Matsunami General Hospital

Gifu-shi, Japan

Matsunami General Hospital

Gifu-shi, Japan
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Yamauchi K.-E.,Kagawa University | Incharoen T.,Kagawa University | Yamauchi K.,Matsunami General Hospital
Anatomical Record | Year: 2010

To demonstrate the relationship between intestinal histology and function, we investigated the possibility that compensatory enlargement of villi in the chickens' remnant intestine can be induced after 50% or 80% jejunal resection as well as after 50% jejunal plus 70% ileal resection. Compared with intact control chickens, operated chickens showed an almost similar body weight, nitrogen retention, and ether extract digestibility, an improved dry matter digestibility, and a much greater absorption of protein and ether extract by the remnant jejunum and ileum. This suggests an enhanced absorptive function of the remnant intestine. In these chickens, increased value of most light microscopic parameters, increased frequency of anastomosing of each villus, and increased number of protuberated epithelial cells appeared with an increase in the intestinal resection area. This suggests that intestinal villi and epithelial cells are hypertrophied in the remnant jejunum and ileum, and that intestinal villi adapt to activated intestinal absorptive function not by increasing their numbers, but by fusing together into larger villi. These findings demonstrate that intestinal histology is intimately related to intestinal function. © 2010 Wiley-Liss, Inc.

Nagata C.,Gifu University | Wada K.,Gifu University | Nakamura K.,Gifu University | Hayashi M.,Matsunami General Hospital | And 2 more authors.
Cancer Causes and Control | Year: 2011

Objective Body size and reproductive factors are important risk factors of breast cancer. The aim of the present study was to examine the associations of these factors with blood concentrations of sex hormones and prolactin in premenopausal Japanese women. Methods We measured the plasma concentrations of estradiol, estrone, testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), follicle- stimulating hormone, luteinizing hormone, and prolactin among 436 women who had regular menstrual cycles less than 40 days long. Information on menstrual and reproductive factors including history of breastfeeding was obtained using a self-administered questionnaire. Height and weight were measured. Results After controlling for age and the phase of the menstrual cycle, the body mass index (BMI) was significantly inversely associated with total estradiol, estrone and SHBG and significantly positively associated with total and free testosterone and DHEAS. Nulliparous women had significantly higher levels of total and free testosterone, DHEAS, and prolactin than parous women. Duration of breastfeeding for the first child was significantly inversely associated with free testosterone and prolactin levels. Conclusions The data suggest that an increased risk of premenopausal breast cancer associated with low BMI is partially mediated by an increased total estradiol. Androgens and prolactin may explain the breast cancer protection provided by giving birth and breastfeeding. © Springer Science+Business Media B.V. 2011.

Tsuji M.,Gifu University | Tamai Y.,Gifu University | Wada K.,Gifu University | Nakamura K.,Gifu University | And 4 more authors.
Cancer Causes and Control | Year: 2012

Objective: Endogenous sex hormones have been implicated in the etiology of breast cancer. Dietary factors such as fat, dietary fiber, soy isoflavones, and alcohol have been suggested to influence endogenous estrogen and other steroid hormone levels. We examined the relationship among these dietary factors and plasma sex hormone levels in premenopausal Japanese women. Methods: We measured the plasma concentrations of estradiol, estrone, testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin, a follicle-stimulating hormone, a luteinizing hormone, and prolactin among 393 premenopausal women who had regular menstrual cycles fewer than 40 days apart. The dietary intakes were estimated with a validated food frequency questionnaire. Results: After controlling for age, BMI, phase of the menstrual cycle, number of births, age at first birth, history of breastfeeding, and smoking status, the saturated fat intake was significantly positively associated with total estradiol and free estradiol levels. Intakes of the other types of fat, dietary fiber, soy isoflavones, and alcohol were not significantly associated with levels of any hormone measured. Conclusions: These data suggest that a high intake of saturated fat is associated with increased estradiol levels in premenopausal Japanese women. Saturated fat intake may have implications in the etiology of breast cancer. © Springer Science+Business Media B.V. 2012.

Yamauchi K.,Matsunami General Hospital | Wakahara K.,Gero Hot Spring Hospital | Fukuta M.,Matsunami General Hospital | Matsumoto K.,Gifu University | And 3 more authors.
American Journal of Sports Medicine | Year: 2010

Background: Little epidemiological research on characteristics of upper extremity injuries resulting from snowboarding has been conducted, particularly in relation to snowboarding stance, falling direction, and the side of the body where the injury occurs. Hypothesis: Snowboarding stance and the direction of the fall may influence the frequency of the side or the location of the upper extremity injury. Study Design: Descriptive epidemiology study. Methods: This study analyzed the information obtained from 1918 patients with fractures or dislocations of the upper extremity (excluding the fingers and scapula) sustained during snowboarding/sliding between 2000 and 2008. Diagnosis, injured part and side, stance (regular or goofy), and falling directions were prospectively analyzed. Associations among these parameters were also analyzed. Results: As characterized by skill level, patients were beginners (57.9%), intermediates (38.0%), and experts (4.0%). Eighty-eight percent had not received instruction from licensed instructors. Diagnoses included wrist fractures (53.7%), upper arm fractures (16.8%), shoulder dislocations (11.5%), and elbow dislocations (9.8%). In sum, 1742 (90.8%) patients were in regular stance when they fell, whereas 176 (9.2%) were in goofy stance. There was a significant difference in the prevalence of the injured side between the 2 stances. When the injured sides were classified according to the sliding direction, wrist fractures (61.7%) occurred on the side opposite the sliding direction, whereas shoulder dislocations (65.6%), upper arm fractures (82.9%), and elbow dislocations (79.8%) occurred on the same side as the sliding direction. When the injured sides were classified according to the falling direction, wrist fractures (68.1%) and elbow dislocations (63.5%) occurred because of backward falls, and shoulder dislocations (68.9%) and upper arm fractures (60.7%) occurred because of forward falls. Conclusion: Two snowboarding stances as well as 2 falling directions had a significant influence on the frequency of the injured side in the upper extremity. © 2010 The Author(s).

Imai A.,Matsunami General Hospital | Suzuki N.,Gifu University
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2010

Pelvic adhesion can form as a result of inflammation, endometriosis or surgical trauma. Most surgical procedures performed by obstetrician-gynecologists are associated with pelvic adhesions that may cause subsequent serious sequelae, including small bowel obstruction, infertility, chronic pelvic pain, and difficulty in postoperative treatment, including complexity during subsequent surgical procedures. An increasing number of adhesion reduction agents, in the form of site-specific and broad-coverage barriers and solutions, are becoming available to surgical teams. The most widely studied strategies include placing synthetic barrier agents between the pelvic structures. Most of the adhesions in the barrier-treated patients develop in uncovered areas in the abdomen. This fact suggests that the application of liquid or gel anti-adhesive agents to cover all potential peritoneal lesions, together with the use of barrier agents, may reduce the formation of postoperative adhesions. This article introduces the topical choices available for adhesion prevention mentioned in preliminary clinical applications and animal models. To date there is no substantial evidence that their use reduces the incidence of postoperative adhesions. In combination with good surgical techniques, these non-barrier agents may play an important role in adhesion reduction. © 2009 Elsevier Ireland Ltd. All rights reserved.

Hashimoto K.-I.,Matsunami General Hospital | Hashimoto K.-I.,Gifu University | Ito Y.,Matsunami General Hospital | Tanahashi H.,Matsunami General Hospital | And 3 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Content: Hyperglycemic chorea-ballism is predominantly observed in older type 2 diabetic patients, and it is rare in type 1 diabetes and diabetic ketoacidosis (DKA). Huntington's disease (HD) is one of several genetic syndromes associated with diabetes, although the reported prevalence of the association varies. There are few opportunities for most physicians to diagnose early-stage HD. Objective: We describe bilateral hyperglycemic chorea-ballism in a 40-yr-old female type 1 diabetes patient with DKA and HD. Setting: The study was conducted in a tertiary care referral hospital. Results: On admission, the patient exhibited severe involuntary movement of bilateral extremities with DKA, and hyperglycemic chorea-ballism was diagnosed. She recovered from chorea-ballism with admission of fluids and insulin, but mild choreatic movement persisted in the upper extremities. Brain magnetic resonance imaging and DNA analysis revealed HD. Although it has been considered that depletion of striatal γ-aminobutyric acid (GABA) content is rare in DKA, it is largely decreased in HD. Therefore, it is probable that hyperglycemic chorea-ballism or exacerbation of Huntington's chorea resulted from transient depletion of GABA. Conclusion: The present case provides important insights on the role of GABA in hyperglycemic chorea-ballism and on the clinical issues associated with HD diagnosis. Copyright © 2012 by The Endocrine Society.

Matsumoto K.,Gifu University | Mori N.,Matsunami General Hospital | Ogawa H.,Gifu University | Akiyama H.,Gifu University
Archives of Orthopaedic and Trauma Surgery | Year: 2015

Introduction: We aimed to assess the accuracy of a new extramedullary guide system for achieving appropriate femoral component alignment in total knee arthroplasty (TKA) and to determine whether it differed between patients operated on by different surgeons. Materials and methods: We performed 100 consecutive primary TKAs in 100 patients using a newly developed extramedullary guide, the “S guide”; 50 were performed by author KM at A Hospital, and 50 by author NM at B Hospital. All patients received the Vanguard RP mobile-bearing prosthesis (Biomet Japan, Tokyo, Japan). We assessed the coronal and sagittal alignment of the femoral component with the mechanical axis using plane radiographs. Data were analyzed statistically using Prism 5.0 software, and a p value of <0.05 was regarded as indicating significance. Results: The mean postoperative coronal alignment angle of the femoral component (α) was 0.1° ± 1.4°, with no significant differences between A Hospital and B Hospital (p = 0.67), and 98 % of patients had an α deviating by less than 3° from the mechanical axis. The mean postoperative sagittal alignment angle of the femoral component (γ) was 1.7° ± 1.7°, with no significant differences between the groups (p = 0.61), and 86 % of patients had a γ deviating by less than 3° from the mechanical axis. Conclusions: This study shows that the S-guide is reliable for use in TKA. © 2015, Springer-Verlag Berlin Heidelberg.

Yasuda K.,Matsunami General Hospital | Hayashi M.,Matsunami General Hospital | Murayama M.,Matsunami General Hospital | Yamakita N.,Matsunami General Hospital
Journal of Clinical Endocrinology and Metabolism | Year: 2016

Context and Objective: Diabetic ketoacidosis (DKA) is associated with a metabolic alkalosis, which is thought to be due to vomiting. However, alkalosis can occur in DKA without vomiting. We retrospectively reviewed the acid-base disturbances in DKA admissions without vomiting. Participants and Methods: We included admissions of the patients with blood glucose and betahydroxybutyrate (βOHB) levels≥250 mg/dL and≥1.0 mmol/L, respectively. Admissions without vomiting were classified into a group with a βOHB ≥3.0 mmol/L (DKA group) and a group with βOHB of 1.0-3.0 mmol/L (pre-DKA group). The acid-base status was analyzed by the modified base excess (BE) method. BE effects were calculated by changes in sodium (BE free water, [BEFW]), and chloride (BECl). Positive and negative values for each parameter suggested alkalosis and acidosis, respectively. Results: Forty-five included admissionsweredivided intoDKA(n=34)andpre-DKA(n=11) groups. Sodium-corrected chloride level and the chloride/sodium ratio were significantly lower in the DKA group than in the pre-DKA group. In both groups, BEFW values were modestly negative. The mean BECl values were positive in both groups, but significantly higher in theDKAgroup. The alkalinizing effects by hypochloremia diminished the base deficit in theDKAgroup by approximately 25%. The BECl value significantly correlated with serum total ketone levels (r =0.66; P ≤.0001). Conclusion: The modified BE method successfully proved the presence of hypochloremic alkalosis in DKA without vomiting. This suggests the direct participation of serum ketoacids in the pathogenesis of hypochloremic alkalosis. © 2016 by the Endocrine Society.

Takagi H.,Matsunami General Hospital | Matsunami K.,Matsunami General Hospital | Imai A.,Matsunami General Hospital
Journal of Obstetrics and Gynaecology | Year: 2010

Congenital abnormalities of the Mllerian duct system can result in various urogenital anomalies, including uterus didelphys with blind hemivagina and ipsilateral renal agenesis (Herlyn-Werner-Wunderlich syndrome). It usually presents after the menarche with progressive pelvic pain during periods secondary to haematocolpos. However, rarely presentation is unusual with consequent diagnostic delay. This paper attempts to review the medical literature for rare presentations that make diagnosis and treatment difficult, including our cases. Clinicians must be aware of the importance of this rare congenital anomaly of the female genital tract, especially many years after the menarche. This condition should be considered to prevent misdiagnosis or suboptimal treatment. © 2010 Informa Healthcare USA, Inc.

Imai A.,Matsunami General Hospital | Matsunami K.,Matsunami General Hospital | Takagi H.,Matsunami General Hospital | Ichigo S.,Matsunami General Hospital
Gynecological Endocrinology | Year: 2013

Hot flashes are very common in women in menopause and can have a detrimental effect on quality of life. Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Several nonhormonal therapies have been tested in randomized placebo-controlled trials including nonpharmacologic approaches and pharmacologic nonhormonal agents. Among them, two classes of nonhormonal medications have been demonstrated to effectively alleviate hot flashes: γ-aminobutyric acid (GABA) analogs and selective serotonin reuptake inhibitors (SSRIs). This article discusses the superior efficacy of the newer nonhormonal prescriptions for the treatment of hot flashes when compared with estrogen replacement therapy, and provides some recommendations regarding use of them in peri- and postmenopausal women. © 2013 Informa UK, Ltd.

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