30 results match your criteria: "Yanagawa Hospital[Affiliation]"

A 62-year-old man was diagnosed with Stage Ⅲ signet ring cell carcinoma of the lower thoracic esophagus. The patient underwent 2 courses of neoadjuvant cisplatin and 5-fluorouracil(SP therapy), demonstrating stable efficacy. Subsequently, the patient underwent subtotal esophagectomy with thoracoabdominal 2-field lymphadenectomy via right thoracotomy, followed by esophageal reconstruction using a gastric tube through a retrosternal route.

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67-year-old woman underwent definitive chemoradiotherapy( dCRT) with cisplatin( CDDP) and 5-fluorouraci(l 5-FU)(FP) for locally advanced unresectable squamous cell carcinoma of the thoracic esophagus. During treatment, the patient developed grade 3 pharyngitis and esophagitis as adverse events. She was administered maintenance chemotherapy with 2 courses of FP and achieved complete response.

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Background And Aims: Precise diagnostic biomarkers are urgently required for pancreatic ductal adenocarcinoma (PDAC). Therefore, the aim of this study was to identify PDAC-specific exosomal microRNAs (Ex-miRs) from pancreatic juice (PJ) and evaluate their diagnostic potential.

Methods: Exosomes in PJ and serum were extracted using ultracentrifugation and confirmed morphologically and biochemically.

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This is a 2-case report of concomitant left atrial( LA) surgical ablation through the left atrial appendage( LAA) for atrial fibrillation( AF) during aortic valve replacement( AVR). Case 1, a 74-year-old man, and Case 2, an 85-years-old woman, were presented for AVR and AF. Under the cardio-pulmonary bypass, right and left pulmonary vein isolations( PVIs) were performed with radiofrequency( RF) ablation devices.

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Article Synopsis
  • * Out of 1280 enrolled patients, 86 (6.7%) developed HCC during the follow-up, with key factors like serum alpha-fetoprotein (AFP) level, Fibrosis-4 index, and MASLD identified as independent risk factors for HCC development.
  • * The findings highlight that MASLD is a significant risk factor for HCC, even in patients with low AFP levels, suggesting the need for monitoring MASLD in patients who have eradicated HCV. *
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This study aimed to evaluate the effect of lenvatinib (LEN) combined with transcatheter intra-arterial therapy (TIT) for advanced-stage hepatocellular carcinoma (HCC) after propensity score matching (PSM). This retrospective study enrolled 115 patients with advanced-stage HCC who received LEN treatment. The patients were categorized into the LEN combined with TIT group ( = 30) or the LEN monotherapy group ( = 85).

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This study aimed to investigate the clinical characteristics of patients with unresectable hepatocellular carcinoma (HCC), who were eligible for sequential systemic therapy. We evaluated 365 patients with HCC who underwent systemic therapy after 2017. The overall survival (OS) was 13.

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Aim: Lenvatinib is used to treat advanced hepatocellular carcinoma (HCC). Metabolic dysfunction-associated fatty liver disease (MAFLD) is becoming a major etiology of HCC. We aimed to evaluate the impact of MAFLD on the efficacy of lenvatinib.

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  • A multicenter study investigated the effectiveness of sofosbuvir/velpatasvir treatment in improving liver function in patients with hepatitis C virus-related decompensated cirrhosis, involving 48 patients classified as Child-Pugh (CP) class B or C.
  • After 12 weeks of treatment, a 95.8% sustained virologic response was observed, with significant improvements in liver function markers at 24 weeks post-treatment, including serum albumin and alanine aminotransferase levels.
  • The study found that while the therapy enhanced liver functional reserve, a body mass index (BMI) of 25 or higher was a barrier to improving the CP class, and factors such as hepatic encephalopathy
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  • - The study investigated how daily living activities (ADL) and related factors impact caregiver burden and potential depression among 50 caregiver-user pairs involved in home rehabilitation.
  • - Participants were categorized into high-burden and low-burden groups based on scores from the Zarit Caregiver Burden Interview, with specific attention given to the Barthel Index's controlling bladder item.
  • - Findings revealed that a score of 5 or less on the bladder control item, combined with caring for a younger recipient (≤78 years), significantly increased the likelihood of high caregiver burden, indicating a risk for caregiver depression.
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This report presents a modified procedure of tricuspid valve ring annuloplasty (R-TAP) with posterior annular plication for functional tricuspid regurgitation (TR). Sutures on the native annulus were placed by a standard fashion in R-TAP, and those on the posterior annulus and its bilateral commissures were passed through in a narrow range between the 3 and 4 o'clock positions of the 26-mm ring. The other sutures were done with an usual manner and the ring was fixed to the annulus, resulting in the posterior annular plication( bicuspidization).

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Background And Aims: Sequential therapy with molecular-targeted agents (MTAs) is considered effective for unresectable hepatocellular carcinoma (HCC) patients. This study purposed to evaluate the efficacy of sequential therapy with sorafenib (SORA) as a first-line therapy and to investigate the therapeutic impact of SORA in nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steato hepatitis (NASH)-related HCC.

Methods: We evaluated 504 HCC patients treated with SORA (Study-1).

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Gemcitabine plus nab-paclitaxel (GnP) is widely used in clinical practice, despite a lack of prospective data to validate its efficacy in locally advanced pancreatic cancer (LAPC). We conducted a phase II study of GnP for LAPC to assess its efficacy and safety.We performed a single-arm, single-institution study with GnP in 24 patients with LAPC.

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We aimed to evaluate the impact of alternating lenvatinib (LEN) and trans-arterial therapy (AT) in patients with intermediate-stage hepatocellular carcinoma (HCC) after propensity score matching (PSM). This retrospective study enrolled 113 patients with intermediate-stage HCC treated LEN. Patients were classified into the AT ( = 41) or non-AT group ( = 72) according to the post LEN treatment.

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This is a 3-case report of successful descending thoracic and thoracoabdominal aortic surgery by preserving the spinal perfusion artery (SPA) identified preoperatively. In Case 1, an 85-year-old woman, computed tomography (CT) showed Crawford type Ⅴ thoracoabdominal aortic aneurysm (TAAA:60 mm) and a SPA originated from L2. In Case 2, a 76-year-old man, CT revealed type Ⅳ TAAA( 58 mm) and a SPA originated from Th11.

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Tyrosine kinase inhibitors are considered for use in patients with hepatocellular carcinoma (HCC) refractory to transarterial chemoembolization (TACE). The aim of the present retrospective study was to identify factors associated with progression-free survival (PFS) and to evaluate the indications for lenvatinib treatment in patients with intermediate-stage HCC refractory to TACE using a data-mining analysis. A total of 171 patients with intermediate-stage HCC refractory to TACE were included.

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We sought to investigate the clinical profile(s) associated with the discontinuation of lenvatinib (LEN) due to severe adverse events (DLSAE) in patients with unresectable hepatocellular carcinoma (HCC). This retrospective study enrolled 177 patients with HCC treated with LEN. Independent factors associated with DLSAE were advanced age, albumin-bilirubin (ALBI) grade 2, fatigue grade ≥ 3, and appetite loss ≥ 2.

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We aimed to investigate the impact of the controlling nutritional status (CONUT) score, an immuno-nutritional biomarker, on the prognosis of patients with hepatocellular carcinoma (HCC) treated with lenvatinib (LEN). This retrospective study enrolled 164 patients with HCC and treated with LEN (median age 73 years, Barcelona Clinic Liver Cancer (BCLC) stage B/C 93/71). Factors associated with overall survival (OS) were evaluated using multivariate and decision tree analyses.

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Article Synopsis
  • The study compares two treatment approaches for advanced ovarian, tubal, and peritoneal cancers: primary debulking surgery (PDS) and neoadjuvant chemotherapy (NACT), finding that NACT may not be as effective as PDS for overall survival (OS).
  • A total of 301 patients were randomized, with median OS of 49.0 months for PDS and 44.3 months for NACT, illustrating that while NACT is less invasive, it did not confirm noninferiority compared to PDS.
  • Factors like tumor resection success and patient characteristics influenced outcomes; thus, while NACT may be effective, further examination is needed to determine if it can broadly replace PDS in treatment
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This is a 2-case report of successful aortic repair surgery for the retrosternal giant aortic aneurysm. Our surgical strategy is "deep hypothermia and left ventricular( LV) unloading under cardiopulmonary bypass before approaching to the aortic aneurysm" in case of possible catastrophic bleeding. Case 1, a 64-year-old woman, had a retrosternal pseudoaneurysm (80 mm) at the distal anastomosis of a Dacron graft used to replace the ascending aorta 7 years before.

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[Mitral Valve Replacement with the On-X Valve].

Kyobu Geka

November 2019

Department of Cardiovascular Surgery, Yanagawa Hospital, Yanagawa, Japan.

This is a 3-case report of mitral valve replacement (MVR) with an On-X mechanical valve followed up to 10 years. Case 1(64-year-old man) and case 2 (66-year-old woman) experienced traffic accident and traumatic event, respectively, in their chronic phase after MVR. Case 1 had multiple bone fractures of the bilateral lower limbs, which was followed by systemic infection and pyogenic spondylitis.

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Stabilization of vulnerable carotid plaques with proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab.

Acta Neurochir (Wien)

March 2019

Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a novel class of monoclonal antibodies, reduce low-density lipoprotein cholesterol levels and improve outcomes of myocardial infarction and stroke. However, the effects of PCSK9 inhibitors on carotid plaques remain unclear. We describe three patients treated with PCSK9 inhibitor alirocumab for progressive carotid stenosis despite lipid-lowering statin therapy.

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Metronidazole-induced encephalopathy in a patient with pyogenic spondylitis: a case report.

BMC Musculoskelet Disord

September 2018

Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.

Background: Metronidazole is an antimicrobial agent commonly used in the treatment of several protozoal and anaerobic infections. Neurotoxicity associated with metronidazole has been rarely reported, and the incidence of metronidazole-induced encephalopathy is unknown. Therefore, the accurate diagnosis of metronidazole-induced encephalopathy is often difficult because of the rarity of the disease.

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Background: We conducted a nationwide survey on chemotherapy-induced nausea and vomiting (CINV) in Japan and demonstrated good compliance with Japanese CINV guidelines, resulting in good control of vomiting. However, almost half the patients experienced breakthrough CINV. We analyzed the survey results in relationship to the management of patients with breakthrough CINV.

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This report discusses intraoperative endoscopic evaluation of the aortic valve performed in 2 cases of aortic valve repair. The "direct" or real image by the endoscopy helped to confirm the preoperatively-known lesion and even to detect a new legion which was not detected preoperatively. The endoscopy also enabled the evaluation of the aortic valve under the pressure-loaded condition without releasing the aortic clamp.

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