PubMed | Funabashi Municipal Medical Center, Hidaka General Hospital, Asahi General Hospital, Chiba Childrens Hospital and 23 more.
Type: Journal Article | Journal: PloS one | Year: 2016
Kawasaki disease (KD; MIM#61175) is a systemic vasculitis syndrome with unknown etiology which predominantly affects infants and children. Recent findings of susceptibility genes for KD suggest possible involvement of the Ca(2+)/NFAT pathway in the pathogenesis of KD. ORAI1 is a Ca(2+) release activated Ca(2+) (CRAC) channel mediating store-operated Ca(2+) entry (SOCE) on the plasma membrane. The gene for ORAI1 is located in chromosome 12q24 where a positive linkage signal was observed in our previous affected sib-pair study of KD. A common non-synonymous single nucleotide polymorphism located within exon 2 of ORAI1 (rs3741596) was significantly associated with KD (P = 0.028 in the discovery sample set (729 KD cases and 1,315 controls), P = 0.0056 in the replication sample set (1,813 KD cases vs. 1,097 controls) and P = 0.00041 in a meta-analysis by the Mantel-Haenszel method). Interestingly, frequency of the risk allele of rs3741596 is more than 20 times higher in Japanese compared to Europeans. We also found a rare 6 base-pair in-frame insertion variant associated with KD (rs141919534; 2,544 KD cases vs. 2,414 controls, P = 0.012). These data indicate that ORAI1 gene variations are associated with KD and may suggest the potential importance of the Ca(2+)/NFAT pathway in the pathogenesis of this disorder.
Emmoto T.,Hashimoto Municipal Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016
We report the case of a patient with acute type A aortic dissection associated with mesenteric ischemia who underwent superior mesenteric artery (SMA) bypass grafting prior to aortic repair, and obtained a satisfactory outcome. A 70-year-old man presented with sudden chest pain. Computed tomography( CT) revealed acute type A aortic dissection with occlusion of the celiac artery and severe stenosis of the SMA. The false lumen, extending from the aortic root to the inferior mesenteric artery, was completely thrombosed except around the entry at the proximal aortic arch. Mesenteric ischemia was diagnosed. In light of the stable hemodynamics and ongoing mesenteric ischemia, a right common iliac artery-to-SMA bypass was performed, primarily to relieve mesenteric ischemia. At 5 days postoperatively, hemodynamics gradually became unstable. CT demonstrated further dilatation of the ascending aorta, growth of pericardial effusion, and recanalization of the thrombosed false lumen. We performed emergency ascending aorta and hemiarch replacement. He was discharged in a good state, 34 days after onset. Two-stage surgical treatment should be considered as alternative management in patients with mesenteric ischemia.
Suzuki H.,Wakayama Medical University |
Terai M.,Tokyo Women's Medical University |
Hamada H.,Tokyo Women's Medical University |
Honda T.,Tokyo Women's Medical University |
And 14 more authors.
Pediatric Infectious Disease Journal | Year: 2011
BACKGROUND: There are still no definite treatments for refractory Kawasaki disease (KD). In this pilot study, we evaluated the use of cyclosporin A (CyA) treatment in patients with refractory KD. METHODS: We prospectively collected clinical data of CyA treatment (4-8 mg/kg/d, oral administration) for refractory KD patients using the same protocol among several hospitals. Refractory KD is defined as the persistence or recurrence of fever (37.5°C or more of an axillary temperature) at the end of the second intravenous immunoglobulin (2 g/kg) following the initial one. RESULTS: Subjects were enrolled out of 329 KD patients who were admitted to our 8 hospitals between January 2008 and June 2010. Among a total of 28 patients of refractory KD treated with CyA, 18 (64.3%) responded promptly to be afebrile within 3 days and had decreased C-reactive protein levels, the other 4 became afebrile within 4 to 5 days. However, 6 patients (21.4%) failed to become afebrile within 5 days after the start of CyA and/or high fever returned after becoming afebrile within 5 days. Although hyperkalemia developed in 9 patients at 3 to 7 days after the start of CyA treatment, there were no serious adverse effects such as arrhythmias. Four patients (1.2%), 2 before and the other 2 after the start of CyA treatment, developed coronary arterial lesions. CONCLUSION: CyA treatment is considered safe and well tolerated, and a promising option for patients with refractory KD. Further investigations will be needed to clarify optimal dose, safety, and timing of CyA treatment. Copyright © 2011 by Lippincott Williams & Wilkins.
Hirabayashi Y.,Hashimoto Municipal Hospital
Nishinihon Journal of Urology | Year: 2012
HoLEP (Holmium YAG laser Enucleation of the Prostate) is a new surgical technique for the treatment of Benign Prostatic Hyperplasia (BPH) that was first described by the medical team of Dr. Gilling in 1998. Fortunately I had the opportunity to abserve actual operations from a relatively early time. Since 2004 I have carried out more than 500 such operations. HoLEP is performed in more than 100 hospitals throughout Japan, and the number of operations has been increasing. However, the absolute technique has yet to be established. The procedure is entrusted to a technique based on the ability and the experience of each individual doctor. Various requirements are necessary so that HoLEP can replace TUR-P which is currently the most common surgical method for BPH. We need the establishment of the technique an assessment of its safety, an evaluation of long-term results, the purchase of equipment, an expansion of the number of hospitals where the procedure can be carried out the establishment of a training system. This time I would like to describe the measures and the reasoning of a point neglected by the original method of Dr. Gilling with the aim of establishment and the transmission of HoLEP. I would also like to refer to techniques for you to be when you are in a leading situation, in spite of this being simply my own personal opinion.
Ikejima M.,Hashimoto Municipal Hospital |
Mitani A.,Hashimoto Municipal Hospital |
Furukawa K.,Hashimoto Municipal Hospital
Journal of the Wakayama Medical Society | Year: 2013
Endometrial carcinoma is diagnosed with increasing frequency across a broad range of ages in recent years. There are several types of endometrial carcinoma, with endometrioid carcinoma accounting for approximately 90% of carcinomas of the uterine corpus. Endometrioid adenocarcinoma with secretory variant, however, is very rare, accounting for only 1-2% of cases of endometrial carcinoma. In this paper, we report two cases of this rare cancer in patients with almost similar backgrounds.
Mikita N.,Wakayama Medical University |
Mikita N.,Hashimoto Municipal Hospital |
Ikeda T.,Wakayama Medical University |
Ishiguro M.,Wakayama Medical University |
Furukawa F.,Wakayama Medical University
Journal of Dermatology | Year: 2011
Lupus erythematosus (LE) includes a broad spectrum of diseases from a cutaneous-limited type to a systemic type. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease which affects multiple organs. Cutaneous lupus erythematosus (CLE) includes skin symptoms seen in SLE and cutaneous-limited LE. Although immune abnormalities, as well as heritable, hormonal and environmental factors, are involved in the pathology of LE, the actual pathogenesis is still unclear. Recently, the involvement of various cytokines has been shown in the pathogenesis of LE. Moreover, some trials with biological agents targeted specific cytokines are also ongoing for SLE. In this article, we review the contributions of major cytokines such as interferon, tumor necrosis factor-α and interleukin-18 to LE, especially SLE and CLE. © 2011 Japanese Dermatological Association.
Onouchi Y.,RIKEN |
Onouchi Y.,Chiba University |
Ozaki K.,RIKEN |
Burns J.C.,University of California at San Diego |
And 61 more authors.
Nature Genetics | Year: 2012
We performed a genome-wide association study (GWAS) of Kawasaki disease in Japanese subjects using data from 428 individuals with Kawasaki disease (cases) and 3,379 controls genotyped at 473,803 SNPs. We validated the association results in two independent replication panels totaling 754 cases and 947 controls. We observed significant associations in the FAM167A-BLK region at 8p22-23 (rs2254546, P = 8.2 × 10 -21), in the human leukocyte antigen (HLA) region at 6p21.3 (rs2857151, P = 4.6 × 10 -11) and in the CD40 region at 20q13 (rs4813003, P = 4.8 × 10 -8). We also replicated the association of a functional SNP of FCGR2A (rs1801274, P = 1.6 × 10 -6) identified in a recently reported GWAS of Kawasaki disease. Our findings provide new insights into the pathogenesis and pathophysiology of Kawasaki disease. © 2012 Nature America, Inc. All rights reserved.
PubMed | Hashimoto Municipal Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012
A 49-year-old woman who complained of abdominal bloating and numbness in the bilateral lower limbs was diagnosed as advanced scirrhous gastric cancer with massive ascites. The biopsy specimen showed a poorly-differentiated adenocarcinoma. She was therefore treated with combined chemotherapy of tri-weekly docetaxel(40mg/m2, day 1, 22)and S-1(60mg/m2, day 1-14 with 1-week rest)for unresectable gastric cancer. After 5 courses, computed tomography showed no ascites. Furthermore, after 31 courses, the loss of ascites continued, and the thickening of the stomach walls was reduced. These findings suggested that a complete response in terms of Evaluation Criteria in Solid Tumors(RECIST)was obtained. The side effects throughout chemotherapy were Grade I anemia and Grade I alopecia. Docetaxel and S-1 chemotherapy may well be one of the effective treatments for advanced scirrhous gastric cancer.
PubMed | National Hospital Organization Minami Wakayama Medical Center, Hashimoto Municipal Hospital, Labour Health and Welfare Organization Wakayama Rosai Hospital, National Hospital Organization Osaka Minami Medical Center and 2 more.
Type: Journal Article | Journal: The British journal of surgery | Year: 2016
Patients quality of life (QoL) deteriorates remarkably after gastrectomy. Billroth I reconstruction following distal gastrectomy has the physiological advantage of allowing food to pass through the duodenum. It was hypothesized that Billroth I reconstruction would be superior to Roux-en-Y reconstruction in terms of long-term QoL after distal gastrectomy. This study compared two reconstructions in a multicentre prospective randomized clinical trial to identify the optimal reconstruction procedure.Between January 2009 and September 2010, patients who underwent gastrectomy for gastric cancer were randomized during surgery to Billroth I or Roux-en-Y reconstruction. The primary endpoint was assessment of QoL using the Functional Assessment of Cancer Therapy-Gastric (FACT-Ga) questionnaire 36months after surgery.A total of 122 patients were enrolled in the study, 60 to BillrothI and 62 to Roux-en-Y reconstruction. There were no differences between the two groups in terms of postoperative complications or mortality, and no significant differences in FACT-Ga total score (P=0496). Symptom scales such as epigastric fullness (heaviness), diarrhoea and fatigue were significantly better in the Billroth I group at 36months after gastrectomy (heaviness, P=0040; diarrhoea, P=0046; fatigue, P=0029). The rate of weight loss in the third year was lower for patients in the BillrothI group (P=0046).The choice of anastomotic reconstruction after distal gastrectomy resulted in no difference in long-term QoL in patients with gastric cancer.NCT01065688 (http://www.clinicaltrials.gov).
PubMed | Hashimoto Municipal Hospital and Wakayama Medical University
Type: | Journal: Case reports in obstetrics and gynecology | Year: 2017
Recurrent ectopic pregnancy in a remnant fallopian tube after ipsilateral salpingectomy is clinically rare. We report the extremely rare case of a third recurrent ectopic pregnancy after two previous salpingectomy procedures involving the opposite tube. A 26-year-old woman, gravida 3 para 0, experienced three ectopic pregnancies brought about by natural conception, all of which were treated surgically (right partial salpingectomy, right remnant tube resection, and left total salpingectomy). During the two salpingectomy procedures involving the right tube, the patency of the intact left tube was intraoperatively confirmed with indigo carmine. The most appropriate surgical intervention should be discussed when managing recurrent ectopic pregnancies. It might be necessary to perform total salpingectomy to reduce the risk of future recurrence on the remaining tube.