129 results match your criteria: "Shinshu Ueda Medical Center[Affiliation]"

Background: In the first-line treatment of elderly patients with advanced-stage non-small cell lung cancer (NSCLC) with high programmed death-ligand 1 (PD-L1) expression (tumor proportion score ≥ 50%), this study aimed to determine whether pembrolizumab monotherapy (MONO) or pembrolizumab plus platinum-based chemotherapy (COMB) should be selected.

Methods: We performed a retrospective multicenter study (sub-analysis of the HOT/NJLCG2001 trial) of 299 patients with NSCLC with high PD-L1 expression who received MONO or COMB as the first-line treatment between December 2018 and January 2020. We selected patients aged 75 years and older and assessed the clinical efficacy and toxicity.

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  • A 29-year-old man was admitted to the hospital with abdominal pain and vomiting, which led to a CT scan revealing serious intestinal issues.
  • The findings included intestinal malrotation, small bowel volvulus, and blockage of major blood vessels, resulting in a critical condition called strangulating small bowel obstruction with necrosis.
  • Emergency surgery was performed, involving extensive resection of the small bowel, and although the patient faced complications like short bowel syndrome, he ultimately returned to a normal diet.
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Superficially spreading cervical squamous cell carcinoma (SCC) is the superficial extension of SCC of the cervix into the uterine lumen, replacing the endometrium. Here, we report a case of superficially spreading cervical SCC manifesting as intrauterine mural nodules with restricted diffusion on magnetic resonance imaging (MRI). A 76-year-old woman with a history of conization presented with a pelvic mass.

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Introduction: Chemoimmunotherapy is widely used as the first-line management of advanced non-small cell lung cancer (NSCLC) in clinical settings. However, predictive factors associated with the development of immune-related adverse events (irAEs) and prognostic factors for NSCLC patients undergoing chemoimmunotherapy remains largely unexplored. Therefore, in this study, we aimed to evaluate predictive factors for irAE development and prognostic factors associated with chemoimmunotherapy in NSCLC patients.

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  • The study assesses the long-term outcomes of patients with nonsmall cell lung cancer (NSCLC) and high PD-L1 expression treated with either pembrolizumab alone (MONO) or in combination with chemotherapy (COMB).
  • A total of 298 patients were observed, with COMB showing better overall survival (33.7 months) compared to MONO (17.2 months), although after adjusting for various factors, the advantage of COMB over MONO was not statistically significant.
  • The findings suggest that while COMB may be beneficial in certain patients, both treatment options have similar discontinuation rates, indicating comparable tolerability.
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The question of whether to perform an appendectomy or conservative treatment for acute appendicitis can differ depending on the facility or surgeon, but antibiotic treatment is administered regardless of whether an appendectomy or conservative treatment is selected. We investigated the contemporary bacteriology for acute appendicitis and evaluated the antibiotic sensitivity of the bacteria that are currently associated with appendicitis. We retrospectively analyzed the bacterial culture results and antibiotic susceptibility of 141 patients who underwent appendicitis surgery, including the identification and antimicrobial susceptibility of the cultured bacteria within the excised appendices.

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Background: Circulating autotaxin (ATX) levels have been reported to correlate with liver inflammation activity and liver fibrosis severity in patients with non-alcoholic fatty liver disease (NAFLD). The objective of this study is to investigate whether serum ATX could predict liver-related events (LRE) in NAFLD patients.

Methods: This retrospective investigation includes 309 biopsy-proven NAFLD patients registered at Shinshu University Hospital.

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When starting a mechanical thrombectomy, manual aspiration with balloon guide catheters inserted into the internal carotid artery (ICA) is an efficient method for thrombus aspiration. However, no complications associated with this procedure have been reported. This study describes the case of a 76-year-old man who presented to our hospital with total aphasia and complete right-sided paralysis due to chronic atrial fibrillation and left occlusion of the ICA.

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  • The study focuses on the link between polypharmacy (taking multiple medications) and aspiration pneumonia in older adults, particularly those aged 65 and above.
  • It compared patients hospitalized for pneumonia with matched controls to analyze the risk factors associated with aspiration pneumonia.
  • The results indicated that while polypharmacy was not a direct risk factor for aspiration pneumonia, other factors like oral intake ability, gender, body mass index, and comorbid conditions were significant.
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Introduction: Combination therapy of anti-programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) antibodies and platinum-based chemotherapy has been widely used as a first-line treatment for patients with unresectable advanced non-small cell lung cancer (NSCLC) in clinical settings; however, prognostic biomarkers associated with survival outcomes have not been sufficiently investigated.

Methods: We enrolled 147 previously untreated patients with advanced NSCLC who were treated with a combination therapy of anti-PD-1/-PD-L1 antibodies and platinum-based chemotherapy at eight institutions in Nagano Prefecture between December 2018 and April 2023. We evaluated the prognostic value of the geriatric nutritional risk index (GNRI), a systemic inflammatory nutritional biomarker calculated from body weight and serum albumin level, for patients with NSCLC treated with a combination therapy of anti-PD-1/-PD-L1 antibodies and platinum-based chemotherapy.

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  • The study investigates how new antirheumatic drugs affect the characteristics of lymphoproliferative disorder (LPD) in rheumatoid arthritis (RA) patients, using data from 53 hospitals in Japan between 1999 and 2021.
  • A total of 752 patients with RA-associated LPD were compared to 770 with sporadic LPD, revealing notable differences in their clinical features and the impact of various drug combinations.
  • The findings suggest that medications taken before LPD onset may alter its characteristics, and recommend tocilizumab (TCZ) as a better treatment option after LPD has developed.
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Background: Rechallenge therapy with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is known to confer some clinical benefit for patients with metastatic EGFR-mutated non-small cell lung cancer (NSCLC). However, little is known about the efficacy of EGFR-TKI rechallenge after resistance to first-line (1L) osimertinib. This study aimed to assess the efficacy and safety of EGFR-TKI rechallenge therapy after resistance to 1L osimertinib in a Japanese clinical setting.

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  • Even in regions where vancomycin-resistant enterococcus (VRE) is not common, medical professionals should take precautions against multidrug-resistant organisms during patient admissions, especially for those with prior medical exposure abroad.
  • A case study highlights a 49-year-old Japanese woman who developed complications, including pyelonephritis and renal failure, after surgery in the U.S. and returned to Japan for further treatment.
  • Following the identification of VRE in her urine and blood cultures, infection control measures were enacted, and she was treated successfully with linezolid.
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Neuroblastoma, a prevalent extracranial solid tumor commonly afflicting pediatric patients, exhibits a diverse spectrum of clinical presentations. Preseptal cellulitis, a childhood infectious ailment, typically demonstrates a favorable response to conservative antibiotic therapy. In this report, we present the case of a two-year-old female child with refractory preseptal cellulitis, ultimately leading to an unforeseen diagnosis of neuroblastoma.

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Background: Serum C-reactive protein (CRP) is an established biomarker for acute inflammation and has been identified as a prognostic indicator for hepatocellular carcinoma (HCC). However, the significance of the serum CRP level, specifically in HCC patients treated with lenvatinib, remains unclear.

Methods: We retrospectively analyzed 125 HCC patients who received lenvatinib treatment at six centers.

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  • Tick-borne encephalitis (TBE) is a serious central nervous system infection caused by the tick-borne encephalitis virus (TBEV), primarily found in Europe and Asia.
  • In Japan, 5 confirmed cases have been reported, all on the northern island of Hokkaido, but evidence suggests TBEV could be more widespread, with possible undiagnosed infections in other regions.
  • A study screened 520 patients with encephalitis or meningitis for TBEV antibodies, confirming 3 cases, highlighting the need for better awareness and diagnostic testing for TBE in Japan.
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We have previously reported that 12p gain may predict the presence of malignant components and poor prognosis for CNS germ cell tumor (GCT). Recently, 3p25.3 gain was identified as an independent predictor of poor prognosis for testicular GCT.

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Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of advanced non-small cell lung cancer (NSCLC) and contributed to the development of precision medicine. Osimertinib is a standard first-line (1L) treatment for -mutated NSCLC and has demonstrated superior survival benefits over previous-generation TKIs. However, resistance to osimertinib is nearly inevitable, and subsequent treatment strategies remain unmet medical needs in this setting.

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Introduction: Combination immunotherapy is widely used in clinical practice as the first-line treatment for advanced non-small-cell lung cancer (NSCLC). However, predictive factors associated with long-term response to combination immunotherapy have not been well investigated. Herein, we compared the clinical findings, including systemic inflammatory nutritional biomarkers, between responders and nonresponders to combination immunotherapy.

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  • Tumor budding is identified as a negative prognostic factor in colorectal adenocarcinoma, and the role of interleukin-6 (IL6), produced by cancer-associated fibroblasts, is investigated as a potential mechanism behind this.
  • In a study of 36 patient samples, IL6 expression was primarily found in the cancer stroma rather than in the cancer cells, with higher tumor budding grades observed in IL6-positive samples.
  • Although IL6 expression correlated with tumor budding and exhibited characteristics of epithelial-mesenchymal transition, it did not significantly impact overall survival rates for patients.
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The chosen treatment for anomalous systemic arterial supply to the basal segment of the lung (ABLL) is typically the division of the anomalous artery and resection of the abnormal area, dependent on the anomalous artery. Although only division or interventional embolization of the anomalous artery may be selected. However, leaving the area dependent on the anomalous artery can lead to complications, such as necrosis and pulmonary infarction.

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Brain metastases of a chondrosarcoma are extremely rare, and treatment remains controversial. A 54-year-old woman had undergone surgical treatment for a femoral chondrosarcoma and its lung metastases. She presented with visual disturbance and dizziness 22 months after the initial surgery; imaging studies of the brain revealed a metastatic tumor in the left parieto-occipital lobe.

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Myxoid liposarcoma (MLS) is a common subtype of liposarcoma. Although the prognosis is generally good, there are factors known to be associated with poor prognosis. Accurate indices are important to predict prognosis.

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  • A study investigates how to use machine learning to predict prescription errors in dosing oral prednisolone, a high-risk drug, due to the common issue of wrong doses causing harm to patients.
  • Data was collected from electronic medical records, analyzed using cluster analysis to group similar prescribing patterns, and different machine learning models were tested to improve accuracy.
  • Results showed that preprocessing the data with the SMOTE method enhanced model performance, with the best results coming from the BRF model (ROC-AUC: 0.917) and SVM after preprocessing (ROC-AUC: 0.820).
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