Sakai City Hospital

Sakai, Japan

Sakai City Hospital

Sakai, Japan
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Nakae A.,Osaka University | Nakai K.,Sakai City Hospital | Nakai K.,Osaka University | Tanaka T.,Osaka University | And 2 more authors.
Neuroscience Letters | Year: 2013

Spinal cord injury can have debilitating consequences, commonly resulting in motor dysfunction below the lesion site and the development of chronic pain syndromes. The serotonin pathway is important for inhibiting noxious stimuli and facilitating motor function after spinal cord injury. The serotonin 2C receptor (5HTR2C) has several characteristic features, and is regulated by the amount of serotonin 2C receptor as well as RNA editing and alternative splicing. In this study, we used a rat model of spinal contusion injury to investigate the relationship between the pain threshold and 5HTR2C alternative splicing. The pain threshold was assessed using mechanical stimulation with von Frey filaments. We then used real-time PCR to examine the RNA levels of 5HTR2C in three sections of the spinal cord: the rostral, injury-core, and caudal positions. On postoperative day 12, the pain threshold in injured rats was significantly reduced compared with sham-operated and naïve rats. The total 5HTR2C levels were significantly lower in injured rats than in naïve rats at all positions, and significantly lower in injured rats compared with sham-operated rats at injury-core and caudal positions. The ratio of exon Vb-skipped nonfunctional 5HTR2C mRNA to total 5HTR2C was significantly higher in injured rats compared with naïve rats at the injury-core and caudal positions, and significantly higher in injured rats compared with sham-operated rats at the caudal position. These results indicate that spinal contusion injury, which causes neuropathic pain, induces serotonergic dysfunction. This dysfunction appears to be mediated by decreased 5HTR2C mRNA expression, and alternative splicing. These results confirm the importance of considering splice variants when examining 5HTR2C. © 2012 Elsevier Ireland Ltd.


Nashimoto A.,Niigata Cancer Center Hospital | Akazawa K.,Niigata University | Isobe Y.,National Hospital Organization Tokyo Medical Center | Miyashiro I.,Japan National Cardiovascular Center Research Institute | And 9 more authors.
Gastric Cancer | Year: 2013

Background: The Japanese Gastric Cancer Association (JGCA) started a new nationwide gastric cancer registration in 2008. Methods: From 208 participating hospitals, 53 items including surgical procedures, pathological diagnosis, and survival outcomes of 13,626 patients with primary gastric cancer treated in 2002 were collected retrospectively. Data were entered into the JGCA database according to the JGCA classification (13th edition) and UICC TNM classification (5th edition) using an electronic data collecting system. Finally, data of 13,002 patients who underwent laparotomy were analyzed. Results: The 5-year follow-up rate was 83.3 %. The direct death rate was 0.48 %. UICC 5-year survival rates (5YEARSs)/JGCA 5YEARSs were 92.2 %/92.3 % for stage IA, 85.3 %/84.7 % for stage IB, 72.1 %/70.0 % for stage II, 52.8 %/46.8 % for stage IIIA, 31.0 %/28.8 % for stage IIIB, and 14.9 %/15.3 % for stage IV, respectively. The proportion of patients more than 80 years old was 7.8 %, and their 5YEARS was 51.6 %. Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed. Conclusions: Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed. © 2012 The Author(s).


Ebihara T.,Sakai City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

A 71-year-old man presented at a clinic with fever and melena. Capsule endoscopy revealed ulcers accompanied by bleeding in the central part of the jejunum. Blood tests revealed a high level of soluble interleukin-2 receptor( sIL-2R). A malignant lymphoma of the small intestine was suspected. A biopsy was performed using double-balloon enteroscopy. We diagnosed a malignant lymphoma, peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). There was a large amount of ascites and we determined that it was stage IIE according to the Lugano International Conference classification. The patient was hospitalized to receive pirarubicin hydrochloride, cyclophosphamide, vincristine sulfate, and prednisolone (THP-COP) therapy. One day after the fourth chemotherapy cycle, the patient complained of abdominal pain. Perforative peritonitis was diagnosed by abdominal computed tomography and emergency laparotomy was performed. A 3.5×2.0 cm perforation was detected in the jejunum, 180 cm from the ligament of Treitz. Approximately 20 cm of the small intestine was resected, and functional end-to-end anastomosis was performed. Histology showed that there were no malignant cells around the perforation site. We believe that the malignant lymphoma had disappeared rapidly because of the effective chemotherapy, and fibrosis could not adequately cover the space from which the tumor had disappeared. Although pancytopenia was observed and granulocyte colony-stimulating factor (G-CSF) was administered to the patient, the postoperative course was uneventful. He received the fifth course of chemotherapy on postoperative day 21.


Kimura Y.,Sakai City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

A 49-year-old man was admitted to our hospital with back pain, appetite loss, and body weight loss in January 2009. Gastroduodenal endoscopy, abdominal computed tomography( CT), and magnetic resonance imaging( MRI) revealed type 4 advanced gastric cancer( signet-ring cell carcinoma) with multiple lymph node( No. 16 LNs), right adrenal gland, and multiple bone metastases. Between February 2009 and April 2011, 20 courses of S-1( 80 mg/m2) plus CDDP( 60 mg/m2) and zoledronic acid hydrate (4 mg/body) were administrated. Since May 2011, S-1 (70 mg/m2) and zoledronic acid hydrate( 4 mg/body) have been continued. The lymph node and adrenal gland metastases showed a complete response( CR), and the gastric tumor showed a partial response; however, the bone metastases did not show CR or progressive disease (PD) for 4 years after initiation of therapy. Chemotherapy with zoledronic acid hydrate is considered as a useful therapeutic option for advanced unresectable gastric cancer with multiple bone metastases.


Fujii C.,Sakai City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

Hand-foot syndrome( HFS) has been reported to be the most common adverse effect of capecitabine, with an incidence of more than 50%. AboundTM, containing β-hydroxy-β-methyl butyric acid( HMB), L-glutamine, and L-arginine is effective in the treatment of decubitus ulcers and in wound healing; however, whether AboundTM is efficacious for HFS caused by capecitabine is not clear. This study aimed at evaluating the effectiveness of AboundTM in the recovery from HFS caused by capecitabine. Capecitabine administration was discontinued in 6 patients with more than grade 2 HFS, and AboundTM was administered. The time to recovery was examined. The median time to recovery to less than grade 1 HFS was 10 days( range, 4-14 days). The grade of HFS decreased following the administration of AboundTM. The findings of this study suggest that AboundTM is effective against HFS caused by capecitabine.


Kawabata R.,Sakai City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

We examined 11 gastric cancer patients undergoing gastroduodenal stent placement for the treatment of gastric outlet obstruction at our hospital, and assessed the significance and problems associated with stenting. None of the patients exhibited any complications associated with stenting, and the median post-stenting fasting period was 3 days(range, 1-7 days). Oral intake improved significantly in all the patients; in patients with nasogastric tubes, the tubes were removed after stenting. However, in patients with peritoneal dissemination, oral intake alone was not sufficient, and additional parenteral nutrition was required. In conclusion, gastroduodenal stenting is believed to be useful for palliative care in gastric cancer patients with pyloric stenosis.


Nakata K.,Sakai City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

We evaluated the efficacy of laparoscopic palliative stoma creation for patients with malignant bowel obstruction (MBO). Patients and Methods: Twenty-four patients with MBO who underwent laparoscopic stoma creation between January 2009 and December 2012 were studied and their clinical outcome was evaluated retrospectively. Results: Compared to the open approach, the laparoscopic approach led to significantly shorter operation times and a significantly lower incidence of surgical site infection( SSI). The rate of removal of the intestinal tube and intravenous drip after surgery was 100% and 88%, respectively, and the rate of oral intake was 100% after palliative stoma creation. The prognosis was 58% in 3 months and 29% in 1 year, and the median survival time was approximately 4 months. Discussion: The quality of surgery by the laparoscopic approach was better than that by the open approach, and the quality of life( QOL) after stoma creation was better than that before surgery. Given the shorter operation time, lower incidence of SSI, and better QOL, laparoscopic stoma creation is a beneficial choice for palliative treatment in patients with MBO.


Kawase T.,Sakai City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

Trousseau's syndrome involves unexplained thrombotic events along with malignancy. We report the cases of 3 patients undergoing chemotherapy for gastric cancer in whom Trousseau's syndrome occurred. Case 1 involved a 43-year-old woman undergoing S-1/cisplatin( CDDP) combination therapy as first-line chemotherapy for type 4 remnant gastric cancer( cT4bN2M1P1/stage IV) who experienced left hemiplegia. Cerebral hemorrhage of the right parietal lobe was diagnosed by computed tomography( CT), and thrombosis from the upper sagittal sinus to the right sinus sigmoideus was diagnosed by magnetic resonance venography( MRV). Case 2 involved a 59-year-old man undergoing S-1/irinotecan (CPT-11) combination therapy as second-line chemotherapy for type 3 gastric cancer( cT3N1M0H1/stage IV) who experienced ataxic, stuttering, and left membrum inferius paralysis. Multiple cerebral infarction of the right parietal lobe was diagnosed by magnetic resonance imaging (MRI). Case 3 involved a 67-year-old woman undergoing S-1/CDDP combination therapy as preoperative chemotherapy for type 3 gastric cancer( cT4aN1M0/stage IIIA) who experienced right cerebellum incontinentia, nystagmus, and right facioplegia. Multiple cerebral infarction of the right cerebellum and pedunculus cerebellaris medius was diagnosed by MRI. An anticoagulant was administered orally for stroke, and chemotherapy for gastric cancer was resumed after activities of daily living( ADL) improved in all 3 patients. Recurrent stroke was not diagnosed in any of the 3 patients. Patients with malignancy often exhibit hypercoagulability associated with cancer. Accordingly, periodic blood tests for coagulation should be performed and dehydration should be prevented to prevent strokes in cancer patients.


Furukawa H.,Sakai City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

We report the case of a 64-year-old man who had early submucosal invasive colorectal cancer with synchronous multiple liver metastases. The patient underwent endoscopic resection for a type Isp polyp of the sigmoid colon. The pathological diagnosis was well-differentiated adenocarcinoma with submucosal layer( sm3) invasion and lymphatic infiltration (ly2). A positive vertical margin was suspected. Abdominal computed tomography revealed multiple tumors at the S2/3, S5, and S8 segments of the liver and a small gastric submucosal tumor. The patient underwent sigmoid colon resection with D3 lymphadenectomy, left lateral hepatic segmentectomy, partial hepatectomy in the S5 and S8 segments, and partial gastrectomy. Histological examination showed lymph node metastasis but no residual cancer in the sigmoid colon. The histological findings from the liver were similar to those found in primary colorectal carcinoma. The gastric submucosal tumor was confirmed to be a gastrointestinal stromal tumor with a low risk grade. As the present case is considered rare, we herein review our previous report on a case of early colorectal cancer with synchronous multiple liver metastases.


Serous ovarian carcinoma is now hypothesized to originate from fallopian tube epithelium (FTE). We investigated the FTE abnormalities in the patients with epithelial ovarian tumors. Our study included 55 cases of serous tumors (24 carcinomas, 8 borderline tumors, and 23 adenomas), 14 mucinous carcinomas, 22 endometrioid carcinomas, 5 clear cell carcinomas, and 2 malignant Brenner tumors. FTE was diagnosed by the diagnostic algorithm, which combines the data of morphology, and p53, Ki-67 immunostaining, as serous tubal intraepithelial carcinoma, serous tubal intraepithelial lesion, p53 signature, and normal/reactive. Serous tubal intraepithelial carcinoma, serous tubal intraepithelial lesion, p53 signature, and normal/reactive were observed in 5, 3, 0, and 16 cases in serous carcinoma; 0, 3, 0, and 5 cases in serous borderline tumor; 0, 1, 1, and 21 cases in serous adenoma; 0, 0, 1, and 13 cases in mucinous carcinoma; 0, 0, 3, and 19 cases in endometrioid carcinoma; 0, 0, 0, and 5 cases in clear cell carcinoma; and 0, 1, 0, and 1 case in malignant Brenner tumor. Among tumors of serous histology and between carcinomas, FTE abnormalities differed significantly (P<0.05). Serous tubal intraepithelial carcinomas were only found in serous carcinoma. The incidence of secretory cell proliferation (SCP) was examined by PAX8 expression. The rate of SCP was extremely high in serous carcinoma (96%). Among tumors of serous histology and between carcinomas, an incidence of SCP differed significantly (P<0.05). Patients with SCP were significantly older (P<0.0001). Our observations were concordant with the hypothesis of serous ovarian carcinogenesis. The SCP has a meaningful association with serous ovarian cancer. © 2014 International Society of Gynecological Pathologists.

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