Comprehensive analysis of genetic alterations and their prognostic impacts in adult acute myeloid leukemia patients.

To clarify the cooperative roles of recurrently identified mutations and to establish a more precise risk classification system in acute myeloid leukemia (AML), we comprehensively analyzed mutations in 51 genes, as well as cytogenetics and 11 chimeric transcripts, in 197 adult patients with de novo AML who were registered in the Japan Adult Leukemia Study Group AML201 study. We identified a total of 505 mutations in 44 genes, while only five genes, FLT3, NPM1, CEBPA, DNMT3A and KIT, were mutated in more than 10% of the patients. Although several cooperative and exclusive mutation patterns were observed, the accumulated mutation number was higher in cytogenetically normal AML and lower in AML with RUNX1-RUNX1T1 and CBFB-MYH11, indicating a strong potential of these translocations for the initiation of AML.

[Clinicopathological analysis of 3 cases in which pulmonary metastasis from the urothelial carcinoma was resected].

We describe 3 cases in which the pulmonary metastasis from the urothelial carcinoma of the bladder and upper urinary tract was resected. The duration from the operation of the primary lesion to the occurrence of the pulmonary metastasis was 19, 11, and 4 years in each of the 3 cases. Repeated treatment of the local recurrence was performed in all the 3 cases.

An 85-year old male with levodopa-responsive parkinsonism followed by dementia and supranuclear ophthalmoplegia caused by alzheimer-type pathology without Lewy bodies.

An 85-year-old man developed l-dopa responsive parkinsonism indistinguishable from Parkinson's disease and subsequent dementia, followed by supranuclear ophthalmoplegia and neck dorsiflexion at the terminal stage. Midbrain tegmentum and medial temporal lobe were atrophic on magnetic resonance imaging, while decreased blood flow was predominant in frontotemporal lobes, detected by 3D-SSP of 123I- IMP SPECT. Alzheimer-type pathology without Lewy body pathology was confirmed at autopsy.

[A case of ilioinguinal hernia with Möbius syndrome].

We gave general anesthesia for an infant with ilioinguinal hernia and Möbius syndrome. Anesthesia was performed with sevoflurane inhalation and intravenous infusion of remifentanil. Intraoperative anesthetic course was uneventful.

[Total joint arthroplasty].

Control of the disease activity is enabled due to the progress of drug therapy for rheumatoid arthritis. However, surgical treatments are necessary for unresponsive cases to the drug or for achieving higher QOL, and we can attain more tight control or cure by combination of drug therapy and surgical treatments. Total joint arthroplasty provides indolence, mobility, stability and is an useful joint reconstruction method.

Impact of attention deficit hyperactivity disorder-like symptoms on the clinical features of adolescents with pervasive developmental disorders.

Introduction: Attention Deficit Hyperactivity Disorder (ADHD)-like symptoms are common among children and adolescents with Pervasive Developmental Disorders (PDD). The purpose of this study was to assess the impact of ADHD-like symptoms on the clinical features of adolescents with PDD.

Methods: A total of 72 subjects (between the ages of 12 and 17) diagnosed as having PDD were split into higher (ADHD+) and lower (ADHD-) groups according to the presence of ADHD-like symptoms as assessed with the Japanese version of the ADHD Rating Scale-IV (ADHD-RS-IV-J).

Speech disturbances due to left precentral cortical lesions.

We encountered two patients with lesions predominantly localized to the left precentral cortex who presented with speech disorders. Patient 1 had a lesion localized to the anterior part of the left precentral cortex along the precentral sulcus, in the middle part of the convexity. Patient 1 predominantly exhibited disturbance of prosody.

[Combined subarachnoidal block and continuous femoral nerve block for two patients undergoing bilateral simultaneous total knee arthroplasty].

We administered combined spinal anesthesia plus bilateral femoral nerve block in two cases undergoing bilateral simultaneous total knee arthroplasty. Although epidural catheters must be removed before anticoagulant treatment can be performed after surgery, femoral nerve block, poses minimal hindrance to anticoagulant therapy. Because femoral nerve block alone cannot provide sufficient postoperative pain relief after total knee arthroplasty, additional sciatic nerve block, spinal anesthesia, opioid administration, or some other means of analgesia is necessary.

Single-session ureteroscopy with holmium laser lithotripsy for multiple stones.

Multiple stones are found in 20-25% of patients with urolithiasis. The stone multiplicity is a powerful adverse factor influencing the treatment outcome after shockwave lithotripsy, although guidelines for the treatment of multiple stones have not been well established yet. Herein we report our most recent experience of a single-session ureteroscopy for multiple stones.

Clinical studies of acute myeloid leukemia in the Japan Adult Leukemia Study Group.

Acute myeloid leukemia (AML) is the most common adult leukemia in Japan. The treatment for AML consists of induction, consolidation, and maintenance therapies. To improve outcomes in the treatment of AML, the Japan Adult Leukemia Study Group has conducted six studies in AML patients aged 15-64 years since 1987.

[Twenty-one-year survival case of rectal GIST treated with combined therapies].

A 55-year-old man underwent Miles' operation with a diagnosis of rectal leiomyosarcoma in 1990. From 1998 to 2004, he had liver and lung metastases and local site recurrent tumors which were removed surgically. Immunohistochemically the recurrent tumor was positive for c-kit and CD34, and the diagnosis of GIST was confirmed.

Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater.

Although percutaneous nephrolithotomy has been recommended as the first-line treatment for renal stones larger than 2 cm, its major complication rate is not negligible and less invasive approaches are to be explored. Thanks to the recent advances in endoscopic technology, flexible ureteroscopy has become another option in this setting. Herein we report our most recent experience with flexible ureteroscopy for large renal stones.

[Transurethral lithotripsy with rigid and flexible ureteroscopy for renal and ureteral stones: results of the first 100 procedures].

We evaluated the clinical outcome of transurethral lithotripsy (TUL) using rigid & flexible ureteroscopy and holmium : yttrium-aluminum-garnet (YAG) laser in our hospital. We retrospectively reviewed 100 consecutive transurethral lithotripsy procedures performed on 82 patients from May 2008 to June 2010 at our hospital. Twenty-five patients (30%) had multiple stones and 10 patients (12%) had bilateral stones.

Lack of non-hematological cross intolerance of dasatinib to imatinib in imatinib-intolerant patients with Philadelphia chromosome positive chronic myeloid leukemia or acute lymphatic leukemia: a retrospective safety analysis.

The aim of this retrospective study was to evaluate the toxicity profiles of dasatinib in patients with Philadelphia chromosome positive chronic myeloid leukemia (CML) or acute lymphatic leukemia (ALL) who were intolerant to imatinib, and who had been enrolled in our previous clinical trials to evaluate efficacy of dasatinib in patients resistant or tolerant to imatinib therapy. Twenty-four patients with CML and four with ALL were enrolled in the clinical studies to evaluate the efficacy according to the eligibility criteria related to intolerance to imatinib therapy. The toxicities reported during imatinib therapy were non-hematological toxicities in 23 patients and hematological toxicities in six patients.

[A case of synchronous double cancer of stomach and lung responding to neoadjuvant chemotherapy].

A 66-year-old male was admitted to our hospital because of dyspnea in 2007. Cancerous pleural effusion and gastric cancer was diagnosed, and the chemotherapy consisted of S-1 + DOC was started for Stage IV gastric cancer. In 2009, lung cancer was found.

[A case with liver resection of metastasis from rectal cancer after bevacizumab treatment].

The advancement of systemic chemotherapy for colorectal carcinoma has improved a clinical response rate and expanded a possibility of resection, which we thought we could not have been operable at the initial visit. It also improved a prognosis of patients. We report here a case with liver resection of metastasis from rectal cancer followed by bevacizumab treatment.

[Resection of local recurrent gastric cancer following total gastrectomy].

We report a case of patient who underwent resection for local recurrent gastric cancer at the anastomotic site curatively. The patient was a 72 years old male with a history of undergoing total gastrectomy for gastric cancer located at the gastric cardia in February 2005. The histological findings of the resected tumor showed a Type 3 advanced gastric cancer invaded into subserosa in the cardia of the stomach with positive lymphatic and venous invasion and lymph node metastasis.

Prognostic potential of detection of WT1 mRNA level in peripheral blood in adult acute myeloid leukemia.

We retrospectively analyzed the potential of Wilms' tumor gene 1 (WT1) mRNA levels in peripheral blood for predicting the prognosis of 50 patients with AML. After achieving complete remission (CR), 34 patients (69.4%) were determined to be positive and 15 (30.

[A long-term survival case of colon cancer with multiple liver metastases treated with multidisciplinary therapy].

A 52-year-old man underwent abdominoperineal resection of the rectum, a partial hepatectomy, and intrahepatic arterial infusion chemotherapy for rectal cancer and liver metastases in 2001. Due to recurrent liver metastases, additional hepatectomies were performed in 2003 and 2005. He then underwent radiofrequency ablation therapy and systemic chemotherapies with mFOLFOX6 and FOLFORI.

[A case of urachal carcinoma with transverse colon fistula].

A 61-year-old woman was admitted to our hospital because of abdominal pain. Computed tomography showed an abscess in the anterior abdominal wall and an intraabdominal tumor. Biopsy from bladder dome presented adenocarcinoma.

A chemical hemostatic technique for bleeding from malignant wounds.

Background: Breast cancer, skin cancer, and head and neck cancer often develops a hemorrhagic malignant wound. Bleeding from the tumor impairs patients' quality of life and can be life threatening, while surgical or electrical hemostasis is often unsuccessful because of the tumor's friability.

Methods: We performed a chemical hemostatic treatment for breast cancer hemorrhage with zinc chloride paste (Mohs' paste), which is usually applied as a fixative in micrographic surgery for cutaneous neoplasms.