Ōita-shi, Japan
Ōita-shi, Japan

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Ando Y.,Oita Prefectural Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016

A 40-year-old woman was noted to have clubbing of the nails during an outpatient service for smoking cessation. Chest computed tomography showed an aneurysm of an aberrant artery running from the descending aorta to the left lower lobe. Hence, we diagnosed anomalous systemic arterialization of the lung. The proximal part of the aberrant artery measured 13 mm in diameter;moreover, it had developed an aneurysm(17 mm in diameter) in the lung parenchyma. The aberrant artery was ligated with a covering material (absorbable felt) and cut via a small access thoracotomy by a cardiovascular surgeon;subsequently, left lower lobectomy was performed. Pathological examination revealed significant atherosclerosis in the aberrant artery, demonstrating its severe fragility. To apply appropriate safety procedures and approaches are recommended when treating an aberrant artery to the lung, especially in the presence of an aneurysm.


Shiozaki A.,University of Toyama | Matsuda Y.,Tokyo Women's Medical University | Satoh S.,Oita Prefectural Hospital | Saito S.,University of Toyama
Journal of Obstetrics and Gynaecology Research | Year: 2013

Aim: To demonstrate the difference between risk factors for gestational hypertension (GH) and preeclampsia (PE). Material and Methods: Using data from women with no essential hypertension and with singleton births between 2001 and 2005 delivering after 22 weeks of gestation at 125 centers in Japan (Japan Perinatal Registry Network) (n = 241 292), we compared risk factors for GH and PE. Odds ratios were calculated using multivariate logistic regression analyses. Results: Of 241 292 women, 2808 (1.2%) developed GH and 6423 (2.7%) developed PE. Thirty-five years or older, primiparity, diabetes mellitus, and renal disease increased the risk of both hypertensive conditions. Forty years or older was a risk factor only for GH, while primiparity, female baby, and renal disease were risk factors only for PE. Early-onsetwas a common risk factor for small-for-gestational-age (SGA) in GH and PE, but in late-onset only PE was a risk factor for SGA. The main population of SGA infants was composed of PE cases because PE accounted for 83.3% of early-onset type before 32 weeks. Girl preponderance in the PE women was observed (sex ratio: boys/girls = 0.904), while slight boy preponderance was seen in normotensive women (1.06) and GH (1.02). Conclusion: Preeclampsia is associated with lower fetal sex ratio (girl preponderance) compared to GH or normotensive. Presence of hypertension is a risk factor for SGA in early-onset GH and PE, and hypertension and proteinuria are risk factors for SGA in late-onset group. © 2012 Japan Society of Obstetrics and Gynecology.


Hayashi M.,Nippon Medical School | Nakai A.,Nippon Medical School | Satoh S.,Oita Prefectural Hospital | Matsuda Y.,Tokyo Women's Medical University
Fertility and Sterility | Year: 2012

Objective: To compare obstetric and perinatal outcomes of singleton pregnancies conceived with different types of assisted reproductive technology (ART) procedures with those of naturally conceived pregnancies. Design: Retrospective cohort study. Setting: The perinatal database of the Japanese Society of Obstetrics and Gynecology. Patient(s): A total of 242,715 women with singleton pregnancies were examined as a base cohort. Three study groups were created according to the type of ART procedure used, namely ovulation stimulation medications (n = 4,111), IUI (n = 2,351), and IVF-ET (n = 4,570). Controls adjusted for multiple maternal characteristics were selected randomly for each study group. Intervention(s): None. Main Outcome Measure(s): Obstetric and perinatal outcomes. Result(s): Patients who conceived through the ART procedures were associated with an increased incidence of placenta previa, preterm delivery, and low birth weight infant and a decreased incidence of spontaneous cephalic delivery, regardless of the type of ART procedure. Conclusion(s): Among singleton pregnancies, patients conceived with ART procedures were at increased risk for several adverse obstetric and perinatal outcomes, regardless of the type of ART procedure used. These results suggest that maternal factors associated with infertility may contribute to the adverse outcomes rather than the ART procedures themselves. © 2012 American Society for Reproductive Medicine, Published by Elsevier Inc.


Satoh S.,Oita Prefectural Hospital
Donald School Journal of Ultrasound in Obstetrics and Gynecology | Year: 2011

Doppler velocimetry has recently become an informative procedure for the real-time and noninvasive evaluation in fetal hemodynamics. The analysis of flow velocity waveforms in various kinds of vessels has been made for not only clarifying fetal physiology and pathophysiology of various disorders but also for determining the most appropriate intervention from the viewpoint of the integrated management protocol. The unique change in both the arterial and venous flow in normal and compromised fetuses has been demonstrated. Clinical applications of the Doppler technique in monitoring the fetus are reviewed.


We performed a detailed analysis of hysterectomy specimens of uterine cervical cancer to determine the appropriate length of uterine body to include within the clinical target volume. Between 2008 and 2011, 54 patients with uterine cervical carcinoma underwent hysterectomy. Those with quality pre-operative magnetic resonance imaging (MRI) data were included for analysis. Tumor sizes measured by MRI and microscopy were compared with regard to brachytherapy-oriented parameters. Detailed descriptive analysis focusing on the extent of tumor involvement was also performed. A total of 31 specimens were analyzed. The median maximal tumor length measured by MRI was slightly shorter than microscopic length (19 vs. 24 mm, respectively), while the maximal radius was almost identical. No tumors with a maximal size <2 cm by MRI (n = 6) extended to the uterine body ≥ 1/3. The majority of maximal tumor length underestimation on MRI was within 1 cm. Precise tumor delineation can be made by MRI. For patients with tumors <2 cm on MRI, treating the entire uterine body length may not be necessary. A 1-cm margin around an MRI-based gross tumor seems to be adequate to cover the actual tumor involvement.


Saburi M.,Oita Prefectural Hospital
[Rinshō ketsueki] The Japanese journal of clinical hematology | Year: 2014

A 28-year-old man complained of pain in the oral mucosa and pharynx in March 2011, and then developed fever and generalized swelling of the cheek. In March 2012, a gum biopsy led to a diagnosis of extranodal natural killer/T-cell lymphoma (ENKL). (18)F-FDG-PET revealed significant uptake in the mouth, tonsils, jawbone, shoulder blade, humerus, ilium, femur, and spleen. After two courses of the SMILE (dexamethasone, methotrexate (MTX), ifosfamide, L-asparaginase, etoposide) regimen, the response was stable disease. However, a high-dose MTX/cytarabine (MA) regimen was effective. After three courses of the MA regimen, a partial response was achieved. Then, allogeneic bone marrow transplantation from an unrelated donor was performed. At 10 months after transplantation, there was no sign of recurrence. Although the optimal treatment for ENKL refractory to the SMILE regimen has yet to be established, our case suggests the MA regimen to be a potentially effective treatment option.


Morikawa M.,Hokkaido University | Yamada T.,Hokkaido University | Sato S.,Oita Prefectural Hospital | Minakami H.,Hokkaido University
Twin Research and Human Genetics | Year: 2012

This study was conducted to review the overall short-term outcome of monoamniotic twins in Japan and to determine the prospective risk of fetal death so as to adequately counsel parents with monoamniotic twins. Study subjects were 101 women with monoamniotic twins who were registered with the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System and who had given birth at ≥22 weeks of gestation during 2002-2009. The gestational week at delivery (mean ± SD) was 31.8 ± 3.7. Fourteen women experienced intrauterine fetal death (IUFD). Short-term outcomes of co-twins born to the 14 women included 8 IUFDs, one early neonatal death within 7 days of life (END), and 5 survivors. Four other women experienced 5 ENDs. Thus, 13.9% (28/202) of infants died perinatally (22 IUFDs and 6 ENDs), 13.9% (14/101) of women experienced IUFD, and 82.2% (83/101) of women experienced neither IUFD nor END. Structural anomalies and twin-to-twin transfusion syndrome explained 17.9% (five infants) and 10.7% (three infants) of the 28 perinatal deaths, respectively. The prospective risk of IUFD was 13.9% (14/101) for women who reached gestational week 22-0/7, gradually decreasing thereafter but remaining at between 4.5% and 8.0% between gestational week 30 -0/7 and 36-0/7. Copyright © The Authors 2012.


Morikawa M.,Hokkaido University | Cho K.,Hokkaido University | Yamada T.,Hokkaido University | Sato S.,Oita Prefectural Hospital | Minakami H.,Hokkaido University
International Journal of Gynecology and Obstetrics | Year: 2012

Objective: To determine risk factors for eclampsia among Japanese women with singleton pregnancies. Methods: A retrospective observational study was carried out among patients with and those without eclampsia who were registered on the Japan Society of Obstetrics and Gynecology registry system and who gave birth to singleton infants at 22 weeks or more between 2005 and 2009. Multivariate logistic regression analyses were performed to determine independent risk factors for eclampsia. Results: One-third (75/225) of eclampsia patients developed the condition in the absence of hypertension. Maternal age, nulliparity, and pregnancy-induced hypertension (PIH) were all independent risk factors for eclampsia. The risk of eclampsia decreased by 3.0% per 1-year increase in maternal age, and increased 2.6-fold and 35.4-fold in nulliparous women and women with PIH, respectively. Among teenaged girls with hypertension, the prevalence of eclampsia was 1 case per 28 teenagers. Conclusion: Hypertension alone was not a reliable predictor of eclampsia. More intensified monitoring of nulliparous women and teenaged girls with hypertension is needed in order to prevent eclampsia. © 2011 International Federation of Gynecology and Obstetrics.


Morikawa M.,Hokkaido University | Yamada T.,Hokkaido University | Sato S.,Oita Prefectural Hospital | Cho K.,Hokkaido University | Minakami H.,Hokkaido University
International Journal of Gynecology and Obstetrics | Year: 2012

Objective: To assess the prevalence of hyperglycemia according to maternal age and pre-pregnancy body mass index (BMI) among Japanese women before introduction of the current diagnostic criteria. Methods: In a retrospective study, data were analyzed from women with singleton pregnancies who were registered with the JSOG Successive Pregnancy Birth Registry System and who gave birth at 22 weeks of gestation or more between January 2007 and December 2009. Results: Among 138 530 women, 3667 (2.6%) were diagnosed with hyperglycemia including gestational diabetes and diabetes mellitus. The prevalence of hyperglycemia increased with advancing maternal age and increasing BMI. Among women aged ≤ 24, 25-34, 35-39, and ≥ 40 years, the prevalence was 0.4%, 0.8%, 1.5%, and 4.0%, respectively, in lean women (BMI < 18.5); 1.0%, 1.6%, 2.3%, and 3.1%, respectively, in normal weight women (BMI 18.5-24.9); and 5.7%, 9.2%, 12.9%, and 15.2%, respectively, in obese women (BMI ≥ 25.0). Of the 1181 newborns with a birth weight of 4000 g or more, 1046 (88.6%) were born to women not diagnosed with hyperglycemia. Conclusion: The results may reflect the baseline prevalence of hyperglycemia and macrosomic neonates (birth weight ≥ 4000 g) during the era of the old diagnostic criteria in Japan. © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.


Komiya K.,Oita University | Komiya K.,Tenshindo Hetsugi Hospital | Ishii H.,Oita University | Umeki K.,Oita University | And 4 more authors.
Respirology | Year: 2013

Background and objective Aspiration pneumonia is one of the common presentations of community-Acquired pneumonia (CAP) and healthcare-Associated pneumonia (HCAP). However, its significance has not yet been fully evaluated due to the difficulties associated with the diagnosis of this condition. This study aimed to evaluate the impact of objectively defined aspiration pneumonia on patients' prognosis with CAP and HCAP. Methods This is a multicenter retrospective cohort study consisting of 417 CAP and 220 HCAP patients. We defined aspiration pneumonia as having both risk factors for aspiration (dysphagia due to a neurological disorder, or disturbance of consciousness) and evidence of gravity-dependent opacity on chest computed tomography (CT). The prognostic factors for 30-day mortality were analysed. Results One hundred sixteen (18%) patients met the definition of aspiration pneumonia, 72 (11%) patients had risks for aspiration alone, 129 (20%) patients had CT findings consistent with aspiration alone, and 320 (50%) patients had neither. Patients diagnosed with aspiration pneumonia had a significantly worse survival than those with risk factors alone (P = 0.001), CT findings of aspiration alone (P = 0.009) and neither (P < 0.001). A multivariate analysis indicated that aspiration pneumonia was independently associated with increased 30-day mortality (adjusted hazard ratio 5.690, P < 0.001) after adjusting for other variables, including the category of pneumonia, performance status, the severity score (CURB-65) and treatment failure due to resistant pathogens. Conclusion Aspiration pneumonia may be a significant predictor of mortality among CAP and HCAP patients. Therefore, the concept of aspiration pneumonia should be considered in the guidelines for these types of pneumonia. Aspiration pneumonia, which is defined as having risk factors for aspiration and evidence of gravity-dependent opacities on CT, was strongly associated with mortality after adjusting for the category of pneumonia, performance status and treatment failure due to resistant pathogens. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

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