Meiwa Hospital

Meiwa, Japan

Meiwa Hospital

Meiwa, Japan
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Fujii C.,Shiratori Pharmaceutical Co. | Sato Y.,Shiratori Pharmaceutical Co. | Mizuyama K.,Meiwa Hospital
Japanese Pharmacology and Therapeutics | Year: 2017

Background Our previous clinical study suggested that intake of extract from Senshinren (Andrographis paniculata) resulted in lowered blood alcohol concentration (BAC) and improved hepatic function in healthy male subjects. Objective The aim of this study was to investigate the effect of Senshinren extract-containing food on alcohol metabolism by measuring BAC and breath alcohol concentration (BrAC) in healthy male subjects with drinking habits in a randomized, double-blind, placebo-controlled, crossover study. Methods/Study design We enrolled 22 male volunteers who regularly drank alcoholic beverage (20-59 years old and being judged homozygous or heterozygous ALDH2 deficiency based on alcohol patch test). Subjects were randomly allocated to 2 groups R and S. Subjects in group R consumed placebo and subjects in group S consumed Senshinren extract-containing food (active food) once 30 min prior to alcohol intake in test period I . Test food assignment was reversed in test period II. All subjects completed the study, however, 2 subjects met the exclusion criteria for efficacy analysis (l in group R and 1 in group S). Thus, data obtained with 20 subjects were analyzed for efficacy. Results There was no significant order effect nor period effect with respect to BAC area under the curve, and we judged that data analysis could be adequately carried out based on the crossover design. In the analysis of total subjects, BrAC 120 min after alcohol intake in active food intake period (0.099 ±0.019 mg/L) was slightly lower than that in placebo food intake period (0.108±0.017 mg/L, P=0.08l). There was no significant difference in BAC between active food intake period and placebo food intake period. In a stratified analysis conducted in subjects with heterozygous ALDH2 deficiency, significantly lower BrAC was observed at 120 min after alcohol intake in active food intake period (0.098 ±0.019 mg/L) compared to placebo food intake period(0.111 ±0.016 mg/L, P=0.006). No serious adverse event was observed in this study. Conclusion: Our results suggest a possibility that intake of Senshinren extract-containing dietary supplement benefits alcohol metabolism in heterozygous ALDH2-deficient subjects.


Hoshino Y.,Kobe University | Kuroda R.,Kobe University | Nagamune K.,University of Fukui | Araki D.,Kobe University | And 3 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2012

Purpose: Rotational instability in ACL insufficient knee addresses the symptom or the abnormal motion which can be reproduced and subjectively evaluated in the clinical exam. Clinically available quantitative measurement for this instability has not been established due to mixed testing maneuvers and complex kinematics. The purpose was to measure knee kinematics during three manually performed rotational tests and to determine the optimal method to detect the abnormality in ACL deficient knees. Method: Thirteen unilateral ACL deficient patients were tested by internal and external pure rotational stress tests and pivot shift test under anesthesia before scheduled ACL reconstructions. Rotation and coupled motion, i. e., tibial anteroposterior translation, were measured using an electromagnetic measurement system. Additionally, the acceleration of the tibial posterior translation during pivot shift test was calculated. The differences of these parameters between ACL intact and deficient knees were tested. Results: Knee rotation is not different between ACL intact and deficient during both pure rotational stress test and pivot shift test. The coupled anterior tibial translation during pivot shift test was significantly different between ACL intact, 13 5 ± 4.1 mm, and deficient knees, 23.1 ± 4.4 mm, (P < 0.01) as well as the acceleration of the tibial posterior translation (1.1 ± 0.4 m/sec2 in intact knees, 3.2 ± 1.5 m/sec2 in deficient knees; P < 0.01). The coupled motion during pure rotational stress tests was similar regardless of ACL condition. Conclusion: The rotational instability of the ACL deficiency was reproduced only by the pivot shift test and detected only by measuring the tibial anteroposterior translation and acceleration of the tibial posterior reduction. Level of evidence Diagnostic study, Level III. © 2011 Springer-Verlag.


Harder J.,University of Kiel | Tsuruta D.,Osaka City University | Murakami M.,Ehime University | Kurokawa I.,Meiwa Hospital | Kurokawa I.,Hyogo Medical College
Experimental Dermatology | Year: 2013

Acne vulgaris is the most common disorder of the pilosebaceous unit leading to inflamed skin characterized by the formation of comedones, papules, pustules and scarring. There is increasing evidence that the abundance of Propionibacterium acnes (P. acnes) in the inflamed acne lesions triggers inflammation. Therefore, in addition to treatment with retinoids, the use of antimicrobial agents has been established as a treatment option for acne. This indicates that antimicrobial mechanisms to control the growth of P. acnes may have an important influence on the severity of inflammatory acne. One import antimicrobial innate defense system comprises the production of antimicrobial peptides (AMP), small molecules with a broad spectrum of antimicrobial activity as well as immunomodulatory properties. Although the role of AMP in acne is still emerging, there is increasing evidence that AMP may be of importance in acne. The aim of this viewpoint is to provide some hypotheses about the potential function of AMP in the pathogenesis of acne and to discuss potential AMP-based therapies for the treatment of acne. © 2013 John Wiley & Sons A/S.


Tsumori Y.,Hyogo College of Medicine | Yoshiya S.,Hyogo College of Medicine | Kurosaka M.,Kobe University | Kobashi S.,University of Hyogo | And 2 more authors.
Journal of Arthroplasty | Year: 2011

We developed a new posterior-stabilized total knee arthroplasty (TKA) with a unique post-cam design that induces and accommodates internal tibial rotation with deep knee flexion. To validate the design concept of this system, we conducted an image analysis study employing a computer-aided diagnosis system for 24 TKA-implanted knees. In the analysis, the tibiofemoral relationship in the following 3 postures was evaluated: standing at extension, forward lunge, and kneeling with maximum knee flexion. The results of the image analysis showed achievement of consistent internal rotation of the tibia in deep flexion with a broad contact area at the post-cam interface as intended by the original design concept of this TKA system. © 2011 Elsevier Inc.


Beppu N.,Hyogo College of Medicine | Matsubara N.,Hyogo College of Medicine | Kakuno A.,Meiwa Hospital | Doi H.,Hyogo College of Medicine | And 4 more authors.
Diseases of the Colon and Rectum | Year: 2015

BACKGROUND: 5-Fluorouracil-based chemotherapy is considered to be a radiosensitizer; however, conventional short-course radiotherapy combined with chemotherapy is generally thought to not be feasible because of the prevalence of side effects. OBJECTIVE: The aim of this study was to evaluate the feasibility of modified short-course radiotherapy combined with a chemoradiosensitizer for T3 rectal cancer. DESIGN AND SETTINGS: This study was retrospective in nature and used a prospectively collected database. PATIENTS: Patients with T3 rectal cancer located below the peritoneum reflection were selected. INTERVENTIONS: A total dose of 25 Gy of radiotherapy was administered in 10 fractions of 2.5 Gy each for 5 days. Radiotherapy was performed with S-1 as a radiosensitizer from day 1 to day 10. Surgery was targeted to be performed 4 weeks after radiotherapy. MAIN OUTCOME MEASUREMENTS: The morbidity, sphincter-preserving rate, anal function, and long-term outcomes were assessed. RESULTS: All patients (n = 170) completed the radiotherapy regimen and 166 (97.6%) completed the combination regimen with chemotherapy. A total of 149 patients (87.6%) had sphincter-preserving surgery (double stapling technique (DST), 58 patients; intersphincteric resection (ISR), 91 patients), and postoperative complications were relatively mild (anastomotic leakage, 15.4%; intra-abdominal infection, 8.2%). Among those undergoing sphincter preserving surgery, the 5-year local relapse-free survival rate was 94.3% in the DST group, and 89.8% in the ISR group. With respect to the anal function, the Wexner score the first year after stoma closure for the double-stapling technique group was 6 and that for intersphincteric resection was 15; however, the score for the intersphincteric resection group was improved to 8 at 4 years after stoma closure. LIMITATIONS: This study had limitations because it was an uncontrolled, 1-arm, retrospective review with a small sample size. CONCLUSIONS: Modified short-course radiotherapy combined with chemoradiosensitizer is a feasible approach for treating T3 rectal cancer. With the use of the short-course approach, efforts to reduce the incidence of side effects by appropriately prolonging the waiting period enable the administration of combination treatment with short-course radiotherapy and chemotherapy. © The ASCRS 2015.


Du Z.-J.,Osaka University | Yamamoto T.,Osaka University | Yamamoto T.,Meiwa Hospital | Ueda T.,Osaka University | And 3 more authors.
Investigative Ophthalmology and Visual Science | Year: 2011

Purpose. Ischemia causes severe and persistent visual loss in many eye diseases, including central retinal vein occlusion (CRVO) and diabetic retinopathy. Activated protein C (APC) has been demonstrated to reduce the cell death associated with ischemia in the brain and kidney. This study was performed to examine the ability of APC to rescue hypoxia-in-duced retinal cell death in vitro and in vivo. Methods. Retinal pigment epithelium (RPE) and photoreceptor cells were placed in either a normoxic or a hypoxic chamber. Immediately before they were subjected to ischemia, the cultures were treated with APC (3-240 fxg/mL). Incubation was followed by an MTT assay to determine the number of viable cells. The activity of caspase-3, -8, and -9 in RPE cells was also analyzed. Various concentrations of APC were intravitreally injected in a rat CRVO model, followed by TUNEL staining to detect the in vivo effects of APC. Results. Lower concentrations of APC (0.3-30 fxg/mL) showed a cell-protective effect against hypoxia in vitro, whereas higher concentrations (>120 fxg/mL) demonstrated cytotoxicity in both RPE and photoreceptor cells. Caspase-3, -8, and -9 were activated when the cells were exposed to hypoxia, but this activation was significantly inhibited by APC. Experimental CRVO-induced retinal cell apoptosis was reduced dramatically by intravitreal injection of APC. Conclusions. APC can reduce ischemia-induced cytotoxicity both in vitro and in vivo via blocking the activation of caspase-3, -8, and -9. APC may be a promising candidate for protecting the retina from ischemia. © 2011 The Association for Research in Vision and Ophthalmology, Inc.


Iida H.,Meiwa Hospital | Aihara T.,Meiwa Hospital | Ikuta S.,Meiwa Hospital | Yamanaka N.,Meiwa Hospital
Hepato-Gastroenterology | Year: 2014

Background/Aims: Splenectomy is performed in patients with severe cirrhosis who have a low platelet count. A portal vein thrombus (PVT) is one of the complications associated with splenectomy. This study aimed to identify predictive factors of postoperative PVT following splenectomy. Methodology: Twenty-eight patients who underwent splenectomy between April 2003 and March 2013 were retrospectively analyzed. Patients were divided into two groups: the PVT(+) group comprising 11 patients who developed postoperative PVT, and the PVT(-) group comprising 17 patients who did not develop postoperative PVT. The patient characteristics of the 2 groups were analyzed. Results: In univariate analysis, the platelet count, rate of simultaneous treatment of hepatocellular carcinoma, and preoperative spleen volume were significantly different between the groups (p < 0.05). In multivariate analysis, preoperative spleen volume alone was an independent factor associated with the development of PVT (p = 0.007). At a preoperative spleen volume cut-off of 450 mL, the sensitivity and specificity were 90% and 73%, respectively. Conclusion: In patients with severe cirrhosis scheduled to undergo splenectomy, if the preoperative spleen volume is >450 mL, as measured by enhanced computed tomography, preventive administration of anticoagulant therapy is recommended to reduce the risk of PVT development. © H.G.E. Update Medical Publishing S.A.


Iida H.,Meiwa Hospital | Aihara T.,Meiwa Hospital | Ikuta S.,Meiwa Hospital | Yamanaka N.,Meiwa Hospital
Hepatology Research | Year: 2014

Aim: Histologically, poorly differentiated hepatocellular carcinomas (HCC) are considered highly malignant. Here, we aimed to evaluate the relative efficacy and safety of hepatic resection or radiofrequency ablation (RFA) for treating this malignancy. Methods: Between April 2004 and May 2011, we enrolled 48 patients who had poorly differentiated HCC that had been diagnosed postoperatively by pathological assessment. All the tumors had a maximum diameter of 3cm and all patients had three or less tumors. Fifteen of these patients underwent hepatic resection (HR group) and 33 patients underwent RFA (RF group). The patient background, tumor characteristics, overall survival rate and recurrence-free survival rate were assessed in both groups. Results: The mean maximum tumor diameter was 2.5 and 2.0cm in the HR and RF groups, respectively. The prothrombin activity level was 94% and 86% in the HR and RF groups, respectively. The 1-, 3- and 5-year cumulative survival rates were 89.1%, 68.7% and 68.7%, respectively, in the HR group, and 59.2%, 40.9% and 32.7%, respectively, in the RF group. The 1-, 3- and 5-year recurrence-free survival rates were 85.1%, 64.8% and 48.6%, respectively, in the HR group, and 29.0%, 7.2% and 7.2%, respectively, in the RF group. There was a significant difference between these groups (P<0.05). Conclusion: As hepatic resection has greater efficacy than RFA in the treatment of poorly differentiated HCC, even in cases with a small tumor size, we recommend its use for this malignancy. © 2013 The Japan Society of Hepatology.


Iida H.,Meiwa Hospital | Aihara T.,Meiwa Hospital | Ikuta S.,Meiwa Hospital | Yamanaka N.,Meiwa Hospital
Hepato-Gastroenterology | Year: 2013

Background/Aims: We retrospectively compared the therapeutic effect of microwave coagulation needle (Lap-MCT) and radiofrequency ablation needle (Lap-RFA). Methodology: Between January 2001 and May 2012, 71 patients underwent laparoscopic ablation therapy for HCC with no extra hepatic metastasis. These patients were divided into 3 groups, according to the surgical strategies: Lap-MCT (n=40), LapMCT+RFA (n=13) and Lap-RFA (n=18). The patient background, tumor characteristics, cumulative survival rate, recurrence-free survival rate, time of operation and duration of hospitalization were compared between the groups. Results: The maximal tumor size, the number of tumors and the hepatic reserve from each group had no significant difference. Likewise, the time of operation and the duration of hospitalization had no significant difference. However, the number of needle punctures in the Lap-MCT group was significantly larger than that in the Lap-RFA group (p<0.05). Postoperative liver function had no significant difference between the groups. The 5-year cumulative survival rate was 71.5% (Lap-MCT), 66.7% (Lap-MCT+RFA) and 80.0% (Lap-RFA) showing no significant difference. Also, the recurrence-free survival rate and the local recurrence rate had no significant difference. Conclusions: In the laparoscopic setting, MCT and RFA are equally effective in terms of short- and long-term results. © H.G.E. Update Medical Publishing S.A.


Iida H.,Meiwa Hospital | Aihara T.,Meiwa Hospital | Ikuta S.,Meiwa Hospital | Yamanaka N.,Meiwa Hospital
World Journal of Gastroenterology | Year: 2012

AIM: To retrospectively evaluate the effectiveness of impedance monitoring for predicting popping during radiofrequency ablation (RFA) using internally cooled electrodes. METHODS: We reviewed 140 patients (94 males, 46 females; age range 73.0 ± 11.1 year) who underwent RFA between February 2006 and November 2008 with a modified protocol using a limited power delivery rather than a conventional one to avoid popping. All the patients provided their written informed consent, and the study was approved by the institutional review board. Intraprocedural impedances were measured for the study subjects, and the tumors were classified into three types according to the characteristics of their impedance curves: increasing, flat, or decreasing. The tumors were further sorted into seven subtypes (A-G) depending on the curvature of the impedance curve' s increase or decrease. Relative popping rates were determined for the three types and seven subtypes. A chi-square test was performed to estimate statistical significance. RESULTS: A total of 148 nodules treated by RFA were analyzed. The study samples included 132 nodules of hepatocellular carcinoma, 14 nodules of metastatic liver cancer, and two nodules of intrahepatic cholangiocarcinoma. The numbers of nodules with each impedance curve type were as follows: 37 increasing-type nodules, 43 flat-type nodules, and 68 decreasing-type nodules. Popping occurrence rates were 24.3%, 46.5% and 64.7%, respectively. Flat-type nodules exhibited a significantly higher rate of popping compared to increasing-type nodules (P = 0.039). Decreasing-type nodules exhibited a significantly higher rate of popping compared to increasing-type nodules (P < 0.0001). Notably, nodules that showed a sharp decrease in impedance in the latter ablation period (subtype E) exhibited a significantly higher rate of popping compared to other subtypes. CONCLUSION: Intraprocedural impedance monitoring can be a useful tool to predict the occurrence of popping during liver tumor RFA performed with internally cooled electrodes. © 2012 Baishideng. All rights reserved.

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