan. Methods: We examined the epidemiology of GEP-NETs [pancreatic endocrine tumors (PETs) and gastrointestinal neuroendocrine tumors (GI-NETs)] in Japan in 2005 using a nationwide stratified random sampling method. Results: A total of 2,845 individuals received treatment for PETs. Prevalence was estimated as 2.23/100,000 with an annual onset incidence of 1.01/100,000. Non-functioning tumor (NF)-PET constituted 47.4%, followed by insulinoma (38.2%) and gastrinoma (7.9%). Distant metastases were reported in 21% patients with NF-PETs and occurred more frequently as tumor size increased (>2 cm). Multiple endocrine neoplasia type 1 (MEN-1) was detected in 10% of PETs but only in 6.1% of NF-PETs. NF-PETs were detected incidentally by physical examination in 24% patients. In 2005, an estimated 4,406 patients received treatment for GI-NETs. Prevalence was estimated as 3.45/100,000, with an annual onset incidence of 2.10/100,000. The locations of GI-NETs varied: foregut, 30.4%; midgut, 9.6%; and hindgut, 60.0%. Distant metastases were observed in 6%. Lymph node metastases occurred more frequently as tumor size increased (>1 cm). The frequency of MEN-1 complications was 1%. Physical examination revealed GI-NETs in 44% patients. The frequency of symptomatic GI-NETs was 3.4%. Interestingly, 77.1% of patients with foregut GI-NETs had type A gastritis. Conclusion: Our results show there are large differences in GEP-NETs between Japan and Western nations, primarily due to differences in the presence of MEN-1 in NF-PETs and the location, symptomatic status, and prevalence of malignancy in GI-NETs. © 2010 Springer.
Santo T.,Osaka Saiseikai Noe Hospital |
Ihara Y.,Ihara Clinic |
Yano H.,Hikone Municipal Hospital
Journal of the Japan Diabetes Society | Year: 2015
A 55-year-old man visited a general practitioner due to a 3 day history of rigor and elevated temperature. Oral antipyretic medicines were administered. The next day he presented to our hospital with an erythematous skin rash. The patient's blood glucose was 113 mg/dl. On the sixth day the papules and erythematous areas became larger and began to merge. His blood glucose level increased to 200 mg/dl on the seventh day. On the ninth day, no deterioration in hepatic function was found but an abdominal CT scan revealed the significant enlargement of the pancreas, liver, and spleen. The patient complained of increased thirst, polyuria and general fatigue from day 11 and he was transferred to our department on the thirteenth day after the onset of symptoms. He was diagnosed with acute diabetic ketoacidosis. His blood glucose level was 807 mg/dl, his arterial blood pH was 7.285 and he was positive for both urine and blood ketones, however, his HbA1c was 6.9% and he was negative for autoantibodies. A glucagon loading test showed a decrease but not a complete exhaustion in his insulin secretion at onset. Here, we report a case of fulminant type 1 diabetes-like disease and the details of the patient's pancreatic size, blood glucose levels and insulin secretion in response to a glucagon stimulation test before and after the onset of symptoms. © Japan Diabetes Society. All rights reserved.
Mishima T.,Osaka Saiseikai Noe Hospital |
Harada J.,Osaka Saiseikai Noe Hospital |
Kawa G.,Osaka Saiseikai Noe Hospital |
Sakurai T.,Osaka Saiseikai Noe Hospital |
Okada T.,Kobe City Medical Center General Hospital
Acta Urologica Japonica | Year: 2016
A 46-year-old man was admitted to hospital presenting with a lower abdominal mass. The patient s testes were not palpable in the scrotum, and the levels of lactic dehydrogenase, α-fetoprotein and human chorionic gonadotropin were all elevated. Enhanced computed tomography revealed that the lumen of the mass had penetrated the prostate. Pathological analysis of biopsy tissue indicated that the mass was a seminoma. Residual tumor resection was performed after chemotherapy. On histological examination, the lumen proved to be a Miillerian structure. Our diagnosis was an intra-abdominal germ cell tumor and persistent Miillerian duct syndrome.
Ueda H.,Osaka City General Hospital |
Yoshida M.,Osaka City General Hospital |
Kanashima H.,Osaka City General Hospital |
Nakao T.,Osaka City General Hospital |
And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014
A 73-year-old woman was diagnosed with myelodysplastic syndrome (MDS). After 11 courses of treatment with azacitidine (AZA), her hemoglobin level and platelet count improved significantly, and she became transfusion independent. Therefore, treatment was discontinued and follow-ups were maintained. Three months later, her platelet count reduced again; we therefore treated her again with AZA. However, MDS transformed to acute myeloid leukemia in the 14th course, and she died 19 months after the initial diagnosis. AZA is an important drug for treating MDS, but premature withdrawal of treatment might cause rapid disease progression. In case treatment is discontinued, the patient needs to be carefully observed.
Teramachi M.,Osaka Saiseikai Noe Hospital |
Nakagawa M.,Osaka Saiseikai Noe Hospital
Japanese Journal of Lung Cancer | Year: 2011
Background. Solitary mediastinal metastasis of hepatocellular carcinoma (HCC) is very rare. Case. A 51-year-old man was admitted to our hospital for transcatheter arterial chemoembolization (TACE) to multiple HCCs. His CT scan revealed a solitary anterior mediastinal mass on the right hemidiaphragm. We suspected non-invasive thymoma and performed right hemithymectomy under thoracoscopic surgery. The pathological examination on immunohistochemical staining including Hep Par 1 revealed metastasis of HCC. As a solitary paraaortic lymph node swelling was found near the right renal artery 3 months after this resection, we speculated the mediastinal mass had also been a solitary metastasis to the right anterior diaphragmatic lymph node. He is receiving UFT orally and is alive with disease 18 months after surgery. The solitary mediastinal metastasis of HCC is very rare and we found only 11 reports including this case. Five cases who had good local control were alive for more than 1 year. Thoracoscopic surgery for a solitary mediastinal metastasis may yield a favorable prognosis. Conclusion. Tumor resection under thoracoscopic surgery for a solitary mediastinal metastasis of HCC is simple and safe, and may yield favorable outcomes for such cases.
Takayasu K.,Osaka Saiseikai Noe Hospital |
Takayasu K.,Kansai Medical University |
Harada J.,Osaka Saiseikai Noe Hospital |
Kawa G.,Osaka Saiseikai Noe Hospital |
And 3 more authors.
Acta Urologica Japonica | Year: 2015
Primary tumors of the seminal vesicles are extremely rare. There have been 25 reports of this tumor from overseas and most cases are cystadenoma. We report a case of seminal vesicle cystadenoma in a 70-year-old man who presented with lower abdominal pain and urinary frequency. A digital rectal examination detected a projecting and hard mass in the right side of the prostate. Magnetic resonance imaging (MRI) showed a 15 cm multiple cystic mass continuous with the right seminal vesicle. A transrectal needle biopsy revealed benign tissue. The tumor was resected using an open transvesical approach that enabled full exposure of the seminal vesicle without damaging the nerves and blood supply of the bladder. Pathology was consistent with a benign seminal vesicle cystadenoma. We describe the natural history, pathology, and surgical approach in this case.
Misawa K.,Aichi Cancer Center Hospital |
Terashima M.,Shizuoka Cancer Center |
Uenosono Y.,Kagoshima University |
Ota S.,Osaka Saiseikai Noe Hospital |
And 6 more authors.
Gastric Cancer | Year: 2015
Background: Distal gastrectomy with Billroth-I reconstruction (DGBI) is the most commonly used treatment approach for gastric cancer patients in Japan. The aim of this study was to assess and elucidate the effect of different surgical DGBI techniques on postgastrectomy syndrome (PGS) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Methods: The newly created PGSAS-45 composed of 45 questions was used in this study. The scale was distributed to 2,922 patients who underwent gastrectomy >1 year prior. Completed forms were returned by 2,520 patients (86 %), of which 909 underwent DGBI. The effects of performing the Kocher maneuver, differences in the size of the gastric remnant and differences the anastomosis technique had on the main outcome measures of PGSAS-45 were analyzed. Results: Patients for whom the Kocher maneuver was performed experienced significantly worse meal-related distress and poorer quality of ingestion. Additionally, a less satisfactory physical and mental component summary from the SF-8 was reported. Patients with larger gastric remnants showed significantly better scores on the diarrhea subscale, a slightly better trend for the need for additional meals and dissatisfaction with eating. Regarding the anastomosis technique, there was no difference between the hand-sewn, circular stapler (CS) and linear stapler end-to-end anastomosis, and there was also no difference between the end-to-end and side-to-end anastomosis with the CS. Conclusions: The Kocher maneuver may increase meal-related distress, reduce the quality of ingestion and impart a negative effect on quality of life (QOL). The larger gastric remnants may cause reduction in diarrhea and an improvement in meal-related scores. © 2014, The International Gastric Cancer Association and The Japanese Gastric Cancer Association.
Hattori R.,Osaka Saiseikai Noe Hospital |
Uchiyama H.,Osaka Saiseikai Noe Hospital
Journal of Cardiac Surgery | Year: 2015
Active infective endocarditis may progress to annular abscess formation. We describe a patch annuloplasty technique to treat the fragile aortic root tissue in these patients. © 2014 Wiley Periodicals, Inc.
Nakagawa M.,Osaka Saiseikai Noe Hospital |
Teramachi M.,Osaka Saiseikai Noe Hospital
Japanese Journal of Lung Cancer | Year: 2013
Background:. Complete situs inversus is a congenital, autosomal recessive genetic condition with a prevalence of 1 to 2 in 10,000 people. Case reports of lung cancer in patients with complete situs inversus are rare. Case. A 76-year-old male with complete situs inversus was referred to our hospital due to an abnormal shadow on a chest X-ray. Chest CT revealed a nodule measuring 2.5 cm in diameter in the right lower lobe and complete situs inversus. Because we were unable to obtain a definitive diagnosis using a bronchoscopic approach, videoassisted thoracic surgery (VATS) aspiration cytology was performed under a preoperative diagnosis of suspicious stage IA lung cancer using a bronchial blocker for differential lung ventilation. We used 3D-CT angiography for the preoperative evaluation of the pulmonary arterial system. The intraoperative diagnosis was non-small cell carcinoma; therefore, we performed VATS right lower lobectomy and nodal dissection. The right lung possessed 2 lobes, and the pulmonary arteries and veins corresponded to the usual left-sided pattern. The final diagnosis was poorly differentiated squamous cell carcinoma, pTlbNOMO. Conclusions:. Preoperative 3D-CT angiography is useful for evaluating the pulmonary arterial system and safely performing surgery for complete situs inversus. Bronchial blockers are useful for administering differential lung ventilation in patients with complete situs inversus. © 2013 The Japan Lung Cancer Society.
PubMed | Osaka Saiseikai Noe Hospital and Kansai Medical University
Type: Case Reports | Journal: Hinyokika kiyo. Acta urologica Japonica | Year: 2015
Primary tumors of the seminal vesicles are extremely rare. There have been 25 reports of this tumor from overseas and most cases are cystadenoma. We report a case of seminal vesicle cystadenoma in a 70-year-old man who presented with lower abdominal pain and urinary frequency. A digital rectal examination detected a projecting and hard mass in the right side of the prostate. Magnetic resonance imaging (MRI) showed a 15 cm multiple cystic mass continuous with the right seminal vesicle. A transrectal needle biopsy revealed benign tissue. The tumor was resected using an open transvesical approach that enabled full exposure of the seminal vesicle without damaging the nerves and blood supply of the bladder. Pathology was consistent with a benign seminal vesicle cystadenoma. We describe the natural history, pathology,and surgical approach in this case.