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Funabashi, Japan

Nakamura J.,Chiba University | Saisu T.,Chiba Childrens Hospital | Yamashita K.,Funabashi Central Hospital | Suzuki C.,Matsudo City Hospital | And 2 more authors.
Arthritis and Rheumatism | Year: 2010

Objective. To clarify whether age at the time of the initial administration of corticosteroids is a risk factor for corticosteroid-associated osteonecrosis in children with systemic lupus erythematosus (SLE), using magnetic resonance imaging (MRI). Methods. From 1986 to 2007, MRI was used to prospectively study 676 joints, including 72 joints (36 hips and 36 knees) in 18 pediatric patients with SLE (<15 years old), 100 joints (50 hips and 50 knees) in 25 adolescent patients with SLE (15-20 years old), and 504 joints (252 hips and 252 knees) in 126 adult patients with SLE (>20 years old), beginning just after corticosteroid administration, for at least 1 year. The followup rate was 100%. Results. In pediatric patients, osteonecrosis developed in 4 joints (6%; all hips). In adolescent patients, osteonecrosis developed in 49 joints (49%; 18 hips and 31 knees). In adult patients, osteonecrosis developed in 207 joints (41%; 95 hips and 112 knees). The rate of osteonecrosis was significantly lower in pediatric patients than in adolescent or adult patients (P = 0.0001). Logistic regression analysis revealed that adolescent and adult patients had a significantly higher risk for osteonecrosis compared with pediatric patients, with an odds ratio of 10.3 (P < 0.0001). The youngest patients with osteonecrosis in the hip and knee were 14.9 years old and 15.5 years old, respectively. Osteonecrosis did not develop in patients younger than age 14 years. Conclusion. Our results suggest that age at the time of the initial administration of corticosteroids is associated with osteonecrosis in pediatric patients with SLE. © 2010, American College of Rheumatology.

Ishihara C.,Perinatal Medical Center | Ibara S.,Perinatal Medical Center | Ohsone Y.,Kimitsu Chuo Hospital | Kato E.,Funabashi Central Hospital | And 5 more authors.
Pediatrics International | Year: 2016

Background: Infant flow biphasic nasal continuous positive airway pressure (Bi-NCPAP) and regular NCPAP (Re-NCPAP) are equally useful with respect to the rate of successful weaning from mechanical ventilation. It remains unclear, however, whether Bi-NCPAP or Re-NCPAP is more effective for reducing apnea of prematurity (AOP). Methods: A multicenter randomized controlled study was conducted of 66 infants assigned to receive Bi-NCPAP and 66 assigned to receive Re-NCPAP for respiratory support after extubation. Primary outcome was the number of AOP events during the 48 h observation period after successful extubation, defined as no reintubation and no adverse events associated with the use of NCPAP during the observation period. The secondary outcome was successful extubation. Reintubation was at the discretion of the attending physician. Results: Baseline characteristics were similar between the two groups. The number of AOP events during the 48 h observation period was significantly lower in infants with Bi-NCPAP than in those with Re-NCPAP (5.2 ± 6.5 vs 10.3 ± 10.9 per infant, respectively; P = 0.002). The rate of successful extubation tended to be greater in those with Bi-NCPAP than in those with Re-NCPAP (92.4%, 61/66 vs 80.3%, 53/66, respectively; P = 0.074). Adverse events occurred in only one of 132 infants: erosive dermatitis developed on the nose after application of Re-NCPAP. The risk of reintubation did not differ significantly between the two groups (7.6%, 5/66 for Bi-NCPAP vs 18.2%, 12/66 for Re-NCPAP; P = 0.117). Conclusions: Bi-NCPAP was superior to Re-NCPAP for reduction of AOP following extubation. © 2015 Japan Pediatric Society

Sakai Y.,Chiba University | Tsuyuguchi T.,Chiba University | Hirata N.,Kameda Medical Center | Sugiyama H.,Chiba University | And 7 more authors.
Hepato-Gastroenterology | Year: 2013

Background/Aims: Covered metallic stent was developed to prevent tumor ingrowth. However, procedural accidents due to its insertion often occur and migration after long-term insertion causes problems. The WallFlex partially covered stent (WF) with reduced axial force enables stenting along the bile duct. We examined the usefulness of WF placement in an unresectable malignant distal biliary obstruction. Methodology: We examined procedural accidents, stent obstruction rate, and patency period caused by WF insertion. Results: Ninety-seven patients were analyzed; procedural accidents caused by WF insertion occurred in 8 patients (7.2%) composed of acute cholecystitis in 3 patients (3.2%), acute pancreatitis in 2 patients (2.1%), acute cholangitis in 1 patient (1%), and other in 1 patient (1%). The stent obstruction rate was 19.6% (19 patients), and obstruction cause includes sludge in 9 patients (9.3%), migration in 4 patients (4.1%), food impaction in 3 patients (3.1%), ingrowth in 1 patient (1%), overgrowth in 0 patients (0%), and unknown in 2 patients (2.1%). The mean stent patency period was 634.918±66.545 (7-946) days. Conclusions: WF has less procedural accidents when inserted into unresectable malignant biliary obstruction patients with reduced migration rate after a long period and low obstruction rate. © H.G.E. Update Medical Publishing S.A.

Sakai Y.,Chiba University | Tsuyuguchi T.,Chiba University | Kato K.,Funabashi Central Hospital | Sugiyama H.,Chiba University | And 3 more authors.
International Journal of Clinical Pharmacology and Therapeutics | Year: 2013

Aim: We investigated the usefulness of doripenem (DRPM), a carbapenem antimicrobial drug, for the treatment of acute cholangitis. Methods: 28 patients who received a diagnosis of moderate or severe cholangitis were included in this investigation. 23 patients had moderate cholangitis; 5 patients had severe cholangitis. When moderate or severe cholangitis was diagnosed, administration of DRPM and endoscopic drainage were performed. The dose of DRPM was fixed at 0.5 g, 3 times daily. Evaluation of clinical findings (abdominal pain and body temperature) and blood test findings (WBC, CRP, ALT, ALP, and T-Bil) was performed before and on Day 5 after administration. Results: Endoscopic drainage was successful in all patients. After administration of DRPM, a significant improvement was observed in all endpoints of both clinical findings and blood test findings (p < 0.05). No adverse events due to administration of DRPM were observed. Conclusion: It was suggested that administration of DRPM may be clinically useful for the treatment of moderate and severe cholangitis. ©2013 Dustri-Verlag Dr. K. Feistle.

Ogasawara T.,Funabashi Central Hospital | Ootsuka Y.,Funabashi Central Hospital | Nakano S.,Funabashi Central Hospital | Shida T.,Funabashi Central Hospital | And 4 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014

A 74-year-old woman underwent distal gastrectomy and D1 + α dissection for the treatment of gastric cancer (pT2a, pN2, HO, PO, MO, Stage in A) in February 2008. She was treated with adjuvant postoperative chemotherapy consisting of TS-1-However, 32 months after the operation, paraaortic lymph node recurrence was confirmed by computed tomography (CT). She was treated with combined TS-1 and cisplatin chemotherapy. After 14 courses, CT revealed that the paraaortic lymph node metastasis had disappeared, and a complete response was attained. The patient is currently disease-free, 6 years after the operation.

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