Fukuoka-shi, Japan
Fukuoka-shi, Japan

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Saitoh G.,Kyushu Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016

A 79-year-old man complaining of an anterior chest mass with pain had an abnormal shadow on chest X-ray. A mass, 7 cm in size, with destruction of the right 4th rib was found on chest computed tomography. A F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) corresponding to the lesion showed an abnormal accumulation of FDG with the standardized uptake value(SUV) max=16.19. A malignant tumor of the chest wall origin was suspected and the tumor was resected with the 3th, 4th, and 5th ribs. Histologically, the tumor was diagnosed as dedifferentiated chondrosarcoma. He died of local recurrence about 5 months after the operation.


Furusyo N.,Kyushu University | Ogawa E.,Kyushu University | Nakamuta M.,National Hospital Organization | Kajiwara E.,Steel Memorial Yawata Hospital | And 10 more authors.
Journal of Hepatology | Year: 2013

Background & Aims This study was performed to evaluate the efficacy of a triple therapy in older Japanese patients; telaprevir (TVR) was added to pegylated interferon α2b and ribavirin. Methods This prospective study enrolled 120 genotype 1b patients with chronic hepatitis C who received 12 weeks of triple therapy followed by a 12-week dual therapy that included pegylated interferon α2b and ribavirin. Patients were categorized according to age: group A, 64 patients aged >60 and group B, 56 patients aged ≤60. Serum HCV RNA levels were monitored by COBAS TaqMan HCV test. Results The rates of undetectable HCV RNA at week 4 (rapid virological response, RVR) were 73.4% in group A and 73.2% in group B. No significant difference in sustained virological response (SVR) was found between groups A (76.6%) and B (83.9%) (p = 0.314). The SVR rates for patients with interleukin 28B (IL28B) (rs8099917) TT allele (89.4% and 91.9% for groups A and B) were significantly higher than for those with the IL28B TG/GG allele (41.2% and 68.4%, respectively) (both p <0.05). Multivariate analysis extracted IL28B TT and RVR as independent factors associated with SVR. Adverse effects resulted in treatment discontinuation by 12.5% in each group. Hemoglobin decrease significantly differed between groups A and B: the decrease to ≥100 g/L, to 85 - <100 g/L, and to <85 g/L, was 9.4%, 40.6%, and 50% in group A patients, respectively, and 41.1%, 25%, and 33.9% in group B patients, respectively (p = 0.0006). Conclusions TVR-based triple therapy can be successfully used to treat older patients with genotype 1b chronic hepatitis C. © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.


Ogawa E.,Kyushu University | Furusyo N.,Kyushu University | Nakamuta M.,National Hospital Organization | Kajiwara E.,Steel Memorial Yawata Hospital | And 10 more authors.
Journal of Hepatology | Year: 2013

Background & Aims Anemia is a common adverse effect of telaprevir (TVR) in combination with pegylated interferon (PegIFN)α and ribavirin (RBV) therapy. It occurs at a higher incidence with the TVR relative to PegIFNα and RBV alone. We herein evaluate the baseline and on-treatment predictors of the development of severe anemia by chronic hepatitis C virus (HCV) patients receiving TVR-based triple therapy. Methods This prospective, multicenter study consisted of 292 patients (median age: 62 years) infected with HCV genotype 1. All received 12 weeks of TVR in combination with 24 weeks of PegIFNα2b and RBV. The definition of severe anemia during antiviral treatment is hemoglobin (Hb) <85 g/L. Results 101 (34.6%) patients developed severe anemia during the treatment period. Multivariable logistic regression analysis of possible pretreatment predictors of the development of severe anemia extracted baseline Hb <135 g/L (Hazard ratio [HR], 2.53; p = 0.0013), estimated glomerular filtration rate <80 ml/min/1.73 m2 (HR, 1.83; p = 0.0265), and inosine triphosphatase (ITPA) CC genotype (rs1127354) (HR, 2.91; p = 0.0024). For patients with ITPA CC (n = 227), multivariable logistic regression analysis of possible pretreatment and on-treatment predictors of the development of severe anemia extracted Hb level at week 2 (HR, 0.96; p = 0.0085) and the initial four weeks of weight-adjusted TVR (HR, 1.05; p = 0.0281). Conclusions Anemia remains a risk for all patients treated with TVR-based triple therapy. However, ITPA polymorphism (rs1127354) is useful for predicting the development of severe anemia and will be helpful in the management of treatment. © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.


Ogawa E.,Kyushu University | Furusyo N.,Kyushu University | Kajiwara E.,Steel Memorial Yawata Hospital | Takahashi K.,Hamanomachi Hospital | And 10 more authors.
Journal of Hepatology | Year: 2013

Background & Aims: The effects of pegylated interferon (PegIFN) α and ribavirin (RBV) treatment of chronic hepatitis C on the incidence of hepatocellular carcinoma (HCC) have not been well established. This study investigated the impact of treatment outcome on the development of HCC by chronic hepatitis C patients treated with PegIFNα2b and RBV. Methods: This large-scale, prospective, multicenter study consisted of 1013 Japanese chronic hepatitis C patients with no history of HCC (non-cirrhosis, n = 863 and cirrhosis, n = 150). All patients were treated with PegIFNα2b and RBV and the follow-up period started at the end of the antiviral treatment (median observation period of 3.6 years). The cumulative incidence rate of HCC was estimated using the Kaplan-Meier method, according to treatment outcome. Results: Forty-seven patients (4.6%) developed HCC during the observation period. In the non-cirrhosis group, the 5-year cumulative incidence rates of HCC for the sustained virological response (SVR) (1.7%) and transient virological response (3.2%) (TVR: defined as relapse or breakthrough) groups were significantly lower than those of the non-virological response (NVR) group (7.6%) (p = 0.003 and p = 0.03, respectively). A significantly low rate of incidence of HCC by TVR patients in comparison with NVR patients was found for patients aged 60 years and over, but not for those under 60 years of age. In the cirrhosis group, the 5-year cumulative incidence rates of HCC for the SVR (18.9%) and TVR groups (20.8%) were also significantly lower than those of the NVR group (39.4%) (p = 0.03 and p = 0.04, respectively). Conclusions: SVR and complete viral suppression during treatment with relapse (TVR) were associated with a lower risk of HCC development when compared with NVR.


Kimitsuki T.,Kyushu Central Hospital
Acta Neurobiologiae Experimentalis | Year: 2013

An increase in hydrostatic pressure in the endolymphatic system causes hydrops-related inner ear diseases such as Meniere's disease or low tone sensorineural hearing loss. In the present study, we investigated the effects of pressure exerted on potassium currents in acutely isolated inner hair cells of the guinea-pig cochlea using whole-cell voltage-clamp techniques. By applying negative or positive pressure via the patch pipette using a syringe, intracellular hydropressure was changed between -40 cm H2O to +20 cm H2O. Negative pressure potentiated the amplitude of potassium currents, whereas positive pressure suppressed the amplitude of potassium currents. Gadolinium, a blocker of stretch-activated cation channels, did not influence pressure-dependent changes in potassium currents; however, cinnarizine blocked pressure-dependent changes in potassium currents. The current changes were not dependent on the sign of the pressure change, that is, similar increases in negative pressures (between -10 cm H2O and -40 cm H2O) and similar decreases in positive pressures (between +10 cm H2O and +20 cm H2O) were observed. © 2013 by Polish Neuroscience Society - PTBUN, Nencki Institute of Experimental Biology.


Yamamoto K.,Kyushu University | Okazaki A.,Kyushu University | Ohmori S.,Kyushu Central Hospital
Journal of Physiological Anthropology | Year: 2011

The aim of this cross-sectional study was to examine the factors which may be associated with the metabolic syndrome by exploring the relationship between psychosocial stress, age, body mass index (BMI), C-reactive protein (CRP), lifestyle factors, and the components of the metabolic syndrome, such as glycated hemoglobin (HbA1c), fasting blood sugar (FBS), body fat percentage, and triglyceride concentration, among apparently healthy subjects. Psychosocial stress was measured by the use of the inventory to measure psychosocial stress (IMPS). One thousand four hundred and ninety-nine people out of 1,941 public school workers admitted to a hospital for a medical check-up responded to the IMPS, yielding a response rate of 77.2%. A total of 1,201 workers excluding 298 who were taking medication for various diseases were analyzed with the use of hierarchical multiple regression models. It was found that IMPS-measured stress score, age, BMI, and smoking habit were associated with an increase in glycated hemoglobin among men, while alcohol consumption was associated with a decrease in glycated hemoglobin. Stress score, age, BMI, and alcohol consumption were found to be associated with an increase in FBS among men, while smoking and exercise habits were associated with a decrease in FBS. CRP was found to be associated with an increase in body fat percentage among men, though stress score was not associated with an increase in body fat percentage. Stress score, age, and BMI were associated with an increase in triglyceride concentration among women. The findings of the present study seem to be in line with the hypothesis that psychosocial stress plays an important role in developing the metabolic syndrome, which may be associated with inflammatory processes in the vascular wall, resulting in atherosclerosis and cardiovascular disease.


Kimitsuki T.,Kyushu Central Hospital | Kimitsuki T.,Kyushu University
Auris Nasus Larynx | Year: 2015

Objective: Nitric oxide (NO) is a diffusible second messenger, which regulates neurotransmission, serving as the principal endothelium-derived relaxing factor. NO also acts as an ion channel modulator. Nitric oxide synthase (NOS) has been identified in the inner ear, although its physiological role remains unclear. In the present study, the effects of NO onto K currents in inner hair cells (IHCs) were investigated. Methods: IHCs were acutely isolated and K currents were recorded by conventional whole-cell voltage-clamp recordings. NO donors sodium nitroprusside (SNP) were applied directly to the cells. Results: In 1mM SNP solutions, the amplitude of outward K currents (IK,f and IK,s) reversely decreased; however, fast activation kinetics was preserved. In the current-voltage relationship curves, the maximal slope conductances were 53.2nS and 44.2nS in control solutions and 1mM SNP solutions, respectively. At the membrane potential of +110mV, the amplitudes of outward currents were 9.2±2.9nA in control solutions and 7.3±2.7nA in 1mM SNP solutions, showing a significant difference. Conclusion: NO acts as a K channel modulator in IHCs. A fast K current suppression may account for the high-frequency hearing impairment by the prevention of fast repolarization. © 2015 Elsevier Ireland Ltd.


Ogawa K.,Kyushu University | Matsumoto T.,Kyushu University | Esaki M.,Kyushu University | Torisu T.,Kyushu University | Iida M.,Kyushu Central Hospital
Journal of Crohn's and Colitis | Year: 2012

Background and aims: The effects of maintenance infliximab for Crohn's disease vary widely among patients. The aim of this study was to examine the cytokine profiles and to identify possible markers predictive of therapeutic effect of maintenance infliximab. Methods: Cytokine profiles of 35 Crohn's disease patients under maintenance infliximab therapy were analyzed prospectively. Blood samples were obtained prior to, and 2 and 6. weeks after infliximab infusion. Circulating cytokine values of interleukin (IL)-23, IL-17A, IL-12, IL-6, interferon gamma (IFN-γ), and tumor necrosis factor alpha (TNF-α) were compared according to the disease activity and therapeutic efficacy. Patients were classified into either the active or quiescent phase according to their disease activity at baseline. Patients were also divided into a sustained response group and non-sustained response group according to therapeutic efficacy of infliximab determined 2 and 6. weeks after infliximab infusion. Results: At baseline, serum levels of IL-23 (p < 0.05), IL-17A (p < 0.01), IFN-γ (p < 0.05), and IL-6 (p < 0.01) were significantly higher in active Crohn's disease than in quiescent disease. These cytokine levels remained unchanged during the follow-up period. When serum cytokine levels were compared between groups classified by therapeutic efficacy of infliximab, patients in the non-sustained response group had a significantly higher level of serum IL-17A than those in the sustained response group (p < 0.05). There were also trends toward higher serum IL-23 and IL-12 in the former than in the latter. Conclusion: Higher levels of IL-17A, IL-23, and IL-12 at baseline may be predictive markers for poor therapeutic response to maintenance infliximab therapy. © 2011 European Crohn's and Colitis Organisation.


Kimitsuki T.,Kyushu Central Hospital
International Journal of Pediatric Otorhinolaryngology | Year: 2014

Two cases of a membranous band between the tympanic membrane and the external auditory canal are presented. These characteristic structures are rare, but observed in several first branchial cleft anomalies. Neither patient presented with an infection. In Case 1, an eleven-year-old girl has this structure in her right ear. In Case 2, a thirteen-year-old boy has this structure in his left ear. Both patients demonstrated slight air-bone gaps in the affected ear with a pure-tone audiometric test, due to limited vibrations of the tympanic membrane. © 2014 Elsevier Ireland Ltd.


Kimitsuki T.,Kyushu Central Hospital
Auris Nasus Larynx | Year: 2016

Objective: There is a correlation between serum hyperlipidemia and hearing loss. Cholesterol is an integral component of the cell membrane and regulates the activity of ion channels in the lipid bilayer. The aim of this study was to investigate the effects of cholesterol on the potassium currents in IHCs by using the cholesterol-depleting drug, MβCD, and water-soluble cholesterol. Methods: IHCs were acutely isolated from a mature guinea-pig cochlea and potassium currents were recorded. MβCD and water-soluble cholesterol were applied to IHCs under pressure puff pipettes. Results: IHCs showed outwardly rectifying currents (I K,f and I K,s) in response to depolarizing voltage pulses, with only a slight inward current (I K,n) when hyperpolarized. In 10mM MβCD solutions, the amplitude of outward K currents reversely decreased; however, fast activation kinetics was preserved. In contrast, in solution of 1mM water-soluble cholesterol, the amplitude of outward K currents reversely increased. At the membrane potential of +110mV, relative conductances were 0.87±0.07 and 1.18±0.11 in MβCD solutions and cholesterol solutions, respectively. Conclusion: The amplitude of K currents in isolated IHCs was reversely changed by cholesterol-depleting drug and water-soluble cholesterol. These results demonstrated the possibility of the involvement of IHC function in hyperlipidemia-induced inner ear disorders. © 2016 Elsevier Ireland Ltd.

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