Okitama Public General Hospital
Okitama Public General Hospital
Niizeki T.,Okitama Public General Hospital |
Ikeno E.,Okitama Public General Hospital |
Kubota I.,Yamagata University
American Journal of Case Reports | Year: 2017
Objective: Unusual setting of medical care Background: Success rates for treatment of chronic total occlusion (CTO) have dramatically improved in recent years with the development of new CTO guidewires and development of new techniques such as the retrograde approach. In the antegrade approach, a guidewire is occasionally passed through a side branch despite successful wire crossing of the CTO lesion. In order to pass a wire through the main artery, there are a few side branch techniques such as a reverse wire technique. Case Report: A 54-year-old man with symptoms of heart failure was admitted to our hospital. Coronary angiography showed CTO of the proximal left anterior descending artery. Percutaneous coronary intervention with an antegrade approach was started. We succeeded in passing the wire through a side branch but not the main artery. Unfortunately, a reverse wire technique failed in this case. Next, the wire passed through a side branch was exchanged with the Soutenir CV, and a retrograde approach was started. The wire crossing from retrograde was entwined around the Soutenir CV. After that, the retrograde wire was snared and guided to the antegrade guiding catheter, which resulted in successful wiring into the main artery easily. Conclusions: The side branch technique using the Soutenir CV may be an effective strategy in some cases. © Am J Case Rep, 2017.
Kobayashi S.,Yamagata University |
Hayashi M.,Yamagata University |
Hayashi M.,Okitama Public General Hospital |
Shinozaki K.,Yamagata City Hospital Saiseikan |
And 5 more authors.
Neuroscience Research | Year: 2016
Spinal reflex arcs mediated by low threshold afferents between the brachioradialis (BR) and flexor carpi radialis (FCR) were studied in eleven healthy human subjects using a post-stimulus time-histogram method. Electrical conditioning stimuli (ES) to the radial nerve branch innervating BR with the intensity below the motor threshold (MT) induced an early and significant trough (inhibition) in 32/85 FCR motor units (MUs) in 9/9 subjects. Such inhibition was never provoked by cutaneous stimulation. The central synaptic delay (CSD) of the inhibition was approximately 1.1 ms longer than that of the homonymous FCR facilitation. ES to the median nerve branch innervating FCR with the intensity below MT induced an inhibition in 27/71 BR-MUs in 10/10 subjects. CSD of the inhibition was about 1.1 ms longer than that of the homonymous BR facilitation. These findings suggest that inhibition between BR and FCR exists in humans. Group I afferents seem to mediate the inhibition through an oligo(di or tri)-synaptic path. © 2016 Elsevier Ireland Ltd and Japan Neuroscience Society
Homma K.,Okitama Public General Hospital |
Investigative Ophthalmology and Visual Science | Year: 2015
PURPOSE. To investigate the relationship between age and ocular higher-order wavefront aberrations (HOAs) in an adult Japanese population, in addition to factors associated with HOA variations.METHODS. In the Yamagata Study (Funagata) cohort, 227 adult Japanese participants (aged 37– 86 years) underwent systemic and ophthalmologic examinations in 2012. Ocular, corneal, and internal HOAs were measured in micrometers. From the Zernike coefficients, we calculated the root mean square of the total HOA, coma, and spherical aberration for a pupil diameter of 4 mm. Linear regression analyses were used to determine whether HOAs were associated with age or other factors.RESULTS. Multiple adjusted linear regression analyses demonstrated that all components of logarithmic HOAs increase with age. Ocular, corneal, and internal HOAs increased by 0.012/y (P < 0.001), 0.007/y (P ¼ 0.010), and 0.014/y (P < 0.001), respectively. Ocular coma also significantly increased with age (0.010/y, P = 0.007), but corneal (P = 0.963) and internal (P = 0.476) coma did not. Age-related spherical aberration increased only in the internal component (0.019/y, P = 0.001). In addition to age, ocular and corneal HOAs were mainly affected by corneal indexes.CONCLUSIONS. Aging is associated with increases in ocular HOAs, independent of other possible confounding factors. The association of ocular HOAs with corneal parameters indicates that ocular HOAs are mainly generated by the cornea. Internal HOAs, supposedly generated from cataract progression, may be associated with systemic factors, including serum creatinine levels and blood pressure. © 2015 The Association for Research in Vision and Ophthalmology, Inc.
PubMed | Red Cross, Okitama Public General Hospital, Kushiro Rosai Hospital, Fukushima Medical University and 11 more.
Type: Clinical Trial | Journal: European journal of clinical pharmacology | Year: 2016
Dasatinib is a novel, oral, multi-targeted kinase inhibitor of breakpoint cluster region-abelson (BCR-ABL) and Src family kinases. The study investigated pharmacokinetic (PK) and pharmacodynamic (PD) analyses of dasatinib in 51 newly diagnosed, chronic phase, chronic myeloid leukemia patients.The dasatinib concentration required to inhibit 50 % of the CrkL (CT10 regulator of kinase like) phosphorylation in bone marrow CD34+ cells (half maximal (50 %) inhibitory concentration (IC50)CD34+cells) was calculated from each patients dose-response curve using flow cytometry. PK parameters were obtained from the population pharmacokinetic analysis of dasatinib concentrations in plasma on day 28 after administration.Early molecular responses were not significantly associated with PK or PD (IC50 CD34+cells) parameters. However, the PK/PD parameter-time above IC50 CD34+cells-significantly correlated with BCR-ABL transcript level at 3 months (correlation coefficient (CC) = -0.292, P = 0.0375) and the reduction of BCR-ABL level at 1 or 3 months (CC = -0.404, P = 0.00328 and CC = -0.356, P = 0.0104, respectively). Patients with more than 12.6 h at time above IC50 CD34+cells achieved a molecular response of 3.0 log reduction at 3 months and those more than 12.8 h achieved a deep molecular response less than 4.0 log reduction at 6 months at a significantly high rate (P = 0.013, odds ratio = 4.8 and P = 0.024, odds ratio = 4.3, respectively).These results suggest that the anti-leukemic activity of dasatinib exhibits in a time-dependent manner and that exposure for more than 12.8 h at time above IC50 CD34+cells could significantly improve prognosis.
PubMed | Okitama Public General Hospital, Yamagata University and Yamagata Saisei Hospital
Type: Journal Article | Journal: Journal of clinical and experimental dentistry | Year: 2016
Acinic cell carcinoma (ACC) is a malignant tumor of the salivary glands. The majority of ACCs occur in the parotid gland, and ACCs of the minor salivary glands (MSGs) are relatively infrequent. We describe here a patient with ACC of the upper lip. The patient was a 31-year-old male who presented with a nodular mass on the left upper lip. The preoperative diagnosis was benign tumor or cyst, and the lesion was surgically excised. The histological diagnosis was ACC. The postoperative course was uneventful. No recurrence or metastasis was detected at 13 months postoperatively. In addition, we retrospectively reviewed 21 reported Japanese patients with ACC of the MSGs. In 7 of the 21 patients, the preoperative diagnosis was benign tumor, and the tumors were resected without preoperative biopsy. Kaplan-Meier analysis showed that disease-free survival was worse in patients who underwent resection with a preoperative diagnosis of benign tumor than in patients who underwent resection with a preoperative diagnosis of malignant tumor. The rate of recurrence was higher for ACCs assumed to be benign lesions on a purely clinical basis, or without an accurate preoperative biopsy. ACCs of the MSGs are easy to be misdiagnosed for benign lesions such as mucous cysts or hemangiomas. Correct preoperative diagnosis and initial therapy may therefore be the most important prognostic factors.
PubMed | Okitama Public General Hospital and Yamagata University
Type: | Journal: The American journal of case reports | Year: 2017
BACKGROUND Success rates for treatment of chronic total occlusion (CTO) have dramatically improved in recent years with the development of new CTO guidewires and development of new techniques such as the retrograde approach. In the antegrade approach, a guidewire is occasionally passed through a side branch despite successful wire crossing of the CTO lesion. In order to pass a wire through the main artery, there are a few side branch techniques such as a reverse wire technique. CASE REPORT A 54-year-old man with symptoms of heart failure was admitted to our hospital. Coronary angiography showed CTO of the proximal left anterior descending artery. Percutaneous coronary intervention with an antegrade approach was started. We succeeded in passing the wire through a side branch but not the main artery. Unfortunately, a reverse wire technique failed in this case. Next, the wire passed through a side branch was exchanged with the Soutenir CV, and a retrograde approach was started. The wire crossing from retrograde was entwined around the Soutenir CV. After that, the retrograde wire was snared and guided to the antegrade guiding catheter, which resulted in successful wiring into the main artery easily. CONCLUSIONS The side branch technique using the Soutenir CV may be an effective strategy in some cases.
PubMed | Okitama Public General Hospital and Yamagata University
Type: Journal Article | Journal: Odontology | Year: 2016
Angioleiomyoma (AL) is a benign tumor derived from smooth muscle. The overwhelming majority of ALs occur in the uterus, gastrointestinal tract, or skin; AL of the oral cavity is infrequent, and AL of the tongue is particularly rare. The present report describes a case of AL of the tongue that resulted in a good outcome. We also review the literature with a special emphasis on the etiology of ALs. It is generally agreed that minor trauma, venous stasis, and hormonal changes are etiological factors for AL. The roles of estrogen and progesterone have been particularly emphasized, and the expression of progesterone receptors (PRs) and estrogen receptors (ERs) has been recently evaluated in some cases of AL. To our knowledge, the presence of PRs and ERs has only been evaluated in seven cases of AL arising in different regions of the body including the oral cavity. This is the first report to demonstrate negative expression of both receptors in an AL of the oral cavity. Further study and additional cases are needed to elucidate the influence of PRs and ERs in AL of the oral cavity.
Miura Y.,Health Sciences University of Hokkaido |
Kanazawa K.,Health Sciences University of Hokkaido |
Nasu I.,Okitama Public General Hospital
Journal of Neurosurgical Anesthesiology | Year: 2015
We previously showed that preischemic administration of high-dose isoflurane worsened the outcome from severe forebrain ischemia in rats. Conversely, high doses of sevoflurane have been reported to improve the outcome from forebrain ischemia when the insult is moderate. To clarify the dose-dependent effects of sevoflurane on severe forebrain ischemia, we performed an outcome study using an identical protocol to that in our previous study with isoflurane. Fasting male Sprague-Dawley rats underwent surgical preparation for forebrain ischemia under halothane anesthesia. Anesthesia was changed to fentanyl/nitrous oxide to eliminate the halothane, after which 30 minutes of 0.5, 1.0, 1.5, 2.0, or 2.5 minimum alveolar concentration sevoflurane was administered. Ten minutes of ischemia was induced by bilateral carotid occlusion plus systemic hypotension, in which cessation of electroencephalographic activity was confirmed. Sevoflurane was discontinued and anesthesia continued with fentanyl/nitrous oxide for an additional 100 minutes. Outcome evaluation at 5 days postischemia included seizure incidence, mortality rate, neuromotor score, and histologic injuries to the cerebral cortex and hippocampal CA1 and CA3. Different doses of sevoflurane did not statistically affect seizure incidence (10.0% to 18.2%), mortality rate (20.0% to 46.7%), cortical damage (mild to moderate degree), or hippocampal CA1 damage (93.7% to 96.7% neuronal necrosis) or CA3 damage (36.3% to 41.7%). Dose-dependent effects of sevoflurane were not observed for any of the outcome variables assessed in this rat model of severe forebrain ischemia. © 2014 Wolters Kluwer Health, Inc.
Yamada M.,Okitama Public General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011
We report a rare case of metastatic brain and lymph node carcinoma of unknown primary origin. A 68-year-old man had been followed up after resection of brain metastasis in right parietooccipital region without suspicious primary site. Seventy-eight months after the resection, a mediastinal lymph node (#2R) of 15 mm in diameter was detected by computed tomography (CT) and was surgically removed. The histological diagnosis was poorly differentiated adenocarcinoma resembling lymphoepithelial carcinoma, which was similar to the histology of the previously resected brain tumor. This patient is alive without recurrence and apparent primary site at 24 months after lymph node resection.
PubMed | Okitama Public General Hospital
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016
An 82-year-old man, who had undergone coronary artery bypass grafting(CABG) with the right gastroepiploic artery( RGEA) 13 years previously, suffered with abdominal pain after meal and tarry stools, and was diagnosed with advanced gastric cancer. Gastroscopy revealed an advanced Borrmann type 4 cancer at the lesser curvature of the gastric body to the pyloric ring. The gastrogram showed poor extension and stenosis at the same part. Abdominal computed tomography showed the tumor reached the subserosal layer and infrapyloric lymph nodes were swollen. Abdominal angiography showed the RGEA graft remained well patent. Total gastrectomy with D2 lymph nodes dissection and arterial reconstruction between the splenic artery and the RGEA graft was performed. He has been well without any sign of cancer recurrence since the operation. Recently, more patients with CABG using RGEA are found to have gastric cancer and require the resection of RGEA for lymph nodes dissection as this case. We consider this procedure one of the options for advanced gastric cancer after coronary bypass grafting using RGEA.