Journal of Nippon Medical School最新文献

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A Case of Grade 3 Gastric Neuroendocrine Tumor with Glandular Formation: Diagnostic Process and Differentiation from Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm. 3级胃神经内分泌肿瘤伴腺状形成1例:与胃神经内分泌-非神经内分泌混合型肿瘤的诊断过程及鉴别。
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-17 DOI: 10.1272/jnms.JNMS.2026_93-502
Makiko Kurata, Takuma Tajiri, Masataka Ueda, Chie Inomoto, Tomoko Sugiyama, Takayoshi Suzuki, Hideki Izumi, Junichi Kaneko, Eiji Nomura, Naoya Nakamura, Yohei Masugi
{"title":"A Case of Grade 3 Gastric Neuroendocrine Tumor with Glandular Formation: Diagnostic Process and Differentiation from Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm.","authors":"Makiko Kurata, Takuma Tajiri, Masataka Ueda, Chie Inomoto, Tomoko Sugiyama, Takayoshi Suzuki, Hideki Izumi, Junichi Kaneko, Eiji Nomura, Naoya Nakamura, Yohei Masugi","doi":"10.1272/jnms.JNMS.2026_93-502","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-502","url":null,"abstract":"<p><p>A 78-year-old man was diagnosed as having a submucosal gastric mass (diameter 4 cm). Preoperative findings from endoscopic ultrasound-guided fine needle aspiration suggested a diagnosis of gastric neuroendocrine neoplasm. Total gastrectomy with excision of a metastatic liver lesion and dissection of gastric lymph nodes was performed. Analysis of frozen sections indicated adenocarcinoma of the peritoneum, which suggested the possibility of a mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN), based on the presence of solid tubules, metastatic spread, and lymphovascular invasion. However, the smooth gastric mucosal surface, organoid architecture with rare atypia or necrosis, immunopositivity for neuroendocrine markers, a Ki-67 index of 21%, and the presence of somatostatin receptor 2 expression confirmed a final pathological diagnosis of grade 3 gastric neuroendocrine tumor (NETG3) with glandular formation. NETG3 with glandular formation can be difficult to distinguish from MiNEN because their histological features overlap. However, gastric NETG3 with glandular formation is distinguishable from MiNEN by the presence of a submucosal tumor with a histological organoid pattern without frequent mitoses and/or necrosis, immunopositivity for neuroendocrine markers, and the absence of an adenocarcinoma or neuroendocrine carcinoma component within the tumor, as determined by immunohistochemistry for somatostatin receptor 2 expression, Ki-67, and Rb1.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Successful Endoscopic Dilation of Obstructions at the Thoracic Inlet and Jejunostomy After Esophagectomy: A Case Report. 食管切除术后胸入口阻塞内镜扩张及空肠造口术成功一例报告。
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-17 DOI: 10.1272/jnms.JNMS.2026_93-603
Shu Yamagata, Tomohiko Yasuda, Komei Kuge, Hiroki Arai, Daisuke Kakinuma, Keisuke Minamimura, Masanori Watanabe, Yoshiharu Nakamura, Hiroshi Yoshida
{"title":"Successful Endoscopic Dilation of Obstructions at the Thoracic Inlet and Jejunostomy After Esophagectomy: A Case Report.","authors":"Shu Yamagata, Tomohiko Yasuda, Komei Kuge, Hiroki Arai, Daisuke Kakinuma, Keisuke Minamimura, Masanori Watanabe, Yoshiharu Nakamura, Hiroshi Yoshida","doi":"10.1272/jnms.JNMS.2026_93-603","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-603","url":null,"abstract":"<p><strong>Introduction: </strong>Because of its lower risk of mediastinal complications, the retrosternal route is commonly used for reconstruction after subtotal esophagectomy. However, cases of postoperative gastric conduit obstruction at the thoracic inlet have been reported, as has passage disturbance at the feeding jejunostomy site. These obstructions are often managed by surgical treatment, but few reports have described endoscopic treatment.</p><p><strong>Case presentation: </strong>A 75-year-old man with advanced mid-thoracic esophageal cancer underwent three courses of DCF chemotherapy, followed by robotic esophagectomy with gastric conduit reconstruction via the retrosternal route and feeding jejunostomy. Preoperative CT showed no thoracic inlet stenosis. On postoperative day (POD) 7, a barium swallow test revealed cervical esophageal dilation and narrowing of the gastric conduit due to external compression at the thoracic inlet. In addition, a passage disturbance at the feeding jejunostomy site developed later. Endoscopic balloon dilation was performed at both sites on POD 26 and 31, resulting in resolution of both obstructions. The patient resumed adequate oral intake and was discharged without the need for reoperation.</p><p><strong>Conclusions: </strong>This case suggests that endoscopic balloon dilation is an effective, minimally invasive alternative to surgery for managing postoperative gastric conduit and jejunostomy obstructions after esophagectomy.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leptomeningeal metastasis from colorectal cancer treated with folinic acid, fluorouracil, and oxaliplatin chemotherapy plus bevacizumab: A case report. 亚叶酸、氟尿嘧啶、奥沙利铂联合贝伐单抗治疗结直肠癌轻脑膜转移1例
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-17 DOI: 10.1272/jnms.JNMS.2026_93-501
Tomohiro Hayakawa, Yoshiharu Nakamura, Hiroki Masuda, Goro Takahashi, Takeshi Matsutani, Hiroshi Yoshida
{"title":"Leptomeningeal metastasis from colorectal cancer treated with folinic acid, fluorouracil, and oxaliplatin chemotherapy plus bevacizumab: A case report.","authors":"Tomohiro Hayakawa, Yoshiharu Nakamura, Hiroki Masuda, Goro Takahashi, Takeshi Matsutani, Hiroshi Yoshida","doi":"10.1272/jnms.JNMS.2026_93-501","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-501","url":null,"abstract":"<p><p>Leptomeningeal metastasis (LM) from colorectal cancer is rare. LM is characterized by rapid progression, making diagnosis and treatment challenging, and are associated with a poor prognosis. A 63-year-old man undergoing chemotherapy with bevacizumab for colorectal cancer was admitted to our hospital with loss of appetite. On admission, he experienced frequent episodes of loss of consciousness. Imaging to identify the underlying cause revealed no abnormalities. Cytological examination of cerebrospinal fluid confirmed LM. Because of worsening symptoms, the patient had difficulty communicating, thus preventing continuation of chemotherapy. He died at 3 weeks post-admission. In patients with cancer who exhibit central nervous system symptoms without abnormal imaging findings, LM should be considered even if the primary tumor is in the transverse colon. In such cases, cytological examination of cerebrospinal fluid and imaging studies should be conducted. This rare case of LM from colorectal cancer after resection and chemotherapy with molecularly targeted agents yielded insights that might guide future treatment strategies.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment of Keloids from Gender-Affirming Mastectomy: A Case Report. 性别确认乳房切除术后瘢痕疙瘩的治疗:1例报告。
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-17 DOI: 10.1272/jnms.JNMS.2026_93-505
Kanae Nakamura, Toru Sakurai, Rei Ogawa
{"title":"Treatment of Keloids from Gender-Affirming Mastectomy: A Case Report.","authors":"Kanae Nakamura, Toru Sakurai, Rei Ogawa","doi":"10.1272/jnms.JNMS.2026_93-505","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-505","url":null,"abstract":"<p><p>A transgender (trans) man is a trans person who was assigned female sex at birth. Some trans men undergo gender-affirming surgical procedures, particularly mastectomy. We present a case of keloid formation after gender-affirming mastectomy that highlights the importance of choosing the most appropriate mastectomy technique in patients at risk of keloid and the most effective therapeutic strategies for anterior-chest keloids. A 40-year-old Japanese trans man developed keloids along inverted-T mastectomy-induced anterior-chest scars. The keloids were completely excised, and the defects were closed by primarily using a layered technique. Starting the next day, the wounds were treated with radiotherapy over 3 consecutive days. The wounds/scars were carefully monitored and treated with continuous taping fixation for 1 year. There was no recurrence, and aesthetic outcomes at 18 months were good. To prevent keloids after gender-affirming mastectomy, surgeons must estimate individual risk of keloid formation. If the patient is young, of Asian or African descent, or has a personal or family history of keloids, surgical methods that leave long lateral scars on the anterior chest (e.g., the inverted T procedure) should be avoided. Tensionless or tension-reducing surgical techniques should also be used, along with postoperative radiotherapy, long-term taping or compression, close follow-up to detect early signs of keloid formation, and referral to a plastic surgery department if any scar induration or elevation is observed. Surgeons performing gender-affirming mastectomy can potentially reduce the risk of keloid formation by carefully considering these factors.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term follow-up of a case of Langerhans cell histiocytosis of the cervical spine with pulmonary involvement. 1例颈椎朗格汉斯细胞组织细胞增多症伴肺受累的长期随访。
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-17 DOI: 10.1272/jnms.JNMS.2026_93-604
Toshikazu Itabashi, Yujiro Tanabe, Takahiro Ueda
{"title":"Long-term follow-up of a case of Langerhans cell histiocytosis of the cervical spine with pulmonary involvement.","authors":"Toshikazu Itabashi, Yujiro Tanabe, Takahiro Ueda","doi":"10.1272/jnms.JNMS.2026_93-604","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-604","url":null,"abstract":"<p><p>Unlike Langerhans cell histiocytosis (LCH) involving the skull, LCH of the vertebrae and lungs requires careful long-term follow-up because of the risks of motor and respiratory dysfunction; however, few reports have addressed this issue. A boy aged 7 years 7 months presented with bilateral shoulder pain and neck pain. Initial imaging revealed C6 vertebral bone lysis, a mass spanning C5-C7, C6 vertebral body flattening, and epidural extension. Chest radiographs and CT scans showed diffuse reticular and funicular shadows, ground-glass opacities, interlobular septal thickening, and swollen hilar lymph nodes. Bone scintigraphy showed cervical accumulation, while gallium scintigraphy revealed diffuse lung uptake. Lung biopsy confirmed LCH (CD1a, S-100, langerin positivity), confirming a diagnosis of multisystem LCH involving lung, bone, skin, and soft tissue. Treatment with cytarabine, vincristine, and prednisolone, in accordance with the Japan LCH Study Group-02 protocol, resulted in rapid respiratory improvement, withdrawal of oxygen, and resolution of neck pain. Seven years after completing chemotherapy, the patient had no neck discomfort and satisfactory cervical motion, normal respiratory function, and no respiratory symptoms. A cervical MRI scan at 1.5 years after the end of chemotherapy showed persistent C6 vertebral flattening from the compression fracture, which remained clinically stable throughout follow-up, with no herniation, mass formation, or epidural recurrence. Chest imaging at a 7-year follow-up examination showed no abnormalities. These findings suggest that timely diagnosis and appropriate chemotherapy yield favorable long-term outcomes in multisystem LCH with vertebral and pulmonary involvement, and avoid major sequelae.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
24-Hour Intraocular Pressure Fluctuation Suppressed by Microhook Trabeculotomy in Ocular Hypertension: A Case Report. 微钩小梁切开术抑制眼压过高症患者 24 小时眼压波动:病例报告。
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-06 Epub Date: 2024-08-21 DOI: 10.1272/jnms.JNMS.2025_92-501
Yutaro Tobita, Naka Shiratori, Yusuke Nishio, Kenji Nakamoto, Fumiki Okamoto
{"title":"24-Hour Intraocular Pressure Fluctuation Suppressed by Microhook Trabeculotomy in Ocular Hypertension: A Case Report.","authors":"Yutaro Tobita, Naka Shiratori, Yusuke Nishio, Kenji Nakamoto, Fumiki Okamoto","doi":"10.1272/jnms.JNMS.2025_92-501","DOIUrl":"10.1272/jnms.JNMS.2025_92-501","url":null,"abstract":"<p><p>A 76-year-old woman was referred to our hospital for evaluation of markedly high intraocular pressures (IOPs): ≥40 mmHg in both eyes. No intraocular inflammation, pseudoexfoliation, or glaucomatous optic neuropathy was observed on ophthalmological examination. The 24-hour IOP fluctuations, measured with a Goldmann tonometer in the sitting position at 8, 12, 16, 20, and 24 o'clock, were 22/17, 33/28, 41/33, 30/22, and 30/24 mmHg, respectively, and showed a peak in the afternoon. The patient was diagnosed with ocular hypertension, and microhook trabeculotomy (μLOT) (right eye with lens reconstruction, left eye initially pseudophakic) was performed. After μLOT surgery in both eyes (4 days postoperatively in the right eye and 1 day postoperatively in the left eye), IOP decreased in both eyes to 12/15, 11/14, 12/15, 10/11, and 10/10 mmHg, and the fluctuation range was suppressed. At 3 months postoperatively (measured at 8, 12, 16, 20, 24, and 4 o'clock), the effect was maintained at 14/15, 15/19, 14/19, 11/12, 13/14, and 13/13 mmHg, respectively, but was slightly attenuated. In a patient with marked 24-hour IOP fluctuation, μLOT was effective in reducing IOP values and fluctuation.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"399-402"},"PeriodicalIF":1.4,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Focal Bacterial Nephritis in an Infant Referred with Apnea Caused by Mixed Infection with Enterococcus raffinosus and Escherichia coli. 一名因呼吸暂停而转诊的婴儿因混合感染拉菲诺斯肠球菌和大肠埃希菌而引发急性局灶性细菌性肾炎。
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-06 Epub Date: 2024-08-21 DOI: 10.1272/jnms.JNMS.2025_92-502
Yuna Kamioka, Kensuke Izumida, Eiji Ohtaka, Yoshiaki Hashimoto, Hajime Okada, Hidehiko Narazaki, Yasuhiko Itoh
{"title":"Acute Focal Bacterial Nephritis in an Infant Referred with Apnea Caused by Mixed Infection with Enterococcus raffinosus and Escherichia coli.","authors":"Yuna Kamioka, Kensuke Izumida, Eiji Ohtaka, Yoshiaki Hashimoto, Hajime Okada, Hidehiko Narazaki, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2025_92-502","DOIUrl":"10.1272/jnms.JNMS.2025_92-502","url":null,"abstract":"<p><p>A 38-day-old infant was referred to our hospital for evaluation of apnea, fever, and pyuria. Invasive bacterial infection, including meningitis, was suspected because of the presence of apnea. A contrast-enhanced CT scan revealed acute localized bacterial nephritis, and meningitis was ruled out. Gram-positive cocci and Gram-negative rods, ie, Enterococcus raffinosus and Escherichia coli, were isolated from a urine culture at the referring hospital. This case report describes the youngest case of E. raffinosus infection. Apnea was the main complaint, but the origin of fever was infant acute focal bacterial nephritis (AFBN) with mixed infection. In infants, bacterial infections, especially invasive bacterial infections, can result in poor outcomes and require careful evaluation and treatment. Furthermore, the possibility of AFBN should not be overlooked, because bacteriuria or leukocyturia may be absent and can flare up if antimicrobials are not administered for an adequate duration. Although ampicillin-susceptible E. raffinosus infection in our patient responded well to treatment, there have been reports of vancomycin-resistant enterococci, which highlights the importance of proper use of antimicrobial agents to avoid producing drug-resistant bacteria.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"403-408"},"PeriodicalIF":1.4,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immune Checkpoint Inhibitor-Related Immunoglobulin A Nephropathy in a Patient with Advanced Head and Neck Cancer. 1例晚期头颈癌患者的免疫检查点抑制剂相关免疫球蛋白A肾病。
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-06 Epub Date: 2025-03-22 DOI: 10.1272/jnms.JNMS.2025_92-505
Sae Aratani, Takeshi Matsunobu, Masashi Nakaishi, Akira Shimizu, Tetsuya Kashiwagi, Yukinao Sakai, Kimihiro Okubo, Masato Iwabu
{"title":"Immune Checkpoint Inhibitor-Related Immunoglobulin A Nephropathy in a Patient with Advanced Head and Neck Cancer.","authors":"Sae Aratani, Takeshi Matsunobu, Masashi Nakaishi, Akira Shimizu, Tetsuya Kashiwagi, Yukinao Sakai, Kimihiro Okubo, Masato Iwabu","doi":"10.1272/jnms.JNMS.2025_92-505","DOIUrl":"10.1272/jnms.JNMS.2025_92-505","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of many cancers, including cancers of the head and neck. Despite the promising therapeutic efficacy of ICIs, immune-related adverse events (irAEs) are a major concern. Acute tubular injury and interstitial nephritis are the most common irAEs involving the kidneys. The present patient was diagnosed as having advanced papillary squamous cell carcinoma of the head and neck. After failure of the initial treatments, including chemotherapy, nivolumab (programmed death-1 inhibitor) was introduced. Shortly after initial administration of nivolumab, the patient developed acute kidney injury with hematuria and proteinuria. A renal biopsy and his clinical course indicated a diagnosis of ICI-related IgA nephropathy. Although glomerular involvement in irAEs is rare and challenging to treatment, the present patient was successfully treated with steroids, which improved kidney function and led to complete remission, as confirmed by urinalysis.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"420-425"},"PeriodicalIF":1.4,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early Laparoscopic Colostomy in Advanced Cancer Patients with Rectovaginal Fistula: Results of Seven Patients. 直肠阴道瘘晚期癌症患者的早期腹腔镜结肠造口术:七名患者的治疗结果
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-11-06 Epub Date: 2024-08-21 DOI: 10.1272/jnms.JNMS.2025_92-504
Satoshi Akita, Kei Ishimaru, Mitsunori Sato, Katsuya Watanabe, Hiroki Sugishita, Yusuke Ogi, Jun Kuwabara, Kazufumi Tanigawa, Satoshi Kikuchi, Hironori Matsumoto, Motohira Yoshida, Shigehiro Koga, Taro Oshikiri
{"title":"Early Laparoscopic Colostomy in Advanced Cancer Patients with Rectovaginal Fistula: Results of Seven Patients.","authors":"Satoshi Akita, Kei Ishimaru, Mitsunori Sato, Katsuya Watanabe, Hiroki Sugishita, Yusuke Ogi, Jun Kuwabara, Kazufumi Tanigawa, Satoshi Kikuchi, Hironori Matsumoto, Motohira Yoshida, Shigehiro Koga, Taro Oshikiri","doi":"10.1272/jnms.JNMS.2025_92-504","DOIUrl":"10.1272/jnms.JNMS.2025_92-504","url":null,"abstract":"<p><p>A rectovaginal fistula (RVF) is an abnormal tract between the rectum and vagina, which requires surgical intervention in many cases. Although there are many different therapeutic approaches for RVF depending on the patients' condition, there are no established guidelines for the care of RVF. This study aimed to evaluate the results of laparoscopic colostomy in advanced cancer patients with RVF, and the safety and efficacy of this surgery. In this study, seven female advanced cancer patients with RVF were hospitalized and successfully treated with laparoscopic colostomy from 2015 to 2018 at our university hospital. Their data were retrospectively evaluated from their medical records. The early use of diverting stomas facilitated timely resumption of cancer treatment and enabled early treatment with chemotherapy or radiotherapy. Although vaginal stool leakage affected three patients, all patients recovered, experiencing neither pain nor infection during their cancer treatment. While colostomy was physically and mentally taxing for the patients, it improved the infection and pain caused by the RVF. We conclude that the early use of diverting stomas had two effects: a significant improvement in infection management and facilitation of the rapid resumption of cancer treatment.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"414-419"},"PeriodicalIF":1.4,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ascites Caused by Intestinal Anisakiasis: A Case Report and Literature Review. 由肠道蛔虫病引起的腹水:病例报告与文献综述
IF 1.4 4区 医学
Journal of Nippon Medical School Pub Date : 2025-09-02 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-401
Yutaka Furuta, Naoto Matsuda, Hiroaki Wakakuri, Hideya Hyodo, Toshihiko Ohara, Gen Takagi, Masahiro Yasutake
{"title":"Ascites Caused by Intestinal Anisakiasis: A Case Report and Literature Review.","authors":"Yutaka Furuta, Naoto Matsuda, Hiroaki Wakakuri, Hideya Hyodo, Toshihiko Ohara, Gen Takagi, Masahiro Yasutake","doi":"10.1272/jnms.JNMS.2025_92-401","DOIUrl":"10.1272/jnms.JNMS.2025_92-401","url":null,"abstract":"<p><p>Anisakiasis is a parasitic infection affecting the human gastrointestinal tract. It is caused by the consumption of contaminated, raw or inadequately cooked fish or squid, which is typically used for making sushi and sashimi. Most cases involve gastric anisakiasis, whereas intestinal anisakiasis is rare. This report describes the case of a 63-year-old Japanese woman with a history of raw fish consumption who presented with acute-onset abdominal pain and vomiting. Abdominal computed tomography (CT) demonstrated thickened small bowel loops and ascites on the liver surface. The patient was admitted for supportive care. On the second day of hospitalization, contrast-enhanced abdominal CT revealed that the ascites had moved from the liver surface to the pouch of Douglas. On the fifth day of hospitalization, the patient was discharged with a substantial improvement in abdominal pain. Five days after the discharge, her eosinophil count was elevated, and parasitic disease was therefore suspected. Anti-Anisakis IgG/A and IgE (RAST) antibody levels were elevated, confirming the diagnosis of intestinal anisakiasis. A review of 51 reported cases of intestinal anisakiasis suggests that the presence of ascites and measurement of anti-Anisakis antibody titers are helpful for diagnosis in cases presenting with nonspecific abdominal symptoms after consumption of raw or undercooked fish.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"368-373"},"PeriodicalIF":1.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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