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Akiba J.,Kurume University | Harada H.,Seichokai Fuchu Hospital | Kawahara A.,Kurume University | Todoroki K.,Kurume University | And 2 more authors.
Pathology International | Year: 2013

Metastasizing pleomorphic adenoma (MPA) is the inexplicable metastasis of a histologically benign pleomorphic adenoma (PA). Approximately 50 cases have been reported. A 62-year-old woman noticed pain in the upper molar area. Her medical history included an operation for PA in the hard palate that was performed 20 years previously. On imaging, four relatively well-defined lesions were demonstrated in the maxillary bone. She underwent an operation for these lesions. Each lesion revealed the same histological features. Morphological findings displayed typical features of PA. Immunohistochemical staining showed that tumor cells of both primary and metastasizing lesions were positive for pleomorphic adenoma gene (PLAG) 1, which is a sensitive marker for PA. Gene fusions involving PLAG1 were examined by reverse transcription-polymerase chain reaction. However, no gene rearrangements of PLAG1 were found. We report here on a case of MPA in the maxillary bone, which appeared 20 years after resection of the primary tumor and review the relevant literature. © 2013 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

Shiozaki A.,University of Toyama | Yoneda S.,University of Toyama | Nakabayashi M.,Aiiku Hospital | Takeda Y.,Aiiku Hospital | And 16 more authors.
Journal of Obstetrics and Gynaecology Research | Year: 2014

Aim: To examine the relationship between preterm birth and socioeconomic factors, past history, cervical length, cervical interleukin-8, bacterial vaginosis, underlying diseases, use of medication, employment status, sex of the fetus and multiple pregnancy. Methods: In a multicenter, prospective, observational study, 1810 Japanese women registering their future delivery were enrolled at 8+0 to 12+6 weeks of gestation. Data on cervical length and delivery were obtained from 1365 pregnant women. Multivariate logistic regression analysis was performed. Results: Short cervical length, steroid use, multiple pregnancy and male fetus were risk factors for preterm birth before 34 weeks of gestation. Multiple pregnancy, low educational level, short cervical length and part-timer were risk factors for preterm birth before 37 weeks of gestation. Conclusion: Multiple pregnancy and cervical shortening at 20-24 weeks of gestation was a stronger risk factor for preterm birth. Any pregnant woman being part-time employee or low educational level, having a male fetus and requiring steroid treatment should be watched for the development of preterm birth. © 2013 Japan Society of Obstetrics and Gynecology.

Shinohara Y.,Akita University | Takahashi N.,Akita University | Nishiwaki K.,Jikei University School of Medicine | Hino M.,Osaka City University | And 19 more authors.
Haematologica | Year: 2013

Achievement of complete molecular response in patients with chronic phase chronic myeloid leukemia has been recognized as an important milestone in therapy cessation and treatment-free remission; the identification of predictors of complete molecular response in these patients is, therefore, important. This study evaluated complete molecular response rates in imatinib-treated chronic phase chronic myeloid leukemia patients with major molecular response by using the international standardization for quantitative polymerase chain reaction analysis of the breakpoint cluster region-Abelson1 gene. The correlation of complete molecular response with various clinical, pharmacokinetic, and immunological parameters was determined. Complete molecular response was observed in 75/152 patients (49.3%). In the univariate analysis, Sokal score, median time to major molecular response, ABCG2 421C>A, and regulatory T cells were significantly lower in chronic phase chronic myeloid leukemia patients with complete molecular response than in those without complete molecular response. In the multivariate analysis, duration of imatinib treatment (odds ratio: 1.0287, P=0.0003), time to major molecular response from imatinib therapy (odds ratio: 0.9652, P=0.0020), and ABCG2 421C/C genotype (odds ratio: 0.3953, P=0.0284) were independent predictors of complete molecular response. In contrast, number of natural killer cells, BIM deletion polymorphisms, and plasma trough imatinib concentration were not significantly associated with achieving a complete molecular response. Several predictive markers for achieving complete molecular response were identified in this study. According to our findings, some chronic myeloid leukemia patients treated with imatinib may benefit from a switch to second-generation tyrosine kinase inhibitors. © 2013 Ferrata Storti Foundation.

Kita M.,Seichokai Fuchu Hospital | Sato M.,Wakayama Medical University | Kawano K.,Seichokai Fuchu Hospital | Kometani K.,Seichokai Fuchu Hospital | And 3 more authors.
Magnetic Resonance Imaging | Year: 2013

Accurate equations for calculating the inversion time of the null point (TInull) in inversion recovery (IR) sequences are required for adequate suppression of fat or cerebrospinal fluid (CSF) but are not widely known. The purpose of this study is to elucidate the process of deriving accurate TInull equations using schematic diagrams that allow the equations to be easily understood, and to devise a convenient online tool for instant calculation of TInull.We investigated various IR sequences in which a 180° inversion pulse is followed by spin echo (SE) type sequences, termed IR-SE-type sequences, including FLAIR (fluid attenuated inversion recovery), STIR (short inversion time inversion recovery), and SPAIR (spectral adiabatic inversion recovery, spectral attenuated inversion recovery). We classified these sequences into three types according to the behavior of the longitudinal magnetization before the next IR pulse: having a train of multiple spin echoes, a single spin echo, or a train of multiple inversions by SPAIR pulses (with no spin echo). For each sequence type, we produced a precise diagram of the behavior of the longitudinal magnetization and clarified the process of deriving the equation for TInull. Three accurate TInull equations were derived. We created an online tool that calculates TInull using these three equations. The validity of the resulting TInull was evaluated on pelvic SPAIR diffusion-weighted (DW) images at 3. T in 21 volunteers, using various inversion times (TI) around the calculated TInull.The tool displays the calculated TInull value instantly, after inputting imaging parameters and the T1 values of fat or CSF. The TInull values calculated using the tool achieved sufficient suppression in all subjects. When the actual TI value differed by more than 5% from the calculated TInull value, the fat suppression effect was significantly less on pelvic SPAIR DW images (P<0.01).In conclusion, this online tool is easily available and enables adequate suppression of fat or CSF according to the imaging parameters. © 2013 Elsevier Inc.

Sogo D.,Seichokai Fuchu Hospital | Nakazawa T.,Seichokai Fuchu Hospital | Nishio W.,Seichokai Fuchu Hospital | Fukukita K.,Seichokai Fuchu Hospital
Japanese Journal of Anesthesiology | Year: 2014

General anesthesia was successfully performed in an 86-year-old woman with severe tracheobronchomalacia. Tracheobronchomalacia in adult is a very rare disease, characterized by weakness of the trachea and bronchi, causing luminal narrowing during expiration. The patient had laparoscopic cholecystectomy. We used propofol remifentanil and rocuronium for induction of anesthesia. For maintenance of anesthesia oxygen, air, propofol fentanyl and remifentanil were used. After the end of operation, we used sugammadex to reverse neuromuscular blockade by rocuronium. The patient showed spontaneous breathing and good awareness, and we extubated. The patient did well and was discharged from the hospital 3 days after the operation. In this case, no special care such as postoperative CPAP was necessary, but normally, general anesthesia for a patient with tracheobronchomalacia requires attention. We gave general anesthesia satisfactorily in a patient with tracheobronchomalacia.

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