Hamada Medical Center

Hamada, Japan

Hamada Medical Center

Hamada, Japan
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Kanno T.,The University of Shimane | Karino M.,The University of Shimane | Yoshino A.,The University of Shimane | Koike T.,The University of Shimane | And 8 more authors.
Journal of Hard Tissue Biology | Year: 2017

Combined orbital floor and medial wall defect fractures can be challenging to repair. The aim of this retrospective clinical study was to evaluate the feasibility of single folded uncalcined and unsintered hydroxyapatite (u-HA) particles and poly-L-lactide (PLLA; u-HA/PLLA) composite sheets with a tack fixation technique in computer-assisted combined orbital floor and medial wall complicated fracture reconstruction. This study included five patients (mean age, 27.2 years) with relatively large complex orbital floor and medial wall defects (three type III defects and two type IV defects). A single folded u-HA/PLLA sheet was fabricated and prepared with an average optimal orbital floor to mesial walls angle (OHMW-angle) of 130.84° ± 5.42; this was followed by adaption and stable fixation with tacks to the inferior orbital rim using computer-assisted and intraoperative navigation-assisted orbital reconstructive surgery. The clinical and radiological data were analyzed, and ophthalmologists diagnosed functional eye complications with a mean follow-up period of 9.1 months (range, 6 to 18 months). Although the postoperative computed tomography (CT) study revealed accurate three-dimensional (3D) orbital wall reconstruction, a slight OHMW-angle increase, to 133.68°± 4.28, between the orbital floor and medial reconstructed walls was observed 1 month postoperatively compared with immediately postoperatively (p <.05), but no other angle changes were observed in the postoperative follow-up study (p >.05). There was full recovery of ophthalmological function and active eyeball mobility without enophthalmos or diplopia. Overall, computer-assisted single folded u-HA/PLLA sheets with a tack fixation technique provide stable and satisfactory ophthalmologic functional results for combined orbital floor and medial wall fracture reconstruction with no intraoperative or postoperative complications. Furthermore, this u-HA/PLLA composite sheet could be an optimal next-generation bioactive osteoconductive implant material for the reconstruction of relatively large orbital wall defects, which could be applied using computer-assisted surgery. © 2017 The Hard Tissue Biology Network Association Printed in Japan, All rights reserved.


Hirabayashi M.,Hamada Medical Center | Hirabayashi M.,The University of Shimane | Doi K.,Hamada Medical Center | Imamachi N.,Hamada Medical Center | And 3 more authors.
Anesthesia and Analgesia | Year: 2017

BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids. METHODS: We obtained institutional review board approval and written informed consent from the 122 patients (American Society of Anesthesiologists [ASA] physical status II; aged 20-40 years) scheduled for elective cesarean delivery who were included in this study. Spinal anesthesia was performed with 10 mg of 0.5% hyperbaric bupivacaine, 10 μg of fentanyl, and 100 μg of morphine. After delivery of the baby and placenta, the parturient women were randomized to intravenously receive 15 mg (1 mL) of pentazocine or 1 mL of saline. All women received postoperative analgesia with the epidural infusion of 0.15% levobupivacaine. The presence of pruritus within the first 24 hours after intrathecal administration of opioids was recorded, and severity of itch, numerical rating scale (NRS) for pain, and adverse effects were also recorded at the time of the arrival on the ward, as well as 3, 6, 12, and 24 hours after the intrathecal administration of opioids. RESULTS: A total of 119 women completed the study. IV pentazocine reduced the overall incidence of pruritus within the first 24 hours compared to IV saline, with an estimated relative risk of 69% (95% confidence interval [CI], 52%, 90%; P =.007). IV pentazocine also reduced the severity of pruritus. The incidence of nausea and vomiting was not significantly different. There were no significant differences in postoperative NRS scores. CONCLUSIONS: A single 15-mg dose of IV pentazocine after delivery can reduce both the incidence and severity of pruritus in women who have received subarachnoid opioids during cesarean delivery. © Copyright 2017 International Anesthesia Research Society.


Ishihara S.,The University of Shimane | Yashima K.,Tottori University | Kushiyama Y.,Red Cross | Izumi A.,Izumi Gastrointestinal Clinic | And 15 more authors.
Journal of Gastroenterology | Year: 2012

Background: It remains unknown whether the Rome III criteria can exclude organic colonic lesions prior to the diagnosis of irritable bowel syndrome (IBS). We evaluated the colonoscopy results of patients meeting the Rome III criteria for the diagnosis of IBS to determine the presence of organic colonic lesions. Methods: This study was prospectively conducted at 17 centers in Japan. We enrolled 4528 patients who underwent diagnostic colonoscopy examinations. The diagnosis of IBS was evaluated by questionnaire results according to the Rome III criteria. Results: We evaluated 4178 patients (350 were excluded because of incomplete data or previous colonic surgery), of whom 203 met the Rome III criteria (mean age 57.9 years; range 14-87 years) prior to the diagnostic colonoscopy examination. We identified organic colonic diseases in 21 of these 203 patients (10.3 %), and these disease were also identified in 338 (8.5 %) of 3975 patients who did not fulfill the Rome III criteria. There were no differences in regard to the prevalence of organic colonic diseases between patients who did and did not fulfill the Rome III criteria. Conclusions: The prevalence of organic colonic diseases in patients who met the Rome III criteria was at an acceptably low level, indicating that the Rome III criteria are adequately specific for the diagnosis of IBS without performing a colonoscopy examination. © 2012 Springer.


Tatebe S.,Tottori University | Tatebe S.,Red Cross | Tsujitani S.,National Center for Global Health and Medicine | Nakamura S.,Tottori Prefectural Central Hospital | And 7 more authors.
Gastric Cancer | Year: 2014

Background: The Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer established oral S-1 administration for 1 year as the standard postoperative adjuvant chemotherapy for gastric cancer in Japan. We conducted a multicenter cooperative prospective study comparing daily and alternate-day S-1 administration as postoperative adjuvant therapy for gastric cancer. Methods: Patients with Stage II or III gastric cancer who underwent curative surgery were randomly assigned to receive standard daily S-1 administration [group A: 80-120 mg/day S-1 depending on body surface area (BSA); days 1-28 every 6 weeks for 1 year] or alternate-day administration (group B: 80-120 mg/day S-1 depending on BSA; alternate days for 15 months). Treatment completion rate was the primary endpoint, and relative dose intensity and safety, overall survival, and relapse-free survival (RFS) were secondary endpoints. Results: Seventy-three patients were enrolled. The treatment completion rate was 72.2 % in group A and 91.8 % in group B; the relative dose intensity was 67.5 % in group A and 81.2 % in group B; and compliance was better in group B. Digestive system adverse effects were less frequent in group B than in group A. Median follow-up time was 2.8 years; 3-year survival rate was 69.6 % in group A and 87.3 % in group B; and 3-year RFS rate was 76.4 % in group A and 73.1 % in group B. Conclusions: Our data show improved compliance and fewer adverse effects with alternate-day S-1 administration, which appears to be a more sustainable option for adjuvant chemotherapy for Stage II or III gastric cancer. © 2013 The International Gastric Cancer Association and The Japanese Gastric Cancer Association.


Kambara E.,Fukuyama Medical Center | Hirata M.,Fukuyama Medical Center | Kashiwabara Y.,Fukuyama Medical Center | Yamakawa F.,Fukuyama Medical Center | And 7 more authors.
IRYO - Japanese Journal of National Medical Services | Year: 2015

This study analyzed the effect of rooming-in care versus mother-infant separate care on the success of breast-feeding in our hospital.Data based on 39 infants in rooming-in and 62 infants in separate care showed a tendency of decrease in rooming-in (p<0.10) in the aspect of full breast feeding rate, compared with separate care at 1 month helth check. No significant differences were demonstrated, however, on decline in abandonment of children and maternal anxiety, assessed by MAI-J and MCQ score, respectively. The Questionnaire in in rooming-in care system showed that there were some discrepancies between images and practical experiences. WHO/UNICEF declared that mother-infant separation care raises maternal insecurity, decreased breast feeding and deprives the baby from mother's love. Our results demonstrated that careful considerations such as frequent visits and nursing instructions should be needed to fulfil the ideal goals of rooming-in care system. © 2015, Japanese Society of National Medical Services. All rights reserved.


Watanabe J.,Tottori Prefectural Cyuo Hospital | Nishimura K.,Tottori Prefectural Cyuo Hospital | Nishimura K.,Tottori Prefectural Kosei Hospital | Miyasaka S.,Tottori Prefectural Cyuo Hospital | And 3 more authors.
International Journal of Angiology | Year: 2015

Heparin-induced thrombocytopenia (HIT) is still a relatively uncommon condition and it is not well known how to administer argatroban during continuous hemodiafiltration (CHDF). A 72-year-old man required CHDF with heparin because of the oliguria and hyperpotassemia directly after the open repair of a juxtarenal abdominal aortic aneurysm. As the postoperative blood platelet count dropped and there was a thrombus in the CHDF circuit, HIT was suspected and nafamostat mesilate, but not heparin, was immediately administered for CHDF. As heparin-platelet factor 4 complex was positive, we diagnosed him with HIT and started argatroban while monitoring the activated clotting time (ACT), resulting in no further obstruction of the CHDF and an increase in the platelets. There was no disadvantage for administering nafamostat mesilate which we have commonly used instead of heparin, we should have used argatroban once we suspected HIT. It may be important to consider the history of heparin especially in administering heparin and it may be useful to monitor the ACT when initially starting argatroban for patients with HIT. Copyright ©, Thieme Medical Publishers. All rights reserved.


PubMed | Hamada Medical Center, Tottori Prefectural Cyuo Hospital and Tottori Prefectural Kosei Hospital
Type: Journal Article | Journal: The International journal of angiology : official publication of the International College of Angiology, Inc | Year: 2016

Heparin-induced thrombocytopenia (HIT) is still a relatively uncommon condition and it is not well known how to administer argatroban during continuous hemodiafiltration (CHDF). A 72-year-old man required CHDF with heparin because of the oliguria and hyperpotassemia directly after the open repair of a juxtarenal abdominal aortic aneurysm. As the postoperative blood platelet count dropped and there was a thrombus in the CHDF circuit, HIT was suspected and nafamostat mesilate, but not heparin, was immediately administered for CHDF. As heparin-platelet factor 4 complex was positive, we diagnosed him with HIT and started argatroban while monitoring the activated clotting time (ACT), resulting in no further obstruction of the CHDF and an increase in the platelets. There was no disadvantage for administering nafamostat mesilate which we have commonly used instead of heparin, we should have used argatroban once we suspected HIT. It may be important to consider the history of heparin especially in administering heparin and it may be useful to monitor the ACT when initially starting argatroban for patients with HIT.


Kawamoto T.,Kure Medical Center | Kouno Y.,Kure Medical Center | Kanme S.,Hamada Medical Center | Okamoto N.,Kure Medical Center | And 3 more authors.
IRYO - Japanese Journal of National Medical Services | Year: 2013

Background : Although regional medical liaison office (RMLO) manages support collaboration between the hospital and clinics, there were many problems in the referral system. Objective : To clarify the effect of improvement on problems of the referral system in RMLO. Subjects : In NHO Kure Medical Center, complaint reduction projects were carried out, which consisted of improvement of referral letters distribution, triage sheet for emergency, and computerized referral management system, and consultation systems for undetermined referrals. The complaints in the RMLO were compared before and after the implementation of the project. Results : The monthly average number of troubles were reduced significantly from 14 ± 6.9 to 5.6 ± 4.5 (p < 0.01 ) The ratio of the trouble cases to the total count of referral letters was significantly decreased from 1.0 ±0.5% to 0.4 ±0.3%. The complaint sources from primary care physician were 61, hospital doctor 54 and patients 29, which was changed to 22,24 and 3, respectively (p=0.04). The contents of complaints were different from before and after the project significantly (p <.0001), in particular, for primary care physicians the number of the undetermined specialist for referral was reduced from 25 to 0 and reply for the referrals was from 16 to 7. For hospital doctors, the problems of referral letters were reduced from 24 to 3 and referrals for undetermined specialists were from 14 to 3. Conclusion : Work performance and information and communication technology system have contributed to the improvement of the referral management and the reduction of complaints from primary care physicians and specialists.

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