189 results match your criteria: "Saga-Ken Medical Centre Koseikan[Affiliation]"

Background: Microsatellite instability (MSI)-high tumors represent a distinct, small-fraction subtype in esophagogastric junction cancer or gastric cancer (GC), yet their clinical significance remains poorly understood. This study aimed to investigate the prevalence and clinicopathological features of chemotherapy-naïve metastatic or recurrent MSI-high GC as a prescreening study for a phase II trial of nivolumab plus ipilimumab.

Methods: Key inclusion criteria included metastatic or recurrent adenocarcinoma of GC, ECOG performance status of 0 or 1, and no prior systemic therapy for metastatic or recurrent disease.

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Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.

Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).

Results: A total of 6575 patients with CDB were included.

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Dasatinib, a second-generation tyrosine kinase inhibitor, has been reported to have immunomodulatory effects. Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (EBV-LPD) occur in immunocompromised patients, such as those receiving methotrexate or other immunosuppressive drugs or after allogenic transplantation. EBV-LPD is also reported to be a rare side effect in patients receiving long-term dasatinib or imatinib.

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When respiratory failure occurs due to intractable pleural effusion, frequent thoracentesis is necessary. We herein report a patient who underwent diaphragmoplasty and pleuroperitoneal shunt for refractory pleural effusion after cardiac surgery. The patient was an 82-year-old man with a history of tricuspid valve replacement for tricuspid regurgitation 9-years ago.

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Background And Aim: Werner syndrome (WS) is an autosomal recessive, adult-onset, progeroid syndrome caused by mutations. As refractory skin ulcers significantly affect the quality of life of patients with WS, this study identified ulcer risk factors and assessed prevention methods.

Methods: We analyzed the data of 51 patients with WS enrolled in the Japanese Werner Syndrome Registry between 2016 and 2022.

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Current Understanding of the Role of Autophagy in the Treatment of Myeloid Leukemia.

Int J Mol Sci

November 2024

Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan.

The most important issues in acute myeloid leukemia are preventing relapse and treating relapse. Although the remission rate has improved to approximately 80%, the 5-year survival rate is only around 30%. The main reasons for this are the high relapse rate and the limited treatment options.

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Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower gastrointestinal bleeding (ALGIB).

Methods: We analyzed 8,956 patients with ALGIB in CODE BLUE-J study and categorized them into four groups based on BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.

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Posterior cardiac drain for atrial fibrillation after aortic valve replacement.

SAGE Open Med

November 2024

Department of Thoracic & Cardiovascular Surgery, Faculty of Medicine, Saga University, Saga, Japan.

Background: Postoperative atrial fibrillation occurs in 27% to 40% of patients after cardiac surgery. One cause of postoperative atrial fibrillation is pericardial effusion, which can be a significant source of inflammation. In this study, we investigated the effect of a drain placed in a posterior site to the heart to reduce pericardial effusion in the early postoperative period to prevent postoperative atrial fibrillation.

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Background And Aims: PuraStat (3-D Matrix, Tokyo, Japan) is an absorbent localized hemostatic agent that utilizes self-assembling peptide technology. In this multicenter pilot study, we evaluated the efficacy and safety of endoscopic hemostasis using PuraStat in patients with colonic diverticular bleeding (CDB).

Methods: This study involved patients who had CDB with stigmata of recent hemorrhage (SRH) and underwent endoscopic hemostasis with PuraStat monotherapy or combination therapy comprising PuraStat with endoscopic band ligation (EBL) or clipping (Group A).

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Article Synopsis
  • Asymmetric tibial components in total knee arthroplasty (TKA) were evaluated against symmetric components to assess bony coverage in cases with simulated bone defects using CT scans from 45 patients.
  • The study examined three models (PCCK, NexGen LCCK, and ATTUNE) with varying thickness augmentations to simulate defects of 5, 10, and 15 mm, measuring coverage, overhang, and underhang rates.
  • Results indicated that asymmetric components (PCCK) provided better overall coverage and reduced both anterior overhang and posterior underhang compared to symmetric components, potentially leading to improved long-term outcomes for patients.
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Introduction: The cognitive function score (CFS) is a public scale for assessing the activities of daily living (ADL) in older adults with dementia in Japan. In contrast, the scores of the revised Hasegawa's dementia scale (HDS-R), an easy-to-use dementia screening tool developed in Japan, are significantly correlated with mini-mental state examination scores and are widely utilized in various countries. This novel study aimed to elucidate the previously unexplored criterion-related validity of the CFS and HDS-R and the Bedriddenness Rank (BR), Barthel index (BI), and Katz index (KI).

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We report the case of a 46-year-old Japanese woman diagnosed with Stage Ⅳ right breast cancer, cT1cN1M1(ovarian and peritoneal metastases). We administered bevacizumab+paclitaxel as the first-line treatment. In the 13th course, the peritoneal dissemination progressed, and the regimen was changed to eribulin(1.

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Pure Red Cell Aplasia in a Patient with Thymic Hyperplasia, Hypogammaglobulinemia and Adult T-cell Leukemia/Lymphoma.

Intern Med

September 2024

Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan.

Article Synopsis
  • A 41-year-old man with no prior health issues presented with severe anemia, swollen lymph nodes, an upper mediastinal mass, and low antibody levels, leading to a diagnosis of pure red cell aplasia (PRCA) and adult T-cell leukemia/lymphoma (ATLL).
  • His mediastinal mass was identified as thymic hyperplasia, but it did not show evidence of ATLL invasion.
  • After surgery to remove the thymus, his anemia improved, but PRCA returned about 500 days later, indicating a potential link between his symptoms and ATLL, possibly as paraneoplastic syndromes.
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Objectives: This study was conducted to verify the effectiveness of Anterior Support Screw (AS2) for unstable femoral trochanteric fractures.

Design: A multicenter, prospective, randomized controlled trial SETTING: This study was conducted across 15 academic medical centers in Japan PATIENTS/PARTICIPANTS: We enrolled 240 cases of femoral trochanteric fractures with posterior crushing and intramedullary displacement of proximal bone fragments across 15 institutions in Japan.

Intervention: All patients were subjected to a reduction in which the anterior cortex was brought into contact.

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Purpose: The aim of this study was to evaluate artifacts in the skull base region of head computed tomography (CT) images with various tilt angles relative to the orbitomeatal line.

Methods: CT images of a head phantom acquired by helical and non-helical scanning with the tilt angles set from 0 to 20 degrees in 5-degree increments were evaluated in this study. Regions of interest (ROIs) were set at the cerebellum, temporal lobe, frontal lobe, and basal ganglia in the phantom images.

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This retrospective cohort study explored the prevalence of substantial weight loss (≥10% per year) in independent older individuals in order to develop and validate a scoring system for high-risk group identification and targeted intervention against malnutrition. We used insurance claims and the Kokuho Database (KDB), a nationwide repository of Japanese-specific health checkups and health assessments for the older people. The study included 12,882 community-dwelling individuals aged 75 years and older who were self-supported in their activities of daily living in Saga Prefecture, Japan.

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Article Synopsis
  • The study examined the link between blood group O and the likelihood of rebleeding in patients with acute lower gastrointestinal bleeding (ALGIB).
  • Out of 2336 patients analyzed, those with blood group O had higher rebleeding rates within 30 days (17.9%) and 1 year (21.9%) compared to non-O patients.
  • Blood group O was found to be an independent risk factor for rebleeding, while rates of thrombosis and mortality were similar between groups.
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Thrombopoietin receptor agonist (TPO-RA) is effective for aplastic anemia (AA) and idiopathic thrombocytopenic purpura (ITP). However, the risk of thrombosis during ITP treatment with TPO-RA is higher than without TPO-RA. It is unclear whether TPO-RA increases the risk of thrombosis in patients with AA.

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The 2023 European Bifurcation Club (EBC) meeting took place in Warsaw in October, and the latest evidence for the use of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) to optimise percutaneous coronary interventions (PCI) on coronary bifurcation lesions (CBLs) was a major focus. The topic generated deep discussions and general appraisal on the potential benefits of IVUS and OCT in PCI procedures. Nevertheless, despite an increasing recognition of IVUS and OCT capabilities and their recognised central role for guidance in complex CBL and left main PCI, it is expected that angiography will continue to be the primary guidance modality for CBL PCI, principally due to educational and economic barriers.

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Article Synopsis
  • About 10% of trauma inpatients experience fractured ribs, which can lead to conditions like flail chest or respiratory failure.
  • Currently, there are no established treatment guidelines for patients with multiple rib fractures who are not experiencing respiratory failure.
  • From 2020 to October 2023, surgical stabilization was performed on 10 cases, leading to the development of useful surgical indications for treating rib fractures.
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Article Synopsis
  • The study aimed to investigate the relationship between certain hypnotic medications (lemborexant, suvorexant, ramelteon) and inpatient falls in a large population, as previous research in this area was lacking.
  • Conducted over three years, the research analyzed data from over 150,000 patients aged 20 and above admitted to multiple hospitals, examining the types of medications prescribed and the incidence of falls during hospital stays.
  • The findings indicated that the use of lemborexant, suvorexant, and ramelteon at admission was not statistically linked to an increased risk of falls among patients.
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Background: Pulmonary vein (PV) stenosis (PVS) is a serious complication of atrial fibrillation (AF) ablation. The objective of this study was to describe interventional treatments for PVS after AF ablation and long-term outcomes in Japanese patients.

Methods and results: This multicenter retrospective observational study enrolled 30 patients (26 [87%] male; median age 55 years) with 56 severe PVS lesions from 43 PV interventional procedures.

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Article Synopsis
  • The study analyzed 8,254 cases of patients with acute lower gastrointestinal bleeding to find key factors that predict mortality and create a reliable prediction tool.
  • Researchers established the CACHEXIA score, which uses factors present at admission and management during hospitalization to assess the risk of death within 30 days and 1 year.
  • The CACHEXIA score demonstrated high accuracy (ROC-AUC 0.93 for 30 days; C-index 0.88 for 1 year) with significant differentiation of mortality risk, indicating that patients with high scores need continuous monitoring after discharge.
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Avelumab, a programmed cell death ligand 1 blocking antibody, was approved for its first indication in Japan in September 2017 to treat unresectable Merkel cell carcinoma (MCC). Given that the pivotal JAVELIN Merkel 200 study only included a few Japanese patients, this post-marketing surveillance (PMS) evaluated the safety and effectiveness outcomes of patients with MCC who received avelumab in general clinical practice in Japan. This prospective, non-comparative, multicenter PMS included data from all patients with unresectable MCC who received avelumab between November 22, 2017 (avelumab launch date) and October 31, 2019.

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