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Kagoshima-shi, Japan

Yamada K.,Kumamoto University | Shiraishi S.-Y.,Kumamoto University | Hamasaki T.,Kagoshima Medical Center | Kuratsu J.-I.,Kumamoto University
Acta Neurochirurgica | Year: 2010

Background 123I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for differentiating idiopathic Parkinson's disease (PD) from other parkinsonian syndromes, but its prognostic value in PD has not been established. The objective of this study was to clarify the correlation between cardiac MIBG uptake parameters and the outcome in PD patients subjected to the subthalamic nucleus stimulation. Method We enrolled 31 consecutive PD patients and calculated the heart-to-mediastinum ratio (H/M) and washout rate (WR) based on the activity measured at 15 min (early phase) and 3 h (delayed phase) after the intravenous injection of MIBG (111 MBq). Cardinal motor symptoms and activity of daily living (ADL) were assessed on the Unified Parkinson's Disease Rating Scale (UPDRS) and Schwab and England (S-E) ADL scale, before and 3 months after surgery. Findings Neither early nor delayed H/M correlated with any of the preoperative subscores on the UPDRS or S-E, nor with postoperative outcome. On the other hand, increased WR was a positive predictor for postoperative improvement rate on S-E in medication-off state (p=0.00003). Also, WR showed a more faint but significant correlation with preoperative levodopa responsiveness on S-E (p=0.008). Conclusion Our findings suggest that 123I-MIBG scintigraphy in combination with levodopa-responsiveness evaluation may represent a useful tool for prediction of outcomes in patients subjected to STN stimulation. © Springer-Verlag 2010. Source


Yonezawa K.,Hakodate National Hospital | Fuse J.,Tokyo Medical Center | Shimizu N.,Tokyo Metropolitan Childrens Medical Center | Hayashi T.,Osaka Medical College | And 7 more authors.
Circulation Journal | Year: 2011

Background: In-hospital cardiopulmonary arrest (CPA) is an important issue, but data in Japan are limited. Methods and Results: To investigate in-hospital CPA, we conducted a prospective multicenter observational registry of in-hospital CPA and resuscitation in Japan (J-RCPR). During January 2008 to December 2009, patients were registered from 12 participating hospitals. All patients, visitors and employees within the facility campus who experience a cardiopulmonary resuscitation event defined as either a pulseless or a pulse with inadequate perfusion requiring chest compressions and/or defibrillation of ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) were registered. Data were collected in 6 major categories of variables: facility data, patient demographic data, pre-event data, event data, outcome data, and quality improvement data. Data for 491 adults were analyzed. The prevalence of pulseless VT/VF as first documented rhythm was 28.1%, asystole was 29.5% and pulseless electrical activity was 41.1%. Immediate causes of event were arrhythmia 30.6%, acute respiratory insufficiency 26.7%, and hypotension 15.7%. Return of spontaneous circulation was 64.7%; the proportion of survival 24 h after CPA was 49.8%, the proportion of survival to hospital discharge was 27.8% and proportion of favorable neurological outcome at 30 days was 21.4%. Conclusions: This is the first report of the registry for in-hospital CPA in Japan and shows that the registry provides important observational data. Source


Yoshinaga M.,Kagoshima Medical Center | Ushinohama H.,Medical Center for Infectious Diseases | Sato S.,Niigata City General Hospital | Tauchi N.,Aichi Saiseikai Rehabilitation Hospital | And 8 more authors.
Circulation: Arrhythmia and Electrophysiology | Year: 2013

Background: Neonatal electrocardiographic screening is used to screen infants with prolonged QT intervals, as previously shown in whites. However, this procedure needs to be confirmed in other ethnic groups. Methods and Results: In 8 areas in Japan, an ECG was recorded in 4285 infants at 1-month medical checkup. A prospective study showed that a provisional criterion of QTc ≥470 ms was appropriate for infants. To assess the validity of the criterion, all infants with a QTc between 460 and 470 ms were followed up. Five infants had a QTc ≥470 ms. Four infants were diagnosed with prolonged QT intervals from follow-up ECGs. Four infants showed no symptoms and did not have a family history of long-QT syndrome. Two infants showed progressive prolongation of QT intervals, and medication was started. Genetic testing was performed in 3 of 4 infants with prolonged QT intervals, and it revealed a KCNH2 mutation (3065 delT, L1021fs+34X) in 1 infant. One infant with a QTc ≥470 ms and 2 infants with a QTc between 460 and 470 ms showed a decline in their QTc values during follow-up. The study screened another infant with Wolff-Parkinson-White syndrome who was diagnosed with noncompaction before symptoms appeared. Conclusions: Neonatal electrocardiographic screening can identify infants likely to be affected by long-QT syndrome in the Japanese population, as already shown in whites. This screening may also be useful in identifying other important cardiac diseases. © 2013 American Heart Association, Inc. Source


Kubo S.,Osaka City University | Nakanuma Y.,Kanazawa University | Takemura S.,Osaka City University | Sakata C.,Osaka City University | And 24 more authors.
Journal of Hepato-Biliary-Pancreatic Sciences | Year: 2014

Background An outbreak of cholangiocarcinoma occurred among workers in the offset color proof-printing department at a printing company in Japan. The aim of this study was to clarify the characteristics of the patients with cholangiocarcinoma. Methods This was a retrospective study conducted in 13 Japanese hospitals between 1996 to 2013. The clinicopathological findings of cholangiocarcinoma developed in 17 of 111 former or current workers in the department were investigated. Most workers were relatively young. Results The cholangiocarcinoma was diagnosed at 25-45 years old. They were exposed to chemicals, including dichloromethane and 1,2-dichloropropane. The serum γ-glutamyl transpeptidase activity was elevated in all patients. Dilated intrahepatic bile ducts without tumor-induced obstruction were observed in five patients. The cholangiocarcinomas arose from the large bile ducts. The precancerous or early cancerous lesions, such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile ducts, as well as non-specific bile duct injuries, such as fibrosis, were observed in various sites of the bile ducts in all eight patients for whom operative specimens were available. Conclusions The present results showed that cholangiocarcinomas occurred at a high incidence in relatively young workers of a printing company, who were exposed to chemicals including chlorinated organic solvents. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery. Source


Hamasaki T.,Kagoshima Medical Center | Imamura J.-I.,Kagoshima Medical Center | Kawai H.,Kagoshima Medical Center | Kuratsu J.-I.,Kumamoto University
Journal of Clinical Neuroscience | Year: 2012

We used a computational strategy, in vivo morphometry, to evaluate structural magnetic resonance (MR) images to investigate individual variations in the location of the central sulcus (CS). To locate the CS we identified six key points on individual brain images obtained from 40 normal subjects and measured the distances between these points along the brain circumference. We also analyzed the difference between the actual location of the CS and the location predicted by conventional estimation methods. Individual variation exceeded 2.7 cm for all measurements used to identify the location of the CS. The margin of error was approximately 2.7 cm even when the location of the CS was predicted by reported and commonly used methods. A "1 inch error" should be taken into consideration when the prediction relies solely on head circumference and surface measurements. Our results point to the importance of pre-surgical planning using individual brain images for each patient. © 2011 Elsevier Ltd. All rights reserved. Source

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