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Kida W.,Tokyo Metropolitan Tama Medical Center
Otolaryngology - Head and Neck Surgery (Japan) | Year: 2011

Malignant myoepithelioma is a rare salivary gland tumor and represnts less than 1% of all salivary gland tumor. Very few cases have been reported. We reported a case of a malignat myoepithelioma of the soft palate minor salivary gland treated by performing a reconstruction using a radial forearm flap with satisfactory prognosis.

Sakashita K.,Tokyo Metropolitan Tama Medical Center
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2011

A 72-year-old man visited our hospital due to persistent cough, fever and weight loss. A chest X-ray film revealed a round tumor in the left lower lung field. A specimen obtained by transbronchial lung biopsy demonstrated histiocytic and lymphocytic infiltration in the alveolar space, with spindle myofibroblasts and plasmacytes in the interstitium, Those findings were consistent with inflammatory pseudotumor. Four weeks later, a chest X-ray film showed only scars of the primary lesion, and his symptoms resolved dramatically. He has had no recurrence of symptoms and pulmonary tumor since then. Although spontaneous remission is uncommon in inflammatory pseudotumor of the lung, there are several case reports about spontaneous remission of hepatic inflammatory pseudotumor and autoimmune pancreatitis, parts of IgG4-related sclerosing disease. Recently, inflammatory pseudotumor is thought to be IgG4-related sclerosing disease. We speculate that IgG4 may be associated with spontaneous remission of inflammatory pseudotumor of the lung, and we discuss this issue in relation to the pertinent literature.

Honda H.,Tokyo Metropolitan Tama Medical Center | Dubberke E.R.,University of Washington
Current Opinion in Gastroenterology | Year: 2014

PURPOSE OF REVIEW: Clostridium difficile infection (CDI) is a growing concern and has a substantial impact on morbidity and mortality. Epidemiology of CDI has dramatically changed over the last decade. Diagnostic and treatment strategies are even more complicated given the wide variety of available diagnostic methods and the emergence of refractory or recurrent CDI. This review is intended to provide information on current CDI epidemiology and guidance for evidence-based diagnosis and management strategies. RECENT FINDINGS: Various studies from the United States, Europe, and Canada revealed increased incidence of CDI since 2000. Although CDI has long been associated with healthcare settings, recent studies indicate it is more common in the community than previously recognized. For diagnostic strategies, newer testing methods, including nucleic acid amplification tests, have enhanced sensitivity compared with toxin testing, but at the expense of decreased specificity. New agents for treating CDI are being developed and higher quality data to support fecal microbiota transplantation for treating recurrent CDI are emerging. SUMMARY: CDI epidemiology continues to evolve. Prompt recognition and an evidence-based treatment approach is the key to successfully manage CDI. Further, studies on diagnostic and therapeutic strategies are needed to further improve patient outcomes. © Lippincott Williams & Wilkins.

Kimura Y.,Tokyo Metropolitan Tama Medical Center
Otolaryngology - Head and Neck Surgery (Japan) | Year: 2013

Desending necrotizing Mediastinitis (DMN) resulting from deep neck infections have a high mortality rate. It is necessary to diagnose DMN rapidly and accurately, as the delay of deagnosis and treatment could lead patients to unfortunate outcome. The dranage by thoracotectomy was the gold standard for DMN spread throughout the mediastinum. However, wereported two cases successfully drained by thoracoscopy, as similar reports have been increasing in recent years. The drainage by thoracoscopy for DMN couls be recommended for some case.

Fuchigami T.,Tokyo Metropolitan Tama Medical Center
Otolaryngology - Head and Neck Surgery (Japan) | Year: 2013

A 21-year-old female presented with a mass of the upper right neck. It was suspected a neurinoma of the vagus nerve by MRI and CT scan. The tumor was located in the higher position of bifurcation of common carotid artery. Intracapsular microscopic enucleation was performed under general anesthesia. We removed the tumor with the vagus nerve preserving the nerve function. Pathological diagnosis was neurinoma. She had no palsy of the vagus nerve after the surgery.

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