Okazaki, Japan
Okazaki, Japan

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PubMed | Red Cross, Toyohashi Municipal Hospital, Konan Kosei Hospital, Tsushima City Hospital and 5 more.
Type: Clinical Trial, Phase II | Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology | Year: 2016

Perioperative introduction of developed chemotherapy into the treatment strategy for locally advanced rectal cancer (LARC) may be a promising option. However, the most prevalent treatment for high-risk LARC remains preoperative chemoradiotherapy (CRT) in Western countries.A phase II trial was undertaken to evaluate safety and efficacy of perioperative XELOX without radiotherapy (RT) for patients with high-risk LARC. Patients received 4 cycles of XELOX before and after surgery, respectively. Primary endpoint was disease-free survival.We enrolled 41 patients between June 2012 and April 2014. The completion rate of the preoperative XELOX was 90.3%. Twenty-nine patients (70.7%) could start postoperative XELOX, 15 of these patients (51.7%) completed 4 cycles. Allergic reaction to oxaliplatin was experienced by 5 patients (17.2%) during postoperative XELOX. One patient received additional RT after preoperative XELOX. Consequently, the remaining 40 patients underwent primary resection. Major complications occurred in 6 of 40 patients (15.0%). Pathological complete response (pCR) rate was 12.2%, and good tumor regression was exhibited in 31.7%. N down-staging (cN+ to ypN0) and T down-staging were detected in 56.7% and 52.5%, respectively. Clinical T4 tumor was a predictor of poor pathological response (p<0.001).We could show the favorable pCR rate after preoperative XELOX alone. However, the T and N down-staging rate was likely to be insufficient. When tumor regression is essential for curative resection, the use of preoperative CRT is likely to be recommended. For patients with massive LN metastasis, the additional Bev to NAC might be a promising option.


Umeda Y.,Toyohashi Medical Center
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

Between March 2005 and September 2009, 41,827 patients visited our emergency outpatient clinic, and 50 patients (0.12%) were admitted to our institution for chest trauma. Seventy percent of the chest traumas were caused by traffic accidents. Eighty-five percent of the traffic accidents were associated with car driving or motorcycle driving. Rib fracture, pneumothorax, hemothorax, and lung injury were seen in 56%, 40%, 22%, and 28% of the patients, respectively. Chest tube drainage was performed in 36% of the patients. Sixty-two percent of the patients with chest trauma underwent conservative follow-up. Only 1 patient underwent the ligation of the intercostal artery. One patient with chest trauma and fracture of the cervical vertebra and the pelvis died, who was in the state of cardio-pulmonary arrest on arrival. Forty-nine patients were discharged in 15.2 +/- 17.0 days. Twenty-two percent of the patients were hospitalized only 1 night.


Umeda Y.,Toyohashi Medical Center
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

Pleomorphic carcinoma is a rare primary lung cancer with a poor prognosis. We report a surgically treated case of pleomorphic carcinoma of the lung. An abnormal shadow was incidentally detected by computed tomography (CT) scan for an 80-year-old male. CT scan performed 1 month before the detection of tumor was normal. Right upper lobectomy with ND2a was performed after 5 months follow-up by CT scan because of the enlargement of the tumor. Histological examination showed numerous atypical spindle cells with massive necrosis, diagnosing as pleomorphic carcinoma. Only 2 months after operation, multiple metastases to the lung, chest wall, pleura, and small intestine were found.


We report a case in which the double-patch technique was used to repair residual shunt after infarct exclusion technique for post-infarction ventricular septal perforation (VSP). A 68-year-old man was diagnosed with post-infarction VSP and surgical interveniton was performed by infarct exclusion technique through left ventriculotomy. Residual shunt was observed by left ventriculography, and he developed cardiac failure in spite of medical therapy. Additional surgery for residual shunt was performed 5 months after the initial operation. The VSP was closed with 2 pericardial patches onto both sides of the septum through right ventriculotomy. Complete closure of the defect was accomplished, and no residual shunt was observed by post-operative left ventriculography. The patient has been doing well with no signs of cardiac failure.


Ikeda M.,Nagoya University | Makino R.,Toyohashi Medical Center | Imai K.,Nagoya University
Australasian Physical and Engineering Sciences in Medicine | Year: 2012

We have proposed a direct evaluation method concerning preservation of noise-free components for image noise reduction. This evaluation method is to graphically estimate how well a noise-reduction method will preserve noise-free image components by using the normal probability plot of the image pixel value difference between an original image and its noise-reduced image; this difference is equivalent to the "method noise" which was defined by Buades et al. Further, by comparing the linearity of a normal probability plot for two different noise reduction methods, one can graphically assess which method will be more able to preserve the noise-free component than the other. As an illustrative example of this evaluation method, we have evaluated the effectiveness of the spatially-adaptive BayesShrink noise-reduced method devised by Chang et al., when applied to chest phantom CT images. The evaluation results of our proposed method were consistent with the visual impressions for the CT images processed in this study. The results of this study also indicate that the spatially-adaptive BayesShrink algorithm devised by Chang et al. will work well on the chest phantom CT images, although the assumption for this method is often violated in CT images, and the assumption postulated for the spatially-adaptive BayesShrink method is expected to have sufficient robustness for CT images. © 2012 Australasian College of Physical Scientists and Engineers in Medicine.


PubMed | Toyohashi Medical Center
Type: Journal Article | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

Between March 2005 and September 2009, 41,827 patients visited our emergency outpatient clinic, and 50 patients (0.12%) were admitted to our institution for chest trauma. Seventy percent of the chest traumas were caused by traffic accidents. Eighty-five percent of the traffic accidents were associated with car driving or motorcycle driving. Rib fracture, pneumothorax, hemothorax, and lung injury were seen in 56%, 40%, 22%, and 28% of the patients, respectively. Chest tube drainage was performed in 36% of the patients. Sixty-two percent of the patients with chest trauma underwent conservative follow-up. Only 1 patient underwent the ligation of the intercostal artery. One patient with chest trauma and fracture of the cervical vertebra and the pelvis died, who was in the state of cardio-pulmonary arrest on arrival. Forty-nine patients were discharged in 15.2 +/- 17.0 days. Twenty-two percent of the patients were hospitalized only 1 night.


PubMed | Toyohashi Medical Center
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

We report a case in which the double-patch technique was used to repair residual shunt after infarct exclusion technique for post-infarction ventricular septal perforation (VSP). A 68-year-old man was diagnosed with post-infarction VSP and surgical interveniton was performed by infarct exclusion technique through left ventriculotomy. Residual shunt was observed by left ventriculography, and he developed cardiac failure in spite of medical therapy. Additional surgery for residual shunt was performed 5 months after the initial operation. The VSP was closed with 2 pericardial patches onto both sides of the septum through right ventriculotomy. Complete closure of the defect was accomplished, and no residual shunt was observed by post-operative left ventriculography. The patient has been doing well with no signs of cardiac failure.


PubMed | Toyohashi Medical Center
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

A 66-year-old man was admitted to our hospital with a diagnosis of advanced gastric cancer, with a tumor embolus in the portal vein and lymph node metastases. Since curative surgery was deemed impossible, we started neoadjuvant chemotherapy using S-1 plus CDDP. After 1 course of chemotherapy, the embolus in the portal vein disappeared. After additional chemotherapy, the primary tumor and lymph nodes were reduced in size, and a total gastrectomy with splenectomy and lymph node dissection was performed. Although he received S-1 medication as adjuvant chemotherapy, a tumor embolus in the portal vein appeared 8 months after the operation. Chemoradiotherapy(S-1+total of 50.4 Gy)was performed and the tumor embolus disappeared.


PubMed | Toyohashi Medical Center
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2014

We report a case of coronary artery bypass grafting for acute myocardial infarction which presented as cardio-pulmonary arrest during a marathon race. A 57-year-old man collapsed at the 18-km point in the Toyohashi half marathon. He was treated with an automated electrical defibrillator( AED) for ventricular fibrillation in an ambulance. Immediately after arriving at our emergency department, he was diagnosed with acute myocardial infarction by electrocardiography. Emergency coronary angiography revealed severe stenosis of the left anterior descending artery. Percutaneous coronary intervention was tried, but it was given up because calcification of the stenotic lesion was severe. He was then referred to our department for emergency coronary artery bypass grafting. Complete re-vascularization was accomplished and the patient has been doing well with no signs of angina.


PubMed | Toyohashi Medical Center
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

Pleomorphic carcinoma is a rare primary lung cancer with a poor prognosis. We report a surgically treated case of pleomorphic carcinoma of the lung. An abnormal shadow was incidentally detected by computed tomography (CT) scan for an 80-year-old male. CT scan performed 1 month before the detection of tumor was normal. Right upper lobectomy with ND2a was performed after 5 months follow-up by CT scan because of the enlargement of the tumor. Histological examination showed numerous atypical spindle cells with massive necrosis, diagnosing as pleomorphic carcinoma. Only 2 months after operation, multiple metastases to the lung, chest wall, pleura, and small intestine were found.

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