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Long-term survival of a case with multiple liver metastases from duodenal gastrointestinal stromal tumor drastically reduced by the treatment with imatinib and hepatectomy

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World Journal of Gastroenterology 2006年第17期12卷 2793-2797页

作者： Chouhei Sakakura Akeo Hagiwara Koji Soga Koji Miyagawa susumu nakashima Tetsuji Yoshikawa Shuichi Kin Yuenn Nakase Nobuki Yamaoka Yoshihiko Sagara Hisakazu Yamagishi Department of Digestive Surgery Kyoto Prefectural University of Medicine Kawaramachi-doriKamigyokuKyoto 602-0841Japan

Constitutive activation of KIT receptor tyrosine kinase is a critical factor in the pathogenesis of gastrointestinal stromal tumors （GISTs）. But there is little information on whether combination of imatinib mesylate （IM） and surgical treatment can prolong survival in the cases with unresectable multiple liver metastases. We report a case of postoperative recurrence of GIST treated by the tyrosine kinase inhibitor IN and surgical treatment. The initial complete response （CR） to treatment continued for 18 mo, but single liver metastasis showed regrowth in the left hepatic lobe during IN treatment. After partial resection of the recurrent tumor, postoperative course was uneventful and the patient has survived without recurrence for 24 too. Currently, imatinib is the first- line therapy for non-resectable GISTs, but a single agent therapy often leads to tumor resistance. Even if tolerance to imatinib occurs, a combination of imatinib and surgical treatment can prolong survival in some cases as reported here. However, further studies on a large number of cases of recurrent GIST are necessary to evaluate the effectiveness of IN treatment combined with surgery.

关键词： GIST Imatinib mesylate Liver metastases

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Increased Spot Urinary Protein-to-Creatinine Ratio Can Be a Useful Predictor of Preeclampsia

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Open Journal of Obstetrics and Gynecology 2015年第14期5卷 808-812页

作者： Mai Nishimura Ayaka nakashima Takuya Kushimoto Mayako Goto susumu Yoshida Osamu Sato Kayoko Shikado Kazuhide Ogita Department of Obstetrics & Gynecology Rinku General Medical Center Osaka Japan

Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.

关键词： Preeclampsia Eclampsia Protein-to-Creatinine Ratio Pregnancy Induced Hypertension Proteinuria

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Predictive Factors of the Presence and Number of Noncalcified Coronary Plaque in Japanese Patients with Zero Coronary Artery Calcium Score Using 64-Slice Multi-Detector Computed Tomography

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Advances in Computed Tomography 2013年第3期2卷 112-120页

作者： Yoshiki Noda Ryo Matsutera Yoshinori Yasuoka Kiyoshi Kume Hidenori Adachi susumu Hattori Ryo Araki Motohiro Kosugi Yasuaki Kohama Tetsufumi nakashima Tatsuya Sasaki Cardiovascular Division Osaka Minami Medical Center National Hospital Organization Osaka Japan

Background: Factors that can predict the presence and number of noncalcified coronary plaques (NCP) in Japanese patients with zero coronary artery calcium scores (CACS) essentially remain undefined. Methods and Results: We assessed independent predictors of the presence and number of segments with NCP in 111 Japanese patients with zero CACS who underwent 64-slice multi-detector computed tomography at our hospital. Thirty five patients (32%) had NCP, and 24 patients (22%) had ≥ 2 NCPs. Multiple logistic regression analysis revealed that significant predictors for the presence of NCP were age (odds ratio [OR]: 1.06, 95% confidence interval [CI] 1.01 - 1.11, p = 0.021), male (OR: 3.61, 95% CI 1.40 - 9.35, p = 0.008) and diabetes mellitus (OR: 3.10, 95% CI 1.02 - 9.45, p = 0.046), and those for the presence of ≥ 2 NCPs were age (OR: 1.08, 95% CI 1.02 - 1.15, p = 0.007) and a current smoking habit (OR: 5.09, 95% CI 1.00 - 25.74, p = 0.049). Multiple linear regression analysis identified advanced age, male gender and diabetes mellitus as independent predictors of the number of NCPs. A novel score calculated from the above four predictors showed moderate accuracy for a diagnosis of NCP and ≥ 2 NCPs, with areas under receiver operating curves of 0.738 and 0.736, respectively. Conclusions: Male Japanese patients with zero CACS, advanced age, diabetes mellitus and a current smoking habit might have NCPs.

关键词： Zero Coronary Artery Calcium Score Number of Noncalcified Coronary Plaque 64-Slice Multi-Detector Computed Tomography Japanese Patients

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