Nissay Hospital

Ōsaka, Japan

Nissay Hospital

Ōsaka, Japan

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Kawada N.,Nissay Hospital | Tanaka S.,Japan National Cardiovascular Center Research Institute
World Journal of Gastroenterology | Year: 2016

Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. © The Author(s) 2016.


Iwazawa J.,Nissay Hospital | Ohue S.,Komatsu Hospital | Hashimoto N.,Nissay Hospital | Mitani T.,Nissay Hospital
Cancer Management and Research | Year: 2012

Purpose: We aimed to compare the local control rates between miriplatin and epirubicin in lipiodol-based transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Patients and methods: Patients who underwent targeted TACE using miriplatin (47 patients, 66 lesions) or epirubicin (64 patients, 79 lesions) as the sole therapy were enrolled. The local control rates were compared using the Kaplan-Meier estimator with the log-rank test. The patient and tumor parameters were subjected to univariate and multivariate analyses using the Cox proportional hazards model. Results: The overall local recurrence rates were 39.3% and 31.6% for the miriplatin and epirubicin groups, respectively. The local control rate was significantly higher in the epirubicin group than in the miriplatin group (P< 0.001). The local control rates at 6 months and 1 year were 70.7% and 44.8% for the miriplatin group and 83.4% and 69.2% for the epirubicin group, respectively. Multivariate analysis showed that the serum α-fetoprotein level ≥ 20 ng/mL (hazard ratio 2.96; P, 0.001), miriplatin usage (hazard ratio 2.53; P = 0.002), and Child-Pugh class B (hazard ratio 1.89; P = 0.042) affected local progression. Conclusion: Lipiodol-based targeted TACE using miriplatin had inferior local control rates as compared to epirubicin in patients with HCC. © 2012 Iwazawa et al, publisher and licensee Dove Medical Press Ltd.


Iwazawa J.,Nissay Hospital | Mitani T.,Nissay Hospital | Sassa S.,Nissay Hospital | Ohue S.,Komatsu Hospital
Diagnostic and Interventional Radiology | Year: 2011

PURPOSE: To assess the feasibility of using magnetic resonance imaging for prostate cancer detection without using a contrast material. MATERIALS AND METHODS: T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCEI) were performed using a phased-array coil at 1.5 T. These examinations were performed in 178 patients with elevated serum prostate-specific antigen levels (>4.0 ng/mL) before systematic needle biopsy. Two radiologists independently evaluated images from DWI, DCEI, and a combination of the two techniques by referring to a T2WI image and by using a predefined confidence scale for cancer detection. The right and left halves of the peripheral zone and the central gland were separately rated. The diagnostic performance (Az) of each technique was assessed by analyzing their associated area under the receiver operating characteristic curves. The results of a biopsy served as a reference standard. RESULTS: Prostate cancer was detected in 72 (40.4%) of the 178 patients. For the entire prostate, the diagnostic performances of DWI (A z = 0.848) (P < 0.001) and the combined technique (Az = 0.845) (P < 0.001) were significantly more accurate than that of DCEI (A z = 0.746). DWI (74.8%) (P < 0.001) and the combined technique (72.9%) (P < 0.001) were significantly more sensitive than DCEI (52.8%). The numbers of cancer lesions that were interpreted using only DWI or DCEI were 83 (26.1%) and 13 (4.1%) of the 318 study lesions, respectively. CONCLUSION: DWI and the combined technique are more accurate and sensitive than DCEI in the detection of prostate cancer; however, DWI and DCEI play complementary roles in the accurate detection of prostate cancer. © Turkish Society of Radiology 2011.


Iwazawa J.,Nissay Hospital | Ohue S.,Komatsu Hospital | Kitayama T.,Otemae Hospital | Sassa S.,Nissay Hospital | Mitani T.,Nissay Hospital
American Journal of Roentgenology | Year: 2011

OBJECTIVE. The purpose of our study was to assess the feasibility of using C-arm CT to detect incomplete accumulation of iodized oil in hepatocellular carcinoma immediately after transarterial chemoembolization (TACE). MATERIALS AND METHODS. This retrospective study included 80 hepatocellular carcinoma lesions in 55 patients (41 men and 14 women; mean age, 69.2 years; mean tumor size, 18.1 mm [range, 5-55 mm]) who underwent TACE with a flat-detector C-arm angiographic system. C-arm CT images were acquired at the end of each session, and unenhanced MDCT images were obtained 7 days later. Two independent observers scored both sets of images, using a predefined detection scale for incomplete iodized oil accumulation. The accuracy for predicting residual lesions was compared using the area under the receiver-operating characteristic curve (Az). Contrast-enhanced CT findings obtained 1 month after TACE served as reference standards. RESULTS. Viable lesions were observed in 18 of the 80 study lesions by contrast-enhanced CT. The accuracy of the C-arm CT (Az = 0.816) was not significantly different (p = 0.449) from that of the MDCT (Az = 0.841). Sensitivity, specificity, and positive and negative predictive values for C-arm CT (80.5%, 74.2%, 47.5%, and 92.9%, respectively) and MDCT (86.1%, 75.0%, 50.0%, and 94.9%, respectively) did not differ significantly. CONCLUSION. C-arm CT is nearly equivalent to MDCT for detecting incomplete iodized oil accumulation after TACE, suggesting that the immediate assessment of iodized oil accumulation with C-arm CT without the need to perform follow-up unenhanced MDCT is likely feasible. © American Roentgen Ray Society.


Iwazawa J.,Nissay Hospital | Ohue S.,Komatsu Hospital | Hashimoto N.,Nissay Hospital | Mitani T.,Nissay Hospital
Clinical Radiology | Year: 2014

AIM: To compare the accuracy of computer software analysis using three different target-definition protocols to detect tumour feeder vessels for transarterial chemoembolization of hepatocellular carcinoma. MATERIALS AND METHODS: C-arm computed tomography (CT) data were analysed for 81 tumours from 57 patients who had undergone chemoembolization using software-assisted detection of tumour feeders. Small, medium, and large-sized targets were manually defined for each tumour. The tumour feeder was verified when the target tumour was enhanced on selective C-arm CT of the investigated vessel during chemoembolization. The sensitivity, specificity, and accuracy of the three protocols were evaluated and compared. RESULTS: One hundred and eight feeder vessels supplying 81 lesions were detected. The sensitivity of the small, medium, and large target protocols was 79.8%, 91.7%, and 96.3%, respectively; specificity was 95%, 88%, and 50%, respectively; and accuracy was 87.5%, 89.9%, and 74%, respectively. The sensitivity was significantly higher for the medium (p = 0.003) and large (p < 0.001) target protocols than for the small target protocol. The specificity and accuracy were higher for the small (p < 0.001 and p < 0.001, respectively) and medium (p < 0.001 and p < 0.001, respectively) target protocols than for the large target protocol. CONCLUSION: The overall accuracy of software-assisted automated feeder analysis in transarterial chemoembolization for hepatocellular carcinoma is affected by the target definition size. A large target definition increases sensitivity and decreases specificity in detecting tumour feeders. A target size equivalent to the tumour size most accurately predicts tumour feeders. © 2013 The Royal College of Radiologists.


Koga M.,Kawanishi City Hospital | Hirata T.,Foundation for Biomedical Research and Innovation | Kasayama S.,Nissay Hospital | Ishizaka Y.,Mitsui Memorial Hospital | Yamakado M.,Mitsui Memorial Hospital
Clinica Chimica Acta | Year: 2015

Background: Glycated albumin (GA) is known to be negatively regulated by body mass index (BMI) in non-diabetic subjects and patients with type 2 diabetes mellitus (T2DM). In non-diabetic subjects, a mechanism has been proposed in which chronic inflammation associated with obesity increases albumin metabolism and negatively regulates GA levels. However, whether this same mechanism exists in T2DM is unclear. We investigated the factor(s) which influence GA levels in T2DM patients. Methods: This study included 179 T2DM patients from among people undergoing complete medical examinations. Correlations between GA and the following variables were examined among fasting samples for T2DM patients: BMI, C-reactive protein (CRP), homeostasis model assessment for β-cell function (HOMA-β) and homeostasis model assessment for insulin resistance (HOMA-R). Results: BMI was significantly positively correlated with CRP, but CRP was not significantly correlated with GA. HOMA-β was significantly positively correlated with BMI and significantly negatively correlated with GA. Multivariate analysis showed that HOMA-β was a significant explanatory variable for GA, but not CRP and HOMA-R. Conclusions: Our findings suggest that insulin secretion plays a greater role than chronic inflammation in the mechanism by which BMI negatively regulates GA in T2DM patients. © 2014 Elsevier B.V.


Koga M.,Kinki Central Hospital | Kasayama S.,Nissay Hospital
Endocrine Journal | Year: 2010

It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Currently, among these glycated proteins, glycated hemoglobin (HbA 1C) is used as the gold standard index of glycemic control in clinical practice for diabetes treatment. However, HbA 1C does not accurately reflect the actual status of glycemic control in some conditions where plasma glucose changes during short term, and in patients who have diseases such as anemia and variant hemoglobin. In comparison, another index of glycemic control, glycated albumin (GA), more accurately reflects changes in plasma glucose during short term and also postprandial plasma glucose. Although GA is not influenced by disorders of hemoglobin metabolism, it is affected by disorders of albumin metabolism. This review summarizes diseases and pathological conditions where GA measurement is useful. These include the status of glycemic control changes during short term, diseases which cause postprandial hyperglycemia, iron deficiency anemia, pregnancy, chronic liver disease (liver cirrhosis), chronic renal failure (diabetic nephropathy), and variant hemoglobin. © The Japan Endocrine Society.


Miyazaki A.,Osaka Medical College | Kohzuma T.,Asahi Kasei Corporation | Kasayama S.,Nissay Hospital | Koga M.,Kinki Central Hospital
Annals of Clinical Biochemistry | Year: 2012

Background: Asymptomatic variant haemoglobin is increasingly being found in the measurement of glycated haemoglobin (HbA1c) for the management of diabetes mellitus. We compared the Hb1c concentrations measured by high-performance liquid chromatography (HPLC) and immunoassay and glycated albumin (GA) concentrations and calculated the respective ratios in order to classify the variant haemoglobin. Methods: Twenty different haemoglobin variants from 43 subjects were identified by mass spectrometry and DNA analysis. Since GA accurately reflects glycaemic control in patients with variant haemoglobin, we calculated respective ratios of Hb1c and GA. Haemoglobin variants causing a low ratio of Hb1c measured by HPLC (HPLC-Hb1c) to GA with a normal ratio of Hb1c measured by immunoassay (IA-Hb1c) to GA were classified as C1. A further classification of α and β was used with abnormalities of the α chain or β chain in the haemoglobin gene. Other haemoglobin variants were classified as non- C1. Eight diabetic patients with stable glycaemic control were used as controls. Results: Twenty forms of variant haemoglobins were classified as C1α(2 variants; I-Interlaken and Hb J-Meerut), C1β (15 variants) and non-C1 (3 variants; Hb Himeji, Hb Woolwich, Hb Peterborough). Positive correlations between GA and HPLCHb1c or IA-Hb1c were seen in the C1β patients with diabetes mellitus. The regression line between GA and HPLC-Hb1c, but not that betweenGAand IA-Hb1c, showed a downward shift in comparison with the data obtained fromthe diabetic controls. Conclusions: Variant haemoglobin could be classified by calculating the ratios of HPLC-Hb1c, IA-Hb1c and GA.


Koga M.,Kinki Central Hospital | Murai J.,Kinki Central Hospital | Saito H.,Kinki Central Hospital | Kasayama S.,Nissay Hospital
Diabetes Care | Year: 2010

OBJECTIVE- Glycated albumin (GA) relative to A1C is a useful marker of short-term glycemic control. We investigated whether endogenous insulin secretion in type 2 diabetes has different effects on GA and A1C levels. RESEARCH DESIGN AND METHODS- A1C, GA, and GA-to-A1C ratio were compared in 202 type 2 diabetic patients by type of treatment. Effect of β-cell function determined by homeostasis model assessment (HOMA-%β) on GA-to-A1C ratio was examined. In addition, GA-to-A1C ratio was compared between type 2 diabetic patients and 16 patients with type 1 diabetes. RESULTS- In type 2 diabetic patients, GA-to-A1C ratio was significantly higher in those treated with insulin than in those treated with diet or oral hypoglycemic agents. HOMA-%β showed a significant inverse correlation with GA-to-A1C ratio. This ratio was higher in type 1 diabetic patients than in type 2 diabetic patients. CONCLUSIONS- In diabetic patients with decreased insulin secretion, serum GA levels are higher relative to A1C. © 2010 by the American Diabetes Association.


Hosono K.,Nissay Hospital
Otolaryngology - Head and Neck Surgery (Japan) | Year: 2013

In recent years, the spread of electronic health record system enabled to keep digital imaging in the medical records. At the present, however, this system is much less common in municipal hospitals, including our hospital, than university hospitals and major hospitals, because it costs expensive. Therefore, we have contrived ways to make effective use of digital imaging (endoscopy unit, ultrasonography, digital photographs) at a moderate price, and report on our new system. The system is useful in clinical practice, and contributes to strengthen partnership with other doctors, nurses, healthcare professionals and improve team medical care.

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