Mitoyo General Hospital

Mitoyo, Japan

Mitoyo General Hospital

Mitoyo, Japan
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Hayama M.,Mitoyo General Hospital | Maeda H.,Mitoyo General Hospital
Annals of Thoracic Surgery | Year: 2010

A 69-year-old man presented to the emergency room with dysphagia and vomiting. A computed tomographic scan revealed a posterior mediastinal mass surrounding the lower portion of the esophagus. Endoscopic examination demonstrated narrowing of the lower esophagus without malignant mucosal lesions. Thoracoscopic biopsies of the mediastinal mass failed to yield a pathologic diagnosis. The hyaluronic acid concentration in the left pleural effusion was remarkably high (755 mg/L), which is a finding strongly suggestive of malignant mesothelioma. Four months after the initial admission, a subcutaneous nodule was found in the left chest wall and a biopsy was taken. The histopathologic and immunohistochemical findings of the biopsy were consistent with the diagnosis of pleural malignant mesothelioma. © 2010 The Society of Thoracic Surgeons.

Miyoshi Y.,Mitoyo General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

Iatrogenic pseudoaneurysm could result in rupture or serious complications. The treatment of this condition involves the use of ultrasound-guided compression therapy;however, when this therapy is not effective, surgical intervention becomes necessary. Although ultrasound-guided compression therapy is a minimally invasive treatment, the patient might experience pain during the procedure and its effectiveness is decreased under anticoagulant therapy. Surgical repair is also invasive and is frequently accompanied by several complications. We successfully treated 3 cases of iatrogenic pseudoaneurysm on the brachial artery (size, 25~45mm) using the ultrasound-guided thrombin injection therapy after the ultrasound-guided compression therapy was unsuccessful. Ultrasound-guided thrombin injection therapy is an alternative treatment that is highly effective with the additional advantage of being a simple and quick procedure with lesser burden on the patient.

Hiraoka S.,Okayama University of Science | Kato J.,Okayama University of Science | Fujiki S.,Tsuyama Central Hospital | Kaji E.,Okayama University of Science | And 9 more authors.
Gastroenterology | Year: 2010

Background & Aims: There is evidence that serrated polyps (serrated adenomas and hyperplastic polyps) have different malignant potential than traditional adenomas. We used a colonoscopy database to determine the association between the presence of serrated colorectal polyps and colorectal neoplasia. Methods: We performed a multicenter observational study of 10,199 subjects who underwent first-time colonoscopies. Data collected on study subjects included age and sex and the location, size, and histology of polyps or tumors found at colonoscopy. Serrated polyps were defined as those diagnosed by the pathologists in the participating hospitals as a serrated lesion (a lesion given the term of "classical hyperplastic polyp," "traditional serrated adenoma," "sessile serrated adenoma," or "mixed serrated polyp"). Large serrated polyps (LSPs) were defined as those ≥ 10 mm. Results: There were 1573 patients (15.4%) with advanced neoplasia, 708 patients (6.9%) with colorectal cancer (CRC), and 140 patients (1.4%) with LSPs in our cohort. Multivariate analysis associated the presence of LSPs with advanced neoplasia (odds ratio [OR], 4.01; 95% confidence interval [CI], 2.83-5.69) and CRC (OR, 3.34; 95% CI, 2.16-5.03). The presence of LSPs was the greatest risk factor for CRC, particularly for proximal CRC (OR, 4.79; 95% CI, 2.54-8.42). Proximal and protruded LSPs were the highest risk factors for proximal CRC (OR, 5.36; 95% CI, 2.40-10.8 and OR, 9.00; 95% CI, 2.75-19.2, respectively). Conclusions: The presence of LSPs is a risk factor for CRC, particularly CRC of the proximal colon. © 2010 by the AGA Institute.

Moriya A.,Mitoyo General Hospital | Iwasaki Y.,Okayama University | Iwasaki Y.,Okayama University of Science | Ohguchi S.,Junpukai Health Maintenance Center | And 5 more authors.
Journal of Hepatology | Year: 2015

Background & Aims Roles of alcohol consumption in non-alcoholic fatty liver disease are still controversial, although several cross-sectional studies have suggested the beneficial effect of light to moderate drinking on fatty liver. We analyzed the longitudinal relationship between drinking pattern and fatty liver. Methods We included 5297 Japanese individuals (3773 men and 1524 women) who underwent a baseline study in 2003 and follow-up at least once from 2004 to 2006. Generalized estimating equation was used to estimate any association between drinking pattern and fatty liver assessed by ultrasonography. Results At baseline, 1179 men (31.2%) and 235 women (15.4%) had fatty liver; 2802 men (74.2%) and 436 women (28.6%) reported alcohol consumption. At the latest follow-up, 348 of 2594 men (13.4%) and 101 of 1289 women (7.8%) had newly developed fatty liver; 285 of 1179 men (24.2%) and 70 of 235 women (29.8%) demonstrated a remission of fatty liver. In men, drinking 0.1-69.9 g/week (odds ratio, 0.79 [95% confidence interval, 0.68-0.90]), drinking 70.0-139.9 g/week (0.73 [0.63-0.84]), drinking 140.0-279.9 g/week (0.69 [0.60-0.79]), and drinking ≥280.0 g/week (0.68 [0.58-0.79]) were inversely associated with fatty liver after adjusting for obesity, exercise, and smoking. In women, drinking 0.1-69.9 g/week (0.71 [0.52-0.96]) and drinking 70.0-139.9 g/week (0.67 [0.45-0.98]) were inversely associated with fatty liver after the adjustment. Conclusions Light to moderate alcohol consumption, or even somewhat excessive amounts especially in men, was likely to protect most individuals against fatty liver over time.

Sogabe Y.,Mitoyo General Hospital | Ohshima K.-I.,National Hospital Organization Okayama Medical Center | Azumi A.,Kobe Kaisei Hospital | Takahira M.,Kanazawa University | And 4 more authors.
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2014

Background: It is well-known that the lacrimal gland (LG) may be affected in IgG4-related ophthalmic disease (IgG4ROD). Recently, IgG4-related ophthalmic lesions other than those of the lacrimal gland have been reported. However, no study to date has revealed the details of these lesions. This study was conducted to evaluate the location and frequency of lesions found in conjunction with IgG4ROD using radiological imaging. Methods: Radiological images and clinical records of 65 patients collected from seven institutions in Japan were reviewed retrospectively. All patients had been pathologically diagnosed with IgG4ROD. Patients of mucosa-associated lymphoid tissue lymphoma associated with IgG4-related lesions were excluded. Orbital magnetic resonance imaging or computed tomography findings were evaluated. Results: Of the 65 patients, 31 (47.7 %) had lesions involving the LG alone, whereas 34 (52.3 %) had lesions involving the areas other than LG, including eight patients who had lesions without any LG involvement. IgG4-related ophthalmic lesions included LG enlargement in 57 patients (87.7 %), trigeminal nerve branch enlargement in 25 (38.5 %), extraocular muscle enlargement in 16 (24.6 %), diffuse orbital fat lesions in 15 (23.1 %), orbital mass lesions in 11 (16.9 %), eyelid lesions in eight (12.3 %), and nasolacrimal duct lesion in one (1.5 %). Six patients (9.2 %) presented with visual disturbance due to optic nerve disturbance, eight (12.3 %) with a restriction of ocular movement, and 19 (29.2 %) with exophthalmos. Conclusions: Thirty-four (52.3%) of the 65 IgG4ROD patients had lesions in areas other than LG. Lesions were found in the trigeminal nerve branch including pterygopalatine fossa, extraocular muscles, orbital fat, eyelid, and nasolacrimal duct. © Springer-Verlag 2014.

Sogabe O.,Mitoyo General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

A 73-year-old woman with dyspnea was diagnosed with a left atrial myxoma by echocardiography. Right and left circumflex coronary angiography showed neovascularity in the tumor and the blood flow jet extending from the tumor to the left atrial cavity, which led to the steal phenomenon in the left anterior descending artery. Surgical excision of the left atrial tumor and the maze procedure were performed with a cardiopulmonary circuit. To our knowledge, this is the 1st study to report the development of the coronary artery steal syndrome due to a cardiac myxoma. Exercise testing would involve risks such as embolism and left ventricular inflow disturbance; furthermore, the presence of concomitant chest symptoms with cardiac myxoma is not rare. Therefore, preoperative coronary angiography would be used for differential diagnosis and for detecting the coronary artery disease, which is reported to be common in patient with cardiac myxomas.

Akiyama K.,Kagawa University | Akiyama K.,Mitoyo General Hospital | Karaki M.,Kagawa University | Samukawa Y.,Kagawa University | Mori N.,Kagawa University
Auris Nasus Larynx | Year: 2013

A 65-year-old man presented with right facial cellulitis and right blindness. Enhanced CT and MRI showed right facial cellulitis involved with pterigopalatine fossa. Additionally, orbital cellulitis, superior ophthalmic vein thrombosis, and pulmonary multiple nodules were observed. 18F-FDG PET/CT supported these findings. He was diagnosed with septic superior ophthalmic vein thrombosis accompanied with Lemierre Syndrome variant and was treated mainly by the administration of intravenous antibiotics. His symptoms and image findings improved after a few days of treatment, but the right visual loss has not recovered. Since septic superior ophthalmic vein thrombosis and Lemierre Syndrome both have life-threatening potential, early diagnosis and appropriate treatment are important and may contribute to reduce the incidence of severe complications. Septic superior ophthalmic vein thrombosis accompanied with Lemierre Syndrome is exceeding rare, and this case is the first report of blindness in Lemierre Syndrome. A literature review and discussion of septic superior ophthalmic vein thrombosis and Lemierre Syndrome are included. © 2012 Elsevier Ireland Ltd.

Ohshima K.-I.,National Hospital Organization Okayama Medical Center | Sogabe Y.,Mitoyo General Hospital | Sato Y.,Okayama University of Science
Japanese Journal of Ophthalmology | Year: 2012

Purpose: To investigate the frequency of infraorbital nerve enlargement (IONE) in orbital lymphoproliferative disorders, and to show that IONE can contribute to the clinical diagnosis of IgG4-related orbital diseases (IgG4- ROD). Subjects and methods: 71 cases in which orbital lymphoproliferative disorders were diagnosed at Okayama Medical Center and Mitoyo General Hospital from April, 2004 to March, 2011 were investigated. The male-to-female ratio was 39:32, and the age range 27-87 years old (average age 64.1 years). Whenever the coronal section of the infraorbital nerve was larger than that of the optic nerve on MRI, it was defined as IONE. Results: The breakdown of the 71 cases was: 45 cases of non-Hodgkin lymphoma, 16 cases of IgG4-ROD, 5 cases of reactive lymphoid hyperplasia, and 5 cases of idiopathic orbital inflammation. Of these, a total of 9 cases had IONE. The incidence of IONE was compared between the IgG4- ROD patient group and the non-IgG4-ROD patient group and was significantly higher in the IgG4-ROD patient group (p < 0.0001). Conclusion: If IONE is observed in a case of orbital lymphoproliferative disorders on MRI, then it is highly possible that such a case is IgG4-ROD. © Japanese Ophthalmological Society 2012.

Domei T.,Kokura Memorial Hospital | Yokoi H.,Kokura Memorial Hospital | Kuramitsu S.,Kokura Memorial Hospital | Soga Y.,Kokura Memorial Hospital | And 9 more authors.
Circulation Journal | Year: 2012

Background: The relationship between major adverse cardiac events (MACE) and serum polyunsaturated fatty acid (PUFA) parameters has not been well documented in patients who have undergone percutaneous coronary intervention (PCI). The aim of the present study was to investigate this relationship. Methods and Results: A total of 284 consecutive patients who underwent elective PCI were enrolled and stratified according to median serum levels of n-6 PUFAs (arachidonic acid [AA]), n-3 PUFAs (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]), and serum EPA/AA and DHA/AA ratios. The relationship between these PUFA parameters and the incidence of MACE including cardiac death, acute coronary syndrome, PCI for de novo lesions, and coronary artery bypass grafting, was analyzed. Multivariate analysis showed that among the PUFA parameters, only a high serum EPA/AA ratio was significantly associated with a low incidence of MACE in all the models tested (model A, without adjusted variables: hazard ratio [HR], 0.52; 95% confidence interval [CI]: 0.27-0.99, P=0.048; model B, adjusted for age and diabetes: HR, 0.51; 95%CI: 0.26-0.98, P=0.043; model C, adjusted for age, sex, diabetes, hypertension, smoking, and low-density lipoprotein cholesterol: HR, 0.49; 95%CI: 0.25-0.94, P=0.033). Conclusions: The incidence of MACE in patients who have undergone PCI is significantly associated with serum EPA/AA ratio.

Imagawa A.,Mitoyo General Hospital
Video Journal and Encyclopedia of GI Endoscopy | Year: 2013

Perforation is a severe complication of endoscopic submucosal dissection (ESD), and the incidence is reported to be 2-6%. Appropriate endoscopic repair should be administered immediately to prevent severe complications. As a first step, it is very useful to create a neoplasia-free area around the edges of the perforation with a dual knife. Then this area can be safely closed with endoclips. During the procedure, it is strongly advisable to use CO2 insufflation instead of air to reduce abdominal discomfort. Here, this method is demonstrated in a case with a large perforation that occurred during the ESD procedure. This article is part of an expert video encyclopedia. © 2013 Elsevier GmbH.

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