Iseikai Hospital

Ōsaka, Japan

Iseikai Hospital

Ōsaka, Japan
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PubMed | Osaka University, Osaka Neurological Institute, Suita Municipal Hospital and Iseikai Hospital
Type: | Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia | Year: 2017

Although proatlas segmentation abnormalities as developmental remnants around the foramen magnum have been reported in postmortem studies, they are rarely documented in a clinical setting. This report details the clinical and radiological characteristics of a rare case of proatlas segmentation abnormalities with clinical onset during the seventh decade of life. This case was suspected to have a familial factor. We also review the literature regarding this condition.


Nishiyama C.,Kyoto University | Iwami T.,Kyoto University | Murakami Y.,Kyoto University | Kitamura T.,Osaka University | And 4 more authors.
Resuscitation | Year: 2015

Objectives: To evaluate the long-term effectiveness of 15-min refresher basic life support (BLS) training following 45-min chest compression-only BLS training. Methods: After the 45-min chest compression-only BLS training, the participants were randomly assigned to either the refresher BLS training group, which received a 15-min refresher training 6 months after the initial training (refresher training group), or to the control group, which did not receive refresher training. Participants' resuscitation skills were evaluated by a 2-min case-based scenario test 1 year after the initial training. The primary outcome measure was the number of appropriate chest compressions during a 2-min test period. Results: 140 participants were enrolled and 112 of them completed this study. The number of appropriate chest compressions performed during the 2-min test period was significantly greater in the refresher training group (68.9. ±. 72.3) than in the control group (36.3. ±. 50.8, p=. 0.009). Time without chest compressions was significantly shorter in the refresher training group (16.1. ±. 2.1. s versus 26.9. ±. 3.7. s, p<. 0.001). There were no significant differences in time to chest compression (29.6. ±. 16.7. s versus 34.4. ±. 17.8. s, p=. 0.172) and AED use between the groups. Conclusions: A short-time refresher BLS training program 6 months after the initial training can help trainees retain chest compression skills for up to 1 year. Repeated BLS training, even if very short, would be adopted to keep acquired CPR quality optimal (UMIN-CTR UMIN 000004101). © 2015 Elsevier Ireland Ltd.


Mega S.,Iseikai Hospital
Japanese Journal of Chest Diseases | Year: 2016

We experienced a rare case of primary lung abscess with acute exacerbation in a 38-year-old man. We initially performed conservative treatment with combined modality therapy. However, the clinical symptoms, blood test findings, and chest computed tomography findings did not improve. Hence, we subsequently performed emergency surgery to save his life. The postoperative course of the patient was good. There are, to our knowledge, no previous reports in Japan on acute exacerbation of a lung abscess successfully treated with emergency surgery. Lung abscesses, although curable by medical procedures, may inevitably require surgery in some cases.


Nishiyama C.,Kyoto University | Iwami T.,Kyoto University | Kitamura T.,Kyoto University | Ando M.,Nagoya University | And 3 more authors.
Academic Emergency Medicine | Year: 2014

Objectives It is unclear how much the length of a cardiopulmonary resuscitation (CPR) training program can be reduced without ruining its effectiveness. The authors aimed to compare CPR skills 6 months and 1 year after training between shortened chest compression-only CPR training and conventional CPR training. Methods Participants were randomly assigned to either the compression-only CPR group, which underwent a 45-minute training program consisting of chest compressions and automated external defibrillator (AED) use with personal training manikins, or the conventional CPR group, which underwent a 180-minute training program with chest compressions, rescue breathing, and AED use. Participants' resuscitation skills were evaluated 6 months and 1 year after the training. The primary outcome measure was the proportion of appropriate chest compressions 1 year after the training. Results A total of 146 persons were enrolled, and 63 (87.5%) in the compression-only CPR group and 56 (75.7%) in the conventional CPR group completed the 1-year evaluation. The compression-only CPR group was superior to the conventional CPR group regarding the proportion of appropriate chest compression (mean ± SD = 59.8% ± 40.0% vs. 46.3% ± 28.6%; p = 0.036) and the number of appropriate chest compressions (mean ± SD = 119.5 ± 80.0 vs. 77.2 ± 47.8; p = 0.001). Time without chest compression in the compression-only CPR group was significantly shorter than that in the conventional CPR group (mean ± SD = 11.8 ± 21.1 seconds vs. 52.9 ± 14.9 seconds; p < 0.001). Conclusions The shortened compression-only CPR training program appears to help the general public retain CPR skills better than the conventional CPR training program. © 2013 by the Society for Academic Emergency Medicine.


Mega S.,Iseikai Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016

Localized malignant mesothelioma of the pleura (LMM) is an extremely rare tumor. The biologic association between LMM and diffuse malignant mesothelioma of the pleura (DMM) remains unclear, and the standard treatment for LMM has not been established to date. We experienced a rare case of LMM. A 49-year-old male was admitted to our hospital because of dyspnea on effort and an abnormal shadow on the chest X-ray. He had a 7 cm pleural tumor with right hemothorax. The tumor was surgically removed completely and the diagnosis of LMM was established pathologically. After surgery, he underwent radio-chemotherapy. The patient has been followed up for 6 years with no evidence of reccurence.


Mega S.,Iseikai Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2015

We experienced a rare case of anterior mediastinal bronchogenic cyst. A 55-year-old female was admitted to our hospital because of paroxysmal supraventricular tachycardia (PSVT) and an abnormal shadow on the chest computed tomography. She had a 5.5 cm tumor at anterior mediastinum. The tumor was surgically removed completely by video assisted thoracoscopic surgery, and the diagnosis of bronchogenic cyst was established pathologically. After surgery, PSVT has disappeared.


Tsuda A.,Akita | Kanaoka Y.,Iseikai Hospital
International Journal of Hyperthermia | Year: 2015

Purpose: The aim of this paper was to evaluate the effectiveness in day clinics of microwave endometrial ablation (MEA) on transcervical microwave myolysis for patients with menorrhagia caused by submucosal myomas. Materials and methods: Thirty-five outpatients (average age 44.8 ± 5.2 years (mean ± SD), range 34-58) with a single submucosal myoma that was 4-7 cm (5.5 ± 2.1 cm) in size underwent MEA with transcervical microwave myolysis using a specifically developed transabdominal ultrasound probe attachment for transcervical puncture. Primary outcomes were the changes in the blood haemoglobin level and the volume of myoma before and after the treatment. Secondary outcomes were the improvement in menorrhagia and satisfaction after the operation, assessed by visual analogue scale (VAS). Results: The mean operation time was 27.9 ± 13.6 min. The myomas had shrunk by 56.2% at 3 months and 73.8% at ≥6 months after the operation. Blood haemoglobin levels had increased significantly at 3 months (10.2 ± 2.0 vs. 12.7 ± 1.2, p < 0.001). The average VAS assessment of menstrual bleeding had decreased to 1.7 ± 1.7 at 3 months after the operation (preoperative VAS = 10). The average VAS score for feelings of satisfaction 3 months after the operation was 9.8 ± 0.5 (full score = 10). Conclusions: MEA with transcervical microwave myolysis is a feasible and effective procedure in a day surgery clinic for menorrhagia caused by submucosal myomas. The procedure may be an alternative to hysterectomy for menorrhagia caused by submucosal myomas in women during the perimenopausal period. © 2015 © 2015 Taylor & Francis.


Matsumoto K.,Iseikai Hospital | Oshino S.,Osaka University | Sasaki M.,Iseikai Hospital | Tsuruzono K.,Iseikai Hospital | And 2 more authors.
Acta Neurochirurgica | Year: 2013

Background: The natural history, including growth and rupture, of unruptured intracranial aneurysms (UIAs) remains unknown. Here, we present the results of serial magnetic resonance angiography (MRA) follow-up study in 111 patients with 136 UIAs. Method: A total of 111 patients with 136 UIAs were followed annually over the past 12 years, using 1.5-Tesla MRA. Follow-up was ended when UIAs were treated surgically, or the patients died of subarachnoid hemorrhage or other causes. Various factors influencing aneurysm rupture or growth were examined statistically. Results: Aneurysm rupture and growth occurred in six and 13 of the 111 patients, respectively. Annual rupture rate was 1.8 % per year and annual growth rate was 3.9 % per year. Aneurysm size was the sole factor influencing rupture(H.R. 1.214, 95 % CI, 1.078-1.368) and multiplicity was the sole factor influencing aneurysm growth (H.R. 5.174, 95 % CI 1.81-14.80). Conclusions: Serial MRA study showed that the incidence of UIA growth was twice as high as that of UIA rupture. As four patients showed aneurysm rupture or growth within 1 year, further investigations are necessary to determine the optimum interval of radiological investigation and to identify which UIAs grow or rupture within a short time. © 2012 Springer-Verlag Wien.


PubMed | Iseikai Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2017

Liver retraction is a necessary operative procedure for enabling greater visualization and a wider surgical field during laparoscopic surgery of the stomach. We have developed a new liver retraction method for laparoscopic surgery that uses penrose drains, is very easy to perform and in minimally invasive. We call this method the V-Shape+1 method. We performed laparoscopic surgery using this method on 16 patients within 8.3(5.3-13.7)min(median). We analyzed the postoperative changes in the serum levels of AST, ALT, and T-Bil, which are indicators of liver function. The serum AST, ALT values were elevated at postoperative day 1. Thereafter, the values improved immediately. This early liver function failure is acceptable. We have not experienced any complication related to this method. Therefore, we believe this method is useful for obtaining wide visualization easily for not only laparoscopic gastrectomy but also for laparoscopic upper abdominal surgery.


We reported a case of hilar cholangiocellularcarcinoma with complete obstruction of the portal vein. The patient, who was a 65-year-old woman, suffered from fever and general fatigue as a result of acute cholangitis after insertion of a tube stent into the right bile duct. The main tumor was present on the right side of S1 and spread to both sides of the bile duct. S1 lobe was swollen and diffuse intrahepatic invasion was noted in the right lobe and S1. The portal vein was completely obstructed at the porta hepatis with a coronary vein-left renal vein shunt. We immediately administered a high-dose hepatic arterialinfusion( 5-FU 1 g3 days: one day off 1 g3 days)(HDHAI)to the right hepatic artery using a transient catheter insertion method. After 2 courses of HDHAI, the intrahepatic invasion decreased. However, after 4 courses of HDHAI(2 on the right side and 2 on the left side), the invasion on the left side of the IVC had increased. We then chose radiation therapy. Subsequently, transient cystic changes were observed; however, 4 months after radiation, the invasion on the left side of the IVC had regrown into the cardia. The patient suffered from vomiting as a result of the narrowing of the esophagus. We chose HDHAI and dilation of the esophagus using a balloon. Finally, the invasion on the left side of the IVC and S1 swelling decreased, and she could eat again. Thirteen months later, she remains an outpatient. We recommend HDHAI and radiation therapy to hilar cholangiocellularcarcinoma even if the portal vein is completely obstructed.

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