Baba Memorial Hospital

Sakai, Japan

Baba Memorial Hospital

Sakai, Japan

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Nakanishi K.,Baba Memorial Hospital | Fukuda S.,University of Occupational and Environmental Health Japan | Tanaka A.,Wakayama Medical University | Otsuka K.,Ishikiriseiki Hospital | And 3 more authors.
Circulation Journal | Year: 2015

Background: Chronic kidney disease (CKD) is strongly associated with coronary artery disease (CAD), although the underlying pathophysiological mechanism remains unclear. Epicardial adipose tissue (EAT) has recently been recognized as an important source of various pro-inflammatory cytokines causing coronary atherosclerosis. This study investigated the relationship between CKD and EAT volume in association with high-risk plaque. Methods and Results: The study included 275 patients with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m2 who underwent multidetector computed tomography (MDCT) for the evaluation of CAD. Patients were classified, according to eGFR, into a CKD group (30≤eGFR<60 ml/min/1.73 m2) or a non-CKD group (eGFR ≥60 ml/min/1.73 m2). MDCT was used to assess coronary plaque morphology and EAT volume. One hundred and ten patients with CKD were more likely to be older, have higher prevalence of hypertension, lower serum HDL-C, higher serum CRP, and larger EAT volume, than those without CKD (all P<0.01). On multivariate analysis age, hypertension, and EAT volume were significantly associated with eGFR (all P<0.01). EAT volume was associated with the presence of high-risk plaque, independent of traditional CAD risk factors (P=0.003). Conclusions: Patients with CKD had significantly increased EAT volume, which could be associated with the presence of high-risk plaque. © 2016, Japanese Circulation Society. All rights reserved.


PubMed | Kansai University of Welfare Sciences, Hanna Chuo Hospital, Baba Memorial Hospital and Shijonawate Gakuen University
Type: Journal Article | Journal: Journal of physical therapy science | Year: 2014

[Purpose] The purpose of this study was to confirm the accuracy of a revised method for predicting the Functional Independence Measure (FIM) at discharge when stroke patients are first admitted to a rehabilitation hospital. [Subjects and Methods] The predictive equation with logarithmic trend line was calculated based on the total score of the FIM at admission and discharge in 93 patients with cerebral infarction (CI) and 60 patients with intracerebral hemorrhage (ICH). In other patients with CI or ICH (validation group), the differences between the actual FIM and the predicted FIM at discharge calculated by the CI or ICH equation and the combined (CI + ICH) equation, as well as by the CI or ICH equation and combined equation used in a previous study, were calculated. [Results] The multiple correlation coefficients of the CI equation, ICH equation, and combined equation were 0.87, 0.71, and 0.8. The residual of the actual FIM and predicted FIM at discharge calculated by the CI equation was the smallest in the CI validation group. In the ICH validation group, the residual calculated for ICH patients alone was smaller than that calculated by the previous ICH equation. [Conclusion] This easy-to-use method using a new equation for prediction was more precise than the previous equation. Therefore, we should revise the equation for predicting stroke patient outcome strata according to data from within the governing medical administration system.


Nakanishi K.,Baba Memorial Hospital | Fukuda S.,University of Occupational and Environmental Health Japan | Yamashita H.,Baba Memorial Hospital | Kosaka M.,Baba Memorial Hospital | And 4 more authors.
JACC: Clinical Electrophysiology | Year: 2016

Objectives This study aimed to investigate the role of atrial natriuretic peptide (ANP) levels to predict left atrial (LA) reverse remodeling in atrial fibrillation (AF) patients. Background Although LA reverse remodeling after radiofrequency catheter ablation (RFCA) for AF was reported to be associated with favorable outcomes and improvement of LA and left ventricular function, the predictor has not been extensively evaluated. Methods This study included 104 consecutive patients who underwent RFCA for AF. All patients underwent multidetector computed tomography examination and laboratory tests, including measurement of ANP, plasma B-type natriuretic peptide (BNP), and high-sensitivity C-reactive protein (hs-CRP) levels before and 6 months after RFCA. The study population was divided according to the extent of the decrease in the LA volume index at follow-up; responders were defined as patients who exhibited a ≥15% decrease in the LA volume index. Results At follow-up, 49 patients (47%) were classified as responders. Pre-procedural serum ANP and BNP levels were significantly higher in the responders than in the nonresponders (both p < 0.01). In the responders, a significant decrease was observed in the log ANP, log BNP, and log hs-CRP levels from baseline to follow-up (all p < 0.01). Multivariate linear regression analysis revealed that log ANP levels before RFCA and maintenance of sinus rhythm during follow-up were independent predictors of LA reverse remodeling (both p < 0.01). Conclusions In this study, 47% of the patients exhibited LA reverse remodeling after RFCA for AF, with a concomitant improvement in serum ANP, BNP, and hs-CRP levels. The pre-procedural ANP level and maintenance of sinus rhythm were independently associated with LA reverse remodeling. © 2016 American College of Cardiology Foundation.


Mashimo M.,Baba Memorial Hospital | Arakawa T.,Osaka City University
Journal of Japanese Society of Gastroenterology | Year: 2010

We present 3 patients with Crohn disease (CD) of the duodenum with progressive symptoms. A 31-year-old man with Crohn ileocolitis presented epigastralgia. A 32-year-old man with Crohn ileocolitis presented upper GI bleeding. In both patients, endoscopy revealed duodenal stenosis. A 33-year-old man was given a diagnosis of CD by gastroduodenal endoscopy. They received an infliximab infusion and had symptomatic relief and macroscopic healings without any adverse effects. Several treatments for upper GI lesions of the CD patients have been tried, but there is no high-quality level evidence-based data to guide the medical management of gastroduodenal CD. Our experience with 3 patients suggests that infliximab is a safe and effective treatment for duodenal CD and it may be appropriate for early use to avoid surgery or balloon dilatation.


Kashiwagi S.,Baba Memorial Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

We report two resected cases of extragastric gastric cancer growth with gastrocolic fistula whose prognoses were fairly good with surgery and chemotherapy. CASE 1: A 45-year-old man was admitted to a nearby clinic complaining of fever and abdominal pain. Endoscopy revealed gastric mucosa-associated white moss under tumor-like lesions to the mucous cancer biopsy results. The patient underwent surgery; the transverse colon had adhered to the posterior wall of the stomach, so a distal gastrectomy and a partial resection of the transverse colon were performed. He enjoyed a good QOL for 56 months after the surgery. CASE 2: A 69-year-old man. An upper GI examination revealed a protrusion at the posterior wall of the stomach, and the barium leaked from the lesion to the colon. Diagnosis of stomach cancer surgery took place. He died 20 months after the surgery.


PubMed | Nishinomiya Watanabe Cardiovascular Center, Baba Memorial Hospital, Wakayama Medical University, Osaka City University and University of Occupational and Environmental Health Japan
Type: | Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology | Year: 2017

We aimed to determine whether elevated serum high-sensitive cardiac troponin T (hs-TnT) levels predict atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI).We included 125 consecutive patients with AF (paroxysmal, n=79; persistent, n=46) who underwent first-time PVI. Serum hs-TnT, high-sensitive C-reactive protein (hs-CRP), atrial natriuretic peptide, and plasma B-type natriuretic peptide levels were measured in venous samples collected before PVI. Elevated hs-TnT was diagnosed in patients with levels0.014g/L. All patients underwent multidetector computed tomographic examinations before PVI to measure left atrial volume (LAV) and left ventricular (LV) mass, which were indexed to body surface area. Arrhythmia recurrence was defined as AF/atrial tachycardia episodes lasting for30s after a 2-month blanking period from the PVI procedure. Elevated hs-TnT levels were observed in 22 (17.6%) patients. Age, diabetes mellitus, LV mass index, estimated glomerular filtration rate, and hs-CRP were independently associated with serum hs-TnT levels (all P<0.05). During a mean follow-up of 12.98.5 months after a single PVI procedure, the clinical recurrence rate was 33% (n=41). Multivariate Cox proportional hazard analysis revealed that a greater LAV index (P=0.01) and elevated serum hs-TnT level (P=0.01) were significant predictors of AF recurrence after PVI.This study demonstrated that elevated serum hs-TnT levels are associated with AF recurrence independent of traditional risk factors and left atrial enlargement.


PubMed | Baba Memorial Hospital
Type: Journal Article | Journal: Brain and nerve = Shinkei kenkyu no shinpo | Year: 2016

Involuntary movement is a rare clinical manifestation of transient ischemic attack (TIA). However, limb-shaking TIA is well described presentation of carotid occlusive disease. We present the case of a patient who developed limb-shaking TIA associated with high-grade stenosis of middle cerebral artery (M1), which was treated with percutaneous transluminal angioplasty (PTA). The procedure was performed successfully without complication and the symptom disappeared immediately after the procedure. The patient remained free of symptoms at the 38-month follow-up. There was no tendency of restenosis of M1. In this case, PTA was technically feasible and beneficial for limb-shaking TIA with M1 stenosis. Limb-shaking TIA can be a symptom of high-grade stenosis of M1.


PubMed | Baba Memorial Hospital
Type: Case Reports | Journal: No shinkei geka. Neurological surgery | Year: 2014

Numerous approaches have been used to access aneurysms of the vertebral artery(VA)-posterior inferior cerebellar artery(PICA)complex for microsurgical clipping. Here, we report the case of a patient with an unruptured aneurysm of the left VA-PICA complex that was successfully treated using a contralateral suboccipital approach. Computed tomography angiography demonstrated a small saccular aneurysm arising from the lateral aspect of the left V4 segment just distal to the PICA origin. The aneurysm deviated to the right from the midline at the level of the jugular tubercle on angiographic evaluation, so we selected a contralateral suboccipital approach. The aneurysm was completely obliterated by neck clipping. After surgery, slight dysphagia and hoarseness appeared, but dysphagia disappeared within several days and hoarseness disappeared within 5 months. VA-PICA aneurysms can vary in their relationship to cranial nerves, brainstem, and bones of the skull base. Neurosurgeons should consider using a contralateral approach for certain aneurysms arising from a tortuous VA that has crossed the midline.


PubMed | Baba Memorial Hospital
Type: Clinical Trial | Journal: Circulation journal : official journal of the Japanese Circulation Society | Year: 2016

Chronic kidney disease (CKD) is strongly associated with coronary artery disease (CAD), although the underlying pathophysiological mechanism remains unclear. Epicardial adipose tissue (EAT) has recently been recognized as an important source of various pro-inflammatory cytokines causing coronary atherosclerosis. This study investigated the relationship between CKD and EAT volume in association with high-risk plaque.The study included 275 patients with an estimated glomerular filtration rate (eGFR) 30 ml/min/1.73 m(2)who underwent multidetector computed tomography (MDCT) for the evaluation of CAD. Patients were classified, according to eGFR, into a CKD group (30eGFR<60 ml/min/1.73 m(2)) or a non-CKD group (eGFR 60 ml/min/1.73 m(2)). MDCT was used to assess coronary plaque morphology and EAT volume. One hundred and ten patients with CKD were more likely to be older, have higher prevalence of hypertension, lower serum HDL-C, higher serum CRP, and larger EAT volume, than those without CKD (all P<0.01). On multivariate analysis age, hypertension, and EAT volume were significantly associated with eGFR (all P<0.01). EAT volume was associated with the presence of high-risk plaque, independent of traditional CAD risk factors (P=0.003).Patients with CKD had significantly increased EAT volume, which could be associated with the presence of high-risk plaque.


PubMed | Baba Memorial Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

The authors report their experience in a patient with brain metastasis from rectal cancer who has survived without recurrence after multidisciplinary treatment. A 60-year-old man presented to the Department of Neurosurgery with the primary complaint of spasm of the left side of the face. Examination revealed a tumor 2 cm in diameter in the right frontal lobe. The tumor was suspected to be metastatic, and brain metastasis from rectal cancer was diagnosed. The brain tumor was removed by a neurosurgeon, and the patient was transferred to the Department of Surgery. Removal of the primary lesion in the rectum was attempted, but only colostomy could be performed due to extensive anterior invasion. Postoperatively, 5 courses of capecitabine and oxaliplatin (XELOX) + bevacizumab were administered. The rectal tumor shrank in size, while another mass, suspected to be a lung metastasis, remained unchanged. Therefore, a second surgery on the rectum was scheduled, and abdominoperineal resection of the rectum and lateral lymphadenectomy were performed. Postoperatively, 4 courses of XE LOX therapy were administered. The patient is currently alive without recurrence at 1 year after surgery. Treatment (including timing) for brain metastasis from rectal cancer has not been established and prognosis is poor. However, multidisciplinary treatment may provide the possibility of cure.

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