Niizuma T.,Tokyo Rinkai Hospital |
Niizuma T.,Koshigaya Municipal Hospital |
Kinoshita K.,Koshigaya Municipal Hospital
Japanese Journal of Infectious Diseases | Year: 2014
We encountered a 3.5-year-old girl with acute encephalopathy associated with human metapneumovirus (hMPV) infection. She had pyrexia and status epilepticus, followed by a coma. Cerebrospinal fluid analysis showed no pleocytosis or elevation of protein levels. hMPV RNA was detected in tracheal aspirate. Acute encephalopathy in the patient was probably related to the hMPV infection. Serum levels of interleukin-6 and matrix metalloproteinase-9 were elevated on admission, and these factors were presumed to be related to acute encephalopathy, associated with her viral infection, or due to status epilepticus. She was treated with dexamethasone pulse therapy, intravenous immunoglobulin, and continuous thiopental infusion. She recovered without neurological sequelae.
PubMed | Hiroshima University, Koshigaya Municipal Hospital, Center for Cancer Control and Information Services, Kyoto University and Aomori Prefectural Central Hospital
Type: Journal Article | Journal: Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) | Year: 2016
This study was undertaken to analyze the results of intensity-modulated radiotherapy (IMRT) dosimetry credentialing using a phantom in the Japanese Clinical Oncology Group clinical trials.All measurements were performed on-site. The IMRT phantom consisted of a phantom shell and a module. Two types of structures, including a C-shaped planning target volume (PTV) around a column-shaped organ at risk (OAR), were included in the module. Each participating institution was asked to image, plan, and treat the phantom. A prescription dose of 2Gy should cover 95% of the PTV. The plan should limit the maximum doses to the PTV and OAR to less than 110% and 60%, respectively. The pass criteria were 3% in terms of chamber dosimetry and a difference in profile position 2mm in the high-dose gradient area of film dosimetry. The positional difference was defined as the largest distance between the measured and calculated positions at doses of 60% or 80%. These tolerances were based on the Japanese Society for Radiation Oncology IMRT guidelines.Credentialing was performed on a total of 44 treatment machines in 32 institutions from 2009 to 2015. All differences between measured and planned doses at the measurement points of the PTV were within 3%. The meansstandard deviations of the positional differences were 1.00.4mm and 0.90.3mm without and with the phantom shell, respectively.The dose differences and positional differences met the desired criteria in all institutions.
PubMed | Koshigaya Municipal Hospital, National Cancer Center Hospital, Institute of Biomedical Research and Innovation, Data Center and 6 more.
Type: | Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology | Year: 2016
A dose escalation study to determine the recommended dose (RD) with stereotactic body radiation therapy (SBRT) for peripheral T2N0M0 non-small cell carcinomas (NSCLC) was conducted. The results of the group with PTV100cc are reported in this paper.The continual reassessment method (CRM) was used to determine the dose level that patients should be assigned to and to estimate the maximum tolerated dose (MTD). Dose limiting toxicity (DLT) was Grade 3 or higher radiation pneumonitis (RP), and Grade 2 or higher RP was used as a surrogate DLT. The RD was equal to the MTD. The dose was prescribed at DThirteen patients were accrued. More patients should have been enrolled but we decided not to prolong the study period. No patients experienced Grade 3 RP. Two patients experienced Grade 2 RP at 50Gy in 4 fractions. The predicted MTD was 50.2Gy. The posterior probability of the Grade 2 RP frequency over 40% was 5.3% for the dose level of 50Gy. The RD was determined to be 50Gy.The RD was determined to be 50Gy in 4 fractions in this population.
A randomized Phase III trial of comparing two dose-fractionations stereotactic body radiotherapy (SBRT) for medically inoperable Stage IA non-small cell lung cancer or small lung lesions clinically diagnosed as primary lung cancer: Japan Clinical Oncology Group Study JCOG1408 (J-SBRT trial)
PubMed | Hiroshima Precise Radiotherapy Center, Koshigaya Municipal Hospital, National Cancer Center Hospital, Hiroshima University and 3 more.
Type: | Journal: Japanese journal of clinical oncology | Year: 2017
A randomized Phase III trial commenced in Japan in February 2016. Currently, 42 Gy in four fractions of stereotactic body radiotherapy prescribed at the D
PubMed | Juntendo University, Niigata Cancer Center Hospital, Koshigaya Municipal Hospital, National Cancer Center Hospital and 4 more.
Type: Journal Article | Journal: Japanese journal of clinical oncology | Year: 2016
No randomized controlled trials comparing stereotactic body radiotherapyand lobectomy for operable early-stage non-small-cell lung cancer have been successfully conducted. This study compared survival outcomes in two multi-institutional clinical trials for stereotactic body radiotherapy (Japan Clinical Oncology Group JCOG0403) and lobectomy (Japan Clinical Oncology Group JCOG0201) with propensity score analysis.Inclusion criteria were operable, cT1N0M0 and adenocarcinoma diagnosed prior to registration of each trial. Forty of 169 patients from JCOG0403 and 219 of 811 patients fromJCOG0201 were included. The primary endpoint was overall survival adjusted with propensity score analysis. The patient selection factors included in the logistic model to estimate the propensity score were age, sex, tumor diameter and consolidation/tumor ratio.Among patient selection factors, age distribution was quite different with little overlap: the median was 79 (interquartile range: 74.5-83.5) instereotactic body radiotherapy and 62 (interquartile range: 55-68) in lobectomy. In propensity score analysis, 21 patients from each group were matched and the hazard ratioforstereotactic body radiotherapy over lobectomy was 9.00 (95% confidence interval: 1.14-71.04). In the post hoc subgroup analysis with propensity score analysis of inverse probability of treatment weighting, patients were limited to be aged 75 or younger because JCOG0201 only included them when aged 75 or younger. Thirteen patients forstereotactic body radiotherapy and 219 for lobectomy were compared, and thehazard ratio for stereotactic body radiotherapy over lobectomy was 1.19 (95%confidence interval: 0.38-3.73).The point estimates ofhazard ratio favored lobectomy overstereotactic body radiotherapy in the limited number of patients. A randomized controlled study is needed for valid comparison.
Kamata A.,Koshigaya Municipal Hospital
Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases | Year: 2010
Increased otitis media rendering acute mastoiditis and mastoid lesions severe or intractable appear to be related to dominant drug-resistant strains and the dissemination of nursery school attendance. Acute mastoiditis involves middle-ear inflammation spreading to the antrum mastoideum and accompanied by subcutaneous abscess. This emergency condition risks progression to subperiosteal abscess and meningitis. Mastoid cavity opacity in computed tomography (CT) scan often occurs with recurrent or intractable otitis media similar to that with mastoiditis. Four of the 8 cases of mastoiditis we treated were infant in whom upper respiratory tract pneumococcus and group A streptococcus were detected. Treatment involved antibiotics and myringotomy in all cases and surgery in two. Nine of the 10 cases of mastoid lesions with otitis media we saw were infant. All had pneumococcus detected, with accociated sinusitis.
Obinata K.,Koshigaya Municipal Hospital |
Obinata K.,Juntendo University |
Okumura A.,Juntendo University |
Nakazawa T.,Juntendo University |
And 4 more authors.
Pediatric Infectious Disease Journal | Year: 2010
Norovirus causes acute gastroenteritis in all age groups. Afebrile convulsion is an occasional neurologic complication in norovirus infection, but encephalitis is rare. We report the case of a previously healthy 15-month-old girl with norovirus encephalopathy who had a poor neurologic outcome. Norovirus (genogroup II) was detected in plasma and stool by real-time reverse transcription polymerase chain reaction, but the cerebrospinal fluid showed negative result for genome. Elevated concentrations of cerebrospinal fluid interleukin-6, interleukin-10, interferon-γ, and tumor necrosis factor-α were observed on the third day of illness. The encephalopathy in our patient may be related to hypercytokinemia rather than to direct viral invasion. Copyright © 2010 by Lippincott Williams & Wilkins.
Fujishiro H.,Nagoya University |
Nakamura S.,Koshigaya Municipal Hospital |
Sato K.,Juntendo University |
Iseki E.,Juntendo University
Geriatrics and Gerontology International | Year: 2015
Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementing disorder after Alzheimer's disease (AD), but there is limited information regarding the prodromal DLB state compared with that of AD. Parkinson's disease (PD) and DLB share common prodromal symptoms with Lewy body disease (LBD), allowing us to use a common strategy for identifying the individuals with an underlying pathophysiology of LBD. Dysautonomia, olfactory dysfunction, rapid eye movement sleep behavior disorder (RBD) and psychiatric symptoms antedate the onset of dementia by years or even decades in patients with DLB. Although RBD is the most potentially accurate prodromal predictor of DLB, disease progression before the onset of dementia could differ between the prodromal DLB state with and without RBD. Experts who specialize in idiopathic RBD and DLB might need communication in order to clarify the clinical relevance of RBD with the disease progression of DLB. The presence of prodromal LBD symptoms or findings of occipital hypoperfusion/hypometabolism helps us to predict the possible pathophysiological process of LBD in non-demented patients. This approach might provide the opportunity for additional neuroimaging, including cardiac123I-metaiodobenzylguanidine scintigraphy and dopamine transporter imaging. Although limited radiological findings in patients with prodromal DLB states have been reported, there is now a need for larger clinical multisite studies with pathological verification. The long prodromal phase of DLB provides a critical opportunity for potential intervention with disease-modifying therapy, but only if we are able to clearly identify the diversity in the clinical courses of DLB. In the present article, we reviewed the limited literature regarding the clinical profiles of prodromal DLB. © 2015 Japan Geriatrics Society.
Tanaka M.,Juntendo University |
Yokota E.,Juntendo University |
Toyonaga Y.,Juntendo University |
Shimizu F.,Juntendo University |
And 3 more authors.
Korean Journal of Urology | Year: 2013
Purpose: To identify the parameters on noncontrast computed tomography (NCCT) that best predict the success of shock wave lithotripsy (SWL). Materials and Methods: We reviewed the records of 75 patients who underwent SWL for urinary calculi measuring 5 to 20 mm. Using NCCT images, we estimated the largest stone cross-sectional area and contoured the inner edge of the stone. Clinical outcome was classified as successful (stone-free or < 4 mm in diameter) or failed (stone fragments, ≥4 mm). The impact of preoperative parameters was evaluated by univariate and multivariate analysis. Results: The overall success rate was 73.3%. Average stone attenuation value, stone length, and stone cross-sectional area in the success and failure groups were 627.4±166.5 HU (Hounsfield unit) vs. 788.1±233.9 HU (p=0.002), 11.7±3.8 mm vs. 14.2±3.6 mm (p=0.015), and 0.31±0.17 cm2 vs. 0.57±0.41 cm2 (p<0.001), respectively. In the multivariate analysis, stone attenuation value was the only independent predictor of SWL success (p=0.023), although stone cross-sectional area had a tendency to be associated with SWL success (p=0.053). Patients were then classified into four groups by using cutoff values of 780 HU for stone attenuation value and 0.4 cm2 for cross-sectional area. By use of these cutoff values, the group with a low stone attenuation value and a low cross-sectional area was more than 11.6 times as likely to have a successful result on SWL as were all other groups (odds ratio, 11.6; 95% confidence interval, 3.9 to 54.7; p<0.001). Conclusions: Stone attenuation value and stone cross-sectional area are good predictors of extracorporeal SWL outcome. © The Korean Urological Association, 2013.
Watari A.,Koshigaya Municipal Hospital |
Kobori H.,Koshigaya Municipal Hospital |
Yamamoto T.,Koshigaya Municipal Hospital
Journal of Minimally Invasive Gynecology | Year: 2011
Malignant hyperthermia (MH) is a life-threatening complication of general anesthesia, and early diagnosis and prompt treatment are important for successful management of this condition. Diagnosis of MH during a laparoscopic operation may be difficult because the early signs of the condition are similar to the expected physical changes that occur during laparoscopy. Herein is presented the case of a successfully treated 37-year-old woman without any pertinent surgical or medical history in whom MH developed during laparoscopic myomectomy. The operation was initiated with the patient under general anesthesia with propofol, sevoflurane, nitrous oxide, and intermittent doses of vecuronium. Twenty minutes after the start of CO 2 insufflation, increased end-tidal CO 2 and tachycardia were observed, which did not improve even with increased ventilation and release of insufflation. The anesthesiologist strongly suspected MH, and dantrolene was immediately administered. The patient quickly recovered, and experienced no postoperative complications. © 2011 AAGL.