Sakai A.,University of Occupational and Environmental Health Japan |
Ikeda S.,Ken Ai Memorial Hospital |
Okimoto N.,Okimoto Clinic |
Matsumoto H.,Sanzai Hospital |
And 7 more authors.
Osteoporosis International | Year: 2014
Summary: This multi-center, prospective, open-label, observational study evaluated the effects of once-monthly minodronate (50 mg) on treatment persistence, bone turnover markers, bone mineral density, low back pain, and upper gastrointestinal symptoms in outpatients with osteoporosis previously treated with daily or weekly bisphosphonate products. Introduction: The purposes of this study were to investigate the effects of once-monthly oral minodronate (MIN 50 mg) on bone turnover markers and bone mineral density, low back pain, and upper gastrointestinal symptoms, as well as preference for and treatment persistence of MIN 50 mg among Japanese osteoporosis patients currently treated with daily or weekly bisphosphonates. Methods: Study patients were allocated based on their preference to either the Switch group (patients willing to switch over to MIN 50 mg) or the Continue group (patients wanting to continue their current therapies). Patients' treatment persistence and satisfaction levels with the therapies were assessed using a self-administered questionnaire. The study endpoints were serum TRACP-5b, serum P1NP, bone mineral density, upper gastrointestinal symptoms, and low back pain. Results: In total, 264 and 133 patients were allocated into the Switch and Continue groups, respectively. Approximately, 65 % of patients were willing to switch to MIN 50 mg, with the predominant reason being "less frequent dosing more convenient." Treatment persistence was significantly higher in the Switch group (MIN 50 mg) than the Continue group. Almost all patients with abnormal bone metabolism markers demonstrated normalization after switchover. MIN 50 mg alleviated low back pain and upper gastrointestinal symptoms induced by prior bisphosphonate use. Conclusions: MIN 50 mg alleviates low back pain, reduces bone turnover markers and increases bone density, and induces fewer upper gastrointestinal symptoms after switchover from prior bisphosphonate products, and therefore, it may provide patients with a more convenient treatment option and enhance long-term treatment persistence. © 2014 The Author(s).
Efficacy of combined treatment with alendronate (ALN) and eldecalcitol, a new active vitamin D analog, compared to that of concomitant ALN, vitamin D plus calcium treatment in Japanese patients with primary osteoporosis
Sakai A.,University of Occupational and Environmental Health Japan |
Ito M.,Nagasaki University |
Tsurukami H.,Tsurukami Clinic of Orthopaedic and Rheumatology Hospital |
Ikeda S.,Ken Ai Memorial Hospital |
And 5 more authors.
Osteoporosis International | Year: 2015
Results: L-BMD, total hip BMD and femoral neck (FN-BMD) increased from baseline by 7.30, 2.41, and 2.70 % in the ALN + ELD group, and by 6.52, 2.27, and 1.18 % in the ALN + VitD group, respectively. Inter-group differences of the L-BMD and total hip BMD values were not significant. The increase of the FN-BMD was larger in the ALN + ELD group than the ALN + VitD group. Reductions of the BTMs were greater in the ALN + ELD group than the ALN + VitD group. Interaction of the percent increase of the L-BMD with the baseline values of the BTMs was observed in the ALN + VitD group only. The increases of the FN-BMD in patients with lower baseline values of type-I-collagen C-telopeptide (sCTX) and serum 25(OH) D levels <20 ng/mL were significantly larger in the ALN + ELD group than the other group.Conclusion: Combination treatment of ALN plus ELD was more effective in reducing the BTMs and increasing the FN-BMD than ALN treatment with vitamin D3 and calcium.Methods: Osteoporotic 219 patients were randomly assigned to the ALN + ELD, or the ALN + VitD group. Primary endpoint was the inter-group differences in lumbar spine BMD (L-BMD) at patient’s last visit. Secondary endpoints included the differences in BMD at other sites and the bone turnover marker (BTM) levels.Summary: Combined treatment with alendronate and eldecalcitol was found to be more effective in reducing the bone turnover markers and increasing bone mineral density than alendronate treatment with vitamin D3 and calcium supplementation in the osteoporotic patients.Introduction: We compared the clinical efficacy and safety of combined treatment with alendronate plus eldecalcitol (ALN + ELD) with those of treatment with ALN plus vitamin D and calcium (ALN + VitD). © 2015, The Author(s).
Fukuda H.,Kyushu University |
Yamanaka N.,Kyushu University |
Yamanaka N.,Kitakyushu General Hospital
Journal of Hospital Infection | Year: 2016
Background: Quantitative information on the effectiveness of safety-engineered devices (SEDs) is needed to support decisions regarding their implementation. Aim: To elucidate the effects of SED use in winged steel needles, intravenous (IV) catheter stylets and suture needles on needlestick injury (NSI) incidence rates in Japan. Methods: Japan EPINet survey data and device utilization data for conventional devices and SEDs were collected from 26 participating hospitals between 1 April 2009 and 31 March 2014. The NSI incidence rate for every 100,000 devices was calculated according to hospital, year and SED use for winged steel needles, IV catheter stylets and suture needles. Weighted means and 95% confidence intervals (CI) were used to calculate overall NSI incidence rates. Findings: In total, there were 236 NSIs for winged steel needles, 152 NSIs for IV catheter stylets and 180 NSIs for suture needles. The weighted NSI incidence rates per 100,000 devices for SEDs and non-SEDs were as follows: winged steel needles, 2.10 (95% CI 1.66-2.54) and 14.95 (95% CI 2.46-27.43), respectively; IV catheter stylets, 0.95 (95% CI 0.60-1.29) and 6.39 (95% CI 3.56-9.23), respectively; and suture needles, 1.47 (95% CI -1.14-4.09) and 16.50 (95% CI 4.15-28.86), respectively. All devices showed a significant reduction in the NSI incidence rate with SED use (< 0.001 for winged steel needles, P = 0.035 for IV catheter stylets and P = 0.044 for suture needles). Conclusion: SED use substantially reduces the incidence of NSIs, and is therefore recommended as a means to prevent occupational infections in healthcare workers and improve healthcare safety. © 2015 The Healthcare Infection Society.
Omori K.,Kitakyushu General Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2010
A 72-year-old man complained of dyspnea and epigastric pain. He was admitted to our hospital with progressive dyspnea and abnormal chest radiograph findings. Chest CT scan on admission showed multiple nodular shadows with and without air-bronchograms, vessels or cavitation. Transbronchial and percutaneous lung biopsy specimens demonstrated poorly differentiated carcinoma. Pulmonary metastases were suspected, but their primary origin was unknown. Chest and abdominal CT scans on the 18th hospital day showed a giant tumor of the small intestine and rapid progression of the pulmonary tumor, forming cavitation. The patient's condition worsened, and he died on the 51st hospital day. At autopsy, a final diagnosis of T-cell lymphoma of the small intestine and pulmonary metastases was obtained. This is a rare case which was found primarily based on the characteristic radiologic features of pulmonary metastases.
Tomoda Y.,Kitakyushu General Hospital |
Izumi Y.,Kitakyushu General Hospital
Japanese Journal of Chest Diseases | Year: 2015
A 71-year-old man was admitted to our hospital for examination of multiple pulmonary nodules detected on a medical check-up. Chest computed tomography demonstrated well-defined multiple nodules adjacent to the pleura in bilateral lung fields, suggestive of a metastatic tumor, and a lung biopsy was performed under video assisted thoracoscopy. The histopathol-ogy of excised nodule showed a necrotic center surrounded by palisading granulomas and plasma cell infiltration, but a definitive diagnosis was not obtained. Seven years later, because of polyarthritis and joint space narrowing on a hand radiograph, the patient was diagnosed with rheumatoid arthritis. Past histo-pathology of his pulmonary nodules was reexamined and showed typical features of rheumatoid nodules. Treatment with methotrexate improved the patient's condition, but the pulmonary nodules were unchanged. In this rare case of rheumatoid nodules preceding rheumatoid arthritis, 7 years were required to confirm the diagnosis.
Excellent outcomes with angiographic subsegmentectomy in the treatment of typical hepatocellular carcinoma: A retrospective study of local recurrence and long-term survival rates in 120 patients with hepatocellular carcinoma
Iwamoto S.,Iwamoto Hospital |
Yamaguchi T.,Iwamoto Hospital |
Hongo O.,Iwamoto Hospital |
Iwamoto H.,Kurume University |
Sanefuji H.,Kitakyushu General Hospital
Cancer | Year: 2010
BACKGROUND: The authors successfully adopted an interesting and effective treatment for hepatocellular carcinoma (HCC) referred to as angiographic subsegmentectomy (AS). This treatment involved simultaneous embolization of the peripheral feeding artery and the portal vein. The result was that almost all of the HCC and peripheral liver parenchyma developed complete anatomic necrosis. METHODS: To determine the effectiveness of this method, the authors retrospectively studied the local recurrence rates of 49 solitary HCCs and the long-term survival rates of 120 patients with HCC between 2000 and 2008. RESULTS: The results indicated that, in 31 small, solitary HCCs (<2.0 cm), the local recurrence rate was only 9.6%; and, in 10 slightly larger HCCs (<3.0 cm), the local recurrence rate was only 10%. The 5-year, 8-year, and 10-year survival rates for patients with stage I and stage I/Child-Pugh grade A HCC were 74.27% and 77.65%, 53.05% and 51.76%, and 53% and 51.76%, respectively; and the 5-year, 8-year, and 10-year survival rates for patients with stage II and stage II/Child-Pugh grade A HCC were 66.21% and 71.41%, 39.9% and 39.60%, and 29.92% and 25%), respectively. There were no severe complications. CONCLUSIONS: AS should be investigated further as potential first-line therapy for the treatment of patients with stage I and II HCC. © 2010 American Cancer Society.
Tanaka S.,University of Occupational and Environmental Health Japan |
Narusawa K.,University of Occupational and Environmental Health Japan |
Narusawa K.,Nakashibetsu Town Hospital |
Onishi H.,University of Occupational and Environmental Health Japan |
And 6 more authors.
Osteoporosis International | Year: 2011
Summary: In patients with femoral neck fracture, clinical factors, bone metabolism markers (in serum, urine, and bone), bone mineral density, radiographic parameters, and bone histomorphometric parameters were investigated to detect determinants of fragility fracture. The osteocalcin/deoxypyridinoline ratio and osteopontin/calcium ratio of cortical bone were selected as significant predictors. Introduction: Measurement of bone mineral density is widely used to assess bone strength, but this also depends on other bone components and on bone structure. The objective of this study was to investigate risk factors for fracture related to bone quality, the patient's history, and the patient's lifestyle. Methods: Twenty-one patients with femoral neck fracture and 18 patients with osteoarthritis were enrolled. Blood and urine samples were collected on admission to hospital, and bone samples were obtained from femoral necks resected during surgery. Multivariate logistic regression analysis was performed using osteoarthritis and femoral neck fracture as combined variables to assess the influence of alcohol or coffee intake, eating natto (fermented soybeans), osteocalcin and calcium concentrations, the osteocalcin/ deoxypyridinoline ratio and osteopontin/calcium ratios of cortical bone and cancellous bone, various bone histomorphometric parameters, the bone mineral density of the lumbar spine and the intact contralateral femoral neck, and various radiographic parameters of the spine Results: By forward stepwise multivariate analysis, the osteocalcin/deoxypyridinoline and osteopontin/calcium ratios of cortical bone were selected as significant factors for fracture (the odds ratios were 0.493 and <0.001, respectively; both P<0.001). Conclusions: A decrease of osteopontin and osteocalcin in bone is important for promoting vulnerability to hip fracture. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.
Watanabe R.,Kitakyushu General Hospital
Nippon Hoshasen Gijutsu Gakkai zasshi | Year: 2010
In optimizing exposures, it is very important to evaluate the impact of image noise on image quality. To realize this, there is a need to evaluate how much image noise will make the subject disease invisible. But generally it is very difficult to shoot images of different quality in a clinical examination. Thus, a method to create a noise addition image by adding the image noise to raw data has been reported. However, this approach requires a special system, so it is difficult to implement in many facilities. We have invented a method to easily create a noise addition image by using the water phantom and image add-subtract software that accompanies the device. To create a noise addition image, first we made a noise image by subtracting the water phantom with different SD. A noise addition image was then created by adding the noise image to the original image. By using this method, a simulation image with intergraded SD can be created from the original. Moreover, the noise frequency component of the created noise addition image is as same as the real image. Thus, the relationship of image quality to SD in the clinical image can be evaluated. Although this method is an easy method of LDSI creation on image data, a noise addition image can be easily created by using image addition and subtraction software and water phantom, and this can be implemented in many facilities.
Yamaguchi S.,Kitakyushu General Hospital |
Ohguri T.,University of Occupational and Environmental Health Japan |
Matsuki Y.,Kitakyushu General Hospital |
Yahara K.,University of Occupational and Environmental Health Japan |
And 3 more authors.
Radiation Oncology | Year: 2013
Background: The purpose of this study was to analyze the efficacy and tolerability of palliative radiotherapy (RT) in patients with a poor performance status (PS) and to evaluate the relationship between the palliative effect and survival time.Methods: One hundred and thirty-three patients with a poor PS (Eastern Cooperative Oncology Group 3 or 4) were treated with palliative RT using the three-dimensional conformal technique and retrospectively analyzed. Each patient's primary symptom treated with palliative RT as the major cause of the poor PS was evaluated using the second item of the Support Team Assessment Schedule (STAS) at the start and one week after the completion of palliative RT.Results: One hundred and fourteen (86%) of the 133 patients completed the planned palliative radiation dose. Grade 3 acute toxicity was observed in two patients (2%) and Grade 2 acute toxicity was observed in 10 patients (9%). No Grade 2 or higher late toxicities were observed, except for Grade 3 radiation pneumonitis in one patient. Improvement in the STAS scores between pre- and post-palliative RT was recorded in 76 (61%) of the 125 patients with available scores of STAS. A significant improvement in the mean STAS score between pre- and post-palliative RT was recognized (p < 0.0001). Improvement in the STAS score was found to be the most statistically significant prognostic factor for overall survival after palliative RT in both the multivariate and univariate analyses. The median overall survival time in the patients with an improvement in the STAS score was 6.4 months, while that in the patients without improvement was 2.4 months (p < 0.0005).Conclusions: Palliative RT in patients with a poor PS provides symptomatic benefits in more than half of patients without inducing severe toxicities. The palliative effect is strongly correlated with prolongation of the survival time and may contribute to improving the remaining survival time in patients with metastatic/advanced cancer with a poor PS. © 2013 Yamaguchi et al.; licensee BioMed Central Ltd.
Watanabe R.,Kitakyushu General Hospital
Nihon Hoshasen Gijutsu Gakkai zasshi | Year: 2013
To create three-dimensional computed tomography angiography (3D-CTA) images of blood vessels, it is important to acquire a high-contrast original image of the blood vessels and the surrounding tissues. However, reexamination is likely to be needed if, due to the condition of the examinee, insufficient contrast enhancement is achieved. This prompted us to design a method of amplifying image contrast using software that simply adds the CT value to each corresponding pixel of the original image, i.e., the same image is added after the scan. This prevents spatial and time discontinuities with the original image. The CT value of the original image can also be increased arbitrarily to any value by adjusting the weighting level of the added image. The difference in CT values between the pixels can thus be amplified without changing the contours of the original image. Since this method enables the original image's contrast to be amplified by post-processing, i.e., without increasing radiation load exposure or employing additional contrast medium, it is a technique with high clinical utility.