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Takasaki, Japan

Ohno H.,Hidaka Hospital
Respiration and Circulation | Year: 2012

A 60-year-old man was admitted to our hospital with thrombosed-type acute aortic dissection (DeBakey type III). No clinical signs specific for acute pancreatitis were observed, despite the presence of hyperamylasemia and CT findings of acute pancreatitis and pseudocysts. MRI showed peripancreatic cystic lesions and an abnormal signal of fatty tissue in the anterior pararenal space without parenchymal change in the pancreas. Anuria occurred immediately after hospital admission, requiring temporary hemodialysis. Conservative treatment for the pseudocysts was used to avoid a high-risk invasive procedure in the acute phase of aortic dissection. Five weeks after the onset of aortic dissection the pseudocysts began to regress and complete resolution was recognized on CT scan after discharge. A more remarkable change of peripancreatic tissues was noted, compared to those of pancreatic parenchyma. This case suggests that severe inflammation due to aortic dissection may affect the retroperitoneal organs. Source


Echida Y.,Tokyo Womens Medical University | Ogawa T.,Tokyo Womens Medical University | Otsuka K.,Tokyo Womens Medical University | Ando Y.,Hidaka Hospital | Nitta K.,Tokyo Womens Medical University
Clinical and Experimental Nephrology | Year: 2012

Background Non-high-density lipoprotein cholesterol (non-HDL-C) has been proposed as a predictor of cardiovascular disease (CVD) in the general population. The aim of this study was to evaluate the utility of non-HDL-C in predicting CV mortality in chronic hemodialysis (HD) patients. Methods We calculated the serum non-HDL-C level of 259 HD patients by subtracting their HDL-C levels from their total cholesterol. Cox proportional hazards models were used to estimate the hazards ratio (HR) for CV mortality and the 95% confidence interval (CI). A receiveroperating characteristic (ROC) analysis was performed to estimate the relationship between sensitivity and specificity of a diagnostic parameter. Results There were 44 deaths (17.0%) during the followup period, 33 (12.7%) of which were due to CVD. A multivariate Cox analysis with adjustments for age, diabetes, dialysis vintage, systolic blood pressure, serum albumin, and lipid levels showed that non-HDL-C was an independent predictor of CV mortality (HR 1.015, 95% CI 1.004-1.025, p = 0.0083). An ROC analysis showed that the plots of the non-HDL-C levels yielded significant specificity and sensitivity for predicting the risk of CVD mortality in HD patients [area under the curve (AUC) 0.62416; p = 0.0366; cutoff value 111.0 mg/dl]. The Kaplan-Meier survival curves of HD patients showed significant differences in CV mortality according to their tertiles with respect to serum non-HDL-C levels (p = 0.0165). Conclusion The results of this study suggest that serum non-HDL-C level is a significant CV mortality predictor of chronic HD patients. © Japanese Society of Nephrology 2012. Source


Kurosawa K.,Hidaka Hospital
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2011

Intraosseous epidermoid cyst of the finger phalanx is rare. We report a case of postoperative recurrent intraosseous epidermoid cyst of the distal phalanx of the ring finger. To prevent further recurrence while maintaining morphology and function, the distal half of the distal phalanx that included the epidermoid cyst was resected to completely remove the lesion. The distal phalanx was then reconstructed by grafting corticocancellous bone from the ilium and shaped into a distal phalanx. The operation was performed using a through-the-nail approach, temporarily removing the nail and placing a longitudinal incision in the nail bed to approach the phalanx. Postoperatively, bone fusion was achieved without recurrence and the shape of the distal phalanx was normal. Distal phalangeal hypertrophy and nail plate deformity also normalized and excellent results were obtained. Source


Amemiya N.,Tokyo Womens Medical University | Ogawa T.,Tokyo Womens Medical University | Otsuka K.,Tokyo Womens Medical University | Ando Y.,Hidaka Hospital | Nitta K.,Tokyo Womens Medical University
Journal of Atherosclerosis and Thrombosis | Year: 2011

Aim: Although serum albumin and C-reactive protein (CRP) levels and pulse wave velocity (PWV) are known to be associated with the clinical outcome of hemodialysis (HD) patients, it is unknown which of these parameters are more predictive of the long-term mortality of such patients. Methods: We measured biochemical parameters, including serum albumin and CRP, and the PWV of 202 patients on maintenance HD therapy and followed their course for 4 years, and 186 of the patients were enrolled in the current study analyses. We divided the 186 patients into three tertiles according to their serum albumin and CRP levels and PWV values, and conducted multivariate analyses to examine the impact of the tertiles on 4-year mortality. Results: Twenty-three (12.4%) patients died during the follow-up period, and the serum albumin of the group that died was significantly lower than in the group that survived, but the CRP levels and PWV were significantly higher in the group that died. The results of Kaplan-Meier analyses revealed a significantly higher risk of all-cause mortality in HD patients with higher CRP based on the results of Cox proportional hazards analyses; however, the serum albumin and PWV values were not associated with all-cause mortality. Conclusion: The results of this study suggest that serum CRP levels are a better mortality predictor than serum albumin or PWV values of chronic HD patients. Source


Sato M.,Tokyo Womens Medical University | Ogawa T.,Tokyo Womens Medical University | Otsuka K.,Tokyo Womens Medical University | Ando Y.,Hidaka Hospital | Nitta K.,Tokyo Womens Medical University
Clinical and Experimental Nephrology | Year: 2013

Background: There is a lack of information on stiffness parameter β, an index of arterial stiffness, in hemodialysis (HD) patients. The aim of the present study was to investigate whether stiffness parameter β is predictive of the long-term mortality of chronic HD patients. Methods: We measured biochemical parameters and the stiffness parameter β of 80 patients on maintenance HD therapy and followed their course for 4 years, and we enrolled 70 of these 80 patients in the study. We divided the 70 patients into tertiles according to their stiffness parameter β values, and conducted multivariate analyses to examine the impact of the tertiles on 4-year mortality. Results: Older age and the presence of diabetes mellitus were found to be independently associated with higher stiffness parameter β values. Fifteen patients (21.4 %) died and 16 (22.9 %) experienced a new cardiovascular event during the follow-up period. The results of a Kaplan-Meier analysis revealed a significantly higher risk of all-cause mortality in the HD patients with highest stiffness parameter β values (p = 0.0106). According to the ROC curve, the cut-off level that yielded maximal sensitivity and specificity for predicting all-cause mortality was 10.1, and the sensitivity and specificity using the cut-off value were 69.2 and 70.2 %, respectively. Conclusion: The results of this study suggest that stiffness parameter β is a predictor of all-cause mortality in chronic HD patients. © Japanese Society of Nephrology 2012. Source

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