Okanami General Hospital

Iga, Japan

Okanami General Hospital

Iga, Japan
SEARCH FILTERS
Time filter
Source Type

PubMed | Nara Medical University, Okanami General Hospital and Ritsumeikan University
Type: Journal Article | Journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons | Year: 2016

An ossicle around the medial malleolus is difficult to differentiate from an unfused ossification center, an avulsion fracture, and os subtibiale. Misdiagnosis can lead to inappropriate or unnecessary treatments. We describe a patient with a symptomatic ossicle of the medial malleolus in the left ankle that prevented participation in sports activities because of medial ankle pain. Plain radiography and computed tomography revealed a small ossicle associated with the anterior colliculus of the medial malleolus. Conservative treatment failed, and the patient underwent ankle arthroscopy. Instability of the ossicle was identified after the hypertrophic inflammatory synovium had been debrided. The ossicle was resected in a step-by-step manner with an arthroscopic shaver and grasper through the anteromedial accessary portal. The deltoid ligament sustained minimal damage after resection. The patient fully recovered and was able to return to sports activities 3months after surgery. Arthroscopic resection of the ossicle at the medial malleolus requires no additional treatments of the deltoid ligament, effectively relieves symptoms, and enables the patient to return to full preinjury activities.


Tarumi T.,Mie University | Takebayashi S.,Mie University | Fujita M.,Kyoto University | Nakano T.,Mie University | And 2 more authors.
Europace | Year: 2010

AimsMyocardial ischaemia and angina have been demonstrated in patients with hypertrophic cardiomyopathy (HCM). We hypothesized that left ventricular (LV) systolic or diastolic dysfunction would be provocated by pacing tachycardia in patients with HCM.Methods and resultsWe investigated LV global and regional systolic and diastolic function in 17 patients with HCM without LV outflow obstruction and 7 normal subjects by analysing LV angiograms and simultaneously obtained high-fidelity LV pressures before and after rapid cardiac pacing (150 b.p.m.). Biplane LV silhouettes were digitized frame by frame (50 frames/s). To quantify regional dynamics, the ventricular area of the right anterior oblique projection was divided into six sections originating from the midpoint of the long axis at end-diastole. There were no significant changes in LV function after pacing in normal subjects. In HCM, the ejection fractions remained unchanged. However, LV end-diastolic pressures rose (+12 mmHg, P < 0.01), and the time constants of isovolumic pressure decay were significantly increased (T1/2: +5.2 ms, P < 0.01; T1/e: +6.8 ms, P < 0.01). The LV global diastolic pressure-volume relationships and regional diastolic pressure-area relationships of regional myocardium shifted upward (indicating decreased diastolic distensibility) in all patients. These diastolic abnormalities were not accompanied by regional asynchrony or asynergy.ConclusionMost patients with HCM have a reduced reactive capacity to chronotropic stress, which is haemodynamically characterized by evenly distributed diastolic dysfunction. In contrast with coronary artery disease, these diastolic abnormalities were not accompanied by systolic dysfunction, regional asynchrony, asynergy, or inhomogenous diastolic distensibility. © The Author 2010.


PubMed | Okanami General Hospital and Nara Medical University
Type: | Journal: BMC musculoskeletal disorders | Year: 2016

Lag screw position is very important in the treatment of intertrochanteric femoral fracture to prevent complications such as screw cut-out. Current studies recommend central or inferior placement of the lag screw on the anteroposterior radiograph, and central placement on the lateral radiographs. These reports are based on radiographic evaluation, but few studies have investigated the importance of bone quality at the site of lag screw placement. In this study, we used multidetector row computed tomography (MDCT) to perform in vivo evaluation of the bone microstructure of the femoral head in patients with intertrochanteric femoral fractures.This study was approved by the Ethics Committee of Okanami General Hospital. MDCT images were obtained in our hospital from ten patients who had sustained intertrochanteric femoral fracture. Patients who needed computed tomography to confirm fracture morphology were included. We defined six areas as regions of interest (ROI): ROI 1-3 were defined as the femoral head apex area, and ROI 4-6 were defined as the femoral neck area. Trabecular microstructure parameters, including mean bone volume to total volume (BV/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), and structure model index (SMI), were evaluated with bone analysis software (TRI/3D-BON). Statistical analyses were performed using EZR software; each parameter among the ROIs was statistically evaluated by analysis of variance (ANOVA) and Tukeys test. Statistical significance was established at p<0.05.In the apical area, all parameters indicated that ROI 1 (superior) had the highest bone quality and ROI 2 (central) was higher in bone quality than ROI 3 (inferior). In the femoral neck, all parameters indicated that bone quality was significantly greater in ROI 6 (inferior) than ROI 5 (central).We could evaluate bone quality with clinical MDCT in vivo. Bone quality in the central area of the femoral head apical was greater than in the inferior area, and bone quality in the inferior area of the femoral neck was greater than in the central area. Recognizing which area of femoral head has greater bone quality may lead to a better clinical result in treating intertrochanteric femoral fracture.


Miyahara M.,Okanami General Hospital
BMJ case reports | Year: 2013

This report presents a case of atypical Kawasaki disease (KD) in a 4-year-old boy developing with severe colitis accompanied by frequent diarrhoea and hypokalemic dehydration. Abdominal ultrasonography showed findings of left colon mucosal thickening and prominent dilatation of the colon. Antibiotic treatment was not effective. Some symptoms of KD appeared with progression of the illness. Intravenous immunoglobulin (IVIG) was administered based on a diagnosis of incomplete KD on the ninth day of the illness. The patient became afebrile soon after IVIG therapy. Diarrhoea and other symptoms dramatically subsided. The patient has recovered during the 3-month follow-up and repeated echocardiograms were normal.


Matsuoka N.,Okanami General Hospital
[Rinshō ketsueki] The Japanese journal of clinical hematology | Year: 2013

A 77-year-old man was admitted because of fever. A small number of large CD20-positive neoplastic cells were seen in the bone marrow specimen. Clinical symptoms improved with oral prednisolone. After 11 months, abdominal CT scan revealed a liver mass. The biopsy specimen from the liver mass showed diffuse infiltration of large CD20-positive neoplastic cells. The patient was diagnosed as having diffuse large B-cell lymphoma. It was of particular interest that only neoplastic B cells within small blood vessels in the liver mass were positive for CD5. The patient died of lymphoma three months after diagnosis.


Miyahara M.,Okanami General Hospital | Hirayama M.,Mie University
BMJ Case Reports | Year: 2013

This report presents a case of atypical Kawasaki disease (KD) in a 4-year-old boy developing with severe colitis accompanied by frequent diarrhoea and hypokalemic dehydration. Abdominal ultrasonography showed findings of left colon mucosal thickening and prominent dilatation of the colon. Antibiotic treatment was not effective. Some symptoms of KD appeared with progression of the illness. Intravenous immunoglobulin (IVIG) was administered based on a diagnosis of incomplete KD on the ninth day of the illness. The patient became afebrile soon after IVIG therapy. Diarrhoea and other symptoms dramatically subsided. The patient has recovered during the 3-month follow-up and repeated echocardiograms were normal. Copyright © 2013 BMJ Publishing Group.


Iemura J.,Okanami General Hospital | Yamamoto Y.,Okanami General Hospital | Kambara A.,Okanami General Hospital
Respiration and Circulation | Year: 2014

There are several reports regarding efficacy of vacuum-assisted closure therapy for pyothorax. We report a case that high pressure vacuum from drainage tubes might be effective for pyopneumothorax. The patient was a 63-year-old man with a history of right lower lobectomy for lung cancer and chronic interstitial pneumonia maintained with 20 mg/day of prednisolone. He also had liver cancer resulting from hepatitis B virus-related liver cirrhosis. The patient was admitted to our hospital for left upper lobe pneumonia with a new bulla in the infected lesion. He subsequently developed a tension pneumothorax when the infected bulla ruptured. Despite intensive care, the infection and air leak did not resolve. Fluid culture yielded pure growth of multidrug-resistant Pseudomonas aeruginosa. Debridement and decortication of the empyema cavity, along with drainage of the abscess and air leak, were performed on the 69th day after the rupture. We administered continuous suction force of-50mm Hg beginning on the day of the surgical procedure. On the 52nd day following the procedure, the air leak spontaneously resolved. Bacterial colonization of the pleural fluid was not detected. The patient was discharged without an open window thoracostomy. He lived about one year without recurrence of pneumothorax or pyothoraxtill his death for cancer.


Iemura J.,Okanami General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 81-year-old female developed diaphragm twitching 2 days after the intravenous implantation of pacemaker (DDD mode) with passive fixation leads. A computed tomography (CT) and fluoroscopy revealed the lead perforating the interventricular septum and the ventricular wall without any sign of pericardial effusion. Surgical procedure through median sternotomy was performed, and the penetrated lead was removed. The injured myocardium was repaired with a U stitch reinforced by Teflon-feltstrips. New epicardial leads were fixed on the right atrial wall and on the inferior wall of the right ventricle. The patient had been doing well until 86-year-old, when she died of myelodysplastic syndrome.


Osawa S.,Okanami General Hospital | Oshima Y.,Vitreoretina and Cataract Surgery Center
Developments in Ophthalmology | Year: 2014

Ten years or more have passed since the current concept of 25-gauge transconjunctival sutureless vitrectomy with a trocar-cannula system emerged. There is no doubt that current microincision vitrectomy surgery with 25- or 23-gauge instrumentation has simplified the vitrectomy procedure and has provided numerous potential advantages over traditional 20-gauge surgery. The established theory regarding surgical wounds is that 'much smaller is better'. Along with the development of new-generation vitrectomy machines with ergonomic instruments, surgeons have been shifting dramatically from 20-gauge systems to 23- and 25-gauge systems over the last years. Thanks to recent innovations and improvements in high-end multifunctional vitrectomy machines and ultrahigh-speed cutters, the development of powerful light sources, and wide-angle viewing systems, several new techniques have also encouraged us to launch the development of a 27-gauge vitrectomy system over the past several years. Similar to the recent evolution in 23- and 25-gauge systems, further development and refinement of the functionality of instruments with a gauge of 27 or more are under way and will continue over the coming years, which in the future will allow us to establish this system for ultra-minimally invasive surgery for the full spectrum of vitreoretinal pathologies. © 2014 S. Karger AG, Basel.


PubMed | Okanami General Hospital
Type: | Journal: Developments in ophthalmology | Year: 2014

Ten years or more have passed since the current concept of 25-gauge transconjunctival sutureless vitrectomy with a trocar-cannula system emerged. There is no doubt that current microincision vitrectomy surgery with 25- or 23-gauge instrumentation has simplified the vitrectomy procedure and has provided numerous potential advantages over traditional 20-gauge surgery. The established theory regarding surgical wounds is that much smaller is better. Along with the development of new-generation vitrectomy machines with ergonomic instruments, surgeons have been shifting dramatically from 20-gauge systems to 23- and 25-gauge systems over the last years. Thanks to recent innovations and improvements in high-end multifunctional vitrectomy machines and ultrahigh-speed cutters, the development of powerful light sources, and wide-angle viewing systems, several new techniques have also encouraged us to launch the development of a 27-gauge vitrectomy system over the past several years. Similar to the recent evolution in 23- and 25-gauge systems, further development and refinement of the functionality of instruments with a gauge of 27 or more are under way and will continue over the coming years, which in the future will allow us to establish this system for ultra-minimally invasive surgery for the full spectrum of vitreoretinal pathologies.

Loading Okanami General Hospital collaborators
Loading Okanami General Hospital collaborators