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1.
Nihon Shokakibyo Gakkai Zasshi ; 120(7): 615-622, 2023.
Artículo en Japonés | MEDLINE | ID: mdl-37423733

RESUMEN

A 65-year-old woman presented with a flat elevated lesion of about 1cm in the cecal diverticulum during a lower gastrointestinal endoscopy that was performed previously by another physician during a medical checkup. The patient was referred to our department for resection. Considering the risk of perforation owing to the diverticular lesion, positive nonlifting sign, and Group 5 diagnosis on the previous biopsy, EMR with over-the-scope clip (OTSC) (EMRO) was selected, and complete resection was achieved without complications.


Asunto(s)
Colon , Endoscopía Gastrointestinal , Femenino , Humanos , Anciano , Biopsia , Resultado del Tratamiento , Estudios Retrospectivos
2.
Jpn J Clin Oncol ; 49(5): 473-476, 2019 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-30920617

RESUMEN

Hyperprogression has recently been recognized as a new pattern of progression in patients undergoing immune checkpoint inhibitor treatment. Here, we report two cases that showed hyperprogression during the initial phase of pembrolizumab treatment for metastatic urothelial carcinoma. The first patient, who received pembrolizumab as a second-line treatment, developed severe respiratory failure due to the rapid progression of lung metastases on the ninth day after the third pembrolizumab treatment. The second patient developed jaundice and hepatic dysfunction due to the progression of a metastatic lymph node of the liver hilum after the first administration of pembrolizumab. She developed multiple brain metastases with intraventricular bleeding on the 10th day after the second administration of pembrolizumab. It is important to be aware that hyperprogression sometimes occurs quite a while after starting treatment, and that both pseudoprogression and hyperprogression may occur in the early stage of treatment.


Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Progresión de la Enfermedad , Neoplasias Urológicas/tratamiento farmacológico , Neoplasias Urológicas/secundario , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Resultado Fatal , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/secundario , Masculino , Tomografía Computarizada por Rayos X , Neoplasias Urológicas/patología
3.
Int J Clin Oncol ; 23(6): 1134-1139, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30069798

RESUMEN

BACKGROUND: The aim of this study was to evaluate the effects and the utility of second-line everolimus treatment for regrown renal angiomyolipoma (AML) with tuberous sclerosis complex (TSC) after transcatheter arterial embolization (TAE). METHODS: We investigated a total of 14 patients who underwent second-line everolimus treatment for TSC-AML that regrew after TAE, and assessed their effects and adverse events. Everolimus treatment was performed for AML with a maximum diameter of 4 cm. To determine the reduction ratio of AML, the volume of AML was measured using multislice helical computed tomography. Adverse events were evaluated according to CTCAE v4.0-JCOG. We further compared the treatment effect and adverse events with those in patients receiving first-line everolimus treatment. RESULTS: The AML volume decreased in all patients, with a ≥ 50% volume decrease in 57% (8 of 14) of the cases, and the mean reduction rate was 53%. We observed no significant difference in the mean reduction rate of AML between second-line everolimus treatment for regrown TSC-AML after TAE and first-line everolimus treatment for TSC-AML. The adverse events were mild and consistent with those reported in our previous study. CONCLUSION: Although further studies are needed, everolimus appears to be effective as second-line treatment for TSC-AML that regrew after TAE and a beneficial treatment option for TSC-AML.


Asunto(s)
Angiomiolipoma/tratamiento farmacológico , Antineoplásicos/uso terapéutico , Catéteres/efectos adversos , Embolización Terapéutica/efectos adversos , Everolimus/uso terapéutico , Neoplasias Renales/tratamiento farmacológico , Esclerosis Tuberosa/terapia , Adolescente , Adulto , Angiomiolipoma/etiología , Angiomiolipoma/patología , Femenino , Humanos , Neoplasias Renales/etiología , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Esclerosis Tuberosa/complicaciones , Adulto Joven
4.
Int Arch Occup Environ Health ; 86(8): 849-59, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23014754

RESUMEN

BACKGROUND: Previous studies reported that exposure to dioxins was associated with an increased risk of various diseases in general populations. OBJECTIVES: The aim of this study was to examine the association between levels of dioxins in blood and allergic and other diseases. METHODS: We conducted a cross-sectional study on 1,063 men and 1,201 women (aged 15-76 years), who were living throughout Japan and not occupationally exposed to dioxins, during 2002-2010. In fasting blood samples, polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like PCBs (DL-PCBs) were analyzed by isotope dilution high-resolution gas chromatography/mass spectrometry. We obtained information on life style and self-reported history of diseases using a questionnaire. Blood pressure, blood levels of hemoglobin A1c, and serum lipids were also measured. Multiple logistic regression models were used to analyze the association between dioxin levels in blood and various diseases. RESULTS: Toxic equivalents of PCDDs/PCDFs and total dioxins showed significant inverse dose-response relationships with atopic dermatitis, after adjustments for potential confounders. The highest quartile for total dioxins had an adjusted odds ratio of 0.26 (95 % confidence interval 0.08-0.70) compared to the reference group (first quartile). The odds ratios for hypertension, diabetes mellitus, hyperlipidemia, gout in men, and gynecologic diseases in women significantly increased with increasing toxic equivalents of PCDDs/PCDFs, DL-PCBs, and total dioxins in blood. CONCLUSIONS: The present findings suggest that background exposure to dioxins was associated with reduced risk of atopic dermatitis. The results also support the idea that low-level exposure to dioxins is associated with an increased risk of diabetes, hypertension, and hyperlipidemia.


Asunto(s)
Benzofuranos/sangre , Dermatitis Atópica/epidemiología , Exposición a Riesgos Ambientales , Bifenilos Policlorados/sangre , Dibenzodioxinas Policloradas/análogos & derivados , Adolescente , Adulto , Anciano , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hiperlipidemias/epidemiología , Hipertensión/epidemiología , Japón/epidemiología , Estilo de Vida , Masculino , Persona de Mediana Edad , Dibenzodioxinas Policloradas/sangre , Encuestas y Cuestionarios , Adulto Joven
5.
bioRxiv ; 2023 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-36747644

RESUMEN

Improved biomarkers are needed for early cancer detection, risk stratification, treatment selection, and monitoring treatment response. While proteins can be useful blood-based biomarkers, many have limited sensitivity or specificity for these applications. Long INterspersed Element-1 (LINE-1, L1) open reading frame 1 protein (ORF1p) is a transposable element protein overexpressed in carcinomas and high-risk precursors during carcinogenesis with negligible detectable expression in corresponding normal tissues, suggesting ORF1p could be a highly specific cancer biomarker. To explore the potential of ORF1p as a blood-based biomarker, we engineered ultrasensitive digital immunoassays that detect mid-attomolar (10-17 M) ORF1p concentrations in patient plasma samples across multiple cancers with high specificity. Plasma ORF1p shows promise for early detection of ovarian cancer, improves diagnostic performance in a multi-analyte panel, and provides early therapeutic response monitoring in gastric and esophageal cancers. Together, these observations nominate ORF1p as a multi-cancer biomarker with potential utility for disease detection and monitoring.

6.
Cancer Discov ; 13(12): 2532-2547, 2023 12 12.
Artículo en Inglés | MEDLINE | ID: mdl-37698949

RESUMEN

Improved biomarkers are needed for early cancer detection, risk stratification, treatment selection, and monitoring treatment response. Although proteins can be useful blood-based biomarkers, many have limited sensitivity or specificity for these applications. Long INterspersed Element-1 (LINE-1) open reading frame 1 protein (ORF1p) is a transposable element protein overexpressed in carcinomas and high-risk precursors during carcinogenesis with negligible expression in normal tissues, suggesting ORF1p could be a highly specific cancer biomarker. To explore ORF1p as a blood-based biomarker, we engineered ultrasensitive digital immunoassays that detect mid-attomolar (10-17 mol/L) ORF1p concentrations in plasma across multiple cancers with high specificity. Plasma ORF1p shows promise for early detection of ovarian cancer, improves diagnostic performance in a multianalyte panel, provides early therapeutic response monitoring in gastroesophageal cancers, and is prognostic for overall survival in gastroesophageal and colorectal cancers. Together, these observations nominate ORF1p as a multicancer biomarker with potential utility for disease detection and monitoring. SIGNIFICANCE: The LINE-1 ORF1p transposon protein is pervasively expressed in many cancers and is a highly specific biomarker of multiple common, lethal carcinomas and their high-risk precursors in tissue and blood. Ultrasensitive ORF1p assays from as little as 25 µL plasma are novel, rapid, cost-effective tools in cancer detection and monitoring. See related commentary by Doucet and Cristofari, p. 2502. This article is featured in Selected Articles from This Issue, p. 2489.


Asunto(s)
Carcinoma , Neoplasias Ováricas , Femenino , Humanos , Elementos de Nucleótido Esparcido Largo , Proteínas/genética , Biomarcadores de Tumor , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/genética
7.
Diagnostics (Basel) ; 12(2)2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-35204468

RESUMEN

Early detection of pancreatic ductal adenocarcinoma (PDAC) in the general population is difficult due to unknown clinical characteristics. This study was conducted to clarify the factors associated with early stage PDAC. Well-known symptoms and factors associated with PDAC were classified into clinical indicators, risk factors, and imaging findings concomitant with early stage PDAC. To analyze these factors for the detection of patients with early stage PDAC compared to patients without PDAC, we constructed new diagnostic strategies. The factors of 35 patients with early stage PDAC (stage 0 and IA) and 801 patients without PDAC were compared retrospectively. Clinical indicators; presence and number of indicators, elevated pancreatic enzyme level, tumor biomarker level, acute pancreatitis history, risk factors; familial pancreatic cancer, diabetes mellitus, smoking history, imaging findings; presence and number of findings, and main pancreatic duct dilation were significant factors for early stage PDAC detection. A new screening strategy to select patients who should be examined by imaging modalities from evaluating clinical indicators and risk factors and approaching a definitive diagnosis by evaluating imaging findings had a relatively high sensitivity, specificity, and areas under the curve of 80.0%, 80.8%, and 0.80, respectively. Diagnosis based on the new category and strategy may be reasonable for early stage PDAC detection.

8.
Nihon Kokyuki Gakkai Zasshi ; 45(5): 436-40, 2007 May.
Artículo en Japonés | MEDLINE | ID: mdl-17554990

RESUMEN

A 68-year-old woman, who had been healthy until this event, presented with a complaint of productive cough since 2000. She went to a neighboring hospital because of bloody sputum in October 2001. Although chest radiograph showed abnormal findings then, she received only an expectorant and cough remedy. She consulted us complaining of dyspnea on exertion in April 2005. Chest radiograph revealed cavity formation, bronchiectasis and a nodular shadow, and her condition had deteriorated. Microbiologically, acid-fast bacilli were detected three times in the culture of sputum, and Mycobacterium gordonae was identified by the biochemical method. However, this Mycobacterium gordonae could not be identified by the DNA-DNA hybridization method. Our case also probably was considered to be a primary type pulmonary nontuberculous infection because of her clinical course. In addition, we recognized that pulmonary M. gordonae infection also worsens without the therapy.


Asunto(s)
Infecciones por Mycobacterium no Tuberculosas/fisiopatología , Tuberculosis Pulmonar/fisiopatología , Anciano , Progresión de la Enfermedad , Femenino , Humanos
9.
Intern Med ; 41(10): 896-8, 2002 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-12413019

RESUMEN

A 21-year-old hemophiliac with human immunodeficiency virus (HIV) infection was admitted to our hospital because of bilateral pneumothoraces associated with Pneumocysis carinii pneumonia (PCP). He underwent chest tube drainages and intravenous pentamidine therapy, resulting in clinical improvement. Two months after treatment for PCP, cystic lesions that had existed before treatment disappeared on chest computed tomography. We concluded that Pneumocystis carinii infection might be associated with lung destruction and cyst formation, and that inflammatory exudates in the small bronchioles might act as a ball-valve with subsequent spontaneous pneumothoraces.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Antiprotozoarios/uso terapéutico , Pentamidina/uso terapéutico , Neumonía por Pneumocystis/complicaciones , Neumotórax/etiología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico por imagen , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Adulto , Lavado Broncoalveolar , Broncoscopía , Tubos Torácicos , VIH-1 , Humanos , Masculino , Pneumocystis/aislamiento & purificación , Neumonía por Pneumocystis/diagnóstico por imagen , Neumonía por Pneumocystis/tratamiento farmacológico , Neumotórax/terapia , Radiografía Torácica , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
10.
Nihon Kokyuki Gakkai Zasshi ; 40(11): 905-9, 2002 Nov.
Artículo en Japonés | MEDLINE | ID: mdl-12645113

RESUMEN

A 32-year-old male was admitted to our hospital complaining of fever and dyspnea on effort. Laboratory data on admission indicated leukocytosis and elevation of C-reactive protein. A chest radiograph showed diffuse reticulonodular shadows in both lower lung fields, and a chest computed tomography showed centrilobular reticulonodular opacity. Bronchoscopic findings revealed a large amount of slightly yellowish secretion in all bronchi. Cells found in the bronchoalveolar lavage fluid (BALF) included 61% neutrophils. Haemophilus influenzae was isolated from cultures of the BALF and sputum. Transtracheal lung biopsy specimens showed focal infiltration of neutrophils in the alveoli, and the pathological findings in the lung were compatible with bronchiolopneumonia. Since the CD4/CD8 ratio was 0.09 and a positive reaction was obtained for anti-human immunodeficiency virus (HIV) antibody, HIV-associated pneumonia due to H. influenzae was diagnosed. Seven days' administration of cefozopran improved the patient's condition. It is interesting that radiological findings are often unusual in HIV-infected patients with H. influenzae pneumonia.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por Haemophilus/etiología , Haemophilus influenzae , Neumonía/etiología , Adulto , Antibacterianos/uso terapéutico , Cefalosporinas/uso terapéutico , Infecciones por Haemophilus/tratamiento farmacológico , Humanos , Masculino , Neumonía/tratamiento farmacológico , Cefozoprán
11.
J Occup Health ; 55(3): 184-94, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23574777

RESUMEN

OBJECTIVE: Perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) have been shown to accumulate in the human body. The purpose of the present study was to examine the factors associated with the blood levels of PFOS and PFOA. METHODS: A cross-sectional study was performed on 307 men and 301 women (aged 16-76 years) living in 15 prefectures in Japan. Blood levels of PFOS and PFOA were measured by liquid chromatography-mass spectrometry. Hepatic enzymes (γ-GTP, GOT, and GPT) and ω-3 polyunsaturated fatty acids (DHA and EPA) levels in serum were also measured. Associations between the levels of PFOS and PFOA in blood and the intake frequency of 41 kinds of dishes, foods and beverages and the serum levels of liver enzymes and ω-3 polyunsaturated fatty acids were examined using rank correlations. RESULTS: Frequency of intake of boiled fish in broth, sliced raw fish and coastal fish showed significant positive correlations with PFOS concentrations in blood after adjustments for potential confounders. Serum levels of GOT, GPT, DHA and EPA showed significant positive correlations with PFOS and PFOA in blood. There was also a significant regional difference in the blood levels of PFOS and 2013PFOA, with medians being highest in the Tokai/Hokuriku/Kinki region. CONCLUSIONS: These findings suggest that the concentrations of PFOS in blood were mainly associated with fish consumption and that the levels of PFOS and PFOA were associated with the serum levels of liver enzymes in Japanese populations. Further investigations are required to clarify the reason for the regional differences in blood levels of PFOS and PFOA in Japan.


Asunto(s)
Ácidos Alcanesulfónicos/sangre , Caprilatos/sangre , Dieta/estadística & datos numéricos , Contaminantes Ambientales/farmacología , Fluorocarburos/sangre , Hígado/enzimología , Adolescente , Adulto , Anciano , Alanina Transaminasa/sangre , Ácidos Alcanesulfónicos/toxicidad , Aspartato Aminotransferasas/sangre , Caprilatos/toxicidad , Estudios Transversales , Ácidos Docosahexaenoicos/sangre , Ácido Eicosapentaenoico/sangre , Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/sangre , Femenino , Fluorocarburos/toxicidad , Conductas Relacionadas con la Salud , Humanos , Japón , Hígado/metabolismo , Masculino , Persona de Mediana Edad , Características de la Residencia , Alimentos Marinos , Adulto Joven , gamma-Glutamiltransferasa/sangre
15.
Intern Med ; 46(9): 617-20, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17473501

RESUMEN

A 35-year-old homosexual man, who had already received sulfamethoxazole/trimethoprim and steroid therapy because of human immunodeficiency virus (HIV)-related Pneumocystis jiroveci pneumonia, was referred to our hospital. He was also diagnosed as having cytomegalovirus (CMV) co-infection, and started receiving intravenous gancyclovir for CMV infection on the 2nd day of admission into our hospital. He had to continue the steroid therapy because his respiratory condition did not improve. On the 10th hospitalization day, when 40 mg of prednisolone was administered, cardiopulmonary arrest suddenly occurred, and his laboratory data showed hyponatremia and hyperpotassemia. In spite of resuscitation, he died two days later. The postmortem examination revealed that he died of adrenal failure due to CMV infection. In general, CMV is thought to cause adrenalitis, but rarely leads to manifestations of adrenal insufficiency during the clinical course. It is important to be aware that grave adrenal failure due to CMV infection can develop even under steroid therapy.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Insuficiencia Suprarrenal/microbiología , Infecciones por Citomegalovirus/complicaciones , Glucocorticoides/uso terapéutico , Prednisolona/uso terapéutico , Insuficiencia Suprarrenal/inducido químicamente , Insuficiencia Suprarrenal/patología , Adulto , Antivirales/uso terapéutico , Infecciones por Citomegalovirus/tratamiento farmacológico , Resultado Fatal , Ganciclovir/uso terapéutico , Glucocorticoides/efectos adversos , Paro Cardíaco/inducido químicamente , Paro Cardíaco/terapia , Humanos , Masculino , Necrosis , Neumonía por Pneumocystis/tratamiento farmacológico , Neumonía por Pneumocystis/virología , Prednisolona/efectos adversos , Resucitación
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