1.Examination of 93 cases of perianal warts and suggestion of a new classification
Jo UNOTORO ; Keigo MATSUO ; Takehiro ARAI ; Shigeru OKADA ; Teruki KAWANISHI ; Ryoichi IKEGAMI ; Shuzo MORI ; Hiroshi MATSUNO
Annals of Coloproctology 2023;39(3):242-249
Purpose:
The anatomical distribution of perianal warts is associated with patient characteristics such as sexual orientation. The purpose of this study is to confirm this experiential knowledge using a quantitative classification system and analysis and to obtain findings useful for future treatment.
Methods:
From January 2014 to December 2020, 93 patients with perianal warts presented to our hospital. Patients were analyzed for age, sex, lesion site, and recurrence type, among other factors. The lesion site was divided into skin (S) and anal epithelium (anoderm, A), and the number and degree of each were classified into grades 0 to 3. The higher grade between S and A determines its dominant type, such as type S (e.g., S3A1) and type A (e.g., S0A2).
Results:
The average age of the patients was 39.6 years, and the percentage of patients who were not married was 54.8%. In all, 95.8% of patients were positive for low-risk human papillomavirus (HPV). Type S accounted for 80.6%, whereas type A accounted for 9.7%. Type A cases were all male and were all presumed to be men who have sex with men (MSM). This indicates that the determination of type A may be highly specific for MSM. The type at the time of recurrence was the same type at the time of the first surgery in almost all cases.
Conclusion
In cases of perianal warts, it is useful to analyze the lesion by considering the range and grade separately for daily clinical practice on proctologist.
2.Combination Therapy with Rituximab and Temozolomide for Recurrent and Refractory Primary Central Nervous System Lymphoma.
Mineko MURAKAMI ; Takamitsu FUJIMAKI ; Shuichiro ASANO ; Hiroshi NAKAGUCHI ; Shoko M YAMADA ; Katsumi HOYA ; Kazuto YAMAZAKI ; Yasuo ISHIDA ; Akira MATSUNO
Yonsei Medical Journal 2011;52(6):1031-1034
High-dose methotrexate-based chemotherapy has extended survival in patients with primary central nervous system lymphoma (PCNSL). However, although salvage treatment is necessary in recurrent and refractory PCNSL, this has not been standardized. We herein describe the efficacy of a combination of rituximab and temozolomide (TMZ) in two consecutive patients with recurrent and refractory PCNSL. Based on the immunohistochemical study, case 1 had a non-germinal center B-cell-like (non-GCB) subtype, was positive for bcl-2 and negative for O6-methylguanine-DNA methyltransferase (MGMT). Case 2 was GCB subtype, bcl-2-, and MGMT+. Because of the positive expression of MGMT, interferon-beta was additionally given in case 2. Complete responses and partial responses were obtained after the third and fourth cycles of combination therapy, respectively. This was maintained for 12 months, with acceptable toxicity. The combination of rituximab and TMZ was effective in tumors with different immunohistochemical profiles. This combination therapy warrants further study in a larger population.
Aged
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Antibodies, Monoclonal, Murine-Derived/*therapeutic use
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Antineoplastic Agents/*therapeutic use
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Central Nervous System Neoplasms/*drug therapy
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Dacarbazine/*analogs & derivatives/therapeutic use
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Drug Therapy, Combination/*methods
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Humans
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Lymphoma/*drug therapy
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Male
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Middle Aged
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Neoplasm Recurrence, Local/drug therapy
3.Current Status of Surgical Technique Training Such as Off the Job Training
Yoshinori INOUE ; Kenji NAMIGUCHI ; Yusuke KINUGASA ; Yutaro MATSUNO ; Hiroshi KODAMA ; Hiromu HORIE ; Sayako NAKAGAWA
Japanese Journal of Cardiovascular Surgery 2021;50(4):4-U1-4-U5
Young cardiovascular surgeons work on various trainings such as OFFJT to improve surgical techniques. In this paper, we conducted a questionnaire survey of U-40 members to find out what they are doing to acquire standard surgical techniques.
4.Intrapleural Urokinase and Antibiotic Therapy for Empyema after In Situ Reconstruction of the Aorta and Lobectomy for Aortopulmonary Fistula due to Thoracic Aortic Aneurysm Rupture
Ryosuke NAWATA ; Ryo SUZUKI ; Toshiki YOKOYAMA ; Sarii TSUBONE ; Yutaro MATSUNO ; Hiroshi KURAZUMI ; Bungo SHIRASAWA ; Akihito MIKAMO ; Kimikazu HAMANO
Japanese Journal of Cardiovascular Surgery 2023;52(2):118-122
A 62-year-old man presented with hemoptysis and hoarseness. He was diagnosed with an aortopulmonary fistula due to a thoracic aortic aneurysm rupture and was referred to our department. Emergency in-situ reconstruction of the aorta and pulmonary lobectomy were performed. Nine days postoperative, he developed empyema. Intrapleural urokinase and antibiotic therapy were selected as management instead of a video-assisted thoracoscopic debridement and decortication due to his worsening condition. The treatment was successful, and he was discharged from the hospital without any further complications. This study highlights the benefit of intrapleural administration of urokinase and antibiotics in patients with acute empyema, when surgical treatment is inappropriate.