Iwata City Hospital

Iwata, Japan

Iwata City Hospital

Iwata, Japan
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Matsumoto R.,Hamamatsu University School of Medicine | Otsuka A.,Hamamatsu University School of Medicine | Suzuki T.,Hamamatsu University School of Medicine | Shinbo H.,Enshu Hospital | And 4 more authors.
International Journal of Urology | Year: 2013

Objectives: To investigate the presence of β-adrenoceptor subtypes in the human ureter, and to examine whether β3-adrenoceptors modulate relaxation of the human ureter. Methods: Expression of messenger ribonucleic acid of β-adrenoceptors in the human ureter was determined by reverse transcription polymerase chain reaction, and distribution of β-adrenoceptors was examined by immunohistochemistry. In functional studies, the relaxant effects of isoproterenol, procaterol, TRK-380, salbutamol and BRL 37344 on KCl-induced contraction of the human ureter were evaluated, and the inhibitory effects of isoproterenol, procaterol and TRK-380 on electrical field stimulation-induced contractions were determined. Results: Expression of β1-, β2- and β3-adrenoceptor messenger ribonucleic acid in the human ureter was confirmed by reverse transcription polymerase chain reaction. Positive staining for β1-, β2- and β3-adrenoceptor was identified not only in smooth muscle, but also in the urothelium of the human ureter. All β-adrenoceptor agonists decreased the tone of KCl-induced contractions of the human ureter with a rank order of relaxant effects of isoproterenol>procaterol>TRK-380>salbutamol>BRL 37344. Furthermore, isoproterenol, procaterol and TRK-380 significantly decreased the amplitude of electrical field stimulation-induced contractions with a rank order of inhibitory effects of isoproterenol>procaterol>TRK-380. Conclusions: Human ureteral relaxation is mediated by both β2- and β3-adrenoceptor stimulation. β3-Adrenoceptor agonists have the potential to relax the human ureter, and their clinical application in the treatment of ureteral stones is expected. © 2013 The Japanese Urological Association.

The large prospective studies of osteoporotic fracture in Europe and the United States have confirmed the utility of calcaneal QUS to predict fracture risk in elderly people. The other side, QUS has unfortunately only a few evidence concerning about usefulness as osteoporosis diagnostic tool in recent reports. For the present, QUS should be used as risk assessment tool of osteoporotic fracture. Because various ultrasound parameters depending on the manufacture are defined, the standardization of these values should be achieved. A large number of normative data have been collect to re-calculate to standardize SOS by the committee of Japan Osteoporosis Society, and age-related change of the standardized Speed of Sound (S-SOS) has been already reported. In this report, the peak value of S-SOS is seen in teenager, and mean of S-SOS in each age are gradually decrease in life. This age related change indicates that fracture risk would be gradually increase in life.

Yamazaki K.,Iwata City Hospital
Clinical calcium | Year: 2013

Previous studies have demonstrated close associations between QUS parameters and osteoporotic status. However, due to the ambiguities in assessing accuracy of QUS and the moderate correlation of DXA and QUS results, currently there is no agreement on how results of QUS devices should be interpreted in order to diagnose osteoporosis. However, I could recommend for clinical application that QUS should be used as the predictor of the risk of osteoporotic fractures. Good portability and low cost of QUS technique might make QUS an attractive technology for assessing risk of fractures in large populations.

Konishi T.,Hamamatsu University School of Medicine | Kono S.,Hamamatsu University School of Medicine | Fujimoto M.,Iwata City Hospital | Terada T.,Hamamatsu University School of Medicine | And 3 more authors.
Journal of Neurology | Year: 2013

Mutations in the NKX2.1 gene, which is essential for the development, differentiation and organization of the basal ganglia, cause benign hereditary chorea (BHC) characterized by childhood-onset non-progressive chorea. We herein report the clinical features of six patients from a single family with a novel intronic mutation and present the dopaminergic neuronal imaging by using positron emission tomography (PET) imaging to assess the integrity of the striatal dopaminergic system using [11C]-CFT for the presynaptic dopamine transporter function and [11C]-raclopride for the postsynaptic D2 receptor function. The patients showed mild generalized chorea without either congenital hypothyroidism or a history of pulmonary infection and some of the patients had goiter. Genetic analyses of NKX2.1 gene showed a novel heterozygous c.464-9C>A mutation that created a new acceptor splice site resulting in the production of an aberrant transcript with a 7-bp insertion identical to a intronic sequence of genomic DNA. Oral levodopa failed to improve the involuntary movement, while haloperidol, a dopamine D2 receptor blocking agent, exacerbated the choric movement in a single patient. The dopaminergic PET studies in the two patients revealed decreased raclopride binding in the striatum, while the CFT binding was not altered. The impairment of D2 receptor function in the basal ganglia may result in exacerbation of the chorea induced by haloperidol. The molecular brain imaging and therapeutic response may help elucidate the pathophysiological mechanism of the motor control in the BHC-associated NKX2.1 mutation. © 2012 Springer-Verlag.

Suzuki A.,Hamamatsu University School of Medicine | Sakaguchi T.,Hamamatsu University School of Medicine | Inaba K.,Hamamatsu University School of Medicine | Suzuki S.,Iwata City Hospital | Konno H.,Hamamatsu University School of Medicine
Journal of Surgical Research | Year: 2012

Background: The number of elderly patients with hepatobiliary malignancies has increased with the steady growth of elderly population. However, the safety of major hepatectomy for elderly patients remains controversial. This study investigated the effect of aging on the hepatic regenerative response after partial resection of livers subjected to ischemic insult. Methods: Two-thirds hepatectomy following 1-h hepatic ischemia was performed in young (12-wk-old) and old (18-mo-old) rats under portosystemic shunt establishment by subcutaneous transposition of the spleen. Results: The survival rate 48 h after hepatectomy of the old rats was significantly lower (20%) than that of the young rats (53%), whereas all animals without hepatic ischemia were alive at 48 h. Hepatic necrosis and hepatocyte apoptosis during the early post-hepatectomy phase were more severe in the aged livers, which also showed delayed Akt activation. Liver mass restoration was significantly retarded in the old rats, despite higher plasma IL-6 levels, rapid and prolonged activation of hepatic STAT3, and increased hepatocyte nuclear cyclin D1 levels. In the young livers, cyclin E, which is essential for G1/S transition, and cyclin A, a marker of S phase, were observed in the nucleus from 24 h, reaching peaks 48 h after hepatectomy. In contrast, the old livers showed greatly delayed and decreased nuclear cyclin E and cyclin A levels. Conclusion: Age-related reductions in the regenerative ability of ischemically damaged livers may be caused by cell cycle disruption at either the late G1 phase or the G1/S transition, despite increased cyclin D1 levels and compensatory IL-6/STAT3 activation. © 2012 Elsevier Inc. All rights reserved.

Shimizu K.,Iwata City Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 56-year-old woman admitted to our hospital because of injury by a road accident. A chest X-ray film and computed tomography (CT) scan showed multiple left rib fractures, hemothorax in the left pleural cavity, and obscurity of the left diaphragm. The stomach and injured spleen were also shown to shift to the left thoracic cavity. The patient was diagnosed as having diaphragmatic rupture with hemothorax in the left pleural cavity due to splenic injury. Emergent surgery was performed and massive bleeding was observed in the thoracic and abdominal cavities. After performing splenectomy and replacing the stomach in the abdominal cavity, the diaphragm was repaired. The patient was discharged 66 days after the surgery. Since traumatic diaphragm rupture can lead to hemorrhagic shock associated with injuries to adjacent organs, it is important to establish an accurate diagnosis and to performed appropriate surgical treatment without delay.

Fukasawa H.,Iwata City Hospital
European Journal of Clinical Nutrition | Year: 2016

Background/Objectives:Higher body mass index appears protective in hemodialysis patients, although it remains to be determined which component of muscle or fat mass is primarily associated with this survival advantage.Subjects/Methods:Eighty-one hemodialysis patients in our institution were prospectively followed from July 2011 to August 2015. Muscle and fat mass were evaluated by measuring the cross-sectional areas of the thigh and abdomen using computed tomography. The relationship between muscle and fat mass, and all-cause and cardiovascular mortality was studied using the Kaplan–Meier analyses and multivariate Cox proportional hazard models.Results:During more than 4 years of follow-up, 26 patients (32%) died. In the Kaplan–Meier curve analyses, lower thigh muscle mass was significantly associated with all-cause and cardiovascular mortality (log-rank test, P<0.01 and P<0.001, respectively), but there was no such association with thigh fat, abdominal muscle and fat mass levels. In multivariate Cox proportional hazard models, each 0.1 cm2/kg increase in the thigh muscle area adjusted by dry weight was associated with an estimated 22% lower risk of all-cause mortality (95% confidence interval (95% CI), 0.64–0.95, P<0.05) and a 30% lower risk of cardiovascular mortality (95% CI, 0.54–0.90, P<0.01).Conclusions:Lower thigh muscle mass is significantly associated with all-cause and cardiovascular mortality in hemodialysis patients. Our findings indicate the importance of focusing on the muscle mass of lower extremities to predict the clinical outcomes of hemodialysis patients.European Journal of Clinical Nutrition advance online publication, 19 October 2016; doi:10.1038/ejcn.2016.186. © 2016 Macmillan Publishers Limited, part of Springer Nature.

Suzuki S.,Kanazawa University | Suzuki S.,Iwata City Hospital | Dobashi Y.,Jichi Medical University | Minato H.,Kanazawa Medical University | And 3 more authors.
Virchows Archiv | Year: 2012

Salivary gland carcinomas encompass a wide spectrum of histological entities. To identify candidate therapeutic targets and innovative treatment options for these carcinomas, we examined epidermal growth factor receptor (EGFR), phosphorylated EGFR (p-EGFR), HER2, and phosphorylated forms of Akt (p-Akt) and mammalian target of rapamycin (p-mTOR) in 47 salivary gland tumors using immunohistochemistry. EGFR overexpression was found in 51 % of the tumors (24/47); in particular, EGFR overexpression occurred in mucoepidermoid (seven out of seven) and salivary duct carcinomas (9/12). Although EGFR amplification was not detected by fluorescence in situ hybridization analysis, increased copy number due to polysomy of chromosome 7, which houses EGFR, was observed in 4 of the 24 tumors with EGFR overexpression; this polysomy occurred most frequently in salivary duct carcinomas (three out of nine). HER2 overexpression was observed in 21 % (10/47) of all tumors; in these 10 tumors, HER2 gene amplification was found in seven cases. p-Akt was found in 51 % (24/47) of all tumors, most frequently in mucoepidermoid carcinomas (six out of seven). p-mTOR was found in 57 % of the latter (four out of seven). Consequently, different signaling cascades were found activated: (1) an EGFR/HER2(-Akt)-mTOR-dependent axis, with gene gains of HER2 and/or EGFR, activated in salivary duct carcinoma and carcinoma ex pleomorphic adenoma; (2) an EGFR(-Akt)-mTOR-dependent pathway activated in mucoepidermoid carcinoma or acinic cell carcinoma, without HER2 or EGFR gene alterations; and (3) an Aktdependent pathway without EGFR/HER2 activation in other types. These findings indicate that phosphoprotein mapping of components in the EGFR/HER2-Akt-mTOR pathways may be a useful guide to select appropriate targeting regimens. © Springer-Verlag 2012.

Fukasawa H.,Iwata City Hospital
Clinical and Experimental Nephrology | Year: 2012

Proteins in mammalian cells are continually being degraded and synthesized. Protein degradation via the ubiquitin-proteasome system (UPS) is the major pathway for non-lysosomal proteolysis of intracellular proteins and plays important roles in a variety of fundamental cellular processes such as regulation of cell cycle progression, differentiation, apoptosis, sodium channel function, and modulation of inflammatory responses. The central element of this system is the covalent linkage of ubiquitins to targeted proteins, which are then recognized by the 26S proteasome composed of adenosine triphosphate- dependent, multi-catalytic proteases. Damaged or misfolded proteins, as well as regulatory proteins that control many critical cellular functions, are among the targets of this degradation process. Consequently, aberration of the system leads to dysregulation of cellular homeostasis and development of many diseases. Based on the findings, it is not surprising that abnormalities of the system are also associated with the pathogenesis of kidney diseases. In this review, I discuss (1) the basic mechanism of the UPS, and (2) the association between the pathogenesis of kidney diseases and the UPS. Diverse roles of the UPS are implicated in the development of kidney diseases, and further studies on this system may reveal new strategies for overcoming kidney diseases. © 2012 Japanese Society of Nephrology.

Shimozato T.,Iwata City Hospital | Okudaira K.,Nagoya University | Fuse H.,University of Tsukuba | Tabushi K.,Nagoya University
Physica Medica | Year: 2013

External electron radiotherapy is performed using a cone or applicator to collimate the beam. However, because of a trade-off between collimation and scattering/bremsstrahlung X-ray production, applicators generate a small amount of secondary radiation (leakage). We investigate the peripheral dose outside the radiation field of a Varian-type applicator. The dose and fluence outside the radiation field were analyzed in a detailed Monte Carlo simulation. The differences between the calculation results and data measured in a water phantom in an ionization chamber were less than ±1% in regions more than 3 mm below the surface of the phantom and at the depth of dose maximum. The calculated fluence was analyzed inside and outside the radiation field on a plane just above the water phantom surface. Changing the electron energy affected the off-axis fluence distribution outside the radiation field; however, the size of the applicator had little effect on this distribution. For each energy, the distributions outside the radiation field were similar to the dose distribution at shallow depths in the water phantom. The effect of secondary electrons generation by photon transmission through the alloy making up the lowest scraper was largest in the region from the field edge to directly below the cutout and at higher beam energies. The results of the Monte Carlo simulation confirm that the peripheral dose outside the field is significantly affected by radiation scattered or transmitted from the applicator, and the effect increases with the electron energy. © 2012 Associazione Italiana di Fisica Medica.

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