National Hospital Organization Beppu Medical Center

Beppu, Japan

National Hospital Organization Beppu Medical Center

Beppu, Japan

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PubMed | Harasanshin Hospital, National Hospital Organization Fukuoka Higashi Medical Center, National Hospital Organization Beppu Medical Center, Fukuoka City Hospital and 7 more.
Type: Journal Article | Journal: Scandinavian journal of gastroenterology | Year: 2016

Although the World Health Organisation (WHO) defined a novel classification of gastroenteropancreatic neuroendocrine tumours (NETs) in 2010, indications for endoscopic resection of rectal NETs in the guidelines were based on evidence accumulated for carcinoid tumours defined by a previous classification. This study was designed to clarify indications for endoscopic resection of rectal NETs corresponding to the new WHO classifications.One hundred-seventy rectal NETs resected endoscopically from April 2001 to March 2012 were histologically re-classified according to the WHO 2010 criteria. The clinicopathological features of these lesions were analysed, and the short- and long-term outcomes of endoscopic resection were evaluated.Of the 170 rectal NETs, 166 were histopathologically diagnosed as NET G1 and four as NET G2. Thirty-eight tumours (22.4%) were positive for lymphovascular invasion, a percentage higher than expected. Although the curative resection rate was low (65.3%), en bloc (98.8%) and complete (85.9%) resection rates were high. Modified endoscopic mucosal resection (88.0%) and endoscopic submucosal dissection (92.2%) resulted in significantly higher complete resection rates than conventional endoscopic mucosal resection (36.4%). No patient experienced tumour recurrence, despite the low curative resection rate.Despite the low curative resection rate, prognosis after endoscopic resection of rectal NETs was excellent. Prospective large-scale, long-term studies are required to determine whether NET G2 and tumours >1 cm should be included in the indication for endoscopic resection and whether tumours with lymphovascular invasion can be followed up without additional surgery.


PubMed | National Hospital Organization Kumamoto Medical Center, Fukuoka University, National Hospital Organization Beppu Medical Center, University of Toyama and National Hospital Organization Kumamoto Saisyunsou Hospital
Type: Journal Article | Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy | Year: 2016

We compared the predictive accuracy of TEIC concentrations (TEIC_conc) calculated using either serum cystatin C (CysC) or serum creatinine (SCr) and the population mean method using the mean population parameter of TEIC_conc for Japan. We also compared the predicted TEIC_conc to measured TEIC_conc. Creatinine clearance (CLCr) predicted using the Cockcroft-Gault (C&G) equation with SCr was 45.23mL/min (interquartile range [IQR]: 32.12-58.28), and the glomerular filtration rate (GFR) predicted using the Hoek equation with CysC was 45.23mL/min (IQR: 35.40-53.79). The root mean-squared prediction error (IQR) based on CLCr predicted using the C&G equation with SCr was 6.88 (3.80-9.96) g/mL, and that based on GFR predicted using the Hoek equation with CysC was 6.72 (3.77-9.68) g/mL. Predicted TEIC_conc did not differ significantly between the two methods. The predictive accuracy of the TEIC_conc using the Hoek equation with CysC was similar to that of CLCr using the C&G equation with SCr. These findings suggest that the predictive accuracy of the TEIC_conc using CLCr based on the G&G equation and SCr might be sufficient for the initial dose adjustment of TEIC. Given that we were unable to confirm that CysC is the optimal method for predicting TEIC_conc, the expensive measurement of CysC might not be necessary.


PubMed | Fukuoka University, National Hospital Organization Beppu Medical Center and University of Toyama
Type: | Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases | Year: 2017

Daptomycin exhibits concentration-dependent antibacterial activity. By monitoring daptomycin serum concentrations, clinicians may be able to predict the effectiveness of treatments for infections more accurately. However, a previous study reported that daptomycin concentrations in plasma samples stored at -20C decreased approximately 25% after 4 weeks. We here in evaluated the stability of daptomycin in serum at various temperatures.Daptomycin serum samples were prepared and stored at different temperatures. The stability of daptomycin under various conditions was evaluated by sequential measurements of its concentrations.Although concentrations losses of daptomycin in serum samples stored in freezers (-80 and -20C) were less than 10% after 168days (six months), those in samples stored in a refrigerator (4C) decreased by more than 70% over the same period. Furthermore, daptomycin concentrations in serum samples stored at close to body temperature (35, 37 and 39C) decreased by more than 50% after only 24h.The results of the present study demonstrate that the measurement of serum concentrations of daptomycin needs to be performed rapidly. Furthermore, the degradation of daptomycin in serum may be involved in its elimination from the living body.


Yano T.,National Hospital Organization Beppu Medical Center | Okamoto T.,Kyushu University | Fukuyama S.,National Hospital Organization Beppu Medical Center | Maehara Y.,Kyushu University
World Journal of Clinical Oncology | Year: 2014

Postoperative recurrence occurs in approximately half of patients with non-small cell lung cancer (NSCLC), even after complete resection. Disease recurrence after surgical resection reduces the patient's life expectancy sharply. The prognosis after postoperative recurrence is considered to largely depend on both the mode of first recurrence (distant, locoregional or combined) and the treatment modality: (1) The majority of cases of postoperative recurrence involve distant metastasis with or without locoregional recurrence. Platinum-based systemic chemotherapy is practically accepted as the treatment for these diseases on the basis of evidence for original stage ? disease. The advent of both pemetrexed and molecular-targeted drugs has improved the survival of nonsquamous NSCLC and changed the chemotherapeutic algorithm for NSCLC; (2) Among patients with distant metastatic recurrence without locoregional recurrence at the primary tumor site, the metastasis is often limited in both organ and number. Such metastases are referred to as oligometastases. Local therapy, such as surgical resection and radiotherapy, has been suggested to be the first-line treatment of choice for oligometastatic recurrence; and (3) While locoregional recurrence is likely to cause troublesome symptoms, it is a potentially limited disease. Therefore, providing local control is important, and radiation is usually beneficial for treating local recurrence. In order to obtain better control of the disease and provide treatment with curative intent in patients with limited disease, the administration of concurrent platinum-based chemoradiotherapy is recommended according to the results of originally nonresectable stage ?A and ?B disease. © 2014 Baishideng Publishing Group Inc. All rights reserved.


Yano T.,National Hospital Organization Beppu Medical Center | Okamoto T.,Kyushu University | Haro A.,Kyushu University | Fukuyama S.,National Hospital Organization Beppu Medical Center | And 3 more authors.
Lung Cancer | Year: 2013

Objectives: We previously reported a retrospective study indicating the prognostic impact of the local treatment of oligometastatic recurrence after a complete resection for non-small cell lung cancer (NSCLC). In the present study, we prospectively observed postoperative oligometastatic patients and investigated the effects of local treatment on progression-free survival (PFS). Methods: Using a prospectively maintained database of patients with completely resected NSCLC treated between October 2007 and December 2011, we identified 52 consecutive patients with postoperative recurrence, excluding second primary lung cancer. Of these patients, 31 suffering from distant metastases alone without primary site recurrence were included in this study. According to the definition of 'oligometastases' as a limited number of distant metastases ranging from one to three, 17 patients had oligometastatic disease. Of those 17 patients, four patients with only brain metastasis were excluded from the analysis. Results: The oligometastatic sites included the lungs in five patients, bone in four patients, the lungs and brain in two patients, the adrenal glands in one patient and soft tissue in one patient. Eleven of the 13 patients first received local treatment. Three patients (lung, adrenal gland, soft tissue) underwent surgical resection, and the remaining eight patients received radiotherapy. The median PFS was 20 months in the oligometastatic patients who received local treatment. There were five patients with a PFS of longer than two years. The metastatic sites in these patients varied, and one patient had three lesions. On the other hand, the two remaining patients first received a systemic chemotherapy of their own selection. The PFS of these two patients was five and 15 months, respectively. Conclusion: Local therapy is a choice for first-line treatment in patients with postoperative oligometastatic recurrence. © 2013 Elsevier Ireland Ltd.


Koga H.,National Hospital Organization Beppu Medical Center | Hidaka T.,National Hospital Organization Beppu Medical Center | Miyako K.,National Hospital Organization Beppu Medical Center | Suga N.,National Hospital Organization Beppu Medical Center | Takahashi N.,National Hospital Organization Beppu Medical Center
Pediatric Cardiology | Year: 2010

Unilateral absence of a pulmonary artery (UAPA) is a rare anomaly. Although UAPA has been reported previously, its age-related pathogenesis and symptoms remain unclear. This retrospective cohort study included cases of UAPA reported in Japan at medical meetings or in the literature from 1990 through 2009. Patients with other congenital cardiac defects were excluded from the study. Clinical status was assessed according to age, and the clinical course of patients with isolated UAPA was compared with that of patients who had UAPA with a patent ductus arteriosus (PDA). Of the 92 patients with UAPA identified, 78 had isolated UAPA (14 with PDA). Hemoptysis and collateral arteries were observed in 0 and 13% of patients with isolated UAPA who were younger than 1 year, as compared with 24 and 50% of those 20 years of age or older, respectively. Pulmonary hypertension was present in 5% of the patients aged 1 to 19 years. Among patients 20 years or older, however, 32% had pulmonary hypertension, and 8% died. Compared with isolated UAPA, UAPA with PDA was associated with an earlier diagnosis (median age, 20 vs. 0 years; p = 0.002), a higher prevalence of pulmonary hypertension (22% vs. 86%; p < 0.0001), and a higher mortality rate (4% vs. 21%; p = 0.046). Collateral artery formation and pulmonary hypertension progress with age in patients with UAPA. Early diagnosis and revascularization may prevent the age-related progression of UAPA. © 2010 Springer Science+Business Media, LLC.


Koga H.,National Hospital Organization Beppu Medical Center | Makimura M.,National Hospital Organization Beppu Medical Center | Tanaka H.,National Hospital Organization Beppu Medical Center | Sumioki H.,National Hospital Organization Beppu Medical Center
Journal of Pediatric Hematology/Oncology | Year: 2014

Placental mesenchymal dysplasia (PMD) is a rare, recently recognized placental vascular anomaly. About 20% of patients with this placental anomaly have Beckwith-Wiedemann syndrome. We report a case of a phenotypically normal neonate with anemia and thrombocytopenia associated with PMD. Histologic examination of the placenta showed findings consistent with PMD, including chorangioma. The patient's hematologic abnormalities resolved during the week following birth. Normal phenotypic fetuses with PMD seem to exhibit hematologic disorders at birth in some cases, especially in the presence of chorangioma. Copyright © 2014 by Lippincott Williams & Wilkins.


Koga H.,National Hospital Organization Beppu Medical Center | Suga N.,National Hospital Organization Beppu Medical Center | Nakamoto T.,National Hospital Organization Beppu Medical Center | Tanaka K.,National Hospital Organization Beppu Medical Center | Takahashi N.,National Hospital Organization Beppu Medical Center
American Journal of Medical Genetics, Part A | Year: 2012

Pfeiffer syndrome (PS) is a classic type of craniosynostosis syndrome. Severe cases usually require emergency care at birth. However, early diagnosis is often precluded by the rarity and consequent low awareness of this disease. This study aimed to clarify phenotypic expressions useful for the diagnosis of PS. We reviewed all cases of PS type 2 or 3 according to Cohen's classification that were reported between 1980 and 2011 in Japan. Clinical and genetic information were extracted from the patients' medical records. A total of 23 patients with PS type 2 or 3 were identified. All 23 patients presented with craniosynostosis, midface hypoplasia, proptosis, broad thumbs, and wide great toes. FGFR2 mutations were confirmed in all 8 patients in whom genetic analyses were performed. In addition to classic symptoms, elbow ankylosis and sacrococcygeal defects were present in 70% and 30% of the patients, respectively. During an average follow-up of 22 months, 22% of patients died before 1 year of age. Elbow ankylosis and sacrococcygeal defects were the phenotypic features recognizable at a glance. These defects strongly suggest the presence of PS in newborns with craniosynostosis. © 2012 Wiley Periodicals, Inc.


Matsumoto T.,National Hospital Organization Beppu Medical Center
Journal of laparoendoscopic & advanced surgical techniques. Part A | Year: 2010

When a patient with a ventriculoperitoneal shunt (VPS) undergoes laparoscopic surgery, there is the concern about possible problems with the shunt due to increased intra-abdominal pressure. We conducted a simplified reflux experiment on VPS valves to demonstrate safety. Each of five different VPS valves was connected via tubes to a glass vessel of our own making. Carbon-dioxide gas was consecutively insufflated into the vessel at 3-25 mm Hg pressure to determine whether reflux occurred when the valves and tubes were empty (opened test) and when filled with physiologic saline (closed test). Reflux occurred for two of five valves at an insufflation pressure of 5 mm Hg or more in the opened test, while not for any valves until 25 mm Hg in the closed test. In clinical settings, there would be no possibility of reflux under the pneumoperitoneum in VPS systems draining cerebrospinal fluid. Laparoscopic surgery in patients with VPS would be performed safely if characteristics of VPS valves are taken advantage of.


PubMed | National Hospital Organization Beppu Medical Center
Type: | Journal: Pediatrics international : official journal of the Japan Pediatric Society | Year: 2016

Urethral prolapse (UP) in children is a rare condition and has commonly been reported in Black girls. The aim of this study was to elucidate the status of medical management for UP in Japanese children.A secondary data analysis was conducted in Japanese children 15 years old with UP. The relationship between initial treatment approach and outcome was investigated, with symptom persistence or recurrence defined as treatment failure.Of 77 cases of UP in Japanese children reported since 1972, initial surgical treatment was performed in 42 cases (55%) and nonsurgical treatment in 35 cases (45%). Underlying conditions constituting possible causative factors were present in 26 cases (34%) in total. Treatment outcomes were evaluated in 59 cases (surgical treatment, n=28; nonsurgical treatment, n=31) during a median follow-up period of 10 months. The rate of treatment failure was significantly higher with nonsurgical treatment (81% [25/31]) than with surgical treatment (18% [5/28]; risk ratio, 4.2; 95% confidence interval, 2.0-8.9; P<0.001). Topical estrogen cream, a standard management worldwide but unavailable for prescription drug in Japan, was given for only 7 cases (20%) in the nonsurgical treatment group.Surgical treatment is more effective than nonsurgical treatment in Japanese children, but both failure rates are high compared to non-Asian children. The present findings suggest that drug approval revision for prescription use of estrogen cream, centralizing the treatment to specialized facilities, and an active policy of surgical management in cases of nonsurgical treatment failure may improve treatment outcomes for pediatric UP in Japan. This article is protected by copyright. All rights reserved.

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