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Hiroshima-shi, Japan

Nitta Y.,Saiseikai Hiroshima Hospital | Oue N.,Hiroshima University
Japanese Journal of Cancer and Chemotherapy | Year: 2015

A 70-year-old man diagnosed with pleomorphic malignant fibrous histiocytoma of the left thigh underwent tumor resection. t,fter 10 months, he underwent extended resection due to local recurrence. However, because multiple lung metastases was detected at this time, chemotherapy with ifosfamide and doxorubicin was administered. After three courses of chemothera y, the lung metastases enlarged and the patient received ifosfamide and etoposide as second line chemotherapy. Even after :three courses of second line treatment, the disease progressed, for which docetaxel and gemcitabine were administered as third line chemotherapy. After three courses of third line treatment, multiple lung metastases reduced and were replaced with scar and cystic lesions (reduction ratio 85.9%). After four courses of treatment, the patient developed left pneumothorax. Partial resection of the left upper lobe was performed by thoracoscopic surgery. Histopathological examination revealed rupture of the visceral pleura in a scar lesion leading to air leakage. After 13 courses of treatment, he developed right pneumothor x. Partial resection of the right middle lobe was performed. Histopathological examination revealed a cystic lesion without timor remnants. After 15 courses of third line treatment, lung metastasis could be controlled. Chemotherapy with docetaxel 1and gemcitabine resulted in few adverse effects that were within tolerance limits.

Kamada T.,Kawasaki Medical School | Haruma K.,Kawasaki Medical School | Ito M.,Hiroshima University | Inoue K.,Kawasaki Medical School | And 10 more authors.
Helicobacter | Year: 2015

Background: Helicobacter pylori infection produces progressive mucosal damage that may eventually result in gastric cancer. We studied the changes that occurred in the presence and severity of atrophic gastritis and the prevalence of H. pylori infection that occurred coincident with improvements in economic and hygienic conditions in Japan since World War II. Materials and Methods: The prevalence of H. pylori infection and histologic grades of gastric damage were retrospectively evaluated using gastric biopsy specimens obtained over a 40-year period. Gastric atrophy and intestinal metaplasia were scored using the updated Sydney classification system. Results: The prevalence of H. pylori and severity of atrophy were examined in 1381 patients including 289 patients examined in the 1970s (158 men; mean age, 44.9 years), 787 in the 1990s (430 men; 44.2 years), and 305 in the 2010s (163 men; 53.2 years). Overall, the prevalence of H. pylori infection decreased significantly from 74.7% (1970s) to 53% (1990s) and 35.1% (2010s) (p < .01). The prevalence of atrophy in the antrum and corpus was significantly lower in the 2010s (33, 19%, respectively) compared to those evaluated in either the 1970s (98, 82%) (p < .001) or 1990s (80, 67%) (p < .001). The severity of atrophy and intestinal metaplasia also declined remarkably among those with H. pylori infection. Conclusions: There has been a progressive and rapid decline in the prevalence of H. pylori infection as well a fall in the rate of progression of gastric atrophy among H. pylori-infected Japanese coincident with the westernization and improvements in economic and hygienic conditions in Japan since World War II. © 2015 John Wiley & Sons Ltd.

Manabe N.,Kawasaki Medical School | Haruma K.,Kawasaki Medical School | Hata J.,Kawasaki Medical School | Imamura H.,Kawasaki Medical School | And 8 more authors.
Scandinavian Journal of Gastroenterology | Year: 2010

Objective. While the Rome III classification seems logical, some aspects need further evaluation. The aim of this study was to evaluate the clinical characteristics of Japanese dyspeptic patients and to determine whether this classification could be applied to them. Material and methods. A total of 364 consecutive patients with a mean age of 54.5 years who had chronic symptoms occurring at least several times per week that could be attributed to the upper gastrointestinal tract were recruited. All of them underwent blood tests, ultrasonography, and endoscopy, which revealed no organic, systemic, or metabolic diseases. They also answered a questionnaire about their symptoms. Results. The subjects were divided into a postprandial distress symptom (PDS) group, epigastric pain symptom (EPS) group, and chronic idiopathic nausea symptom group. There was considerable overlap among these groups (109/198, 55.1%), and patients with non-erosive reflux disease accounted for 52.0% (103/198) of all subjects. The Rome III classification could not be applied to 62.7% of the PDS group and 61.3% of the EPS group because the onset of symptoms occurred less than 6 months before diagnosis (4.6 ± 0.4 months for PDS and 4.6 ± 0.5 months for EPS). Conclusions. The current Rome III criteria for functional dyspepsia dose not adequately identify a large proportion of Japanese dyspeptic patients, primarily due to earlier presentation for medical evaluation. Therefore, the 6-month period after onset of dyspeptic symptoms should be shortened at least in the Japanese population experiencing dyspeptic symptoms. © 2010 Informa UK Ltd.

Miyahara E.,Saiseikai Hiroshima Hospital | Itagaki T.,Saiseikai Hiroshima Hospital | Kuwahara M.,Saiseikai Hiroshima Hospital | Kameda A.,Saiseikai Hiroshima Hospital | Oue N.,Hiroshima University
Japanese Journal of Cancer and Chemotherapy | Year: 2014

We report a case of an elderly patient with non-squamous non-small cell lung cancer who was successfully treated with chemotherapy using carboplatin (CBDCA), pemetrexed (PEM), and bevacizumab (Bev). The patient was an 84-year-old man who presented with a chief complaint of dyspnea. The right lung was completely collapsed due to malignant pleural effusion, and the mediastinum was shifted to the left. Right thoracic drainage was performed, but this was complicated by pneumothorax and a thoracotomy was performed. An absorbent tissue reinforcing agent was attached to the site of the air leakage and fibrin glue was applied. After discharge, the patient was administered 500 mg/m2 PEM plus 15 mg/kg Bev for the first course of chemotherapy and experienced no serious side effects. CBDCA (area under the curve [AUC] 4) was added from the second course After the administration of seven courses, pleural effusion had almost disappeared and the primary tumor in the upper right lobe was observed to have shrunk. Administration of PEM + Bev was continued thereafter The right pleural effusion was well controlled for up to 12 months (14 courses) from the start of the administration of chemotherapy, and shrinkage of the primary tumor was maintained. The side effects were mild and chemotherapy was administered safely. After the administration of 16 courses, a left malignant pleural effusion was observed, and the patient died 15 months after the initiation of chemotherapy.

Miyahara E.,Saiseikai Hiroshima Hospital | Itagaki T.,Saiseikai Hiroshima Hospital | Kuwahara M.,Saiseikai Hiroshima Hospital | Kameda A.,Saiseikai Hiroshima Hospital | Sentani K.,Hiroshima University
Japanese Journal of Cancer and Chemotherapy | Year: 2014

A 64-year-old man was diagnosed with a gastric ulcer, and a tumor shadow was observed in the right lower lung field on a chest radiograph. Chest computed tomography (CT) revealed the tumor shadow to be 33×25 mm in the right lower lobe; it also revealed a 7-mm nodule in the right S3, and lymph node swelling in the upper and lower mediastinum. Positron emission tomography (PET)-CT revealed an SUVmax of 12.8, 1.2, 7.6, and 10.0 for the right lower lobe tumor, right S3 nodule, and the No. 4 and No. 7 lymph nodes, respectively. The right lower lobe tumor was diagnosed as an adenocarcinoma via trans-bronchial lung biopsy. The patient was diagnosed with cT4N2M0, cStage IIIB cancer. Four courses of carboplatin, peme-trexed, and bevacizumab were administered. After the fourth course, chest CT revealed that the right lower lobe tumor and the right S3 nodule significantly reduced to 14×7 mm and 5 mm respectively, and the mediastinal lymph node swelling was nearly eliminated. Subsequent PET-CT examination revealed an SUVmax of 1.3 and 0.8 in the right lower lobe tumor and right S3 nodule, respectively. The patient was diagnosed with ycT4N0M0, ycStage III A cancer, and he underwent right lower lobe resection, right S3 partial resection, and lymph node. Postoperative pathological analysis was used to make a diagnosis of mixed type adenocarcinoma for the right lower lobe tumor, and a diagnosis of papillary adenocarcinoma for the right S3 nodule. Both tumors were diagnosed as primary lung cancers. There were no metastatic cancer cells in the dissected lymph nodes.

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