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Kikuchi S.,Aichi Medical University | Obata Y.,Aichi University | Yagyu K.,Aichi Medical University | Lin Y.,Aichi Medical University | And 7 more authors.
Cancer Science | Year: 2011

The relationship between gastric cancer and serum vascular endothelial growth factor receptor-1 (sVEGFR-1) and sVEGFR-2, which are soluble form receptor proteins of vascular endothelial growth factor (VEGF), has not been extensively studied. VEGF, sVEGFR-1 and sVEGFR-2 were measured in the sera obtained before surgical operation from 164 gastric cancer patients and from 164 healthy controls matched for age and gender. Compared with controls, the cases showed elevated VEGF (P<0.01) and reduced sVEGFR-1 (P=0.07) and sVEGFR-2 (P=0.02). The difference in VEGF levels was small among men and when the outcome was early cancer. The difference in sVEGFR-1 levels was significant or borderline significant only in men and when the outcome was diffuse type cancer. The difference in sVEGFR-2 levels was significant only in men and when the outcome was advanced or diffuse type cancer. The sensitivities and specificities of VEGF, sVEGFR-1 and sVEGFR-2 were all approximately 60%. For diffuse type cancer, sVEGFR-2 showed a sensitivity of 62.4% and a specificity of 63.4%, which was similar to serum pepsinogen. In conclusion, elevated VEGF and reduced sVEGFR-1 and sVEGFR-2 in serum are characteristic of gastric cancer patients, and the value of serum sVEGFR-2 in the diagnosis of diffuse type gastric cancer should be further evaluated. © 2011 Japanese Cancer Association.


Okada A.,Suifu Hospital | Okada A.,Mito Medical Center | Hata M.,Suifu Hospital | Taeda Y.,Suifu Hospital | Ushijima R.,Suifu Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2013

A 75-year-old man who complained of upper abdominal discomfort was diagnosed with primary duodenal cancer. The patient was treated with a pancreaticoduodenectomy, ascending colectomy and postoperative chemotherapy of S-1 and irinotecan [IRIS; S-1, 80 mg/m2 (days 1-14); irinotecan 100mg/m2 (days 1 and 15, every 4 weeks)]. However, after 4 IRIS cycles, computed tomography revealed a liver metastasis and massive ascites. The patient received second-line chemotherapy of tri-weekly docetaxel [60 mg/m 2, (day 1, every 3 weeks)]. After 2 cycles of docetaxel therapy, the liver tumor and ascites became undetectable. The patient was doing well 13 months after the operation.


Okada A.,Suifu Hospital | Hata M.,Suifu Hospital | Taeda Y.,Suifu Hospital | Ushijima R.,Suifu Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

A 75-year-old man who complained of upper abdominal discomfort was diagnosed with primary duodenal cancer. The patient was treated with a pancreaticoduodenectomy, ascending colectomy and postoperative chemotherapy of S-1 and irinotecan[IRIS; S-1, 80mg/m2(days 1-14); irinotecan, 100 mg/m2(days 1 and 15, every 4 weeks)]. However, after 4 IRIS cycles, computed tomography revealed a liver metastasis and massive ascites. The patient received second-line chemotherapy of tri-weekly docetaxel[60mg/m2,(day 1, every 3 weeks)]. After 2 cycles of docetaxel therapy, the liver tumor and ascites became undetectable. The patient was doing well 13 months after the operation.


Suzuki-Uematsu S.,National Hospital Organization | Suzuki-Uematsu S.,Iwate Prefectural Central Hospital | Shiraishi K.,National Hospital Organization | Ito T.,National Hospital Organization | And 6 more authors.
Breast Cancer | Year: 2010

Here we present a case of malignant phyllodes tumor which was composed almost exclusively of a fibrosarcomatous component. A 52-year-old Japanese female noted a rapid increase of her right breast tumor. On admission, multiple lung metastases were detected by imaging. Right simple mastectomy was performed. The tumor, 10 × 10 cm in the largest dimension, had somewhat of a pushing margin, and showed a flesh-like appearance with marked necrosis. Microscopically, the tumor showed proliferation of atypical ovoid- or spindle-shaped cells in a myxoid matrix. Multiple sectioning revealed that the tumor had only focal occurrence of elongated tubular structures, and the occurrence of a small component of benign phyllodes tumor, leading to the aforementioned final diagnosis. Spindle cell carcinoma was excluded on the basis of the HE findings and the lack of immunoreactivity for cytokeratin when using a broad spectrum antibody mixture. Although the patient received adjuvant chemotherapy, no responsiveness was obtained. The patient died 4 months following surgery. We reviewed 15 malignant phyllodes tumors with metastases reported in Japan. The estimated 2.2-year survival rate following detection of metastasis was 11%, thus confirming the aggressiveness of the disease. © 2009 The Japanese Breast Cancer Society.


Arihara Z.,Suifu Hospital | Sakurai K.,Suifu Hospital | Osaki Y.,Suifu Hospital | Fukazawa H.,Suifu Hospital | And 5 more authors.
Endocrine Journal | Year: 2011

GH-producing pituitary adenomas frequently co-produce other certain anterior pituitary hormones, such as prolactin (PRL). In contrast, GH-producing adenomas which express all of corticotropin-releasing factor (CRF), urocorin1 (Ucn1) and urocortin3 (Ucn3) have not been reported. A 39-year-old woman was admitted for evaluation of the pituitary tumor. The diagnosis of acromegaly was confirmed by elevated serum GH and IGF-I levels, and the absence of GH suppression by oral glucose tolerance test. ACTH response to desmopressin (DDAVP) was observed (plasma ACTH levels increased from 13.9 to 50.4pg/mL at 90min). Although it is known that ACTH response to DDAVP is considerably useful for the diagnosis of ACTH-dependent Cushing's syndrome, the diagnosis of Cushing's disease was not supported by the criteria. The patient underwent transsphenoidal resection of the pituitary tumor. Immunohistological examination confirmed a GH and PRL-producing adenoma, whereas ACTH was negative. ACTH response to DDAVP disappeared after tumor removal. To determine the cause of preoperative ACTH response to DDAVP, we examined expression of CRF family peptides and vasopressin V1b receptor in the pituitary adenoma by immunohistochemistry. Immunohistochemistry revealed positive immunostaining for CRF, Ucn1, Ucn3 and vasopressin V1b receptor in the adenoma. These observations raised the possibility that DDAVP caused an ACTH response, perhaps via the paracrine effects of tumor-derived CRF and Ucn1. When ACTH response to DDAVP is observed in patients with pituitary tumor, not only the direct effect of DDAVP on ACTH secretion, but also a possible involvement of CRF and/or urocortins expressed in the pituitary adenoma, should be considered. © The Japan Endocrine Society.


PubMed | Suifu Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

A 75-year-old man who complained of upper abdominal discomfort was diagnosed with primary duodenal cancer. The patient was treated with a pancreaticoduodenectomy, ascending colectomy and postoperative chemotherapy of S-1 and irinotecan[IRIS; S-1, 80mg/m2(days 1-14); irinotecan, 100 mg/m2(days 1 and 15, every 4 weeks)]. However, after 4 IRIS cycles, computed tomography revealed a liver metastasis and massive ascites. The patient received second-line chemotherapy of tri-weekly docetaxel[60mg/m2,(day 1, every 3 weeks)]. After 2 cycles of docetaxel therapy, the liver tumor and ascites became undetectable. The patient was doing well 13 months after the operation.


GH-producing pituitary adenomas frequently co-produce other certain anterior pituitary hormones, such as prolactin (PRL). In contrast, GH-producing adenomas which express all of corticotropin-releasing factor (CRF), urocorin1 (Ucn1) and urocortin3 (Ucn3) have not been reported. A 39-year-old woman was admitted for evaluation of the pituitary tumor. The diagnosis of acromegaly was confirmed by elevated serum GH and IGF-I levels, and the absence of GH suppression by oral glucose tolerance test. ACTH response to desmopressin (DDAVP) was observed (plasma ACTH levels increased from 13.9 to 50.4 pg/ml at 90 min). Although it is known that ACTH response to DDAVP is considerably useful for the diagnosis of ACTH-dependent Cushings syndrome, the diagnosis of Cushings disease was not supported by the criteria. The patient underwent transsphenoidal resection of the pituitary tumor. Immunohistological examination confirmed a GH- and PRL-producing adenoma, whereas ACTH was negative. ACTH response to DDAVP disappeared after tumor removal. To determine the cause of preoperative ACTH response to DDAVP, we examined expression of CRF family peptides and vasopressin V1b receptor in the pituitary adenoma by immunohistochemistry. Immunohistochemistry revealed positive immunostaining for CRF, Ucn1, Ucn3 and vasopressin V1b receptor in the adenoma. These observations raised the possibility that DDAVP caused an ACTH response, perhaps via the paracrine effects of tumor-derived CRF and Ucn1. When ACTH response to DDAVP is observed in patients with pituitary tumor, not only the direct effect of DDAVP on ACTH secretion, but also a possible involvement of CRF and/or urocortins expressed in the pituitary adenoma, should be considered.


PubMed | Sendai Thyroid Clinic, Tohoku University, Suifu Hospital, Nagoya University and Tohoku Kosai Hospital
Type: | Journal: Japanese clinical medicine | Year: 2016

Familial dysalbuminemic hyperthyroxinemia (FDH) is a familial autosomal dominant disease caused by mutation in the albumin gene that produces a condition of euthyroid hyperthyroxinemia. In patients with FDH, serum-free thyroxine (FT4) and free triiodothyronine (FT3) concentrations as measured by several commercial methods are often falsely increased with normal thyrotropin (TSH). Therefore, several diagnostic steps are needed to differentiate TSH-secreting tumor or generalized resistance to thyroid hormone from FDH. We herein report a case of a Japanese man born in Aomori prefecture, with FDH caused by a mutant albumin gene (R218P). We found that a large number of FDH patients reported in Japan to date might have been born in Aomori prefecture and have shown the R218P mutation. In conclusion, FDH needs to be considered among the differential diagnoses in Japanese patients born in Aomori prefecture and showing normal TSH levels and elevated FT4 levels.

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