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Suzuki S.,Shonantobu General Hospital | Goto M.,Shonantobu General Hospital | Okamoto T.,Shonantobu General Hospital | Tomita I.,Shonantobu General Hospital | And 5 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2010

The patient was a 63-year-old male admitted for further evaluation of the bleeding esophageal tumor. Endoscopic biopsy revealed small cell carcinoma. CT scan of the abdomen demonstrated nodular enlargement at the celiac axis. Under diagnosis of small cell carcinoma of the esophagus at cStage IVa, neoadjuvant chemotherapy with FP (5-FU+CDDP) was given. Immediately after fluid load, levels of serum sodium decreased to 117 mEq/L and persisted during chemotherapy treatment despite aggressive corrections. Response and shrinkage of the distant nodal metastases were confirmed, and an esophagectomy was conducted. Pathological examination with IHC demonstrated positive staining for CD56, NSE and synaptophysin but negative for ADH. Lymph node and liver metastases recurred. Progression of the disease again triggered hyponatremia.


Yamamoto Y.,Shonantobu General Hospital | Goto M.,Shonantobu General Hospital | Okamoto T.,Shonantobu General Hospital | Tomita I.,Shonantobu General Hospital | And 5 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2010

The case was a 77-year-old male with swelling of his right leg. Physical examination revealed an ill-defined mass at RLQ. Computed tomography (CT) and 3 dimensional CT showed an 8-cm tumor on the IVC, partially replacing iliac vessels and invading the psoas muscle. A diagnosis of malignant fibrohistiocytoma was made by pathological examination of biopsied specimens at exploratory laparotomy. Five courses of combination chemotherapy of ifosfamide (IFM) and doxorubicin (DXR) resulted in PR. Edema of the lower leg and hydronephrosis were both alleviated. Another 5 courses of chemotherapy with epirubicin and IFM were added. PR lasted 2 years, though the patient succumbed to the disease in 2 years and 8 months.


Tsuruya K.,Kyushu University | Fukuma S.,Kyoto University | Fukuma S.,Institute for Health Outcomes and Process Evaluation Research iHope International | Fukuma S.,Fukushima Medical University | And 14 more authors.
PLoS ONE | Year: 2015

Background & Objectives: Little is known about actual dietary patterns and their associations with clinical outcomes in hemodialysis patients. We identified dietary patterns in hemodialysis patients in Japan and examined associations between dietary patterns and clinical outcomes. Design, setting, participants, measurements: We used data from 3,080 general-population participants in the Hisayama study (year 2007), and data from 1,355 hemodialysis patients in the Japan Dialysis Outcomes and Practice Patterns Study (JDOPPS: years 2005-2007). Food intake was measured using a brief self-administered diet-history questionnaire (BDHQ). To identify food groups with the Hisayama population data, we used principal components analysis with Promax rotation. We adjusted the resulting food groups for total daily energy intake, and then we used those adjusted food-group scores to identify dietary patterns in the JDOPPS patients by cluster analysis (Ward's method). We then used Cox regression to examine the association between dietary patterns and a composite of adverse clinical outcomes: hospitalization due to cardiovascular disease or death due to any cause. Results: We identified three food groups: meat, fish, and vegetables. Using those groups we then identified three dietary patterns: well-balanced, unbalanced, and other. After adjusting for potential confounders, we found an association between an unbalanced diet and important clinical events (hazard ratio 1.90, 95% C.I. 1.19-3.04). Conclusions: Hemodialysis patients whose diet was unbalanced were more likely to have adverse clinical outcomes. Thus hemodialysis patients might benefit not only from portion control, but also from a diet that is well-balanced diet with regard to the food groups identified here as meat, fish, and vegetables. © 2015 Tsuruya et al.


Tsuda T.,St. Marianna University School of Medicine | Inaba H.,General Sagami Kosei Hospital | Miyazaki A.,General Sagami Kosei Hospital | Izawa N.,St. Marianna University School of Medicine | And 7 more authors.
Esophagus | Year: 2011

Background: Standard chemoradiotherapy (CRT) using 5-FU and CDDP is the optimal treatment for patients with stage II/III (non-T4) esophageal carcinoma. However, patient quality of life (QOL) cannot necessarily be maintained during this therapy, because 5-FU must be continuously infused for 24 h and CDDP administration requires a large transfusion volume. Therefore, hospitalization is unavoidable. We conducted a study of definitive CRT with S-1 and nedaplatin. Methods: The study was conducted between July 2004 and December 2006. Eligibility criteria were stage II/III (non-T4), PS 0-2, age 20-79 years, and adequate organ function. S-1 80 mg/m2 was given on days 1-14, and nedaplatin 90 mg/m2 on day 1 every 4 weeks. Patients received two courses with concurrent radiotherapy of more than 50 Gy. Results: Twenty patients (age range, 50-75 years; PS 0/1, 8/12; stage IIA/IIB/III, 11/2/7) were enrolled. Grade 4 leukopenia, thrombocytopenia, and anemia occurred in 15%, 10%, and 5% of patients, respectively. Grade 3 nonhematotoxicity included esophagitis in 3 patients (15%) and anorexia in 2 (10%). One patient developed febrile neutropenia; another developed an esophageal fistula. Complete response was achieved in 80%. The 3-year overall survival rate was 58.0%. Thirteen subjects received treatment as outpatients. Conclusions: S-1 and nedaplatin in combination with radiotherapy is feasible, and toxicity is tolerable. This treatment method has the potential to shorten hospitalization and maintain patient QOL without impairing the efficacy of CRT. © 2011 The Japan Esophageal Society and Springer.


PubMed | Shonantobu General Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2010

The patient was a 63-year-old male admitted for further evaluation of the bleeding esophageal tumor. Endoscopic biopsy revealed small cell carcinoma. CT scan of the abdomen demonstrated nodular enlargement at the celiac axis. Under diagnosis of small cell carcinoma of the esophagus at Stage IVa, neoadjuvant chemotherapy with FP (5-FU+CDDP) was given. Immediately after fluid load, levels of serum sodium decreased to 117 mEq/L and persisted during chemotherapy treatment despite aggressive corrections. Response and shrinkage of the distant nodal metastases were confirmed, and an esophagectomy was conducted. Pathological examination with IHC demonstrated positive staining for CD56, NSE and synaptophysin but negative for ADH. Lymph node and liver metastases recurred. Progression of the disease again triggered hyponatremia.


PubMed | Shonantobu General Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2010

The case was a 77-year-old male with swelling of his right leg. Physical examination revealed an ill-defined mass at RLQ. Computed tomography (CT) and 3 dimensional CT showed an 8-cm tumor on the IVC, partially replacing iliac vessels and invading the psoas muscle. A diagnosis of malignant fibrohistiocytoma was made by pathological examination of biopsied specimens at exploratory laparotomy. Five courses of combination chemotherapy of ifosfamide (IFM) and doxorubicin (DXR) resulted in PR. Edema of the lower leg and hydronephrosis were both alleviated. Another 5 courses of chemotherapy with epirubicin and IFM were added. PR lasted 2 years, though the patient succumbed to the disease in 2 years and 8 months.

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