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Allergology International 02/2013;
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ABSTRACT: Complete situs inversus is a rare abnormality of autosomal recessive inheritance; it requires particular care during surgery, because the viscus anatomy is a mirror image of the normal anatomy. Reports of surgery for lung cancer in cases of complete situs inversus are very rare. Here, we report a case of lobectomy for lung cancer of the right lower lobe performed using video-assisted thoracic surgery (VATS) in a patient with complete situs inversus. We emphasize the importance of careful examination of the relationship between the bronchus, pulmonary artery, and pulmonary vein in the hilum of the lung in cases of complete situs inversus requiring lung resection for cancer; this is even more necessary when VATS is performed.
General Thoracic and Cardiovascular Surgery 05/2012;
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ABSTRACT: The incidence of fibrous dysplasia (FD) is not frequent in the case of benign bone tumors of the chest wall, and differential diagnosis between FD and the malignancy on the basis of imaging findings is difficult. We report a case of a painful FD lesion (size, 9×8 cm) that originated from the 5th rib of a 52-year-old man and was surgically resected. His symptoms improved after the operation. Painful and large FD lesions should be resected because of a difficulty in differential diagnosis from malignant tumors.
Kyobu geka. The Japanese journal of thoracic surgery 05/2012; 65(5):423-6.
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ABSTRACT: A 47-year-old woman was transported to our hospital because of vomiting and syncope after breakfast. Physical examination revealed icterus and anemia of bulbar conjunctivas, and abnormal neurological findings were detected. Laboratory data indicated marked anemia and thrombocytopenia (Hb 5.2 g/dl, Plt. 0.6×10(4)/μl), but no leukocyte abnormalities were found. Transaminase was slightly elevated, and serum indirect bilirubin in was also elevated. Based on these data, we initially suspected Evan's syndrome, which involves idiopathic thrombocytopenic purpura with autoimmune hemolytic anemia. So we transfused red blood cells, performed platelet transfusion, and administered steroids, but there was no response to these therapies. On the 4th day of admission, she developed a stroke followed by coma. After the stroke, we diagnosed the case as thrombotic thrombocytopenic purpura (TTP) because laboratory findings showed diminished activity of ADAMTS 13 (a disintegrin-like metalloproteinase with thrombospondin type 1 motifs 13) and ADAMTS 13 antigen. It is important to suspect TTP when hemolytic anemia with thrombocytopenia is observed, and to check the activity and antigen of ADAMTS13 immediately for the diagnosis. Platelet transfusion should be done cautiously in these cases.
[Rinshō ketsueki] The Japanese journal of clinical hematology 01/2012; 53(1):105-9.
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ABSTRACT: An 83-year-old woman was admitted to our hospital with abdominal pain. Examination revealed mediastinal lymphoadenopathy, hepatosplenomegaly, and infiltration of abnormal cells into the bone marrow with hemophagocytosis, and CD5-positive diffuse large B cell lymphoma was diagnosed. Chemotherapy was administered and progressive weakness of the limbs, resembling a Guillain-Barré-like syndrome, subsequently appeared. Cerebrospinal fluid examination indicated lymphoma cell infiltration. Although immune globulin and steroid therapies were not effective, intrathecal injection of methotrexate, predonisolone, and cytarabine improved these symptoms. Subsequent to chemotherapy, cell surface antigen changes were observed in the cerebrospinal fluid relative to those in bone marrow. [J Clin Exp Hematopathol 52(3) : 199-204, 2012].
Journal of Clinical and Experimental Hematopathology 01/2012; 52(3):199-204.
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Tomoya Kawaguchi,
Minoru Takada,
Masahiko Ando,
Kyoichi Okishio,
Shinji Atagi,
Yuka Fujita,
Yoshio Tomizawa,
Kenji Hayashihara, Yoshio Okano,
Fumiaki Takahashi,
Ryusei Saito,
Akihide Matsumura,
Atsuhisa Tamura
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ABSTRACT: To evaluate the efficacy and feasibility of the consolidation therapy of the oral fluoropyrimidine agent S-1 after concurrent chemoradiotherapy for unresectable stage III non-small cell lung cancer (NSCLC).
Eligible patients had unresectable stage III NSCLC with performance status of 0 or 1. Chemoradiotherapy at a total dose of 60 Gy consisted of cisplatin (80 mg/m(2)) on days 1 and 29, vinorelbine (20 mg/m(2)) on days 1, 8, 29 and 36. Sequential consolidation S-1 therapy was commenced at a dose of 80-120 mg twice daily on day 57 with two cycles of 4 weeks administration and 2 weeks withdrawal.
Of the 66 patients, 65 were evaluated. Chemoradiotherapy was completed in 57 (87.7%) patients, and S-1 consolidation therapy was administered in 45 (69.2%) and completed in 31 (47.6%). Grade 3 pneumonitis developed in three patients with one dying of it. The response rate was 61.5% (95% confidence interval [CI], 48.6-73.3%). The median progression-free survival was 10.2 (95%CI, 8.6-13.7) months and median survival time 21.8 (95%CI, 15.6-27.6) months. The 1- and 3-year survival rates were 73.9% and 34.0%, respectively.
Chemoradiotherapy with cisplatin and vinorelbine followed by S-1 consolidation demonstrated a reasonable overall survival in patients with stage III NSCLC. However, less than half of the patients completed this regimen, and the additional effect of S-1 was marginal compared with historical control. We concluded that chemoradiotherapy alone is still the recommended standard treatment for patients.
European journal of cancer (Oxford, England: 1990) 12/2011; 48(5):672-7. · 4.12 Impact Factor
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Hideki Tomimoto,
Masaki Hanibuchi,
Fumitaka Ogushi, Yoshio Okano,
Tsutomu Shinohara,
Hiroyuki Doi,
Akiyoshi Yamamoto,
Eiji Takeuchi,
Akihiko Yamamoto,
Masahiko Azuma,
Hiroya Tada,
Takanori Kanematsu,
Soji Kakiuchi,
Hisatsugu Goto,
Seiji Yano,
Yasuhiko Nishioka,
Saburo Sone
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ABSTRACT: S-1 is an oral anticancer fluoropyrimidine agent designed to elevate anticancer activity with a decrease in gastrointestinal toxicity. We conducted a phase II study to evaluate the efficacy and safety of combination chemotherapy with S-1 plus cisplatin in patients with advanced non-small cell lung cancer (NSCLC). Chemotherapy-naïve patients were treated with S-1 administered orally at 40 mg/m(2) twice a day for 21 consecutive days, and cisplatin (60 mg/m(2)) infused intravenously on day 8, repeated every 5 weeks. Of the 44 patients enrolled in the study, 40 were assessable for efficacy and safety. The median number of cycles administered was 3 (range 1-9 cycles). Among the 40 assessable patients, 7 partial responses were observed, with an overall response rate (RR) of 17.5% [95% confidence interval (CI), 5.2-29.8]. Patients with squamous cell carcinoma showed a significantly higher RR (55.5%) than those with adenocarcinoma (9.1%) or other types of NSCLC (0%). The median progression-free survival was 4.3 months (95% CI, 3.4-4.9), the median survival time was 17.9 months (95% CI, 15.0-20.8), and the 1- and 2-year survival rates were 63.3 and 27.3%, respectively. Major grade 3-4 hematologic toxicities were leukocytopenia (7.5%), neutropenia (5.0%), anemia (15.0%) and thrombocytopenia (2.5%). No grade 4 non-hematologic toxicity or treatment-related death occurred. These results suggest that combination chemotherapy with S-1 plus cisplatin is a promising therapeutic candidate for patients with advanced NSCLC, particularly squamous cell carcinoma.
Oncology letters 05/2011; 2(3):465-470. · 0.11 Impact Factor
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Hisanori Machida,
Tsutomu Shinohara,
Hiroyuki Hino,
Mitsuteru Yoshida,
Nobuo Hatakeyama, Yoshio Okano,
Mami Inayama,
Emiko Hosokawa,
Shuichi Abe,
Keishi Naruse,
Yoshihito Iwahara,
Fumitaka Ogushi
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ABSTRACT: We here report a rare case of a patient with IgD-lambda-positive multiple myeloma presenting with FDG-PET/CT negative bone marrow involvement. A 72-year-old man was admitted to our hospital for evaluation of a paravertebral tumor of the chest. Thoracotomy was performed and a histopathological evaluation of resected intrathoracic tumor demonstrated a plasmacytic neoplasma. Initially we thought that this case was a solitary plasmacytoma because there were no positive findings on postoperative FDG-PET/CT. However, bone marrow aspiration study demonstrated massive infiltration of myeloma cells (72%). It is necessary to recognize that IgD-lambda type myeloma cells may not be sufficiently metabolically active to form high uptake on FDG-PET/CT.
Internal Medicine 01/2011; 50(14):1483-7. · 0.94 Impact Factor
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ABSTRACT: We describe a patient with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) that clinically resembled acute promyelocytic leukemia (APL). The karyotype of his leukemic cells was 46, XY, del (3) (q?) and did not include a chromosomal translocation involving the retinoic acid receptor-α gene. However, retinoic acid syndrome developed, and partial remission was achieved after treatment with all-trans retinoic acid (ATRA) followed by chemotherapy. Our case might provide new insights into the mechanism of the growth inhibitory effect of ATRA on APL-like cells.
Internal Medicine 01/2011; 50(24):3037-41. · 0.94 Impact Factor
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ABSTRACT: Bronchial asthma, characterized by chronic airway inflammation, involves many inflammatory cytokines. Interleukin (IL)-10 is a potent inhibitor of cytokine synthesis. Thus, the effects of IL-10 were examined on the production of granulocyte–macrophage colony stimulating factor (GM-CSF), IL-5, IL-1β, IL-2 and interferon (IFN)-γ by antigen (Dermatophagoides farinae, Df)-stimulated mononuclear cells obtained from asthmatic patients who were sensitized with the antigen and from healthy subjects in vitro. Production of IL-5 and IL-2 was enhanced by Df antigen in the asthmatic subjects, but not in the healthy controls. In contrast, levels of GM-CSF, IFN-γ and IL-1β production were enhanced by the antigen in both groups. Exogenous IL-10 (10 ng/mL) inhibited the production of GM-CSF, IFN-γ and IL-1β induced by Df antigen in both groups and also inhibited the production of IL-5 and IL-2 induced by the antigen in the asthmatics subjects. The inhibition of GM-CSF production by IL-10 was stronger than that by IL-4. These results indicated that the responsiveness to the inhibitory effect of IL-10 on the production of inflammatory cytokines is not abrogated in asthmatic patients and that IL-10 may be useful in the treatment of bronchial asthma.
Allergology International 06/2008; 49(1):55 - 62.
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ABSTRACT: Thirty-65% of patients with metastatic lung cancer will develop bone metastasis. Bone metastases cause considerable skeletal morbidity, including bone pain, pathologic fractures, spinal cord compression and it is necessary to develop the effective treatment against bone metastasis. We reported cases of non-small-cell lung cancer who had dramatic improvements of pathologic fractures with gefitinib. In addition, gefitinib treatments elevated levels of serum Bone ALP, ICTP and ratio of Bone ALP/ICTP in patients with bone metastasis. Gefitinib may have inhibitory effects against bone resorption as well as antitumor effects.
Clinical calcium 05/2008; 18(4):527-33.
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ABSTRACT: To investigate the activity of gemcitabine combined with irinotecan in patients with relapsed small cell lung cancer (SCLC).
SCLC patients who had experienced treatment failure with one prior chemotherapy were eligible. Patients were required to have a performance status of 0-2 and adequate organ function. Treatment consisted of gemcitabine (1,000 mg/m(2)) and irinotecan (150 mg/m(2)) on days 1 and 15 of a 28 day cycle.
Thirty-one patients were enrolled and 30 patients received protocol treatment (10 had refractory disease and 20 had sensitive disease). The median age was 64 years, and the median performance status was one. An objective response was obtained in 36.7% (95% CI: 17.3.1-56.0%) of the patients. The median overall survival time was 14.4 months, and the 1 year survival rate was 51%. The chief grade 3/4 toxicities included neutropenia (42%), thrombocytopenia (3%), diarrhea (9%), and liver dysfunction (3%). The only grade 4 toxicities were one case of grade 4 neutropenia (3.3%) and one case of grade 4 thrombocytopenia (3.3%).
Gemcitabine plus irinotecan is an active regimen that seems to be well-tolerated by patients with previously treated SCLC.
Cancer Chemotherapy and Pharmacology 04/2008; 61(3):503-8. · 2.83 Impact Factor
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ABSTRACT: We report an autopsy case of rapid progressive atypical carcinoid of the lung discovered as multiple nodular shadows. The patient was an 82-year-old man with non-productive cough. Both chest radiography and computed tomography revealed multiple nodules in both the lung and pleural effusion. Multiple metastases to bone and liver were also noted. Samples from the wall-side pleural lesion were obtained by video-assisted thoracoscopic surgery under local anesthesia, and histological examination led to a diagnosis of atypical carcinoid. Treatment was ineffective and the patient died on day 39 after admission. The primary site was identified as the lung after autopsy. We believe that early detection is crucial in the treatment of atypical carcinoid due to poor prognosis.
The Journal of Medical Investigation 03/2008; 55(1-2):142-6.
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ABSTRACT: Interleukin-15 (IL-15), which shares many functional activities of IL-2, is proposed as a potential modulator of T and natural killer (NK) cell-mediated inflammatory diseases. Since IL-15 gene is expressed in various cell types including epithelial cells, we examined how proinflammatory modulators affect IL-15 gene expression in both freshly isolated human bronchial epithelial cells (HBECs) and the human bronchial epithelial cell line BEAS-2B.
HBECs were obtained from 25 patients with primary lung cancer by bronchial brushing under bronchofiberscopy. The expressions of IL-15 and its receptor were examined using reverse transcription-polymerase chain reaction (RT-PCR), Northern blot analysis and enzyme-linked immunosorbent assay.
IL-15 mRNA was constitutively expressed in the cells and was upregulated by several proinflammatory cytokines such as IL-1beta, tumor necrosis factor-alpha, interferon-gamma (IFN-gamma) and lipopolysaccharide. In addition, IFN-gamma but not other cytokines induced the synthesis and secretion of IL-15 protein. Investigation of IL-15 receptor expression using RT-PCR showed that IL-15Ralpha and IL-2Rbeta chains but not IL-2Ralpha or gamma chain were constitutively expressed in these cells.
Bronchial epithelial cells may contribute to T and NK cell-mediated airway inflammation through IL-15 production.
International Archives of Allergy and Immunology 12/2004; 135(3):235-42. · 2.40 Impact Factor
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ABSTRACT: A 71-year-old man visited the surgical department of our hospital due to back pain in November, 1999. Esophagogram showed bronchoesophageal fistula and a plain chest radiograph showed a nodular shadow in the left upper area with left pleural effusion. As the symptom disappeared on treatment with an antimicrobial agent, he was followed up as an outpatient. In August, 2001, he presented to the Respiratory Department of our hospital with low-grade fever and productive cough. Since tubercle bacilli were detected in a sputum culture, combined treatment with antituberculous chemotherapy was started. But, none of the symptoms were improved. These bacilli were identified as being multi-drug-resistant. After the chemotherapy regimen was changed, the symptoms disappeared and the esophagorespiratory fistula was closed. We report a rare case of esophagorespiratory fistula with multi-drug resistant tuberculosis, which was improved by chemotherapy.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 09/2004; 42(8):755-9.
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ABSTRACT: Although cigarette smoking is a recognized cause of acute eosinophilic pneumonia (AEP), and an increase in eosinophils in the lung is a common occurrence in AEP, early-phase neutrophilia in AEP is not well understood. We describe three cases of cigarette smoke (menthol type)-induced AEP with neutrophilia in the lungs or blood. Increased in-vitro production of the neutrophil chemoattractant interleukin (IL)-8 by human bronchial epithelial cells (HBECs) was correlated with neutrophilia. We suggest that IL-8 released from HBECs is involved in neutrophilia in the lung in AEP, and is newly recognized as an important factor in the early phase of AEP development.
Internal Medicine 10/2003; 42(9):839-45. · 0.94 Impact Factor
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ABSTRACT: Smoking causes various changes in the lung. This report describes a case of cigarette smoke-induced acute eosinophilic pneumonia (CS-AEP) with neutrophilia in the blood. However, the precise mechanism is unknown, so we examined the effect of exposure to cigarette smoke extracts on the production of interleukin (IL)-4, IL-5, IL-8, IL-18, granulocyte macrophage-colony stimulating factor (GM-CSF), and vascular endothelial growth factor (VEGF) by human bronchial epithelial cells (HBECs) obtained from the patient. We found that IL-8 released from HBECs was involved in neutrophilia in the blood, and is a new factor in the development of AEP, especially in the early phase.
Internal Medicine 12/2002; 41(11):993-6. · 0.94 Impact Factor
