We examined the problems by evaluating the current status of breast cancer screening study conducted in our hospital. Subject of investigation have received a breast cancer screening in our hospital in 2010. Breast cancer detection rate in our hospital, abnormal interpretation rate, positive predictive value, the consultation rate of detailed examination, data were summarized. We referenced the date of the national average and Yamaguchi Prefecture in 2007. The breast cancer detection rate of our hospital, abnormal interpretation rate, positive predictive value, the consultation rate of detailed examination respectively 0.833%, 15.28%, 5.455%, 98.2%. Breast cancer detection rate in our hospital was high. Because Yamaguchi City is shooting two-projection mammography, the determination by the certifying physician interpreting mammograms even five, and the consultation rate of detailed examination is extremely high in our hospital, which is to facilitate the induction of detailed examination from screening, breast cancer detection rate is high. On the other hand, a rate of abnormal interpretation is high, we should think how to improve the specificity issue in terms of health economics. In our hospital, we have been working to improve the consultation rate for breast cancer screening in several measures with the gynecologist.

View full abstract

A 61-year-old man with refractory myeloma was treated using lenalidomide(LEN)as salvage therapy. Three days after initiating LEN therapy, skin eruptions appeared on his limbs and extremities. The eruptions rapidly disappeared on discontinuing LEN and initiating therapy with low-dose prednisolone(10 mg/day),olopatadine, and intravenous glycyrrhizinate. The eruptions recurred at the time that LEN was readministered and did not disappear on administering only prednisolone and olopatadine. Additional therapy with oral glycyrrhizinate effectively controlled the eruptions, and therefore, the patient was allowed to continue LEN therapy.

View full abstract

A 12-year-old girl presented with chief complaints of severe dysmenorrhea and lower abdominal pain. Magnetic resonance imaging, computed tomography and drip infusion pyelography showed uterus didelphys with right hematometra and hematosalpinx, and right renal agenesis. Under diagnosis of Wunderlich syndrome, we performed laparoscopic exploration. Although excision of the obstructing cervix has been recommended as the first treatment for this syndrome, we couldn't perform resection of vaginal wall. So we selected supra-cervical hysterectomy of right uterus. After surgery, her symptoms are quite improved.

View full abstract

A 57-year-old man had been followed up for hepatocellular carcinoma in S2 and S6 since May 2001. He had received several sessions of radiofrequency ablation(RFA)and transcatheter arterial chemoembolization(TACE)till 2009. He underwent S6 partial hepatectomy for hepatocellular carcinoma in January 2010. When seen for right lower abdominal pain in December 2010, abdominal CT revealed a tumor 10 cm in diameter in the ileocecal region. We suspected abdominal recurrence of hepatocellular carcinoma because of a rise in the PIVKA-Ⅱ level, and performed extirpation of the tumor with appendectomy. Although macroscopically the tumor adhered to the posterior wall of the ileocecal region, histopathologically the wall of the appendix was intact. Six months later there was a subsequent episode of ileus, and abdominal CT revealed a new tumor measuring 7.5 cm on the lateral side of the descending colon. As enhanced CT in the arterial early phase also revealed several nodules, we diagnosed extensive dissemination of hepatocellular carcinoma. We report this rare case of peritoneal dissemination of hepatocellular carcinoma after repeated RFA/TACE treatment and partial hepatectomy along with a review of the literature.

View full abstract