Nagasaki Rosai Hospital

Nagasaki-shi, Japan

Nagasaki Rosai Hospital

Nagasaki-shi, Japan
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Osaki M.,Nagasaki University | Tatsuki K.,Takeda Pharmaceutical | Hashikawa T.,Nagasaki University | Norimatsu T.,Nagasaki University | And 6 more authors.
Osteoporosis International | Year: 2012

Summary: A 36-month observational study compared the incidence of unaffected side hip fracture in Japanese female osteoporosis patients with a history of hip fracture between 173 patients receiving risedronate and 356 risedronate-untreated controls. New hip fractures were significantly less frequent in the risedronate group, suggesting a preventive effect in high-risk patients. Introduction: The purpose of this study was to investigate the preventive effect of risedronate on second hip fracture immediately following a first hip fracture in Japanese female osteoporosis patients with unilateral hip fracture. Methods: We conducted a prospective matched cohort study in 184 patients treated with risedronate and 445 patients not receiving risedronate after discharge from hospital. Both groups were followed-up for 36 months, and the incidence of unaffected side hip fracture and the frequency of adverse events were assessed. Results: Efficacy could be investigated in 173 patients from the risedronate group and 356 patients from the control group. Hip fracture was detected in 5 and 32 patients, respectively. Kaplan-Meier estimates of the 36-month fracture incidence were 4.3% in the risedronate group and 13.1% in the control group (P = 0.010, log-rank test). The hazard ratios (95% confidence intervals) obtained by univariate and multivariate analysis were 0.310 (0.121-0.796) and 0.218 (0.074-0.639), respectively, indicating a significantly lower incidence of unaffected side hip fracture in the risedronate group. Adverse events occurred in 38 patients (48 events) from the risedronate group and 94 patients (108 events) from the control group, with serious adverse events in 21 patients (26 events) and 78 patients (88 events), respectively. Conclusions: No significant differences were observed between the two groups. The incidence of unaffected side hip fracture was significantly lower in the risedronate group. Accordingly, risedronate may have a preventive effect on hip fracture in high-risk Japanese female osteoporosis patients for fracture with a history of unilateral hip fracture. © 2011 The Author(s).


Matsudaira K.,Kanto Rosai Hospital | Matsudaira K.,Tokyo Medical University | Konishi H.,Nagasaki Rosai Hospital | Miyoshi K.,Yokohama Rosai Hospital | And 4 more authors.
PLoS ONE | Year: 2014

Study Design: Two-year, prospective cohort data from the Japan epidemiological research of occupation-related back pain study in urban settings were used for this analysis. Objective: To examine the association between aggravated low back pain and psychosocial factors among Japanese workers with mild low back pain. Summary of Background Data: Although psychosocial factors are strongly indicated as yellow flags of low back pain (LBP) leading to disability, the association between aggravated LBP and psychosocial factors has not been well assessed in Japanese workers. Methods: At baseline, 5,310 participants responded to a self-administered questionnaire including questions about individual characteristics, ergonomic work demands, and work-related psychosocial factors (response rate: 86.5%), with 3,811 respondents completing the 1-year follow-up questionnaire. The target outcome was aggravation of mild LBP into persistent LBP during the follow-up period. Incidence was calculated for the participants with mild LBP during the past year at baseline. Logistic regression was used to explore risk factors associated with persistent LBP. Results: Of 1,675 participants who had mild LBP during the preceding year, 43 (2.6%) developed persistent LBP during the follow-up year. Multivariate analyses adjusted for individual factors and an ergonomic factor found statistically significant or almost significant associations of the following psychosocial factors with persistent LBP: interpersonal stress at work [adjusted odds ratio (OR): 1.96 and 95% confidence interval (95%CI): 1.00-3.82], job satisfaction (OR: 2.34, 95%CI: 1.21-4.54), depression (OR: 1.92, 95%CI: 1.00-3.69), somatic symptoms (OR: 2.78, 95%CI: 1.44-5.40), support from supervisors (OR: 2.01, 95%CI: 1.05-3.85), previous sick-leave due to LBP (OR: 1.94, 95%CI: 0.98-3.86) and family history of LBP with disability (OR: 1.98, 95%CI: 1.04-3.78). Conclusions: Psychosocial factors are important risk factors for persistent LBP in urban Japanese workers. It may be necessary to take psychosocial factors into account, along with physical work demands, to reduce LBP related disability. © 2014 Matsudaira et al.


Matsudaira K.,Kanto Rosai Hospital | Konishi H.,Nagasaki Rosai Hospital | Miyoshi K.,Yokohama Rosai Hospital | Isomura T.,CLINICAL STUDY SUPPORT INC. | And 4 more authors.
Spine | Year: 2012

Study Design: Two-year, prospective cohort data from the Japan epidemiological research of occupation-related back pain study were used for this analysis. Objective: To examine the association between a new onset of low back pain (LBP) with disability and potential risk factors among initially symptom-free Japanese workers. Summary of Background Data: Despite strong evidence that psychosocial issues may influence LBP onset among symptom-free persons, these and other LBP risk factors have not been well investigated in the Japanese workplace. Methods: Of 5310 participants responding to a self-administered baseline questionnaire (response rate: 86.5%), 3194 (60.2%) completed both 1- and 2-year follow-up questionnaires. The baseline questionnaire assessed individual characteristics, ergonomic work demands, and work-related psychosocial factors. The outcome of interest was new-onset LBP with disability during the follow-up period. Incidence was calculated for the participants who reported no LBP during the past year at baseline. Logistic regression was used to explore risk factors associated with new-onset LBP with disability. Results: Of 836 participants who were symptom-free during the preceding year, 33 (3.9%) reported LBP with disability during the 2-year follow-up. In univariate analyses, "history of LBP," "frequent lifting," "interpersonal stress at workplace," and "monotonous tasks" were all significant predictors of LBP incidence. All of these factors remained statistically significant or almost significant in the multivariate analysis adjusting for the other variables as well as age and sex: adjusted odds ratio (OR) and 95% confidence interval (95% CI) for history of LBP (OR: 3.25, 95% CI: 1.53-6.91), frequent lifting (OR: 3.77, 95% CI: 1.16-12.3), interpersonal stress at workplace (OR: 2.42, 95% CI: 1.08-5.43), and monotonous tasks (OR: 2.21, 95% CI: 0.99-4.94). Conclusion: Both ergonomic and work-related psychosocial factors may predict the development of LBP with disability among previously asymptomatic Japanese workers. Thus, workplace interventions aimed at reducing the incidence of LBP should focus on both ergonomic and psychosocial stress. Copyright © 2012 Lippincott Williams & Wilkins.


Terao Y.,Nagasaki Rosai Hospital | Tanise T.,Nagasaki Rosai Hospital | Sumikawa K.,Nagasaki University | Ichinomiya T.,Nagasaki Rosai Hospital | And 3 more authors.
Journal of Anesthesia | Year: 2012

Purpose Patients undergoing extensive cervical spine surgery (ECSS) occasionally require emergency reintubation due to postoperative airway complications. To avoid it, an endotracheal tube is retained in patients maintained under sedation overnight. This study was conducted to determine whether dexmedetomidine would be superior in sedative effects to propofol for postoperative sedation after ECSS. Methods We studied 32 consecutive patients undergoing ECSS who required prophylactic intubation postoperatively under sedation overnight. The patients were randomly divided into two groups. Group D (n = 16) received dexmedetomidine 0.1 μg/kg/min for 10 min as a loading dose, followed by a continuous infusion at 0.4 μg/kg/h. Group P(n = 16) received propofol 0.1 mg/kg/min for 10 min as a loading dose, followed by a continuous infusion at 1 mg/kg/h. All patients received analgesia with buprenorphine. Ramsay sedation scale, extremity movement, and pain intensity were recorded every 2 h. Dexmedetomidine and propofol dosages were adjusted to maintain a desired sedation level. Nursing staff adjusted dopamine to maintain systolic blood pressure <100 mmHg and administered atropine when the heart rate was >50 bpm. Results The proportions of adequate sedation level, movement, and pain status were similar between groups. In group D, heart rates were lower, frequency of atropine use was greater, and dopamine dose was higher than in group P. Conclusion Both sedatives are efficacious after ECSS; however, dexmedetomidine decreased heart rate and required higher dose of dopamine. © 2011 Japanese Society of Anesthesiologists.


Higashijima U.,Nagasaki Rosai Hospital | Terao Y.,Nagasaki Rosai Hospital | Ichinomiya T.,Nagasaki Rosai Hospital | Miura K.,Nagasaki Rosai Hospital | And 2 more authors.
Anaesthesia | Year: 2010

The aim of this study was to determine the effect of thiamylal and propofol on heart rate-corrected QT (QTc) interval during anaesthetic induction. We studied 50 patients undergoing lumbar spine surgery. Patients were administered 3 μg.kg-1 fentanyl and were randomly allocated to receive 5 mg.kg-1 thiamylal or 1.5 mg.kg-1 propofol as an induction agent. Tracheal intubation was performed after vecuronium administration. Heart rate, mean arterial pressure, bispectral index score, and 12-lead electrocardiogram were recorded at the following time points: just before (T1) and 2 min after (T2) fentanyl administration; 2 min after anaesthetic administration (T3); 2.5 min after vecuronium injection (T4); and 2 min after intubation (T5). Thiamylal prolonged (p < 0.0001), but propofol shortened (p < 0.0001), the QTc interval. © 2010 The Association of Anaesthetists of Great Britain and Ireland.


Kawahara Y.,Nagasaki Rosai Hospital | Yamaguchi T.,Nagasaki Rosai Hospital | Honda Y.,Nagasaki Rosai Hospital | Tomita Y.,Nagasaki University | Uetani M.,Nagasaki University
Radiology | Year: 2016

Purpose: To assess the position and signal intensity of the ulnar nerve at elbow extension and flexion by using magnetic resonance imaging. Materials and Methods: Institutional review board approval and written informed consent were obtained. Transverse T2-weighted images were obtained perpendicular to the upper arm in 100 healthy elbows of 50 volunteers (23 men, 27 women; age range, 21-57 years) and nine elbows with ulnar neuropathy (five men, four women; age range, 24-59 years) with extension and 130° of flexion. Ulnar nerve position was classified into three types: no dislocation, subluxation, or dislocation. One-way analysis of variance, paired t tests, Student t tests, and multiple regression analysis were used to analyze correlations between ulnar nerve movement angle during flexion and age, sex, presence of the anconeus epitrochlearis muscle, and ulnar neuropathy and to compare the contrast-to-noise ratio of nerve to muscle between extension and flexion. Results: Nerve positions in healthy elbows were as follows: All had no dislocation at extension, and at flexion, 51 of 100 elbows (51.0%) had no dislocation, 30 of 100 elbows (30.0%) had subluxation, and 19 of 100 elbows (19.0%) had dislocation. Nerve movement angle was smaller in elbows with the anconeus epitrochlearis muscle than in those without the muscle (P =.045,.015). Presence of the muscle was the only significant factor associated with nerve movement angle (P =.047,.013). Only dominant elbows with nerve movement angle of less than 15° and nondominant elbows with nerve movement angle of less than 10° showed contrast-to-noise ratio increase at flexion (P =.021-.030). Conclusion: Ulnar nerve movement during flexion was apparent in approximately half of healthy elbows and was similar between healthy elbows and elbows with ulnar neuropathy. Nerve signal intensity increased during flexion only in elbows without apparent nerve movement. © 2016 RSNA.


Oji M.,Nagasaki Rosai Hospital | Terao Y.,Nagasaki Rosai Hospital | Toyoda T.,Nagasaki Rosai Hospital | Kuriyama T.,Nagasaki Rosai Hospital | And 3 more authors.
Journal of Clinical Monitoring and Computing | Year: 2013

There have been conflicting reports on whether propofol prolongs, shortens, or does not change QT interval. The aim of this study was to determine the effect of target-controlled infusion (TCI) of propofol on heart rate-corrected QT (QTc) interval during anesthetic induction. We examined 50 patients undergoing lumbar spine surgery. Patients received 3 μg/kg of fentanyl and were randomly allocated to one of the following 2 groups. Group S patients received 5 mg/kg of thiamylal followed by sevoflurane, 5 % at the inhaled concentration. Group P patients received propofol using TCI system at 5 μg/mL for 2 min followed by 3 μg/mL. Tracheal intubation was performed after vecuronium administration. Heart rate (HR), mean arterial pressure (MAP), bispectral index score (BIS), and QTc interval in 12-lead electrocardiogram were recorded at the following time points: just before fentanyl administration (T1), 2 min after fentanyl injection (T2), 1 min after thiamylal injection or 2 min after the start of TCI (T3), just before intubation (T4), and 2 min after intubation (T5). BIS and MAP significantly decreased after anesthetic induction in both groups. HR decreased after anesthetic induction and recovered after tracheal intubation in group P, whereas it did changed in group S throughout the study period. QTc interval was shortened at T3 and T4 in group P, but prolonged at T3, T4, and T5 in group S, as compared with T1. Propofol TCI shortens QTc interval, whereas sevoflurane prolongs QTc interval during anesthetic induction. © 2012 Springer Science+Business Media New York.


Kawahara Y.,Nagasaki Rosai Hospital
Japanese Journal of Clinical Radiology | Year: 2014

We have selected clinical questions, which are related to imaging modalities frequently used for the diagnosis of common musculoskeletal diseases. Many radiologists, who are not familiar with musculoskeletal radiology, are compelled to accept most of the imaging examinations ordered by other physicians, even if they seem inappropriate. However, it is one of the duties of radiologists to tell them the appropriate indication of imaging modalities based on the evidence. We hope that this guideline will assist radiologists in choice of adequate imaging modalities.


Kawano H.,Nagasaki Rosai Hospital | Matsumoto Y.,Nagasaki Rosai Hospital | Arakawa S.,Nagasaki Rosai Hospital | Hayano M.,Nagasaki Rosai Hospital | Fijisawa H.,Nagasaki Rosai Hospital
Internal Medicine | Year: 2011

Although the etiology of Takotsubo cardiomyopathy (stress-induced cardiomyopathy) is unknown, there is a wide variability in the psychological and physical triggers for Takotsubo cardiomyopathy. We report here a case of Takotsubo cardiomyopathy associated with severe hyponatremia. © 2011 The Japanese Society of Internal Medicine.


PubMed | Nagasaki University and Nagasaki Rosai Hospital
Type: | Journal: Journal of surgical education | Year: 2016

The central venous access port (CVAP) has played an important role in the safe administration of chemotherapy and parenteral nutrition. The aim of the present study was to clarify the optimal access vein for CVAP implantation when performed by residents rather than attending surgeons.A consecutive cases of CVAP implantation via the subclavian vein (SV) using a landmark-guided technique or via the internal jugular vein (JV) using an ultrasound-guided technique were divided into 2 groups according to whether the intervention was performed by a resident or an attending surgeon. Early and late complications were compared retrospectively between the 2 groups, and the outcomes of the CVAPs were compared between those implanted via the SV and those implanted via the JV in resident group.A total of 207 cases of CVAP implantation were performed. Overall, 114 implantations were performed by residents, and another 93 implantations were performed by attending surgeons. Early complications were seen more frequently in the resident group (6.1%) than in the attending-surgeon group (1.1%), but the difference was not significant. No differences in operating time or late complications were observed between the 2 groups. In the resident group, CVAP implantations via the JV using the ultrasound-guided technique were associated with a shorter operating time compared with the SV approach.Residents can perform CVAP implantations safely using both the SV and JV approaches. However, the JV approach using an ultrasound-guided technique can be performed in less time than the SV approach.

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