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Midorikawa H.,Southern Tohoku General Hospital
Kyobu geka. The Japanese journal of thoracic surgery

We report the initial and long-term results of open stent-grafting (OSG) applied with a Matsui-Kitamura (MK) stent in the treatment of thoracic aortic aneurysm (TAA). From August 2005 to March 2013, OSG for TAA was applied in 46 cases( male/female, 36/10, 54-86 years old, mean age 71). During deep hypothermic circulatory arrest with antegrade selective cerebral perfusion, stent graft was delivered through the transected proximal aortic arch, followed by arch replacement with a 4-branched prosthesis. Operative mortality within 30 days was 6.5%(respiratory failure in 1, multiple organ failure in 1and ischemic enteritis in 1) and there was 1 in hospital death due to brain stem infarction. Perioperative morbidity included 2( 4.3%) stroke, 5( 10.9%) spinal cord injuries( paraplegia in 1, paraparesis in 1 and transient paraparesis in 3). In long-term follow-up, survival was 86.8%, 77.2%, and 72.0% for 1, 3 and 5 years. Freedom from aortic event was 97.3%, 93.8% and 89.1% for 1, 3 and 5 years. Theseresults suggested the OSG method applied with a MK stent is a useful surgical procedure for the treatment of TAA. Source

Ihara F.,Southern Tohoku General Hospital | Ihara F.,Funabashi Municipal Medical Center | Ihara F.,Chiba University | Otsuka Y.,Funabashi Municipal Medical Center
Journal of Otolaryngology of Japan

Tetanus develops following inoculation of damaged human tissue with Clostridium tetani which transforms into a vegetative rod-shaped bacterium and produces the tetanospasmin. Usually we make a diagnosis of tetanus based on typical symptoms and history of trauma. But, when patients have no noticeable history of trauma, we have to diagnose tetanus on the basis of the clinical course and symptoms. We report herein on two cases of tetanus without a clear history of trauma. The first patient visited us with the chief complaints of pain in the neck and shoulder, and difficulty in opening the mouth. Based on these symptoms, we diagnosed tetani in the first stage and we started treatment, consisting mainly of human anti-tetanus immunoglobulin on the first day. The second patient also had typical symptoms of tetanus. However, he rejected the use of human anti-tetanus immunoglobulin on the first day. Because his symptoms worsened on the 2nd day, we insisted that he used it. On the 5th hospital day he developed partial opisthotonus of neck. However he recovered without tracheotomy or intratracheal intubation. Source

Midorikawa H.,Southern Tohoku General Hospital
Kyobu geka. The Japanese journal of thoracic surgery

For the improvement in the clinical results of open stent-grafting, the development of a device system and prevention of spinal cord injury are important. For that reasons, we devised 2 methods for the open stent-grafting with the Matsui-Kitamura (MK) stent. First, the applicator using transesophagial echo transducer cover made insertion of the stent-graft system easy and safe. Next, to prevent ischemic spinal injury and protect major abdominal organ, blood return to lower body was established from femoral artery with occluding the stent graft by balloon. However, these procedures might need to examine whether it really contributes to the improvement in the clinical results. Source

Terunuma H.,Biotherapy Institute of Japan | Deng X.,Biotherapy Institute of Japan | Nishino N.,Southern Tohoku General Hospital
Journal of Stem Cells and Regenerative Medicine

Natural killer (NK) cells have been known to enhance the host immune responses against cancer. NK cell number and cytotoxicity in patients with cancer is often low. Therefore, we developed a large-scale ex vivo NK cell expansion method without feeder layers and introduced NK cell-based autologous immune enhancement therapy (AIET). In this paper, we discuss the epidemiological data that show the relationship between NK activity and cancer incidence, monitoring of NK cell number and activity, anti-cancer activities of NK cells in vitro and in vivo and the effects of the combination of expanded NK cells with monoclonal antibody drugs on cancers through antibody-dependent cellular cytotoxicity. Finally, we also present the clinical cases of NK cell-based AIET and the effect of AIET on advanced stage of pancreatic cancer and on various advanced cancers refractory to conventional therapies. NK cell-based AIET might be a useful strategy in the multidisciplinary approach to cancer. © Journal of Stem Cells and Regenerative Medicine. All rights reserved. Source

Fujiu K.,Southern Tohoku General Hospital | Miyamoto H.,Southern Tohoku General Hospital | Suzuki H.,Fukushima Medical University
Japanese Journal of Cancer and Chemotherapy

We present a case of choroidal metastasis of lung cancer in which choroidal metastasis, the first manifestation of recurrence, was successfully treated with erlotinib. A 49-year-old woman with a 2.0 cm nodule in the right lung was diagnosed with adenocarcinoma, and a right upper lobectomy was performed. After 2 months, she presented with blurred vision of the right eye. Her right visual acuity had decreased to 0.1, and there was a visual field defect temporal to the macula. Fundus examination of the right eye revealed an elevated mass with exudative retinal detachment temporal to the disc. Fluorescein angiography revealed hypofluorescence during the prearterial and arteriovenous phases, and fluorescein leakage surrounded by a circular hypofluorescence area during the venous phase. Spectral-domain optical coherence tomography showed exudative retinal detachment. The cancer cells had a mutation of the epidermal growth factor receptor gene in exon 19. She was treated with erlotinib at 100 mg per day, and after 4 days, her right visual acuity had improved to 1.2. Source

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