Niigata-shi, Japan
Niigata-shi, Japan

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Sawatsubashi T.,Tsubame Rosai Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

We evaluated the effects of stenting for malignant bowel obstruction in terminally ill cancer patients. Six terminally ill cancer patients with malignant bowel obstruction underwent gastrointestinal stenting at our department from November 2010 to October 2012. Stent insertion was successful and abdominal symptoms improved in all cases. Oral intake improved in 4 cases. Descending colon perforation occurred in 1 case. The survival time ranged between 10 and 184 days( median, 71.5 days). The palliative performance status (PPS) improved in 4 cases, and the survival time was extended as assessed by the palliative prognostic index (PPI). In cases with a PPI of were more than 6.0, namely cases for which the estimated survival time was less than 3 weeks, survival time and oral intake did not change. These findings suggest that gastrointestinal stenting is clinically useful for malignant obstruction and improving the PPS and prognosis in terminally ill patients with malignant bowel obstruction.


Kanda T.,Tsubame Rosai Hospital | Ishikawa T.,Niigata University | Takahashi T.,Osaka University | Nishida T.,Osaka Police Hospital
Expert Opinion on Pharmacotherapy | Year: 2013

Introduction: Imatinib, a selective tyrosine kinase inhibitor (TKI), is currently the standard treatment for unresectable and metastatic gastrointestinal stromal tumors (GISTs). However, the disease control time by imatinib is limited due to intolerance or resistance. Nilotinib, a second-generation TKI, is expected to show enhanced clinical efficacy against advanced GIST. Areas covered: PubMed and ClincalTrial.gov were searched to identify clinical trials of nilotinib for GIST. The key words used were GIST and nilotinib and/or AMN107. This review summarizes the clinical trials of nilotinib for advanced GIST and outlines current understanding of the clinical usefulness of nilotinib in GIST therapy. Expert opinion: Clinical trials of nilotinib for advanced GIST were readily advanced from a Phase I study to Phase III studies. Unfortunately, the clinical utility of nilotinib was not demonstrated by the randomized control trials either in patients with imatinib-resistant GIST or in patients who used nilotinib as the first-line treatment. On the basis of the trial results, nilotinib is not recommended for GIST therapy generally. Nevertheless, a comparable number of patients showed significant response with different side-effect profiles from imatinib. Thus, this new TKI may still merit attention as an important alternative to imatinib in advanced GIST patients who are intolerant to imatinib. © 2013 Informa UK, Ltd.


Nakatsuka H.,Tsubame Rosai Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

Rupture of a pseudoaneurysm after pancreaticoduodenectomy is a fatal complication. To prevent this, we used the round ligament of the liver to separate the hepatic artery from pancreatic anastomosis, obtaining good results. The procedure involved detaching the round ligament of the liver from the abdominal wall during laparotomy and winding it from the proper and common hepatic artery mainly on a gastroduodenal artery stump after reconstruction. Postoperative computed tomography (CT) scan revealed that a thick layer of fat separated the hepatic artery from the abdominal abscess. We retrospectively analyzed 56 patients who had undergone pancreaticoduodenectomy at Tsubame Rosai Hospital from 2003 until 2012. The round ligament was used for 22 patients( ligament group) and was not used for 34 patients( non-ligament group). There was no difference in morbidity from intra-abdominal abscess and pancreatic fistula between the ligament and non-ligament group. Intra-abdominal hemorrhage occurred in 2 patients( 5.9%) in the non-ligament group but did not occur in the ligament group. We believe that this procedure is easy and useful for the prevention of post-pancreatectomy hemorrhage.


Iwasaki T.,Tsubame Rosai Hospital | Nagashima A.,Tsubame Rosai Hospital | Nakatsuka H.,Tsubame Rosai Hospital | Ogata N.,Tsubame Rosai Hospital
Internal Medicine | Year: 2016

Localized hepatic tuberculosis (LHTB) is difficult to diagnose preoperatively, and most cases of LHTB are diagnosed based on pathological findings. A relationship between imaging features and the pathological stage of hepatic tuberculosis (TB) has recently been reported, which could aid in the diagnosis of hepatic TB. We herein present a case study of a patient with LHTB diagnosed postoperatively who demonstrated imaging changes due to the progression of TB. An awareness of the presence of LHTB might have permitted a preoperative diagnosis. This is the first report of an LHTB patient who exhibited imaging changes during the course of the disease. © 2016 The Japanese Society of Internal Medicine.


Matsuzaki H.,Tsubame Rosai Hospital
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2012

We evaluated the injuries, survival rats, and secondary surgeries of patients who had undergone finger replantation or revascularization between October 2005 and July 2010. The 70 digits came from 43 patients (average age, 46 years; range, 19 to 78 years; 37 men). Overall replantation survival rate was 94%; 93% (27/29) for complete amputations and 95% (39/41) for near-amputations. In all, 39 digits from 21 patients required 48 secondary surgeries; skin grafts, tenolysis, joint fusion, bone graft, osteotomy, and web plasty. The more proximal or more severe the injuries, the higher the need of secondary surgeries. The most common surgery soon after replantation was skin coverage; the most common after two months was tendon surgery. Primary repair must be adequate to restore the function and appearance of amputated digits; however, the possible need for secondary surgeries must be kept in mind to avoid restricting the options for secondary procedures.


Sawatsubashi T.,Tsubame Rosai Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

We report a case of a 41-year-old woman who underwent mastectomy and axillary lymph node dissection for right breast cancer(T3N3cM0) in 2004. She was treated with chemotherapy for multiple bone metastases and recurrence in the iliopsoas from January 2008. Right chest wall recurrence was observed in May 2010 and it progressed to ulcer. She was admitted to our hospital complaining of dyspnea on December 2, 2011. We diagnosed open pneumothorax and inserted a chest tube, and then packed the ulcer. No recurrence was observed in the liver and lungs. After stabilization of her general condition, we performed chest wall resection and reconstruction with a latissimus dorsi flap. She was discharged 2 weeks after surgery without severe complications. Although there were distant metastases, this surgical procedure may be effective for patients with open pneumothorax from recurrent breast cancer in order to maintain quality of life.


Ichikawa H.,National Cancer Center Research Institute | Ichikawa H.,Niigata University | Kanda T.,Niigata University | Kanda T.,Tsubame Rosai Hospital | And 5 more authors.
Journal of Proteome Research | Year: 2013

To reveal the proteomic background of lymph node metastasis (LNM) in gastric cancer, we performed a proteomic study of tumor and matched nontumor tissues obtained from surgically resected specimens of 22 patients with or without LNM. Using laser microdissection, we recovered specific populations of tumor and nontumor cells. We used two-dimensional difference gel electrophoresis with a large format electrophoresis apparatus to obtain protein expression profiles consisting of 3228 protein spots, and we classified them according to their expression pattern. We found that macrophage-capping protein (CapG) was up-regulated in the tumor tissues of patients with LNM, whereas it showed an equivalent expression level between nontumor and tumor tissues of patients without LNM. It was reported that CapG associated with invasion and metastasis in various malignancies. However, CapG was not investigated in gastric cancer until our study. Western blotting of the laser microdissected tissue samples confirmed up-regulation of CapG in the tumor tissues of patients with LNM. Functional assays demonstrated that CapG promoted tumor cell invasion, but not cell proliferation. The association between CapG expression and LNM is a novel finding in gastric cancer. Further investigation for a prognostic utility of CapG may lead to a risk stratification therapy for gastric cancer. © 2013 American Chemical Society.


PubMed | Tsubame Rosai Hospital
Type: Journal Article | Journal: Expert opinion on pharmacotherapy | Year: 2013

Imatinib, a selective tyrosine kinase inhibitor (TKI), is currently the standard treatment for unresectable and metastatic gastrointestinal stromal tumors (GISTs). However, the disease control time by imatinib is limited due to intolerance or resistance. Nilotinib , a second-generation TKI, is expected to show enhanced clinical efficacy against advanced GIST.PubMed and ClincalTrial.gov were searched to identify clinical trials of nilotinib for GIST. The key words used were GIST and nilotinib and/or AMN107. This review summarizes the clinical trials of nilotinib for advanced GIST and outlines current understanding of the clinical usefulness of nilotinib in GIST therapy.Clinical trials of nilotinib for advanced GIST were readily advanced from a Phase I study to Phase III studies. Unfortunately, the clinical utility of nilotinib was not demonstrated by the randomized control trials either in patients with imatinib-resistant GIST or in patients who used nilotinib as the first-line treatment. On the basis of the trial results, nilotinib is not recommended for GIST therapy generally. Nevertheless, a comparable number of patients showed significant response with different side-effect profiles from imatinib. Thus, this new TKI may still merit attention as an important alternative to imatinib in advanced GIST patients who are intolerant to imatinib.


PubMed | Tsubame Rosai Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

We report a case of portal vein stenosis due to pancreatic cancer recurrence that was successfully treated with intravenous stent implantation. The patient was a 70-year-old man who had undergone a subtotal stomach-preserving pancreatoduodenectomy with the modified Child method for pancreatic cancer. He was readmitted due to melena, dorsal pain, and severe ascites 8 months after the operation. Computed tomography (CT) findings revealed that pancreatic cancer recurrence had narrowed the portal vein. Neither gastrointestinal nor colon endoscopy could locate the source of gastrointestinal bleeding. Bleeding from the varices increased, and a hepatopetal collateral was considered to be the cause. We therefore placed an intravenous stent at the site of portal vein stenosis, by the transileocolic portal vein. After the stent placement, no further gastrointestinal hemorrhagic episodes occurred.


PubMed | Tsubame Rosai Hospital
Type: Case Reports | Journal: Internal medicine (Tokyo, Japan) | Year: 2016

Localized hepatic tuberculosis (LHTB) is difficult to diagnose preoperatively, and most cases of LHTB are diagnosed based on pathological findings. A relationship between imaging features and the pathological stage of hepatic tuberculosis (TB) has recently been reported, which could aid in the diagnosis of hepatic TB. We herein present a case study of a patient with LHTB diagnosed postoperatively who demonstrated imaging changes due to the progression of TB. An awareness of the presence of LHTB might have permitted a preoperative diagnosis. This is the first report of an LHTB patient who exhibited imaging changes during the course of the disease.

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