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Satoh M.,Mie University | Ogawa J.-I.,Yamaha | Nakao K.,Kinan Hospital | Kida H.,Mie University | Tomimoto H.,Mie University
PLoS ONE | Year: 2014

Background: Physical exercise has positive effects on cognitive function in elderly people. It is unknown, however, if combinations of non-pharmaceutical interventions can produce more benefits than single ones. This study aimed to identify if physical exercise combined with music improves cognitive function in normal elderly people more than exercise alone. Methods: We enrolled 119 subjects (age 65-84 years old). Forty subjects performed physical exercise (once a week for an hour with professional trainers) with musical accompaniment (ExM group), developed by YAMAHA Music Foundation; 40 subjects performed the same exercise without music (Ex group); 39 subjects were the control group (Cont group). Before and after the year-long intervention, each patient was assessed by neuropsychological batteries. MRIs were performed before and after intervention; the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD) was used to assess medial temporal lobe atrophy. Results: Analysis of variance (ANOVA) was significant only in visuospatial function. The multiple comparison (ExM vs. Ex, ExM vs. Cont, Ex vs. Cont) was significant between the ExM and Cont group. Intra-group analyses before and after intervention revealed significant improvement in visuospatial function in the ExM group, and significant improvements in other batteries in all three groups. The VSRAD score significantly worsened in the ExM and Ex groups. Conclusions: Physical exercise combined with music produced more positive effects on cognitive function in elderly people than exercise alone. We attributed this improvement to the multifaceted nature of combining physical exercise with music, which can act simultaneously as both cognitive and physical training. Trial Registration: UMIN Clinical Trials Registry (UMIN-CTR) UMIN000012148 © 2014 Satoh et al.

Miyake K.,Kinan Hospital | Sakagoshi N.,Kinan Hospital | Kitabayashi K.,Kinan Hospital
Journal of Artificial Organs | Year: 2016

A 70-year-old woman underwent an axillobifemoral artery bypass using a bifurcated ring-supported Dacron graft in 2004 and then noticed a pulsatile mass in the left flank 10 years later. A Fogarty thrombectomy was performed for acute graft occlusion. Eight months later, computed tomography revealed pseudoaneurysm formation in the graft body and surgical graft interposition was performed. The operative findings showed a transverse rupture of the graft just above the bifurcation. Histological findings revealed graft deterioration with filaments broken off from the graft. Although the cause of pseudoaneurysm formation was not apparent, the combination of graft deterioration and additional damage from the Fogarty thrombectomy was highly suspicious. © 2016 The Japanese Society for Artificial Organs

Suzuki H.,Wakayama Medical University | Suenaga T.,Wakayama Medical University | Takeuchi T.,Wakayama Medical University | Shibuta S.,Kinan Hospital | Yoshikawa N.,Wakayama Medical University
Pediatrics International | Year: 2010

Background: The aim of this study was to investigate whether T-cell activation is involved in the pathogenesis of Kawasaki disease (KD) resistant to intravenous immunoglobulin (IVIG) treatment. Methods: Serum samples were obtained from 27 patients who fulfilled the diagnostic criteria for KD. These 27 patients were divided into three groups according to their responses to IVIG: Group A, nine patients who showed no response to either initial IVIG or additional IVIG; Group B, six patients who did not respond to initial IVIG but did respond to additional IVIG; Group C, 12 patients who responded to initial IVIG. Serum samples were obtained before and after initial IVIG. Using a commercial chemiluminescence enzyme immunoassay, we examined the serum levels of two cytokines related to T-cell activation and the severity of inflammation: soluble interleukin-2 receptor and interleukin-6. Results: There were no significant differences in the serum levels of the two cytokines before initial IVIG among the three groups, but significant intergroup differences were evident after initial IVIG in the serum levels of soluble interleukin-2 receptor (P < 0.01, Group A > C) and interleukin-6 (P < 0.01, Group A > B > C). Conclusions: Our results show that marker of T-cell activation is elevated most markedly in KD patients resistant to both initial and additional IVIG, and suggest that T cells may be activated in refractory KD. © 2010 Japan Pediatric Society.

Kohama H.,Hyogo College of Medicine | Komasawa N.,Hyogo College of Medicine | Ueki R.,Hyogo College of Medicine | Samma A.,Hyogo College of Medicine | And 3 more authors.
Journal of Anesthesia | Year: 2011

Purpose: In the 2005 American Heart Association (AHA) guidelines, the laryngeal mask (LMA) was proposed as an alternative to tracheal intubation for cardiopulmonary resuscitation (CPR). We compared the utility of a newly developed LMA, the Supreme® (Supreme), with a conventional LMA, the Soft Seal® (Soft Seal). Methods: A total of 19 novice doctors in our anesthesia department performed insertion of the Supreme or Soft Seal on a manikin with or without chest compression. Insertion time and number of attempts for successful ventilation were measured. After successful ventilation, the amount of air entering the stomach and maximum ventilation pressure were measured. The subjective difficulty of using the devices was also measured. Results: The ventilation success rate of first insertion did not differ between the Supreme and Soft Seal without chest compression. However, the success rate was significantly lower with the Soft Seal than the Supreme during chest compression. Insertion time was lengthened by chest compression with the Soft Seal, but not with the Supreme. Maximum ventilation pressure was higher with the Supreme than the Soft Seal. The amount of air entering the stomach was significantly lower with the Supreme than the Soft Seal. The Supreme also scored better than the Soft Seal on a visual analog scale of subjective difficulty in insertion. Conclusions: The Supreme is an effective device for airway management during chest compression. © 2010 Japanese Society of Anesthesiologists.

Komasawa N.,Hyogo College of Medicine | Ueki R.,Hyogo College of Medicine | Fujii A.,Hyogo College of Medicine | Samma A.,Hyogo College of Medicine | And 3 more authors.
Journal of Anesthesia | Year: 2011

Purpose: In emergency situations, rescuers occasionally must secure the airway while the patient is in a position other than the ideal supine position. We hypothesized that the laryngeal mask airway Supreme® (Supreme) may be useful for emergent airway management in several positions and compared the utility of the Supreme with that of the conventional Soft Seal® (Soft Seal) device. Methods: Nineteen novice doctors in our anesthesia department attempted insertion of the Supreme or Soft Seal device on a simulated manikin in the supine, left lateral decubitus (left-LT), right lateral decubitus (right-LT), prone, and sitting positions. For each device, successful ventilation attempts, mean time to secure the airway, and difficulty of use [using the visual analog scale (VAS)] were evaluated. Results: The success rate of ventilation was significantly higher with the Supreme than the Soft Seal in the prone and sitting positions (P < 0.05). Compared with the Soft Seal, time to secure the airway was significantly shorter with the Supreme when the manikin was in the sitting position but not in the other four positions. VAS scores for Supreme use were significantly higher than those for Soft Seal use in the right-LT, prone, and sitting positions. Conclusion: Airway management attempts by novice doctors were more successful with the Supreme than the Soft Seal in the right-LT, prone, and sitting positions in the manikin. The Supreme may therefore be useful for emergent airway management. © 2011 Japanese Society of Anesthesiologists.

Kakimoto N.,Wakayama Medical University | Suzuki H.,Wakayama Medical University | Kubo T.,Wakayama Medical University | Suenaga T.,Wakayama Medical University | And 5 more authors.
Canadian Journal of Cardiology | Year: 2014

Optical coherence tomography (OCT) is a high-resolution intracoronary arterial imaging modality. We describe 2 patients who were admitted to undergo coronary angiography and OCT for follow-up of Kawasaki disease with coronary artery aneurysms. OCT clearly demonstrated thrombus, stenosis, fibrotic intimal thickening with lamellar calcification, and partial disappearance of the tunica media at the aneurysm site. In addition, focal calcification, intimal thickening, and medial irregularity were observed even in regions of coronary arterial walls that appeared to be normal using coronary angiography. OCT is useful for evaluating coronary arterial sequelae of Kawasaki disease. © 2014 Canadian Cardiovascular Society.

PubMed | Kinan Hospital and Wakayama Medical University
Type: | Journal: International journal of urology : official journal of the Japanese Urological Association | Year: 2017

To identify biomarkers predicting prognosis in bladder cancer patients undergoing the gemcitabine and cisplatin regimen.We studied 52 patients with metastatic bladder cancer treated with the gemcitabine and cisplatin regimen by evaluating the relationship between the expression of two biomarkers, ribonucleotide reductase subunit M1 and excision repair cross complementing 1, by immunohistochemistry and clinical outcomes.The patients with low expression of ribonucleotide reductase subunit M1 showed a higher objective response rate by the gemcitabine and cisplatin regimen than those with high expression of ribonucleotide reductase subunit M1 (80.0% and 45.5%, respectively). No differences were observed according to the expression level of excision repair cross complementing 1. Low expression of ribonucleotide reductase subunit M1 significantly prolonged overall survival and progression-free survival compared with the high expression group. Low expression of excision repair cross complementing 1 tended to prolong overall survival and progression-free survival, but there were no significant differences (P = 0.07 and 0.10, respectively). Multivariate analysis showed that the expression of ribonucleotide reductase subunit M1 was the only independent prognostic factor (P = 0.012).The expressions of ribonucleotide reductase subunit M1 seem to be associated with clinical response and survival in patients with metastatic bladder cancer treated with gemcitabine and cisplatin-based chemotherapy.

PubMed | Kinan Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2017

A 75-year-oldman presenting with obstructive jaundice was referredto our hospital. Basedon a diagnosis of carcinoma of the ampulla of Vater, we performed pancreatoduodenectomy. Postoperative histopathological examination revealed a welldifferentiated papillotubular adenocarcinoma, T3, N0, M0, Stage III . Six months after surgery, an isolatedliver metastasis in S6 was identifiedon CT scan andMRI; therefore, we administeredgemcitabine plus cisplatin chemotherapy. After 6 courses of this regimen, a clinical complete response(CR)was obtained. After 12 courses, the clinical CR continued; however, grade 3 lower-extremity peripheral neuropathy appeared. Therefore, gemcitabine monotherapy was administered as second line chemotherapy. However, multiple liver metastases appearedandthe patient passedaway owing to exacerbation of the disease 2 years after initiating chemotherapy. Although recurrent ampullary carcinoma is difficult to treat, our patient had a long-term survival. Here we report the details of our case and review the relevant literature.

PubMed | Kinan Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2017

A36 -year-old man with intellectual disabilities consulted a local physician complaining of a cough, and an abdominal mass was observed on palpation. The patient visited our hospital for close examination. Abdominal contrasting CT revealed a mass with a clear boundary with heterogeneous contrast on the left side of his abdominal cavity. We performed a laparotomy and observed that the tumor originated from the greater omentum. The tumor size was 986 cm and its weight was 200 g. Histopathologic examination showed hyperplastic spindle-shaped tumor cells with less nuclear fission. Immunohistochemical staining showed that the tumor was positive for CD34, CD99, and bcl-2, slightly positive for p53, and negative for S-100, a- SMA, c-kit, and desmin. Based on the results, a diagnosis of solitary fibrous tumor (SFT) was made. The patient has not shown any recurrence 8 months after surgery.

PubMed | Kinan Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2017

Curative treatment for unresectable colon cancer is difficult, and therefore, chemotherapy is often administered in an attempt to improve the prognosis. However, the safety andfeasibility of chemotherapy for elderly patients over 80-years-old have not yet been clarified. We report an elderly colon cancer patient with multiple liver metastases who was successfully treatedwith mFOLFOX6 andsLV5 FU2 chemotherapy. The patient was an 83-year-old-man who was referredto our hospital. After performing sigmoidectomy, we administered mFOLFOX6 chemotherapy. After 5 courses, the regimen was changed to sLV5FU2 owing to grade 3 neuropathy. Liver metastases disappearedanda complete response was obtained1 year after chemotherapy administration. Twenty-four courses of sLV5FU2 chemotherapy had been safely performed. Although grade 1 neutropenia developed, no other adverse event was observed. Currently, the patient is alive without recurrence. Chemotherapy for elderly patients is both feasible and safe.

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