17 results on '"Okimoto T"'
Search Results
2. Acute Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis That Responded to Glucocorticoid Therapy.
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Ozaka S, Kodera T, Tsutsumi K, Fukuda M, Iwao M, Hirashita Y, Takahashi H, Fukuda K, Okamoto K, Arakawa M, Ogawa R, Endo M, Mizukami K, Okimoto T, Kamiyama N, Kodama M, Kobayashi T, and Murakami K
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- Humans, Glucocorticoids therapeutic use, Granulomatosis with Polyangiitis complications, Granulomatosis with Polyangiitis drug therapy, Granulomatosis with Polyangiitis diagnosis, Churg-Strauss Syndrome diagnosis, Cholecystitis, Acute complications, Cholecystitis, Acute drug therapy, Cholecystitis complications, Cholecystitis drug therapy, Eosinophilia complications, Eosinophilia drug therapy
- Abstract
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic disorder characterized by tissue eosinophilic infiltration and vasculitis. Although EGPA causes multiple organ damage, it causes cholecystitis less frequently. We herein report a case of acute cholecystitis associated with EGPA in which successful treatment with glucocorticoid therapy allowed surgery to be avoided. EGPA can present as acute cholecystitis. It is important not to overlook acute cholecystitis associated with EGPA in patients with abdominal pain with peripheral eosinophilia. Furthermore, in cases of mild cholecystitis associated with EGPA that are diagnosed preoperatively, cholecystectomy might be avoided with conservative glucocorticoid treatment.
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- 2023
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3. Comparative Analysis of the Attitudes toward Palliative Care between Medical Oncologists and Pulmonologists.
- Author
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Okimoto T, Tsubata Y, Nakao M, Hotta T, Hamaguchi M, Hamaguchi S, and Isobe T
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- Attitude of Health Personnel, Humans, Palliative Care, Pulmonologists, Retrospective Studies, Neoplasms, Oncologists
- Abstract
Objective In Japan, both medical oncologists and pulmonologists treat lung cancer patients; however, the difference in their attitude toward palliative care referral is unknown. Thus, we retrospectively investigated the difference in attitudes toward palliative care referral between medical oncologists and pulmonologists in Japan. Methods We retrospectively reviewed the charts of patients with thoracic malignancy who died at Shimane University Hospital between June 2011 and October 2015. We compared the patients' demographics and medical history according to their doctor's specialty (i.e., medical oncologist or pulmonologist). Results We identified 182 patients, among whom 90 were treated by medical oncologists and 56 by pulmonologists at the outpatient clinic. Thirty-six patients did not undergo outpatient clinic treatment. Out of 59 patients, 22 (37.3%) referred by medical oncologists, and 7 out of 36 patients (19.4%) referred by pulmonologists, were referred to palliative care specialists in the outpatient setting (p=0.107, Fisher's exact test). The median survival time after admission to PCU was 21 (95% CI: 13-32) and 9 (95% CI: 5-15) days among the patients treated by medical oncologists and pulmonologists, respectively (p=0.128). Conclusion Medical oncologists are more likely to refer their patients to palliative care in the outpatient setting, thus enabling patients to receive longer end of life care in the PCU. Bridging the research gap regarding differences between the physicians' attitudes toward palliative care referral may lead to patients receiving more quality palliative care.
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- 2021
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4. An Autopsy Case of Acute Pancreatitis Caused by Cholesterol Crystal Embolization.
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Sato Y, Okamoto K, Fukuda M, Oyama Y, Kondo Y, Nishida H, Daa T, Togo K, Sonoda A, Fukuda K, Matsunari O, Ogawa R, Honda K, Mizukami K, Okimoto T, Kodama M, and Murakami K
- Subjects
- Acute Disease, Autopsy, Cholesterol, Humans, Male, Embolism, Cholesterol complications, Embolism, Cholesterol diagnosis, Pancreatitis diagnosis, Pancreatitis etiology
- Abstract
Cholesterol crystal embolization (CCE) shows a poor prognosis and it can cause ischemic organ damage due to a cholesterol embolism from atherosclerotic lesions in large blood vessels. Such an embolism mainly affects the kidneys and skin, although cases involving digestive organs have also been reported. We encountered an autopsy case of CCE with damage mainly to the digestive organs, including the pancreas. The patient had non-specific abdominal symptoms or image findings. Symptomatic therapy failed to save him. CCE can involve the digestive organs, and so must be differentiated from abdominal pathologies. Moreover, conventional treatments may be ineffective, and new treatments might thus be necessary.
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- 2021
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5. Characteristic Facial Appearance Was the Key to Diagnosing Chronic Enteropathy Associated with SLCO2A1 -associated Primary Hypertrophic Osteoarthropathy.
- Author
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Sonoda A, Wada Y, Togo K, Mizukami K, Fuyuno Y, Umeno J, Fujioka S, Fukuda K, Okamoto K, Ogawa R, Okimoto T, and Murakami K
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- Aged, Chronic Disease, Diagnosis, Differential, Humans, Male, Osteoarthropathy, Primary Hypertrophic genetics, Treatment Outcome, Facial Asymmetry diagnosis, Intestinal Diseases diagnostic imaging, Organic Anion Transporters genetics, Osteoarthropathy, Primary Hypertrophic diagnosis, Osteoarthropathy, Primary Hypertrophic therapy, Parenteral Nutrition
- Abstract
Patients with chronic enteropathy associated with SLCO2A1 (CEAS) develop multiple circular, longitudinal, or eccentric ulcers in the ileum. It is sometimes difficult to distinguish CEAS from Crohn's disease. CEAS and primary hypertrophic osteoarthropathy (PHO) are together known to be caused by a mutation of SLCO2A1 gene. The case of a 65-year-old man whose characteristic appearance due to pachydermia of the forehead folds led to the diagnosis of CEAS with PHO is presented.
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- 2020
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6. Acute Interstitial Lung Disease Induced by Rechallenge with Ceritinib.
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Hotta T, Okimoto T, Hamaguchi M, Tsubata Y, and Isobe T
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- Adult, Anaplastic Lymphoma Kinase metabolism, Humans, Male, Pyrimidines therapeutic use, Receptor Protein-Tyrosine Kinases antagonists & inhibitors, Sulfones therapeutic use, Tomography, X-Ray Computed, Adenocarcinoma of Lung drug therapy, Lung Diseases, Interstitial chemically induced, Lung Neoplasms drug therapy, Protein Kinase Inhibitors adverse effects, Pyrimidines adverse effects, Sulfones adverse effects
- Abstract
A 40-year-old Japanese man with advanced pulmonary adenocarcinoma harboring anaplastic lymphoma kinase (ALK)-rearranged was administered the selective ALK inhibitor ceritinib as a third-line treatment and continued treatment for nine months. After fourth-line treatment, we performed rechallenge with ceritinib as a fifth-line treatment. On day 54 after rechallenge, the patient developed acutely deteriorating dyspnea. Chest computed tomography showed extensive ground-glass opacities. We diagnosed him with ceritinib-induced interstitial lung disease (ILD) and initiated methylprednisolone pulse therapy. To our knowledge, this is the first report of ceritinib-induced ILD in a Japanese patient. Since it may newly emerge with rechallenge therapy, close attention is necessary.
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- 2020
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7. Varicella-zoster Virus Related Pulmonary Granulomas in Which Varicella-zoster Virus DNA Was Demonstrated in a Thoracoscopic Lung Biopsy Specimen.
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Isobe T, Umemoto J, Kobayashi M, Okuno T, Shiratsuki Y, Kodama A, Nakao M, Amano Y, Hotta T, Hamaguchi M, Okimoto T, Hamaguchi S, and Tsubata Y
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- Acyclovir therapeutic use, Adult, Antiviral Agents therapeutic use, Cyclophosphamide therapeutic use, DNA, Viral isolation & purification, Humans, Male, Pneumonia etiology, Polymerase Chain Reaction, Prednisolone therapeutic use, Procarbazine therapeutic use, Tomography, X-Ray Computed, Treatment Outcome, Varicella Zoster Virus Infection diagnosis, Vincristine therapeutic use, Granuloma genetics, Granuloma virology, Pneumonia pathology, Pneumonia virology, Varicella Zoster Virus Infection complications, Varicella Zoster Virus Infection drug therapy, Varicella Zoster Virus Infection genetics
- Abstract
A 43-year-old man with malignant lymphoma who had been treated with the cyclosphamide, vincrstine, procarbazine, and prednisolone (C-MOPP) regimen was admitted to our hospital with skin eruption. He was diagnosed to have varicella, and treatment with acyclovir and immune globulin was started. Chest computed tomography revealed multiple nodules in the both lung fields. Diagnostic thoracoscopic lung biopsy specimens revealed granuloma formation, and polymerase chain reaction testing revealed the presence of varicella-zoster virus DNA in the granulomatous tissue. It was unusual for the lung nodule in varicella pneumonia to increase in size over time in a patient who had undergone antiviral therapy, while also demonstrating multiple granulomas.
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- 2019
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8. Post-trauma Mycobacterium avium chronic Rhinosinusitis Mimicking a Neoplasm.
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Okimoto T, Shimizu Y, Nagase M, and Isobe T
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- 2019
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9. A Low Crizotinib Concentration in the Cerebrospinal Fluid Causes Ineffective Treatment of Anaplastic Lymphoma Kinase-positive Non-small Cell Lung Cancer with Carcinomatous Meningitis.
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Okimoto T, Tsubata Y, Hotta T, Hamaguchi M, Nakao M, Hamaguchi SI, Hamada A, and Isobe T
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- Adenocarcinoma of Lung cerebrospinal fluid, Adenocarcinoma of Lung radiotherapy, Adenocarcinoma of Lung secondary, Anaplastic Lymphoma Kinase analysis, Antineoplastic Agents therapeutic use, Brain Neoplasms cerebrospinal fluid, Brain Neoplasms radiotherapy, Brain Neoplasms secondary, Combined Modality Therapy, Cranial Irradiation, Crizotinib therapeutic use, Disease Progression, Fatal Outcome, Humans, Lung Neoplasms cerebrospinal fluid, Male, Meningeal Carcinomatosis cerebrospinal fluid, Meningeal Carcinomatosis radiotherapy, Middle Aged, Neoplasm Recurrence, Local cerebrospinal fluid, Neoplasm Recurrence, Local drug therapy, Adenocarcinoma of Lung drug therapy, Antineoplastic Agents cerebrospinal fluid, Crizotinib cerebrospinal fluid, Lung Neoplasms drug therapy, Meningeal Carcinomatosis drug therapy
- Abstract
The central nervous system is a common site of relapse in patients receiving crizotinib, which is presumed to be associated with the low concentration of crizotinib in the cerebrospinal fluid (CSF). Our patient received surgical treatment for anaplastic lymphoma kinase-positive stage IIA lung adenocarcinoma. His cancer recurred with brain metastases and carcinomatous meningitis. We started whole-brain radiation therapy (WBRT) and subsequently administered crizotinib. The concentration of crizotinib on day 15 in the plasma was 158 ng/mL, and that in the spinal fluid was 4.32 ng/mL. WBRT may elevate the CSF/plasma crizotinib concentration ratio; clinicians may therefore consider performing WBRT prior to crizotinib initiation.
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- 2019
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10. Disseminated Nocardiosis Initially Manifesting as Visual Field Defects.
- Author
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Okimoto T, Tsubata Y, Nakao M, and Isobe T
- Subjects
- Aged, Bacteriological Techniques, Humans, Male, Nocardia isolation & purification, Ophthalmoscopy, Radiography, Thoracic, Tomography, X-Ray Computed, Endophthalmitis diagnosis, Endophthalmitis microbiology, Nocardia Infections complications, Nocardia Infections diagnosis, Vision Disorders microbiology, Visual Fields
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- 2019
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11. Deep Ulcers in the Ileum Associated with Mycophenolate Mofetil.
- Author
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Sonoda A, Wada K, Mizukami K, Fukuda K, Shuto M, Okamoto K, Ogawa R, Okimoto T, and Murakami K
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- C-Reactive Protein analysis, Graft Rejection prevention & control, Humans, Immunosuppressive Agents administration & dosage, Kidney Transplantation, Male, Middle Aged, Mycophenolic Acid administration & dosage, Ileal Diseases complications, Immunosuppressive Agents adverse effects, Mycophenolic Acid adverse effects, Ulcer chemically induced
- Abstract
A 54-year-old man was treated with mycophenolate mofetil (MMF) after undergoing living donor renal transplantation. Two years later, he experienced repeated episodes of diarrhea, and his C-reactive protein (CRP) level was found to be 12.63 mg/dL. Ileocolonoscopy showed multiple deep, punched-out ulcers that were similar to Behçet's disease (BD) and cytomegalovirus (CMV) in the ileum. CMV infection was suspected. However, anti-cytomegalovirus agents were ineffective. The patient was subsequently diagnosed with gastrointestinal toxicity of MMF and MMF was switched to mizoribine. His symptoms improved immediately, and his CRP level normalized. Six months later, the patient's mucosa was healed.
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- 2017
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12. A Comparison between the Instantaneous Wave-free Ratio and Resting Distal Coronary Artery Pressure/Aortic Pressure and the Fractional Flow Reserve: The Diagnostic Accuracy Can Be Improved by the Use of both Indices.
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Shiode N, Okimoto T, Tamekiyo H, Kawase T, Yamane K, Kagawa Y, Fujii Y, Ueda Y, Hironobe N, Kato Y, and Hayashi Y
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- Aged, Coronary Angiography, Coronary Artery Disease, Female, Heart, Humans, Hyperemia physiopathology, Male, Middle Aged, Papaverine pharmacology, Sensitivity and Specificity, Severity of Illness Index, Vasodilator Agents pharmacology, Aorta physiology, Arterial Pressure physiology, Coronary Stenosis diagnosis, Fractional Flow Reserve, Myocardial physiology
- Abstract
Objectives The fractional flow reserve (FFR) is an index of the severity of coronary stenosis that has been clinically validated in several studies. The instantaneous wave-free ratio (iFR) and the resting distal coronary artery pressure/aortic pressure (Pd/Pa) are nonhyperemic pressure-derived indices of the severity of stenosis. This study sought to examine the diagnostic accuracy of the iFR and resting Pd/Pa with respect to hyperemic FFR. Methods Following an intracoronary injection of papaverine, the iFR, resting Pd/Pa, and FFR were continuously measured in 123 lesions in 103 patients with stable coronary disease. Results The iFR and resting Pd/Pa values were strongly correlated with the FFR (R=0.794, p<0.001, R=0.832, p<0.0001, respectively). A receiver operator curve (ROC) analysis revealed that the optimal iFR cut-off value for predicting an FFR of <0.80 was 0.89 (AUC 0.901, sensitivity 84.1%, specificity 80.0%, positive predictive value 69.8%, negative predictive value 90.0%, diagnostic accuracy 81.3%), while the optimal resting Pd/Pa cut-off value was 0.92 (AUC 0.925, sensitivity 90.9%, specificity 78.5%, positive predictive value 70.2%, negative predictive value 93.9%, diagnostic accuracy 82.9%). The lesions with an iFR value of ≤0.89 and a Pd/Pa value of ≤0.92 were defined as double-positive lesions, while the lesions with an iFR value of >0.89 and a Pd/Pa value of >0.92 were defined as double-negative lesions. In these 109 lesions, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 92.3%, 82.9%, 75.0%, 95.1%, and 86.2%, respectively. Conclusion This analysis demonstrated that the iFR and resting Pd/Pa were strongly correlated with the FFR and that the diagnostic accuracy of the iFR was similar to that of the resting Pd/Pa. The diagnostic accuracy can be improved with the use of both the iFR and the resting Pd/Pa.
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- 2017
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13. Contrast-induced Hyperemia as an Alternative to Drug-induced Hyperemia in the Evaluation of the Fractional Flow Reserve in Coronary Lesions.
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Shiode N, Okimoto T, Tamekiyo H, Kawase T, Yamane K, Kagawa Y, Fujii Y, Ueda Y, Hironobe N, Kato Y, and Hayashi Y
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- Adenosine administration & dosage, Aged, Coronary Angiography, Coronary Artery Disease physiopathology, Female, Humans, Hyperemia physiopathology, Infusions, Intravenous, Male, Papaverine administration & dosage, Predictive Value of Tests, Severity of Illness Index, Contrast Media administration & dosage, Coronary Artery Disease diagnostic imaging, Fractional Flow Reserve, Myocardial, Hyperemia chemically induced, Vasodilator Agents administration & dosage
- Abstract
Objective Measuring the fractional flow reserve (FFR) requires the induction of coronary hyperemia, usually with adenosine, adenosine triphosphate (ATP), or papaverine. However, adenosine can induce rhythmic complications, and intracoronary boluses of papaverine that prolong the QT interval can cause ventricular tachycardia. Injection of contrast media, which is routinely performed to validate the FFR guidewire placement, also induces hyperemia and may be an alternative method of measuring the FFR. We evaluated the diagnostic accuracy of the FFR after contrast hyperemia (FFRcont) compared to FFR evaluated after intracoronary papaverine (FFRpp). Methods This study included 109 lesions in 93 patients (mean age 70.4±8.7 years) with stable coronary disease. The FFR was measured as follows: 1) baseline pressure value; 2) FFRcont after intracoronary contrast injection (iopamidol, 8 mL for left coronary artery [LCA] or 6 mL for right coronary artery [RCA]); 3) FFRpp after intracoronary injection of papaverine (12 mg for LCA or 8 mg for RCA). Results FFRcont values were strongly correlated with FFRpp (R=0.940, p<0.0001; FFRpp = FFRcont ×1.007-0.032). The best cut-off point in the receiver operator curve analysis for predicting a FFRpp <0.80 was 0.82 (area under the curve =0.980; sensitivity 95.1%, specificity 91.2%, positive predictive value 86.7%, negative predictive value 96.9%). Conclusion FFRcont is highly accurate for predicting FFRpp. An FFRcont threshold value of 0.82 provides excellent sensitivity and a negative predictive value. FFRcont is an alternative method of inducing hyperemia.
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- 2017
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14. Effect of statin on the 5 years clinical outcomes in dialysis patients treated with sirolimus-eluting stent.
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Kagawa Y, Toyofuku M, Masaoka Y, Muraoka Y, Okimoto T, Otsuka M, Tamekiyo H, Mito S, Kawase T, Yamane K, Amioka M, Shiode N, and Hayashi Y
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- Aged, Biomarkers, Cause of Death, Comorbidity, Coronary Disease complications, Coronary Disease surgery, Dyslipidemias complications, Dyslipidemias drug therapy, Female, Follow-Up Studies, Heart Failure etiology, Humans, Kaplan-Meier Estimate, Kidney Failure, Chronic complications, Kidney Failure, Chronic therapy, Male, Middle Aged, Myocardial Revascularization statistics & numerical data, Proportional Hazards Models, Retrospective Studies, Sirolimus administration & dosage, Treatment Outcome, Coronary Disease drug therapy, Drug-Eluting Stents, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Renal Dialysis, Sirolimus therapeutic use
- Abstract
Objective: The optimal medication therapies are recommended in patients with coronary artery disease even after the coronary revascularization. However, the information of optimal medical therapy in dialysis population is scant. We assessed the efficacy of statin on the clinical outcomes after Sirolimus-eluting stent (SES) implantation in patients with and without dialysis., Methods and Results: We analyzed date from 843 consecutive patients who successfully treated with SES in our institution between August 2004 and November 2006. Among patients, 96 patients (11.4%) were undergoing dialysis. In non-dialysis patients, 405 patients (54%) were treated with statin at hospital discharge. In dialysis patients, only 16 patients (17%) were treated with statin. In non-dialysis patients, mortality rate was significantly lower in patients treated with statin than those without statin (4.4% vs. 13.9%, p<0.0001). While in dialysis patients, mortality rate was similar between patients treated with and without statin (56.3% vs. 57.6%, p=0.86). After adjusting for confounders, the hazard ratios for mortality were 0.39 (95% confidence interval (CI), 0.14-0.99; p=0.047) in non-dialysis patients and 1.79 (95% CI, 0.39-7.86; 0.45) for dialysis patients. The interaction probability between statin use and dialysis for mortality was 0.016., Conclusion: The use of statin may have beneficial effect on reducing mortality rate in patients after SES implantation in non-dialysis patients. However, such favorable effect was not observed in dialysis population.
- Published
- 2014
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15. Solitary fibrous tumor with rapid progression after 16 years' follow up.
- Author
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Okimoto T, Horimasu Y, Hamaguchi S, Sutani A, Amano C, Harada Y, Maruyama R, Miyamoto N, Kishimoto K, and Isobe T
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- Aged, Disease Progression, Dyspnea etiology, Fatal Outcome, Fatigue etiology, Female, Follow-Up Studies, Humans, Solitary Fibrous Tumor, Pleural pathology, Time Factors, Biopsy, Fine-Needle methods, Solitary Fibrous Tumor, Pleural complications, Solitary Fibrous Tumor, Pleural diagnosis
- Abstract
A 79-year-old woman was admitted to our hospital for an investigation of a large 13-cm tumor in the chest and treatment for dyspnea in January 2010. The tumor had been observed on chest X-rays since 1992. It had measured 7 cm in 2008, then started to grow rapidly. Further investigations revealed that it was a malignant solitary fibrous tumor that was strongly suspected to have transformed from a benign to malignant state. Resection was not possible, and the patient died one month later. Benign solitary fibrous tumors of the pleura may become malignant during long-term follow-up. All suspected or proven solitary fibrous tumors of the pleura should be resected.
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- 2014
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16. Causes of very late stent thrombosis investigated using optical coherence tomography.
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Amioka M, Shiode N, Kawase T, Kagawa Y, Yamane K, Takahashi L, Okubo Y, Tamekiyo H, Otsuka M, Okimoto T, Masaoka Y, Hayashi Y, Itakura K, Kato M, Dote K, and Kihara Y
- Subjects
- Aged, Coronary Angiography, Coronary Restenosis etiology, Diagnosis, Differential, Female, Follow-Up Studies, Graft Occlusion, Vascular complications, Humans, Male, Percutaneous Coronary Intervention, Retrospective Studies, Time Factors, Acute Coronary Syndrome surgery, Coronary Restenosis diagnosis, Drug-Eluting Stents, Graft Occlusion, Vascular diagnosis, Tomography, Optical Coherence methods
- Abstract
Objective: Very late stent thrombosis (VLST) remains an unresolved problem, and recent reports have indicated that VLST onset can occur in patients treated with both drug-eluting stents (DES) and bare metal stents (BMS). We evaluated the causes of VLST using optical coherence tomography (OCT)., Methods: OCT was performed in 22 patients (12 DES-treated patients, 10 BMS-treated patients). Because two instances of VLST occurred simultaneously in one case in the DES group, the DES group comprised 13 lesions, while the BMS group comprised 10 lesions. All struts were counted in each frame, and the proportion of uncovered or malapposed struts was calculated based on the overall number of struts in the stent., Results: The interval from stent implantation to VLST onset was significantly longer in the BMS group. The proportion of uncovered struts and the ratio of malapposed struts were significantly higher in the DES group than in the BMS group. The OCT analysis demonstrated intimal hyperplasia or intimal disruption in all patients in the BMS group. However, in the DES group, severe hyperplasia and/or neoatherosclerosis was observed in only eight lesions (61.5%), while uncovered and malapposed struts were involved in the other lesions., Conclusion: In most BMS-treated lesions, it appeared that VLST was caused by the occurrence of neoatherosclerosis after stent implantation. The causes of VLST in DES-treated lesions are more various and complicated than those observed for BMS-treated lesions.
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- 2014
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17. Pancreatic injury successfully treated with endoscopic stenting for major pancreatic duct disruption.
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Abe T, Nagai T, Murakami K, Anan J, Uchida M, Ono H, Okawara H, Tanahashi J, Okimoto T, Kodama M, and Fujioka T
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- Adult, Cholangiopancreatography, Endoscopic Retrograde instrumentation, Humans, Male, Treatment Outcome, Cholangiopancreatography, Endoscopic Retrograde methods, Pancreas injuries, Pancreatic Ducts injuries, Stents, Wounds, Nonpenetrating therapy
- Abstract
We present a 43-year-old Japanese man with major pancreatic duct disruption caused by blunt pancreatic head damage. Computed tomography (CT) revealed pancreatic head injury, and endoscopic retrograde pancreatography showed pancreatic duct disruption at the injury site along with contrast media leakage. We placed a pancreatic stent for 3 months, after which closure of the pancreatic duct fistula was confirmed. CT on the 9th hospital day showed acute pancreatic fluid collections, but these had disappeared at the 3 month follow-up CT. The patient has remained asymptomatic at follow-up for 3 years.
- Published
- 2009
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