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PubMed | Red Cross, Tokyo Women's Medical University, Sakakibara Heart Institute of Okayama, Tenri Hospital and 13 more.
Type: Journal Article | Journal: Journal of the American College of Cardiology | Year: 2016

Point-by-point catheter ablation is an established treatment for drug-refractory paroxysmal atrial fibrillation (PAF). However, it is time consuming, requires excellent technique to achieve complete pulmonary vein (PV) isolation, and is associated with severe complications.The purpose of this study was to evaluate the safety and effectiveness of a HotBalloon ablation (HBA) compared with antiarrhythmic drug therapy (ADT) for the treatment of PAF.A prospective multicenter randomized controlled study was conducted in Japan. Patients with symptomatic PAF refractory to antiarrhythmic drugs (Class I to IV) were randomized to HBA or ADT at a 2:1 ratio and assessed for effectiveness in a comparable 9-month follow-up period.A total of 100 patients in the HBA group and 43 patients in the ADT group received treatment at 17 sites. HBAprocedure produced acute complete PV isolation in 98.0% (392 of 400) of the PVs and in 93.0% (93of100) of patients in the HBA group. The chronic success rates after the 9-month effective evaluation periodwere59.0% in the HBA group (n= 100) and 4.7% in the ADT group (n= 43; p< 0.001). The incidence of major complications was 11.2% (15of 134 patients). The incidences of PV stenosis (>70%) and transient phrenic nerve injurywere 5.2% and 3.7%, respectively. The mean fluoroscopy time was 49.4 26.6 min (n= 134), and the mean procedure duration was 113.931.9 min (n= 133).This study demonstrates the superiority of HBA compared with ADT for treatment of patients with PAF,and a favorable safety profile.


Nishikawa T.,Yokohama Rosai Hospital | Omura M.,Yokohama Rosai Hospital | Satoh F.,Tohoku University | Shibata H.,Keio University | And 3 more authors.
Endocrine Journal | Year: 2011

The Japan Endocrine Society (JES) attempted to develop guidelines for the diagnosis and treatment of primary aldosteronism (PA). The Task Force Committee (TFC) was composed of a chair, selected by the JES, and additional experts. Systematic reviews of available evidence for Japanese patients were used to recommend the key treatment and prevention. We have evaluated the methods of screening, confirmatory tests and imaging, plus adrenal vein sampling (AVS). Consensus was guided by systematic review of evidence and discussion during each annual meeting of the JES, plus its related meetings, and by e-mail communication. The drafts prepared by TFC were reviewed successively by the members of Research on Intractable Diseases provided by the Japanese Ministry of Health, Labour and Welfare, and in comments from the JES's councilors. At each stage of review, TFC received written comments and incorporated suggested changes. In conclusion, all patients with hypertension should be screened for PA, because of the high prevalence of cardiovascular disease and the current low case-detection rate in Japan. Case detection can be performed in hypertensive patients and those with hypokalemia by determining the aldosterone/renin ratio, and the diagnosis of PA can be confirmed by two of three confirmatory tests. The presence of a unilateral aldosterone-producing adenoma should be established/ excluded by AVS by an experienced radiologist, optimally followed by laparoscopic adrenalectomy. In contrast, patients with bilateral adrenal hyperplasia, or those unsuitable for surgery, are optimally treated medically with mineralocorticoid receptor antagonists. © The Japan Endocrine Society.


PubMed | Osaka City General Hospital, Koseikai Takeda Hospital, Osaka City University, Shiga University of Medical Science and Tokyo Metroplitan University
Type: | Journal: SpringerPlus | Year: 2014

Carcinoid tumors are slow-growing tumors originating in the neuroendocrine cells, and occur most frequently within the gastrointestinal tract. Although the liver is the most common site for metastatic carcinoid tumors, primary hepatic carcinoid tumors are exceedingly rare and reports of the imaging findings have been very scarce. We herein report imaging findings with an emphasis on magnetic resonance imaging in two cases of primary hepatic carcinoid tumors. In both cases, the tumors showed cystic areas with hemorrhagic components and early enhanced solid areas.


Chen Y.-W.,Central South University of forestry and Technology | Chen Y.-W.,Tokyo Metroplitan University | Furukawa A.,Tokyo Metroplitan University | Taniguchi A.,Ritsumeikan University | And 2 more authors.
2015 12th International Conference on Fuzzy Systems and Knowledge Discovery, FSKD 2015 | Year: 2015

In this paper, we propose an automated method for assessment of small bowel contraction movement based on the simple linear iterative clustering (SLIC) with cine-MRI. In our proposed method, the small bowel in each frame is considered as a super-pixel and is first segmented by the use of SLIC. SLIC performs a local clustering of pixels in a 3-D space defined by intensity and (x, y) coordinates. Then the dynamic area change of the segmented small bowel is used for quantitative analysis of the small bowel motility function. Compared with existing methods, our proposed method can achieve better results. © 2015 IEEE.


Furumoto K.,Koseikai Takeda Hospital | Kogire M.,Kishiwada City Hospital | Lizuka N.,Kishiwada City Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2015

A 63-year-old man who complained of hematochezia underwent colonoscopy, and a type 2 tumor was detected at the Rs portion. The tumor was initially diagnosed as a poorly differentiated adenocarcinoma by biopsy. Laparoscopy-assisted anterior resection with regional lymphadenectomy was performed, and pathological examination showed the tumor was a neuroendocrine carcinoma (NEC) with muscular invasion and lymph node metastasis. The Ki-67 index of the tumor was more than 70%. This patient underwent adjuvant chemotherapy with capecitabine for 6 months and is now alive without recurrence, more than 40 months after surgery. Although the prognosis of NEC is generally poor, capecitabine might be effective as an adjuvant chemotherapy regimen after curative resection.


Iejima D.,Tokyo Medical University | Minegishi Y.,Tokyo Medical University | Takenaka K.,Kyoto University | Takenaka K.,Koseikai Takeda Hospital | And 8 more authors.
Oncogene | Year: 2010

An adaptor protein FRS2Β inhibits epidermal growth factor-receptor (EGFR) tyrosine kinase without being phosphorylated at tyrosine residues after EGF stimulation. Although binding to ERK appears to be important for this inhibition, the precise molecular mechanisms and the role of FRS2Β in signal transduction mediated by other EGFR family members, as well as its role in human cancer, remain unclear. In this study, we demonstrate that FRS2Β inhibits anchorage-independent cell growth induced by oncogenic ErbB2, another member of EGFR family, and that it inhibits heterodimer formation between EGFR and ErbB2. We mapped the residues important for the FRS2Β and ERK interaction to two docking (D) domain-like sequences on FRS2Β and two aspartic acid residues in the common docking (CD) domain of ERK. Moreover, in response to EGF, ERK translocated to the plasma membrane in cells expressing FRS2Β but not an FRS2Β mutant in which four arginine residues in the D domains were replaced with alanines, suggesting that FRS2Β serves as a plasma membrane anchor for activated ERK. Finally, a low mRNA expression level of FRS2Β was significantly correlated with poor prognosis in a cohort of 60 non-small cell lung cancer patients. Therefore, we have identified the molecular mechanisms by which FRS2Β acts as a feedback inhibitor of EGFR family members and suggest a role for FRS2Β as a tumor suppressor. © 2010 Macmillan Publishers Limited All rights reserved.


Ueda T.,Rakuwakai Marutamachi Hospital | Narushima E.,Rakuwakai Marutamachi Hospital | Ishida E.,Rakuwakai Marutamachi Hospital | Akiguchi I.,Koseikai Takeda Hospital
Internal Medicine | Year: 2013

Neuronal ceroid lipofuscinosis (NCL) is a rare disease with onset typically during childhood; however, that developing during adulthood can lead to early-onset dementia. We report a 54-year-old man whose onset coincided with speech impairment, amnesia and dyscalculia. On brain MRI, marked diffuse leukoencephalopa-thy with periventricular predominance was observed. On a skin biopsy, characteristic fingerprint images were noted, and the patient was diagnosed with NCL. The differential diagnosis of cognitive impairment with leu-koencephalopathy is wide ranging; however, when marked symmetrical periventricular-predominant leukoen-cephalopathy is prevalent and no peripheral neuropathy or gait disorders are evident, a diagnosis of NCL should be suspected and a skin biopsy should be performed. © 2013 The Japanese Society of Internal Medicine.


Furumoto K.,Koseikai Takeda Hospital | Kogire M.,Koseikai Takeda Hospital | Iizuka N.,Koseikai Takeda Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

A 63-year-old man who complained of hematochezia underwent colonoscopy, and a type 2 tumor was detected at the Rs portion. The tumor was initially diagnosed as a poorly differentiated adenocarcinoma by biopsy. Laparoscopy-assisted anterior resection with regional lymphadenectomy was performed, and pathological examination showed the tumor was a neuroendocrine carcinoma (NEC) with muscular invasion and lymph node metastasis. The Ki-67 index of the tumor was more than 70%. This patient underwent adjuvant chemotherapy with capecitabine for 6 months and is now alive without recurrence, more than 40 months after surgery. Although the prognosis of NEC is generally poor, capecitabine might be effective as an adjuvant chemotherapy regimen after curative resection.


PubMed | Koseikai Takeda Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

A 63-year-old man who complained of hematochezia underwent colonoscopy, and a type 2 tumor was detected at the Rs portion. The tumor was initially diagnosed as a poorly differentiated adenocarcinoma by biopsy. Laparoscopy-assisted anterior resection with regional lymphadenectomy was performed, and pathological examination showed the tumor was a neuroendocrine carcinoma (NEC) with muscular invasion and lymph node metastasis. The Ki-67 index of the tumor was more than 70%. This patient underwent adjuvant chemotherapy with capecitabine for 6 months and is now alive without recurrence, more than 40 months after surgery. Although the prognosis of NEC is generally poor, capecitabine might be effective as an adjuvant chemotherapy regimen after curative resection.


PubMed | Koseikai Takeda Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

We performed transanal local excision of anal canal cancer in a 51-year-old man. The tumor was detected as an Isp polyp(7 mm)on the dentate line, by colonofiberscopic examination. Pathological findings indicated adenocarcinoma(T1b). The patient desired preservation of anal function, and hence refused abodominoperineal rectal transection with lymph node dissection. We obtained informed consent for recurrence, and observed the patient rigorously. No recurrence or metastasis has been detected 3 years and 3 months after tumor excision. We propose that transanal local excision might be a treatment option for early stage cancer of the anal canal.

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