Niigata Prefectural Central Hospital

Jōetsu, Japan

Niigata Prefectural Central Hospital

Jōetsu, Japan
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Suzuki S.,Niigata Prefectural Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016

A 57-year-old woman with Marfan syndrome had undergone the surgical treatment for pectus excavatum at 15 years of age. She had since been screened regularly by computed tomography(CT) to detect any vascular diseases. CT demonstrated a left subclavian arterial aneurysm at 55 years of age. It enlarged to a diameter of 32 mm, and surgical treatment was performed. The subclavian artery and the aneurysm were identified by echography in order to locate the exact sites of supraclavicular and subclavicular skin incisions. The subclavian artery aneurysm was resected without dividing the clavicle, and replaced by a vascular graft. Echography is useful for precisely locating a subclavian artery aneurysm, which enables feasible resection without dividing the clavicle.

Shioda N.,Tohoku University | Moriguchi S.,Tohoku University | Oya T.,Niigata Prefectural Central Hospital | Ishii Y.,University of Toyama | And 5 more authors.
Hippocampus | Year: 2012

The physiological role of platelet-derived growth factor (PDGF) in the central nervous system (CNS) synaptic function remains uncharacterized. Here we identify physiological roles of PDGF receptor-β (PDGFR-β) in the CNS by conditional knockout of the gene encoding it. In the hippocampus, PDGFR-β colocalized immunohistochemically with both presynaptic synaptophysin and postsynaptic density-95 (PSD-95). In the hippocampal CA1 region, expression levels of postsynaptic proteins, including spinophilin, drebrin, and PSD-95, were significantly decreased in PDGFR-β knockout mice, although presynaptic synaptophysin levels remained comparable to controls. Interestingly, in hippocampal CA1 pyramidal neurons, dendritic spine density in PDGFR-β knockout mice was significantly decreased compared with that seen in wild-type mice, although spine length and number of dendritic branches remained unchanged. Consistent with these findings, impairment in hippocampal long-term potentiation (LTP) and in hippocampus-dependent memory formation were seen in PDGFR-β knockout mice. These results suggest PDGFR-β plays critical roles in spine morphology and memory formation in mouse brain. © 2011 Wiley Periodicals, Inc.

Saeki T.,Red Cross | Kawano M.,Kanazawa University | Mizushima I.,Kanazawa University | Yamamoto M.,Sapporo Medical University | And 9 more authors.
Kidney International | Year: 2013

Long-term follow-up for IgG4-related kidney disease, including relapse information, is sparse. To gather data on this we retrospectively examined the clinical course of 43 patients with IgG4-related kidney disease, in which most patients were treated with, and maintained on, corticosteroids. One month after the start of treatment, most of the abnormal serology and radiology parameters had improved. In 34 of the steroid-treated patients whose follow-up period was more than 12 months (median 34 months), excluding one hemodialysis patient, the estimated glomerular filtration rate (eGFR) before treatment was over 60 ml/min in 14 patients (group A) and under 60 ml/min in 20 patients (group B). In group A, there was no difference between the eGFR before therapy and at the last review. In group B, the mean eGFR before treatment (34.1 ml/min) was significantly improved after 1 month (45.0 ml/min), and renal function was maintained at a similar level through last follow-up. Among 24 evaluated patients at the last review, however, renal atrophy had developed in 2 of 9 in group A and in 9 of 15 in group B. Relapse of IgG4-related lesions occurred in 8 of 40 treated patients. Thus, the response of IgG4-related kidney disease to corticosteroids is rapid, not total, and the recovery of renal function persists for a relatively long time under low-dose maintenance. A large-scale prospective study to formulate more useful treatment strategies is necessary. © 2013 International Society of Nephrology.

Shirato T.,Niigata Prefectural Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

62-year-old man with obstructive pneumonitis due to metastatic lung cancer admitted for surgery. Anticancer chemotherapy combined with bevacizumab had been canceled 8 weeks before surgery. Right lower lobectomy and wedge resection of right upper lobe were performed. Subcutaneous emphysema and prolonged air leakage appeared 5 days after surgery. Re-operation was performed 6 days after surgery, in order to control air leakage from suture line of the lung. The reason of prolonged air leakage was possibly the side effect of bevacizumab.

Shirato T.,Niigata Prefectural Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

59-year-old man falling from the roof was transported to our hospital by ambulance. When thoracic drainage was done for tension pneumothorax of the left lung, massive intrathoracic hemorrhage was noted as well. Chest computed tomography (CT) revealed contusion of left lower lobe. Emergency operation was done, but complete hemostasis was not achieved. To control hemorrhage from lung, intrathoracic packing was performed. After improving general condition, left pneumonectomy could be performed by 2nd operation. His postoperative course was uneventful.

Kitahara A.,Niigata Prefectural Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

77-year-old man was treated by wedge resection for bronchioloalveolar carcinoma (BAC) of right upper lobe 6 years before. Follow up computed tomography (CT) performed 5 years later revealed partial thickening of the resected line of the initial surgery which was diagnosed as adenocarcinoma with bronchoscopic cytology. Thoracoscopic right upper lobectomy and nodal dissection was performed. Histological diagnosis was papillary adenocarcinoma, which was thought to be a 2nd primary lung cancer.

Gotoh T.,Niigata Prefectural Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

A 59-year-old man was diagnosed as Aspergillus empyema with fistula after left upper lobectomy and radiation therapy. His pyrexia was continued after conservative treatment with antifungal agents. Initially, fenestration and vacuum-assisted closure (VAC) therapy were performed. The Aspergillus terreusdisappeared and inflammatory reactions were normalized. Eight days after fenestration, pectoralis major muscle flap transposition was subsequently performed. His postoperative course was uneventful. No recurrent empyema was found 15 months after surgery.

Hara N.,Niigata University | Mizusawa T.,Niigata Prefectural Central Hospital | Obara K.,Niigata University | Takahashi K.,Niigata University
Therapeutic Advances in Urology | Year: 2013

Naftopidil, which to a certain extent shows an affinity to α1D-adrenoceptor subtype in addition to a high affinity to α1A-adrenoceptor, has been used for the treatment of benign prostatic obstruction and benign prostatic hyperplasia (BPH) associated lower urinary tract symptoms (LUTS). The aim of the present review is to systematically refer to the published studies on this unique agent for BPH. Based on a randomized prazosin-controlled study and another double-blind placebo-controlled study, which verified the dose-dependent effects of naftopidil, the Japanese Ministry of Health, Labor and Welfare approved naftopidil for treating men with BPH in 1996. Several tamsulosin-controlled studies have suggested treatment effects of naftopidil similar to those of tamsulosin and potentially higher efficacy for alleviating storage symptoms by naftopidil. Although well-designed, randomized studies are warranted to confirm the long-term outcomes and effector/target of naftopidil, the α1A-antagonist naftopidil, which also blocks α1D-adrenoceptor, improves voiding symptoms, and may also be useful for the management of men with storage symptoms represented by nocturia, retrieving their quality of life impaired by BPH-associated LUTS. © The Author(s), 2012.

Maruyama H.,Niigata University | Takata T.,Nagaoka Chuo General Hospital | Tsubata Y.,Niigata Prefectural Central Hospital | Tazawa R.,Niigata University | And 5 more authors.
Clinical Journal of the American Society of Nephrology | Year: 2013

Background and objectives Previous reports of Fabrydisease screening indialysispatients indicate thata-galactosidase A activity alone cannot specifically and reliably identify appropriate candidates for genetic testing; a marker for secondary screening is required. Elevated plasma globotriaosylsphingosine is reported to be a hallmark of classic Fabry disease. The purpose of this studywas to examine the usefulness of globotriaosylsphingosine as a secondary screening target for Fabry disease. Design, setting, participants, & measurements This study screened 1453 patients, comprising 50% of the male dialysis patients in Niigata Prefecture between July 1, 2010 and July 31, 2011. Screening for Fabry disease was performed by measuring the plasma α-galactosidase A enzyme activity and the globotriaosylsphingosine concentration, by high-performance liquid chromatography. Genetic testing and genetic counseling were provided. Results A low level of plasma α-galactosidase A activity (<4.0 nmol/h per milliliter) was observed in 47 patients (3.2%). Of these, 3 (0.2%) had detectable globotriaosylsphingosine levels. These patients all had α-galactosidase A gene mutations: one was p.Y173X and two were the nonpathogenic p.E66Q. The patient with p.Y173X started enzyme replacement therapy. Subsequent screening of his family identified the samemutation in his elder sister and her children. Genetic testing for 33 of the other 44 patients detected 7 patients with p.E66Q. Thus, the plasma lyso-Gb3 screen identified Fabry disease with high sensitivity (100%) and specificity (94.3%). Conclusions Plasma globotriaosylsphingosine is a promising secondary screening target that was effective for selecting candidates for genetic counseling and testing and for uncovering unrecognized Fabry disease cases.

Ogawa O.,Niigata Prefectural Central Hospital | Watanabe R.,Niigata Prefectural Central Hospital | Shimizu H.,Niigata Prefectural Central Hospital | Masani F.,Niigata Prefectural Central Hospital
Internal Medicine | Year: 2011

A young woman who was experiencing repeated convulsions was admitted. The patient's brain magnetic resonance image revealed reversible posterior leukoencephalopathy. Blood pressure fluctuated at times to more than 200 mmHg, and the measurement of the right and left upper arms differed by approximately 70 mmHg. Enhanced computed tomography revealed stenotic lesions of some arteries including the left renal artery. Such findings led to an initial diagnosis of Takayasu arteritis and hypertensive encephalopathy caused by renovascular hypertension. A percutaneous transluminal renal angioplasty was successfully performed. The patient's blood pressure returned to normal value without the use of antihypertensive drugs. © 2011 The Japanese Society of Internal Medicine.

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