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Nakashima K.,Higashi Totsuka Memorial Hospital | Oishi A.,Higashi Totsuka Memorial Hospital | Itokawa H.,Kasai Cardiology and Neurosurgery Hospital
Japanese Journal of Neurosurgery | Year: 2010

A 61-year-old man with a history of esophageal carcinoma operated one year before was admitted to our hospital because of left hemiparesis including face. MRI revealed a cystic mass with a solid nodule in the right parietal lobe. The cyst was hypointense on T1-wighted images of MRI, with markedly enhancing rim after Gd injection. On T2-weighted images, the cyst was hyperintense, and the solid portion appeared to be heterogeneous. Based on the patient's past history, a metastatic brain tumor from esophageal carcinoma was suspected. A parietal craniotomy was performed, and the tumor was completely excised macroscopically. Histological diagnosis was a moderately differentiated squamous cell carcinoma, confirming our preliminary diagnosis. The patient had a good postoperative course, with complete resolution of his symptoms. Brain metastases from esophageal carcinoma are relatively rare, and little information is available on the clinical course and radiological findings. Here we report clinical and radiological features of brain metastasis from esophageal carcinoma focusing on MRI findings, with review of the literature.


Nakashima K.,Higashi Totsuka Memorial Hospital | Oishi A.,Higashi Totsuka Memorial Hospital | Itokawa H.,Kasai Cardiology and Neurosurgery Hospital | Fujimoto M.,Showa University
Neurological Surgery | Year: 2010

Objective: Cerebrospinal fluid (CSF) shunts are frequently used to treat hydrocephalus. The use of a programmable valve allows the operator to easily change the opening pressure. In Japan, many people use magnetic Induction therapy apparatuses in their homes. However, - exposing patients with adjustable CSF shunt valves to the permanent magnets included in these apparatuses may alter the shunt valve's programmed settings or permanently damage the device. Therefore, the goal of this study was to determine the health risk associated with magnetic induction therapy for patients using programmable CSF shunt valves. Methods: Five models of shunt valves from five different manufacturers, the Miethke proGAV (proGAV), the Codman Hakim programmable valve (CHPV), Sophysa Sophy model SM8 (Sophy valve), Sophysa Polaris model SPV (Polaris valve), and Strata II valve (Strata valve) were evaluated in this study. Magnetic field interactions were determined for the programmable valves by using magnetic stones with various magnetic flux densities. The maximum distance between the valve and the magnetic stone affecting the valve pressure setting was measured by X-ray. Results: The proGAV and Polaris valve were immune to unintentional reprogramming by the magnetic stones. The CHPV, Sophy valve and Strata valve, however, randomly changed settings by magnetic stones. Conclusions: Whereas the CHPV. Sophy valve and Strata valve were promptly reset by exposure to a magnetic stone with a similar strength to that used in magnetic induction therapy, proGAV and Polaris valve were resistant to inadvertent reprogramming when exposed to magnets up to 190 mT.


Sadamura H.,Higashi totsuka Memorial Hospital | Suzuki N.,Showa Pharmaceutical University | Sotome C.,Showa Pharmaceutical University | Kanzaki Y.,Kogakuin University
Electrochemistry | Year: 2010

The possibility using a solar battery as a power source for the electrochemical disinfection of microorganisms was examined. A single solar battery with an open circuit voltage 20 V and a capacity of 1 A was used for laboratory scale-examination. The electrochemical disinfection cell containing palladium-coated carbon cloth electrodes was reported previously and a dominant parameter on the disinfection was found to be the concentration of chloride ions. The concentration of NaCl as a source of chloride ions was varied from 0.154 mol dm -3 (saline solution) to 0.00154 mol dm -3 (the concentration being four to ten times that of NaCl in tap water in Tokyo) in this study. Disinfection was examined in only one flow-passage of the microorganisms' suspension across the electrolytic cell. Escherichia coli was selected as a model microorganism. Disinfection under a clear sky was complete, and was almost complete even under an obscured sky. The viability of E. coli at a current of 100 mA was less than 1 × 10 -6 irrespective of the concentration of NaCl. The viability of E. coli at a current of 50 mA increased to 0.001 in the suspension containing 0.00154 mol dm -3 of NaCl.


Sadamura H.,Higashi totsuka Memorial Hospital | Suzuki N.,Showa Pharmaceutical University | Kanzaki Y.,Kanagawa Institute of Technology
Electrochemistry | Year: 2012

The endoscope is one of the most extensively used medical devices. Endoscopes are deterged with extreme care because they are inserted directly in the body. Electrochemical disinfection using a palladium-coated carbon cloth electrode was applied to deterge a rod-shaped tool as a potential endoscope-deterging method because It required no toxic agent, did not cause secondary pollution, and provided an eco-friendly disinfection system. The anodic polarization of palladium in an NaCI-containing solution led to the effective generation of disinfective CIO" and the simultaneous gas evolution caused natural convection that Increased the disinfection efficacy. Electrochemical degreasing could also be attained by alternating between positive and negative electrode polarities. © The Electrochemical Society of Japan. All rights reserved.


Kutoh E.,Biomedical Center | Kutoh E.,Higashi Totsuka Memorial Hospital
Diabetes and Metabolism | Year: 2014

Aim: Unlike other dipeptidyl peptidase 4 (DPP-4) inhibitors, the excretion of linagliptin is mainly through a biliary route. Despite this fact, liver injury with linagliptin has thus far not been reported in the literature. However, this report describes the first case of probable linagliptin-induced liver toxicity. Methods: The clinical history, diagnosis, investigations and drug treatment of the patient are reviewed here. Results: A 58-year-old Japanese woman presented with fatigue, nausea, jaundice and marked elevations of hepatic enzymes 4. weeks after starting linagliptin 5. mg/day as monotherapy. No other medications were taken, and imaging studies revealed no other obvious causes of hepatic injury. Tests for viral serology and antinuclear antigen were negative. Symptoms disappeared and the levels of hepatic parameters (serum aminotransferases and biliary enzymes) slowly recovered after discontinuation of linagliptin. The slow recovery process may have been due to the very long half-life of the drug. The patient's Naranjo scale score was 6 and RUCAM score was 7. Conclusion: Although linagliptin currently carries no liver warnings, it may be necessary to monitor hepatic function in some patients upon administration of this drug until further evidence is obtained. © 2013 Elsevier Masson SAS.


Igota S.,Nippon Medical School | Igota S.,Higashi totsuka Memorial Hospital | Tosa M.,Nippon Medical School | Murakami M.,Nippon Medical School | And 4 more authors.
International Journal of Medical Sciences | Year: 2013

Keloid is characterized by fibroblastic cell proliferation and abundant collagen synthesis. Numerous studies have shown that the Wingless type (Wnt) signaling pathways play key roles in various cellular functions including proliferation, differentiation, survival, apoptosis and migration. The aim of this study was to clarify the role of Wnt signaling pathway in keloid pathogenesis. Primary fibroblast cultures and tissue samples from keloid and normal appearing dermis were used. The expression of Wnt family members, frizzled (FZD)4 receptor, receptor tyrosine kinase-like orphan receptor (ROR)2 and the Wnt signaling downstream targets, glycogen synthase kinase (GSK)3-β and β-catenin were assessed using semi-quantitative RT-PCR, Western blot, or immunohistochemical methods. Of the Wnt family members, Wnt5a mRNA and protein levels were elevated in keloid fibroblasts (KF) as compared to normal fibroblasts (NF). A higher expression of β-catenin protein was also found in KF. No detectable levels of FZD4 receptor and ROR2 proteins were observed in both NF and KF. Functional analysis showed that treatment of NF and KF with recombinant Wnt5a peptide resulted in an increase in protein levels of total β-catenin and phosphorylated β-catenin at Ser33/37/Thr 41 but no significant change in phosphorylated β-catenin at Ser45/Thr 41 positions. In addition, the expression of total GSK3-β protein was not affected but its phosphorylated/inactivated form was increased in NF and KF. Our findings highlight a potential role for a Wnt/β-catenin canonical signaling pathway triggered by Wnt5a in keloid pathogenesis thereby providing a new molecular target for therapeutic modulations. © Ivyspring International Publisher.


Gonai S.,Higashi Totsuka Memorial Hospital | Kamio Y.,Showa University | Matsuoka T.,Higashi Totsuka Memorial Hospital | Harunari M.,Kawasaki Municipal Hospital | And 2 more authors.
American Journal of Emergency Medicine | Year: 2016

Although techniques for autoreduction of anterior shoulder dislocation have been developed, no reports have detailed an autoreduction method using the zero position and traction on the affected arm. Therefore, we developed a new autoreduction technique using the zero position and gentle autotraction. The objective of this study is to present our experiencewith a newmethod for autoreduction of anterior shoulder dislocation called the GONAIS (a backronym for "Grasp a waist-high object, Opposite arm assists, Nonsedated, Autoreduction/autotraction, Immobilize the grasped object, and Squatting and stooping") method. A 41-year-old healthy woman with a history of left shoulder dislocation presented to the emergency department with left shoulder pain while attaching her seatbelt. The X-ray examination revealed subcoracoid dislocation of the left shoulder. The patient tried the GONAIS method after simple guidance and demonstration. Although she felt pain once when weakening traction, she achieved autoreduction successfully in only 2min and 50 s. Clinical examination after autoreduction revealed normal neurovascular findings and appearance of the shoulder. The X-ray revealed glenohumeral joint reduction and no fracture. Here, our patient using the GONAIS method achieved shoulder autoreduction in a short time. The GONAIS method does not require lying down or sitting on the ground, does not necessarily require the opposite arm, and is minimally invasive. This method would likely be helpful for those who cannot quickly reach a hospital for treatment of anterior shoulder dislocation. © 2015 Elsevier Inc. All rights reserved.


Nakashima K.,Higashi Totsuka Memorial Hospital | Ogura Y.,Higashi Totsuka Memorial Hospital | Oishi A.,Higashi Totsuka Memorial Hospital | Itokawa H.,Showa University | And 5 more authors.
Brain and Nerve | Year: 2010

A 36-year-old man who was poorly compliant with his antihypertensive medication regimen was admitted to our hospital because he had nausea and an altered mental status. His disorientation increased on admission. His blood pressure was 219/156mmHg. No focal neurologic deficits were detected, but a cranial computed tomography (CT) performed on admission revealed a low-density area in the brainstem region. Subsequent cranial T2-weighted and fluid-attenuated inversion-recovery (FLAIR) magnetic resonance imaging (MRI) performed on the same day revealed high-intensity areas in the brainstem, bilateral cerebellar hemisphere, bilateral occipito-temporal subcortical white matter, right thalamus, and the right basal ganglia region. Diffusion-weighted MRI revealed that the edema was of vasogenic origin and was not indicative of ischemia/infarction. Biochemical testing revealed a blood urea nitrogen level of 35.7mg/dL, a serum creatinine level of 3.27mg/dL, proteinurea (4.6g/24 hours), and a glomerular filtration rate of 47. 6mL/min/1.73m2. These findings suggested a diagnosis of chronic kidney disease (CKD). The patient was diagnosed with hypertensive encephalopathy, and treatment with intravenous diltiazem was initiated. The clinical symptoms resolved 3 days after admission, and the abnormal findings in CT and MRI demonstrated completely resolved 44 days after admission. This was a rare case of reversible posterior leukoencephalopathy syndrome (RPLS) that was caused by severe hypertension and was aggravated by discontinuation of antihypertensive therapy. RPLS was caused by vasogenic edema because of sudden elevations in systemic blood pressure which exceed the autoregulatory capacity of the brain vasculature.


PubMed | Higashi Totsuka Memorial Hospital
Type: Journal Article | Journal: No shinkei geka. Neurological surgery | Year: 2010

Cerebrospinal fluid (CSF) shunts are frequently used to treat hydrocephalus. The use of a programmable valve allows the operator to easily change the opening pressure. In Japan, many people use magnetic induction therapy apparatuses in their homes. However, exposing patients with adjustable CSF shunt valves to the permanent magnets included in these apparatuses may alter the shunt valves programmed settings or permanently damage the device. Therefore, the goal of this study was to determine the health risk associated with magnetic induction therapy for patients using programmable CSF shunt valves.Five models of shunt valves from five different manufacturers, the Miethke proGAV (proGAV), the Codman Hakim programmable valve (CHPV), Sophysa Sophy model SM8 (Sophy valve), Sophysa Polaris model SPV (Polaris valve), and Strata II valve (Strata valve) were evaluated in this study. Magnetic field interactions were determined for the programmable valves by using magnetic stones with various magnetic flux densities. The maximum distance between the valve and the magnetic stone affecting the valve pressure setting was measured by X-ray.The proGAV and Polaris valve were immune to unintentional reprogramming by the magnetic stones. The CHPV, Sophy valve and Strata valve, however, randomly changed settings by magnetic stones.Whereas the CHPV, Sophy valve and Strata valve were promptly reset by exposure to a magnetic stone with a similar strength to that used in magnetic induction therapy, proGAV and Polaris valve were resistant to inadvertent reprogramming when exposed to magnets up to 190 mT.


PubMed | Higashi Totsuka Memorial Hospital
Type: Journal Article | Journal: Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan | Year: 2013

In the future, home medical care will become increasingly significant. The Heisei 24 annual budget request included 2,000,000,000 yen for the base pharmacy service which provides home medical care, more is anticipated, and greater expectations are attached to activity in the area of the pharmacist. However, as to the actual setting of this care, home medical care provided by pharmacists is still lacking. The community-based pharmacist is pursued and supported by the pharmaceutical business, and deals with issues of patient compatibility. Therefore, in the current pharmacy model, concern with home patients is not adequate. Also, as regards home medical care, the problem is not only with the community-based pharmacist. For medicine prescribed in a hospital to a patient for home medical care, it is a hospital-based pharmacist that serves as a bridge. However, hospital-based pharmacists are constantly tasked with multiple in-hospital business functions, so in this present situation, the pharmacists concern with home care is minimal. There should be cooperation between pharmacists concerned with treatment at home, discussion of how to introduce ideas based on cooperative medicine in the area, and so on, as regards the actual state of the conference. This would lead to the realization that medical treatment without a break in care would involve patients leaving the hospital, and assuring continued medical/pharmaceutical oversight, with a medical exchange as an example.

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