Time filter

Source Type

Kakogawa, Japan

Hisamatsu C.,Kobe University | Okata Y.,Kobe University | Zaima A.,Red Cross | Yasufuku M.,Kakogawa West City Hospital | And 3 more authors.
Pediatric Surgery International | Year: 2012

Purpose: The innominate artery sometimes compresses the trachea, leading to tracheomalacia and highly fatal tracheoinnominate fistula in patients with severe chest deformity. This study is focused on the indication of innominate artery transection for the definitive treatment of these complications. Patients and methods: We retrospectively analyzed the medical records of eight patients who underwent transection of innominate artery. Results: All patients had developed severe chest deformity and their symptoms were life-threatening anoxic spell or endotracheal hemorrhage. Bronchoscopy showed tracheomalacia with or without pulsatile granulations on the anterior wall of the trachea underlying the innominate artery. In six cases who had previously undergone tracheostomy or laryngotracheal separation, the tracheal tube tip made granulations or tracheoinnominate fistulas. In addition to transection of innominate artery, the tracheoinnominate fistula was closed in two cases and the artery was transposed in one. All patients survived without neurologic complications and airway symptoms postoperatively. Conclusions: For patients with severe chest deformity, innominate artery transection is indicated when they have tracheal compression by the artery and need to be intubated through the compressed part of trachea to secure the airway. This would be the best timing to schedule the prophylactic operation. © Springer-Verlag 2012. Source

Yamada Y.,West Dermatology | Kitagawa C.,West Dermatology | Kamioka I.,Kakogawa West City Hospital | Chen K.-R.,Tokyo Saiseikai Central Hospital | Oka M.,Kobe University
Dermatology Online Journal | Year: 2013

A case of a 7-year-old girl with microscopic polyangiitis (MPA) with a skin eruption characterized by maculopapular, erythematous and purpuric lesions on the face, elbows, and knees is presented. Anti-neutrophil cytoplasmic autoantibodies (ANCA) with myeloperoxidase specificity (MPO-ANCA) were identified. Chest X-ray and computed tomography scan revealed diffuse infiltrates in both lung fields, suggesting alveolar hemorrhage. Microscopic hematuria was detected but a renal biopsy showed no abnormalities. Histological examination of a skin biopsy from a purpuric papule showed leukocytoclastic vasculitis of the small vessels in the entire dermis. The patient was treated with prednisolone and mizoribine, resulting in an improvement in the skin lesions except for those on the knee. © 2013 by the article author(s). Source

Mitsutsuji M.,National Hospital Organization Kobe Medical Center | Okamura A.,Kakogawa West City Hospital
Journal of Japanese Society of Gastroenterology | Year: 2011

A 71-year-old woman was found in gastroendoscopic examination to have a type 2 tumor at the posterior wall of the stomach with two type 0-IIa early adenocarcinomas at the lesser curvature and anterior wall. She underwent distal gastrectomy. Pathological evaluation of the type 2 tumor was mixed adenoneuroendocrine carcinoma and that of two type 0-IIa tumors were well differentiated tubular adenocarcinomas. The solitary metastasis was found in liver S8 on 15th month though S-1 was taken after the operation. Partial resection of the liver was performed, and its histological findings were similar to the mixed adenoneuroendocrine carcinoma of the stomach. After adjuvant chemotherapy with S-1 + CPT-11 during half a year, S-1 single therapy was done for 16 months, and there is no evidence of recurrence for 28 months after liver resection. Source

Nakajima T.,Hyogo Prefectural Kaibara Hospital | Okamura A.,Kakogawa West City Hospital
Journal of Japanese Society of Gastroenterology | Year: 2012

A 77-year-old woman was referred to our hospital because of right-back pain. Dynamic computed to-mography (CT) studies showed a huge tumor in the right lobe of the liver. After admission, transcatheter arterial embolization (TAE) was immediately performed because of the risk of rupture. The tumor, however, was hypovascular and we judged that the procedure had no effect on preventing rupture. Therefore, based on a diagnosis of cystadenocarcinoma or cholangiocarcinoma, we conducted right trisegmentectomy and caudate lobectomy in July 2010. The definitive pathological diagnosis was intrahepatic cholangiocarcinosarcoma. The postoperative course was uneventful, and the patient was discharged on postoperative day (POD) 17. Afterwards, despite chemotherapy treatment, a local recurrence on the right diaphragm was detected 2 months postoperatively, and she died 4 months postoperatively. Intrahepatic cholangiocarcinosarcoma is very rare. We report this case with a review of some relevant literature. Source

Okajima H.,Nishi Kobe Medical Center | Tanaka O.,Nishi Kobe Medical Center | Ushio M.,Kakogawa West City Hospital | Higuchi Y.,Nishi Kobe Medical Center | And 4 more authors.
Journal of Anesthesia | Year: 2015

Purpose: Both paravertebral block (PVB) and thoracic epidural block (TEB) are recommended for postoperative pain relief after lung surgery. The addition of fentanyl to the anesthetic solution became popular for TEB because of the stronger effects; however, there have been few comparable trials about the addition of fentanyl to PVB. The purpose of this study was thus to compare postoperative analgesia, side effects, and complications between ultrasound-guided PVB (USG-PVB) and TEB with the addition of fentanyl to ropivacaine after lung surgery. Methods: We examined 90 consecutive patients (age 18–75 years) scheduled for video-assisted thoracic surgery (VATS). In both groups, all blocks (four blocks in USG-PVB and one block in TEB) and one catheter insertion were performed preoperatively. Continuous postoperative infusion (0.1 % ropivacaine plus fentanyl at 0.4 mg/day) was undertaken for 36 h in both groups. The recorded data included the verbal rating scale (VRS) for pain, blood pressure, side effects, complications for 2 days, and overall satisfaction score. Results: There was no difference in the frequency of taking supplemental analgesics (twice or more frequently), or in VRS. Hypotension occurred significantly more frequently in TEB (n = 7/33) than in PVB (n = 1/36) (P = 0.02); on the other hand, the incidences of PONV and pruritus, as well as overall satisfaction score, were similar. There were no complications in both groups; however, the catheters migrated intrathoracically in four patients in PVB. Conclusion: USG-PVB achieved similar pain relief and lowered the incidence of hypotension compared with TEB. We conclude that both blocks with the same concentration of ropivacaine and fentanyl can provide adequate postoperative analgesia for VATS. © 2014, Japanese Society of Anesthesiologists. Source

Discover hidden collaborations