Nagato, Japan
Nagato, Japan

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PubMed | Yamaguchi Grand Medical Center, Nagato General Hospital, Kurashiki Municipal Hospital, JA Hiroshima General Hospital and 8 more.
Type: Journal Article | Journal: Drug research | Year: 2016

Clinical evidences of inhaled salmeterol/fluticasone propionate combination (SFC) therapy are insufficient in early childhood asthma.To examine the effects of SFC50, a combination product of salmeterol xinafoate (50g/day) and fluticasone propionate (100g/day), in infants and preschool children with asthma.The study was conducted at 31 sites in Japan. 35 patients (6 months to 5 years old) with asthma insufficiently controlled by inhaled corticosteroids (100g/day) were initiated to treat with SFC50 twice a day for 12 weeks with pressurized metered dose inhalers. The efficacy of SFC50 was assessed using nighttime sleep disorder score as the primary endpoint and the other efficacy measurements. The safety measurement included the incidences of adverse event (AE).Mean patient age was 3.1 years, and 94.2% had mild-to-moderate persistent asthma (atopic type: 65.7%). Nighttime sleep disorder scores, assessed by a nighttime sleep diary, significantly decreased after treatment with SFC50 throughout the study period (p<0.01). SFC50 also significantly improved other efficacy outcomes including asthma symptom score, frequency of short-acting beta-agonist treatment, frequency of unscheduled visits to clinic, frequency of exacerbation due to virus infection, asthma control score and patient QOL score (p<0.01). AEs of cold, upper respiratory inflammation and asthmatic attack occurred in each of the 3 patients (8.6%); however, these were not regarded as treatment-related AEs.SFC50 improved nighttime sleep disorder score and other efficacy outcome measures with no safety concerns. The results suggest that SFC50 treatment is useful to control the mild-to-moderate asthma in infant and preschool-aged children.


Takanashi J.-I.,Kameda Medical Center | Miyamoto T.,Kosai General Hospital | Ando N.,Nagoya City University | Kubota T.,Anjo Kosei Hospital | And 6 more authors.
American Journal of Neuroradiology | Year: 2010

BACKGROUND AND PURPOSE: Neurological manifestations, such as benign convulsions and encephalitis/ encephalopathy have been reported in patients with rotavirus gastroenteritis. However, cerebellitis has not attracted much attention. The purpose of this study was to identify and report the clinical and radiologic features of rotavirus cerebellitis. MATERIALS AND METHODS: Records of patients with rotavirus gastroenteritis exhibiting cerebellar lesions on MR imaging were collected from multiple centers in Japan. Their clinical, laboratory, and radiologic data were reviewed retrospectively. RESULTS: A diagnosis of acute cerebellitis concurrent with encephalitis was made for 11 of 13 patients identified. Two patients who were diagnosed as having injury due to hypovolemic shock were excluded from the study. All 11 patients with acute cerebellitis had disorders of consciousness with onset on days 2 to 4, followed by mutism in 10 patients. Other cerebellar symptoms included dysarthria following the mutism, hypotonia, ataxia, tremor, nystagmus, and dysmetria. MR imaging lesions in the vermis or cerebellar cortex were seen at some point (day 5 to 1 year) in 10 patients. A reversible splenial lesion (3 isolated and 3 with concurrent cerebellar lesions) was found in 6 patients scanned between days 4 and 6. Transient lesions in the cerebellar white matter/nuclei manifesting reduced diffusion were seen in 6 patients during days 5 through 7. The final MR imaging performed after 1 month showed cerebellar atrophy in 10 patients. CONCLUSIONS: The 11 patients with rotavirus cerebellitis exhibited nearly identical clinical and MR imaging features. Involvement of the cerebellar white matter/nuclei may be associated with the mutism. An isolated splenial lesion with homogeneously reduced diffusion is not always a benign sign indicative of complete clinical and radiologic recovery in patients with rotavirus gastroenteritis.


Matsumoto J.,Yamaguchi University | Imate Y.,Yamaguchi University | Yamashita H.,Yamaguchi University | Ebisumoto H.,Nagato General Hospital
Practica Oto-Rhino-Laryngologica | Year: 2010

Renal cell carcinoma is potentially highly metastastic to any organ, with that to the head and neck not unusual. We report a case of parotid metastasis from renal cell carcinoma. A 70-year-old man who had undergone left nephrectomy for renal cell carcinoma in 1987 was found to have lung metastasis surgically removed between 1996 and 1998. In August 2005, he presented with a parotid mass necessitating superficial parotidectomy with facial nerve preservation. The pathological diagnosis was metastatic renal clear cell carcinoma. Six months later, this tumor recurred deep in the parotid gland lobe, requiring total parotidectomy. We discusss the diagnosis and management of parotid gland metastasis in renal cell carcinoma.


Tanaka N.,Yamaguchi University | Emoto T.,Shimonoseki Municipal Central Hospital | Suda H.,Nagato General Hospital | Kunihiro Y.,Yamaguchi University | And 3 more authors.
Japanese Journal of Radiology | Year: 2012

Purpose To evaluate the high-resolution computed tomography (HRCT) findings of novel influenza virus (n-IFV) pneumonia and compare them with the findings for seasonal (s-IFV) pneumonia. Materials and methods We evaluated 29 cases of pure IFV pneumonia that occurred between 1990 and 2010. We evaluated the existence, extent, and patterns of HRCT findings and compared these features between s-IFV and n-IFV. Results Consolidation was less frequent in s-IFV than in n-IFV (40.0 vs. 84.2%, respectively; p = 0.014). Consolidation with a loss of volume was frequent in n-IFV (62.5%). There was no significant difference in the occurrence of ground-glass opacity (GGO) between s-IFV and n-IFV (100 vs. 84.2%, respectively). GGO with reticular opacities was more frequent in s-IFV than in n-IFV (70.0 vs. 25.0%, respectively; p = 0.024). The frequency of nodules was not significantly different between the two groups. The mosaic pattern was more frequent in s-IFV than in n-IFV patients (80.0 vs. 15.8%, respectively; p = 0.0007). Mucoid impaction was more frequent in patients with n-IFV than with s-IFV (52.6 vs. 10.0%, respectively; p = 0.025). Conclusions Consolidation and mucoid impaction were more frequent in n-IFV, whereas GGO with reticular opacities and a mosaic pattern occurred more frequently in s-IFV; otherwise, there were no significant differences between the two groups. © 2011 Japan Radiological Society.


Tanaka N.,Saiseikai Yamaguchi General Hospital | Tanaka N.,Yamaguchi University | Emoto T.,Fukuoka Wajiro Hospital | Suda H.,Nagato General Hospital | And 2 more authors.
Japanese Journal of Radiology | Year: 2015

Purpose: To elucidate what kinds of lesions tend to be overlooked or misinterpreted and why they were overlooked or misinterpreted on chest radiographs in the diagnosis of community-acquired pneumonia (CAP) by comparing radiographic findings with HRCT findings. Materials and methods: In 129 patients with CAP (107 bacterial and 22 atypical) and 105 healthy subjects, the chest radiographic findings were correlated with the HRCT findings. The diagnostic accuracy of each chest radiographic finding was evaluated by comparing it with the HRCT finding. Results: The false negative rate of radiographic interpretation tended to be higher for nodules and thickening of the bronchial wall, especially in patients with atypical pneumonia. The most frequent reason for false negative interpretations of nodules and bronchial wall thickening was the overlapping of these findings with airspace consolidation or ground-glass opacity (GGO). Thin lesions were the most frequent reasons for the false negative interpretation of airspace consolidation and GGO. Conclusion: The chest radiographic interpretations of GGO and airspace consolidation were influenced by the thickness of lesions, and those of nodules and thickening of bronchial walls were influenced by coexisting GGO and airspace consolidation and may contribute to a misinterpretation of these lesions and an incorrect diagnosis of CAP. © 2015, Japan Radiological Society.


Amasaki Y.,Nagato General Hospital | Kuga T.,Nagato General Hospital | Kunisue Y.,Nagato General Hospital | Hirata K.,Nagato General Hospital | And 3 more authors.
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

In October 2012, a man in his 60s was hospitalized for the examination of ascites, and was diagnosed with gastric cancer and carcinomatous peritonitis. S-1+cisplatin (CDDP) therapy was administered as neoadjuvant chemotherapy; however, during therapy, he developed cerebral infarction. We suspected that the cerebral infarction was caused by a coagulation disorder owing to Trousseau's syndrome. After completing 5 courses of chemotherapy, total gastrectomy was performed. Thereafter, the treatment was changed to S-1+docetaxel(DTX), followed by nab-paclitaxel (PTX). Although cerebral infarction did not relapse after the administration of an anticoagulant agent, the patient died of gastric cancer 1 year and 5 months after the operation. Trousseau's syndrome is a coagulation disorder in cancer patients. Cerebral infarctions caused by Trousseau's syndrome have a high tendency to relapse, and the prognosis is poor. This syndrome should be kept in mind when treating cancer patients.


Amasaki Y.,Nagato General Hospital | Kuga T.,Nagato General Hospital | Kunisue Y.,Nagato General Hospital | Hirata K.,Nagato General Hospital | And 3 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2015

In October 2012, a man in his 60s was hospitalized for the examination of ascites, and was diagnosed with gastric cancer and carcinomatous peritonitis. S-1+cisplatin (CDDP) therapy was administered as neoadjuvant chemotherapy; however, during therapy, he developed cerebral infarction. We suspected that the cerebral infarction was caused by a coagulation disorder owing to Trousseau's syndrome. After completing 5 courses of chemotherapy, total gastrectomy was performed. Thereafter, the treatment was changed to S-1+docetaxel (DTX), followed by nab-paclitaxel (PTX). Although cerebral infarction did not relapse after the administration of an anticoagulant agent, the patient died of gastric cancer 1 year and 5 months after the operation. Trousseau's syndrome is a coagulation disorder in cancer patients. Cerebral infarctions caused by Trousseau's syndrome have a high tendency to relapse, and the prognosis is poor. This syndrome should be kept in mind when treating cancer patients.


PubMed | Red Cross, Shimonoseki City Hospital, Nagato General Hospital, Toyoura Hospital and 3 more.
Type: Journal Article | Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy | Year: 2014

Human herpesvirus-6 (HHV-6) is a cause of exanthema subitum and, sometimes, of febrile seizures. However, the pathogenesis of febrile seizures associated with HHV-6 infection remains unclear. We investigated serum matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) levels in infants with HHV-6 infection. Serum levels of both MMP-9 and TIMP-1 were significantly higher in infants with HHV-6 infection than in controls. Serum TIMP-1 levels were significantly higher in infants with febrile seizures than in infants without febrile seizures. Serum MMP-9/TIMP-1 ratios were significantly lower in infants with febrile seizures than in infants without febrile seizures. In infants with HHV-6 infection, positive correlations were found between serum MMP-9 concentrations and the white blood cells (WBC) count, and between serum TIMP-1 concentrations and the WBC count. Positive correlations were also found between the amounts of HHV-6 DNA and the ratios of MMP-9/TIMP-1 in infants with HHV-6 infection. In conclusion, we suggest that high serum levels of MMP-9 and TIMP-1 in infants with HHV-6 infection may induce dysfunction of the blood-brain barrier, eventually causing febrile seizures.


PubMed | Nagato General Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

In October 2012, a man in his 60s was hospitalized for the examination of ascites, and was diagnosed with gastric cancer and carcinomatous peritonitis. S-1+cisplatin (CDDP) therapy was administered as neoadjuvant chemotherapy; however, during therapy, he developed cerebral infarction. We suspected that the cerebral infarction was caused by a coagulation disorder owing to Trousseaus syndrome. After completing 5 courses of chemotherapy, total gastrectomy was performed. Thereafter, the treatment was changed to S-1+docetaxel(DTX), followed by nab-paclitaxel (PTX). Although cerebral infarction did not relapse after the administration of an anticoagulant agent, the patient died of gastric cancer 1 year and 5 months after the operation. Trousseaus syndrome is a coagulation disorder in cancer patients. Cerebral infarctions caused by Trousseaus syndrome have a high tendency to relapse, and the prognosis is poor. This syndrome should be kept in mind when treating cancer patients.


PubMed | Yamaguchi University, Yamaguchi Prefectural University and Nagato General Hospital
Type: Journal Article | Journal: PloS one | Year: 2015

Hepatic arterial infusion chemotherapy (HAIC) is an option for treating advanced hepatocellular carcinoma (HCC). Because of the poor prognosis in HAIC non-responders, it is important to identify patients who may benefit from continuous HAIC treatment; however, there are currently no therapeutic assessment scores for this identification. Therefore, we aimed to establish a new therapeutic assessment score for such patients.We retrospectively analyzed 90 advanced HCC patients with elevated baseline alpha-fetoprotein (AFP) and/or des-gamma-carboxy prothrombin (DCP) levels and analyzed various parameters for their possible use as predictors of response and survival. AFP and DCP responses were assessed after half a course of HAIC (2 weeks); a positive-response was defined as a reduction of 20% from baseline.Multivariate analysis identified DCP response (odds ratio 16.03, p < 0.001) as an independent predictor of treatment response. In multivariate analysis, Child-Pugh class A (hazard ratio [HR] 1.99, p = 0.018), AFP response (HR 2.17, p = 0.007), and DCP response (HR 1.90, p = 0.030) were independent prognostic predictors. We developed an Assessment for Continuous Treatment with HAIC (ACTH) score, including the above 3 factors, which ranged from 0 to 3. Patients stratified into two groups according to this score showed significantly different prognoses ( 1 vs. 2 points: median survival time, 15.1 vs. 8.7 months; p = 0.003).The ACTH score may be useful in the therapeutic assessment of HCC patients receiving HAIC.

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