Kure kyosai Hospital

Kure Hiroshima, Japan

Kure kyosai Hospital

Kure Hiroshima, Japan

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Togao O.,Advanced Imaging Research Center | Doi S.,Southwestern Medical Center | Kuro-o M.,Southwestern Medical Center | Masaki T.,Advanced Imaging Research Center | Takahashi M.,Kure Kyosai Hospital
Radiology | Year: 2010

Purpose: To test, in a murine model of unilateral ureteral obstruction (UUO), whether the magnetic resonance (MR) imaging-derived apparent diffusion coefficient (ADC) changes during the progression of renal fibrosis and correlates with the histopathologic changes observed in renal fibrogenesis. Materials and Methods: This study was approved by the institutional animal care and use committee. A UUO was created in each of 14 mice. In five mice, longitudinal diffusion-weighted (DW) imaging was performed before the UUO (day 0) and on days 3 and 7 after the UUO and was followed by histopathologic analysis. The nine remaining mice were examined with cross-sectional studies on days 0 ( n = 4) and 3 ( n = 5). ADCs were measured with a spin-echo echo-planar sequence at five b values ranging from 350 to 1200 sec/mm2. Differences in ADC among the time points and between the sides were assessed by using Tukey-Kramer and Student t tests, respectively. ADC was correlated with cell density and α-smooth muscle actin (α-SMA, a marker of myofibroblasts) expression at linear regression analysis. Results: Histopathologic examination revealed typical renal fibrosis on the side with UUO. The ADC decreased over time on the UUO side, from (1.02 ± 0.06 [standard deviation]) x 10-3 mm2/sec on day 0 to (0.70 ± 0.08) x 10-3 mm2/sec on day 3 (P < .001) and (0.57 ± 0.10) x 10-3 mm2/sec on day 7 (P < .001). The percentage change in ADC was greater on the UUO side than on the contralateral side on days 3 (29% ± 9, P = .05) and 7 (44% ± 11, P < .01). ADC correlated with both increased cell density and increased α-SMA expression (P < .001 for both correlations). Conclusion: An ADC decrease in renal fibrosis is associated with an increased number of cells, including fibroblasts. ADC has the potential to serve as a sensitive noninvasive biomarker of renal fibrosis. © RSNA, 2010.


Itano H.,Kure Kyosai Hospital | Hirokawa Y.,Hiroshima Heiwa Clinic | Takauchi K.,Hiroshima Heiwa Clinic
Interactive Cardiovascular and Thoracic Surgery | Year: 2010

The objectives of this study were to devise a new image processing technique to reconstruct dynamic three-dimensional (3D) virtual mediastinoscopic images on the basis of positron-emission tomography/computed tomography (PET/CT) datasets, and to examine the clinical utility of this technique for preoperative simulation of and intraoperative guidance during mediastinoscopic nodal biopsy. Of 54 patients with suspected or proven lung cancer (LC) who underwent mediastinoscopy between January 2005 and December 2007, 37 also underwent preoperative PET/CT. Of these 37 patients, we tested our image processing protocol in 15 consecutive patients with significant mediastinal uptake of fluorodeoxyglucose (FDG). We reconstructed 3D virtual mediastinoscopy movies in two mutually complementary demonstration modes - the tracheobronchial- and vessel-modes - with accurate representation of actual mediastinoscopic procedures. The benefit of these virtual imaging was evaluated with regard to their utility in mediastinoscopic nodal biopsy. Our new technique enabled better understanding of the spatial interrelationship between FDG-avid nodes and mediastinal structures. It facilitated more accurate and safer nodal biopsy under virtual guidance. In conclusion, we showed the feasibility of our virtual mediastinoscopic technique, which may improve the procedural safety and diagnostic accuracy of mediastinoscopic nodal biopsy and nodal staging in LC. © 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.


PubMed | Tokyo Electron, Okinawa Chubu Tokushukai Hospital, Uwajima Tokushukai Hospital, Kagoshima Tokushukai Hospital and 2 more.
Type: Journal Article | Journal: Transplantation proceedings | Year: 2015

To relieve the chronic shortage of donor kidneys, we conducted a prospective kidney transplantation trial using kidneys removed from 10 unrelated patients (51 to 79 years of age) who had undergone nephrectomy for small renal cell carcinoma (1.5 to 3.9 cm) of low-to-moderate complexity based on RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior location relative to polar lines) nephrometry (objective description helpful for operative indication and planning).Donors were selected from among 15 patients who opted to undergo nephrectomy for small renal cell carcinoma. A total of 76 dialysis patients 34 to 85 years of age who agreed to undergo restored kidney transplantation were recruited as transplant candidates.In stage 1 (5 cases), high-risk patients were selected without human leukocyte antigen testing, and accelerated acute rejection occurred in 4 of 5 recipients. This trial was subsequently extended with human leukocyte antigen testing, and an additional 5 patients were enrolled in stage 2. Eight recipients, including 4 recipients with a history of renal transplantation, experienced rejection; 1 patient resumed dialysis 35 months after transplantation. The most recent serum creatinine levels ranged from 1.10 to 3.19 mg/dL in the 9 recipients with functioning grafts and from 0.84 to 4.68 mg/dL in the 10 donors. No tumor recurrence was noted at 32 to 58 months after surgery in either the recipients or the donors.Restored kidney transplantation using kidneys with a small renal tumor seems suitable for carefully selected high-risk recipients and, in particular, elderly kidneys can also function well. Avoiding cancer transmission, fair recipient selection, close follow-up, and a well-organized tracking system warrant further study.


PubMed | Red Cross, Nara Prefectural Gojo Hospital, Tachikawa General Hospital, Fujiyoshida Municipal Hospital and 46 more.
Type: Journal Article | Journal: Gastroenterology research | Year: 2016

To examine the effects of percutaneous endoscopic gastrostomy (PEG) on quality of life (QOL) in patients with dementia.We retrospectively included 53 Japanese community and tertiary hospitals to investigate the relationship between the newly developed PEG and consecutive dementia patients with swallowing difficulty between Jan 1st 2006 and Dec 31st 2008. We set improvements in 1) the level of independent living, 2) pneumonia, 3) peroral intake as outcome measures of QOL and explored the factors associated with these improvements.Till October 31st 2010, 1,353 patients with Alzheimers dementia (33.1%), vascular dementia (61.7%), dementia with Lewy body disease (2.0%), Pick disease (0.6%) and others were followed-up for a median of 847 days (mean 805 542 days). A total of 509 deaths were observed (mortality 59%) in full-followed patients. After multivariate adjustments, improvement in the level of independent living was observed in milder dementia, or those who can live independently with someone, compared with advanced dementia, characterized by those who need care by someone: Odds Ratio (OR), 3.90, 95% confidence interval (95%CI), 1.59 - 9.39, P = 0.003. Similarly, improvement of peroral intake was noticed in milder dementia: OR, 2.69, 95%CI, 1.17 - 6.17, P = 0.02. Such significant associations were not observed in improvement of pneumonia.These results suggest that improvement of QOL after PEG insertion may be expected more in milder dementia than in advanced dementia.


Kawamura N.,Osaka Rosai Hospital | Tokoeda Y.,Shonan Kamakura General Hospital | Oshima M.,Sapporo Tokushukai Hospital | Okahata H.,Kure Kyosai Hospital | And 6 more authors.
Vaccine | Year: 2011

A phase III, randomized, double-blind study evaluated the efficacy, reactogenicity, safety and immunogenicity of a human rotavirus vaccine, RIX4414 in Japanese infants aged 6-14 weeks when administered as two doses (0, 1-month schedule). Efficacy against any and severe rotavirus gastroenteritis leading to medical intervention caused by circulating wild-type rotavirus from two weeks post-Dose 2 until two years of age was 79.3% (95% CI: 60.5-89.8%) and 91.6% (95% CI: 62.4-99.1%), respectively. Solicited, unsolicited symptoms and serious adverse events were reported at a similar frequency in both groups. Serum anti-rotavirus antibody seroconversion rate one-month post-Dose 2 was 85.3% (95% CI: 68.9-95%) in RIXX4414 group. RIX4414 was efficacious, well-tolerated and immunogenic in Japanese infants and introduction of vaccination could help in reducing the disease burden. © 2011 Elsevier Ltd.


PubMed | Otemon Gakuin University, Hiroshima City General Rehabilitation Center, Hiroshima University, Tsukuba International University and 2 more.
Type: Journal Article | Journal: BMC psychiatry | Year: 2017

Amygdala hyper-reactivity is sometimes assumed to be a vulnerability factor that predates depression; however, in healthy people, who experience early life stress but do not become depressed, it may represent a resilience mechanism. We aimed to test these hypothesis examining whether increased amygdala activity in association with a history of early life stress (ELS) was negatively or positively associated with depressive symptoms and impact of negative life event stress in never-depressed adults.Twenty-four healthy participants completed an individually tailored negative mood induction task during functional magnetic resonance imaging (fMRI) assessment along with evaluation of ELS.Mood change and amygdala reactivity were increased in never-depressed participants who reported ELS compared to participants who reported no ELS. Yet, increased amygdala reactivity lowered effects of ELS on depressive symptoms and negative life events stress. Amygdala reactivity also had positive functional connectivity with the bilateral DLPFC, motor cortex and striatum in people with ELS during sad memory recall.Increased amygdala activity in those with ELS was associated with decreased symptoms and increased neural features, consistent with emotion regulation, suggesting that preservation of robust amygdala reactions may reflect a stress buffering or resilience enhancing factor against depression and negative stressful events.


Umemura S.,Sumitomo Besshi Hospital | Tsubouchi K.,Kurashiki Central Hospital | Yoshioka H.,Kurashiki Central Hospital | Hotta K.,Okayama University | And 10 more authors.
Lung Cancer | Year: 2012

Objective: We examined the prognosis of patients with leptomeningeal metastasis (LM) from non-small cell lung cancer (NSCLC) and that stratified by epidermal growth factor receptor (EGFR) mutation status in LM patients receiving EGFR-tyrosine kinase inhibitors (TKIs). Methods: We retrospectively analyzed a series of 91 consecutive NSCLC patients with LM between 2001 and 2010. Results: Most of the LM patients had adenocarcinoma histology and a poor performance status (PS). The median survival time (MST) for all patients was 3.6 months. Adenocarcinoma and TKI treatment were associated with a better prognosis. Among the patients, 51 received EGFR-TKIs. Of these, the EGFR mutation status was assessed in 30 patients; 7 (23%) showed no mutation (group 1), 10 (33%) had a mutation in exon 21 (group 2), and 13 (43%) had deletions in exon 19 (group 3). Interestingly, PS was significantly improved in groups 2 and 3 but not in group 1. The MST in these subgroups was 1.4, 7.1, and 11.0 months in groups 1, 2, and 3, respectively (p< 0.001). The median time to progression or symptom deterioration was 0.9, 2.0, and 7.8 months for groups 1, 2, and 3, respectively (p< 0.001). A multivariate analysis showed that EGFR-mutant tumors were associated with a better prognosis in patients receiving EGFR-TKIs. Conclusions: The prognosis for patients with LM from NSCLC was still poor. Survival after the initiation of EGFR-TKI treatment differed according to the type of EGFR mutation, suggesting the potential benefit of TKIs for patients with EGFR mutations, even though they suffered from LM. © 2012 Elsevier Ireland Ltd.


PubMed | Ajou University, Kure Kyosai Hospital, Health Sciences University of Hokkaido, Tooth Bank and Seoul National University
Type: Journal Article | Journal: Journal of the Korean Association of Oral and Maxillofacial Surgeons | Year: 2015

In cases of severe alveolar bone atrophy in the posterior maxillary area, which has only a thin sinus floor, the autogenous tooth bone graft block (ABTB) was used to wrap the implant to enhance its primary stability and osseointegration in the sinus. These cases with four years of clinical follow-up demonstrate the applicability of the ABTB in maxillary sinus membrane elevation to improve the outcomes of implant placement.


Yamada H.,Hamamatsu University School of Medicine | Shinmura K.,Hamamatsu University School of Medicine | Ito H.,Showa University | Kasami M.,Shizuoka Cancer Center Hospital and Research Institute | And 9 more authors.
Cancer Science | Year: 2011

Germline point or small frameshift mutations of the CDH1 (E-cadherin) gene are known to cause familial gastric cancer (FGC), but the frequency of CDH1 mutations is low in Japanese patients with FGC. Because recent studies have reported germline large genomic deletions of CDH1 in European and Canadian patients with FGC, in the present study we examined DNA samples from 13 Japanese patients with FGC to determine whether similar germline changes were present in CDH1 in this population. Using a sequencing analysis, a 1-bp deletion (c.1212delC), leading to the production of a truncated protein (p.Asn405IlefsX12), was found in an FGC family; immunohistochemical analysis revealed the loss of CDH1 protein expression in the tumors in this family. Using a combination of multiplex ligation-dependent probe amplification (MLPA) and RT-PCR analyses, we also found a large genomic deletion (c.164-?-387+?del), leading to the loss of exon 3 and the production of a truncated protein (p.Val55GlyfsX38), in another FGC family. The functional effects of the detected mutations were examined using a slow aggregation assay. Significant impairment of cell-cell adhesion was detected in CHO-K1 cells expressing Ile405fsX12- and Gly55fsX38-type CDH1 compared with cells expressing wild-type CDH1. Our results suggest that the p.Asn405IlefsX12 and p.Val55GlyfsX38 mutations of the CDH1 gene contribute to carcinogenesis in patients with FGC. This is the first report of CDH1 germline truncating mutations in Japanese patients with FGC. Screening for large germline rearrangements should be included in CDH1 genetic testing for FGC. © 2011 Japanese Cancer Association.

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