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Hosoya Y.,University of Tokyo | Watanabe M.,University of Tokyo | Terashima M.,Cardiovascular Imaging Clinic Iidabashi | Amiya E.,University of Tokyo | And 9 more authors.
International Heart Journal | Year: 2013

Amniotic fluid embolism (AFE) is a rare but devastating complication of pregnancy. Acute circulatory failure and obstetric disseminated intravascular coagulopathy are often associated with AFE and lead to poor prognosis of this syndrome. Although many reports of AFE and its cardiopulmonary complications exist, their etiology remains unknown. Classically, it was believed that the fatal cardiopulmonary complication in AFE is due to acute and severe pulmonary hypertension caused by critical obstruction of the pulmonary vessels by embolized amniotic fluid. However, recent hypotheses are suggesting that anaphylactic reaction or a cytokine effect induced by amniotic fluid is the main pathophysiological mechanism. We report a case in which cardiac magnetic resonance imaging was performed at the chronic stage of AFE. Late gadolinium enhancement (LGE) was detected at the mid-wall of the left ventricle with no evidence of pulmonary hypertension. This finding suggests that the pathophysiological mechanism of severe cardiac complications in AFE may include direct left ventricular myocardial injury through an immune reaction or cytokine release, rather than pulmonary embolism. Source


Jimbo R.,Odaira Memorial Tokyo Hitachi Hospital | Shimosawa T.,University of Tokyo
International Journal of Hypertension | Year: 2014

Patients with chronic kidney disease (CKD) are at increased risk of mortality, mainly from cardiovascular disease. Moreover, abnormal mineral and bone metabolism, the so-called CKD-mineral and bone disorder (MBD), occurs from early stages of CKD. This CKD-MBD presents a strong cardiovascular risk for CKD patients. Discovery of fibroblast growth factor 23 (FGF23) has altered our understanding of CKD-MBD and has revealed more complex cross-talk and endocrine feedback loops between the kidney, parathyroid gland, intestines, and bone. During the past decade, reports of clinical studies have described the association between FGF23 and cardiovascular risks, left ventricular hypertrophy, and vascular calcification. Recent translational reports have described the existence of FGF23-Klotho axis in the vasculature and the causative effect of FGF23 on cardiovascular disease. These findings suggest FGF23 as a promising target for novel therapeutic approaches to improve clinical outcomes of CKD patients. © 2014 Rika Jimbo and Tatsuo Shimosawa. Source


Nozawa H.,Odaira Memorial Tokyo Hitachi Hospital | Yamada Y.,Odaira Memorial Tokyo Hitachi Hospital | Muto Y.,Odaira Memorial Tokyo Hitachi Hospital | Endo J.,Odaira Memorial Tokyo Hitachi Hospital | And 4 more authors.
European Journal of Gastroenterology and Hepatology | Year: 2010

We report a male patient with double advanced tumors in the jejunum and descending colon and multiple lung tumors. The intestinal cancers were surgically resected. Immunoprofiling of the specimens revealed a rare phenotype: the jejunal cancer was positive for cytokeratin (CK) 7, partially positive for CK20, and Cdx-2-negative, whereas the colon cancer was CK7(+), CK20(-), and Cdx-2(-). Biopsied lung tumor was diagnosed as tubular adenocarcinoma, and CK7(+)/CK20(+)/Cdx-2(-). Together with clinical information, we deduced that the jejunal adenocarcinoma had presumably metastasized to the lung. Moreover, postoperative oxaliplatin, including chemotherapy, significantly reduced the lung metastases, suggesting that this regimen is a promising treatment option for advanced small bowel adenocarcinoma. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Chen J.-T.,J.T. Chen Clinic | Tominaga K.,Loma Linda Clinic | Sato Y.,Sophia Ladies Clinic | Anzai H.,Anzai and Associates | Matsuoka R.,Odaira Memorial Tokyo Hitachi Hospital
Journal of Alternative and Complementary Medicine | Year: 2010

Background: Insulin resistance is a prominent feature of polycystic ovary syndrome (PCOS), and insulin-sensitizing drugs are used to induce ovulation. Recently, it was reported that an extract from Maitake mushroom (Grifola frondosa) improves insulin resistance. Objectives: The objective was to explore the effects of Maitake extract (SX-fraction: MSX) to induce ovulation in patients with PCOS in comparison with and in combination with clomiphene citrate (CC). Design: We conducted an open trial with 80 patients with PCOS at three clinics in Japan. Seventy-two (72) new patients were randomly assigned to receive MSX or CC monotherapy for up to 12 weeks. Eighteen (18) patients who did not respond to MSX or CC were subjected to combination therapy of MSX and CC for up to 16 weeks. Eight (8) patients with documented history of failure to CC received combination therapy from the beginning. Ovulation was assessed by ultrasonography. Results: Twenty-six (26) patients in the MSX group and 31 in the CC group were evaluated for ovulation. The ovulation rates for MSX and CC were as follows: 76.9% (20/26) and 93.5% (29/31), respectively by the patients (NS), and 41.7% (30/72) and 69.9% (58/83), respectively, by the cycles (p=0.0006). In the combination therapy, 7 of 7 patients who failed in MSX monotherapy and 6 of 8 patients who failed in CC monotherapy showed ovulation. Conclusions: The present study suggests that MSX alone may induce ovulation in PCOS patients and may be useful as an adjunct therapy for patients who failed first-line CC treatment. © Copyright 2010, Mary Ann Liebert, Inc. Source


Shimoishi K.,Odaira Memorial Tokyo Hitachi Hospital | Muto Y.,Odaira Memorial Tokyo Hitachi Hospital | Asakage M.,Odaira Memorial Tokyo Hitachi Hospital | Yamada Y.,Odaira Memorial Tokyo Hitachi Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2012

The patient was a 72-year-old woman, admitted to our hospital due to appetite loss. We performed gastroscopy, colonoscopy and abdominal CT. She had both advanced ascending colon cancer with multiple liver metastasis (cStage IV: cT3N1H3) and early gastric cancer (cStage 0: cTisN0M0). She received chemotherapy with modified FOLFOX6 (mFOLFOX6), and the chemotherapy was judged effective for her gastric cancer. During the next 6 months, a total of 10 courses had been performed. The tumor marker scores (CEA, CA19-9) decreased significantly. Gastric cancer was diagnosed as CR (complete response) in gastroscopy after 6 courses of chemotherapy. In this case, chemotherapy with mFOLFOX6 was effective for gastric cancer. Source

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