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Yazawa H.,Red Cross | Soeda S.,Fukushima Medical University | Hiraiwa T.,Red Cross | Takaiwa M.,Red Cross | And 3 more authors.
Journal of Minimally Invasive Gynecology | Year: 2013

Study Objective: To describe the incidence of uterine vascular malformations (UVMs) including uterine arteriovenous malformations (AVMs) in patients after abortion or delivery and in outpatients. Design: Prospective study (Canadian Task Force classification II-3). Setting: Fukushima Red Cross Hospital. Patients: Six patients with a UVM including 1 with an AVM. Interventions: Clinical screening of patients using transvaginal color Doppler ultrasonography between April 2010 and March 2012. Measurements and Main Results: The incidence of UVM developing after abortion or delivery or in outpatients was prospectively evaluated using transvaginal color Doppler ultrasonography. From 959 patients, we identified 6 (0.63%) with UVMs, including 1 (0.10%) with a uterine AVM. Specifically, we detected UVMs in 4 of 77 patients (5.2%) after abortion, 1 of 458 patients (0.22%) after delivery, and 1 of 424 outpatients (0.24%). Four patients after abortion and 1 after delivery reported mild symptoms, which were treated conservatively; however, the outpatient had a severe uterine AVM, which was confirmed via 3-dimensional computed tomography angiography. Conclusion: The incidence of UVMs was relatively higher, in particular in the patients after abortion, and was significantly higher than that in postpartum or outpatient groups. Therefore, it is important to consider the possibility of UVMs in any patient with episodes of unexplained uterine bleeding and to perform follow-up analysis using color Doppler ultrasonography. Such an approach will facilitate accurate diagnosis and lead to appropriate clinical management to prevent unnecessary dangerous repeat curettage, which might induce profuse uterine bleeding. © 2013 AAGL.

Katayose Y.,Tohoku University | Yamamoto K.,Miyagi Cancer Center | Nakagawa K.,Tohoku University | Takemura S.,Shirakawa Kosei General Hospital | And 9 more authors.
Hepato-Gastroenterology | Year: 2015

Background/Aims: This multicenter and single arm phase II clinical trial was performed to examine the safety and efficacy of modified F0LF0X6 (mF0LF0X6) as adjuvant treatment after resection of liver metastases from colorectal cancer. Methodology: Patients who had undergone R0-1 resection of liver metastases were assigned to 12 cycles of mF0LF0X6. The primary end point was disease-free survival (DFS). Results: We enrolled 49 cases and analyzed adverse events in 48 cases, since in one patient cancer recurred before starting treatment. As to the relative dose intensity, 5-FU was 78.8%, and oxaliplatin was 75.9%. Adverse events of Grade 3 and above included 18 cases of neutropenia (37.5%), 4 cases of sensory neuropathy (8.3%), 4 cases of thrombocytopenia (8.3%) and 4 cases of allergy (8.3%), and there were no cases of fatality caused by adverse events. The most difference of adverse event compared with MOSAIC trial (Multicenter International Study of Oxaliplatin/5FU-LV in the Adjuvant Treatment of Colon Cancer) was thrombocytopenia. The 2-year DFS was 59.2% (95% CI: 36.7-78.4) in the 49 enrolled cases. Conclusion: mF0LF0X6 after hepatectomy was tolerable. And mF0LF0X6 also seemed to improve DFS. mFOLFOX is one of the options for such patients and appears promising as an adjuvant treatment. © H.G.E. Update Medical Publishing S.A., Athens-Stuttgart.

Sato Y.,Fukushima Medical University | Satokawa H.,Fukushima Medical University | Yamamoto A.,Fukushima Medical University | Yokoyama H.,Fukushima Medical University | Maehara K.,Shirakawa Kosei General Hospital
Asian Cardiovascular and Thoracic Annals | Year: 2015

A 28-year-old man was referred to our hospital with a giant right atrial diverticulum. The mass of the right atrial diverticulum compressed the right atrium and right ventricle, and thrombus formation was suspected. The diverticulum was surgically excised and the patient remained asymptomatic a year later. © The Author(s) 2013.

Ito A.,Tohoku University | Shintaku I.,Tohoku University | Satoh M.,Sen en Rifu Hospital | Ioritani N.,Sendai Shakai Hoken Hospital | And 11 more authors.
Japanese Journal of Clinical Oncology | Year: 2013

Objective: The Pirarubicin Monotherapy Study Group trial was a randomized Phase II study that evaluated the efficacy of intravesical instillation of pirarubicin in the prevention of bladder recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma. This study conducted further analysis of the Pirarubicin Monotherapy Study Group cohort, focusing on intravesical seeding of cancer cells. Methods: Using the data from the Pirarubicin Monotherapy Study Group trial, bladder recurrence-free survival rates and factors associated with bladder recurrence in the control group were analyzed. Results: Of 36 patients in the control group, 14 with positive urine cytology had more frequent recurrence when compared with the 22 patients with negative cytology (P=0.004). Based on the multivariate analysis in the control group, voided urine cytology was an independent predictive factor of bladder recurrence (hazard ratio, 5.54; 95% confidence interval 1.12-27.5; P=0.036). Of 72 patients in the Pirarubicin Monotherapy Study Group trial, 31 had positive urine cytology. Among the 31 patients, 17 patients who received pirarubicin instillation had fewer recurrences when compared with 14 patients who received control treatment (P=0.0001). On multivariate analysis, pirarubicin instillation was an independent predictor of better recurrence-free survival rates in the patients with positive urine cytology (hazard ratio, 0.02; 95% confidence interval, 0.00-0.53; P=0.018). Of 21 patients with bladder recurrence, 17 had recurrent tumor around cystotomy or in the bladder neck compromised by the urethral catheter, supporting the notion that tumor cells seeded in the injured urothelium. Conclusions: Intravesical instillation of pirarubicin immediately after nephroureterectomy significantly reduced the bladder recurrence rate in patients with positive voided urine cytology. The results suggest that intravesical seeding of upper urinary tract urothelial carcinoma occurs during nephroureterectomy. © The Author 2013. Published by Oxford University Press. All rights reserved.

Yatabe J.,Fukushima Medical University | Yatabe M.S.,Fukushima Medical University | Ishibashi K.,Bange Kosei General Hospital | Nozawa Y.,Shirakawa Kosei General Hospital | Sanada H.,Fukushima Medical University
Diagnostic Pathology | Year: 2013

Most tumor markers have low detection rates for curable stages of cancer and are therefore not satisfactory for use in a healthy population. A new cancer risk calculation method, AminoIndex Cancer Screening (AICS), uses multiple plasma amino acid concentrations to calculate the risks for several cancers simultaneously and is suggested to have a high detection rate for early-stage cancers and a low false-positive rate for adenomas. Here, we describe a male patient with a family history of colorectal cancer who underwent AICS. He was judged as Rank C for colorectal cancer, which reportedly has a specificity of 95%, a sensitivity of 41%, and an estimated positive predictive value of 0.67%. He underwent colonoscopy for a secondary screening, which revealed a 10-mm adenoma-like lesion in the ascending colon, with a biopsy report of partial carcinoma. The tumor was endoscopically removed and diagnosed as carcinoma in situ (carcinoma in adenoma). This early detection method allowed complete resection of the carcinoma, and the patient is in remission. This is the first case in which a curable cancer was detected using AICS. With its high detection rate for early-stage cancers and its ease of use, this tool, which recently became available in Japan, may be beneficial for simultaneous screening of the general population for multiple cancers.Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2145080259887842. © 2013 Yatabe et al.; licensee BioMed Central Ltd.

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