RESUMO
A 61-year-old woman was found to have multiple ground-glass nodules( GGNs) in both lungs by chest computed tomography (CT) scan. The lesion of the right S2 contained a partial solid component and was suspected to be minimally invasive adenocarcinoma. Three-dimensional CT showed two anomalous V2s descending dorsally to the intermediate bronchus and draining into the inferior pulmonary vein. Thoracoscopic segmentectomy of the right S2 was performed safely. The pathological diagnosis was adenocarcinoma in situ. Since aberrant pulmonary vessels increases the surgical risk during video-assisted thoracoscopic anatomical lung resection, preoperative three-dimensional CT is useful in performing safe surgical procedure.
Assuntos
Adenocarcinoma , Neoplasias Pulmonares , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Drenagem , Feminino , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
A 66-year-old man was pointed out a nodular shadow in the right lower lobe by chest computed tomography (CT) 4 years ago. Since the size of the shadow has been increasing for 4 years, he hospitalized for surgery. Partial resection of the right lower lobe was performed. Histopathologically, the tumor was composed of cartilage tissue without epithelial components, and was diagnosed as a chondroma. Postoperative course was uneventful and there has been no recurrence at 1 years and 8 months after surgery.
Assuntos
Condroma , Neoplasias Pulmonares , Idoso , Condroma/diagnóstico por imagem , Condroma/patologia , Condroma/cirurgia , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Tomografia Computadorizada por Raios XRESUMO
A 70-year-old woman had undergone right S8+9 segmentectomy for stage I A lung cancer. Surgical staplers were used for an intersegmental line. Two years after surgery, routine chest computed tomography(CT) showed a 40-mm mass around the staple line in the right lower lobe, and positron emission tomography (PET) was positive. The mass was suspected to be local recurrence of lung cancer, and she was done additional surgery for resection of the remaining right lower lobe. The pathologic diagnosis was lung nontuberculous mycobacteriosis. It was suggested that nontuberculous mycobacteriosis developed at the atelectasis around the staple line. In addition to local recurrence, the possibility of nontuberculous mycobacteriosis should be considered in cases of pulmonary nodules appearing at the staple line after pulmonary resection.
Assuntos
Pneumopatias/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Infecções por Mycobacterium não Tuberculosas/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Idoso , Feminino , Humanos , Margens de Excisão , Pneumonectomia/métodos , Tomografia por Emissão de Pósitrons , Grampeamento Cirúrgico/métodos , Fatores de TempoRESUMO
Fetal adenocarcinoma is a rare disease. We report a case of fetal adenocarcinoma requiring differential diagnosis of metastatic lung tumor. A 75- year-old woman was pointed out a 8 mm tumor in the right lower lobe by chest computed tomography(CT) 6 month ago. Because the size of the tumor had been increasing for 6 months, she was hospitalized for surgery. Because of the tumor shape, we suspected that the tumor was metastatic lung tumor of hepatocellular carcinoma for which she had undergone hepatic arterial infusion chemotherapy and radiofrequency ablation. A right lower lobectomy with lymph node dissection was performed and pathological diagnosis was high-grade fetal adenocarcinoma, stage IV.
Assuntos
Adenocarcinoma de Pulmão/diagnóstico , Neoplasias Pulmonares/diagnóstico , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/secundário , Idoso , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/secundário , Carcinoma Hepatocelular/terapia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/secundário , Excisão de LinfonodoRESUMO
The aim of this study was to compare impressions of COVID-19 vaccination and influenza vaccination in Japan by analyzing social media (Twitter®) using a text-mining method. We obtained 10,000 tweets using the keywords "corona vaccine" and "influenza vaccine" on 15 December 2022 and 19 February 2023. We then counted the number of times the words were used and listed frequency of these words by a text-mining method called KH Coder. We also investigated concepts in the data using groups of words that often appeared together or groups of documents that contained the same words using multi-dimensional scaling (MDS). "Death" in relation to corona vaccine and "severe disease" for influenza vaccine were frequently used on 15 December 2022. The number of times the word "death" was used decreased, "after effect" was newly recognized for corona vaccine, and "severe disease" was not used in relation to influenza vaccine. Through this comprehensive analysis of social media data, we observed distinct variations in public perceptions of corona vaccination and influenza vaccination in Japan. These findings provide valuable insights for public health authorities and policymakers to better understand public sentiment and tailor their communication strategies accordingly.
RESUMO
The present study investigated the use of complementary and alternative medicine (CAM) and its relationship with health-related quality of life (HRQOL) in patients with type 2 diabetes mellitus. A total of 421 patients with type 2 diabetes mellitus who completely met the inclusion criteria, aged 67.3 ± 12.8 years, among 622 outpatients were recruited in this cross-sectional study. We examined the use of CAM, such as supplements, Kampo, acupuncture, and yoga. HRQOL was assessed by EuroQOL. A total of 161 patients (38.2%) with type 2 diabetes mellitus used some type of CAM. The use of supplements and/or health foods was the highest among CAM users (112 subjects, 26.6%). HRQOL was significantly lower in patients who used some CAM (0.829 ± 0.221) than in those without any CAM use (0.881 ± 0.189), even after adjustments for confounding factors [F(1, 414) = 2.530, p = 0.014]. Proper information on CAM is needed for patients with type 2 diabetes mellitus.
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The aim of this study was to investigate the pre-impressions of the third Coronavirus disease 2019 (COVID-19) vaccination among Japanese medical staff using quantitative analysis. Among 413 medical staff, 260 (60 men and 200 women) aged 40.4 ± 12.3 years were enrolled in this cross-sectional study. Pre-impressions of the third COVID-19 vaccination were analyzed using the text-mining analysis software, KH coder. Among 260 subjects, 242 (93.1%) agreed to the third vaccination, with the rate being lower among subjects in their 30s (87.3%) than those in the other age groups. The word "side effects" was characteristic of subjects in their 20s and nurses, and "pregnancy" of those in their 30s and administrative staff. Pre-impressions of the third COVID-19 vaccination varied among age groups and different professions. The results obtained provide useful information for promoting the third COVID-19 vaccination to Japanese adults.
RESUMO
BACKGROUND: Immunoglobulin G4-related disease (IgG4-RD) is characterized by the formation of inflammatory lesions with fibrosis and infiltration of IgG4-positive plasma cells and lymphocytes in various organs of the body. Since the first report of IgG4-related autoimmune pancreatitis, IgG4-RD affecting various organs has been reported; however, only a few reports of IgG4-related lung disease (IgG4-RLD) exist. In this report, we describe a case of IgG4-RLD that was difficult to differentiate from malignancy, and the usefulness of the surgical approach in determining the appropriate diagnosis and treatment plan. CASE PRESENTATION: A 61-year-old man was referred to our hospital after a chest radiograph revealed an abnormal chest shadow. At the time of his first visit, he had a slight fever and dyspnea on exertion. Chest computed tomography (CT) revealed a middle lobe hilar mass with irregular margins and swelling of the right hilar and mediastinal lymph nodes. These findings were not present on CT 1.5 years ago. 18F-fluorodeoxyglucose-positron emission tomography revealed a mass lesion with a maximum diameter of 5.5 cm, maximum standardized uptake value (SUVmax) of 11.0, and areas with high SUV in the hilar and mediastinal lymph nodes. We suspected lung cancer or malignant lymphoma and performed a thoracoscopic lung biopsy to confirm the diagnosis. Histopathological examination revealed no malignant findings, and IgG4-RLD was diagnosed. One month after treatment with prednisolone (PSL), the tumor had shrunk, but a CT scan during the third month of PSL treatment revealed multiple nodular shadows in both lungs. Considering the possibility of malignant complications and multiple lung metastases, we performed thoracoscopic partial lung resection of the new left lung nodules to determine the treatment strategy. Histopathological examination revealed no malignant findings in any of the lesions, and the patient was diagnosed with IgG4-RLD refractory to PSL monotherapy. CONCLUSIONS: IgG4-RLD refractory to PSL monotherapy showed changes from a solitary large mass (pseudotumor) to multiple nodules on chest CT. It was difficult to distinguish malignancy from IgG4-RLD based on imaging tests and blood samples alone, and the surgical approach was useful in determining the appropriate diagnosis and treatment plan.
Assuntos
Doença Relacionada a Imunoglobulina G4 , Neoplasias Pulmonares , Humanos , Imunoglobulina G , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/tratamento farmacológico , Doença Relacionada a Imunoglobulina G4/patologia , Pulmão/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , EsteroidesRESUMO
The present study investigated the pre-impressions of medical staff toward coronavirus disease 2019 (COVID-19) vaccination in a designated medical institution for class II infectious diseases in Sakaide, Japan using a text mining analysis. A total of 387 medical staff were surveyed on their pre-vaccination impressions toward the COVID-19 vaccine using an open-ended questionnaire from March 1st to 7th (the first survey) and from March 22nd to 28th (the second survey) at Sakaide City Hospital, Sakaide, Japan. A total of 296 people answered the question for the first time and 234 people answered for the second time among the 387 people. The vaccination rate was slightly lower for the younger generation than for the older generation. Before the first vaccination, the younger generation expressed concerns about side effects as well as a negative impact on pregnancy. However, before the second vaccination, there were fewer concerns regarding side effects and words of reassurance were also noted. Nurses expressed more opinions about side effects in both the first and second vaccinations than other medical staff. Concerns regarding side effects among medical staff decreased with the progression of COVID-19 vaccination. These data may provide useful information about the promotion of COVID-19 vaccination to the public, particularly in the young generation and women.
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Background: The aim of the present study was to investigate the relationship between the number of deaths due to renal failure and air temperature parameters in Hokkaido (the northernmost region) and Okinawa (the southernmost region) prefectures, Japan. Methods: Monthly data on the number of deaths due to renal failure between January 2008 and December 2016 and annual population data were collected from the Hokkaido and Okinawa official prefecture websites. Air temperature parameters were obtained from the Japan Meteorological Agency. The relationship between the number of deaths due to renal failure and air temperature parameters was evaluated by an ecological study. Results: The number of deaths due to renal failure (per 100,000 people/month) in Hokkaido and Okinawa were 2.28 ± 0.30 and 1.17 ± 0.31. In Hokkaido, the number of deaths due to renal failure negatively correlated with air temperature parameters in both sexes. The number of deaths due to renal failure was significantly higher in January than from June to September in all subjects. However, in Okinawa, no significant difference was observed among months. Conclusions: The present results suggest that the relationship between the number of deaths due to renal failure and air temperature parameters differs between Hokkaido and Okinawa.
RESUMO
In intrahepatic cholangiocarcinomas (ICCs), the prognostic significance of p27(Kip1), a cyclin-dependent kinase inhibitor, remains controversial, and there have been no studies of degradation pathway associated proteins, S-phase kinase-interacting protein (Skp2), and Jun activation domain-binding protein-1 (Jab1). In the present study of 74 patients with ICC-mass forming type (ICC-MF) undergoing radical surgery, we determined immunohistochemical expression of p27(Kip1), Skp2, and Jab1 and examined relationships with clinicopathologic findings and patient survival. On the basis of the average of labeling indices, we set cutoff values to define high and low expressors and divided the cases into two groups. A statistically significant correlation was found between low p27(Kip1) expression and lymph node metastasis (P = .009). Patient survival in the low p27(Kip1) expression group (n = 25) was also significantly worse than that in the high p27(Kip1) expression group (n = 49, P = .0007). A significant inverse correlation was found between p27(Kip1) and Skp2 expression (P = .016). High Skp2 expression (n = 36) was significantly associated with poor prognosis (P = .0046). High Jab1 expression was observed in 32 cases, but there was no statistically significant relationship with clinicopathologic findings or patient survival. The multivariate analysis revealed that low p27(Kip1) and high Skp2 expression are independent and significant factors of poor prognosis. The results suggest that low p27(Kip1) and high Skp2 expression are associated with aggressive tumor behavior, and these cell-cycle regulators are useful markers to predict outcome of patients with ICC-MF.
Assuntos
Neoplasias dos Ductos Biliares/mortalidade , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/mortalidade , Inibidor de Quinase Dependente de Ciclina p27/metabolismo , Proteínas Quinases Associadas a Fase S/metabolismo , Idoso , Idoso de 80 Anos ou mais , Neoplasias dos Ductos Biliares/metabolismo , Neoplasias dos Ductos Biliares/patologia , Biomarcadores Tumorais/metabolismo , Complexo do Signalossomo COP9 , Colangiocarcinoma/metabolismo , Colangiocarcinoma/patologia , Feminino , Hepatócitos/metabolismo , Humanos , Técnicas Imunoenzimáticas , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Peptídeo Hidrolases/metabolismo , Prognóstico , Taxa de SobrevidaRESUMO
The patient was a 76-year-old man having gastric cancer with peritoneal dissemination. He underwent total gastrectomy for resection of the primary tumor and improvement of the oral intake. He developed ileus and peritonitis after the surgery, which necessitated two additional operations. An intestinal stoma was thus therefore created using a catheter for tube feeding, and tube feeding was initiated after the surgery. Nutrients, as well as TS-1 (taken out of the capsule; 80 mg/day) were administered via the catheter for tube feeding. This therapy was followed by a reduction in tumor marker levels and improvement of the patient's performance status (PS), after which the patient could be discharged. He stayed at home for about 8 months, with a much-improved quality of life during this period. We concluded that the TS-1 therapy via the catheter used for alimentation was effective for the treatment of cancer in this patient. We report our experience with this case, in which tube feeding became necessary after total gastrectomy, but administration of TS-1 via the same catheter used for alimentation improved the patient's PS and made it possible for him to receive chemotherapy at home.
Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Nutrição Enteral/instrumentação , Gastrectomia , Ácido Oxônico/administração & dosagem , Piridinas/administração & dosagem , Neoplasias Gástricas/tratamento farmacológico , Tegafur/administração & dosagem , Idoso , Cateterismo , Terapia Combinada , Esquema de Medicação , Combinação de Medicamentos , Humanos , Masculino , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Qualidade de Vida , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgiaRESUMO
Cyclins, cyclin-dependent kinases (Cdks), and Cdk inhibitors (CdkIs) are frequently altered in human cancer. p18INK4C, a member of the INK4 family of CdkIs, is a potential tumor-suppressor gene product. However, the expression of p18INK4C in hepatocellular carcinoma (HCC) remains unknown. The aim of this study was to examine the expression of p18INK4C in various liver diseases including HCC and to assess its clinical significance in HCC. To that end, we examined the expression of p18INK4C by immunohistochemistry in various liver diseases, including 51 HCCs, and also studied the relationship between p18INK4C expression, the phosphorylation of retinoblastoma protein (pRb), and the activity level of Cdk4 and Cdk6. Immunohistochemical analysis revealed the frequent loss of p18INK4C expression in HCC, especially in poorly differentiated HCC. The loss of p18INK4C expression was shown to be associated with a poor prognosis compared with that associated with p18INK4C- positivity. Further, the kinase activity of Cdk4 was found to be higher in p18INK4C-negative HCCs than in p18INK4C- positive HCCs. However, the level of Cdk6 activity was similar in the 2 groups of HCCs. In p18INK4C- positive HCCs, p18INK4C dominantly interacted with Cdk4 rather than with Cdk6. pRb phosphorylated at serine(Ser) 780 was detected more frequently in p18INK4C - negative than in p18INK4C - positive HCCs. In conclusion, the loss of p18INK4C expression may play a role in the differentiation and development of HCC through the up-regulation of Cdk4 activity.