Mimihara General Hospital

Japan

Mimihara General Hospital

Japan

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Takada S.,Osaka City General Hospital | Shimizu T.,Emory University | Hadano Y.,Shizuoka Cancer Center | Matsumoto K.,National Medical Clinic | And 4 more authors.
Molecular Medicine Reports | Year: 2012

Cryoglobulins are immunoglobulins that precipitate at low temperatures and redissolve upon rewarming. Cryoglobulinemia refers to the presence of circulating cryoglobulins in serum, and generally leads to a systemic inflammatory syndrome characterized by fatigue, arthralgia, purpura, neuropathy and glomerulonephritis. The disease mainly involves small to medium-sized blood vessels and causes vasculitis due to cryoglobulin-containing immune complexes. Cryoglobulinemia is classified into three types (I, II and III) on the basis of immunoglobulin composition. Predisposing conditions include lymphoproliferative disease, collagen disease and hepatitis C virus (HCV) infection. The diagnosis of cryoglobulinemic syndrome is predominantly based on the laboratory demonstration of serum cryoglobulins. Treatment is often directed towards the underlying disease state. For patients with chronic HCV infection, anti-viral therapy is indicated. Intense immunosuppressive or immunomodulatory therapy, including steroids, plasmapheresis and cytotoxic agents, is reserved for organ-threatening or recalcitrant disease. In this review, we discuss the clinical characteristics of the three types of cryoglobulinemia.


Takanashi J.-I.,Kameda Medical Center | Takahashi Y.,Shizuoka Institute of Epilepsy and Neurologic Disorders | Imamura A.,Gifu Prefectural General Medical Center | Kodama K.,Mimihara General Hospital | And 4 more authors.
Pediatrics | Year: 2012

Delirious behavior associated with influenza usually has an onset within a few days after fever and lasts <24 hours. As we encountered several patients with 2009 H1N1 influenza who presented with lateonset and long-standing delirious behavior, we retrospectively evaluated the clinical, radiologic, and laboratory features to elucidate the possible pathophysiology. This information was collected on 5 previously healthy patients (2 boys and 3 girls, aged 10-15 years) with 2009 H1N1 influenza who presented with late onset (>3 days after fever) and long-standing (>48 hours) delirious behavior. Each exhibited mild to moderate drowsiness between the episodes of delirious behavior. Electroencephalography was normal except for 1 patient with high voltage and slow activity bilaterally in the occipital regions. Brain MRI was normal. The outcome was excellent with no neurologic sequel in 4 of the 5 patients. In all 5 patients, autoantibodies against N-methyl-D-aspartate type glutamate receptor were elevated or positive in cerebrospinal fluid or serum; the autoantibody levels normalized in the 3 patients who had follow-up studies. This study indicates that 2009 H1N1 influenza has a tendency to cause lateonset and long-standing delirious behavior, at least in Japanese children. Mild autoimmune-mediated encephalitis should be considered as an underlying cause. Copyright © 2012 by the American Academy of Pediatrics.


Omodaka K.,Tohoku University | Kurimoto T.,Mimihara General Hospital | Nakamura O.,Tohoku University | Sato K.,Tohoku University | And 5 more authors.
Journal of Neuroscience Research | Year: 2014

Artemin, a recently discovered member of the glial cell line-derived neurotrophic factor (GDNF) family, has neurotrophic effects on damaged neurons, including sympathetic neurons, dopamine neurons, and spiral ganglion neurons both in vivo and in vitro. However, its effects on retinal cells and its intracellular signaling remain relatively unexplored. During development, expression of GFRα3, a specific receptor for artemin, is strong in the immature retina and gradually decreases during maturation, suggesting a possible role in the formation of retinal connections. Optic nerve damage in mature rats causes levels of GFRα3 mRNA to increase tenfold in the retina within 3 days. GFRα3 mRNA levels continue to rise within the first week and then decline. Artemin, a specific ligand for GFRα3, has a neuroprotective effect on axotomized retinal ganglion cells (RGCs) in vivo and in vitro via activation of the extracellular signal-related kinase- and phosphoinositide 3-kinase-Akt signaling pathways. Artemin also has a substantial effect on axon regeneration in RGCs both in vivo and in vitro, whereas other GDNF family members do not. Therefore, artemin/GFRα3, but not other GDNF family members, may be of value for optic nerve regeneration in mature mammals. © 2014 Wiley Periodicals, Inc.


Ishihara S.,Mimihara General Hospital | Tabata S.,Mimihara General Hospital | Inoue T.,Mimihara General Hospital
Catheterization and Cardiovascular Interventions | Year: 2015

Coronary perforation is a rare, but life-threatening complication during percutaneous coronary intervention. Prolonged balloon inflation is one option for achieving hemostasis, but it often causes ST elevation, chest pain, decreased blood pressure, or fatal arrhythmia due to ischemia. We present the case of a 73-year-old woman who suffered severe coronary perforation after stent implantation and post-dilatation. To allow prolonged balloon inflation without ischemia, we perfused the distal area with the patient's own arterial blood injected via micro-catheter. With this method, we could prolong balloon inflation for 20 min, successfully achieving hemostasis. This novel technique, which we named the "distal perfusion technique," is useful to minimize ischemia during prolonged balloon inflation. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.


Inoue T.,Mimihara General Hospital
The Journal of heart valve disease | Year: 2013

The cases are reported of mitral valve repair with symmetrical papillary muscle approximation from heads to bases close to cardiac apex for functional mitral regurgitation (FMR). The two papillary heads attaching the chordae to both leaflets from the posteromedial papillary muscle were approximated parallel to the solitary head of the anterolateral papillary muscle. This procedure permits an even reduction of lateral shift of the papillary muscle, resulting in an elimination of mitral tethering, and provides a satisfactory and durable mitral valve repair with good outcomes in patients with idiopathic dilated cardiomyopathy and FMR.


Inoue T.,Mimihara General Hospital | Yugami S.,Kinki University | Nishino T.,Kinki University | Saga T.,Kinki University
Asian Cardiovascular and Thoracic Annals | Year: 2016

A 70-year-old man with severe multivalvular disease, atrial fibrillation, and kyphoscoliosis, had Cheyne-Stokes respiration with central sleep apnea. After triple-valve surgery with the maze procedure, adjunctive adaptive servo-ventilation therapy was initiated on the first postoperative day and continued seamlessly in the postoperative period. Seamless adaptive servo-ventilation therapy as an adjunct to triple-valve surgery is more likely to prevent heart failure remodeling without worsening of pulmonary hypertension and recurrence of atrial fibrillation. © The Author(s) 2014.


Inoue T.,Mimihara General Hospital | Ogawa T.,Kinki University | Yugami S.,Kinki University | Saga T.,Kinki University
Canadian Journal of Cardiology | Year: 2013

The present report describes a simple modification to the reinforcement technique by Copeland etal. using autologous pericardium for the Bentall procedure. Our modified technique may decrease the probability of leaks at the aortic root. Further, this technique preserves the advantages of the Valsalva graft, including tension-free coronary anastomosis and anatomical adaptability. © 2013 Canadian Cardiovascular Society.


PubMed | Mimihara General Hospital and Kinki University
Type: Case Reports | Journal: Asian cardiovascular & thoracic annals | Year: 2016

A 70-year-old man with severe multivalvular disease, atrial fibrillation, and kyphoscoliosis, had Cheyne-Stokes respiration with central sleep apnea. After triple-valve surgery with the maze procedure, adjunctive adaptive servo-ventilation therapy was initiated on the first postoperative day and continued seamlessly in the postoperative period. Seamless adaptive servo-ventilation therapy as an adjunct to triple-valve surgery is more likely to prevent heart failure remodeling without worsening of pulmonary hypertension and recurrence of atrial fibrillation.


PubMed | Mimihara General Hospital
Type: Case Reports | Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions | Year: 2015

Coronary perforation is a rare, but life-threatening complication during percutaneous coronary intervention. Prolonged balloon inflation is one option for achieving hemostasis, but it often causes ST elevation, chest pain, decreased blood pressure, or fatal arrhythmia due to ischemia. We present the case of a 73-year-old woman who suffered severe coronary perforation after stent implantation and post-dilatation. To allow prolonged balloon inflation without ischemia, we perfused the distal area with the patients own arterial blood injected via micro-catheter. With this method, we could prolong balloon inflation for 20 min, successfully achieving hemostasis. This novel technique, which we named the distal perfusion technique, is useful to minimize ischemia during prolonged balloon inflation.


PubMed | Mimihara General Hospital and Kinki University
Type: | Journal: Lower urinary tract symptoms | Year: 2016

To assess the efficacy of dutasteride add-on therapy for patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) with small prostates who have been treated with -blocker therapy for>3months.A total of 110 men with clinical BPH were enrolled. There were 17 and 93 subjects with a prostate volume (PV)<30 and30mL, respectively. All subjects had been treated with -blocker therapy for>3months. Subjective and objective clinical variables were assessed using the total International Prostate Symptom Score (IPSS-T), IPSS quality of life (IPSS-QoL), IPSS voiding subscore (IPSS-V), IPSS storage subscore (IPSS-S), overactive bladder symptom score (OABSS), PV, prostate specific antigen (PSA) level, post-void residual (PVR), and maximum flow rate (Qmax). These variables were assessed at baseline and every 3months for 1year.In the small prostate group, IPSS-T and IPSS-V showed improvements from baseline at 6 and 9months, storage subscore at 6months, and OABSS at 3months, but no sustained improvements were observed. During the study period, only the IPSS QoL scores did not show any improvement. Conversly, dutasteride was significantly effective at improving IPSS-T, IPSS-V, IPSS-S, and IPSS-QoL scores throughout the study period in the large prostate BPH group. PSA levels and PV significantly decreased in both groups throughout the study.Benign prostatic hyperplasia in LUTS patients with small prostates did not show a sustainable benefit from the addition of dutasteride to -blocker therapy.

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