Metformin for chemoprevention of metachronous colorectal adenoma or polyps in post-polypectomy patients without diabetes: a multicentre double-blind, placebo-controlled, randomised phase 3 trial.

Background: The prevalence of, and mortality from, colorectal cancer is increasing worldwide, and new strategies for prevention are needed to reduce the burden of this disease. The oral diabetes medicine metformin might have chemopreventive effects against cancer, including colorectal cancer. However, no clinical trial data exist for the use of metformin for colorectal cancer chemoprevention.

Thoracoscopic reoperation for recurrent pneumothorax after single-incision thoracoscopic surgery.

An 18-year-old male patient who had undergone single-incision thoracoscopic surgery for left spontaneous pneumothorax was diagnosed with bilateral recurrent pneumothorax. We performed thoracoscopic reoperation and observed adhesions between the previous incision and the left lung. A bulla that was thought to be the cause of the recurrent left pneumothorax was found on the mediastinal side of previously ligated lesions.

Right Lower Lobe Superior Segmentectomy in a Patient With a Displaced Bronchus.

An 81-year-old woman with adenocarcinoma in the lower superior segment of the right lung underwent superior segmentectomy of the right lower lobe through a thoracotomy. Preoperatively, we detected an anomalous B10c bronchus branching from the right lower superior segment bronchus with multiplanar reconstruction computed tomography and virtual bronchoscopy. Intraoperatively, we stapled and cut the right lower superior segment bronchus at the level of the peripheral anomalous B10c bronchus under bronchoscopic visualization.

Comparison of Functional Outcomes of Patients Who Underwent Hand-Sewn or Stapled Ileal Pouch-Anal Anastomosis for Ulcerative Colitis.

Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for patients with ulcerative colitis (UC). The purpose of this study was to investigate the long-term functional outcomes and quality of life (QOL) associated with hand-sewn and stapled IPAA. Ninety-one patients with UC had undergone IPAA using hand-sewn anastomosis with mucosectomy (32 patients) or stapled anastomosis (59 patients) from January 1988 to May 2010.

[Spontaneous Pneumothorax During Pregnancy Successfully Managed with a Thoracic Vent before Surgical Therapy; Report of a Case].

A 34-year-old pregnant woman presented to our department at 31 weeks of gestation after being diagnosed as spontaneous pneumothorax based on chest X-ray findings. We inserted a Thoracic Vent( TV), and she was followed as an outpatient. However, since pneumothorax recurred twice after the TV was removed, she was finally admitted to the Department of Obstetrics because threatened premature delivery was suspected.

The Effects of Bazedoxifene on Bone, Glucose, and Lipid Metabolism in Postmenopausal Women With Type 2 Diabetes: An Exploratory Pilot Study.

Background: Selective estrogen receptor modulators (SERMs) decrease homocysteine and cross-linking of pentosidine and reduce low-density lipoprotein cholesterol (LDL-C), and they are expected to improve bone quality and atherosclerosis. Therefore, the potential effects of bazedoxifene on bone (bone resorption, bone formation, and bone quality), as well as on glucose and lipid metabolism markers, were examined in Japanese postmenopausal women with type 2 diabetes mellitus (T2DM).

Methods: Eligible patients received 20 mg of bazedoxifene tablets once daily and were followed up for 12 weeks.

Bilothorax as a complication of percutaneous transhepatic biliary drainage.

We report two cases of bilothorax that occurred as a complication of percutaneous transhepatic biliary drainage. In an 86-year-old woman who had undergone percutaneous transhepatic biliary drainage for obstructive jaundice, bilothorax occurred after accidental removal of the tube. She recovered with chest drainage only.

Fever pattern and C-reactive protein predict response to rescue therapy in Kawasaki disease.

Background: Evidence to guide rescue therapy in refractory Kawasaki disease (KD) is lacking. The aim of this study was to determine the most important variables in predicting non-response to rescue therapy in refractory KD.

Methods: We retrospectively analyzed 171 patients diagnosed with refractory KD resistant to initial i.

Cough-induced rib fractures.

Background: Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures.

Methods: Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing.

Chest injuries related to surfing.

Background: Surfing is a popular sport in coastal areas, which can be associated with chest injuries.

Methods: Between 2008 and 2013, 6 patients were referred to our hospital with chest injuries sustained during surfing. Clinical data were collected from their medical records and analyzed retrospectively.

Xiphoidectomy for xiphoid process-induced pain in a surfer.

A 53-year-old man who had been surfing for more than 30 years was referred to our hospital with upper abdominal wall pain. Computed tomography showed that his xiphoid process was protruding forward and the overlying skin was thickened. We diagnosed chronic abdominal wall pain due to repeated compression between the surfboard and his xiphoid process.

Outpatient Treatment of Pneumothorax with a Thoracic Vent: Economic Benefit.

Background: Since rising medical costs currently represent a growing problem worldwide, finding cost-effective treatment options is important. In our hospital, outpatient treatment of pneumothorax using a thoracic vent began in December 2012.

Objectives: We aimed to test our hypothesis that outpatient treatment of pneumothorax with a thoracic vent can reduce medical expenses.

Thoracoscopic surgery for multiple peripheral pulmonary arteriovenous fistulas.

A 37-year-old woman with dyspnea was referred to our department with the diagnosis of multiple bilateral pulmonary arteriovenous fistulas. Computed tomography of the chest showed nine fistulas in the right lung and four in the left lung. Because the fistulas were small and located peripherally, we chose thoracoscopic surgery instead of transcatheter pulmonary artery embolization.

Comparison of Azelnidipine and Trichlormethiazide in Japanese Type 2 Diabetic Patients with Hypertension: The COAT Randomized Controlled Trial.

Objective: This study compared the efficacy and safety of azelnidipine with that of trichlormethiazide in Japanese type 2 diabetic patients with hypertension.

Methods: In a multicenter, open-label trial, 240 patients with adequately controlled diabetes (HbA1c ≤ 7.0%) under lifestyle modification and/or administration of hypoglycemic agents and inadequately controlled hypertension (systolic blood pressure [sBP] ≥ 130 mmHg or diastolic blood pressure [dBP] ≥ 80 mmHg) who were being treated with olmesartan were enrolled.

A randomized controlled trial of liraglutide versus insulin detemir plus sitagliptin: Effective switch from intensive insulin therapy to the once-daily injection in patients with well-controlled type 2 diabetes.

This study aimed to compare the efficacy and safety of liraglutide versus insulin detemir plus sitagliptin in Japanese patients with type 2 diabetes treated with a basal-bolus insulin regimen. In this multicenter, open-label trial, 90 patients whose diabetes had been controlled well or moderately (glycated hemoglobin [HbA1c ] ≤ 7.3%) with basal-bolus insulin regimen were randomly assigned to a liraglutide group or a detemir group and were followed up for 24 weeks.

Androgen deprivation therapy prevents bladder cancer recurrence.

Although accumulating preclinical evidence indicates the involvement of androgen receptor signals in bladder cancer (BC) development, its clinical relevance remains unclear. We aimed to evaluate the predictive role of androgen deprivation therapy (ADT) in BC recurrence in prostate cancer (PC) patients. We retrospectively reviewed 20,328 patients with PC diagnosed during 1991-2013 and identified 239 (1.

Outpatient Drainage Therapy with a Thoracic Vent for Traumatic Pneumothorax due to Bull Attack.

Outpatient drainage therapy is generally indicated for spontaneous pneumothoraces. A 63-year-old man, who had been attacked by a bull sustaining injuries on the right side of his chest, was referred to the emergency room with dyspnea. His chest X-ray showed a small pneumothorax.

Thymoma with ring calcification.

A 59-year-old man was referred to our department for evaluation of an asymptomatic abnormal mediastinal shadow detected on chest roentgenogram. Computed tomography (CT) of the chest showed an anterior mediastinal tumor with ring calcification. Thymectomy through a median sternotomy was performed.

Sternal closure with absorbable pins and cords in general thoracic surgery.

After median sternotomy, the sternum is commonly closed using metal wires, which sometimes cause complications because they are permanent foreign bodies. As an alternative, we used a combination of absorbable sutures and pins for full median sternotomy in 24 adult general thoracic surgery patients. There were three cases of sternal dehiscence detectable by computed tomography, none of which required re-operation.

[Video-assisted thoracoscopic surgery for pleuroperitoneal communications as a complication of continuous ambulatory peritoneal dialysis( CAPD)].

A 54-year-old female who was started on continuous ambulatory peritoneal dialysis( CAPD) for endstage renal disease secondary to focal developed 2 pleuroperitoneal communications. At first, she developed chest pain and cough on the day following introduction. A 99m-technetium-macroaggregated albumin (99mTc-MAA) radionuclide scan showed a communication between the abdomen and the right pleural cavity.

[Mediastinal schwannoma resected through the 10th intercostal space via a posterolateral thoracotomy].

A 64-year-old woman with a mediastinal tumor incidentally found on computed tomography( CT) was referred to our hospital. CT and magnetic resonance imaging( MRI) showed the tumor had a clear border and was located on the right side of the 12th thoracic vertebra, spanning the thoracic and abdominal cavities. She was suspected of having a benign neurogenic tumor of the mediastinum.