Shimagaki T, Yoshizumi T, Kimura K
… +10 more, Motomura T, Nagatsu A, Okabe H, Itoh S, Harada N, Harimoto N, Ikegami T, Uchiyama H, Soejima Y, Maehara Y
Fukuoka Igaku Zasshi
· 2016 Jun · PMID 29210543
BACKGROUND: Living donor liver transplantation (LDLT) in an elderly recipient is controversial. CASE PRESENTATION: We report a case of LDLT in a 74-year-old female who had decompensated liver cirrhosis and hepatocellular...BACKGROUND: Living donor liver transplantation (LDLT) in an elderly recipient is controversial. CASE PRESENTATION: We report a case of LDLT in a 74-year-old female who had decompensated liver cirrhosis and hepatocellular carcinoma (HCC). She was the oldest recipient who received LDLT in Japan ever. She was rejected for LDLT at a nearby hospital because of her age.We decided to perform LDLT because her general condition was good (the Eastern Cooperative Oncology Group (ECOG) performance status 2 ). The surgery was uncomplicated and the postoperative course was uneventful, and the patient was discharged 35 days after the surgery. Currently she is living at home, and she has maintained a good quality of life. CONCLUSIONS: We believe that a recipient in good general condition is capable of undergoing LDLT despite advanced age.
Tsujita J, Kaku Y, Ichiki T
… +9 more, Eto A, Maemura H, Otsuka A, Nakaie R, Kitagawa N, Morioka Y, Matsuda T, Yoshida M, Furue M
Fukuoka Igaku Zasshi
· 2015 Dec · PMID 27159948
The expression of p16INK4a has been reported to be a significant marker for malignant transformation of epidermal tumors. However, little is known about sweat gland tumors. We examined the immunohistological expression o...The expression of p16INK4a has been reported to be a significant marker for malignant transformation of epidermal tumors. However, little is known about sweat gland tumors. We examined the immunohistological expression of p16INK4a in benign and malignant sweat gland tumors. The ductal and acrosyringial portion of normal eccrine glands were positively stained with p16INK4a while it was negative in the normal epidermis. Moderate to strong expression of p16INK4a was found in 16 of 17 eccrine poromas, 4 of 5 hidradenomas, 3 of 3 syringocystadenoma papilliferums, 2 of 2 mixed tumors, and 3 of 3 syringomas. The p16INK4a expression was observed focally or diffusely in 4 of 4 porocarcinomas, 4 of 4 apocrine carcinomas and 12 of 17 extramammary Paget's diseases. We conclude that the p16INK4a expression is not a good marker for dictating malignant transformation of sweat gland tumors.
Kubo Y, Ohishi M, Nakashima Y
… +4 more, Okazaki K, Fukushi J, Oyamada A, Iwamoto Y
Fukuoka Igaku Zasshi
· 2015 Dec · PMID 27159947
PURPOSE: Tumor necrosis factor inhibitors (TNFi) such as infliximab (IFX) and adalimumab have been shown to be efficacious not only for rheumatoid arthritis but also for Ankylosing Spondylitis (AS). However, only a limit...PURPOSE: Tumor necrosis factor inhibitors (TNFi) such as infliximab (IFX) and adalimumab have been shown to be efficacious not only for rheumatoid arthritis but also for Ankylosing Spondylitis (AS). However, only a limited number of reports regarding the effect of TNFi on AS in Japanese population have been published. MATERIALS AND METHODS: We retrospectively evaluated all 11 patients (8 males and 3 females) with AS who were treated with IFX. RESULTS: After a mean follow-up period of 19 months, the mean BASDAI decreased from 4.7 ± 2.2 to 1.7 ± 1.2 and the serum CRP level decreased from 1.62 ± 1.94 mg/dl to 0.23 ± 0.45 mg/dl. There was no case of serious infection or anaphylaxis. CONCLUSIONS: Our results indicate that IFX is efficacious and safe for AS in Japanese patients.
Ikematsu H, Chong Y, Shirane K
… +7 more, Toh H, Sasaki H, Matsumoto S, Noda N, Hotta T, Uchiumi T, Kang D
Fukuoka Igaku Zasshi
· 2016 May · PMID 29210538
BACKGROUND: Neuraminidase (NA) is a surface protein essential for influenza virus replication. NA inhibitors are commonly used for the treatment of influenza patients in Japan. Several mutations that reduce the effect of...BACKGROUND: Neuraminidase (NA) is a surface protein essential for influenza virus replication. NA inhibitors are commonly used for the treatment of influenza patients in Japan. Several mutations that reduce the effect of NA inhibitors have been reported. We sequenced the whole NA segment of isolated virus from influenza patients and investigated the relation between the NA amino acid sequence and the 50％ inhibitory concentration (IC_50) of four NA inhibitors. MATERIALS AND METHODS: Forty A/H3N2 and 19 B influenza virus isolated from patients in the 2014/15 influenza season were analyzed. The IC_50 was determined by a neuraminidase inhibition assay using a fluorescent substrate. Viral RNA was amplified by RT-PCR and the genome was sequenced using a next generation sequencer. The deduced amino acid sequences were analyzed. RESULTS: There was no AA change in the NA catalytic site of the A/H3N2 and B viruses isolated in the 2014-15 influenza season. There was no significant relation between the NA amino acids and the IC_50 of the four NA inhibitors for A/H3N2 or B viruses. CONCLUSION: The catalytic site of NA was highly conserved for these A/H3N2 and B viruses. No emergence of NA amino acid mutations related to the sensitivity of the four currently used NA inhibitors was observed.
Shimogawa T, Morioka T, Hagiwara N
… +7 more, Akiyama T, Sayama T, Haga S, Furuta Y, Murao K, Kanazawa Y, Arakawa S
Fukuoka Igaku Zasshi
· 2015 Nov · PMID 27044137
UNLABELLED: Abstract BACKGROUND AND PURPOSE: Patients with severe intracranial hemorrhage (ICH) often develop infectious complications during the acute stage. Animal experiments have demonstrated that enteral immunonutri...UNLABELLED: Abstract BACKGROUND AND PURPOSE: Patients with severe intracranial hemorrhage (ICH) often develop infectious complications during the acute stage. Animal experiments have demonstrated that enteral immunonutrition with a dietary fluid containing whey peptide (WP) enhances immunoactivity and prevents infection. The aim of the current study was to investigate the infection control effect of WP in the clinical management of patients with severe ICH. METHODS: Fourteen patients with ICH were given enteral nutrition from January 2012 to December 2012. Nine patients were given WP (WP group) and the other five were given control dietary fluid (Non-WP group) for two weeks. We retrospectively analyzed the incidence of infectious complications and chronological changes in white blood cell (WBC) count, C-reactive protein (CRP), and total lymphocyte count. RESULTS: All patients in the Non-WP Group experienced infectious complications, whereas 5 out of 9 patients in the WP Group did not experience them. There was a tendency for a decrease in WBC count and CRP value in the WP group. In contrast, WBC and CRP increased in 3 patients in the Non-WP Group. Total lymphocyte count tended to increase earlier in the WP Group; however this tendency was not noted in the Non-WP Group. CONCLUSION: Although the number of cases was small, our study suggests that WP might have an infection control effect, capable of preventing infectious complications associated with severe ICH in the acute stage.
Katafuchi T, Hossain MS, Mineno K
… +1 more, Mohamed FA
Fukuoka Igaku Zasshi
· 2015 Nov · PMID 27044136
The bioactive lipids plasmalogens (Pls), especially the ethanolamine types, PlsEtn, are found to be enriched in the central nervous system (CNS). Previous reports showed that the brain and serum Pls levels were reduced i...The bioactive lipids plasmalogens (Pls), especially the ethanolamine types, PlsEtn, are found to be enriched in the central nervous system (CNS). Previous reports showed that the brain and serum Pls levels were reduced in Alzheimer's disease (AD). However, the role of the Pls in AD is mostly elusive. Furthermore Pls have been suggested to have pathophysiological significance in ageing and stress responses in the CNS, which often involve neuroinflammation characterized by glial cell activation. Focusing on these lipids function in the murine brain, we first show that Pls can ameliorate microglial activation induced by systemic inflammatory stimuli. Then their protective effects on the neuronal cell death are demonstrated. The precise mechanism of how these lipids function in the brain is now under investigation but our study will reveal the myth of these crucial lipid components in the CNS. Future study also could suggest novel therapeutics to safeguard our brain from various stresses including ageing, neuroinflammation as well as the memory disturbance in AD.
Komori K, Nakamura K, Ihara E
… +4 more, Iwasa T, Hirahashi M, Oda Y, Takayanagi R
Fukuoka Igaku Zasshi
· 2016 Apr · PMID 29210540
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has become a standard procedure for the resection of early gastric cancer (EGC). However, the feasibility of ESD for very elderly patients, aged ≥ 80 years, has not...BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has become a standard procedure for the resection of early gastric cancer (EGC). However, the feasibility of ESD for very elderly patients, aged ≥ 80 years, has not been determined. METHODOLOGY: The study population included 67 non-elderly (NE) patients aged ≤ 65 years (80 lesions) and 22 very elderly (VE) patients ≥ 80 years (26 lesions) with EGC who underwent ESD and met the criteria for absolute or expanded indications. Eighteen patients (18 lesions) who underwent ESD but did not meet the criteria for absolute and expanded indications were defined as the outside the indications (OI) group. RESULTS: En bloc and complete resection rates were excellent in both the VE and NE groups, without differing significantly. Although the rates of ischemic heart disease and antithrombotic agent use were higher in the VE than in the NE group, procedure-related complication rates did not differ significantly. Of the seven very elderly patients in the OI group, two underwent additional gastrectomy, and the other five were followed-up without surgery. No patient in any group experienced local recurrence, metastasis or disease-specific death. CONCLUSIONS: Short- and long-term outcomes of ESD for VE patients with EGC were favorable and did not differ significantly from outcomes in NE patients. ESD may therefore be a good therapeutic option for both VE and NE patients with EGC.
Terawaki Y, Murase K, Motonaga R
… +6 more, Tanabe M, Nomiyama T, Shakado S, Mizoguchi M, Sakisaka S, Yanase T
Fukuoka Igaku Zasshi
· 2016 Mar · PMID 29115108
A 38-year-old man diagnosed with craniopharyngioma at 8 years old underwent repeated surgery and radiation therapy. Complications included panhypopituitarism including growth hormone deficiency and hypogonadism at 13 yea...A 38-year-old man diagnosed with craniopharyngioma at 8 years old underwent repeated surgery and radiation therapy. Complications included panhypopituitarism including growth hormone deficiency and hypogonadism at 13 years old. At 26 years of age, a slight fatty liver was found, which finally developed into liver cirrhosis (LC) at 35 years old. Viral infection or other etiologies causing LC were negative on serum examinations. Liver biopsy suggested a possibility of burn-out non-alcoholic steatohepatitis. This case indicates that a long-standing growth hormone deficiency and hypogonadism may lead to LC as a type of burn-out non-alcoholic steatohepatitis.
Kusumoto E, Ota M, Tsutsumi N
… +5 more, Hashimoto K, Egashira A, Sakaguchi Y, Kusumoto T, Ikejiri K
Fukuoka Igaku Zasshi
· 2015 Oct · PMID 26817055
We herein report a case involving a 70-year-old man who was diagnosed with early gastric cancer that occurred after coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA) for effort-induced a...We herein report a case involving a 70-year-old man who was diagnosed with early gastric cancer that occurred after coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA) for effort-induced angina. He was successfully treated by laparoscopic surgery. Preoperative cardiac three-dimensional computed tomography and coronary angiography showed an occlusion of the RGEA graft, which could lead to ligation of the RGEA to dissect the lymph nodes along the RGEA. The laparoscopic approach helps to identify and avoid injury to the RGEA graft because of its enlarged and precise viewing field compared with laparotomy followed by retractor placement. Laparoscopic surgery is a useful method in such cases to reduce perioperative complications risk.
Kusumoto E, Sugiyama M, Ota M
… +7 more, Tsutsumi N, Kimura Y, Hashimoto K, Egashira A, Sakaguchi Y, Kusumoto T, Ikejiri K
Fukuoka Igaku Zasshi
· 2015 Sep · PMID 26742219
Laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) was performed in consecutive three patients for whom it was unable to place a percutaneous endoscopic gastrostomy (PEG). The mean operation time was 40.3...Laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) was performed in consecutive three patients for whom it was unable to place a percutaneous endoscopic gastrostomy (PEG). The mean operation time was 40.3 min, and mean blood loss was 1.3 g. Three trocars were placed, two for working and another for endoscopy, and a PEG was established by an usual Introducer method. There were no complications both intra- and post-operatively. LAPEG might be a safe alternative when the application of PEG is difficult.
Okadome J, Matsumoto T, Aoyagi Y
… +11 more, Matsuda D, Tanaka S, Kawakubo E, Kyuragi R, Morisaki K, Homma K, Iwasa K, Ohmine T, Guntani A, Fukunaga R, Maehara Y
Fukuoka Igaku Zasshi
· 2015 Sep · PMID 26742218
OBJECTIVE: To evaluate the efficacy of hybrid procedure for peripheral arterial disease (PAD), we compared the cases treated using the hybrid procedure with those treated using open revascularization (bypass alone) in ou...OBJECTIVE: To evaluate the efficacy of hybrid procedure for peripheral arterial disease (PAD), we compared the cases treated using the hybrid procedure with those treated using open revascularization (bypass alone) in our facilities. MATERIALS AND METHODS: We retrospectively reviewed 204 patients who underwent revascularization for PAD between 2007 and 2013. We divided the patients into two groups based on the type of procedure. Group 1 included patients who underwent the hybrid procedure, that is, doing endovascular therapy (EVT) either femoral or iliac resion and added the bypass procedure (infragenicular vein bypass) to the below knee artery, and group 2 included patients who underwent only bypass procedure (used autovein), that is, central anastomotic region was femoral artery region and peripheral anastomotic region was below knee artery. We evaluated various factors between the two groups, including the primary patency rate, secondary patency rate, amputation-free survival rate, and determined the efficacy of the hybrid procedure for PAD. RESULTS: In the patient's characteristics, there was significant difference between the two groups in the cases with cerebrovascular disease, only (p = 0.03). There were no significant differences in the primary or secondary patency rates, and the amputation-free survival rate. CONCLUSIONS: Primary patency rate, secondary patency rate, and amputation-free survival rate of the hybrid procedure were comparable to those of bypass (alone) procedure. The hybrid procedure is therefore an acceptable strategy for patients with PAD.