Iwaki Kyoritsu General Hospital

Fukushima-shi, Japan

Iwaki Kyoritsu General Hospital

Fukushima-shi, Japan
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Sato H.,Iwaki Kyoritsu General Hospital
Journal of clinical and experimental hematopathology : JCEH | Year: 2015

We confirmed the characteristic clinical features of necrotizing lymphadenitis (NEL) in 66 cases (23 male, 43 female) in Japan, which included high fever (38-40°), painful cervical lymphadenopathy (62/66, 93.9%), and leukopenia (under 4,000/mm(3)) (25/53, 47.2%), without seasonal occurrence, in a clinicopathological, immunohistochemical, electron microscopic serological study. Patient age varied from 3-55 years, and 72.7% (44/66) of patients were younger than 30 years. Histopathology of NEL was characterized by the presence of CD8(+) immunoblasts, CD123(+) cells (plasmacytoid dendritic cells; PDCs), histiocytes and macrophages phagocytizing CD4(+) apoptotic lymphocytes, but no granulocytes or bacteria. The number of PDCs and CD8(+) cells in lesions tended to increase with time, and PDCs tended to be larger and irregular in the lesions compared with the non-lesion tissue of the lymph nodes. In addition, PDCs showed no temporal morphological change in the lymph nodes. The number of CD4(+) cells in the lymph node lesions sharply decreased from the 2nd to the 4th week, and then tended to increase; however, CD4(+) cells gradually decreased with time in non-lesion tissue. PDCs may produce interferon-α (IFN-α), which induces Mx1 expression. Strong Mx1 immunoreactivity is indicative of IFN-α production. IFN-α induces transformation of CD8(+) cells into immunoblasts, as well as phagocytosis of apoptotic cells derived from CD4(+) cells by macrophages. Thus, PDCs may play an important role with immune cells, including CD8(+) and CD4(+) cells, in necrotizing lymphadenitis.


Kimura T.,Kyoto University | Morimoto T.,Kinki University | Natsuaki M.,Kyoto University | Shiomi H.,Kyoto University | And 17 more authors.
Circulation | Year: 2012

Background-Several recent randomized trials comparing everolimus-eluting stent (EES) and sirolimus-eluting stent (SES) reported similar outcomes. However, only 1 trial was powered for a clinical end point, and no trial was powered for evaluating target-lesion revascularization. Methods and Results-Randomized Evaluation of Sirolimus-eluting versus Everolimus-eluting stent Trial is a prospective multicenter randomized open-label trial comparing EES with SES in Japan. The trial was powered for evaluating noninferiority of EES relative to SES in terms of target-lesion revascularization. From February and July 2010, 3197 patients were randomly assigned to receive either EES (1597 patients) or SES (1600 patients). At 1 year, the primary efficacy end point of target-lesion revascularization occurred in 65 patients (4.3%) in the EES group and in 76 patients (5.0%) in the SES group, demonstrating noninferiority of EES to SES (Pnoninferiority<0.0001, and Psuperiority=0.34). Cumulative incidence of definite stent thrombosis was low and similar between the 2 groups (0.32% versus 0.38%, P=0.77). An angiographic substudy enrolling 571 patients (EES, 285 patients and SES, 286 patients) demonstrated noninferiority of EES relative to SES regarding the primary angiographic end point of in-segment late loss (0.06±0.37 mm versus 0.02±0.46 mm, Pnoninferiority<0.0001, and Psuperiority=0.24) at 278±63 days after index stent implantation. Conclusions-One-year clinical and angiographic outcome after EES implantation was noninferior to and not different from that after SES implantation in a stable coronary artery disease population with relatively less complex coronary anatomy. One-year clinical outcome after both EES and SES use was excellent with a low rate of target-lesion revascularization and a very low rate of stent thrombosis. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035450. © 2012 American Heart Association, Inc.


Sano H.,Tohoku University | Mineta M.,Iwaki Kyoritsu General Hospital | Kita A.,Red Cross | Itoi E.,Tohoku University
Journal of Orthopaedic Science | Year: 2010

Background. Surgical treatment of massive rotator cuff tears is challenging for shoulder surgeons. The purpose of this study was to investigate both clinical outcomes and cuff integrity after tendon patch grafting using the long head of the biceps (LHB) tendon for irreparable massive rotator cuff tears. Methods. A short deltoid splitting approach was used to expose the torn cuff tendon stump. After tenodesis of the LHB tendon, its intraarticular portion was resected. If the size of the harvested tendon was smaller than that of the cuff defect, it was split into two layers. Then, the LHB tendon was sutured to the remnant cuff tendons and fi xed to the footprint using the transosseous suture technique. A total of 14 patients (12 men, 2 women; average age 64 years) underwent this procedure. The average postoperative follow-up period was 28 months (range 12-51 months). Active elevation angle of the shoulder as well as the Japanese Orthopaedic Association (JOA) score were assessed before surgery and at the time of follow-up. Postoperative cuff integrity was assessed using T2-weighted magnetic resonance imaging (MRI). Results. All cuff defects were successfully closed with this technique. Average active elevation angle improved from 69° to 149°. Total JOA score also improved from 54.7 points to 83.1 points. Thirteen shoulders showed no re-tearing on T2-weighted MRI; a minor discontinuity of the repaired cuff tendon was observed in the other shoulder. Conclusions. The LHB tendon is available in case tenodesis or tenotomy is needed. The resected tendon may be used as a graft for rotator cuff repair without any additional skin incision, which could reduce both the surgical invasion and the risk of infection. The LHB tendon patch grafting may be one of the useful options for surgical treatment of irreparable massive rotator cuff tears. © The Japanese Orthopaedic Assocation.


Shimodaira Y.,Tohoku University | Takahashi S.,Iwaki Kyoritsu General Hospital | Kinouchi Y.,Tohoku University | Endo K.,Tohoku University | And 4 more authors.
Biochemical and Biophysical Research Communications | Year: 2014

To explore the relationship between UPR and autophagy in intestinal epithelial cells, we investigated whether autophagy was induced by endoplasmic reticulum (ER) stress in colon cancer cell lines. We demonstrated that autophagy was induced by ER stress in HT29, SW480, and Caco-2 cells. In these cells, inositol-requiring enzyme1α (IRE1α) and C/EBP homologous protein (CHOP) were involved in the ER stress-autophagy pathway, and CHOP was a regulator of IRE1α protein expression. Our findings suggest that CHOP promotes IRE1α and autophagy especially in ER stress conditions. This study will provide important insights into the disclosure of the ER stress-autophagy pathway. © 2014 Elsevier Inc. All rights reserved.


Hidaka H.,Iwaki Kyoritsu General Hospital | Hidaka H.,Tohoku University | Kuriyama S.,Tohoku University | Yano H.,Tohoku University | And 2 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2011

Peritonsillar abscess (PTA) is conventionally considered to be a complication of acute tonsillitis, but no pathogenical association has been demonstrated. To investigate the precipitating factors in the pathogenesis of PTA, the clinical status of 117 patients with PTA and 78 patients with peritonsillar cellulitis (PC) were reviewed, comparing them with 188 cases of acute tonsillitis as a control group. The period between the onset of symptoms and the date of starting hospitalized medication was 4 to 5 days in all the three groups, with no significant differences. Higher prevalence of smoking habit was noted in the PTA group (odds ratio, 1.92; 95% confidence interval, 1.17-3.16). Bacteriological culture revealed that 55 of 67 aerobic isolates were Streptococcus subspecies, with the Streptococcus milleri group (SMG) as the most common (20 isolates). Twenty-three anaerobic species were isolated. Only 51% of the patients with neither the SMG nor anaerobic bacteria were smokers, whereas 90% of the patients with both the SMG and anaerobic bacteria were smokers.We hypothesize that delay or failure to receive medical care do not contribute to the pathogenesis of PTA or PC, and that smoking is positively correlated with the occurrence of PTA, as well as the bacteriological character. © Springer-Verlag 2010.


Kuroda M.,Japan National Institute of Infectious Diseases | Sekizuka T.,Japan National Institute of Infectious Diseases | Shinya F.,Iwaki Kyoritsu General Hospital | Takeuchi F.,Japan National Institute of Infectious Diseases | And 3 more authors.
Journal of Clinical Microbiology | Year: 2012

Deep sequencing detected a potential bioterrorism agent, Francisella tularensis, in a human abscess sample (Iwaki-08) of unknown etiology. Identified single-nucleotide variations suggest that the Iwaki-08 case was associated with Francisella tularensis subsp. holarctica (biovar japonica) but not the highly virulent type A (Francisella tularensis subsp. tularensis). Copyright © 2012, American Society for Microbiology. All Rights Reserved.


Asano S.,Iwaki Kyoritsu General Hospital
Journal of clinical and experimental hematopathology : JCEH | Year: 2012

In this review, representative types of granulomatous lymphadenitis (GLA) are described. GLA can be classified as noninfectious GLA and infectious GLA. Noninfectious GLA includes sarcoidosis and sarcoid-like reaction. The cause of sarcoidosis remains unknown, but it has good prognosis. Sarcoid-like reaction, which is considered to be a biological defense mechanism, is observed in regional lymph nodes with many underlying diseases. Infectious GLA can be classified as suppurative lymphadenitis (LA) and nonsuppurative LA. Suppurative LA generally shows follicular hyperplasia and sinus histiocytosis in the early phase. In tularemia and cat scratch disease, monocytoid B lymphocytes (MBLs) with T cells and macrophages contribute to the formation of granuloma. However, none of the epithelioid cell granulomas of Yersinia LA contains MBLs like in cat scratch disease. In addition, almost all have a central abscess in granulomas induced by Gram-negative bacteria. In terms of the lymph nodes, tularemia and cat scratch disease are apt to affect the axillary and cervical regions while Yersinia LA affects the mesenteric lymph node. Nonsuppurative LA includes tuberculosis and BCG-histiocytosis. These are induced by delayed allergic reaction of M. tuberculosis. Tuberculosis LA mainly appears in the cervical lymph node. Organisms are histologically detected by Ziehl-Neelsen staining in the necrotic area. Toxoplasmosis is also a nonsuppurative protozoan infection (Toxoplasma gondii). In toxoplasma LA, MBLs can also be seen, but round and organized, well-formed granulomas are not found in this disease. Furthermore, necrosis is not induced and there are no accompanying neutrophils, eosinophils and fibrosis. GLA described above is associated with characteristic histological findings. An accurate pathological diagnosis using the above findings can lead to precise treatment.


Ikemoto K.,Iwaki Kyoritsu General Hospital
African Journal of Psychiatry (South Africa) | Year: 2015

Brain bank is an indispensable research resource for pathophysiological studies of mental illnesses. In Japan, a national law for autopsy and dead body storage (1949) has been applied to manage brain bank, though this law is said to need some amendment for research use of human brain materials. In history of Japanese psychiatry, problems of Utsunomiya Hospital, which continued from 1960's and manifested in 1987, caused serious incredulity on psychiatric research and psychiatric medicine. There has been tremendous illegality including autopsy performed by "no" autopsy-qualified individuals such as nurses in Utsunomiya Hospital. In 1987, the Law of Mental Health was amended in Japan in order to protect patients' human right. Recently, following the Great East Japan Earthquake and nuclear disaster in 2011, Fukushima Psychiatric Brain bank, established in 1997, continued its activity in spite of lacking an autopsy-qualified researcher among them. This illegality has been concealed for approximately 2 years. Some problems of human right which have been infringed by brain researchers of psychiatric brain bank and of post-mortem brain studies of psychiatric illnesses in Japan are described. © 2015 Ikemoto K.


Ikemoto K.,Iwaki Kyoritsu General Hospital
African Journal of Psychiatry (South Africa) | Year: 2015

Brain bank is an indispensable research resource for pathophysiological studies of mental illnesses. In Japan, a national law for autopsy and dead body storage has been applied to manage brain bank, though this law is said to need some amendment for research use of human brain materials. In history of Japanese psychiatry, problems of Utsunomiya Hospital, manifested in 1987, caused serious loss of credit on psychiatric research and psychiatric medicine. It was reported that autopsy had been done by no autopsy-qualified individuals for example nurses in Utsunomiya Hospital. Recently, following the Great East Japan Earthquake and nuclear disaster, Fukushima Psychiatric Brain bank, established in 1997, has continued its activity in spite of lacking an autopsy-qualified researcher among them. This illegality has been concealed for approximately 2 years. Some problems which have disturbed development of psychiatric brain bank and post-mortem brain studies of psychiatric illnesses in Japan were discussed. © 2015 Ikemoto K.


Ikemoto K.,Iwaki Kyoritsu General Hospital
African Journal of Psychiatry (South Africa) | Year: 2015

Brain bank is an indispensable research resource for pathophysiological studies of mental illnesses. In Japan, a national law for autopsy and dead body storage has been applied to manage brain bank, though this law is said to need some amendment for research use of human brain materials. In history of Japanese psychiatry, problems of Utsunomiya Hospital, manifested in 1987, caused serious loss of credit on psychiatric research and psychiatric medicine. It was reported that autopsy had been done by no autopsy-qualified individuals for example nurses in Utsunomiya Hospital. Recently, following the Great East Japan Earthquake and nuclear disaster, Fukushima Psychiatric Brain bank, established in 1997, has continued its activity in spite of lacking an autopsy-qualified researcher among them. This illegality has been concealed for approximately 2 years. Some problems which have disturbed development of psychiatric brain bank and post-mortem brain studies of psychiatric illnesses in Japan were discussed. © 2015 Ikemoto K.

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