A nationwide survey of intravenous antimicrobial use in intensive care units in Japan.

Although most patients in the intensive care unit (ICU) receive antibiotics, little is known about patterns of antibiotic use in ICUs in Japan. The objective of this study was to evaluate the pattern of antibiotic use in ICUs. A nationwide one-day cross-sectional surveillance of antibiotic use in the ICU was conducted three times between January 2011 and December 2011.

Upper urinary tract stone disease in patients with poor performance status: active stone removal or conservative management?

Background: It remains controversial as to whether active stone removal should be performed in patients with poor performance status because of their short life expectancy and perioperative risks. Our objectives were to evaluate treatment outcomes of active stone removal in patients with poor performance status and to compare life prognosis with those managed conservatively.

Methods: We retrospectively reviewed 74 patients with Eastern Cooperative Oncology Group performance status 3 or 4 treated for upper urinary tract calculi at our four hospitals between January 2009 and March 2016.

Identification of antigenic peptides from novel renal cancer stem-like cell antigen, DNAJB8.

Objectives: To identify antigenic peptides of cancer stem-like cells (CSCs) antigen, DNAJB8, and establish a mouse CSCs-targeting immunotherapy model.

Materials And Methods: To induce DNAJB8-specific immune reaction, we stimulated human CD8 lymphocytes with antigen-presenting cells pulsed with a cocktail of three candidate HLA-A*24:02 restricted peptides and assessed peptide specific human cytotoxic T lymphocytes (CTLs) induction. One of the antigenic peptides showed identical amino acid sequence as corresponding mouse DNAJB8.

Wakayama Medical University Hospital perinatal helicopter ambulance service: 14 year review.

Background: In 2003, a perinatal helicopter air ambulance service was introduced for remote areas of Wakayama and Mie prefectures, Japan, but its long-term impact on perinatal medicine has not yet been analyzed.

Methods: A retrospective observational study was conducted on helicopter air ambulance cases recorded between January 2003 and December 2016 at Wakayama Medical University Hospital (WMUH).

Results: During that period, 61 pregnant mothers were transferred by helicopter air ambulance to WMUH.

Diabetes mellitus adversely affects mortality and recurrence after valve surgery for infective endocarditis.

Background: Although diabetes mellitus (DM) increases the incidence of infective endocarditis (IE), little is known about the outcome of valve surgery for active IE in patients with DM. We evaluated the clinical outcomes of valve surgery for IE in patients with DM.

Methods: Between 2009 and 2016, 470 patients underwent valve surgery for definitive left-sided active IE at 12 affiliated hospitals.

Physical Exercise with Music Maintains Activities of Daily Living in Patients with Dementia: Mihama-Kiho Project Part 21.

Background: Recent studies suggest that combined non-pharmacological interventions are more beneficial than single interventions for primary and secondary prevention of dementia. We previously reported enhanced effects of physical exercise with music (ExM) on cognitive function in normal elderly people compared to exercise alone.

Objective: To identify if ExM improves cognitive function and activities of daily livings (ADLs) in dementia patients over cognitive stimulation (CS).

PRG4 expression in myxoid liposarcoma maintains tumor cell growth through suppression of an antitumor cytokine IL-24.

PRG4 is one of the downstream molecules of the myxoid liposarcoma (MLS)-specific fusion oncoproteins TLS-CHOP and EWS-CHOP. Exogenous PRG4 expression increases the tumorigenicity of cells injected in nude mice. The molecular functions of PRG4 in tumorigenesis and/or tumor progression of MLS cells, however, still remain unclear.

[A Surgical Case of Solitary Fibrous Tumor Originating from the Greater Omentum].

A36 -year-old man with intellectual disabilities consulted a local physician complaining of a cough, and an abdominal mass was observed on palpation. The patient visited our hospital for close examination. Abdominal contrasting CT revealed a mass with a clear boundary with heterogeneous contrast on the left side of his abdominal cavity.

[A Case of Liver Metastasis of Ampullary Carcinoma That Developed Postoperatively That Was Effectively Treated with Gemcitabine plus Cisplatin].

A 75-year-oldman presenting with obstructive jaundice was referredto our hospital. Basedon a diagnosis of carcinoma of the ampulla of Vater, we performed pancreatoduodenectomy. Postoperative histopathological examination revealed a welldifferentiated papillotubular adenocarcinoma, T3, N0, M0, Stage III .

[An Elderly Colon Cancer Patient with Multiple Liver Metastases Who Was Successfully Treated Using mFOLFOX6 and sLV5FU2 Chemotherapy - A Case Report].

Curative treatment for unresectable colon cancer is difficult, and therefore, chemotherapy is often administered in an attempt to improve the prognosis. However, the safety andfeasibility of chemotherapy for elderly patients over 80-years-old have not yet been clarified. We report an elderly colon cancer patient with multiple liver metastases who was successfully treatedwith mFOLFOX6 andsLV5 FU2 chemotherapy.

An Epstein-Barr virus susceptible immature T-cell line, WILL4, established from a patient with T-lymphoblastic lymphoma bearing CD21 and a clonal EBV genome.

We managed a patient with an Epstein-Barr virus-associated T-cell lymphoblastic lymphoma. Mediastinal tumor cells at initial admission were positive for CD4, CD8, and TdT. Interestingly, a lymph node at necropsy was compatible for a CD4-positive peripheral T-cell lymphoma without CD8 and TdT expression, suggesting a different phenotype from the mediastinal tumor.

Overexpression of ribonucleotide reductase subunit M1 protein predicts shorter survival in metastatic bladder cancer patients treated with gemcitabine-containing combination chemotherapy.

Objectives: To identify biomarkers predicting prognosis in bladder cancer patients undergoing the gemcitabine and cisplatin regimen.

Methods: We studied 52 patients with metastatic bladder cancer treated with the gemcitabine and cisplatin regimen by evaluating the relationship between the expression of two biomarkers, ribonucleotide reductase subunit M1 and excision repair cross complementing 1, by immunohistochemistry and clinical outcomes.

Results: The patients with low expression of ribonucleotide reductase subunit M1 showed a higher objective response rate by the gemcitabine and cisplatin regimen than those with high expression of ribonucleotide reductase subunit M1 (80.

[GIANT CELL CARCINOMA OF THE RENAL PELVIS AND URETER WITH GIANT HYDRONEPHROSIS; A CASE REPORT].

A 78-year-old woman presented with macroscopic hematuria. We diagnosed giant hydronephrosis with a left ureteral stone and multiple renal pelvic carcinoma cT3N0M0 tumors.Open nephroureterectomy proceeded via a peritoneal approach, and 8,600 mL of urine were collected from the renal pelvis.

[Two Cases of Spontaneous Rupture of the Urinary Bladder Associated with Radiation Cystitis, Repaired with Omentum Covering].

We experienced two cases of spontaneous rupture of the urinary bladder associated with radiation cystitis. Case 1 and Case 2 were a 45-year-old female and a 71-year-old female, respectively. Both of them were admitted to our hospital with complaints of high grade fever and severe lower abdominal pain.

Pregnancy and cesarean delivery after multimodal therapy for vulvar carcinoma: A case report.

Reports of pregnancy following treatment for vulvar carcinoma are extremely uncommon, as the main problem of subsequent pregnancy is vulvar scarring following radical surgery. We herein report the case of a patient who was diagnosed with stage I squamous cell carcinoma of the vulva at the age of 17 years and was treated with multimodal therapy, including neoadjuvant chemotherapy, wide local excision with bilateral inguinal lymph node dissection and adjuvant radiotherapy. The patient became pregnant spontaneously 9 years after her initial diagnosis and the antenatal course was good, except for mild acute pyelonephritis at 25 weeks of gestation.

Incidence and risk factors for aspiration pneumonia after cardiovascular surgery in elderly patients.

Objective: Pneumonia after cardiovascular surgery is the leading cause of mortality. Postoperative aspiration pneumonia becomes a critical issue in the management of cardiovascular surgery in the aging society. The aim of this study was to investigate the incidence and risk factors of aspiration pneumonia after cardiovascular surgery for elderly patients.

Right atrial approach for repairing a posterior ventricular septal rupture: a case report.

Background: Ventricular septal rupture (VSR) is a life-threatening complication following acute transmural myocardial infarction. Posteriorly located ruptures are one of the main predictors of poor prognoses because of the surgical difficulties associated with this location.

Case Presentation: A 72-year-old man with a posterior VSR underwent surgical repair via the right atrial approach.

A retrospective study of in-hospital cardiac arrest.

Aim: In-hospital cardiac arrest is an important issue in health care today. Data regarding in-hospital cardiac arrest in Japan is limited. In Australia and the USA, the Rapid Response System has been implemented in many institutions and data regarding in-hospital cardiac arrest are collected to evaluate the efficacy of the Rapid Response System.

Transverse rupture of ring-supported Dacron graft 10 years after axillobifemoral artery bypass: induced by graft deterioration and Fogarty thrombectomy.

A 70-year-old woman underwent an axillobifemoral artery bypass using a bifurcated ring-supported Dacron graft in 2004 and then noticed a pulsatile mass in the left flank 10 years later. A Fogarty thrombectomy was performed for acute graft occlusion. Eight months later, computed tomography revealed pseudoaneurysm formation in the graft body and surgical graft interposition was performed.