Kobe-shi, Japan

Kobe Tokiwa University

Kobe-shi, Japan

Kobe Tokiwa University is a co-educational private university in Nagata-ku, Kobe, Hyōgo, Japan.The university was established in 2008 by reorganizing two departments of Kobe Tokiwa College. In 2012 the Department of Pedagogy of the college will be merged into the university to constitute the Faculty of Education. Wikipedia.

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Kakudo K.,Kobe Tokiwa University | Bai Y.,Peking University | Liu Z.,Shandong University | Li Y.,Wakayama Medical University | And 2 more authors.
Endocrine Journal | Year: 2012

We propose a new classification of thyroid follicular cell tumors which is correlated with patient's prognosis. It is unique as to two new categories: borderline malignancy between benign and malignant, and moderately differentiated adenocarcinoma (MDA) as a differentiation classification to stratify tumor aggressiveness. As to diagnostic criteria, we recommend invasiveness (capsular and vascular invasion) to separate benign and malignant and it should not be based on presence or absence of papillary thyroid carcinoma (PTC) type nuclear features (PTC-N). Thus borderline malignancy in our new classification includes some of the formerly malignant tumors and they are 1) papillary microcarcinoma, 2) encapsulated conventional PTC (EncPTC), 3) encapsulated follicular variant PTC (EnFVPTC), 4) well differentiated tumor of uncertain malignant potential (WDT-UMP), 5) follicular tumors of uncertain malignant potential (FT-UMP), and 6) capsular invasion only follicular thyroid carcinoma (FTC). Review of the literature revealed that those thyroid tumors have consistently excellent outcome. Well differentiated follicular cell adenocarcinoma (WDA) in our classification includes common type PTC and low-risk follicular carcinoma (FTC). They are invasive (diffuse infiltrative) common type PTC and minimally invasive type FTC with less than 4 foci of angioinvasion. Moderately differentiated follicular cell adenocarcinoma (MDA) includes FTC with angioinvasion (more than 4), aggressive variants of PTC, such as tall cell, columnar cell, solid, loss of cellular polarity/cohesiveness (hobnail) variants and encapsulated carcinoma with high grade histology. Poorly differentiated carcinoma (PDC) includes PDC of WHO definition, insular carcinoma, tumors with minor anaplastic transformation and tumors with distant metastasis at presentation. © The Japan Endocrine Society.

Kakudo K.,Kobe Tokiwa University | Kakudo K.,Wakayama Medical University | Bai Y.,Peking University | Liu Z.,Shandong University | Ozaki T.,Wakayama Medical University
Pathology International | Year: 2012

Papillary thyroid carcinoma (PTC) has long been diagnosed based on its unique nuclear features (PTC-N); however, significant observer discrepancies have been reported in the diagnosis of encapsulated follicular patterned lesions (EnFPLs), because the threshold of PTC-N is subjective. An equivocal PTC-N may often occur in non-invasive EnFPLs and benign/malignant disagreements often create serious problems for patients' treatment. This review collects recent publications focusing on the so-called encapsulated follicular variant of papillary thyroid carcinoma (EnFVPTC) and tries to emphasize problems in the histopathological diagnosis of this spectrum of tumors, which covers encapsulated common-type PTC (EncPTC), EnFVPTC, well-differentiated tumor of uncertain malignant potential (WDT-UMP), follicular adenoma (FA) with equivocal PTC-N and minimally invasive follicular carcinoma (mFTC). We propose that EnFVPTC and other EnFPLs with equivocal PTC-N should be classified into a unified category of borderline malignancy, such as well-differentiated tumor of uncertain behavior (WDT-UB), based on their homogeneous excellent outcome. It is suggested that the unified nomenclature of these lesions may be helpful to reduce significant observer disagreements in diagnosis, because complete agreement in the diagnosis of an EncPTC, EnFVPTC or FA by all pathologists may be not possible for this problematic group of tumors. In conclusion, a malignant diagnosis of EnFVPTC should not be used to cover this spectrum of tumors until uncertainty about the nature of this lesion is settled, whether it is benign, precancerous or malignant. © 2012 The Authors. Pathology International © 2012 Japanese Society of Pathology and Blackwell Publishing Asia Pty Ltd.

Li Y.,Shandong University | Li Y.,Wakayama Medical University | Zhou G.,Shandong University | Ozaki T.,Wakayama Medical University | And 8 more authors.
Modern Pathology | Year: 2012

A form of Hashimotos thyroiditis with lymphoplasmacytic sclerosing changes and increased numbers of IgG4-positive plasma cells has recently been reported in the literature. These histopathological features suggest that this subtype of Hashimotos thyroiditis may be closely related to IgG4-related disease. Therefore, this unique form of IgG4-related Hashimotos thyroiditis, which is referred to as IgG4 thyroiditis, has its own clinical, serological, and sonographic features that are distinct from those associated with non-IgG4 thyroiditis. IgG4 thyroiditis shares similarities with the well-known fibrous variant of Hashimotos thyroiditis; however, the detailed histopathological features of IgG4 thyroiditis have not been well established. Based on immunostaining results, 105 patients with Hashimotos thyroiditis were divided into an IgG4 thyroiditis group (n=28) and a non-IgG4 thyroiditis group (n=77). As in our previous reports, IgG4 thyroiditis was associated with a patient population of a younger age, a lower female-to-male ratio, rapid progression, higher levels of thyroid autoantibodies, subclinical hypothyroidism, and diffuse sonographic echogenicity. Histopathologically, this group revealed severe lymphoplasmacytic infiltration, dense stromal fibrosis, marked follicular cell degeneration, numerous micro-follicles, and notable giant cell/histiocyte infiltration. Importantly, the IgG4-related group did not completely overlap with fibrous variant of Hashimotos thyroiditis. Four cases (14%) in the IgG4 thyroiditis group presented only mild fibrosis in the stroma, whereas 29 cases (38%) in the non-IgG4 thyroiditis group met the diagnostic criteria for fibrous variant of Hashimotos thyroiditis. Furthermore, we observed three patterns of stromal fibrosis in Hashimotos thyroiditis: interfollicular fibrosis, interlobular fibrosis, and scar fibrosis. The IgG4 thyroiditis group was significantly associated with the presence of predominant interfollicular fibrosis. In conclusion, IgG4 Hashimotos thyroiditis presents histopathological features quite distinct from its non-IgG4 counterpart. © 2012 USCAP, Inc. All rights reserved.

Kakudo K.,Kobe Tokiwa University | Kakudo K.,Wakayama Medical University | Bai Y.,Peking University | Ozaki T.,Wakayama Medical University | And 3 more authors.
Histology and Histopathology | Year: 2013

Carcinoma of possible thymic epithelial origin may occur within the thyroid gland, which was first reported by Miyauchi et al. as intrathyroid epithelial thymoma (ITET). ITET is a rare tumor comprising about 0.08% of all primary thyroid malignancies. It is a lowgrade thyroid carcinoma with squamous cell differentiation whose overall survival rate was found to be 71%. Lymph node metastasis at surgery was found in 40% and hematogenous metastases developed in bones, liver and lungs. This tumor grows within the thyroid gland and invades into the thyroid parenchyma as well as into the extrathyroid structures. It is a wellcircumscribed solid tumor with a sharp tumor border, but is not capsulated. After fixation, the cut surface of the tumor is gray-white in color and is a solid tumor with lobulation. Tumor calcification was not detected in our 15 cases. The tumor cells show solid sheets of growth with occasional keratinization without follicular or papillary structures. Lymphocytic infiltration in the stroma is one of the most characteristic features of this tumor. The tumor cells are polygonal epithelial cells with distinct nucleoli and ill-defined cell border. Positive immunoreactivity for CD5 is a key feature to differentiate it from undifferentiated carcinoma, poorly differentiated carcinoma, medullary (C cell) carcinoma and high-grade squamous cell carcinoma (so-called primary squamous cell carcinoma) of the thyroid. Negative immunoreactivity for calcitonin, TTF1 and thyroglobulin, and positive immunoreactivity for p63 and KIT are also helpful for differential diagnosis. Nuclear atypia is mild and mitoses are less frequent, with an intermediate proliferation index (MIB-1 labeling index is usually less than 20%), which are also helpful to differentiate it from high-grade primary squamous cell carcinoma of the thyroid. The tumors in our 15 cases demonstrate 3 histological subtypes: keratinizing squamous cell carcinoma type, non-keratinizing basaloid cell carcinoma (lymphoepithelioma-like) type and neuroendocrine carcinoma type, which correspond to subtypes of the mediastinal thymic carcinomas.

Although preparation for frequently occurring disasters is required in the context of preparing a home care environment wherein people reside and receive care, existing preparations cannot be described as sufficient. Therefore, effective preparation has become a research focus. This study aimed to identify the risks faced by people receiving home care in disaster situations and to clarify the risk-related actions taken by various stakeholders in order to study appropriate risk management for people receiving care. We interviewed 8 individuals, including people receiving care and their family members, who were victims in the large-scale disasters associated with the Great Hanshin-Awaji Earthquake(1995)or later, conducted the factorsearch qualitative analysis, and mapped the actions taken by stakeholders. As a result, identified risks were classified into 5 categories and 13 subcategories. Risk actions taken by professionals and others could be elucidated from the stakeholder map. Our findings indicate the necessity of establishing risk management protocols for people receiving home care and preparing in ordinary times.

Ugai C.,Kobe Tokiwa University
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

We clarified the role of cooperation of nursing personnel who work in day care services, to precede our examination of inter-occupational cooperation. The study results revealed that there were four cooperation levels. Subjects for the cooperation included:"difficulty in sharing information,""difficulty in understanding the whole picture,""difficulty in finding directions, "and"difficulty in dealing with emergency cases."The purpose of this study was to clarify the inter-occupational cooperation levels in a day care service and its subjects. We also conducted semi-structured interviews with 13 persons of differing occupations(other than nurses), and who worked in day-care services in A prefecture. As a result, it was revealed that there were three inter-occupational cooperation levels and its subjects included:"difficulty in sharing information" (which was answered the same as the nurses),"difficulty in sharing goals"(which were different among individual occupations), "lack of consistency in care,""necessity of learning because of insufficient knowledge,"and"hesitation to notify."

Umimoto K.,Osaka Electro-Communication University | Nagata S.,Osaka Electro-Communication University | Yanagida J.,Kobe Tokiwa University
Journal of Physics: Conference Series | Year: 2013

When water containing ionic substances is electrolyzed, electrolyzed water with strong bactericidal ability due to the available chlorine(AC) is generated on the anode side. Slightly acidic to neutral electrolyzed water (pH 6.5 to 7.5) is physiological pH and is suitable for biological applications. For producing slightly acidic to neutral electrolyzed water simply, a vertical-type electrolytic tank with an asymmetric structure was made. As a result, a small amount of strongly alkaline water was generated in the upper cathodic small chamber, and a large amount of weakly acidic water generated in the lower anodic large chamber. The pH and AC concentration in solutin mixed with both electrolyzed water were 6.3 and 39.5 ppm, respectively, This solution was slightly acidic to neutral electrolyzed water and had strong bactericidal activity. This device is useful for producing slightly acidic to neutral electrolyzed water as a disinfectant to employ at home care, when considering economic and environmental factors, since it returns to ordinary water after use. © 2013 Published under licence by IOP Publishing Ltd.

Hata K.,Kobe Tokiwa University
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

The number of patients requiring testing in the future is expected to increase further with an increase in the number of home care patients that are highly dependent on medical care and in the process of developing health care policies that aim at the creation of regional-based total medical care. The effective use of new technologies to support patients is examined to avoid the fact that fluctuations in patients' health and the limitations of caregivers' capacity make it difficult to continue home care. This study focuses on mobile testing equipment and aims to clarify test applications using this equipment, as well as issues during applications. Interviews were conducted with four physicians that have actual experience in using mobile testing equipment at home care support clinics, and a qualitative analysis was carried out. As a result, seven categories for test applications and five categories for issues were identified. The current state of and new approaches for home care were inferred using evidence from those categories.

Hata K.,Kobe Tokiwa University
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2014

With the rising number of patients who rely on medical care, it is necessary to use evolving health care technology appropriately, to control health care costs, and to enhance the well-being of patients in the home care setting. Point of care testing (POCT)is instrumental system for such demands for home care; however, this term remains relatively unknown in Japan. For this research, I conducted a qualitative analysis of factors based on stories obtained through group interviews of 11 experienced home visiting nurses who work at three home-visit nursing stations for the purpose of clarifying issues in the introduction of POCT. The results of the research identified five categories and 16 subcategories for issues in the introduction of POCT. The identified categories are expected to be useful for the spread of POCT in the future. Key words: Point of care testing, Home care nursing.

Sakamoto H.,Kobe Tokiwa University
Rinsho byori. The Japanese journal of clinical pathology | Year: 2011

The Great East Japan Earthquake caused a tragic tsunami and resulted in serious damage to north region of Japan on March 11, 2011. The Japanese Society of Laboratory Medicine, JSLM launched an ad hoc Committee to support Laboratory Medicine affairs in the affected area. We expected that laboratory testing demands would increase during the weeks following the disaster. We decided to support the use of Point-of-Care Testing. Many POCT devices use battery-powered analyzers. This is definite advantage for their use in areas with limited access to power and water supplies. We contacted many companies about the possibility of providing POCT devices, IVD reagents and/or any laboratory supplies including disposable materials. Finally, forty companies agreed to support this project and we received list of reagents materials for more than one hundred IVD tests. We entered this information on our web site and continued to update it as additional support was received. Once a request of support was received, communication were made to confirm the amount of material, the method of shipping/receipt and if any specific training that would be required for its use at the testing site. Also, we dispatched volunteer Medical Technologists for eight weeks to assist in the laboratory work. Some of the crucial points in recruiting volunteer laboratory professions are expenses and accommodations. We prepared not only accommodations but also transportation methods and covered all expenses including insurance and meals. Our relief activities have shown that Laboratory Medicine and Medical Technologists are useful in disaster-affected area.

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