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PubMed | Kasukabe Chuo General Hospital, Miyagi Prefectural Cardiovascular and Respiratory Center, Toyohashi Heart Center, Kokura Memorial Hospital and 18 more.
Type: Journal Article | Journal: Journal of cardiology | Year: 2016

Percutaneous coronary interventions involving small coronary vessels represent a true challenge because of the increased risk of restenosis and adverse outcomes. We evaluated the 2-year clinical outcomes between single everolimus-eluting stents (EES) and paclitaxel-eluting stents (PES) in small coronary artery disease.From the data of SACRA (SmAll CoronaRy Artery treated by TAXUS Libert) and PLUM (PROMUS/Xience V Everolimus-ELUting Coronary Stent for sMall coronary artery disease) registries, 245 patients with 258 lesions and 264 patients with 279 lesions, respectively, were enrolled in this study.The 2-year clinical driven target lesion revascularization (4.5% vs. 10.6%, p=0.01) and target vessel revascularization (8.0% vs. 13.9%, p=0.03) rates were significantly lower in the EES group compared with the PES group. Major adverse cardiac events in the EES group tended to be lower than those in the PES group (8.7% vs. 14.3%, p=0.05). On the other hand, all new lesions for remote target vessel revascularization were observed at the proximal site of target lesions in both groups and those rates were not different between the two groups (3.4% vs. 3.3%, p>0.99).EES showed better clinical results at 2-year follow-up compared with PES in small coronary artery diseases, however, new lesions at the proximal remote site of the target lesion remain problematic.

PubMed | Red Cross, Kyoto Prefectural University of Medicine and Daini Okamoto General Hospital
Type: Journal Article | Journal: The Thoracic and cardiovascular surgeon | Year: 2015

The surgical treatment of Kommerell diverticula is associated with high mortality and morbidity rates. In the mid-2000s, hybrid aortic arch repair was developed, and the procedure has since been used to repair Kommerell diverticula. In the present study, we focused on the postoperative outcomes of two-stage hybrid repair of Kommerell diverticula that required supra-aortic debranching (type I hybrid arch repair).From August 2010 to July 2013, a total of four patients (aged 73.5 9.5 years) underwent two-stage hybrid repair (type I hybrid arch repair) for Kommerell diverticula, and their cases were retrospectively studied. All four patients had right aortic arches and aberrant left subclavian arteries. The repair procedure consisted of two stages: (1) debranching of the supra-aortic vessels via a median sternotomy; (2) exclusion of the Kommerell diverticulum by performing thoracic endovascular repair via a femoral approach and coil embolization of the orifice of the aberrant subclavian artery.There were no in-hospital deaths. One patient developed an acute kidney injury and required hemodialysis on postoperative day 2, although his renal function recovered within 48 hours. No strokes, paraplegia, or early aortic events were observed in our series. The mean follow-up period was 19.5 months (range, 5-47 months). All patients remained free from aortic events and endoleaks during the follow-up period.The early and mid-term outcomes of hybrid repair for Kommerell diverticula that require supra-aortic debranching, which are less invasive and do not involve hypothermic circulatory arrest, are acceptable. However, this procedure requires the insertion of an endograft into the ascending aorta, and careful and long-term follow-up is required to confirm its efficacy.

Sakai N.,Daini Okamoto General Hospital | Sakai N.,Osaka Electro-Communication University | Matsumura M.,Daini Okamoto General Hospital | Matsumura M.,Osaka Electro-Communication University
IEEJ Transactions on Electronics, Information and Systems | Year: 2014

The purpose was also to verify that the precision of this method was at least equivalent to that of a conventional polygraph in a medical facility. I measured an oral throat sound and nose pressure signal at the same time. I measured an oral throat sound when it was with amplitude 100%, 75%, 50%, 25%, 10% of nose pressure signals. I collected breathing and an oral throat sound at the time of the hypopnea and each average of the Peak to Peak level of the amplitude of the nose pressure signal each and I calculated an oral throat sound and a coefficient of correlation of the amplitude of the nose pressure signal and usually demanded correlations. At 100% of the nose pressure signal, the throat sound was 25.96 dB; at 75%, it was 18.11 dB; at 50%, it was 14.47 dB; at 25%, it was 8.54 dB; and at 10%, it was 6.61 dB. A strong correlation between nose pressure and throat sound was shown (r2 = 0.98, P < 0.001). The throat sound and nose pressure signal showed a strong correlation, which suggested a precision similar to that of a polygraph in a medical facility. © 2014 The Institute of Electrical Engineers of Japan.

Uraminami S.,Osaka Electro-Communication University | Sakai N.,Daini Okamoto General Hospital | Oishi T.,Osaka Electro-Communication University | Matsumura M.,Osaka Electro-Communication University
IEEJ Transactions on Electronics, Information and Systems | Year: 2016

In this study, a breath monitoring system is being developed using a contact type microphone attached the neck and measuring the sound at the time of respiration (breath sound). In this paper, I made s sound measuring amplifier with adjustable frequency bandwidth amplification degree, so it fits each subject properly as well as improving the sound measuring circuit. Then I demonstrated that normal breathing, apnea and hypopnea could be determined analysing the relation between nasal airflow and the amplitude of the sound produced at neck level doing respiration. In addition, I verified the efficacy of the breath monitoring system by comparing it to an equipment that can, in a simple manner, examine the sleep apnea. © 2016 The Institute of Electrical Engineers of Japan.

Noguchi Y.,Daini Okamoto General Hospital | Mitani T.,Daini Okamoto General Hospital | Kawara H.,Daini Okamoto General Hospital | Tokuyama Y.,Daini Okamoto General Hospital | And 3 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2015

In recent years, the incidence of adverse ocular reactions, including corneal problems and lacrimal duct obstruction, due to antineoplastic agents such as S-1 has increased. Very few reports of adverse ocular reactions caused by capecitabine, a fluorinated pyrimidine antineoplastic agent like S-1, exist, and consequently, the mechanism underlying these reactions is not well understood. This report describes our recent experience with a case of lacrimal duct obstruction caused by capecitabine. The patient was a 71 -year-old woman who was being administered trastuzumab plus capecitabine combination chemotherapy for breast cancer-related bone metastasis. She complained of epiphora 7 days after capecitabine was initiated. Thereafter, her capecitabine dose was reduced owing to exacerbation of hand-foot syndrome, but the epiphora persisted. Capecitabine was discontinued 287 days after initiation owing to exacerbation of the hand-foot syndrome. However, because the epiphora persisted, the patient visited the ophthalmology department. The ophthalmologist diagnosed the patient with binocular nasolacrimal duct obstruction and cataract, and prescribed a 0.3% gatifloxacin ophthalmic solution and 0.1% fluorometholone ophthalmic suspension. Thereafter, the epiphora reduced. When the patient returned to the ophthalmology department, symptom improvement was confirmed. In this case, lacrimal duct obstruction likely developed due to capecitabine. The symptoms were reversible with discontinuation of capecitabine and ophthalmic treatment. We believe that reporting this case could be valuable in discussing capecitabine-induced lacrimal duct obstruction.

Noguchi Y.,Daini Okamoto General Hospital | Nishimura R.,Daini Okamoto General Hospital | Kawara H.,Daini Okamoto General Hospital | Omori K.,Daini Okamoto General Hospital | And 4 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2013

We have observed several cases of adverse reactions to paclitaxel, including visual impairment and lacrimation. Therefore, we conducted a survey of the current status of adverse reactions to paclitaxel and also performed a retrospective analysis of the initial symptoms and the times of their appearance. Of the 22 study patients, 8 (36.4%) presented with adverse ocular reactions, such as visual impairment and lacrimation, and for 3 (13.6%), an ophthalmologist confirmed that paclitaxel could not be ruled out as the direct cause of their adverse reactions. The group of patients who presented with adverse ocular reactions included significantly more patients with ocular complications and a previous history of ocular ailments, compared to the group showing no such reactions. The timing of reaction appearance did not show a consistent pattern. The results of this study suggest that the initial symptoms were mainly visual impairment and lacrimation, and that caution must be taken when administering paclitaxel to patients with a previous history of ocular ailments and ocular complications because of the risk of adverse ocular reactions. Thus, adverse ocular reactions to paclitaxel were indicated as a possible risk, in addition to other adverse events such as myelosuppression and peripheral neuropathy.

PubMed | Daini Okamoto General Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

Hepatitis Bvirus (HBV)reactivation induced by cancer chemotherapy is increasingly being observed. However, most reports of resolved HBV[hepatitis Bsurface antigen(HBs-Ag)negative and hepatitis Bsurface antibody(HBs-Ab)positive and/or hepatitis Bcore antibody(HBc-Ab)positive]infection involve patients with hematological malignancies, whereas few describe patients with solid cancers. In this study, we report our experience with a patient with resolved HBV infection who was undergoing bevacizumab plus FOLFIRI treatment for rectal cancer when HBV reactivation was noted. This 74-year-old man was HBs-Ag negative, HBs-Ab negative, HBcAb positive, hepatitis B e antigen(HBe-Ag)negative, and hepatitis Be antibody(HBe-Ab)negative and had HBV-DNA levels below the detection limit. Forty-two days after the 21st cycle of bevacizumab plus FOLFIRI treatment, his aspartate aminotransferase and alanine aminotransferase levels increased. At followup examination, he was HBs-Ag positive, HBs-Ab negative, HBc-Ab positive, HBe-Ag positive, and HBe-Ab positive, while his HBV-DNA levels had increased to>9.0 log copies/mL, confirming HBV reactivation. His treatment included entecavir(0.5mg/ day)administration and plasmapheresis, but he succumbed to liver failure 82 days after his final dose of bevacizumab plus FOLFIRI. Thus, HBV reactivation can occur during bevacizumab plus FOLFIRI treatment in rectal cancer patients with a resolved prior HBV infection. No similar report has been published to date, and we believe that this study will be important when discussing HBV reactivation in patients with resolved HBV infection. Future studies will require detailed investigations in a larger number of institutions.

PubMed | Daini Okamoto General Hospital
Type: Journal Article | Journal: Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan | Year: 2010

In January 2007, Daini Okamoto General Hospital introduced a new system in which pharmacists, together with physicians and nurses, address patients with cardiopulmonary arrest on arrival and inpatients with de novo cardiopulmonary arrest. Over the past 2 years since the introduction of the system, the role of pharmacists in cardiopulmonary resuscitation (CPR) at the hospital has become increasingly established. Pharmacists prepare drugs for CPR, measure intervals during drug administration, and check the heart rhythm, produce records, pass drugs to physicians and nurses, and serve as CPR staff. CPR involves a large number of processes, and requires rapid responses. The participation of pharmacists in time management and drug administration, playing specific roles, has promoted role-sharing among physicians, nurses, and pharmacists, as well as the establishment of a resuscitation team in the hospital. Emergency medicine is in a difficult situation. We believe that our efforts have helped pharmacists contribute to emergency care and provide high-quality CPR.

PubMed | Daini Okamoto General Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2014

We encountered cases of capecitabine-induced increase in blood triglyceride (TG) levels, which is relatively rare in routine medical practice. Although capecitabine-induced hypertriglyceridemia (CI-HTG) has been occasionally reported in other countries, such cases have not been reported in Japan. Therefore, the details of this condition remain to be clarified. To obtain evidence that would be useful in routine medical practice, we conducted a retrospective study of patients with CI-HTG. The study included 56 patients, of whom, 14 (25.0%) had TG levels < 150 mg/dL before capecitabine treatment that increased to 150 mg/dL after treatment. Adverse events were graded according to the Common Terminology Criteria for Adverse Events, v4.0, Japanese edition, Japan Clinical Oncology Group version (CTCAE v4.0-JCOG). We found that TG levels were markedly elevated ( Grade 3) in 2 patients (3.6%). Thus, CI-HTG also affects Japanese patients, although its frequency is relatively low. Detailed studies including a larger number of facilities should be conducted in future.

PubMed | Daini Okamoto General Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

In recent years, the incidence of eye disorders due to antineoplastic agents such as S-1 has increased. Eye disorders including visual field defect, visual field impairment, optic neuritis, and visual acuity reduction have been reported as serious adverse effects of oxaliplatin, an agent that is frequently used as a standard therapy for colorectal cancer. However, specific details about these conditions, such as the timing relative to oxaliplatin administration and frequencies at which they appear, remain to be clarified; therefore, we conducted a retrospective analysis of patients with eye disorders due to oxaliplatin in order to obtain evidence that would be useful in routine medical practice. Of the 55 patients who were treated with oxaliplatin in this analysis 10 (18.2%) presented with eye disorders, including blepharoptosis (5 patients, 9.1%), visual field impairment (2 patients, 3.6%), visual acuity reduction (2 patients, 3.6%), eye pain (1 patient, 1.8%), congestion (1 patient, 1.8%), watering eyes (1 patient, 1.8%), and blurred vision (1 patient, 1.8%). These symptoms appeared during the early period of treatment, such as after the first or the second dose. We found that all patients had mild symptoms (Grade 1 or 2), and most improved spontaneously. Thus, eye disorders due to oxaliplatin affect Japanese patients somewhat frequently, although the symptoms are reversible and are mild in most cases. Detailed studies that include data from a larger number of facilities should be conducted in the future.

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