1.A Successful Case of Cardiac Operation and Chemotherapy for Primary Cardiac Malignant Lymphoma with Superior Vena Cava Syndrome
Takao Tsuchida ; Kentaro Yano ; Hitoshi Fukumoto
Japanese Journal of Cardiovascular Surgery 2014;43(3):146-149
Primary cardiac lymphomas are rare cardiac neoplasms with poor prognoses. We report a 61-year-old man who presented with superior vena cava (SVC) syndrome. Trans-thoracic echocardiography showed a 77×91-mm mass occupying the right atrium. The tumor obstructed the SVC. The deteriorating hemodynamics of our patient prompted a surgical intervention. We resected as much of the tumor as possible under cardiopulmonary bypass. The postoperative course was uneventful, and the SVC syndrome disappeared. Pathological examination was consistent with malignant lymphoma, diffuse large B-cell type. After cardiac operation, the patient was treated with rituximab, cyclophosphamaide, adriamycin, vincristin, and prednisone (CHOP-R). The patient has been in good health for 30 months without signs of recurrence.
2.A Patient with an Aberrant Right Subclavian Artery Who Underwent Endovascular Aortic Repair for Stanford Type B Acute Aortic Dissection
Takao Tsuchida ; Masataka Yoshida ; Kentaro Yano ; Hitoshi Fukumoto
Japanese Journal of Cardiovascular Surgery 2016;45(4):205-210
Case : A 75-year-old man was brought to our hospital by ambulance with dorsal pain. Contrast-enhanced computed tomography (CT) revealed acute communicating aortic dissection (Stanford type B) complicated by an aberrant right subclavian artery (ARSCA). Under a diagnosis of type B dissection, conservative treatment by hypotensive therapy and resting was performed. One month after onset, contrast-enhanced CT showed the expansion of the false lumen, and intermittent abdominal pain persisted. To close the entry of the distal arch and reconstruct the ARSCA route, right common carotid artery-right axillary artery bypass, thoracic endovascular aortic repair (TEVAR), and coil embolization of the ARSCA were performed. Five days after surgery, contrast-enhanced CT revealed the expansion of a false abdominal lumen. Abdominal endovascular aortic repair (EVAR) was additionally conducted, leading to the disappearance of false lumen blood flow. ARSCA is a congenital arch vessel abnormality. It may cause obstruction of the esophagus/trachea, aortic aneurysm/dissection of an adjacent area, or aneurysmal changes/rupture of the ARSCA. Various techniques have been reported ; reconstruction of the ARSCA route and closure of the false lumen by de-branch TEVAR may be effective for acute communicating aortic dissection with an ARSCA.
3.Specificity of the meridians and acupuncture-points. Effects of qiuxu on the gallbladder's form.
Tadashi YANO ; Yoshiki OYAMA ; Nobuyuki YAMADA ; Kazu MORI ; Toshinori YUKIMACHI ; Shinichi FUSHITA ; Kentaro MAEDA ; Ryo KAWAMOTO ; Katsuhiko SHIMOYA ; Takao SHIBATA ; Shigeru IHARA ; Naoto HONTANI ; Katsutoshi GOTO ; Hiroshi NAKATA ; Misao OKIEBISU
Journal of the Japan Society of Acupuncture and Moxibustion 1990;40(4):343-350
Objective:
There have been a few reports on the specificity of the meridians and Acupuncture-points. In order to identify the specific effects of the meridians and Acupuncture-points, the functional relations between “the gallbladder Meridian and gallbladder” were investigated using the gallbladder's form as an index.
Materials and Methods:
Ten healthy male adult volunteers participated in the experiments in fasting conditions. The target organ was the gallbladder, and its form was measured with the ultrasonic diagnostic apparatus (Toshiba SSA-90A). The images of the gallbladder form were taken at the point when the major long axis of the cross-section of the gallbladder reached the peak. The cross-sectional area of the gallbladder was measured with the image analyzer. The measurement of the gallbladder form was conducted after 15 minutes lying on the back, taking images for 10 minutes before stimulation, for 30 minutes during and after stimulation, every two to five minutes. The acupuncture stimulation was given at the points of G34, G36, G37, G40 and G44 on the right side of the body. After getting the deqi, 1 minute of sparrow pecking needle technique and 1 minute of leaving needle technique were conducted three times. The effect of the G40 under the egg yolk loading were also investigated.
Results:
1) The stimulation of the G34, G36, G37, and G44 showed no effects on the gallbladder form. 2) The stimulation of the G40 caused the distension of the gallbladder form. 3) The stimulation of the G40 showed the suppressive effect on the contraction of the gallbladder due to the load of egg yolk.
As described above, the results of this study showed that there is an acupuncture-point on the gallbladder meridian to cause the distension of the gallbladder specifically. It suggests the existence of the specificity of acupuncture-point.
4.Clinicopathologic features, treatment, prognosis and prognostic factors of neuroendocrine carcinoma of the endometrium: a retrospective analysis of 42 cases from the Kansai Clinical Oncology Group/Intergroup study in Japan
Harunobu MATSUMOTO ; Mototsugu SHIMOKAWA ; Kaei NASU ; Ayumi SHIKAMA ; Takaya SHIOZAKI ; Masayuki FUTAGAMI ; Kentaro KAI ; Hiroaki NAGANO ; Taisuke MORI ; Mitsutake YANO ; Norihiro SUGINO ; Etsuko FUJIMOTO ; Norihito YOSHIOKA ; Satoshi NAKAGAWA ; Muneaki SHIMADA ; Hideki TOKUNAGA ; Yuki YAMADA ; Tomohiko TSURUTA ; Kazuto TASAKI ; Ryutaro NISHIKAWA ; Shiho KUJI ; Takashi MOTOHASHI ; Kimihiko ITO ; Takashi YAMADA ; Norihiro TERAMOTO
Journal of Gynecologic Oncology 2019;30(6):e103-
OBJECTIVE: We conducted a retrospective, multi-institutional, collaborative study to accumulate cases of neuroendocrine carcinoma of the endometrium, to clarify its clinicopathologic features, treatment, prognosis and prognostic factors to collate findings to establish future individualized treatment regimens. To our knowledge, this is the largest case study and the first study to statistically analyze the prognosis of this disease. METHODS: At medical institutions participating in the Kansai Clinical Oncology Group/Intergroup, cases diagnosed at a central pathologic review as neuroendocrine carcinoma of the endometrium between 1995 and 2014 were enrolled. We retrospectively analyzed the clinicopathologic features, treatment, prognosis and prognostic factors of this disease. RESULTS: A total of 65 cases were registered from 18 medical institutions in Japan. Of these, 42 (64.6%) cases were diagnosed as neuroendocrine carcinoma of the endometrium based on the central pathological review and thus included in the study. Advanced International Federation of Gynecology and Obstetrics stages (stage III and IV) and pure type small cell neuroendocrine carcinoma cases had a significantly worse prognosis. Upon multivariate analysis, only histologic subtypes and surgery were significant prognostic factors. Pure type cases had a significantly worse prognosis compared to mixed type cases and complete surgery cases had a significantly better prognosis compared to cases with no or incomplete surgery. CONCLUSION: Our findings suggest that complete surgery improves the prognosis of neuroendocrine carcinoma of the endometrium. Even among cases with advanced disease stages, if complete surgery is expected to be achieved, clinicians should consider curative surgery to improve the prognosis of neuroendocrine carcinoma of the endometrium.
Carcinoma, Large Cell
;
Carcinoma, Neuroendocrine
;
Carcinoma, Small Cell
;
Endometrial Neoplasms
;
Endometrium
;
Female
;
Gynecology
;
Japan
;
Medical Oncology
;
Multivariate Analysis
;
Obstetrics
;
Prognosis
;
Retrospective Studies