Kawasaki Municipal Kawasaki Hospital

Kawasaki, Japan

Kawasaki Municipal Kawasaki Hospital

Kawasaki, Japan

Time filter

Source Type

Lee H.-M.,Osaka University | Sugino H.,Osaka University | Aoki C.,Wakayama Medical University | Shimaoka Y.,Yukioka Hospital | And 5 more authors.
Arthritis Research and Therapy | Year: 2011

Introduction: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic synovitis that progresses to destruction of cartilage and bone. Bone marrow (BM) cells have been shown to contribute to this pathogenesis. In this study, we compared differentially expressed molecules in BM cells from RA and osteoarthritis (OA) patients and analyzed abnormal regulatory networks to identify the role of BM cells in RA.Methods: Gene expression profiles (GEPs) in BM-derived mononuclear cells from 9 RA and 10 OA patients were obtained by DNA microarray. Up- and down-regulated genes were identified by comparing the GEPs from the two patient groups. Bioinformatics was performed by Expression Analysis Systemic Explorer (EASE) 2.0 based on gene ontology, followed by network pathway analysis with Ingenuity Pathways Analysis (IPA) 7.5.Results: The BM mononuclear cells showed 764 up-regulated and 1,910 down-regulated genes in RA patients relative to the OA group. EASE revealed that the gene category response to external stimulus, which included the gene category immune response, was overrepresented by the up-regulated genes. So too were the gene categories signal transduction and phosphate metabolism. Down-regulated genes were dominantly classified in three gene categories: cell proliferation, which included mitotic cell cycle, DNA replication and chromosome cycle, and DNA metabolism. Most genes in these categories overlapped with each other. IPA analysis showed that the up-regulated genes in immune response were highly relevant to the antigen presentation pathway and to interferon signaling. The major histocompatibility complex (MHC) class I molecules, human leukocyte antigen (HLA)-E, HLA-F, and HLA-G, tapasin (TAP) and TAP binding protein, both of which are involved in peptide antigen binding and presentation via MHC class I molecules, are depicted in the immune response molecule networks. Interferon gamma and interleukin 8 were overexpressed and found to play central roles in these networks.Conclusions: Abnormal regulatory networks in the immune response and cell cycle categories were identified in BM mononuclear cells from RA patients, indicating that the BM is pathologically involved in RA. © 2011 Lee et al.; licensee BioMed Central Ltd.


Ochi K.,Kawasaki Municipal Kawasaki Hospital | Ochi K.,Tokyo Women's Medical University | Horiuchi Y.,Kawasaki Municipal Kawasaki Hospital | Nakamura T.,Keio University | And 3 more authors.
Journal of Hand Surgery: European Volume | Year: 2013

Simple decompression of the ulnar nerve at the elbow has not been shown to reduce nerve strain in cadavers. In this study, ulnar nerve strain at the elbow was measured intraoperatively in 11 patients with cubital tunnel syndrome, before and after simple decompression. Statistical analysis was performed using a paired Student's t-test. Mean ulnar nerve strain before and after simple decompression was 30.5% (range 9% to 69%) and 5.5% (range -2% to 11%), respectively; this difference was statistically significant (p < 0.01) with a statistical power of 96%. Simple decompression reduced ulnar nerve strain in all patients by an average of 24.5%. Our results suggest that the pathophysiology of cubital tunnel syndrome may be multifactorial, being neither a simple compression neuropathy nor a simple traction neuropathy, and simple decompression may be a favourable surgical procedure for cubital tunnel syndrome in terms of decompression and reduction of strain in the ulnar nerve. © The Author(s) 2012.


Ochi K.,Kawasaki Municipal Kawasaki Hospital | Horiuchi Y.,Kawasaki Municipal Kawasaki Hospital | Tanabe A.,Kawasaki Municipal Kawasaki Hospital | Waseda M.,Kawasaki Municipal Kawasaki Hospital | And 2 more authors.
Journal of Shoulder and Elbow Surgery | Year: 2012

Background: Shoulder internal rotation enhances symptom provocation attributed to cubital tunnel syndrome. We present a modified elbow flexion test-the shoulder internal rotation elbow flexion test-for diagnosing cubital tunnel syndrome. Methods: Fifty-five ulnar nerves in cubital tunnel syndrome patients and 123 ulnar nerves in controls were examined with 5 seconds each of elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests before and after treatment (surgery in 18; conservative in others). For the shoulder internal rotation elbow flexion test position, 90° abduction, maximum internal rotation, and 10° flexion of the shoulder were combined with the elbow flexion test position. The test was considered positive if any symptom for cubital tunnel syndrome developed <5 seconds. Influence of the shoulder internal rotation elbow flexion test was evaluated by nerve conduction studies in 10 cubital tunnel syndrome nerves and 7 control nerves. Results: The sensitivities/specificities of the 5-second elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests were 25%/100%, 58%/100%, and 87%/98%, respectively. Sensitivity differences between the shoulder internal rotation elbow flexion test and the other two tests were significant. Shoulder internal rotation elbow flexion test results and cubital tunnel syndrome symptoms were significantly correlated. Influence of the shoulder internal rotation elbow flexion test on the ulnar nerve was seen in 8 of 10 cubital tunnel syndrome nerves but not in controls. Conclusions: The 5-second shoulder internal rotation elbow flexion test is specific, easy and quick provocative test for diagnosing cubital tunnel syndrome. © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.


Ochi K.,Kawasaki Municipal Kawasaki Hospital
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2011

Here we presented the first case of pacifier type thumb duplication. A newborn Japanese girl with no family history had a duplicated thumb on her left hand. The duplicated thumb showed a very large, oedematous soft-tissue nubbin in its appearance and was resected on the fifth day after birth. X-ray showed hypoplastic phalanx bone, suggesting type II polydactyly. Histology of the resected thumb showed enormous oedema in its connective tissue with cartilaginous and neural elements. This case was quite similar to literary reported cases of pacifier polydactyly in post-axial polydactyly, and its pathological condition seemed to be distinctly different from floating type or rudimentary type thumb duplication. We considered this type of thumb duplication as pacifier type thumb duplication, rather than floating or rudimentary type, in order to understand its underlying pathophysiology and to avoid confusion in further discussions.


Ochi K.,Kawasaki Municipal Kawasaki Hospital | Horiuchi Y.,Kawasaki Municipal Kawasaki Hospital | Nakamichi N.,Kawasaki Municipal Kawasaki Hospital | Morita K.,Kawasaki Municipal Kawasaki Hospital | And 2 more authors.
Journal of Hand Surgery | Year: 2011

Purpose: The elbow flexion test is a standard, provocative diagnostic test for cubital tunnel syndrome (CubTS). The purpose of this study was to investigate the association between the elbow flexion test and the degree of extraneural pressure in the cubital tunnel of CubTS patients. Methods: Extraneural pressure on the ulnar nerve in the cubital tunnel was evaluated using 0.7-mm thickness catheter during surgery of 25 CubTS cases and compared with the results of preoperative elbow flexion testing. Statistic analysis was performed using Student's t-test with a confidence level of 95% (p < .05). Results: Forty-eight percent of the patients were positive for the elbow flexion test. Mean extraneural pressure was significantly higher in maximum elbow flexion than in maximum elbow extension (p < .001). No significant association was seen between the result of 45 seconds of the elbow flexion test and the extraneural pressure in the cubital tunnel induced by maximum elbow flexion (p = .45). Conclusions: Our results suggested that the mechanism of provocation of symptoms of CubTS by the elbow flexion could not be explained simply by dynamic pressure in the cubital tunnel, and other pathophysiological factors could also be contributing. Type of study/level of evidence: Diagnostic III. © 2011 American Society for Surgery of the Hand.


Moi M.L.,Japan National Institute of Infectious Diseases | Takasaki T.,Japan National Institute of Infectious Diseases | Kotaki A.,Japan National Institute of Infectious Diseases | Tajima S.,Japan National Institute of Infectious Diseases | And 5 more authors.
Emerging Infectious Diseases | Year: 2010

Travelers can introduce viruses from disease-endemic to non-disease-endemic areas. Serologic and virologic tests confirmed dengue virus infections in 3 travelers returning to Japan: 2 from Tanzania and 1 from Côte d'Ivoire. Phylogenetic analysis of the envelope gene showed that 2 genetically related virus isolates belonged to dengue virus type 3 genotype III.


Harato K.,Kawasaki Municipal Kawasaki Hospital | Harato K.,International University of Health and Welfare | Ozaki M.,International University of Health and Welfare | Sakurai A.,International University of Health and Welfare | And 2 more authors.
Knee | Year: 2014

Stress fractures after total knee arthroplasty (TKA) occur mainly in patients with considerable deformity of the knee. In addition, the majority of these fractures after TKA involve the hip joint. We present two cases of stress fractures of the first metatarsal after TKA in patients with severe varus deformity. Correction of leg alignment and pain reduction obtained by TKA lead to stress fracture of the bone. Gait analysis was carried out for both cases in order to clarify the gait characteristics of the stress fracture. As a result, side-to-side differences of the distance between first metatarsal and foot center of pressure in the coronal plane were observed using gait analysis in these patients. Fortunately, conservative treatment was successful for these patients. Stress fractures should be considered when a patient who had a considerable severe deformity of the knee preoperatively complains of foot pain on the affected side. Contrary to stress fractures at the hip joint, patients with the fracture of the first metatarsal can be treated without surgery. © 2012 Elsevier B.V.


Harato K.,National Hospital Organization | Harato K.,Kawasaki Municipal Kawasaki Hospital | Yoshida H.,National Hospital Organization | Otani T.,Keio University
Journal of Arthroplasty | Year: 2013

Unilateral total knee arthroplasty (TKA) would produce asymmetric changes of lower extremity in patients with bilateral varus deformity. Our purpose was to investigate whether asymmetry of the leg alignment would affect trunk bending in the coronal plane after unilateral TKA. Twenty patients (mean 76. years old) with bilateral end-stage knee osteoarthritis (OA) participated. Spine images during relaxed standing were obtained on pre- and postoperative day 21. As a result, the shoulder tilted more to the TKA side and the pelvis inclined more to the contralateral OA side. These results suggested that the trunk would bend away from the contralateral OA side after unilateral TKA in patients with bilateral end-stage knee OA and varus deformity. Asymmetry of the leg alignment led to asymmetric trunk bending. © 2013 Elsevier Inc.


Harato K.,Kawasaki Municipal Kawasaki Hospital | Yoshida H.,National Hospital Organization
Journal of Arthroplasty | Year: 2013

Postoperative pseudogout after total knee arthroplasty is rare. If pseudogout attacks are misdiagnosed as periprosthetic sepsis, patients may undergo unnecessary surgical procedures. We report a case of pseudogout in the early postoperative period. The attack ensued shortly after a nonsteroidal antiinflammatory drug was discontinued. The diagnosis was confirmed by aspiration, and the patient improved after readministration of the nonsteroidal antiinflammatory drug. Although rare, pseudogout should be considered in the differential when approaching a suspected infection after total knee arthroplasty. © 2013 Elsevier Inc.


Horiuchi Y.,Kawasaki Municipal Kawasaki Hospital
Brain and Nerve | Year: 2014

There are many risks of iatrogenic peripheral-nerve injuries during routine medical procedures. These injuries may occur during venipuncture for drawing blood, endoscopic treatments, punctures of joints or ganglions, various kinds of surgical procedures, and in numerous other situations. It is important to create a "Manual" of such accidents or incidents. In case an accident occurs, both the medical staff and the injured patient should receive adequate support to avoid any anxiety. The doctor must examine the person's injury carefully, and must judge its severity as soon as possible. The doctor must also offer the patient a prompt explanation about their injury and its proper care or treatment. This explanation must be easy to understand. This step can reduce patient anxiety and even prevent the early stages of complex regional pain syndrome (CRPS). One of my therapeutic strategies for treating early-stage CRPS is to use prednisolone for a short period for the treatment of strong pain and serious edema; the other approach is to do administer a warm-cold alternating bath with range-of-motion (ROM) exercise. Creation of manuals and education of staff to quickly respond to such situations is extremely essential.

Loading Kawasaki Municipal Kawasaki Hospital collaborators
Loading Kawasaki Municipal Kawasaki Hospital collaborators