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Kasukabe, Japan

Kuwabara H.,Shuuwa General Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

We encountered a case of colorectal cancer with pelvic abscess treated with radical surgery following colostomy and chemotherapy. The patient was a man in his 60s with advanced rectal cancer. The tumor had expanded locally and formed an abscess. We evaluated the primary lesion as unresectable, and performed chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin( mFOLFOX) plus bevacizumab after colostomy. After 13 courses of chemotherapy, the tumor shrank remarkably. We performed a low anterior resection followed by adjuvant chemotherapy with capecitabine. The patient has had no recurrence for 18 months after surgery. Source


Mitsuoka A.,Shuuwa General Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

The patient was a 73-year-old woman with hematemesis, who was brought to our hospital by an ambulance. Emergency upper gastrointestinal endoscopy was performed, and a thickened wall and multiple ulcers were noted in the middle- lower region of the stomach body. The biopsy revealed gastric cancer (por), and the macroscopic depth of invasion was up to the subserosal layer. Multiple white granular protruding lesions were observed in the duodenal bulb and were diagnosed as follicular lymphoma by biopsy. As follicular lymphoma generally takes a long time to progress in many cases, the vital prognosis would be determined by the gastric cancer. Thus, total gastrectomy was performed for gastric cancer. For reconstruction, the double-tract method was used. Duodenal follicular lymphoma was continuously monitored by upper gastrointestinal endoscopy. Here, we describe the case of a patient with a complication of follicular lymphoma arising from duodenal and gastric cancer, which is very rare, and report this case along with a literature review. Source


Kuwabara H.,Shuuwa General Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

We report the case of a patient with unresectable progressive advanced rectal cancer, who has been able to maintain a good quality of life because of combination therapy, including chemoradiotherapy. A 52-year-old woman was diagnosed with progressive locally advanced rectal cancer and invasion of the adnexa of the uterus and the left ureter. No distant metastasis was detected. Colostomy was performed, followed by chemoradiotherapy combined with S-1; then, mFOLFOX6 +bevacizumab (BV) therapy was administered. Aggravation of bilateral hydronephrosis was detected upon completion of 2 courses of treatment, and therefore, percutaneous nephrostomy of the right kidney was performed. After the patient underwent 20 courses of treatment, imaging showed a reduction in the size of the lesion, and the CEA level returned to normal. Later, remission was sustained by sLV5FU2+BV therapy and oral administration of S-1. As a result, we were able to remove the nephrostomy tube from the right kidney in February 2011. Four years after initiation of the treatment, the patient has shown no indication of recurrence. Source


The patient was a 43-year-old woman who visited our hospital with a primary complaint of intermittent abdominal pain. Upper gastrointestinal endoscopy revealed mild gastritis. The patient was treated with oral drugs, and the course was followed. Subsequently, the abdominal pain aggravated, and computed tomography (CT) was performed, in which right colic intussusception with a 4 cm cystic mass in the advanced portion was noted. Reduction by enema was attempted on the same day; however, a residual tumorous lesion was present in the ileocecal region. The patient was diagnosed with a cecal submucosal tumor with intussusception, and therefore, laparoscopic surgery was performed. Intussusception of the entire appendix in the ascending colon was noted, for which laparoscopic ileocecal resection was performed. In the excised specimen, a cystic lesion comprising the appendix filled with mucus was present. The postoperative recovery was favorable, and the patient was discharged on the seventh postoperative day. The lesion was histopathologically diagnosed as low-grade appendiceal mucinous neoplasm. Source


Tamaki J.,Kinki University | Iki M.,Kinki University | Kadowaki E.,Kinki University | Sato Y.,Jin-ai University | And 4 more authors.
Osteoporosis International | Year: 2011

We evaluated the predictive ability of FRAX® in a cohort of 815 Japanese women. The observed 10-year fracture rate did not differ significantly from that predicted by FRAX®. The predictive ability of FRAX® without femoral neck bone mineral density (BMD) was similar to that with femoral neck BMD. Introduction: We evaluated the ability of the Japanese version of FRAX®, a World Health Organization fracture risk assessment tool, to predict the 10-year probability of osteoporotic fracture. Methods: Self-reported major osteoporotic fracture (N=43) and hip fracture (N=4) events were ascertained in the 10-year follow-up survey of the Japanese Population-Based Osteoporosis Cohort Study. Participants were 815 women aged 40-74 years at the baseline survey. Receiver operating characteristic curve analysis compared FRAX® with multiple logistic models based on age, body weight, and femoral neck BMD. Results: The number of observed major osteoporotic or hip fracture events did not differ significantly from the number of events predicted by the FRAX® model (with or without BMD). The area under the curve (AUC) value for FRAX® with BMD for predicting major osteoporotic fractures was similar to that of a logistic model with age, body weight, and BMD (0.69 vs. 0.71, respectively; p=0.198); the AUC of FRAX® with BMD for predicting hip fractures was similar to that of a model based on age and BMD (0.88 vs. 0.89, respectively; p=0.164). The AUCs of FRAX® without BMD for predicting major osteoporotic and hip fractures were similar to those with BMD (0.69 vs. 0.67, respectively; p=0.121; 0.88 vs. 0.86, respectively; p=0.445). Conclusions: The Japanese version of FRAX® without BMD estimated the 10-year probability of osteoporotic fracture in this population with few clinical risk factors as similar to that of FRAX® with BMD. © 2011 International Osteoporosis Foundation and National Osteoporosis Foundation. Source

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