Biomedical subjects

Yasushi Rino

Publications and source records attributed to Yasushi Rino.

At least 19 recordsLinked to original sources

PubMed2006

Long-term outcome after hernia repair with the prolene hernia system.

PURPOSE: We evaluated the long-term outcome and symptoms after inguinal hernia repair using the Prolene Hernia System (PHS). METHODS: We reviewed the medical records of all patients who underwent PHS surgery at our hospital to assess the postoperative complications and recurrence rates. Late symptoms were evaluated by a standardized interview using a questionnaire. RESULTS: A total of 395 hernias in 367 patients were studied. Postoperative complications developed after 20 repairs (5.1%), including a severe mesh infection in one patient. Seven (1.8%) patients suffered recurrence. Of 395 cases, 363 (91.9%) responded to the interview. After a median follow-up interval of 19.3 months (range 1.0-55.8), moderate pain and moderate discomfort were reported by only 1.9% and 0.8% of patients, respectively. CONCLUSIONS: Prolene Hernia System surgery is a safe and feasible procedure with low rates of complication, recurrence, and late symptoms.

Adolescent↗

PubMed2006

Prognostic value of the sixth edition AJCC/UICC TNM classification for differentiated thyroid carcinoma with extrathyroid extension.

CONTEXT: The prognostic value of the sixth edition AJCC/UICC TNM classification is currently unclear. OBJECTIVE: The aim was to evaluate the prognostic value of the sixth edition. DESIGN AND PATIENTS: We retrospectively assessed 354 primary differentiated thyroid carcinomas (77 men and 277 women; age, 51.2 yr; follow-up, 107.6 months) between 1964 and 2003. Sixty percent of patients underwent lobectomy, 40% underwent subtotal/total thyroidectomy, and only 2% were given radioiodine. There were 153, 104, 86, and 11 patients in fifth stages I, II, III, and IV, and 175, 76, 14, 68, 10, and 11 patients in sixth stages I, II, III, IVA, IVB, and IVC, respectively. RESULTS: New T1-3 had no significant influence. In Cox proportional hazard analysis, T4a and T4b were significantly related to disease-specific survival (DSS). We separately analyzed 68 patients (age 45 yr or older) with extrathyroid extension. These T4 (fifth) tumors were reclassified as 6 T3, 52 T4a, and 10 T4b tumors. The 10-yr DSS rates were 100, 69.3, and 10.0% for T3, T4a, and T4b, respectively. T4b exhibited worse prognoses compared with T4a (P < 0.0001; hazard ratio, 10.1; 95% confidence interval, 4.1-25.3). Stages I and II in both editions achieved favorable prognoses. The 10-yr DSS rates were 67.0 and 27.3% in fifth stages III and IV, and 100, 74.5, 10.0, and 27.3% in sixth stages III, IVA, IVB, and IVC, respectively. DSS curves differed significantly between all sixth TNM stages (P < 0.0001). CONCLUSION: The sixth edition more accurately predicts different outcomes according to the revised criteria for the degree of extrathyroid extension.

Female↗

PubMed2006

Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion.

AIM: The aim of this study is to evaluate the outcome of different modes of resection in papillary thyroid carcinoma (PTC) with laryngotracheal invasion. MATERIALS AND METHODS: Sixty-four primary PTCs with laryngotracheal invasion between 1964 and 2003 were retrospectively analyzed (17 men and 47 women; mean age, 61.6 years; mean follow-up, 92.3 months). Thirteen curative resections included six pharyngolaryngoesophagectomies, two total laryngectomies, and five circumferential resections (complete surgery). Eighteen patients who were candidates for curative resection refused to undergo complete surgery to avoid functional impairment, especially laryngeal function (incomplete surgery). Thirty-three patients with minimal invasion underwent shave or partial resection (conservative surgery). Clinical outcomes were compared between the three groups. The influence of different types of surgery and invasion was also evaluated by Cox proportional hazard analysis. RESULTS: Three (23.1%) complete, 17 (94.4%) incomplete, and 4 (13.8%) conservative surgery patients died of disease (P < 0.0001). The 10-year disease-specific survival (Kaplan-Meier) in complete, incomplete, and conservative surgery patients were 62.9, 11.1, and 87.7%, respectively (log rank test, P < 0.0001). Incomplete surgery related to worse prognosis [p < 0.0001; hazard ratio (HR), 12.9) than complete or conservative surgery. Tracheal deep invasion (p = 0.0019, HR 7.6) and larynx invasion (p < 0.0001, HR 9.9) related to worse prognosis than minimal invasion. CONCLUSION: Curative resection improves clinical outcomes in PTCs with laryngotracheal invasion. Conservative resection for minimal invasion also can achieve favorable prognosis. The degree of tumor invasion is significantly related to survival.

Adult↗

PubMed2006

Successful treatment of multiple small-bowel perforations caused by cytomegalovirus in a patient with malignant lymphoma: report of a case.

We report the successful management of multiple small-bowel perforations caused by cytomegalovirus (CMV) infection in a 60-year-old man, 1 day after CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) therapy induction for malignant lymphoma. Emergency laparotomy was performed for perforative peritonitis, but we did not resect the lesions at this time. Instead, we exteriorized the small bowel and then irrigated the peritoneal cavity and intestinal tract. His white blood cell count was low, at 200 cells/microl, so this therapy was continued until it recovered. The intestine was highly edematous, but it improved after irrigation with peritoneal dialysis solution. In the second-stage procedure, we resected the small bowel with the perforations, and constructed a jejunostomy and colostomy, then closed the abdominal cavity. Although the patient needed central venous hyperalimentation, he had a favorable postoperative course and started treatment again for the malignant lymphoma.

Antibodies, Viral↗

PubMed2006

[A case of thymic cancer with pericardial tamponade as initial manifestation].

We report a case of thymic cancer with pericardial tamponade in a 70-year-old woman. The patient complained of chest pain and was carried to our hospital. CT scan showed a mediastinal mass and massive pericardial effusion. The effusion was serous fluid, not bloody, and no malignant cells were found. The patient underwent a tumor resection, and the final pathological diagnosis was squamous cell carcinoma of the thymus. In a review of 14 cases of thymic tumor with pericardial tamponade as initial manifestations in the Japanese literature,there were only three cases of thymic cancer. The prognosis was reported to be extremely poor.Some reports showed the effectiveness of chemotherapy and irradiation therapy. We should keep looking for the best treatment for this disease.

Aged↗

PubMed2006

[Clinical results of single therapy with TS-1 for advanced/recurrent gastric cancer].

In cases with advanced/recurrent gastric cancer undergoing single therapy with TS-1, we retrospectively discussed the antitumor effects and adverse events and considered the clinical utility of TS-1. The subjects consisted of 131 cases with advanced/recurrent gastric cancer who received one or more courses of therapy with TS-1 alone between July 1999 and August 2003. We carried out 4-week administration of 80-120 mg/day of TS-1 according to body surface area, followed by a 2-week discontinuation, then repeated administration which adjusting the dosage according to the incidence of side effects, and discussed the antitumor effects and adverse events. The response rate in all cases was 21% and the median survival time (MST) was 343 days, or 25.3% and 265 days if limited to unresectable and recurrent cases. The response rates were 38.2% for unresectable cases, 16.3% for recurrent cases and 14.6% for curability C cases, and the MSTs were 250 days, 276 days and 419 days, respectively. The response rates in terms of whether or not patients had received chemotherapy were 11.6% for those who had received chemotherapy and 40.0% for those who had not, and the MSTs were 239 days and 325 days, respectively. Thus, both were significantly better in patients who had not received chemotherapy. The response rates for patients who had not received chemical therapy by target organs were favorable on the order of 50% for stomach and 33% for liver metastasis, and the MSTs were on the order of 474 days for peritoneum, 39 1 days for liver metastasis and 326 days for lymph nodes. There were 10 cases of long-term survival of 600 days or longer, but not in unresectable cases, and the target organs in many of the cases were the peritoneum and lymph nodes. Adverse reactions were observed in 34.4% of all cases and those of grade 3 or more in 9.4%, all of which were improved only by discontinuation of the drug. It was again confirmed that single therapy with TS-1 for advanced/recurrent gastric cancer is an excellent therapy providing both high antitumor effects and safety.

Adenocarcinoma↗

PubMed2006

[Clinical efficacy and safety of weekly paclitaxel therapy as second-line chemotherapy for patients with advanced and recurrent gastric cancer who were previously treated with TS-1 therapy].

The clinical efficacy and safety of weekly paclitaxel therapy were studied retrospectively in 17 patients with advanced and recurrent gastric cancer who had previously been treated with TS-1 therapy. The overall response rate was 0%, but MST was 495 days. The adverse effects observed were grade 3 leukopenia in 2 patients (11.8%) and grade 1 and 2 alopecia in 13 patients (76.5%). However, weekly paclitaxel therapy was performed for all outpatients. Weekly paclitaxel therapy could be useful and safe as second-line chemotherapy.

Aged↗

PubMed2006

[A case of flat elevated type carcinoma in adenoma of the duodenum with gastric cancer].

Duodenal adenoma is rare, and there have been very few case reports of flat elevated type adenoma. We report a case of flat elevated type carcinoma in adenoma of the duodenum with gastric cancer. A 58-year-old man was referred to our hospital for gastric cancer. Endoscopic examination revealed the gastric cancer and a flat elevated tumor in the descending part of the duodenum, measuring 6 cm in diameter. The biopsy specimen of the duodenal lesion was diagnosed as adenoma. Distal gastrectomy and segmental partial resection of the duodenum were performed with no complication. Histologically, the gastric cancer was poorly differentiated adenocarcinoma with submcosal invasion and without lymph node metastasis, and the duodenal tumor was a well differentiated carcinoma in villous adenoma. The duodenal adenocarcinoma was limited to the mucosal layer and the resected margins were free of tumor. It is difficult to distinguish a carcinoma from a benign elevated lesion in the duodenum. Therefore, a resection of the whole tumor is necessary. Though endoscopic resection is the first choice of therapy, a surgical partial resection is necessary when it is difficult. Then, a segmental resection may be one of the useful procedures of surgery.

Adenocarcinoma↗

PubMed2005

Growth index, assessed with Ki-67 and ssDNA labeling; a significant prognosticator for patients undergoing curative resection for hepatocellular carcinoma.

BACKGROUND AND OBJECTIVES: The aggressiveness and greater malignant potential of cancers are characterized by several biological phenomena such as accelerated growth invasiveness, and the ability to form distant metastasis. Thus, knowledge of such biological difference may be a more accurate prognosticator for cancer patients. Tumor growth depends on the degree of imbalance between cell production and loss. This study aimed to clarify a possible role for the modified prognosticator, growth index (GI); defined as the difference between Ki-67 (%) and single-stranded DNA (ssDNA) (%) labeling indices, in patients undergoing curative resection for hepatocellular carcinoma (HCC). METHODS: Tissue specimens were obtained from 40 HCC patients who underwent curative surgery. Immunohistochemical staining was performed using the avidin-biotin-peroxidase-complex method. RESULTS: The GI in HCC ranged from -1.90% to 28.65%, median 3.73. GI was related to histologic grade, intrahepatic metastasis, and pathologic T stage. Cumulative survival was poorer in patients with higher GI (> or = median value). Multivariate analysis demonstrated that GI is an independent prognosticator along with vascular invasion and intrahepatic metastasis. CONCLUSIONS: The higher GI values were significantly associated with histologic aggressive features of HCCs, and GI was a significant independent prognosticator in HCC patients after curative resection.

Aged↗

PubMed2005

Water-generated negative air ions activate NK cell and inhibit carcinogenesis in mice.

Negative ions are considered to have potential health benefits, but few studies have examined their effects in vivo. We studied water-generated negative ions (WNI) with respect to physical properties as well as immunologic activation and anti-tumor activity (inhibition of carcinogenesis and tumor growth) in mice. Electrically, generated negative ions (ENI) served as control. Water-generated negative ions had a long life, significantly enhanced the cytotoxic activity of natural killer cells, and significantly decreased the incidence of cancer and inhibited tumor growth. Anti-tumor effects were attributed to enhancement of natural killer cell activity. The mechanisms and applications of negative ions warrant further investigation.

Animals↗

PubMed2005

Solitary metachronous metastasis to the thyroid from renal clear cell carcinoma 19 years after nephrectomy: report of a case.

We report a rare case of a solitary metachronous metastasis of renal clear cell carcinoma (RCC) presenting as a thyroid tumor 19 years after a nephrectomy. Our search of the English-language literature found only sporadic reports of late RCC metastases to the thyroid. Fine-needle aspiration biopsy of the thyroid tumor was not accompanied with thyroglobulin (Tg) staining, leading us to initially suspect a primary follicular thyroid carcinoma. The patient, a 77-year-old man, underwent a total thyroidectomy with modified neck dissection. Histological examination confirmed the tumor to be RCC metastasis, and immunohistochemical analysis revealed that both Tg and thyroid transcription factor-1 (TTF-1) were negative in the tumor cells. Thus, the possibility of late RCC metastasis to the thyroid should be considered, even in a patient with a remote history. Furthermore, TTF-1 is useful for identifying thyroid metastatic carcinomas.

Aged↗

PubMed2005

[Treatment of neurological complication due to postgastrectomy vitamin E deficiency].

Although postgastrectomy vitamin E deficiency rarely occurs, it can cause neuromuscular disorder such as neuropathy, myopathy and cerebellar ataxia. We encounter a lot of cases whose serum vitamin E level were decreased after gastrectomy. We evaluated the oral vitamin E intake as a therapy to these cases. The subjects of this study were 11 gastrectomized patients (8 patients had total gastrectomy, 2 subtotal gastrtectomy, 1 partial gastrectomy) with decreased vitamin E. 10 patients had neurological complications such as dizziness, dysesthesia, truncal ataxia. Serum vitamin E increased to normal level in 10 patients and neurological disturbances were improved in 9 patients. The minimum requirement of oral vitamin E intake was 150 mg a day for normalization of serum vitamin E, on the other hand, it decreased with 150 mg intake in some patients. Their serum level increased with 300 mg. We suggest that it is important to check serum vitamin E in gastrectomized patients and oral vitamin E should be supplied over 300 mg for the therapy with vitamin E deficiency.

Administration, Oral↗

PubMed2005

[A case of advanced gastric cancer effectively treated by combined chemotherapy of TS-1 and paclitaxel].

A patient was a 66-year-old male who had advanced gastric cancer with left gastric artery lymph node metastasis and invasion of pancreas and spleen. We thought a complete resection was difficult, so he was given neo-adjuvant chemotherapy by combined of TS-1 100 mg/day (2 weeks administration and 1 week rest) and Paclitaxel (PTX) 75 mg/body (day 1, 8). After 2 courses of this neo-adjuvant chemotherapy, tumor and lymph node swelling had decreased in size, and the tumor markers were reduced remarkably (CEA 9 2.5 --> 12.2 ng/ml, CA 19-9 2, 739 --> 19 3 U/ml). He underwent total gastrectomy and Roux-en Y reconstruction. No.4 d and No.7 lymph nodes were swollen and hard, but white with a neurotic-like appearance. On pathological study, no malignancy was seen in the lymph nodes, and a good partial response was achieved. In this chemotherapy, no side effects were seen, and he maintained good quality of life. TS-1/PTX therapy was thought to be an effective neoadjuvant chemotherapy for advanced gastric cancer.

Aged↗

PubMed2004

Route from the paraaortic lymphatic system to the tracheobronchial lymph nodes evidenced on lymphangiogram in a patient with gastric cancer.

Lung metastasis from gastric or colonic cancer, without liver metastasis, is seldom seen. However, its metastatic pathway has not been delineated on imaging. We present and discuss such a lymphatic route in a patient with gastric cancer. The appearance of the mediastinum on a lymphangiogram is discussed. To the best of our knowledge, the lymphangiographic demonstration of the route from the paraaortic lymphatics to the tracheobronchial lymph nodes has been not reported. Lymphatics running from the paraaortic to the tracheobronchial lymph nodes through the diaphragm may play an important part in direct metastasizing to lung or tracheobronchial lymph nodes in certain patients.

Aorta↗

PubMed2004

Autologous salvaged blood transfusion in spontaneous hemopneumothorax.

Spontaneous hemopneumothorax (SHP) is a rare clinical entity, and an emergent operation due to continuous bleeding or hypovolemic shock is at times necessary. Although allogeneic blood transfusions are urgently required for significant blood loss, autologous blood transfusions can also be considered in patients with SHP. We herein report two cases of successful autologous blood transfusions using blood in the pleural space, decreasing or obviating the need for allogeneic blood transfusion.

Adult↗

PubMed2004

Sustained low alanine aminotransferase levels can predict the survival for 10 years without hepatocellular carcinoma development in patients with hepatitis C virus-associated liver cirrhosis of child stage A.

An analysis was performed of the patients with hepatitis C virus-associated liver cirrhosis (HCV-LC) who never developed hepatocellular carcinoma (HCC) for 10 years after the histological diagnosis of LC. Seventy-four consecutive HCV-LC patients of Child stage A were observed for >10 years prospectively for the development of HCC with frequent ultrasonography and magnetic resonance imaging or computed tomography. Of the 63 patients who fulfilled the study, 48 patients were treated and 15 were nontreated because of their stable state. They were subdivided into three groups according to their serum alanine aminotransferase (ALT) levels: the high ALT group comprised of 23 patients whose annual average serum ALT level was persistently high (>/=80 IU); the low ALT group comprised of 28 patients whose annual average serum ALT level was persistently low (<80 IU), and the unclassified ALT group comprised of 12 patients. In the low ALT group, as high as 71.4% of patients had never developed HCC for 10 years, in contrast to only 17.4% in the high ALT group (p < 0.001). In the 30 patients who never developed HCC for 10 years, 20 patients belonged to the low ALT group, in contrast to only 4 belonging to the high ALT group. Sustained low ALT levels were important to survive for 10 years without developing HCC in the HCV-LC patients of Child stage A.

Alanine Transaminase↗

PubMed2004

[An institution-randomized trial of 5-fluorouracil and l-leucovorin therapy given monthly versus every two months to patients with advanced colorectal carcinoma].

The aim of this study was to evaluate the efficacy and toxicity of 5-fluorouracil (5-FU) and l-leucovorin (l-LV) given at the same dose intensity and administered monthly (given weekly for 3 weeks followed by a week of rest; arm A) or every 2 months (given weekly for 6 weeks followed by 2 weeks rest; arm B) to patients with advanced colorectal carcinoma. The dose of 5-FU was 500 mg/body or 750 mg/body, with an average dose of 432.8 mg/m2. A total of 7 institutions participated in this multi-center study and were randomly divided into 2 groups of arms A and B. Thirty-three patients were entered into arm A and 21 into B. The overall response rate was significantly (p = 0.007) greater in arm B (23.5%) than in arm A (0%). The most frequently observed toxicity was diarrhea, which was observed in 6.5% of arm A and in 33.3% of arm B, marking a significant difference (p = 0.034). These data suggest that a monthly 5-FU/l-LV regimen might be less toxic than a 2-months regimen and less effective at the dose given as above. Further study is needed to evaluate the efficacy of a monthly regimen.

Adult↗

PubMed2004

Expression of survivin mRNA associates with apoptosis, proliferation and histologically aggressive features in hepatocellular carcinoma.

The clinical impact of survivin on human cancer pathogenesis and prognosis has been investigated. To clarify the clinical effect of survivin on tumor behavior and prognosis of patients with hepatocellular carcinoma (HCC), the expression of survivin mRNA in 40 samples of HCC tissue and matched-adjacent liver tissue, as well as 7 healthy hepatic tissue samples were measured by a real-time reverse transcription polymerase chain reaction. The expressed level of survivin mRNA (log copies/microg total RNA) in healthy liver tissue was 1.95+/-0.44, in morbid liver tissue adjacent to the tumors was 4.79+/-0.96, and in HCC tissue was 5.87+/-0.73 (values are mean +/- SD and P<0.001). The amount of survivin mRNA in HCC tissues correlated negatively with the apoptotic indices (r=-0.573 and P<0.001) and correlated positively with the proliferation indices (r=0.433 and P=0.005). Expression of survivin was significantly related with histologic grade (P=0.011) and pathological tumor stage (P=0.017). Patients with HCC tumors that had a large amount of survivin mRNA (> or = mean) had lower survival rate (P=0.030), but multivariate analysis showed only Ki-67 labeling index, histologic grade, and pathologic T stage to be the independent prognosticators. These findings indicate that survivin is associated with reduced tumor cell apoptosis, increased tumor cell proliferation, and histologically aggressive tumor features, and may play an important role in tumor progression of HCC. However, further examination is needed to clarify its predictive significance for HCC patients.

Aged↗