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Sato Y.,Hyogo Prefectural Amagasaki Hospital
Journal of Cardiology | Year: 2015

The mortality associated with end-stage heart failure (HF) is high despite the development of new and increasingly effective drugs and non-pharmacological therapies. Repetitive hospitalizations predict fatal outcomes and each hospitalization should prompt individual conversations with the patient, the family, and the caregivers. A multidisciplinary disease management program promotes the education of patients and their families and modifies their behavior, with a view to ultimately improve the prognosis and quality of life. From the early to the late stages of HF, a multidisciplinary disease management program should be implemented. In Western societies this multidisciplinary management has long been debated and endorsed, in contrast to Japan, where it has just begun. In 2012, the Japanese Nursing Association launched a certification in chronic HF nursing. A Japanese version of HF disease management should soon be developed in its own social environment. © 2015 .

Matsuoka T.,Hyogo Prefectural Amagasaki Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 75-year-old woman was followed up at the urology department of our hospital after left nephrectomy for renal cell carcinoma. Chest computed tomography (CT) showed ground-glass opacity in the right lower lobe( S6), 6 mm in size, in December 2010. 3 months later, the tumor was enlarged and she was introduced to our department. Wedge resection was performed to establish giagnosis. Pathological diagnosis was atypical adenomatous hyperplasia( AAH) and many small spindle-shaped cell nests were found at the same tissue. Immunohistochemically, this nest was shown to be minute pulmonary meningothelial-like nodules(MPMNs). MPMNs are asymptomatic small pulmonary nodules incidentally found during pathologic evaluation of pulmonary specimens. Combinations of MPMNs with adenocarcinoma or AAH have been reported, and the genetic relation of MPMNs and AAH is suggested.

A 65-year-old woman presenting with cardiac sarcoidosis underwent serial measurement of her serum high-sensitivity cardiac troponin I (Hs-cTnI) and N-terminal proB-type natriuretic peptide (NT-proBNP) concentrations. She was treated with 1,000 mg/day methylprednisolone for 2 days, which was subsequently replaced by 30 mg/day prednisolone, and decreased to 20 mg/day at the time of discharge, 2 months later. Her echocardiogram showed improvements in the left ventricular systolic and diastolic function, along with a decrease in the concentration of Hs-cTnI and NT-proBNP. This is the first report suggesting that Hs-cTnI might be a reliable means of assessing the effects of treatment of cardiac sarcoidosis.

Takemura G.,Gifu University | Kanoh M.,Gifu University | Minatoguchi S.,Gifu University | Fujiwara H.,Hyogo Prefectural Amagasaki Hospital
International Journal of Cardiology | Year: 2013

It has been suggested that apoptosis may be responsible for a significant amount of the cardiomyocyte death that contributes to the development and progression of heart failure. However, studies of actual heart disease and in vivo experimental models have provided little or no direct morphological evidence that cardiomyocyte apoptosis occurs at any stage of heart failure, despite the availability of much indirect evidence that includes detection of DNA fragmentation and apoptosis-related factors. The Nomenclature Committee on Cell Death (NCCD), an international organization consulting on cell death, proposed an international standard for the definition and classification of cell death, in which cell death was defined based purely on morphological criteria. This is because there is no clear-cut equivalence between ultrastructural alterations and biochemical cell death characteristics. This review will first introduce the NCCD definition and classification of cell death and, based on this classification, survey the available data from both animals and humans to critically assess the impact of cardiomyocyte apoptosis during the progression of heart failure of various etiologies. Particularly noteworthy is the wide variation in the reported rates of apoptosis - e.g., the difference was > 1000-fold in one heart failure model - but even more importantly, no morphological (ultrastructural) data has ever been shown definitively demonstrating apoptosis of a cardiomyocyte. We conclude from our survey that even the existence of cardiomyocyte apoptosis in heart failure remains controversial. © 2013 Elsevier Ireland Ltd.

Oh H.,Hyogo Prefectural Amagasaki Hospital
Developments in Ophthalmology | Year: 2014

Idiopathic macular hole is a disease that arises from adhesion in the vitreomacular interface and can theoretically be treated by vitrectomy surgery. Surgical techniques include removal of the vitreous with or without simultaneous peeling of the internal limiting membrane (ILM), fluid-air exchange, and gas tamponade. Since the advent of microincision vitrectomy surgery, macular hole surgery has been performed with minimal invasiveness, and significant visual improvement is a common outcome. This chapter describes the pathology of this disease, including presurgical evaluation using optical coherence tomography (OCT), and then shows the fundamental techniques required for the surgery. Also important is the understanding of the postsurgical 'healing' process of the disease, which may confirm the fact that the subjective improvement is closely related to the retinal imaging obtained by OCT. More recent advances are the inverted ILM peeling technique for larger macular holes and 27-gauge vitrectomy that can potentially minimize the surgical invasiveness mainly by smaller wound construction and the reduced volume of irrigation during surgery. © 2014 S. Karger AG, Basel.

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