Fujisawa, Japan
Fujisawa, Japan

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Tsuchiya N.,Fujisawa Municipal Hospital | Yamagishi S.,Fujisawa Municipal Hospital | Ishibe A.,Fujisawa Municipal Hospital | Matsuo K.,Fujisawa Municipal Hospital | And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014

In October 2008, a 66-year-old male patient underwent resection of the right half of the colon for ascending colon cancer. Histopathological examination revealed a tumor classification of tub2, pSE, ly1, v0, PM0, DM0, RM0, pN1 (2/23), H0, P0, Stage III a. The patient was treated with uracil/tegafur plus Leucovorin (UFT/LV) chemotherapy after surgery. However, he developed Grade 2 liver dysfunction after completion of 1 course, so UFT/LV was discontinued. In June 2009, a rise in the carcinoembryonic antigen (CEA) level was observed, and computed tomography (CT) and positron emission tomography with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG-PET) showed a single enlarged lymph node, 2 cm in diameter, located around the aorta. We informed the patient of the therapeutic effect of anticancer drug treatment and surgery, risk of adverse events, and other management methods, and UFT/LV chemotherapy was selected as treatment. After 3 courses, the lymph node had completely disappeared, and UFT/LV was discontinued in April 2011, as there was no sign of recurrence. The patient remains alive and well. We report a case of para-aortic lymph node metastasis after surgery, treated with UFT/LV, which led to a complete response without major adverse events.


Maeda A.,Yokohama City University | Tamura K.,Yokohama City University | Wakui H.,Yokohama City University | Ohsawa M.,Yokohama City University | And 10 more authors.
BioMed Research International | Year: 2014

In the present study, we examined the therapeutic effects of olmesartan, an angiotensin II (Ang II) type 1 receptor (AT1R)-specific blocker, in genetically obese diabetic KKAy mice, a model of human metabolic disorders with visceral obesity, with a focus on an olmesartan effect on the adipose tissue. Olmesartan treatment (3 mg/kg per day) for 4 weeks significantly lowered systolic blood pressure but did not affect body weight during the study period in KKAy mice. However, there were three interesting findings possibly related to the pleiotropic effects of olmesartan on adipose tissue in KKAy mice: (1) an inhibitory effect on adipocyte hypertrophy, (2) a suppressive effect on IL-6 gene expression, and (3) an ameliorating effect on oxidative stress. On the other hand, olmesartan exerted no evident influence on the adipose tissue expression of AT1R-associated protein (ATRAP), which is a molecule interacting with AT1R so as to inhibit pathological AT1R activation and is suggested to be an emerging molecular target in metabolic disorders with visceral obesity. Collectively, these results suggest that the blood pressure lowering effect of olmesartan in KKAy mice is associated with an improvement in adipocyte, including suppression of adipocyte hypertrophy and inhibition of the adipose IL-6-oxidative stress axis. Further study is needed to clarify the functional role of adipose ATRAP in the pleiotropic effects of olmesartan. © 2014 Akinobu Maeda et al.


Mori R.,Fujisawa Municipal Hospital | Misuta K.,Fujisawa Municipal Hospital | Eguchi K.,Fujisawa Municipal Hospital | Nakano A.,Fujisawa Municipal Hospital | Iemoto Y.,Fujisawa Municipal Hospital
Gastroenterological Endoscopy | Year: 2011

We experienced three cases of prostate cancer which presented with an annular stricture of the rectum. Case 1 : A 65-year-old man suspected of having rectal cancer was referred to our department. He was diagnosed as having rectal involvement secondary to prostatic cancer from the high level of his serum PSA level and the positive PSA staining of the rectal biopsy specimen. Case 2 : An 82-year-old man suspected of having an intestinal obstruction due to rectal cancer was referred to our department and sigmoid colostomy was performed. Finally we diagnosed his condition as a rectal stricture secondary to prostatic cancer based on the findings of the prostate biopsy. Cases of prostate cancer directly invading the rectum are rare, however sometimes an annular stricture exists and the patients have dyschezia. Serum PSA and PSA staining of rectal biopsy specimens are useful diagnostic tools in these cases.


Azushima K.,Yokohama City University | Tamura K.,Yokohama City University | Haku S.,Yokohama City University | Wakui H.,Yokohama City University | And 21 more authors.
Atherosclerosis | Year: 2015

There is no clinical evidence that supports the benefit of integrative medicine, defined as combination therapy of oriental and western medicine, on obesity-related hypertension. This study evaluates the efficacy of Bofu-tsusho-san (BOF), an oriental herbal medicine, on the ambulatory blood pressure (BP) profile in hypertensive patients with obesity. Methods: The study design was a multicenter, randomized, open-label, parallel-group controlled trial in 107 hypertensive patients with obesity. Participants were randomly assigned to receive either the conventional control therapy or BOF add-on therapy. In both groups antihypertensive therapy was aimed at achieving the target clinic BP. The primary outcome was change in the ambulatory BP profile from baseline to 24 weeks after randomization. Results: Daytime systolic BP variability, an important parameter of ambulatory BP profile, was decreased in the BOF group, and the difference in the changes in daytime systolic BP variability was significant between the BOF and control group (Control vs BOF; the change from baseline in daytime systolic BP variability, 1.0±3.3 vs-1.0±3.3%; p=0.006). Conclusion: The BOF add-on therapy effectively improved the ambulatory BP variability. This is the first report suggesting that an integrative medicine approach may exert favorable effects on obesity-related hypertension compared with conventional pharmaceutical treatment. Clinical trial registration: UMIN000003878. © 2015 The Authors.


Iizuka Y.,Toho University | Koda E.,Toho University | Tsutsumi Y.,National Center for Child Health and Development | Konishi Y.,Kyorin University | And 2 more authors.
Neuroradiology Journal | Year: 2013

A male neonate presented a dural arteriovenous fistula (DAVF) at the confluence with paralysis of the orbicularis oris muscle. The interesting features in our case were the clinical symptoms (orbicularis oris muscle paralysis at birth), angioarchitecture (high-flow arteriovenous shunts at the confluence) and the size and hemodynamic flow (mid-sized venous pouch) of the fistula. Additionally, the embolization technique (i.e., occipital artery approach, closing shunts with pure glue) automatically resulted in the immediate and complete closure of accessory feeders without any additional treatment, and the midterm clinical outcome was good. We succeeded improving the symptoms of a neonate with a congenital high-flow DAVF by closing a fistula using a small amount of glue.


Isoda S.,Fujisawa Municipal Hospital | Imoto K.,Yokohama City University | Uchida K.,Yokohama City University | Karube N.,Yokohama City University | And 6 more authors.
General Thoracic and Cardiovascular Surgery | Year: 2016

Background: We have reported “sandwich technique,” via a right ventricular incision, to treat a post-infarction ventricular septal defect (VSD). This technique involves the placement of patches on both the left and right sides of the septum, pinching the VSD sealed with surgical adhesive between the two patches. In this study, we analyzed factors influencing 1-year mortality to determine the pitfalls in our procedure. Methods: We evaluated 24 consecutive patients with post-infarction VSD who underwent the “sandwich technique” via a right ventricular incision. One-year survival and major residual leak were used as the criteria for the analysis of survival and technical success, respectively. In protocol 1, clinical variables were evaluated as predictors of one-year mortality. In protocol 2, surgical techniques were evaluated as predictors of major residual leak, which was found to be related to one-year mortality in protocol 1. Results: In protocol 1, the one-year mortality was higher in patients with major residual leak (75 %, 3/4) than in those without (15 %, 3/20) (p = 0.035). In protocol 2, the patients with major residual leak had smaller patches than those without (41.9 ± 3.8 vs. 47.8 ± 4.8 mm, p = 0.031) and a smaller size difference between the patches and the VSD (22.5 ± 6.5 vs. 30.0 ± 5.7 mm, p = 0.028). Conclusion: For the “sandwich technique” via a right ventricular approach to treat post-infarction VSD, the choice of patch size according to VSD size is an important variable for reducing major residual leak. © 2016 The Japanese Association for Thoracic Surgery


PubMed | Yokohama City University and Fujisawa Municipal Hospital
Type: | Journal: BioMed research international | Year: 2014

In the present study, we examined the therapeutic effects of olmesartan, an angiotensin II (Ang II) type 1 receptor (AT1R)-specific blocker, in genetically obese diabetic KKAy mice, a model of human metabolic disorders with visceral obesity, with a focus on an olmesartan effect on the adipose tissue. Olmesartan treatment (3mg/kg per day) for 4 weeks significantly lowered systolic blood pressure but did not affect body weight during the study period in KKAy mice. However, there were three interesting findings possibly related to the pleiotropic effects of olmesartan on adipose tissue in KKAy mice: (1) an inhibitory effect on adipocyte hypertrophy, (2) a suppressive effect on IL-6 gene expression, and (3) an ameliorating effect on oxidative stress. On the other hand, olmesartan exerted no evident influence on the adipose tissue expression of AT1R-associated protein (ATRAP), which is a molecule interacting with AT1R so as to inhibit pathological AT1R activation and is suggested to be an emerging molecular target in metabolic disorders with visceral obesity. Collectively, these results suggest that the blood pressure lowering effect of olmesartan in KKAy mice is associated with an improvement in adipocyte, including suppression of adipocyte hypertrophy and inhibition of the adipose IL-6-oxidative stress axis. Further study is needed to clarify the functional role of adipose ATRAP in the pleiotropic effects of olmesartan.


Tamura K.,Yokohama City University | Tsurumi-Ikeya Y.,Yokohama City University | Wakui H.,Yokohama City University | Maeda A.,Yokohama City University | And 12 more authors.
Therapeutic Apheresis and Dialysis | Year: 2013

Cardiovascular disease (CVD) is a major cause of death in patients with chronic kidney disease (CKD). Patients with CKD are reported to have a significant greater risk of CVD-associated mortality than that of the general population after stratification for age, gender, race, and the presence or absence of diabetes. CKD itself is also an independent risk factor for the development of atherosclerosis, and in particular, patients undergoing dialysis typically bear many of the risk factors for atherosclerosis, such as hypertension, dyslipidemia and disturbed calcium-phosphate metabolism, and commonly suffer from severe atherosclerosis, including peripheral arterial disease (PAD). Low-density lipoprotein (LDL) apheresis is a potentially valuable treatment applied to conventional therapy-resistant hypercholesterolemic patients with coronary artery disease and PAD. Although previous and recent studies have suggested that LDL apheresis exerts beneficial effects on the peripheral circulation in dialysis patients suffering from PAD, probably through a reduction of not only serum lipids but also of inflammatory or coagulatory factors and oxidative stress, the precise molecular mechanisms underlying the long-term effects of LDL apheresis on the improvement of the peripheral circulation remains unclear and warrants further investigation. © 2012 International Society for Apheresis.


PubMed | Red Cross, Yokohama City University, Yamato Municipal Hospital, Azushima Medical Clinic and Fujisawa Municipal Hospital
Type: Journal Article | Journal: Atherosclerosis | Year: 2015

There is no clinical evidence that supports the benefit of integrative medicine, defined as combination therapy of oriental and western medicine, on obesity-related hypertension. This study evaluates the efficacy of Bofu-tsusho-san (BOF), an oriental herbal medicine, on the ambulatory blood pressure (BP) profile in hypertensive patients with obesity.The study design was a multicenter, randomized, open-label, parallel-group controlled trial in 107 hypertensive patients with obesity. Participants were randomly assigned to receive either the conventional control therapy or BOF add-on therapy. In both groups antihypertensive therapy was aimed at achieving the target clinic BP. The primary outcome was change in the ambulatory BP profile from baseline to 24 weeks after randomization.Daytime systolic BP variability, an important parameter of ambulatory BP profile, was decreased in the BOF group, and the difference in the changes in daytime systolic BP variability was significant between the BOF and control group (Control vs BOF; the change from baseline in daytime systolic BP variability, 1.03.3 vs -1.03.3%; p=0.006).The BOF add-on therapy effectively improved the ambulatory BP variability. This is the first report suggesting that an integrative medicine approach may exert favorable effects on obesity-related hypertension compared with conventional pharmaceutical treatment.UMIN000003878.


PubMed | Yokohama City University, Fujisawa Municipal Hospital and Yano Heart Clinic1099 5 Fujisawa
Type: | Journal: General thoracic and cardiovascular surgery | Year: 2016

We have reported sandwich technique, via a right ventricular incision, to treat a post-infarction ventricular septal defect (VSD). This technique involves the placement of patches on both the left and right sides of the septum, pinching the VSD sealed with surgical adhesive between the two patches. In this study, we analyzed factors influencing 1-year mortality to determine the pitfalls in our procedure.We evaluated 24 consecutive patients with post-infarction VSD who underwent the sandwich technique via a right ventricular incision. One-year survival and major residual leak were used as the criteria for the analysis of survival and technical success, respectively. In protocol 1, clinical variables were evaluated as predictors of one-year mortality. In protocol 2, surgical techniques were evaluated as predictors of major residual leak, which was found to be related to one-year mortality in protocol 1.In protocol 1, the one-year mortality was higher in patients with major residual leak (75%, 3/4) than in those without (15%, 3/20) (p=0.035). In protocol 2, the patients with major residual leak had smaller patches than those without (41.93.8 vs. 47.84.8mm, p=0.031) and a smaller size difference between the patches and the VSD (22.56.5 vs. 30.05.7mm, p=0.028).For the sandwich technique via a right ventricular approach to treat post-infarction VSD, the choice of patch size according to VSD size is an important variable for reducing major residual leak.

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