Otsuki K.,Showa University |
Imai N.,Hachinohe City Hospital
Biochemistry and Cell Biology | Year: 2017
We previously reported that lactoferrin (LF) could be effective for preventing preterm delivery and intrauterine infections, based on data derived from mice and rabbits. Here we describe 6 women with a history of multiple pregnancy losses or preterm delivery and refractory bacterial vaginosis, who received prebiotic LF therapy and delivered an infant normally. Five of the women were pregnant and one was not at the time of this study. The Ethics Committee at Showa University Hospital and Showa University Koto Toyosu Hospital approved the therapeutic protocol. Vaginal suppositories and oral prebiotic LF were administered to patients who were refractory to conventional treatment for vaginosis and had a history of late miscarriages and very early preterm delivery due to refractory vaginitis and chorioamnionitis. LF significantly improved the vaginal bacterial flora. Lactobacillus, which was detectable in the vaginas of all patients after one month of LF therapy, gradually became dominant. The findings from these 6 patients suggest that administering LF to humans could help prevent refractory vaginitis, cervical inflammation, and preterm delivery. © 2017 Published by NRC Research Press.
PubMed | Tohoku University, Hachinohe City Hospital and Hakodate Municipal Hospital
Type: Journal Article | Journal: Transplantation proceedings | Year: 2014
Posttransplant lymphoproliferative disorder (PTLD) is a life-threatening complication of organ transplantation that results from immunosuppression therapy. Most cases of PTLD derive from the B-cell lineage. T-cell PTLD, particularly natural killer (NK)/T-cell PTLD, is quite rare; only a few cases have been described.A 42-year-old woman received a living-related renal allograft from her father. Sixteen years after transplantation, the patient presented with a 1-week history of low-grade fever and epigastralgia. Computed tomography revealed intestinal masses and a right upper lung lobe mass. Gallium scintigraphy showed uptake in the abdominal mass. Epstein-Barr virus-related antibody was not detected in the patients serum sample. We performed extirpation of the jejunum and ileum tumors. The pathologic findings showed that these 2 tumors were NK/T-cell lymphoma. After the operation, the lung mass rapidly enlarged, and right upper lobectomy was performed. The right upper lung lobe tumor showed the same histopathologic findings as the small bowel tumor. The final histologic diagnosis was established as multiple extranodal NK/T cell type PTLD of the small bowel and right upper lung lobe.After reduction of the immunosuppressive agent, no recurrence of PTLD has been observed for the past 9 years.
PubMed | Tohoku University, Hachinohe City Hospital and Kohnan Hospital
Type: | Journal: Journal of neurological surgery. Part A, Central European neurosurgery | Year: 2016
Hemangioblastoma tends to occur in the infratentorial regions and rarely in the supratentorial regions. This tumor is strongly associated with von Hippel-Lindau disease (VHLD), especially in the supratentorial regions, with only 12 cases of suprasellar hemangioblastoma unrelated to VHLD. However, all these cases were diagnosed based on clinical screening and confirmation of family history. We report a case of suprasellar hemangioblastoma that was successfully removed through an extended transsphenoidal approach and diagnosed as a sporadic case unrelated to VHLD by immunohistochemical examination.A 67-year-old woman had mild diabetes insipidus and a visual field defect. Head magnetic resonance imaging revealed a suprasellar tumor compressing the optic chiasm upward. The tumor was totally removed without complication through an extended transsphenoidal approach. Postoperative histologic examination disclosed large vacuolated stromal cells and rich capillary networks, and the diagnosis was established as hemangioblastoma. Clinical screening and confirmation of family history revealed no specific results, and additional immunohistochemical staining showed diffuse cytoplasmic expression of anti-VHLD gene-derived protein (pVHL).We emphasize that pVHL immunohistochemical evaluation would be wise to adopt, especially for patients with a high risk of VHLD related to younger age and supratentorial lesions.
Sasaki E.,Hirosaki University |
Tsuda E.,Hirosaki University |
Yamamoto Y.,Hirosaki University |
Iwasaki K.,Hirosaki University |
And 7 more authors.
International Orthopaedics | Year: 2013
Purpose: Although serum hyaluronan (HA) levels increase in patients with osteoarthritis (OA), the association between OA severity and elevation of serum HA levels is not clear. Our purpose was to investigate the relationship between serum HA levels and OA in various anatomical sites and to detect which joints are strongly correlated with elevated serum HA levels. Methods: Seven hundred and ten individuals from the general population who participated in the Iwaki Health Promotion Project in 2008 were involved. Kellgren-Lawrence grade 2 or higher in the knee, hip, lumbar spine, finger and wrist was defined as OA. Serum HA levels were determined on the same day. Spearman's correlation coefficients between serum HA levels and total number of joints affected by OA were calculated. Linear regression was analysed with serum HA levels as the independent variable; age, gender, presence of OA and intake of supplements were used as dependent variables. Results: Prevalence of knee OA was 30.7 %, hip 16.8 %, lumbar spine 65.1 %, wrist 9.0 % and finger 22.0 %. Serum HA levels had a positive correlation with the number of involved joints, and the correlation coefficient was 0.410 (p < 0.001). Serum HA was significantly affected by age (β = 0.382), knee OA (β = 0.163) and finger OA (β = 0.164). Conclusion: Although this biomarker reflects a systemic condition, higher serum HA levels were associated with total number of OA joints. Knee and finger OA were key joints related to increased serum HA levels. These results are valuable in understanding characteristics of serum HA levels as a biomarker for osteoarthritis. © 2013 Springer-Verlag Berlin Heidelberg.
Fujiwara H.,Hachinohe City Hospital |
Matsuki K.,Hachinohe City Hospital
General Thoracic and Cardiovascular Surgery | Year: 2012
We report a case of complete atrioventricular block subsequent to thrombosed-type acute aortic dissection. An 81-year-old woman with thrombosed-type acute aortic dissection experienced cardiopulmonary arrest and complete atrioventricular block 6 days after aortic dissection. After temporary pacing, a permanent pacemaker was implanted. Atrioventricular conductivity disorders that result in complete atrioventricular block are rare complications developing after aortic dissection, especially thrombosed-type aortic dissection. We discuss the cause of atrioventricular block subsequent to aortic dissection. © The Japanese Association for Thoracic Surgery 2012.
Hirayama Y.,Hachinohe City Hospital |
Kudo T.,Hachinohe City Hospital |
Kasai N.,Hachinohe City Hospital
Internal Medicine | Year: 2016
Rathke’s cleft cysts are known to cause hormone-related abnormalities. However, the natural history of this disorder is obscure, so it is rarely associated with acute adrenal insufficiency. We herein describe a case of Rathke’s cleft cyst associated with acute adrenal insufficiency in a 27-year-old man. The patient experienced severe headaches due to acute adrenal insufficiency without changes in the size of the cyst. Glucocorticoid administration improved these symptoms, and the cyst spontaneously shrank before operation. This case led us to conclude that Rathke’s cleft cysts should be considered in the differential diagnosis of patients who present with adrenal insufficiency, and that the cysts can be reduced by glucocorticoids. © 2016 The Japanese Society of Internal Medicine.
PubMed | Shinshu University, Osaka City General Hospital and Hachinohe City Hospital
Type: | Journal: Modern rheumatology | Year: 2016
Familial Mediterranean fever (FMF) can be classified into typical and incomplete/atypical types. Periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis (PFAPA) syndrome-like symptoms has been found in atypical type carrying P369S-R408Q mutations in the responsible gene MEFV. A 28-year-old female with recurrent fever and her young sisters and mother, all of whom had tonsillectomy for tonsillitis, carried heterozygous alterations involving E148Q/P369S/R408Q. A diagnosis of atypical FMF, MEFV exon3 variants with PFAPA syndrome-like symptoms, was made.
PubMed | Hachinohe City Hospital
Type: Journal Article | Journal: Journal of medical case reports | Year: 2016
Preoperative uterine artery embolization has been shown to help reduce blood loss, with few complications. Most reports indicated that uterine artery embolization is safe for uterine fibrosis; the occurrence of hyperkalemia and acute kidney failure as complications of preoperative uterine artery embolization has not been reported previously. Here we report the occurrence of hyperkalemia and acute kidney failure after preoperative uterine artery embolization for a large uterine fibroid. To the best of our knowledge, this is the first report on the occurrence of hyperkalemia and acute kidney failure after preoperative uterine artery embolization.A 48-year-old Japanese woman presented to our hospital complaining of compression in her abdomen and an abdominal mass. Magnetic resonance imaging showed a large uterine fibroid measuring 37.52713.5 cm. Therefore, we planned preoperative uterine artery embolization to help reduce blood loss. However, hyperkalemia and acute kidney failure occurred owing to the development of necrotic tissue after uterine artery embolization; therefore, emergency total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. She experienced 105 g of blood loss intraoperatively. The weight of her uterus was 10.8 kg and the volume was 9964 cmWe reported the occurrence of serious complications, including hyperkalemia and acute kidney failure, after preoperative uterine artery embolization for a large uterine fibroid.
PubMed | Hachinohe City Hospital
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2015
Primary cardiac malignant lymphoma within a cardiac myxoma is extremely rare. Here we report a case of a previously healthy 71-year-old woman who developed acute myocardial infarction. Transthoracic echocardiography showed a 6945-mm solid tumor in the left atrium that was moving in a circular manner in the left atrial and ventricular cavities. Coronary angiography revealed an occlusion due to a coronary emboli in the distal part of the right coronary artery. Thrombectomy with an aspiration catheter was successfully performed to remove large red thrombi from the arterial lumen. Emergent surgical removal of the left atrial tumor along with tricuspid valve annuloplasty was performed under cardiopulmonary bypass. The postoperative course was uneventful. Histological examination demonstrated presence of malignant lymphoma within the myxoma. The patient was treated with rituximab, tetrahydropyranyl adriamycin, cyclophosphamide, vincristine, and predonisone (R-THP-COP) and is doing well without recurrence of lymphoma at 18-month follow-up. We emphasise that all surgical cardiac specimens should be sent for histological analysis aiming at the best treatment.
PubMed | Hachinohe City Hospital
Type: Case Reports | Journal: Internal medicine (Tokyo, Japan) | Year: 2016
Rathkes cleft cysts are known to cause hormone-related abnormalities. However, the natural history of this disorder is obscure, so it is rarely associated with acute adrenal insufficiency. We herein describe a case of Rathkes cleft cyst associated with acute adrenal insufficiency in a 27-year-old man. The patient experienced severe headaches due to acute adrenal insufficiency without changes in the size of the cyst. Glucocorticoid administration improved these symptoms, and the cyst spontaneously shrank before operation. This case led us to conclude that Rathkes cleft cysts should be considered in the differential diagnosis of patients who present with adrenal insufficiency, and that the cysts can be reduced by glucocorticoids.