Omuta City General Hospital

Ōmuta, Japan

Omuta City General Hospital

Ōmuta, Japan
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Kikuchi K.,Yame Public General Hospital | Uchikado H.,Kurume University | Miura N.,Kagoshima University | Morimoto Y.,Kagoshima University | And 11 more authors.
Experimental and Therapeutic Medicine | Year: 2011

Historically, clinical outcomes following spinal cord injury (SCI) have been dismal. Severe SCI leads to devastating neurological deficits, and there is no treatment available that restores the injury-induced loss of function to a degree that an independent life can be guaranteed. To address all the issues associated with SCI, a multidisciplinary approach is required, as it is unlikely that a single approach, such as surgical intervention, pharmacotherapy or cellular transplantation, will suffice. High mobility group box 1 (HMGB1) is an inflammatory cytokine. Various studies have shown that HMGB1 plays a critical role in SCI and that inhibition of HMGB1 release may be a novel therapeutic target for SCI and may support spinal cord repair. In addition, HMGB1 has been associated with graft rejection in the early phase. Therefore, HMGB1 may be a promising therapeutic target for SCI transplant.

Kikuchi K.,Yame Public General Hospital | Kikuchi K.,Kurume University | Takeshige N.,Kurume University | Miura N.,Kagoshima University | And 14 more authors.
Experimental and Therapeutic Medicine | Year: 2012

Free radicals play an important role in the pathogenesis of a variety of diseases; thus, they are an attractive target for therapeutic intervention in these diseases. Compounds capable of scavenging free radicals have been developed for this purpose and some, developed for the treatment of cerebral ischemic stroke, have progressed to clinical trials. One such scavenger, edaravone, is used to treat patients within 24 h of stroke. Edaravone, which can diffuse into many disease-affected organs, also shows protective effects in the heart, lung, intestine, liver, pancreas, kidney, bladder and testis. As well as scavenging free radicals, edaravone has anti-apoptotic, anti-necrotic and anti-cytokine effects in various diseases. Here, we critically review the literature on its clinical efficacy and examine whether edaravone should be considered a candidate for worldwide development, focusing on its effects on diseases other than cerebral infarction. Edaravone has been safely used as a free radical scavenger for more than 10 years; we propose that edaravone may offer a novel treatment option for several diseases.

Kaneyuki M.,Yokokura Hospital | Shihara M.,Yokokura Hospital | Toyama Y.,Omuta City General Hospital | Mitsutake Y.,Kurume University | And 4 more authors.
Circulation Journal | Year: 2013

Background: The Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy (MAPPY) study has shown that losartan/hydrochlorothiazide (HCTZ) combination is superior to high-dose losartan in not only reducing morning systolic blood pressure (SBP) but also ameliorating urinary albumin excretion (UAE) after 3-month treatment. The purpose of the present study was to investigate factors associated with UAE reduction in on-treatment patients with morning hypertension. Methods and Results: A total of 95 patients registered in the MAPPY study were analyzed. Patients were treated with either a losartan/HCTZ combination regimen (n=47) or a high-dose losartan regimen (n=48). Three-month treatment significantly reduced morning SBP, evening SBP, and clinic SBP (P<0.001, P<0.05, and P<0.01, respectively). UAE and serum uric acid were significantly decreased (P<0.01 for both) without the change in estimated glomerular filtration rate. Multiple linear regression analysis indicated that %morning SBP reduction and baseline UAE were independent determinants of the UAE reduction (P=0.001 for both). After adjustments for the reduction in morning-evening SBP difference, baseline UAE, and %uric acid reduction, estimated %UAE reduction level was positively correlated with the tertiles of the increasing %morning SBP reduction level (P=0.031 for trend). Moreover, subgroup analysis showed that morning SBP reduction was an independent determinant of UAE reduction in both treatment regimens. Conclusions: Reduction in morning SBP was a key factor in UAE reduction in patients with morning hypertension, irrespective of treatment regimen.

Torisu H.,Kyushu University | Kira R.,Kyushu University | Ishizaki Y.,Kyushu University | Ishizaki Y.,Fukuoka Childrens Hospital Medical Center | And 18 more authors.
Brain and Development | Year: 2010

Acute disseminated encephalomyelitis (ADEM) has recently been studied in several countries owing to the development and wide spread use of imaging technology, but few epidemiological studies of childhood ADEM have been undertaken in Asian countries. To perform a comprehensive survey of ADEM and related diseases in Japanese children, we conducted a multicenter, population-based study on childhood ADEM, multiple sclerosis, and acute isolated transverse myelitis in Fukuoka Prefecture, Japan. We identified 26 children with ADEM, 8 with multiple sclerosis, and 4 with acute transverse myelitis during 5. years between September 1998 and August 2003. The incidence of childhood ADEM under the age of 15. years was 0.64 per 100,000 person-years, mean age at onset was 5.7. years, and male-female ratio was 2.3:1. The prevalence of childhood multiple sclerosis was 1.3 per 100,000 persons. The mean age at onset of multiple sclerosis, 9.3. years, was significantly higher than that of ADEM. Nineteen (73%) and four (15%) patients with ADEM experienced antecedent infectious illnesses and vaccinations, respectively, within 1. month before the onset. Clinical and radiological findings of ADEM revealed that the frequency of seizures, mean white blood cell counts in cerebrospinal fluid, and the frequency of subcortical lesions in Fukuoka study, seemed to be higher than those in previous non-Asian studies. These findings suggest that there are ethnic or geographical differences in the incidence and clinical features of ADEM, and that there might be potent genetic or environmental risk factors for ADEM distinct from those for multiple sclerosis. © 2009 Elsevier B.V.

Matono S.,Kurume University | Fujita H.,Kurume University | Tanaka T.,Kurume University | Tanaka Y.,Kurume University | And 5 more authors.
Surgery Today | Year: 2011

We report the case of a 50-year-old man with a double aortic arch who underwent esophagectomy for cancer in the middle thoracic esophagus at clinical Stage IIA (T3N0M0), based on the TNM classification (UICC 2002). The patient underwent esophagectomy with three-field lymphadenectomy following neoadjuvant chemotherapy. In such a case, it is important to recognize the anatomy in the upper mediastinum, especially the relationship between the right and left aortic arch, and the recurrent laryngeal nerves using computed tomography (CT) and three-dimensional CT. At first, we performed a cervical lymphadenectomy in order to isolate the bilateral recurrent laryngeal nerves, then mediastinal lymphadenectomy through a right thoracotomy. However, we could not confirm the bilateral recurrent laryngeal nerves during mediastinal lymphadenectomy, and were thus unable to resect them. The postoperative course was uneventful. The patient died of multiple liver metastasis 4 years after the surgery, with no evidence of recurrence in any lymph node. © 2011 Springer.

Koga Y.,Kurume University | Hara M.,Omuta City General Hospital | Mori S.,Koyanagi Memorial Hospital | Miyawaki N.,Kurume University | And 3 more authors.
Japanese Journal of Anesthesiology | Year: 2011

This retrospective study was performed to identify the perioperative factors affecting the mortality rate in 28 patients, who had received emergency surgery for ruptured abdominal aortic aneurysms from January, 2005 to June, 2008. Five (17.9%) of these 28 patients died of massive bleeding, sepsis, or multiple organ failure during or within 11 days after surgery. Various factors which might influence the outcomes were compared between the survivors and non-survivors. Preoperative hypotension defined as a systolic blood pressure ≦80 mmHg associated with hemorrhagic shock was the only significant factor affecting the mortality. There were no significant differences in age, gender, the time from the admittance to the hospital to aortic cross clamping, duration of surgery, and the amount of blood products transfused and intraoperative blood loss, between the two groups. Of great importance is that preoperative hypotension should be corrected before the onset of hemodynamic deterioration.

Kikuchi K.,Yame Public General Hospital | Uchikado H.,Kurume University | Miyagi N.,Yame Public General Hospital | Morimoto Y.,Kagoshima University | And 10 more authors.
International Journal of Molecular Medicine | Year: 2011

Free radicals play major roles in the pathogenesis of tissue damage in many diseases and clinical conditions, and the removal of free radicals may offer a treatment option. Several modulators of free radical scavenger pathways have been developed and some have progressed to clinical trials. One such agent, edaravone, was approved in 2001 in Japan for the treatment of cerebral infarction. It has since been shown that edaravone can diffuse into many organs and, in addition to its effects on hydroxyl radical removal, edaravone modulates inflammatory processes, matrix metalloproteinase levels, nitric oxide production, apoptotic cell death, and necrotic cell death. Edaravone also exerts protective effects in a number of animal models of disease and tissue damage, including models of myocardial, lung, intestinal, liver, pancreatic and renal injury. Together with the proven safety of edaravone following 9 years of use as a modulator of free radical scavenging pathways in neurological disease, these additional effects of edaravone suggest that it may offer a novel treatment for several non-neurological diseases and clinical conditions in humans.

Matono S.,Kurume University | Tanaka T.,Kurume University | Tanaka Y.,Kurume University | Nagano T.,Kurume University | And 5 more authors.
Japanese Journal of Gastroenterological Surgery | Year: 2010

Introduction: Definitive Chemoradiotherapy (CRT) for esophageal cancer has become common, raising the incidence of salvage esophagectomy for residual and recurrent tumors after definitive CRT. We investigated indications, for salvage esophagectomy based on outcome. Methods: We reviewed 18 cases of subjects with esophageal cancer who underwent salvage esophagectomy after definitive CRT with more than 50Gy of radiation from 1986 to 2008. Results: Seven had cStage I-III (nonT4), and 11 cStage III (T4) -IVa before definitive CRT. Definitive CRT (former cStage/later cStage) resulted in responders for 6/7, non-responders for 1/4. Median duration definitive CRT to salvage esophagectomy (former cStage/later cStage) was 6/2 months. Curative surgery was underwent 2/4 (former cStage/later cStage) and palliative surgery was underwent 5/7 (former cStage/later cStage). One, 3 and 5-year survival after curative surgery was 83%, 33% and 17%. No patient survived more than one year after palliative surgery. One, 3 and 5-year survival after responders to CRT was 39%, 15% and 7%. No patient survived more than one year after non-responders. Morbidity was 94%. Postoperative severe complications occurred more after palliative surgery than after curative surgery. Hospital mortality occurred only palliative surgery. Survival was better among responders to CRT and in those undergoig curative surgery. There is no relation between cStage and survival. Conclusions: It appears to offer some survival benefit to responders to definitive CRT and to those undergoing curative surgery. © 2010 The Japanese Society of Gastroenterological Surgery.

Naito Y.,Kurume University | Kusano H.,Kurume University | Nakashima O.,Kurume University | Sadashima E.,Kurume University | And 24 more authors.
World Journal of Gastroenterology | Year: 2012

AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ, high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy. © 2012 Baishideng. All rights reserved.

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