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Onomichi, Japan

Tokuoka S.,Kawasaki Medical School | Inagawa K.,Kawasaki Medical School | Suenobu K.,Okayama Medical Center | Takata H.,Onomichi Municipal Hospital
Japanese Journal of Plastic Surgery

We investigated dermal running sutures using the V-Loc™180 closure device (V-Loc) for closing donor-site wounds. Between May 2007 and December 2011. 28 patients underwent donor-site wound closure using a V-Loc and absorbable sutures at the time of reconstruction. Postoperative scarring and complications were investigated for 6 months after the operation. We also compared the buried suture time using a knot suture and V-Loc 15-cm-long wound closure (12 times each) in porcine skin. The overall mean V-Loc visual analog scale (VAS) score was 7.3, while the mean absorbable suture VAS score was 6.5. There were no significant differences between groups at the 5 % significance level. The V-Loc suture time was about 30 % faster than the knot suture time. Therefore, we conclude that the V-Loc method was more effective for donor-site wound closure. Source

Kawamata O.,Onomichi Municipal Hospital
Japanese Journal of Lung Cancer

Background. Diffuse malignant pleural mesothelioma (MPM) has a poor prognosis and there is no consensus on standard therapy. Furthermore, it is difficult to make a definitive diagnosis of MPM. In the present case, chemotherapy was performed after diagnosis by thoracoscopic biopsy. Six years after diagnosis extra-pleural pneumonectomy was performed. Case. A 54-year-old man had pleural effusion pointed out in a medical examination in early, 2001. MPM was diagnosed by pleural needle biopsy at another hospital. However, a diagnosis of MPM was not confirmed by another physician, and the patient was referred to our hospital in 2002. We performed thoracoscopic pleural biopsy in March, 2003, which resulted in a diagnosis of epithelial-type MPM (T1bN0M0 stage IB). We administered chemotherapy, after which we performed extra-pleural pneumonectomy. We confirmed recurrence by additional examination in the postoperative first year, but he is still alive at the time of writing. Conclusion. In order to obtain long-term survival by chemotherapy in such cases, careful consideration of the possibility of early-stage MPM is essential. © 2010 The Japan Lung Cancer Society. Source

Orimi S.,Medical Engineering Center | Mizuno K.,Medical Engineering Center | Narahara M.,Medical Engineering Center | Umakosi H.,Kidney Center | And 2 more authors.
Therapeutic Apheresis and Dialysis

We examined appropriate flow rates for high collection rates of Total Protein (TP) and Albumin (Alb) and a change of IL-6 concentrations in the cell-free and concentrated ascites reinfusion therapy (CART) process. No significant changes were observed in IL-6 concentration in the ascites storage test and the circulatory stimulation test. However, it was confirmed that the quantity of IL-6 in the ascites decreased by means of filtration and concentration. In some cases, it quickly reached high concentration rates at a higher flow rate (200mL/min) setting, but clogging or pressure increase has occurred in the hollow fiber filter. Therefore, it was concluded that a low flow rate (50mL/min) setting was best and provides safer conditions for filtration and concentration in order to collect TP and Alb effectively and reuse it as autologous protein, which is the primary objective of CART. © 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis. Source

Iwamuro M.,Okayama University of Science | Tanaka S.,Iwakuni Clinical Center | Shiode J.,Okayama Saiseikai General Hospital | Imagawa A.,Mitoyo General Hospital | And 9 more authors.
Internal Medicine

Objective: To analyze the clinical characteristics of patients with gastrointestinal bezoars and their response to therapy. Patients: We retrospectively reviewed the cases of 19 patients diagnosed with gastrointestinal bezoars at the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences or one of 15 collaborating institutions between December 2004 and August 2013. We investigated the epidemiology and etiology of the gastrointestinal bezoars by determining the gender, age at diagnosis, medical history, symptoms, complications, modalities used for diagnosis, treatments, outcomes and bezoar location, color and contents. Results: There were 17 patients with gastric bezoars and two patients with small intestinal bezoars. All patients were 62 years of age or older, except for one case of a trichobezoar in a 10-year-old patient. Some of the patients had a history of surgery of any part of the gastrointestinal tract (n=5) and/or diabetes mellitus (n=2). The two patients with small intestinal bezoars required surgical removal in order to relieve ileus. Approximately one-half of the patients with gastric bezoars had ulcerations in the stomach (9/17 patients, 52.9%) and/or gastrointestinal bleeding (8/17, 47.1%). Endoscopic fragmentation was performed in 10 patients, whereas bezoar dissolution was achieved with a gastroprokinetic agent (n=1) and without any treatment (n=3) in the remaining cases. Conclusion: As previously reported, elderly individuals with a positive history of surgery and/or diabetes mellitus were observed in this bezoar patient series. Gastric ulcers and gastrointestinal bleeding were frequently observed. The majority of patients underwent endoscopic fragmentation, while spontaneous resolution of the gastric bezoar was observed in several cases. © 2014 The Japanese Society of Internal Medicine. Source

Iwamuro M.,Okayama University of Science | Kawai Y.,Onomichi Municipal Hospital | Matsumoto T.,Onomichi Municipal Hospital | Uda M.,Onomichi Municipal Hospital | Okada H.,Okayama University

A 60-year-old Japanese man presented to our hospital for further investigation of an elevated serum anti-p53 antibody level. He was diagnosed with colon cancer and the tumour was surgically resected. Histological diagnosis of advanced colon cancer without lymph node involvement or distant metastasis was made. It was noteworthy that both serum carcinoembryonic antigen (CEA) and a fecal occult blood test that were performed preoperatively were non-diagnostic. This case highlights the potential usefulness of serum anti-p53 antibody tests for detection of colorectal cancers. Moreover, sequential changes in the anti-p53 antibody levels after curative resection were observed. © the authors; licensee ecancermedicalscience. Source

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