Kyoto, Japan
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Senoo T.,Kansai Medical University | Motohiro M.,Kyoto Kujo Hospital | Kamihata H.,Kansai Medical University | Yamamoto S.,Kansai Medical University | And 6 more authors.
American Journal of Cardiology | Year: 2010

Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after coronary angiography and percutaneous coronary intervention (PCI). The aim of the present study was to assess the clinical features and in-hospital outcomes of CIN after emergency PCI. The serum creatinine (SCr) concentration was measured from days 0 to 30 in 338 consecutive patients with acute coronary syndrome undergoing emergency PCI. CIN was defined as an increase in SCr of >25% or >0.5 mg/dl within 2 days after PCI. Overall, 94 patients (28%) developed CIN. The mean SCr on admission was not significantly different between patients with CIN and those without CIN. The CIN group had significantly greater SCr at days 1, 2, and 30 than did the no CIN group. Multivariate analysis showed female gender (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.12 to 5.07, p = 0.025), a culprit lesion in the left anterior descending artery (OR 2.37, 95% CI 1.31 to 4.27, p = 0.0042), contrast agent volume >200 ml (OR 3.60, 95% CI 1.96 to 6.62, p <0.001) and end-diastolic pulmonary arterial pressure >15 mm Hg (OR 2.03, 95% CI 1.02 to 4.04, p <0.01) to all correlate independently with CIN. The in-hospital mortality rate was greater in the CIN group than in the no CIN group (9.6% vs 3.3%, respectively; p = 0.025). In conclusion, CIN is a frequent complication of emergency PCI for acute coronary syndrome and is associated with a greater mortality rate and persistent renal dysfunction. © 2010 Elsevier Inc. All rights reserved.


Motohiro M.,Kyoto Kujo Hospital | Kamihata H.,Kansai Medical University | Tsujimoto S.,Kansai Medical University | Seno T.,Kansai Medical University | And 5 more authors.
American Journal of Cardiology | Year: 2011

Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality rates. Although a previous study reported that pretreatment with sodium bicarbonate is more effective than sodium chloride for prophylaxis of CIN, this has not been a universal finding. We performed a prospective randomized trial to investigate whether CIN can be avoided using sodium bicarbonate. In total 155 patients with a glomerular filtration rate (GFR) <60 ml/min/1.73 m 2 who were undergoing coronary angiography were enrolled. We assigned patients to sodium chloride plus sodium bicarbonate (bicarbonate group, n = 78) or sodium chloride alone (chloride group, n = 77). Infusion of sodium bicarbonate at 1 ml/kg/hour continued from 3 hours before to 6 hours after coronary angiography. CIN was defined as a 25% increase in serum creatinine from baseline value or an absolute increase of <0.5 mg/dl, which appeared within 2 days of contrast. Baseline GFR was not significantly different between the 2 groups. Patients in the bicarbonate group had a higher GFR than those in the chloride group on day 2 (45.8 ± 13.4 vs 40.9 ± 14.6 ml/min/1.73 m 2, p = 0.031) and at 1 month (49.5 ± 14.7 vs 43.7 ± 15.5 ml/min/1.73 m 2, p = 0.019). CIN occurred in 10 patients (13%) in the chloride group but in only 2 patients (2.6%) in the bicarbonate group (p = 0.012). Sodium chloride plus sodium bicarbonate is more effective than sodium chloride alone for prophylaxis of CIN and can lead to retention of better long-term renal function. © 2011 Elsevier Inc. All rights reserved.


Hosogi S.,Kyoto Prefectural University of Medicine | Hosogi S.,Heian Jogakuin University | Kusuzaki K.,Heian Jogakuin University | Kusuzaki K.,Kyoto Kujo Hospital | And 6 more authors.
Journal of Cellular and Molecular Medicine | Year: 2014

The purpose of the present study was to clarify roles of cytosolic chloride ion (Cl-) in regulation of lysosomal acidification [intra-lysosomal pH (pHlys)] and autophagy function in human gastric cancer cell line (MKN28). The MKN28 cells cultured under a low Cl- condition elevated pHlys and reduced the intra-lysosomal Cl- concentration ([Cl-]lys) via reduction of cytosolic Cl- concentration ([Cl-]c), showing abnormal accumulation of LC3II and p62 participating in autophagy function (dysfunction of autophagy) accompanied by inhibition of cell proliferation via G0/G1 arrest without induction of apoptosis. We also studied effects of direct modification of H+ transport on lysosomal acidification and autophagy. Application of bafilomycin A1 (an inhibitor of V-type H+-ATPase) or ethyl isopropyl amiloride [EIPA; an inhibitor of Na+/H+ exchanger (NHE)] elevated pHlys and decreased [Cl-]lys associated with inhibition of cell proliferation via induction of G0/G1 arrest similar to the culture under a low Cl- condition. However, unlike low Cl- condition, application of the compound, bafilomycin A1 or EIPA, induced apoptosis associated with increases in caspase 3 and 9 without large reduction in [Cl-]c compared with low Cl- condition. These observations suggest that the lowered [Cl-]c primarily causes dysfunction of autophagy without apoptosis via dysfunction of lysosome induced by disturbance of intra-lysosomal acidification. This is the first study showing that cytosolic Cl- is a key factor of lysosome acidification and autophagy. © 2014 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.


PubMed | Kyoto Prefectural University of Medicine and Kyoto Kujo Hospital
Type: Journal Article | Journal: Acta radiologica short reports | Year: 2014

We experienced a case with a gastric varix that did not have a catheterizable main drainage vein and had multiple afferent veins. For this case we successfully performed percutaneous transhepatic sclerotherapy using the following procedure. After the drainage vein was embolized by metallic coils and n-butyl cyanoacrylate from a microcatheter that was advanced through the gastric varix, 5% ethanolamine oleate-iopamidol was infused into the gastric varix from one main afferent vein under balloon occlusion.


Matsubara T.,Mie University | Kusuzaki K.,Kyoto Kujo Hospital | Matsumine A.,Mie University | Nakamura T.,Mie University | Sudo A.,Mie University
Clinical Orthopaedics and Related Research | Year: 2013

Background: Wide-margin resections are an accepted method for treating soft tissue sarcoma. However, a wide-margin resection sometimes impairs function because of the lack of normal tissue. To preserve the normal tissue surrounding a tumor, we developed a less radical (ie, without a wide margin) surgical procedure using adjunctive photodynamic therapy and acridine orange for treating soft tissue sarcoma. However, whether this less radical surgical approach increases or decreases survival or whether it increases the risk of local recurrence remains uncertain. Questions/purposes: We determined the survival, local recurrence, and limb function outcomes in patients treated with a less radical approach and adjunctive acridine orange therapy compared with those who underwent a conventional wide-margin resection. Methods: We treated 170 patients with high-grade soft tissue sarcoma between 1999 and 2009. Fifty-one of these patients underwent acridine orange therapy. The remaining 119 patients underwent a conventional wide-margin resection for limb salvage surgery. We recorded the survival, local recurrence, and functional score (International Society of Limb Salvage [ISOLS]) score) for all the patients. Results: The 10-year overall survival rates in the acridine orange therapy group and the conventional surgery group were 68% and 63%, respectively. The 10-year local recurrence rate was 29% for each group. The 5-year local recurrence rates for Stages II, III, and IV were 8%, 36%, and 40%, respectively, for the acridine orange group and 13%, 27%, and 33%, respectively, for the conventional surgery group. The average ISOLS score was 93% for the acridine orange group and 83% for the conventional therapy group. Conclusion: Acridine orange therapy has the potential to preserve limb function without increasing the rate of local recurrence. This therapy may be useful for eliminating tumor cells with minimal damage to the normal tissue in patients with soft tissue sarcoma. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of the levels of evidence. © 2012 The Association of Bone and Joint Surgeons®.


Yoshino N.,Kyoto Kujo Hospital | Watanabe N.,Kyoto Kujo Hospital | Fukuda Y.,Kyoto Kujo Hospital | Watanabe Y.,Teikyo University | Takai S.,Teikyo University
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2011

Purpose: Balancing the gap is essential in total knee arthroplasty (TKA). The purpose of this study was to quantify the influence of patellar position on femoro-tibial joint load in TKA. We hypothesized that resetting of the patella increased medial joint load and decreased lateral joint load. Methods: Our original tensor system was used during posterior-stabilized (PS) and cruciate-retaining (CR) total knee arthroplasty (TKA) using medial para-patellar approach (MPP) or sub-vastus approach (SV). Results: In PS-TKA, by resetting the patella, the ratios between medial and lateral compartments were not changed in both extension and flexion position using MPP and were significantly changed in flexion position using SV. In CR-TKA, by resetting the patella, the load of the lateral component decreased and the ratios between medial and lateral compartments were changed significantly in both extension and flexion position using SV. Conclusion: It is important to be aware that, when performing CR-KA, the load of the lateral compartment will decrease by resetting the patella using SV. Level of evidence: Therapeutic studies investigating the results of treatment, Level II. © 2011 Springer-Verlag.


Murakami M.,Kyoto Kujo Hospital | Hirai M.,Kyoto Kujo Hospital | Sakakibara T.,Kyoto Kujo Hospital | Yamaki T.,Kyoto Kujo Hospital | Kusuzaki K.,Kyoto Kujo Hospital
Neurologia Medico-Chirurgica | Year: 2014

A 50-year-old female presented with more than 20-year history of a large subcutaneous mass in the left parieto-occipital portion. Magnetic resonance (MR) imaging revealed the lipomatous mass to show a high signal intensity in both T1and T2-weighted images. A part of the lipomatous lesion progressed into the underlying hyperostosis and skull. The preoperative diagnosis was skull invasion of a well-differentiated liposarcoma. The tumor was removed completely, including the underlying hyperostosis and skull. Microscopy confirmed a lipoma without any lipoblasts, which was firmly attached to the reactive hyperostosis, and islands of lipoma were involved in the underlying hyperostosis and skull cortex. A pathological diagnosis of parosteal lipoma with reactive hyperostosis was made. Long-term progression of parosteal lipoma may cause to involve the underlying hyperostosis and skull, and led to the diagnosis of invasion of a malignant tumor on MR imaging.


Shiomi N.,Saiseikai Shiga Hospital | Echigo T.,Saiseikai Shiga Hospital | Hino A.,Saiseikai Shiga Hospital | Hashimoto N.,Kyoto Prefectural University | Yamaki T.,Kyoto Kujo Hospital
Neurologia Medico-Chirurgica | Year: 2016

Criteria for computed tomography (CT) to head injured infants have not been established. Since the identification of neurological findings is difficult in infants, examination by CT may be necessary in some cases, but it may be difficult to perform CT because of problems with radiation exposure and body movement. Moreover, even though no intracranial abnormality was found immediately after injury, abnormal findings may appear after several hours. From this viewpoint, course observation after injury may be more important than CT in the initial treatment of head trauma in infants. The complaints and neurological manifestations of infants, particularly those aged 2 or younger, are frequently unclear; therefore, there is an opinion that CT is recommended for all pediatric patients. However, the appropriateness of its use should be determined after confirming the mechanism of injury, consciousness level, neurological findings, and presence/absence of a history of abuse. Among the currently available rules specifying criteria for CT of infants with head trauma, the Pediatric Emergency Care Applied Research Network (PECARN) study may be regarded as reliable at present. In Japan, where the majority of emergency hospitals are using CT, it may be necessary to develop criteria for CT in consideration of the actual situation. CT diagnosis for pediatric head trauma is not always necessary. When no imaging is performed, this should be fully explained at the initial treatment before selecting course observation at home. Checking on a state of the patients by telephone is useful for both patients and physicians. © 2016, Japan Neurosurgical Society. All rights reserved.


Satonaka H.,Mie University | Kusuzaki K.,Kyoto Kujo Hospital | Akeda K.,Mie University | Tsujii M.,Mie University | And 7 more authors.
Anticancer Research | Year: 2011

Although the survival of patients with osteosarcoma has improved following development of chemotherapy and surgery, the presence of pulmonary metastases indicate a poor prognosis. We developed photodynamic and radiodynamic therapies with acridine orange (AO-PDT and AO-RDT) for minimally invasive surgery to treat musculoskeletal sarcomas and reported a good clinical outcome of local control and limb function. We investigated the effect of AO-PDT using flash-wave light (FWL) on pulmonary metastasis of mouse osteosarcoma. In in vitro and in vivo studies, AO alone and AO-PDT significantly inhibited cell invasion and the growth of pulmonary metastases from primary mouse osteosarcoma. AO may have a specific metastasis-inhibitory effect, different from the effect of AO-PDT The fluorovisualization effect on pulmonary metastases following intravenous AO administration showed that pulmonary metastases localized on the lung surface were recognized as brilliant green lesions. In conclusion, AO-PDT using FWL inhibited cell invasion and pulmonary metastases in mouse osteosarcoma; therefore, this treatment modality might be applicable for treating pulmonary metastasis from malignant musculoskeletal tumors in humans.


PubMed | Kyoto Kujo Hospital
Type: Journal Article | Journal: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA | Year: 2011

Balancing the gap is essential in total knee arthroplasty (TKA). The purpose of this study was to quantify the influence of patellar position on femoro-tibial joint load in TKA. We hypothesized that resetting of the patella increased medial joint load and decreased lateral joint load.Our original tensor system was used during posterior-stabilized (PS) and cruciate-retaining (CR) total knee arthroplasty (TKA) using medial para-patellar approach (MPP) or sub-vastus approach (SV).In PS-TKA, by resetting the patella, the ratios between medial and lateral compartments were not changed in both extension and flexion position using MPP and were significantly changed in flexion position using SV. In CR-TKA, by resetting the patella, the load of the lateral component decreased and the ratios between medial and lateral compartments were changed significantly in both extension and flexion position using SV.It is important to be aware that, when performing CR-KA, the load of the lateral compartment will decrease by resetting the patella using SV.

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