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Ōsaka, Japan

Ohfuji S.,Osaka City University | Fukushima W.,Osaka City University | Deguchi M.,Osaka City Juso Hospital | Yoshida H.,Osaka Public Health Center | And 3 more authors.
Journal of Infectious Diseases | Year: 2011

Background: Pregnant women are a high-risk group for influenza-associated complications and hospitalizations. Methods: To examine the immunogenicity of a monovalent 2009 influenza A (H1N1) vaccine among pregnant women, a prospective cohort study was performed at 2 medical institutes of obstetrics in Japan. One hundred fifty subjects received 2 subcutaneous doses of vaccine 3 weeks apart. The hemagglutination inhibition antibody titer was measured in serum samples collected at 3 time points: before vaccination, 3 weeks after the first dose, and 4 weeks after the second dose. Results:The first dose of vaccine induced a ≥10-fold rise in the average level of antibody. The seroresponse rate (≥4-fold rise) was 91%, and the seroprotection rate (postvaccination titer ≥1:40) was 89%. The second dose of vaccine conferred little additional induction of antibodies. Similar immune responses were observed irrespective of body mass index before pregnancy, trimester, or age at vaccination. However, lesser immune response was shown in subjects who had received the 2009-2010 seasonal influenza vaccine before the H1N1 vaccination. Conclusions: A single dose of vaccine induced an adequately protective level of immunity in pregnant women. The potential interference with seasonal vaccination requires a more thorough investigation to prepare for future influenza pandemics. © The Author 2011. Source


Fukunaga Y.,Bell Land General Hospital | Kameyama M.,Bell Land General Hospital | Kawasaki M.,Bell Land General Hospital | Takemura M.,Osaka City General Hospital | Fujiwara Y.,Osaka City Juso Hospital
Digestive Surgery | Year: 2011

Purpose: We retrospectively investigated the impact of prior abdominal surgery on the outcome of laparoscopic colorectal surgery. Patients: Among 607 colorectal cancer patients who underwent laparoscopic surgery, 192 patients had previously undergone abdominal surgery (S group) and 415 had not (non-S group). Results: The percentage of female patients was higher in the S group than in the non-S group. The incidence of conversion to open surgery was higher in the S group (5.2%, 10/192) than in the non-S group (2.6%, 11/415), but the difference was not significant (p = 0.108). Although the mean operating time and estimated blood loss were similar in the two groups, right and transverse colectomy after prior gastrectomy and ipsilateral colectomy after prior colectomy took longer and were associated with greater blood loss. The morbidity rates of the two groups were similar (S group: 15.6%, 30/192; non-S group: 14.5%, 60/415). There were 5 intraoperative small-bowel injuries or postoperative small-bowel perforations in the S group, especially in the patients with prior gastrointestinal-tract surgery. Conclusion: Our findings suggest that there is no reason to avoid laparoscopic procedures in most patients with prior abdominal surgery despite a higher conversion rate, but caution is warranted in patients who have undergone major gastrointestinal-tract surgery. Copyright © 2011 S. Karger AG. Source


Fukushima W.,Osaka City University | Ohfuji S.,Osaka City University | Deguchi M.,Osaka City Juso Hospital | Kawabata K.,Kawabata Womens Clinic | And 4 more authors.
Vaccine | Year: 2012

In order to estimate the effectiveness of an influenza A (H1N1) 2009 monovalent vaccine among pregnant women, we prospectively observed 135 Japanese pregnant women who received an influenza A (H1N1) 2009 monovalent vaccine during November 2009. We calculated an index of "antibody efficacy", in which the medical visits for respiratory illnesses were compared between those with and without post-vaccination hemagglutination inhibition (HI) titer ≥1:40. The product of antibody efficacy and achievement rate is theoretically equivalent to the vaccine effectiveness. Among all subjects, an inverse but non-significant relationship during the epidemic period was observed between post-vaccination HI titer ≥1:40 and medical visits for respiratory illnesses. After stratification by trimester at recruitment, a significant inverse association during the epidemic period was found among subjects in the first or second trimester (antibody efficacy: 91%, vaccine effectiveness: 79%). The influenza A (H1N1) 2009 monovalent vaccine administered in the first or second trimester reduced medical visits for respiratory illnesses among Japanese pregnant women. © 2012 Elsevier Ltd. Source


Kurai O.,Osaka City Juso Hospital
Journal of Japanese Society of Gastroenterology | Year: 2010

A 20-year-old man had suffered from dysphagia since primary school. Upper gastrointestinal and endoscopy examinations revealed severe circumferential stenosis of the upper intra-thoracic esophagus. Secondary stenosis due to factors such as inflammation did not appear present, so congenital esophageal stenosis (CES) was diagnosed. Dysphagia improved after two endoscopic balloon dilatations. Almost all cases of CES are treated in babyhood, and individuals who remain untreated until adulthood are rare. Check ups and diagnoses should be made taking CES into consideration, even in adults. Source


Various types of granulocyte colony-stimulating factor (G-CSF)-producing malignant tumors have been reported. However, a G-CSF-producing colorectal cancer is rare. We present a case of G-CSF-producing ascending colon cancer. An 81-year-old man was referred to our hospital with right lower abdominal pain. A colon fiberscopy revealed an ascending colon tumor, and histological examination revealed tubular adenocarcinoma. He was admitted due to worsening abdominal pain. Although laboratory data showed an elevated white blood cell (WBC) count of 17000/mm3 with 77.8% neutrophils, elevated C-reaction protein (CRP) was insignificant (1.06 mg/dL), and he was afebrile. Because computed tomography indicated that the tumor penetrated into surrounding tissue, a semi-urgent ileocecal resection was performed. An abscess was not located. The tumor was staged as T3N2aM0 and as stage IIB according to the TNM classification. Microscopically, significant neutrophil infiltration between cancer cells was observed, suggesting the presence of a G-CSF-producing tumor. Immunohistochemical staining using a G-CSF antibody revealed cytoplasmic staining in cancer cells. The serum concentration of G-CSF upon admission was 334 pg/mL. After surgical resection, the WBC count decreased to within a normal range. These findings confirmed the diagnosis of G-CSF-producing ascending colon cancer. The prognosis of G-CSF-producing tumors is considered to be poor. Early diagnosis and surgical treatment are needed for patients with G-CSF-producing tumors, and continuous careful follow-up is required. Source

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