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Hiroshima Journal of Medical Sciences

Yuta Ibuki, Yoichi Hamai, Jun Hihara, Junya Taomoto, Takaoki Furukawa, Ichiko Yamakita, Morihito Okada
Patients with esophageal cancer often have various comorbidities, and these sometimes limit treatment choices. We describe a patient with stage IA esophageal cancer accompanied by interstitial lung disease (ILD). Endoscopic resection and radiotherapy were not appropriate because of clinically diagnosed submucosal invasion and the patient was at high risk of ILD exacerbation. We therefore selected transhiatal esophagectomy without a thoracotomy considering the risk of postoperative respiratory complications, and administered methylprednisolone and sivelestat in the perioperative period for the reduction of surgical stress...
March 2016: Hiroshima Journal of Medical Sciences
Kenjiro Okada, Takeshi Sudo, Katsunari Miyamoto, Yujiro Yokoyama, Yoshihiro Sakashita, Yasushi Hashimoto, Hironori Kobayashi, Hiroyuki Otsuka, Takuya Sakoda, Fumio Shimamoto
The localization and diagnosis of microgastrinomas in a patient with multiple endocrine neoplasia type 1 is difficult preoperatively. The selective arterial calcium injection (SACI) test is a valid diagnostic method for the preoperative diagnosis of these invisible microgastrinomas. We report a rare case of multiple invisible duodenal microgastrinomas with severe duodenal stenosis diagnosed preoperatively by using the SACI test. A 50-year-old man was admitted to our hospital with recurrent duodenal ulcers. His serum gastrin level was elevated to 730 pg/ml...
March 2016: Hiroshima Journal of Medical Sciences
Junichiro Ochiai, Satoshi Yamaguchi, Masaaki Takeda, Rupendra Bahadur Adhikari, Manish Kolakshyapati, Vega Karlowee, Kazuhiko Sugiyama, Kaoru Kurisu
We report a rare case of neonatal cutaneous meningioma derived from a rudimentary meningocele. This neonate had a congenital skin-covered hump in the thoracolumbar region. Computed tomography showed bifid laminae of T12 and L1 underneath the mass lesion. Magnetic resonance images showed the mass to have no cerebrospinal fluid space and that it had a stalk connecting to the spinal canal. Split cord malformation was also observed under the bifid laminae. Because of the increasing size of the lump and cosmetic reasons, the parents opted for surgical treatment...
March 2016: Hiroshima Journal of Medical Sciences
Yosuke Arima, Kanji Yoshimoto, Akira Namera, Ryosuke Makita, Kazuhiro Murata, Masataka Nagao
Organophosphorus compounds, such as sarin, are highly toxic nerve agents that inhibit acetylcholinesterase (AChE), but not cholinesterase, via multiple mechanisms. Recent studies have shown that organophosphorus compounds increase cyclooxygenase-2 (COX-2) expression and induce neurotoxicity. In this study, we examined the toxicity of the sarin-like organophosphorus agent bis(isopropyl methyl)phosphonate (BIMP) and the effects of BIMP on COX-2 expression in SK-N-SH human neuroblastoma cells. Exposure to BIMP changed cell morphology and induced caspase-dependent apoptotic cell death accompanied by cleavage of caspase 3, caspase 9, and poly (ADP-ribose) polymerase (PARP)...
March 2016: Hiroshima Journal of Medical Sciences
Takashi Nonoshita, Shinya Otsuka, Masaru Inagaki, Hiromi Iwagaki
A 58-year-old woman with advanced gastric cancer underwent total gastrectomy in May 2012. The histological diagnosis was poorly differentiated adenocarcinoma, cT4a (SE), pN1, cM0; fStage IIIA. Chemotherapy by S-1 was started after surgery. Six months after the operation, two metastatic nodules were noticed on the liver. Therefore, the chemotherapy was switched to S-1 plus cisplatin (CDDP) in November 2012. TS-1 (80 mg/body) was administrated from day 1 to 21 followed by 14 days rest as one course. CDDP (70 mg/body) was infused on day 1...
December 2015: Hiroshima Journal of Medical Sciences
Prasanna Karki, Hirofumi Hirano, Hitoshi Yamahata, Shingo Fujio, Hajime Yonezawa, Koji Iida, Manoj Bohara, Tatsuki Oyoship, Ryosuke Hanaya, Kazunori Arita
Langerhans cell histiocytosis (LCH) is a proliferation of Langerhans cells intermixed with inflammatory cells, in particular eosinophils, that may manifest as a unisystem (unifocal or multifocal) or multisystem disease. We describe the clinical and histologic spectrum of LCH of the orbit and skull in our two cases. Both cases had unifocal erosive skull lesions with a history of trauma. Typical histologic features included numerous histiocytes with varying degrees of giant cell formation and scattered eosinophilic granulocytes...
December 2015: Hiroshima Journal of Medical Sciences
Daisuke Komoto, Koji Iida, Toru Higaki, Yoko Kaichi, Komei Takauchi, Koji Arihiro, Akiyoshi Kakita, Yutaka Hirokawa, Kazuo Awai
To compare the diagnostic performance of 18F-FDG PET, 11C-FMZ PET, and 11C-FMZ BP imaging for the evaluation of patients with intractable partial epilepsy whose MRI findings are normal by using statistical imaging analysis. Ten patients underwent comprehensive presurgical evaluation, including PET studies, to assess the epileptic foci. The extent of cortical resection was based on the results of intracranial video-electroencephalography (IVEEG) monitoring and brain mapping under stimulation. The images of 10 patients and 30 controls were spatially normalized to templates generated in-house by non-rigid registration and the standardized images of the patients and controls were statistically compared...
December 2015: Hiroshima Journal of Medical Sciences
Takuya Sakoda, Yoshiaki Murakami, Naru Kondo, Kenichiro Uemura, Yasushi Hashimoto, Naoya Nakagawa, Taijiro Sueda
Mirizzi syndrome is a rare complication of cholelithiasis, which is defined as a common bile duct obstruction due to stones impacted in Hartman's pouch or the cystic duct of the gallbladder. The impacted stones and surrounding inflammation can lead to a biliobiliary fistula. We herein present the case of a 73-year-old Japanese man with a biliobiliary fistula that was diagnosed by peroral cholangiography (POCS). We performed partial cholecystectomy and choledochoplasty as the stone had eroded almost the entire circumference of the bile duct...
September 2015: Hiroshima Journal of Medical Sciences
Manoj Bohara, Sei Sugata, Yosuke Nishimuta, Prasanna Karki, Tetsuya Nagayama, Shigeyuki Sakamoto, Hiroshi Tokimura, Kazunori Arita
Episodic headache is common in childhood moyamoya disease (MMD). The onset, mechanism, cause of headache and the effect of revascularization surgery on headache are not yet clear. We studied 10 cases of children (7 boys and 3 girls) younger than 18 years who underwent revascularization for MMD between 2009 and 2013. We evaluated frequency of headache and cerebral blood flow changes by single photon emission computed tomography brain imaging with [I123]-labeled iofetamine (IMP-SPECT) before and after surgery...
September 2015: Hiroshima Journal of Medical Sciences
Ryuichi Nakanuno, Toshimichi Yasuda, Hiroshi Hamada, Hiroshi Yoshikawa, Ryuji Nakamura, Noboru Saeki, Masashi Kawamoto
Responses to surgical stress can be modulated by anesthetics. We prospectively compared the effects of two different anesthetic/sedative techniques on the peak postoperative bladder temperature (BT) and the postoperative C-reactive protein (CRP) level. Twenty patients who were scheduled to undergo elective thoracoabdominal esophagectomy were allocated to receive either propofol anesthesia followed by propofol sedation (PP group, n = 10) or sevoflurane anesthesia followed by midazolam sedation (SM group, n = 10)...
September 2015: Hiroshima Journal of Medical Sciences
Yoichi Hamai, Jun Hihara, Kazuaki Tanabe, Takaoki Furukawa, Ichiko Yamakita, Yuta Ibuki, Morihito Okada
We describe a 74-year-old man with repeated aspiration pneumonia who developed gastric obstruction due to giant esophageal hiatal hernia (EHH). We repaired the giant EHH by laparoscopic surgery and subsequently anchored the stomach to the abdominal wall by percutaneous endoscopic gastrostomy (PEG) using gastrofiberscopy. Thereafter, the patient resumed oral intake and was discharged on postoperative day 21. At two years after these procedures, the patient has adequate oral intake and lives at home. Because this condition occurs more frequently in the elderly with comorbidities, laparoscopic surgery contributes to minimally invasive treatment...
June 2015: Hiroshima Journal of Medical Sciences
Takahiro Zenda, Tomomi Hagishita, Makio Moriya, Tadashi Kamesui, Junzo Shimizu, Isao Nakanishi
A 55-year-old Japanese man with a history of diverticulitis underwent colonoscopy for careful evaluation of progressive anemia. A 5-mm depressed lesion oozing spontaneously was observed at the hepatic flexure. On suspicion of depressed-type of cancer, right-sided hemicolectomy was performed. Histopathological examination indicated a collapsed lymphangioma exactly over a diverticulum, which had previously been complicated diverticulitis. The colonic mucosa and lymphangioma prolapsed beyond the subserosal layer via the muscularis propria defect, resulting in a depressed lesion and mucosal laceration with hemorrhage...
June 2015: Hiroshima Journal of Medical Sciences
Wataru Fukumoto, Yuko Nakamura, Toru Higaki, Fuminari Tatsugami, Makoto Iida, Kazuo Awai
This retrospective study was to investigate whether adding diffusion-weighted imaging (DWI) to Gd-EOB-DTPA-enhanced MRI (EOB-MRI) improved the detection of liver metastasis in radiology resident and board-certified radiologist groups. It was approved by our institutional review board. We selected 18 patients with 35 liver metastases and 12 patients without liver tumors. Five board-certified radiologists and 5 radiology residents participated in the observer performance study. Each observer first interpreted T1- and T2-weighted-, plain-, arterial phase-, and hepatobiliary phase images and specified the location of the liver metastases...
June 2015: Hiroshima Journal of Medical Sciences
Hideaki Miyaso, Kazuhide Iwakawa, Yuki Hamada, Nanako Yasui, Gou Nishii, Masaaki Akai, Kengo Kawada, Takashi Nonoshita, Hiroki Kajioka, Kenta Isoda, Kouji Kitada, Manabu Nishie, Ryosuke Hamano, Naoyuki Tokunaga, Yosuke Tsunemitsu, Shinya Otsuka, Masaru Inagaki, Hiromi Iwagaki
Colovesical fistula (CVF) resulting from colon diverticulosis is a comparatively rare disease, and neither the diagnosis nor treatment has been established. Our experience with CVF due to sigmoid diverticulitis over a 9-year period was reviewed to clarify the clinical presentation and diagnostic confirmation. Ten patients with CVF were identified in this period, and chief complaints, laboratory findings, presenting symptoms, diagnostic investigations, and subsequent treatments were reviewed. Preoperative urinalysis showing bacteriuria (100%) was the most common presentation, followed by fecaluria (40%), abdominal pain (40%), pneumaturia (30%), hematuria (30%), pain on urination (30%), pollakiuria (10%), and dysuria (10%)...
June 2015: Hiroshima Journal of Medical Sciences
Naomi Nakagawa, Masao Yoshizumi, Masahiro Kamada, Yukiko Ishiguchi
Percutaneous closure of atrial septal defects using an Amplatzer Septal Occluder (ASO) has recently become the procedure of first choice. However, when ASO deployment is difficult, procedures may be prolonged and complications may occur. We investigated a method for identifying cases in which ASO deployment would be difficult. After retrospectively identifying 70 patients (age: 4.1-70.4 years; body weight: 15.6-77.3 kg) who underwent atrial septal defect closure using an ASO in 2007 or later, we classified them into three groups: Group A, implantation by a conventional approach; Group B, implantation by a right upper pulmonary vein approach, and Group C,...
June 2015: Hiroshima Journal of Medical Sciences
Yasutaka Imada, Kiyoshi Yuki, Keisuke Migita, Takashi Sadatomo, Masashi Kuwabara, Toru Yamada, Kaoru Kurisu
Familial cerebral cavernous malformations (FCCM) are autosomal-dominant vascular malformations. At present, 3 cerebral cavernous malformation genes (KRIT1/CCM1, MGC4607/CCM2, and PDCD10/CCM3) have been identified. Few genetic analyses of Japanese FCCM have been reported. A Japanese pedigree of 4 patients with FCCM has been reported that includes the genetic analysis of one of the patients. All 4 patients showed multiple lesions in the brain. Surgical removal was performed at our hospital due to enlargement or hemorrhage of the intracranial lesions in a 21-year-old female (Case 1) and a 30-year-old male (Case 2)...
December 2014: Hiroshima Journal of Medical Sciences
Sayuru Miyamura, Satoshi Yamaguchi, Atsushi Tominaga, Yasuyuki Kinoshita, Masaaki Takeda, Satoshi Usui, Mizuki Morishige, Kazuhiko Sugiyama, Kaoru Kurisu
A transcranial approach in combination with a transpetrosal setting has been the mainstream of surgical treatment of cholesterol granulomas in the petrous apex. However, endoscopic endonasal surgery has become a choice of treatment for these lesions with recent advancements in surgical techniques and instruments. We report a successful case of cholesterol granuloma managed with endoscopic endonasal surgery. A 45-year-old woman, who had a long-standing history of otitis media, presented with left abducens nerve palsy and discomfort around the left eye...
December 2014: Hiroshima Journal of Medical Sciences
Yasufumi Saito, Yuji Takakura, Takao Hinoi, Hiroyuki Egi, Hirotaka Tashiro, Hideki Ohdan
Loop ileostomy is widely employed after low rectal anastomosis to prevent pelvic sepsis from anastomotic leakage. However, stoma closure carries a risk of morbidity and even mortality in some cases. It is important to assess complications after stoma closure for maximizing the benefit of making loop ileostomy. The aim of this study was to review and examine the possible risk factors associated with complications after closure of loop ileostomies. A retrospective analysis, which focused on risk factors for complications after surgery, was performed for 82 consecutive patients who underwent elective closure of loop ileostomy from 2005-2012 at Hiroshima University Hospital...
December 2014: Hiroshima Journal of Medical Sciences
Satomi Aoi, Takashi Miyake, Toshihide Harada, Fumiko Ishizaki, Hiromi Ikeda, Yumiko Nitta, Tadayuki Iida, Chiho Chikamura, Noriko Tamura, Kohsaku Nitta, Hideki Miyaguchi
Subcutaneous fat depots play an important role in regulating metabolic profile in Japanese postmenopausal women. We investigated the possibility of neck circumference (NC) as a surrogate marker for metabolic disease risk estimates in Japanese postmenopausal women. We examined the association of NC with several markers of insulin resistance, lipid metabolism and atherosclerosis in 64 healthy postmenopausal women aged 63.6 ± 7.1 years in community-based samples in Japan. As a result, NC was significantly associated with indices of whole body obesity and visceral fat accumulation, such as body mass index (BMI) and Waist circumference (WC)...
December 2014: Hiroshima Journal of Medical Sciences
Hiroki Takehara, Kazuaki Tanabe, Nobuaki Fujikuni, Hiroyuki Tahara, Kentaro Ide, Yuka Tanaka, Wataru Yasui, Hideki Ohdan
Only a few cases of de novo malignancy, especially gastric cancer after living donor liver transplantation (LDLT), have been reported. We report a case of gastric cancer following LDLT, after which immunosuppressants were minimized in accordance with the results of the mixed lymphocyte reaction (MLR) assay. A 65-year-old woman had previously undergone LDLT for hepatocellular carcinoma associated with hepatitis B virus infection. The liver graft had been donated by her son. During the course of postoperative surveillance with the MLR assay in order to minimize immunosuppressants, she was incidentally found to have gastric cancer during an endoscopic examination, 8 years after the liver transplantation...
September 2014: Hiroshima Journal of Medical Sciences
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