The case of a 20-year-old female with Cockayne syndrome, presenting with reduced intake of food, is described. At admission, her intake of food and her body weight were low. The patient's food swallowing function was recorded by video fluorography and evaluated. Reduced transfer of food boluses to the posterior site of the oral cavity, incomplete formation of boluses in the oral phase, and residual food after swallowing in the pharynx phase were observed. No aspiration was observed, however, during video fluorography. The patient's nutrition was managed by changing her meals to fluid-type food to shorten the eating time.

　　Recently, eosinophilic chronic rhinosinusitis (ECRS) has become a very common disease in Japan. ECRS differs from other types of sinusitis in terms of clinical features, such as high rate of recurrence, olfactory disorders, ineffective macrolide therapy, and severe paranasal sinus shadow on CT imaging. The diagnosis of ECRS requires a biopsy of nasal polyps. Therefore, we tried to predict ECRS by evaluating CT images using the Lund-Mackay CT Scoring system (LMS). This retrospective study involved 105 patients who had undergone surgical treatment (ESS) between July 2011 and November 2012. These patients were divided into three groups based on patterns of pathogenesis: ECRS, fungal sinusitis (FS), and chronic sinus infection (CSI). The pathological classification of nasal polyp was graded on a 3-point scale according to the degree of eosinophilic infiltration. Total LMS score for the ECRS was 9.4±0.6 (mean±SE), which was significantly higher than for the other LMS scores (FS: 4.6±1.0, CSI: 5.8±0.2). LMS scores for the maxillary sinus were high for all three patterns of pathogenesis (ECRS: 1.4± 0.1, FS: 1.7±0.2, CSI: 1.3±0.1). The scores for the frontal and sphenoid sinus forECRS were significantly higher than the scores for the FS and CSI (maxillary sinus, ECRS: 1.5±0.1, FS: 0.4±0.2, CSI: 0.6±0.1; sphenoid sinus, ECRS: 1.4±0.2, FS: 0.2±0.1, CSI: 0.6±0.3). We assessed for and found a positive correlation between the bilateral LMS score and eosinophilic infiltration (rs＝0.665). Therefore, ECRS can be predicted by LMS without biopsy and LMS helps determine the management of chronic rhinosinusitis.

The case of a 20-year-old female with Cockayne syndrome, presenting with reduced intake of food, is described. At admission, her intake of food and her body weight were low. The patient's food swallowing function was recorded by video fluorography and evaluated. Reduced transfer of food boluses to the posterior site of the oral cavity, incomplete formation of boluses in the oral phase, and residual food after swallowing in the pharynx phase were observed. No aspiration was observed, however, during video fluorography. The patient's nutrition was managed by changing her meals to fluid-type food to shorten the eating time.

AIMTo assess the efficacy and limitation of free/total prostate-specific antigen ratio (f/tPSA) at a single institution in Japan, focusing on the avoidance of pointless prostate biopsies.

METHODSIn total, 631 men between 44 and 93 years old (mean 69.8 years) with elevated PSA underwent power-Doppler ultrasoundgraphy-guided transrectal 10-core prostate biopsies at Niigata Cancer Center Hospital, and their histological features were investigated with total PSA (tPSA) and f/tPSA.

RESULTSPCa was detected in 126 of 134 patients (94.3%) with tPSA of 26 ng/mL or higher. The detection rate was 59.4% for tPSA of 21-25 ng/mL, followed by 39.2% for 16-20 ng/mL, 30.0% for 11-15 ng/mL, 20.0% for 4.1-10 ng/mL and 7.6% for = or <4.0 ng/mL. f/tPSA of the PCa group was significantly lower than that of non-malignamt disorders in any tPSA ranges (mean 0.122 vs. 0.160, P<0.001). Receiver-operating characteristics analyses showed that f/tPSA (AUC:0.664) performed more valuably than tPSA (AUC:0.559) in patients with tPSA between 3.0-10 ng/mL (P<0.01). Although f/tPSA of 0.250 for the cut-off value might miss 1.8% PCa patients, it potentially spares 9.2% of unnecessary biopsies.

CONCLUSIONf/tPSA is more valuable compared with tPSA alone for the prediction of the occurrence of PCa. We recommend 0.250 as the cut-off value for f/tPSA in PCa screening for Asian men having so-called grey-zone tPSA.

Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Humans ; Japan ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; diagnosis ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography, Doppler

AIMTo investigate the outcomes for Asian populations with locally advanced/clinical stage III prostate cancer (PCa) treated with currently prevailing modalities.

METHODSWe reviewed the record of 209 patients with clinical stage III PCa, who were treated at Niigata Cancer Center Hospital between 1992 and 2003. Treatment options included hormone therapy-combined radical prostatectomy (RP+HT), hormone therapy-combined external beam irradiation (EBRT+HT) and primary hormone therapy (PHT).

RESULTSThe 5- and 10-year overall survival rates were 80.3% and 46.1% in all cohorts, respectively. The survival rates were 87.3% and 66.5% in the RP+HT group, 94.9% and 70.0% in the EBRT+HT group and 66.1% and 17.2% in the PHT group, respectively. A significant survival advantage was found in the EBRT+HT group compared with that in the PHT group (P < 0.0001). Also, the RP+HT group had better survival than the PHT group (P = 0.0107). The 5- and 10-year disease-specific survival rates for all cases were 92.5% and 80.0%, respectively. They were 93.8% and 71.4% in the RP+HT group, 96.6% and 93.6% in the EBRT+HT group and 88.6% and 62.3% in the PHT group, respectively. A survival advantage was found in the EBRT+HT group compared with the PHT group (P = 0.029). No significant difference was found in disease-specific survival between the EBRT+HT and RP+HT groups or between the RP+HT and PHT groups.

CONCLUSIONAlthough our findings indicate that radiotherapy plus HT has a survival advantage in this stage of PCa, we recommend therapies that take into account the patients'social and medical conditions for Asian men with clinical stage III PCa.

Aged ; Follow-Up Studies ; Humans ; Japan ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatectomy ; Prostatic Neoplasms ; drug therapy ; mortality ; pathology ; radiotherapy ; surgery ; Retrospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome