[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to examine clinical features and treatment modality approaches in patients with chronic obstructive pulmonary disease (COPD), particularly in those aged 80 years and older. Using databases available at Mito Kyodo General Hospital (Japan), the medical records of COPD patients between April 2009 and December 2011 were retrospectively reviewed. The patient population was divided into three age groups; less than 70 years (the <70 age group), between 70-79 years (the 70-79 age group) and 80 years or older (the ≥80 age group). Demographic data, as well as the efficacy and safety of tiotropium, were compared between the three groups. Patients in the ≥80 age group comprised 35.6% of the study population with COPD (n=174). The ≥80 and 70-79 age groups demonstrated a higher proportion of comorbid disease compared with the <70 age group. A subjective improvement of dyspnea on effort as well as no additional adverse effects were observed in the ≥80 age group, similar to the other two age groups. However, higher incidence of acute exacerbation of COPD in patients aged ≥80 years old was found, particularly in those with comorbid disease. The efficacy and safety of tiotropium in COPD patients in the ≥80 age group were almost identical to patients <80 years old, however, physicians must be cautious with acute exacerbation of COPD in the extremely elderly population with comorbid disease.
Experimental and therapeutic medicine 04/2013; 5(4):997-1000. · 0.34 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to examine the survival difference between non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) patients with diabetes mellitus (DM) according to the first-line therapy. All patients with lung cancer diagnosed at our hospitals between April 1999 and March 2011 were retrospectively analyzed. The definition of DM was strictly determined and included fasting plasma glucose and HbA1c levels. The patients were divided into 2 groups: those with DM (DM group) and those without DM (non-DM group). For each treatment type, the survival of these 2 groups was evaluated. For NSCLC patients overall, the difference in survival between the DM group and the non-DM group was not significant (p = 0.112). However, in surgically treated NSCLC patients, the difference in survival between the 2 groups was significant (p = 0.022). In chemotherapy-treated NSCLC patients, the difference in survival between the 2 groups was not significant (p = 0.942). On the other hand, for SCLC patients overall, the difference in survival between the DM group and the non-DM group was significant (p = 0.012). In chemotherapy-treated SCLC patients, the difference in survival between the 2 groups was significant (p = 0.026). The influence of DM may differ between NSCLC and SCLC patients. At the current treatment level for unresectable NSCLC, the influence of DM might not be the same for NSCLC patients treated with surgery as for SCLC patients treated with chemotherapy. Elucidation of the mechanism by which hyperglycemia influences the progression of lung cancer will improve survival in lung cancer patients with DM.
Medical Oncology 03/2013; 30(1):367. · 2.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study was conducted to explore a bibliometric approach to quantitatively assess current research trends in cisplatin-containing chemotherapy for small cell lung cancer (SCLC), using related literature in the Science Citation Index Expanded database from 1992 to 2011. Articles were analyzed by the scientific output and research performances of countries and institutions. The distribution of key words in the article title and author-selected keywords were used to evaluate research trends. It was observed that the number of articles devoted to cisplatin-containing chemotherapy for SCLC did not increase with time. The USA and Japan were the top two countries with the highest number of articles devoted to cisplatin-containing chemotherapy for SCLC. In both countries, the number of articles did not increase with time, and a decreasing trend was identified in the USA over the last 10 years. This study demonstrates trends in cisplatin-containing chemotherapy for SCLC. The clinical application of novel drugs is required for successful SCLC treatment.
[Show abstract][Hide abstract] ABSTRACT: Pneumococcal pericarditis complicated by a malignant effusion has not been reported previously. We experienced an independent 62-year-old man with lung cancer who was hospitalized for acute onset of atrial flutter and moderate pericardial effusion. He was afebrile; however, pericardiocentesis showed Streptococcus pneumoniae and malignant squamous cells in purulent pericardial fluid. This case shows that clinicians should keep in mind the possibility of afebrile bacterial pericarditis in cancer patients with pericardial effusions and that cultures of pericardial fluid should be performed in such patients along with cytological examinations.
Internal Medicine 01/2013; 52(12):1413-6. · 0.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In lung cancer patients, chemotherapy-induced complications are considered to be distressing reactions even in the era of new antiemetics, such as aprepitant. The aim of this study was to evaluate the incidence of such complications. This prospective observational study was performed in our institution between 2011 and 2012. Certain complications including nausea, vomiting, appetite, stomatitis, constipation, diarrhea and dysesthesia, on days 1-7 were evaluated by pharmacists. The questionnaires and diaries of chemotherapy-induced complications were evaluated in the 31 patients included in the study. The majority of the enrolled patients were male (81%). Six (19%) patients were administered cis-diamminedichloroplatinum(II) (CDDP)-, 21 (69%) chemotherapy by carboplatin (CBDCA)- and 4 (13%) non-platinum regimen chemotherapies. Ten (32.3%) of the 31 patients exhibited nausea but only 3 (9.7%) of them experienced vomiting. On days 5-6, 23.8 and 9.5%, respectively, of patients treated with CDDP-regimens had nausea and vomiting. Three of the other most common complications were constipation, general fatigue and appetite loss. The incidence of these complications was 77.4, 71.0 and 67.7%, respectively. Even in the era of new antiemetics, CDDP-regimen chemotherapy-induced nausea and vomiting as well as constipation; general fatigue and appetite loss continue to be problems. A better appreciation of the incidence of these chemotherapy-related complications by medical oncologists and medical staff is essential for their adequate control.
Molecular and Clinical Oncology 01/2013; 1(1):65-68.
[Show abstract][Hide abstract] ABSTRACT: We report a 69-year-old female patient with pulmonary adenocarcinoma complicated by the syndrome of inappropriate secretion of antidiuretic hormone(SIADH)following systemic chemotherapy with cisplatin(CDDP)and vinorelbine(VNR). She was admitted to our hospital for chemo-radiotherapy for advanced lung cancer, and became restless 4 hours after the administration of CDDP and VNR. Symptoms such as restlessness and incontinence were worsening despite the massive infusion that was completed. Laboratory examinations on day 6 after chemotherapy showed severe hyponatremia(107mEq/L)with decreased serum osmolarity(227mOsm/L)and increased urine osmolarity(452mOsm/L). The serum anti-diuretic hormone(ADH)level was elevated to 16. 7 pg/mL despite severe hyponatremia. She was diagnosed with SIADH and was treated with hypertonic saline infusion and fluid restriction. Her restlessness and other psychiatric symptoms were improved. The use of carboplatin and VNR in the subsequent course did not develop SIADH, indicating that the SIADH was induced by CDDP. Although SIADH following CDDP administration is rare, the electrolyte balance should be carefully monitored throughout the clinical course of chemo-radiation therapy, when psychiatric symptoms are found in patients with lung cancer.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(11):1711-1714.
[Show abstract][Hide abstract] ABSTRACT: The aim of our retrospective study was to evaluate the clinicopathological features associated with distant metastasis from small cell lung cancer (SCLC). We reviewed patients diagnosed with SCLC metastasis at the time of presentation between 1999 and 2010. Among the consecutive 251 SCLC patients diagnosed, 152 (60.6%) patients had distant metastasis, of which 20.3, 18.3, 15.5, 10.0 and 6.0% of patients had liver, bone, brain, lung and adrenal gland metastasis, respectively. In a multivariate analysis using Cox's proportional hazards model, we identified that liver, bone and brain metastasis as well as the presence of pleural and/or pericardial fluids were unfavorable prognostic factors. However, lung, adrenal gland and extrathoracic lymph node metastasis were not statistically significant prognostic factors. With regard to the treatment of SCLC patients, particularly those with liver, bone and brain metastasis or pleural and/or pericardial fluids, we should take the metastasizing organs into consideration.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to clarify the effect of aging on renal function. Serum creatinine (SCr), blood urea nitrogen (BUN) and 24-h creatinine clearance (measured-CrCl) were examined in lung cancer patients and the measured-CrCl were compared with CrCl estimates by employing two commonly used equations. In total, 787 lung cancer patients who were diagnosed between 2001 and 2010 were retrospectively analyzed. SCr and urine creatinine, BUN and measured-CrCl were evaluated prior to treatment. The Cockcroft-Gault (CG) and modification of diet in renal disease (MDRD) formulae were also used to estimate CrCl. SCr, BUN and measured-CrCl showed a significant decline in the elderly. In the 787 lung cancer patients, a significant correlation coefficient was found between measured-CrCl and age. However, in patients aged 80 years or older, no significant correlation coefficient was found between measured-CrCl and age. In the comparison between the measured CrCl and the CrCls estimated by the two formulae, the CG-CrCl levels were lower than those of the measured-CrCl, whereas the MDRD-CrCl levels were higher. Age is a crucial factor influencing renal function in patients with lung cancer. Particularly in the elderly, a decline in CrCl and greater individual variability in CrCl, as well as discrepancies in measured-CrCl and estimated CrCls are significant factors.
[Show abstract][Hide abstract] ABSTRACT: A 29-year-old man with a history of resected bulbar hemangioblastoma was admitted to hospital with nighttime breathing disturbance, but with apparently normal breathing while awake. After diagnostic work-up, including polysomnographic testing, he was diagnosed as having central alveolar hypoventilation syndrome due to surgical resection for bulbar hemangioblastoma. Non-invasive positive pressure ventilation (NIPPV) via oronasal facemask was given for nocturnal ventilatory support. Two months after leaving our hospital, he was readmitted because of aspiration pneumonia. The pneumonia was successfully treated with antibiotics, but the desaturation during sleep worsened despite non-invasive ventilatory support. Higher bi-level positive pressure using a full facemask successfully alleviated sleep hypoventilation and apnea. To the best of our knowledge, this is the first case report of central alveolar hypoventilation syndrome due to surgical resection for bulbar hemangioblastoma.
Internal Medicine 02/2009; 48(11):925-30. · 0.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A 69-year-old woman was admitted to because of bloody sputum. Chest CT showed some nodules. The patient was seronegative for PR3-ANCA. One month after the admission, these shadows vanished with no medication. She was asymptomatic for one and a half years, and then she complained of cough again. Multiple nodules were seen on chest CT again. She was admitted, and surgical biopsy by video-assisted thoracoscopic surgery was performed. She was diagnosed to have a limited form of Wegener's granulomatosis. Multiple shadows vanished without medication, again. Administration of sulfamethoxazole-trimethoprim was started and there has been no relapse.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 10/2007; 45(9):726-30.
[Show abstract][Hide abstract] ABSTRACT: We describe a 64-year-old man with locally advanced lung adenocarcinoma who had meningeal relapse soon after the completion of intensive chemo-radiotherapy. Diagnosis of the malignant meningitis was established by cytological examination of the cerebrospinal fluid, which showed malignant cells consistent with adenocarcinoma from the primary site. Although very rare, it is possible that successful chemo-radiotherapy for locally advanced lung cancer could not prevent malignant meningitis as observed in our patient. Physicians should consider performance of brain MRI or contrast CT of the brain and a lumbar puncture to exclude the diagnosis of malignant meningitis, an uncommon but devastating complication of malignancy.
Internal Medicine 02/2007; 46(20):1749-51. · 0.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Gefitinib is a selective epidermal growth factor receptor tyrosine kinase inhibitor, which blocks signal transduction pathways implicated in proliferation and survival of cancer cells. Long-term survival in patients with metastatic non-small-cell lung carcinoma (NSCLC) treated with gefitinib has recently been reported. We showed herein two cases of fatal rapid recurrence after a long-term disease control by gefitinib. The biology of fatal aggressive recurrence of gefitinib-treated NSCLC is not well characterized. Regardless of the mechanism, however, physicians treating patients with gefitinib should be alert to the possibility of fatal rapid recurrence after a long-term disease control by this drug.
[Show abstract][Hide abstract] ABSTRACT: A 50-year-old woman was transferred to our hospital because of acute renal failure and thrombocytopenia. Due to rapid enlargement of the kidney, we first suspected that she had diffuse renal invasion of anaplastic carcinoma or lymphoma of the kidney. Anti-bacterial treatment for complicated urinary tract infection and hemodialysis treatment resulted in recovery of both renal function and thrombocytopenia. Serial CT study demonstrated disappearance of kidney swelling and multiple masses within the kidney. We finally made a diagnosis of acute multifocal bacterial nephritis. Timely initiation of dialysis therapy and appropriate anti-bacterial treatment was essential to rescue this case.
Internal Medicine 11/2005; 44(10):1084-7. · 0.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Spontaneous pneumothorax is most common in adolescents and young adults. Some of them develop contralateral pneumothorax. In this paper, we report the case of a patient with spontaneous contralateral pneumothorax, whose body mass index (BMI) was 18.8 kg/m2. For either chest physicians or thoracic surgeons, follow up with recognition of increased risk of the contralateral pneumothorax is important especially in patients with contralateral bullous lesions and low BMI.
Central European Journal of Medicine 7(6). · 0.26 Impact Factor