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Tomakomai, Japan

Ohata Y.,Tomakomai City Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society

A 50-year-old man with a history of asbestos inhalation developed symptoms related to a metastatic brain tumor was admitted. Chest X-ray images showed an opacity in the left lower lung field. We were unable to differentiate between lung cancer and malignant pleural tumor using either transbronchial lung biopsy or computed tomography (CT)-guided needle biopsy. After 3 months the patient died from rapid disease progression despite radiation therapy, drainage of large quantities of the pleural effusion and chemotherapy. A diagnosis of asbestos-related pleomorphic carcinoma of the lung was made after autopsy and immunohistochemical examination of the tumor. Source

Koike R.,Tokyo Medical and Dental University | Tanaka M.,Tokyo Medical and Dental University | Komano Y.,Tokyo Medical and Dental University | Sakai F.,Saitama University | And 16 more authors.
Pulmonary Pharmacology and Therapeutics

Background: Tacrolimus (TAC) was approved in Japan in 2005 for rheumatoid arthritis (RA) patients having inadequate response to other disease-modifying anti-rheumatic drugs. As of May 2007, spontaneous reports identified twenty-seven cases of exacerbation or new development of interstitial pneumonia among RA patients given TAC in Japan. Objective: To describe the clinical and radiological characteristics of TAC-induced pulmonary injury (TIPI). Patients and methods: Eleven RA patients diagnosed with de novo pulmonary injury or exacerbation of IP during treatment with TAC were identified. Clinical, radiological, and laboratory data of ten of these cases were retrospectively analyzed. Results: Baseline data for the ten patients were a mean age of 69.7 years; gender, 70% female; mean RA disease duration, 9.1 years; and pulmonary comorbidities, 90%. Six cases were classified as presumptive TAC-induced pulmonary injury (TIPI) and four as probable TIPI. Among the six presumptive cases, TIPI developed at an average of 84 days after initiation of treatment (n = 5) or four days after reinstitution of TAC (n = 1). Five cases were an exacerbation of pre-existing interstitial pneumonia and one was a de novo pulmonary injury. Radiological patterns of thoracic computed tomography (CT) scans of patients in the presumptive TIPI cases were hypersensitivity pneumonia like-pattern (n = 3), ground-glass opacity (n = 2), and organizing pneumonia-pattern (n = 1). All patients with presumptive TIPI were treated with high dosage glucocorticosteroids and one received concomitant immunosuppressants. Two of the six presumptive TIPI patients died. Conclusion: Rheumatologists should be aware of this rare but potentially life-threatening adverse event in RA patients receiving TAC. © 2011 Elsevier Ltd. Source

Tsushima N.,Tomakomai City Hospital | Kuroda T.,Tomakomai City Hospital
Practica Oto-Rhino-Laryngologica

Between July 2008 and November 2012, we treated 4 patients with cervical node metastasis from unknown primary sites (CUP) and 1 patient suspected as having CUP. Every patient who was diagnosed as having CUP underwent random biopsy, bilateral tonsillectomy, neck dissection and radiotherapy. No primary lesion was detected by the random biopsy or tonsillectomy. Two patients died of distant metastasis and the other 3 patients are surviving, including 1 patient in whom investigation is ongoing. In all five cases, the histopathological diagnosis of cervical lymph node was squamous cell carcinoma. Extracapsular spread was found in 3 cases. The 2 patients who died of distant metastasis had invasion of the blood vessels. Source

Nakatsumi H.,Wakkanai City Hospital | Nakatsumi H.,Hokkaido University | Komatsu Y.,Hokkaido University | Yuki S.,Hokkaido University | And 10 more authors.

Background: Indisetron is a serotonin (5-hydroxytryptamine type 3) receptor antagonist that also antagonizes 5-hydroxytryptamine type 4 receptors. We designed a pilot study in order to explore the optimal dosing period for indisetron during modified FOLFOX6 (mFOLFOX6). Patients and Methods: Forty-two chemotherapy-naive patients with advanced colorectal cancer scheduled to receive mFOLFOX6 were randomly assigned to either a 1- or 3-day indisetron regimen arm. The primary endpoint was complete protection from vomiting. Results: Proportions of patients with complete protection from vomiting were 85.7% [95% confidence interval (CI) 63.7-97.0] with the 3-day regimen and 81.0% (95% CI 58.1-94.6) with the 1-day regimen. Proportions of patients with complete protection from nausea were 47.6% in each arm (95% CI 25.7-70.2). No rescue therapy rates were 66.7% (95% CI 43.0-85.4) versus 57.1% (95% CI 34.0-78.2). No severe adverse events were observed in either arm. Conclusion: Both 1- and 3-day indisetron regimens were feasible for preventing nausea and vomiting induced by mFOLFOX6. © 2012 S. Karger AG, Basel. Source

Suda G.,Hokkaido University | Kudo M.,Sapporo Hokuyu Hospital | Nagasaka A.,Sapporo City General Hospital | Furuya K.,JCHO Hokkaido Hospital | And 20 more authors.
Journal of Gastroenterology

Background: HCV infection in chronic hemodialysis patients is high, has a poor prognosis and high risk of renal graft failure, and requires nosocomial infection control measures. However, options of anti-HCV therapy in such patients are limited and unsatisfactory. In this study, we report effectiveness and safety of HCV-NS5A-inhibitor daclatasvir (DCV) and protease-inhibitor asunaprevir (ASV) combination therapy for hemodialysis patients with HCV infection. Methods: This study was registered at the UMIN Clinical Trials Registry as UMIN000016355. Thirty-four dialysis patients were treated with DCV/ASV combination therapy between January 2015 and November 2015. Of those, 21 patients who were followed more than 12 weeks after treatment ended were included. We evaluated the 12-week sustained virologic response (SVR12) and adverse events during treatment. Results: Of the 21 patients, four had compensated liver cirrhosis and three had resistance-associated variant of NS5A (NS5A RAVs)-Y93H at baseline. Overall, total of 95.5 % (20/21) of the patients achieved SVR12. Of note, all patients with cirrhosis or NS5A RAVs achieved SVR12. One relapser patient at 4 weeks post-treatment had NS3 D168E RAVs at baseline. A total of 20 patients (95.5 %) completed the 24-week therapy. One patient discontinued treatment at week 12 due to ALT elevations and achieved SVR12. Conclusions: DAV and ASV combination therapy for chronic hemodialysis patients with HCV infection was highly effective and well tolerated, even in elderly patients and patients with liver cirrhosis and NS5A-RAVs. © 2016, Japanese Society of Gastroenterology. Source

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