Kanazawa Municipal Hospital
Kanazawa Municipal Hospital
Minamide H.,Ishikawa Prefectural Central Hospital |
Minamide H.,Kanazawa Municipal Hospital |
Hayashi Y.,Ishikawa Prefectural Central Hospital |
Uchiyama N.,Kanazawa University
Neurological Surgery | Year: 2017
A 58-year-old man presented with slowly progressive chemosis. exophthalmos, and blepharedema of the left eye. Digital subtraction angiography revealed multiple dural arteriovenous fistulas (dAVFs) involving the bilateral tentorium, superior sagittal sinus, and right frontal convexity. In addition, occlusion of the left cavernous sinus and left sigmoid sinus were observed, which could lead to venous hypertension and might be associated with the occurrence of multiple dAVFs. Along with the congestion of the left ophthalmic vein, increased intracranial pressure due to the left tentorial dAVF with cortical venous reflux could have caused the left eye symptoms I therefore, the tentorial lesion was treated first. Although the proximal occlusion of the vein of Labbe. drainer of the left tentorial dAVF. was achieved after embolization using n-butyl cyanoacrylate via the external carotid artery, an arteriovenous shunt between the middle cerebral artery and the distal site of the vein of Labbe was newly visualized after embolization. The newly visualized lesion was treated with further surgical intervention. A pial AVF arising from several peripheral branches of the left middle cerebral artery with drainage into the distal site of the vein of Labbe was confirmed during the surgery, and interruption of the vein of Labbe was performed. The left eye symptoms of the patient significantly improved after the surgery, and postoperative angiogram revealed no residual shunt. Thus, the patient was treated using a combined approach of endovascular and direct surgeries, after which he recovered uneventfully.
Kumahata K.,Japan Advanced Institute of Science and Technology |
Mori F.,Japan Advanced Institute of Science and Technology |
Ishikawa S.,Kanazawa Municipal Hospital |
Matsuzawa T.,Japan Advanced Institute of Science and Technology
Journal of Biomechanical Science and Engineering | Year: 2010
The nasal cavity performs several important functions for the inhaled air, such as temperature and humidity adjustments. Although it is necessary to obtain velocity, temperature, and humidity distributions during inhalation in order to understand the nasal cavity's functions, it is difficult to measure them noninvasively in the nasal cavity. Therefore, we have continued to study nasal flow simulation with heat and humidity transport. In such a simulation, the governing equations include a continuum equation and the equations describing momentum, energy, and water transport. The temperature and humidity of the inhaled air are adjusted by heat and water exchange on the nasal cavity wall's surface. Therefore, in the simulation, these roles of the wall in the energy and water transport equations were included as the boundary conditions. Although in related studies of nasal flow simulation with heat and humidity transport, the nasal cavity wall's surface temperature and humidity were constant, here they were treated as degrees of using Newton's cooling law. A flow including temperature and humidity in a realistic human nasal cavity shape was simulated. The simulation results agreed well with the measurements reported by Keck at al. Therefore, this study concludes that our model can simulate the heat and humidity exchange occurring in the nasal cavity. In addition, it was found that the temperature and humidity adjustment functions worked effectively in the front and narrow regions of the nasal cavity. © 2010 by JSME.
PubMed | Red Cross, Gifu University, Kanazawa Municipal Hospital, University of Tsukuba and 4 more.
Type: | Journal: Journal of autoimmunity | Year: 2016
To identify and characterize a novel connective tissue disease (CTD)-related autoantibody (autoAb) directed against scaffold attachment factor B (SAFB).AutoAb specificity was analyzed using RNA and protein-immunoprecipitation assays. Autoimmune targets were affinity purified using patients sera and subjected to liquid chromatography mass spectrometry.By immunoprecipitation assay, 10 sera reacted with a protein with a molecular weight of approximately 160kDa. Liquid chromatography mass spectrometry of the partially purified autoantigen and additional immunoblot-based analyses revealed that the Ab specifically recognized SAFB. Anti-SAFB Abs were detected in 2 of 646 patients with systemic sclerosis (SSc) (0.3%), 1 of 1570 patients with polymyositis/dermatomyositis (0.06%), 4 of 270 patients with interstitial lung disease (ILD) (1.5%), 1 of 43 patients with overlap syndrome (2.3%) and 2 patients with other diseases including primary Raynauds disease and eosinophilic pneumonia. Five patients with anti-SAFB Abs had Raynauds phenomenon and 3 had nail fold punctate hemorrhage. Of note, 8 of the 10 patients (80%) suffered from ILD. None of the patients with anti-SAFB Abs had pulmonary arterial hypertension, heart disease, or renal involvement.Anti-SAFB Ab is a novel CTD-related autoAb possibly associated with ILD.
Takato H.,Kanazawa University |
Waseda Y.,Kanazawa University |
Watanabe S.,Kanazawa University |
Inuzuka K.,Kanazawa University |
And 4 more authors.
Respiratory Medicine | Year: 2013
Background: Autoantibodies against aminoacyl-tRNA synthetases (ARS) have been found to be highly specific for polymyositis and dermatomyositis (PM/DM) and to correlate strongly with complicating interstitial pneumonia (IP). The aim of the present study was to compare the clinical presentations of anti-ARS antibody-positive IP patients with or without manifestations of PM/DM. Methods: We retrospectively examined 36 IP patients with anti-ARS antibodies. Sixteen patients presented with and 20 without the features of PM/DM. They were divided into PM/DM-IP and idiopathic-IP (IIP) groups. Clinical symptoms, findings on physical examination, laboratory data, pulmonary function, computed tomography (CT), and bronchoalveolar lavage fluid (BALF) cell counts were compared. Results: Skin findings, myalgia, and elevation of serum creatinine kinase were found in the PM/DM-IP group. Features common to both groups included: volume loss in lower bilateral lobes; ground-glass opacities, reticular shadows and traction bronchiectasis on chest CT; high percentage of lymphocytes (IIP: 44.0% ± 21.0% (mean ± SD), PM/DM-IP: 50.5% ± 23.5%) and low CD4/8 ratios (IIP: 0.36 ± 0.34, PM/DM-IP: 0.44 ± 0.42) in BALF; decreased pulmonary function, including percentage of predicted vital capacity (VC) (IIP: 80.1% ± 15.4%, PM/DM-IP: 73.6% ± 16.4%), residual volume (RV) (IIP: 70.7% ± 21.7%, PM/DM-IP: 71.5% ± 17.1%), total lung capacity (TLC) (IIP: 73.4% ± 13.6%, PM/DM-IP: 71.6% ± 13.0%), and diffusing capacity DLco (IIP: 57.5% ± 26.7%, PM/DM-IP: 46.4% ± 10.3%). Both groups achieved good responses to initial corticosteroid or immunosuppressant therapy. Conclusion: Patients with anti-ARS antibody-positive IP have common pulmonary manifestations regardless of the presence of PM/DM. © 2012 Published by Elsevier Ltd.
Yasui M.,Kanazawa Municipal Hospital
Japanese Journal of Chest Diseases | Year: 2015
Clinical features of patients with anti-aminoacyl-tRNA synthetase-positive interstitial pneumonia are as follows: nonproductive cough; elevated levels of serum KL-6, surfactant protein-D, and surfactant pro-tein-A; decrease in vital capacity, total lung capacity, residual volume, and diffusing capacity of the lung for carbon monoxide; and a high percentage of Bron-choalveolar lavage fluid (BALF) lymphocyte; low BALF-CD4/8 ratio; good response to corticosteroid or immunosuppressant therapy; and good prognosis.
Igarashi K.,Kanazawa Municipal Hospital |
Kawahara M.,Kanazawa Municipal Hospital
Yakugaku Zasshi | Year: 2014
A case in which aminophylline solution was administered to a patient with congestive heart failure is reported and the problems caused by administration were solved by subsequent experiments. Dopamine solution was added from the side route using a mechanical pump, and mixed with aminophylline solution in the main route. Furosemide was administered after clamping and flushing the main route according to the supplier's information that indicated the compatibility of dopamine and aminophylline. However, the aminophylline solution turned black in color 3 h after furosemide administration. Several examinations were carried out to clarify the cause of the incompatibility in this case. The results showed that solutions with all possible combinations, including aminophylline and dopamine, turned black at 24 h after mixing, and the UV absorption at 430 nm increased from 0 to 0.28. UV absorption of the mixed solution increased in a dopamine dose-dependent manner in the range of 1.5-12 mg. When aminophylline was added to physiological saline or hypotonic electrolyte solution, the pH of each solution increased. These results suggested that degradation of dopamine to a melanin-like polymer under alkaline conditions caused the change in color of the solution. It is presumed that dopamine was inappropriately injected into aminophylline solution as the route was clamped tightly to shut out furosemide contamination. Aminophylline and dopamine are often co-administered to patients in critical condition. Thus, even if compatibility of aminophylline with dopamine is indicated by the supplier, they should be administered through separate routes. © 2014 The Pharmaceutical Society of Japan.
Maruyama K.,Kanazawa University |
Morishita E.,Kanazawa University |
Sekiya A.,Kanazawa University |
Omote M.,Kanazawa University |
And 7 more authors.
Journal of Atherosclerosis and Thrombosis | Year: 2012
Aim: Obstructive sleep apnea syndrome (OSAS) has been associated with high cardiovascular morbidity and mortality, and patients suffer from repeated episodes of hypoxia. Platelet-derived microparticles (PDMPs) are released via platelet activation by various agonists, including inflammatory cytokines or high shear stress. Plasminogen activator inhibitor -1 (PAI-1) is a fibrinolytic marker and soluble fibrin (SF) is a coagulation activation marker. We examined plasma levels of PDMPs, PAI-1 and SF in patients with OSAS. We also examined the effects of continuous positive airway pressure (CPAP) on plasma levels of PDMPs. Methods: Full polysomnography (PSG) monitoring was performed on 27 patients. The apneahypopnea index (AHI) of 5 events/h or less than 30 events/h indicated mild to moderate OSAS, and an AHI of 30 events/h or more indicated severe OSAS. Plasma levels of PDMPs were measured using an ELISA kit, and PAI and SF were determined by a latex immunoassay. In addition, the effects of CPAP treatment were studied in 7 patients. Result: The plasma level of PDMPs was significantly higher in patients with severe OSAS (15.8±10.4 U/mL) than normal controls (10.8±7.1 U/mL, plt;0.05) and patients with mild to moderate OSAS (9.2±3.5 U/mL, p<0.05). The plasma levels of PDMPs correlated with the AHI (r = 0.39, p<0.05). In addition, CPAP treatment decreased the plasma level of PDMPs (11.9±5.6 U/mL to 6.7±3.2 U/mL, p<0.05). Conclusions: Patients with OSAS might be at increased cardiovascular risk due to elevated PDMPs. Moreover a decrease in the plasma level of PDMPs by treatment with CPAP might reduce cardiovascular risk.
Nakase J.,Kanazawa University |
Aiba T.,Kanazawa Municipal Hospital |
Goshima K.,Toyama Municipal Hospital |
Takahashi R.,Kanazawa nishi Hospital |
And 4 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2014
Purpose: The aim of this study was to compare ultrasonography stages of the tibial tuberosity development and physical features. Methods: This study examined 200 knees in 100 male football players aged 10-15 years. Tibial tuberosity development on ultrasonography was divided into 3 stages: Sonolucent stage (stage S), Individual stage (stage I), and Connective stage (stage C). Age, height, quadriceps and hamstring muscle tightness, and muscle strength in knee extension and flexion were determined. These findings were compared with the respective stages of development. Results: The tibial tuberosity was stage S in 27 knees, stage I in 69 knees, and stage C in 104 knees, with right and left sides at the same stage in 95 %. Average age and height significantly increased with advancing tibial tuberosity development. Quadriceps tightness increased with tibial tuberosity development. Hamstring tightness decreased with development. The strength of both knee extension and flexion increased with advancing development, with a greater change seen in knee extension, hamstring/quadriceps ratio: stage C, 0.74; stage A, 0.64; stage E, 0.53. Conclusions: Osgood-Schlatter pathogenesis reportedly involves increased quadriceps tightness with rapidly increasing femoral length during tibial tuberosity development. In this study, it was confirmed that quadriceps tightness increased, yet hamstring tightness decreased, suggesting that quadriceps tightness is not due to femoral length alone. Other factors, including muscle strength, may be involved. The study shows that thigh muscle tightness and thigh muscle performance change with the skeletal maturation of the distal attachment of the patellar tendon. These results add new information to the pathogenesis of Osgood-Schlatter disease. Level of evidence: Cross-sectional study, Level III. © 2012 Springer-Verlag Berlin Heidelberg.
Inomata J.-I.,Kanazawa University |
Murai H.,Kanazawa University |
Kaneko S.,Kanazawa University |
Hamaoka T.,Kanazawa University |
And 7 more authors.
Journal of Hypertension | Year: 2014
OBJECTIVE:: Calcium channel blockers (CCBs) are used as antihypertensive agents and have a strong vasodilatory effect; however, the sympathetic activation mediated by baroreflex might cause adverse effects. A recently developed CCB, azelnidipine, decreases the heart rate (HR) while lowering blood pressure (BP), possibly by inhibiting sympathetic nerve activity in animal models. In this study, we evaluated whether azelnidipine inhibited sympathetic nerve activity, compared to amlodipine, in primary hypertensive patients. DESIGN AND METHODS:: We conducted a prospective, randomized, open-label, and crossover study of 14 patients. We measured the patients' BP, HR and baroreflex sensitivity, and directly recorded muscle sympathetic nerve activity (MSNA), via microneurography, after treatment with either CCB for 8 weeks. RESULTS:: Although systolic and diastolic BPs did not differ between the azelnidipine and amlodipine groups, the HR in the azelnidipine group significantly decreased compared with that in the amlodipine group. MSNA was significantly reduced in the azelnidipine compared with the amlodipine group (47.7±14.9 vs. 61.5±10.7bursts per 100 beats, P<0.05). However, no significant difference was observed in terms of the baroreflex control of HR, or MSNA, between the two groups. CONCLUSION:: Our data show, first, that azelnidipine, compared with amlodipine, exerted a favorable effect on sympathetic nerve activity, without affecting baroreflex sensitivity, in hypertensive patients. These results indicate that azelnidipine might be useful for treating hypertensive patients, in whom hypertension is complicated by heart failure and ischemic heart disease. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.
PubMed | Kanazawa Municipal Hospital and Kanazawa University
Type: Journal Article | Journal: Journal of medical case reports | Year: 2016
Intestinal angina is characterized by recurrent postprandial abdominal pain and anorexia. Commonly, these symptoms are caused by severe stenosis of at least two vessels among the celiac and mesenteric arteries. However, intestinal perfusion is affected not only by the degree of arterial stenosis but also by systemic perfusion. We experienced a unique case of intestinal angina caused by relatively mild stenosis of the abdominal arteries complicated with hypertrophic obstructive cardiomyopathy.We report an 86-year old Japanese man with hypertrophic obstructive cardiomyopathy and advanced atrioventricular block who was diagnosed with intestinal angina. Computed tomography showed mild stenosis of the celiac artery and severe stenosis of the inferior mesenteric artery, and these lesions were relatively mild compared with other reports. A dual-chamber pacemaker with right ventricular apical pacing was implanted to improve the obstruction of the left ventricular outflow tract. After implantation, the patients abdominal symptoms diminished markedly, and improvement of the left ventricular outflow tract obstruction was observed.Although intestinal angina is generally defined by severe stenosis of at least two vessels among the celiac and mesenteric arteries, the present case suggests that hemodynamic changes can greatly affect intestinal perfusion and induce intestinal angina in the presence of mild stenosis of the celiac and mesenteric arteries.