Kizawa Memorial Hospital

Minokamo, Japan

Kizawa Memorial Hospital

Minokamo, Japan

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Fushimi K.,Kizawa Memorial Hospital | Miyamoto K.,Gifu University | Hioki A.,Gifu University | Hosoe H.,Gifu Prefectural General Medical Center | And 2 more authors.
Bone and Joint Journal | Year: 2013

There have been a few reports of patients with a combination of lumbar and thoracic spinal stenosis. We describe six patients who suffered unexpected acute neurological deterioration at a mean of 7.8 days (6 to 10) after lumbar decompressive surgery. Five had progressive weakness and one had recurrent pain in the lower limbs. There was incomplete recovery following subsequent thoracic decompressive surgery. The neurological presentation can be confusing. Patients with compressive myelopathy due to lower thoracic lesions, especially epiconus lesions (T10 to T12/L1 disc level), present with similar symptoms to those with lumbar radiculopathy or cauda equina lesions. Despite the rarity of this condition we advise that patients who undergo lumbar decompressive surgery for stenosis should have sagittal whole spine MRI studies pre-operatively to exclude proximal neurological compression. © 2013 The British Editorial Society of Bone & Joint Surgery.


Osumi T.,Nagoya University | Osumi T.,Japan Society for the Promotion of Science | Nakao T.,Ottawa Health Research Institute | Kasuya Y.,Kizawa Memorial Hospital | And 3 more authors.
Journal of Affective Disorders | Year: 2012

Background: Individuals with psychopathy have an increased tendency toward certain types of aggression. We hypothesized that successful psychopaths, who have no criminal convictions but can be diagnosed with psychopathy in terms of personality characteristics, are skilled at regulating aggressive impulses, compared to incarcerated unsuccessful psychopaths. Methods: In this block-designed functional magnetic resonance imaging (fMRI) study, we sought to clarify the neural mechanisms underlying differences in frustration-induced aggression as a function of psychopathy in non-criminal populations. Twenty male undergraduate students who completed a self-report psychopathy questionnaire were scanned while they completed a task in which they either could or could not punish other individuals who made unfair offers of monetary distribution. Results: Individuals with high psychopathic tendencies were less likely to make a decision to inflict costly punishment on people proposing unfair offers. During this decision-making, psychopathy was associated with less amygdala activity in response to the unfairness of offers. Moreover, the amygdala dysfunction in psychopathic individuals was associated with reduced functional connectivity with dopaminergic-related areas, including the striatum, when punishment was available compared to when it was unavailable. Limitations: The possibility that levels of psychopathic traits in a regular population were milder than in incarcerated populations cannot be ruled out. Conclusions: The findings indicate that amygdala dysfunction underlies affective deficits of psychopathy. We propose that the insensitivity of the amygdala to the affective significance of social stimuli contributes to an increased risk of violation of social norms, but enhances the ability to attenuate impulses toward maladaptive aggression in successful psychopaths. © 2012 Elsevier B.V.


Hiroyasu S.,Osaka City University | Ozawa T.,Osaka City University | Kobayashi H.,Osaka City University | Ishii M.,Osaka City University | And 6 more authors.
American Journal of Pathology | Year: 2013

Bullous pemphigoid (BP) is an autoimmune blistering skin disease induced by pathogenic autoantibodies against a type II transmembrane protein (BP180, collagen type XVII, or BPAG2). In animal models, BP180 autoantibody-antigen interaction appears insufficient to develop blisters, but involvement of complement and neutrophils is required. However, cultured keratinocytes treated with BP-IgG exhibit a reduction in the adhesive strength and a loss of expression of BP180, suggesting that the autoantibodies directly affect epidermal cell-extracellular matrix integrity. In this study, we explored the consequences of two distinct epithelial cells treated with BP-IgG, particularly the fate of BP180. First, we followed the distribution of green fluorescent protein-tagged BP180 in an epithelial cell line, 804G, and normal human epidermal keratinocytes after autoantibody clustering. After BP-IgG treatment, the adhesive strength of the cells to their substrate was decreased, and BP180 was internalized in both cell types, together with the early endosomal antigen-1. By using various endocytosis inhibitors and a fluid-uptake assay, we demonstrated that BP-IgG-induced BP180 internalization is mediated via a macropinocytic pathway. Moreover, a macropinocytosis inhibitor rescued a BP-IgG-induced reduction in the adhesive strength of the cells from their substrate. The results of this study suggest that BP180 internalization induced by BP-IgG plays an important role in the initiation of disease pathogenesis. Copyright © 2013 American Society for Investigative Pathology.


Murakami H.,Integrative Brain Imaging Center | Nakao T.,Hiroshima University | Matsunaga M.,Okazaki National Research Institute | Kasuya Y.,Kizawa Memorial Hospital | And 3 more authors.
PLoS ONE | Year: 2012

Mindfulness is currently attracting a great deal of attention as a psychotherapy technique. It is defined as bringing one's complete attention to the experiences occurring in the present moment in a nonjudgmental or accepting way. The Five Facet Mindfulness Questionnaire (FFMQ) was developed to assess individual differences in mindfulness states. The FFMQ is composed of five facets representing elements of mindfulness: non-reactivity to inner experience, non-judging, acting with awareness, describing, and observing. In the present study, we applied voxel-based morphometry to investigate the relationship between the brain structure and each facet as measured by the FFMQ. The results showed a positive association between the describing facet of mindfulness on the FFMQ and gray matter volume in the right anterior insula and the right amygdala. In conclusion, mindfulness was related with development in parts of the somatic marker circuit of the brain. © 2012 Murakami et al.


Matsuo M.,Kizawa Memorial Hospital | Miwa K.,Gifu University | Tanaka O.,Kizawa Memorial Hospital | Shinoda J.,Gifu University | And 9 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2012

Purpose: The purpose of this work was to define the optimal margins for gadolinium-enhanced T 1-weighted magnetic resonance imaging (Gd-MRI) and T 2-weighted MRI (T 2-MRI) for delineating target volumes in planning radiation therapy for postoperative patients with newly diagnosed glioblastoma multiforme (GBM) by comparison to carbon-11-labeled methionine positron emission tomography ([ 11C]MET-PET) findings. Methods and Materials: Computed tomography (CT), MRI, and [ 11C]MET- PET were separately performed for radiation therapy planning for 32 patients newly diagnosed with GBM within 2 weeks after undergoing surgery. The extent of Gd-MRI (Gd-enhanced clinical target volume [CTV-Gd]) uptake and that of T 2-MRI of the CTV (CTV-T 2) were compared with the extent of [ 11C]MET-PET (CTV - [ 11C]MET-PET) uptake by using CT - MRI or CT - [ 11C]MET-PET fusion imaging. We defined CTV-Gd (x mm) and CTV-T 2 (x mm) as the x-mm margins (where x = 0, 2, 5, 10, and 20 mm) outside the CTV-Gd and the CTV-T 2, respectively. We evaluated the relationship between CTV-Gd (x mm) and CTV - [ 11C]MET-PET and the relationship between CTV-T 2 (x mm) and CTV - [ 11C]MET-PET. Results: The sensitivity of CTV-Gd (20 mm) (86.4%) was significantly higher than that of the other CTV-Gd. The sensitivity of CTV-T 2 (20 mm) (96.4%) was significantly higher than that of the other CTV-T 2 (x = 0, 2, 5, 10 mm). The highest sensitivity and lowest specificity was found with CTV-T 2 (x = 20 mm). Conclusions: It is necessary to use a margin of at least 2 cm for CTV-T 2 for the initial target planning of radiation therapy. However, there is a limit to this setting in defining the optimal margin for Gd-MRI and T 2-MRI for the precise delineation of target volumes in radiation therapy planning for postoperative patients with GBM. Copyright © 2012 Elsevier Inc. Printed in the USA. All rights reserved.


Aoyama Y.,Okayama University | Nagai M.,Gifu University | Kitajima Y.,Kizawa Memorial Hospital
British Journal of Dermatology | Year: 2010

Background Pemphigus vulgaris (PV) is characterized by autoantibodies against desmoglein (Dsg) 3 or both Dsg1 and Dsg3, i.e. desmosomal adhesion molecules. Objectives We examined whether or not PV IgG binding to Dsg3 directly impairs the adhesion of desmosomes. Methods For immunofluorescence microscopy, keratinocytes were first incubated with PV IgG for 30 min in low Ca2+ medium, in which no desmosomes were formed, and then for 1 h in high Ca 2+ medium to generate desmosomes. For immunoelectron microscopy, after a 30-min incubation with PV IgG in low Ca2+ medium, cells were incubated with antihuman IgG with 5-nm gold particles for 5 min; after washing, cells were further incubated in high Ca2+ medium for 1 h. For tracing of PV IgG/Dsg3 immune complexes formed in the desmosomal core domain, cells were first incubated with PV IgG for 5 min to allow PV IgG to bind the desmosomal core domain and were further incubated with PV IgG-free medium for different times. Results Immunofluorescence microscopy revealed that PV IgG bound in a random-punctate pattern on the cell surface in low Ca2+ medium was translocated to the cell-cell contacts forming a dotted-linear distribution, suggesting desmosome generation even in the presence of PV IgG. Immunoelectron microscopy revealed that half-desmosome-like structures decorated with gold particles in low Ca2+ keratinocytes coupled to form desmosomes and gold particles were sandwiched in the desmosomal core domain after Ca2+ switch, even though their surfaces were covered with PV IgG/antihuman IgG 5-nm gold particles. In the tracing experiments, although PV IgG demonstrated a dotted-linear distribution along the cell-cell contacts colocalized with desmoplakin (DPK) after a 30-min tracing, it disappeared from cell-cell contacts after a 5-h tracing, leaving DPK and desmocollin 3. Conclusions These results suggest that the PV IgG/Dsg3 immune complexes are excluded from the desmosomal core domain rather than directly splitting the desmosome. © 2010 British Association of Dermatologists.


Yorifuji T.,Osaka City General Hospital | Kawakita R.,Osaka City General Hospital | Hosokawa Y.,Osaka City General Hospital | Fujimaru R.,Osaka City General Hospital | And 6 more authors.
Clinical Endocrinology | Year: 2013

Objective To evaluate the efficacy of long-term, continuous, subcutaneous octreotide infusion for congenital hyperinsulinism caused by mutations in the KATP-channel genes, KCNJ11 and ABCC8. Patients Fifteen Japanese patients with diazoxide-unresponsive, KATP-channel hyperinsulinism. Methods Molecular diagnoses were made by sequencing and multiple ligation-dependent probe amplification analysis. In patients with paternally inherited, monoallelic mutations, 18F-DOPA PET scans were performed to determine the location of the lesion. The patients were treated with continuous, subcutaneous octreotide infusion at a dosage of up to 25 μg/kg/day, using an insulin pump to maintain blood glucose levels higher than 3·33 mmol/l. Additional treatments (IV glucose, glucagon or enteral feeding) were administered as needed. The efficacy of the treatment was assessed in patients who received octreotide for 4 months to 5·9 years. Results Three patients had biallelic mutations, and 12 had monoallelic, paternally inherited mutations. Four patients with monoallelic mutations showed diffuse 18F-DOPA uptake, whereas seven patients showed focal uptake. Octreotide was effective in all the patients. The patients with biallelic mutations required a higher dosage (17-25 μg/kg/day), and two patients required additional treatments. By contrast, the patients with monoallelic mutations required a lower dosage (0·5-21 μg/kg/day) irrespective of the PET results and mostly without additional treatments. Treatment was discontinued in three patients at 2·5, 3·3 and 5·9 years of age, without psychomotor delay. Except for growth deceleration at a higher dosage, no significant adverse effects were noted. Conclusions Long-term, continuous, subcutaneous octreotide infusion is a feasible alternative to surgery especially for patients with monoallelic KATP-channel mutations. © 2012 John Wiley & Sons Ltd.


Kaneko Y.,Kizawa Memorial Hospital
Japanese Journal of Clinical Radiology | Year: 2015

Sarcomatoid renal cell carcinoma (SRCC), also known as renal cell carcinoma of the spindle cell type, is a relatively rare and aggressive renal tumor with poor prognosis. We present two cases of SRCC that showed intense uptake on FDG-PET. We may need to consider the possibility of SRCC when a renal tumor shows intense FDG uptake on FDG-PET.


Kamiya H.,Kizawa Memorial Hospital
Nihon rinsho. Japanese journal of clinical medicine | Year: 2012

Early radiation dermatitis develops after large doses of X-radiation. Inflammatory erythema develops within about a week. This may heal with desquamation and pigmentation. If the dose was high enough, painful blisters may develop at the site of erythema. In that case, healing usually takes place with atrophy, teleangiectasia, and irregular hyperpigmentation. Subsequent to very large doses, ulceration occurs, generally within 2 months. Such an ulcer may heal ultimately with severe atrophic scarring. Chronic radiation dermatitis occurs from a few months to many years. The skin shows atrophy, teleangiectasia, and irregular hyper- and hypopigmentation. Ulceration may be seen within the areas of atrophy. Radiation ulcerations should be studied by biopsy if they have been present for three or more months. After a long latent period, various malignant neoplasms may form. Most frequent is the basal cell carcinoma, followed by squamous cell carcinoma.


Watanabe K.,Kizawa Memorial Hospital
Brain and Nerve | Year: 2016

Gene-microbiota interactions are now proposed to be a special case of gene-environmental interaction. Preclinical and clinical data summarized in this article reveal that a specific serum metabolite, associated with alterations in gut microbiome composition, might have an emerging role in the onset and pathogenesis of autism. Altered level of this specified metabolite may induce perturbations in the epigenome and modulate the expression of key disease susceptible genes in neurons and their associated cells during critical periods of neurodevelopment. The gut microbiota itself is now regarded as a reservoir for environmental epigenetic factors.

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