PubMed | Yatsuo General City Hospital, Toyama City Hospital, Toyama Prefectural Central Hospital, Kanazawa Medical University and 7 more.
Type: Journal Article | Journal: International journal of clinical oncology | Year: 2016
The purpose of our study was to evaluate the efficacy of a new combination antiemetic therapy consisting of palonosetron, aprepitant, and dexamethasone in gastric cancer patients undergoing chemotherapy with S-1 plus cisplatin.This prospective, multi-institutional observational study assessed patient-reported nausea, vomiting, use of rescue therapy, change of dietary intake, and Functional Living Index-Emesis (FLIE) questionnaire results. The percentages of patients showing complete response (CR; no emesis and non-use of any rescue antiemetics) and complete protection (CP; no significant nausea and non-use of any rescue antiemetics), change of dietary intake, and impact of chemotherapy-induced nausea and vomiting on daily life during the overall (0-120h after cisplatin administration), acute (0-24h), and delayed (24-120h) phases were examined. These findings were compared with our previous study, which used granisetron, aprepitant, and dexamethasone, to assess the relative effectiveness of palonosetron versus granisetron in combination antiemetic therapy.Of the 72 included patients, 66 (91.6%), 70 (97.2%), and 50 (69.1%) achieved CR, and 48 (66.7%), 61 (84.7%) and 49 (68.1%) achieved CP during in the overall, acute, and delayed phases of cisplatin administration, respectively. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 78.6% of patients maintained their quality of life. Palonosetron was not superior to granisetron in combination antiemetic therapy.Three-drug combination antiemetic therapy with palonosetron, aprepitant, and dexamethasone was tolerable in gastric cancer patients undergoing treatment with S-1 plus cisplatin. The predominance of palonosetron to granisetron was not demonstrated in this study.
PubMed | Toranomon Hospital, Takaoka City Hospital, Toyonaka Municipal Hospital and Kanazawa University
Type: Journal Article | Journal: The British journal of radiology | Year: 2016
This immunohistochemical study aimed to elucidate the molecular mechanism underlying the increased fluorine-18 fludeoxyglucose (FDG) uptake in hepatocyte nuclear factor 1 (HNF1)-inactivated hepatocellular adenomas (H-HCAs).Three resected H-HCAs were studied using FDG positron emission tomography. Each maximum standardized uptake value (SUVmax) was determined. Resected samples were subjected to immunohistochemical staining for the following glucose metabolism-related proteins: glucose transporter 1 (GLUT1) and glucose transporter 2 (GLUT2), indicative of uptake and transport of glucose into cellular cytoplasm; hexokinase 2 (HK2) and hexokinase 4 (HK4), glucose phosphorylation; glucose-6-phosphate transporter 1 (G6PT1), uptake and transport of glucose-6-phosphate into endoplasmic reticulum; and glucose-6-phosphatase (G6Pase), dephosphorylation.All three H-HCAs exhibited increased FDG intake, with an average SUVmax of 6.6 (range: 5.2-8.2). No sample expressed GLUT1 and HK2; all the samples exhibited equivalent GLUT2 and HK4 expression, equivalent or slightly increased G6Pase expression and significantly decreased G6PT1 expression relative to the non-neoplastic hepatocytes of background liver.The increased FDG uptake observed in H-HCAs is associated with GLUT2 and HK4 expression and G6PT1 inactivation.H-HCA exhibits a high FDG uptake owing to the inactivation of G6PT1, which is transcriptionally regulated by HNF1.
Arahata M.,Nanto Municipal Hospital |
Tajiri K.,University of Toyama |
Nomoto K.,University of Toyama |
Tsuneyama K.,University of Toyama |
And 2 more authors.
International Archives of Allergy and Immunology | Year: 2013
A 64-year-old female with advanced liver cirrhosis who had never experienced severe infections presented in 2004 with general malaise. At the time, her serum showed low levels of immunoglobulin (Ig) M (11 mg/dl) with high levels of both IgG (2,942 mg/dl) and IgA (808 mg/dl). Because serum levels of IgG and IgA in previous cases of selective IgM deficiency were normal, this case could have a novel immunological mechanism. By 2006, serum IgM was undetectable (<5 mg/dl). Liver biopsy showed liver cirrhosis from autoimmune hepatitis. She had no other autoimmune diseases or hematological malignancies. She developed hepatocellular carcinoma (HCC) several times and died of liver failure. Immunological analyses performed before the first diagnosis of HCC showed polyclonal γ-globulin elevation, normal chromosome and normal gene rearrangement of immunoglobulin heavy chain Cμ. Peripheral blood showed low count B cells with few surface IgM-positive B lymphocytes, but the percentages of T cell subsets were normal. Expression of activation-induced cytidine deaminase (AID), which plays a critical role in immunoglobin class switching, was found to be overexpressed in the HCC tissue and B cells in bone marrow. This phenomenon could account for the clinical and immunological features of this case. In conclusion, we propose a novel type of selective IgM deficiency in association with the overexpression of AID. © 2012 S. Karger AG, Basel.
Tajiri K.,University of Toyama |
Shimizu Y.,Takaoka City Hospital |
Tokimitsu Y.,University of Toyama |
Tsuneyama K.,University of Toyama |
Sugiyama T.,University of Toyama
Internal Medicine | Year: 2012
Here, we report an elderly man with acute-on-chronic hepatitis accompanied by massive ascites. He showed elevated serum transaminase and anti-nuclear antibody (ANA) levels. Liver biopsy showed diffuse multinucleated giant hepatocytes with interface hepatitis, and he recovered with administration of azathioprine in addition to corticosteroids. Follow-up liver biopsy after recovery showed improvement of hepatic inflammation and reduction of giant hepatocyte formation. The patient is receiving low-dose orticosteroid maintenance therapy and he has remained healthy for 8 years to date. Active immunosuppressive treatment may be beneficial in patients with adult syncitial giant cell hepatitis (AGCH). © 2012 The Japanese Society of Internal Medicine.
PubMed | Takaoka City Hospital and University of Toyama
Type: Comparative Study | Journal: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association | Year: 2015
In cervical myelopathy, significant findings are seen in flexion-extension MRI due to the increased likelihood of cord compression during neck extension. In addition, a high intramedullary signal on T2-weighted MR images has been reported to be a prognostic factor in this condition. However, the relationship between Japanese Orthopaedic Association (JOA) scores and the signal intensity in preoperative cervical flexion-extension T2-weighted images has not been evaluated. The purpose of this study was to evaluate whether preoperative flexion-extension MRI may be used to predict surgical outcomes in patients with cervical myelopathy.A total of 121 patients who underwent surgery for cervical myelopathy were included. All patients underwent preoperative cervical flexion-extension MRI followed by cervical decompression surgery, with or without spinal fusion, and postoperative follow-up for at least 2 years. Pre- and postoperative (2 years after surgery) JOA scores were recorded, and the degree of postoperative improvement was calculated. The relationship between intramedullary signal intensity on preoperative cervical dynamic MRI findings and degree of clinical recovery was examined.Patients with a high intramedullary signal on the extension MRI had significantly better neurological recovery than those with a high signal on the flexion MRI (p < 0.000005). There was no significant difference in neurological recovery between patients with and without a high intramedullary signal on extension MRI.A preoperative high intramedullary signal on flexion MRI was associated with a poor surgical outcome, while no such association was seen with extension MRI.
PubMed | Takaoka City Hospital, Toyama Rosai Hospital and University of Toyama
Type: | Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society | Year: 2017
Complications of adult spinal deformity surgery are problematic in osteoporotic individuals. We compared outcomes between Japanese patients treated perioperatively with teriparatide vs. low-dose bisphosphonates.Fifty-eight osteoporotic adult Japanese female patients were enrolled and assigned to perioperative teriparatide (33 patients) and bisphosphonate (25 patients) groups in non-blinded fashion. Pre- and post-operative X-ray and computed tomography imaging were used to assess outcome, and rates were compared between the groups and according to age. Pain scores and Oswestry Disability Indices (ODI) were calculated before and 2years after surgery.Adjacent vertebral fractures and implant failure, fusion failure, and poor pain and ODI outcomes were significantly more common in the bisphosphonates group than the teriparatide group.Perioperative administration of teriparatide is more effective than that of low-dose bisphosphonates in preventing complications and maintaining fusion rates in osteoporotic Japanese females with spinal deformities undergoing surgery.
Tsujimoto M.,Takaoka City Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011
The patient was a 47-year-old man who had been found to have an intrathoracic lipoma arising from the left chest wall during a routine physical examination 4 years previously, and had been followed-up. He visited our hospital because of left chest pain. Since the tumor had enlarged, he was scheduled for surgery. He developed pneumothorax before surgery, and imaging studies confirmed the presence of a pedunculated growth. It was easy to perform thoracoscopic resection of the tumor, which was diagnosed as lipoma by pathology. The patient is free of recurrence 2 years after surgery.
Yamakawa Y.,Takaoka City Hospital |
Ushijima M.,Takaoka City Hospital |
Kato K.,Takaoka City Hospital
International Journal of Clinical Oncology | Year: 2011
Primary squamous cell carcinoma (SCC) associated with ovarian endometriosis is extremely rare and has a poor prognosis due to insufficient information on the optimal postoperative treatment. Here, we describe the response of this tumor to the administration of paclitaxel-carboplatin. A 45-year-old woman diagnosed with stage IIIc primary SCC of the ovary associated with endometriosis underwent optimal surgery followed by six courses of chemotherapy at 3-week intervals with paclitaxel and carboplatin. She tolerated the chemotherapy well and remained without evidence of disease during first-line chemotherapy. Two months later, she was readmitted with recurrence of a pelvic tumor. Although she was treated with chemotherapy (weekly paclitaxel and chemotherapeutic regimen of irinotecan + mitomycin C), the tumor was resistant to second-line and third-line chemotherapy and she died 15 months after surgery. Paclitaxel-carboplatin administration may be an effective treatment for primary SCC of the ovary but further studies are required to investigate it true efficacy in the treatment of this disease. © 2011 Japan Society of Clinical Oncology.
PubMed | Takaoka City Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016
A 67-year-old man was treated for diabetes mellitus by his family doctor. A splenic tumor was suspected based on his pain in the left side of the abdomen. He was admitted to our hospital for close inspection and medical treatment. Abdominal CT and MRI scans showed a tumor, 10 cm in diameter, in the spleen. An opaque boundary with the diaphragm was also observed. On PET-CT, accumulations of FDG were observed in the left supraclavicular fossa and the left axilla. The serum levels of LDH and sIL-2R were elevated, and therefore a diagnosis of malignant lymphoma was suspected. Due to the risk of splenic rupture, a splenectomy was performed. After pathological examination, the patient was diagnosed with diffuse large B-cell malignant lymphoma. He is currently being treated with chemotherapy at another medical institute. Splenic rupture occurs in some cases of splenic malignant lymphoma, although the number of reported cases is low. In some of the cases, splenic rupture occurred during treatment of the malignant lymphoma. There is no specific way to measure the risk of splenic rupture; however, performing a prophylactic splenectomy is one option in cases where tumor cells have extended to the capsula lienis, similar to that in our patient.
PubMed | Takaoka City Hospital and Itoigawa General Hospital
Type: | Journal: Case reports in neurological medicine | Year: 2015
We recently experienced two patients with stroke-like symptoms and ascending aortic dissection (AAD) in our outpatient department. Both patients were transferred to our hospital presenting with neurological deficit such as hemiparesis and conjugate deviation. They did not complain from any chest or abdominal pain. Their MRI did not show fresh infarction or main branch occlusion. A chest CT image showed AAD. The former patient was immediately transferred to a tertiary hospital and the latter received conservative management in the cardiovascular department. Discussion. As neither patient was experiencing any pain, we initially diagnosed them with ischemic stroke and began treatment. Fortunately, bleeding complications did not occur. In such cases, problems are caused when intravenous tissue plasminogen activator (t-PA) injection is administered with the aim of reopening the occluded intracranial arteries. In fact, patients with AAD undergoing t-PA injection have been reported to die from bleeding complications without any recognition of the dissection. These findings suggest that confirmation using carotid ultrasound, carotid MR angiography, and a D-dimer test is crucial and should be adopted in emergency departments.