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Matsuyama-shi, Japan

Oguru M.,Hyogo College of Medicine | Tachibana H.,Hyogo College of Medicine | Toda K.,Toda Orthopedics Neurology Clinic | Okuda B.,Ehime Prefectural Central Hospital | Oka N.,NHO South Kyoto Hospital.
Journal of Geriatric Psychiatry and Neurology | Year: 2010

The purpose of this study was to investigate the prevalence and clinical correlates of apathy and depression in Parkinson disease (PD), and to clarify whether apathy can be dissociated from depression. One hundred fifty patients with PD completed the Beck Depression Inventory Second Edition (BDI-II), Starksteins Apathy Scale (AS), and a quality of life (QOL) battery. Hoehn and Yahr (HY) staging, the Unified Parkinsons Disease Rating Scale (UPDRS), and the Mini-Mental State Examination (MMSE) were performed on the same day. Apathy (AS score ≤ 16) was diagnosed in 60% of patients and depression (BDI-II score ≤ 14) in 56%. Apathy coexisted with depression in 43% of patients, compared with depression without apathy in 13% and apathy without depression in 17%. Apathy scale score was significantly correlated with UPDRS scores, HY stage, and age, whereas BDI-II score was correlated only with UPDRS scores. Both AS and BDI-II scores were negatively correlated with QOL. However, multiple regression analysis revealed that depression was strongly and negatively associated with emotional well-being and communication, whereas apathy was mainly associated with cognition and stigma. These findings suggest that apathy and depression may be separable in PD, although both are common in patients with PD and are associated with QOL. Source


Kobayashi T.,Kochi Medical School | Hyodo M.,Kochi Medical School | Honda N.,Ehime Prefectural Central Hospital
International Journal of Pediatric Otorhinolaryngology | Year: 2013

Primary endobronchial tumors are rare in children and often are misdiagnosed, resulting in a delay of appropriate treatment. Here, we present a case of 4-year-old girl with primary endobronchial lymphoma who presented with persistent pneumonia despite medical treatment. Her chest radiograph showed left atelectasis, and a bronchial foreign body was initially suspected. Bronchoscopic examination demonstrated a granulomatous tumor occupying the left main bronchus. Localized Burkitt's lymphoma in the left trachea was diagnosed histopathologically. This case emphasizes the consideration of endobronchial tumor and bronchoscopy in children who show persistent atelectasis or recurrent pneumonia. © 2013 Elsevier Ireland Ltd. Source


Taniguchi D.,Ehime Prefectural Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 61-year-old man, with a history of renal transplant for immunoglobulin A (IgA) nephropathy and surgery for advanced gastric carcinoma, was noted to have a nodular shadow of 1.3 cm in diameter in the left lung( S8) based on chest computed tomography( CT), and was suspected to have primary pulmonary carcinoma or a metastatic pulmonary tumor, for which surgical resection was performed. A rapid pathological diagnosis of inflammatory granuloma was made, and the patient was finally diagnosed as having pulmonary cryptococcosis based on the histopathology, and received fluconazole postoperatively. Patients with organ transplant history showing a nodular shadow in the lung should undergo a careful workup in consideration of both malignant tumor and infection. Source


Ryu C.,Ehime Prefectural Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 71-year-old male consulted a physician for a chest abnormal shadow detected by mass screening. As computed tomography (CT) revealed a nodular shadow in the left upper lobe, he was referred to our hospital. Positron emission tomography (PET) showed high-level accumulation of fluorodeoxy glucose (FDG) at the same site, and the level of Pro gastrin-releasing peptide(ProGRP) as a tumor marker was high(59.5 pg/ml). The level of ProGRP increased to 83.0 pg/ml 2 months later and the surgery was performed to make a diagnosis, however, historological examination during surgery by both needle biopsy and partial resection showed no malignancy. A final diagnosis of fibrosis associated with anthracosis was made, and neither active inflammation nor neoplastic lesion was not demonstrated. At 2 years and 2 months postoperatively, the level of ProGRP was still high(58.5 pg/ml). Although the high level of ProGRP is well known as a useful marker for the diagnosis of lung small cell carcinoma, some patients with renal dysfunction, pneumonia, interstitial pneumonia, pleurisy, or lung carcinoma that is not small cell carcinoma are also positive for ProGRP. Since the present case showed a mild impairment of renal function, it was suggested that the cause of the high level of ProGRP was other than lung cancer. Source


Ishii M.,Hoshigaoka Kosei Nenkin Hospital | Wada E.,Ehime Prefectural Central Hospital | Hamada M.,Hoshigaoka Kosei Nenkin Hospital
Journal of Spinal Disorders and Techniques | Year: 2012

STUDY DESIGN:: A retrospective investigation. OBJECTIVE:: To clarify at which age and at what point in the postoperative period neurological deterioration occurs in patients with cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA:: Inferior surgical outcomes tend to be seen with increasing age, however, the age threshold and the postoperative period associated with deterioration have not been established. METHODS:: Of 273 patients who underwent laminoplasty, 75 were enrolled in our study who met the criteria of having cervical spondylotic myelopathy, being monitored for a minimum of 2 years after surgery, and experiencing no morbidities within 2 years after surgery. Participants were classified into 4 age groups: group A, 54 years or below (n=12); group B, 55-64 years (n=22); group C, 65-74 years (n=24); and group D, 75 years or above (n=17). Preoperative physical status scores, using the American Society of Anesthesiologists (ASA) classification system, and neurological recovery, indicated by Japanese Orthopaedic Association (JOA) scores, were compared and surgical complications were reviewed. RESULTS:: The ASA physical status score was significantly lower in group A (1.4±0.5) than in group C (2.0±0.5) or group D (2.2±0.4) (P<0.0083). No difference was seen between the preoperative and 1-year postoperative JOA scores between the groups. However, the JOA score at ≥2 years after surgery was significantly lower in group D (12.9±2.0) than in group A (15.2±1.4; P<0.0083). Major complications of cardiopulmonary disorders were documented only in patients in groups C and D with A higher ASA scores. CONCLUSIONS:: Inferior surgical outcomes were seen in patients 75 years of age or above at 2 years after surgery compared with patients of 54 years or below of age. These clinical features could be reasonably explained by the patients' preexisting physical status related to age. © 2012 by Lippincott Williams & Wilkins. Source

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