65 research outputs found

    Biological Behavior of Papillary Carcinoma of the Thyroid Including Squamous Cell Carcinoma Components and Prognosis of Patients Who Underwent Locally Curative Surgery

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    Thyroid carcinoma showing squamous differentiation throughout the entire lesion is diagnosed as squamous cell carcinoma of the thyroid (SCCT) in the WHO classification. This entity is a rare disease and shows a dire prognosis; however, squamous differentiation is more frequently detected in only a portion of papillary thyroid carcinoma. In this paper, we present our experience of 10 patients (8 primary lesions and 2 with recurrence in the lymph nodes) with papillary thyroid carcinoma having an SCC component (PTC-SCC). Only 3 of 8 primary lesions (38%) and none of the 2 recurrent nodes were preoperatively diagnosed as or suspected of having SCC components. All 10 patients underwent locally curative surgery. To date, 3 patients have died of carcinoma, and 2 had distant metastasis at diagnosis or had an undifferentiated carcinoma component. The other 7 are currently alive 5 to 43 months after diagnosis. Systemic adjuvant therapy after the detection of recurrence was effective for 2 patients. It is possible that some PTC-SCC patients without distant metastasis who undergo locally curative surgery can survive for a prolonged period and adjuvant therapies can be effective for local and distant recurrences

    Total synthesis of the marine natural products lukianols A and B

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    Total synthesis of the pyrrolic marine natural products lukianols A (1) and B (2) has been achieved using N-benzenesulfonyl-3,4-dibromopyrrole (3) as a common starting material. The key synthetic strategy developed is the combined bromine-directed lithiation and palladium-catalyzed cross-coupling of 3 to produce 3,4-diarylpyrrol-2-carboxylates. Regioselective iodination of the phenolic intermediate 24 was thoroughly investigated for the synthesis of lukianol B

    The first case of thrombocytopenia, anasarca, fever, renal impairment or reticulin fibrosis, and organomegaly (TAFRO) syndrome with unilateral adrenal necrosis: a case report

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    Abstract Background TAFRO syndrome, which was first reported in 2010 in Japan, is a relatively rare disease characterized by thrombocytopenia, anasarca, fever, renal impairment, reticulin fibrosis, and organomegaly. Although this disease is considered similar to multicentric Castleman disease, some of the clinical features, such as thrombocytopenia, are different from typical cases of multicentric Castleman disease. In addition, the etiology of TAFRO syndrome remains unknown and controversial. There have only been a few cases of TAFRO syndrome complicated with adrenal gland lesions, and all of them have had hemorrhagic involvement. Case presentation This report describes the case of a 46-year-old Asian man who presented with fever, epigastric pain, and back pain for 1 month. A computed tomographic scan revealed ascites, mild lymphadenopathy, and left adrenal necrosis without hemorrhage. A blood test showed thrombocytopenia, anemia, and elevated C-reactive protein, alkaline phosphatase, and creatinine levels. Based on the edema, severe thrombocytopenia, fever, reticulin myelofibrosis shown by bone marrow biopsy, mild lymphadenopathy, and progressive renal insufficiency, we diagnosed this patient as having TAFRO syndrome. He was successfully treated by immediate administration of glucocorticoids and tocilizumab. Conclusions There have been no previous reports of a case of TAFRO syndrome complicated with adrenal necrosis. Because the biopsy of the left adrenal gland revealed necrosis without any evidence of hemorrhage, we concluded that the unilateral adrenal necrosis in this case was caused by either ischemia from infarction or organomegaly itself under severe hypercytokinemia. This unusual clinical course is useful for further analysis of the etiology of TAFRO syndrome

    Annual meeting of the Japan Traditional Chinese Medicine Association: Quantifying and objectifying traditional Chinese medicine

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    Five researchers reported on their studies to quantify and objectify traditional medicine at the symposium “Verification of Traditional Chinese Medicine” during the 2016 annual meeting of the Japan Traditional Chinese Medicine Association. Takao Namiki reported on a methodology to quantify tongue diagnosis. Tetsuhiro Yoshino presented work on predictive prescribing two Kampo formulas for dysmenorrhea, Tangkuei and Peony Powder (Danggui Shaoyao San) and Cinnamon Twig and Poria Pill (Guizhi Fuling Wan). Koh Iwasaki presented work on validation of a questionnaire for assessing qi stagnation and Mitsuyuki Takamura reported on application of the questionnaire to evaluate the efficacy of Pinellia and Magnolia Bark Decoction (Banxia Houpo Tang). Kaoru Sakatani presented research on near-infrared spectroscopy as a diagnostic tool for wei bing, a concept of pre-symptomatic state in traditional Chinese medicine

    Risk perception regarding a nuclear accident and common factors related to health among guardians residing near a restarted nuclear power plant in Japan after the Fukushima accident

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    Ten years have passed since the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in Japan, and nine of 33 reactors have gradually been restarted following the new regulations outlined by the Nuclear Regulatory Authority. The purpose of the study was to assess the risk perception regarding a nuclear accident and to identify common factors related to health among guardians residing near the Genkai Nuclear Power Plant (GNPP), one of the nuclear power plants restarted after the FDNPP accident. We distributed self-administered questionnaires to approximately 3400 guardians of children in 36 kindergartens located around the GNPP, including the precautionary action zone and the urgent protective action planning zone. We obtained responses from 2249 guardians. Results showed that 58.9% of guardians thought that genetic effects would occur among the generations who were children at the time of the FDNPP accident. In contrast, 28.8% of guardians were anxious about their children consuming foods from Fukushima. Regression analysis showed that females were 1.9 times more anxious about administering prophylactic stable iodine (SI) than male guardians. A total of 1.5 times more female than male guardians considered that genetic effects would occur in the generations who were children at the time of the FDNPP accident. Interestingly, there was no significant relationship between overall risk perception and the distance of guardians’ residence to the GNPP

    Prognosis of Patients with Papillary Thyroid Carcinoma Located in One Lobe Showing Lateral Node Metastasis in the Contralateral but Not Ipsilateral Compartment

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    Papillary thyroid carcinoma (PTC) frequently metastasizes to the lymph node in lateral compartment, which can often be detected on preoperative ultrasonography (N1b). However, PTC located in one lobe showing contralateral but not ipsilateral N1b is not common. We analyzed the clinicopathological features and prognosis of 13 patients with PTC limited in one lobe showing contralateral but not ipsilateral N1b. Sizes of the primary lesions ranged from 0.8 cm to 3.0 cm and only 2 tumors showed extrathyroid extension. Metastatic lateral node measured from 0.6 to 3.1 cm. Ten patients showed pathological central node metastasis and 5 had minute PTC lesions in the contralateral lobe. However, 3 patients did not show either of these. None of the patients have developed carcinoma recurrence or died of carcinoma to date. Taken together, PTC located in one lobe with contralateral but not ipsilateral N1b is rare and generally shows an indolent behavior. Although most patients had central node metastasis and/or minute PTC lesions in the contralateral lobe, it is also possible for carcinoma cells to metastasize directly from primary lesions to the contralateral lateral node. Total thyroidectomy with central node dissection and therapeutic MND of the contralateral compartment may be an acceptable surgical design and bilateral MND might not be mandatory