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Okamoto E.,Tokyo Metropolitan Toshima Hospital
Gan to kagaku ryoho. Cancer & chemotherapy

A 67-year-old woman with complaints of cough and dyspnea was admitted; her chest radiographs and computed tomography (CT) scans revealed pulmonary carcinomatous lymphangitis. Endoscopic examination revealed advanced gastric cancer and the patient was treated with a combination of 40 mg/m2 docetaxel, administered on day 1, and S-1 100 mg/body/day, administered for 14 days followed by a 7-day interval, as 1 course despite her performance status( PS) being grade 3. After 2 courses of chemotherapy, CT showed that the carcinomatous lymphangitis had improved, and the patient was discharged with PS of grade 0. We report that combination chemotherapy with docetaxel and S-1 might be effective for the treatment of advanced gastric cancer with carcinomatous lymphangitis of the lung in patients with a poor systemic condition. Source

Matsumoto T.,National Institute of Mental Health | Ozaki S.,Tokyo Metropolitan Toshima Hospital | Kobayashi O.,Kanagawa Psychiatric Center | Wada K.,National Institute of Mental Health
Activitas Nervosa Superior

The purpose of the present study is to examine the current situation of sedative-related disorders (mainly benzodiazepines) in Japan and the clinical characteristics of Japanese patients with this disorder. Subjects were 671 drug-related disorder patients diagnosed according to the ICD-IO classification as "Fl: mental and behavioural disorders due to psychoactive substance use/7 who abused psychoactive substances other than alcohol. Of all the psychiatric hospitals in Japan between September and October 2010, these drug-related disorder patients had consecutively consulted or were admitted to 153 psychiatric hospitals. The present study was conducted by means of a mail survey. Subjects7 clinical information, including history of psychoactive substance use, means of access to the primary drug of abuse, other ICD-10 diagnoses including Fl subcategory and comorbid psychiatric disorders, and recent history of self-destructive behavior, were collected from the attending psychiatrists of each subject. The data thus gathered concerning sedative-related disorder patients were compared with those patients with methamphetamine-related disorder, which has been the most serious drug-related problem in Japan since the 1950s. Out of the 671 subjects, 119 patients mainly abusing sedatives (the SRD group) were identified, while 361 patients were identified as mainly abusing methamphetamine (the MRD group). The MRD group was the largest population (53.8% of the total subjects), followed by the SRD group (17.7%), the inhalant-related disorder group with 56 patients (8.3%), and so on. Compared with the MRD group, the SRD group was younger, contained more female patients, and had a lower incidence of history of involvement with anti-social societies and anti-social behavior. Patients of the SRD group were more likely to have started abusing drugs with the intention of reducing the unpleasant symptoms of insomnia (42.9%), anxiety (26.1%), and depression (16.0%), and to acquire the drugs they abused from medical institutions such as psychiatric or primary care clinics (82.1%), while patients of the MRD group were more likely to have started out of curiosity (35.1%) or in response to peer pressure (47.1%), and to acquire their drugs from a "pusher77 (32.8%). Additionally, in the SRD group, the ICD-10 [Translated with permission from Seishinshinkeigaku-zasshi (Psychiatria et Neurologia Japonica), vol. 113, 1184- 1198, 2011] Fl subcategory diagnoses that were clinically most important were "dependence syndrome" (64.0%), "harmful use" (16.2%) and "acute intoxication" (16.2%), while the most important subcategory diagnosis in the MRD group was "psychotic disorder" (34.3%) and "residual disorder and late-onset psychotic disorder" (32.9%). Further, comorbid psychiatric disorders were more frequently found in the SRD group than in the MRD group; notably, co-occurrence of mood disorder was found in 45.0% of the SRD group in contrast to the MRD group (11.9%). Recent episodes of deliberate self-harm behavior were also more frequently found in the SRD group than the MRD group (33.6% vs. 10.5%); the major means by which these patients harmed themselves was by overdosing on prescribed drugs (23.5% vs. 4.7%). The present study suggests that sedative-related disorder is an important clinical issue in the field of drug-related disorders in Japan today, and that SRD patients may represent a distinct type of drug abusers whose clinical characteristics are different from those of MRD patients. The development and spread of treatment programs for "dependence syndrome" and "harmful use" will help SRD patients, and educating psychiatrists about SRD will help prevent future sedative abuse. © 2015, Neuroscientia o.s. All Rights Reserved. Source

Nakamura M.,Tokyo Metropolitan Toshima Hospital
Gan to kagaku ryoho. Cancer & chemotherapy

A 69-year-old male was operated on sigmoidectomy for sigmoid colon cancer (SS, N2, H0, P0, M0, stage IIIb) 7 years ago. Two years later, he was diagnosed for rectal cancer and bilateral lung metastases by TBLB. We performed Mile's operation, and the rectal focus was pathologically diagnosed with a recurrence of sigmoid colon cancer. After surgery, chemotherapy with FOLFOX was started for bilateral lung metastases, resulting in CR during the 22 months. But bilateral lung metastases were exacerbated, and then we administered several other chemotherapies. Five years have passed since chemotherapy started, although the focuses tended to progress. Right now, he has been a chemotherapy outpatient for last 5 years. Source

Nagahama T.,Tokyo Metropolitan Toshima Hospital
Gan to kagaku ryoho. Cancer & chemotherapy

We have experienced a case of esophageal carcinoma developing esophago-bronchial fistula that was successfully treated by esophageal bypass surgery followed by chemo-radiation. A man aged 64 years old with developed esophago- bronchial fistula after initial chemo-radiation was undergone a gastric bypass surgery to separate esophagus and bronchus. Though closure of fistula was just 4 months after definitive chemo-radiation, an oral feeding was possible until the death of the patient. Stent placement for esophageal carcinoma was less invasive treatment though chemo-radiation after a stent placement was accompanied by high incidence of stent associated morbidity. Since esophageal bypass surgery can definitely separate airway from esophagus, chemo-radiation with oral feeding can be easily carried out. Esophageal bypass surgery was a treatment recommendation for the patient with esophageal carcinoma invading trachea or bronchus. Source

Ami K.,Tokyo Metropolitan Toshima Hospital
Gan to kagaku ryoho. Cancer & chemotherapy

The treatment of hepatic metastasis of colon cancer was in progress by new biochemical agents. Generally, a resection was the first alternative treatment against hepatic metastasis of colon cancer, but new antitumor agents were more effective than conventional antitumor agents. Disappearance of metastasis for colon cancer treated with only antitumor agents was commenced to report. We were experienced a case of transverse colon cancer without a recurrence lesion after five years from the resection of hepatic metastasis. A case was a 77-year-old man. He was operated against transverse colon cancer in February 2003. Pathological stage was ss, n0, Stage II. In April 2004, serum CEA was increased. CT examination was not detected a hepatic metastasis but ultrasound examination and MRI detected the metastasis at S7 lesion in the liver. In July 2004, he was admitted to S-1 and PSK until October 2004. In December 2004, the lesion of hepatic metastasis was reduced and serum CEA was decreased. But in September 2005, the metastatic lesion was re-grown. A resection for hepatic metastasis was executed in November 2005. After the resection for hepatic metastasis, he was admitted to UFT/ UZEL from January 2006 to October 2006. Present time( June 2011), the lesion of recurrence was not detected by several examinations (CT, MRI, Ultrasound etc). Source

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