Osaka General Hospital of West Japan Railway Company

Ōsaka, Japan

Osaka General Hospital of West Japan Railway Company

Ōsaka, Japan
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Kato M.,Osaka City General Hospital | Namikawa T.,Osaka City General Hospital | Matsumura A.,Osaka City General Hospital | Konishi S.,Osaka General Hospital of West Japan Railway Company | Nakamura H.,Osaka City University
Global Spine Journal | Year: 2017

Study Design: Retrospective clinical study. Objective: We evaluated the relationship between cervical sagittal alignment parameters and clinical status in patients with cervical myelopathy and analyzed the effect of cervical sagittal balance on cervical laminoplasty. Methods: Patients with cervical myelopathy (n = 110) who underwent laminoplasty were included in this study. The relationship between cervical sagittal alignment parameters and clinical status was evaluated. The changes in radiographic cervical sagittal parameters and clinical status 2 years after surgery were compared between patients with preoperative C2-7 SVA ≥35 mm (group A) and those with preoperative C2-7 SVA <35 mm (group B). Results: Preoperatively, C2-7 SVA had no correlation with defined health-related quality of life evaluation scores. At 2-year follow-up, the improvement in SF-36 physical component summary was significantly lower in group A than in group B. The postoperative change of C2-7 SVA did not significantly differ in 2 groups. Patients in group A maintained cervical regional balance after laminoplasty but experienced extensive postoperative neck pain. Conclusions: Our patients with a C2-7 SVA of ≥35 mm maintained cervical regional balance after laminoplasty and their improvement in myelopathy was equivalent to that in patients with a C2-7 SVA of <35 mm. However, the patents with a C2-7 SVA of ≥35 mm experienced severe postoperative neck pain. C2-7 SVA is a parameter worth considering because it can lead to poor QOL and axial neck pain after laminoplasty. © 2017 The Author(s).


Katsumori T.,Saiseikai Shiga Hospital | Arima H.,Fukuoka University | Asai S.,Saiseikai Shiga Hospital | Hayashi N.,Osaka General Hospital of West Japan Railway Company | Miura H.,Kyoto Prefectural University of Medicine
CardioVascular and Interventional Radiology | Year: 2017

Purpose: To compare acute pain after uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM) versus gelatin sponge particles (GS) for leiomyoma. Materials and Methods: This was a single-institution, retrospective study. Between July 2008 and November 2016, 101 consecutive patients with symptomatic uterine leiomyoma underwent UAE with the same protocol for post-procedural pain. GS was employed with near-stasis endpoint for the first 49 patients, whereas TAGM was used with limited endpoint for the next 52 patients. Post-UAE pain levels were compared between both groups with a linear mixed model using visual analog scale (VAS) scores from 0 to 18 h as a repeat measure outcome. Peak VAS < 24 h or dose of drugs for analgesia and conscious sedation was compared by analysis of variance. Tumor infarction was assessed with post-procedural contrast-enhanced MRI. Results: Baseline demographics and most outcomes including tumor infarction were similar between both groups. The average VAS scores during the period <24 h were significantly lower in TAGM group (1.68, 95% CI 1.23–2.13) compared to GS group (3.28, 95% CI 2.82–3.74, p < 0.0001). The difference remained significant even after adjustment for other factors (p < 0.0001). The mean peak VAS < 24 h was also lower in TAGM group (3.89, 95% CI 3.25–4.53) than in GS group (5.90, 95% CI 5.20–6.53, p < 0.0001). The dose of drugs for analgesia and conscious sedation was significantly lower in TAGM group (p = 0.001, p = 0.004, respectively). Conclusion: TAGM had an advantage over GS in UAE for leiomyoma in terms of less post-procedural pain <24 h, with lower doses of drugs for analgesia and conscious sedation. © 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE)


Kario K.,Jichi Medical University | Ando S.-I.,Fukuokaken Saiseikai Futsukaichi Hospital | Kido H.,Meimai Central Hospital | Nariyama J.,Osaka General Hospital of West Japan Railway Company | And 7 more authors.
Journal of Clinical Hypertension | Year: 2013

The Ambulatory Blood Pressure Control and Home Blood Pressure (Morning and Evening) Lowering By N-Channel Blocker Cilnidipine (ACHIEVE-ONE) trial is a large-scale clinical study on blood pressure (BP) and pulse rate (PR) in the real world with use of cilnidipine, a unique L/N-type Ca channel blocker, possessing a suppressive action on increased sympathetic activity in patients with essential hypertension. The effects of cilnidipine on morning hypertension were examined. The authors examined 2319 patients treated with cilnidipine for 12weeks. Clinic systolic BP (SBP) decreased by 19.6mm Hg from 155.0mm Hg, whereas morning SBP decreased by 17.0mm Hg from 152.9mm Hg after 12-week cilnidipine treatment. Cilnidipine reduced both morning SBP and PR more markedly in patients with higher baseline morning SBP (-3.2mm Hg and -1.3beats per minute in the first quartile of morning SBP, -30.9mm Hg and -3.2beats per minute in the fourth quartile), and also reduced both morning PR and SBP more markedly in patients with higher baseline morning PR (0.6beats per minute and -15.6mm Hg in <70beats per minute, and -9.7beats per minute and -20.2mm Hg in ≥85beats per minute). Cilnidipine significantly reduced BP and PR in hypertensive patients at the clinic and at home, especially with higher BP and PR in the morning. © 2012 Wiley Periodicals, Inc.


Fujii T.,Nara Medical University | Ishida E.,Osaka General Hospital of West Japan Railway Company | Shimada K.,Nara Medical University | Hirao K.,Hirao Hospital | And 3 more authors.
Cancer Investigation | Year: 2014

In order to study multiple contiguous prostate cancer lesions, we constructed computer-assisted, three-dimensional models of multifocal prostate cancer specimens obtained by radical prostatectomy. We then examined the genetic heterogeneity among the specimens by DNA microarray analysis. Cancer foci with high Gleason patterns were found to occur de novo, whereas those with low Gleason patterns occurred contiguously with cancers of low Gleason patterns. Three-dimensional analysis showed that distinct, noncontiguous cancerous foci were genetically independent and multicentric. In contrast some contiguous multifocal lesions had the same genetic origin. © 2014 Informa Healthcare USA, Inc.


Nakai N.,Kyoto Prefectural University of Medicine | Nakai N.,University of Bonn | Hartmann G.,University of Bonn | Kishimoto S.,Osaka General Hospital of West Japan Railway Company | Katoh N.,Kyoto Prefectural University of Medicine
Pigment Cell and Melanoma Research | Year: 2010

Eleven years have passed since the start of the first trial of dendritic cell (DC) vaccination for melanoma. A review of 54 trials was performed to evaluate the relationship between clinical effects and vaccine parameters. Significant differences were found between use of immature and mature DCs with regard to progressive disease (PD), between stage III and IV for clinical response, between use and non-use of adjuvants with regard to stable disease (SD) in treatment with tumor/tumor lysate-pulsed DCs, between positive and negative delayed-type hypersensitivity (DTH) for PD, and between increased and unchanged interferon (IFN)- γ-secreting T cells for clinical response. These results are consistent with the partial efficacy of vaccination with mature DCs in early stage melanoma and the partial correlation of efficacy with positive DTH and increased IFN-γ-secreting T cells. DC vaccination alone had a limited clinical effect and a modified regimen is needed to enhance antigen-specific cytotoxic T cells and decrease immunosuppression. © 2010 John Wiley & Sons A/S.


Kario K.,Jichi Medical University | Nariyama J.,Osaka General Hospital of West Japan Railway Company | Kido H.,Meimai Central Hospital | Ando S.-I.,Fukuoka University | And 5 more authors.
Journal of Clinical Hypertension | Year: 2013

The authors examined the effect of cilnidipine, a unique L/N-type calcium channel blocker, on abnormal nocturnal blood pressure (BP) dipping in Japanese hypertensive patients in the real world. The Ambulatory Blood Pressure Control and Home Blood Pressure (Morning and Evening) Lowering by N-Channel Blocker Cilnidipine (ACHIEVE-ONE), a large-scale clinical study, was designed to evaluate the effects of cilnidipine in daily medical practice. Among the study, 24-hour ambulatory BP data were obtained from 615 patients and classified according to their nocturnal dipping status as extreme dippers, dippers, nondippers, or risers. A 12-week treatment with cilnidipine significantly reduced 24-hour BP in all groups (P<.001). Changes in nocturnal systolic BP (SBP) from baseline were -17.9 mm Hg from 154.6 mm Hg in risers and -11.9 mm Hg from 142.1 mm Hg, -6.6 mm Hg from 128.5 mm Hg, and 0.1 mm Hg from 115.8 mm Hg in nondippers, dippers, and extreme dippers, respectively. Changes from baseline in nocturnal SBP reduction rate were 8.2% in risers (P<.001) but -7.0% in extreme dippers (P<.001), while no change was observed in the nighttime SBP reduction rate for the total patients (-0.2%±9.6%, P=617). Cilnidipine partially, but significantly, restored abnormal nocturnal dipping status toward a normal dipping pattern in hypertensive patients. © 2013 Wiley Periodicals, Inc.


PubMed | Kumamoto University, Imamura Bun in Hospital, Kumamoto Shinto General Hospital, Kyoto Prefectural University of Medicine and 3 more.
Type: | Journal: Scientific reports | Year: 2016

Human T-cell leukemia virus type 1 (HTLV-1) causes adult T-cell leukemia and inflammatory diseases. Because anti-HTLV-1 immune responses are critical for suppressing infected cells, enhancing cellular immunity is beneficial for the treatment of HTLV-1-associated diseases. Using simian T-cell leukemia virus type 1 (STLV-1) infected Japanese macaques, we analyzed the immune responses to viral antigens and the dynamics of virus-infected cells. The chemokine receptor CCR4 is expressed on STLV-1 infected cells, and administration of humanized monoclonal antibody to CCR4, mogamulizumab, dramatically decreased the number of STLV-1-infected cells in vivo. Concurrently, mogamulizumab treatment enhanced STLV-1 specific CD4(+) and CD8(+) T cell responses by simultaneously targeting CCR4(+) effector regulatory T (Treg) cells and infected cells. Mogamulizumab promoted the phagocytosis of CCR4(+) infected cells by macrophages, which likely enhanced antigen presentation. Vaccination with recombinant vaccinia virus (rVV) expressing viral antigens suppressed the proviral load and the number of Tax-expressing cells. Enhanced T-cell responses were also observed in some ATL patients who were treated with mogamulizumab. This study shows that mogamulizumab works not only by killing CCR4(+) infected cells directly, but also by enhancing T cell responses by increasing the phagocytosis of infected cells by antigen-presenting cells and suppressing CCR4(+) effector Treg cells.


PubMed | Seikeikai Hospital, Yodogawa Christian Hospital, Osaka City University, Sato Hospital and 5 more.
Type: | Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA | Year: 2016

This study revealed the time course of osteoporotic vertebral fracture by magnetic resonance imaging using a simple classification. Signal changes were associated with the compression degree and mobility of the fractured vertebral body. This classification showed sufficient reliability in categorizing magnetic resonance imaging findings of osteoporotic vertebral fractures.Magnetic resonance imaging (MRI) is useful in diagnosing osteoporotic vertebral fractures (OVFs). This study investigated the time course of OVFs by MRI using a simple classification.This multicenter cohort study was performed from 2012 to 2015. Consecutive patients with 2-week-old OVFs were enrolled in 11 institutions. MRI was performed at enrollment and at 1-, 3-, 6-, and 12-month follow-up. Signal changes on T1-weighted imaging (T1WI), T2WI, and short inversion recovery (STIR) were classified according to signal intensity. Height and angular motion of vertebral bodies were also measured.The 6-month follow-up was completed by 153 patients. At enrollment, fractured vertebrae signal changes were 43% diffuse and 57% confined low on T1WI; on T2WI, 56, 24, and 5% were confined low, high, and diffuse low, respectively; on STIR, 100% were high. On T1WI, diffuse low remained most common (90% at 1month and 60% at 3months) until 6 and 12months, when most were confined low (54 and 52%, respectively). On T2WI, confined low remained most common (decreasing to 41% at 12months). On STIR, high signal change was shown in 98, 87, and 64% at 3, 6, and 12months, respectively. At 3, 6, and 12months, diffuse low signal change was associated with significantly lower vertebral height, and high signal change was associated with significantly greater angular motion.MRI signal changes were associated with the compression degree and angular motion of fractured vertebrae. This classification showed sufficient reliability in categorizing MRI findings of OVFs.


PubMed | Red Cross, SRL Inc., Tokyo Medical and Dental University, University of Toyama and 12 more.
Type: Journal Article | Journal: Journal of clinical microbiology | Year: 2015

Quantitative PCR (qPCR) analysis of human T-cell leukemia virus type 1 (HTLV-1) was used to assess the amount of HTLV-1 provirus DNA integrated into the genomic DNA of host blood cells. Accumulating evidence indicates that a high proviral load is one of the risk factors for the development of adult T-cell leukemia/lymphoma and HTLV-1-associated myelopathy/tropical spastic paraparesis. However, interlaboratory variability in qPCR results makes it difficult to assess the differences in reported proviral loads between laboratories. To remedy this situation, we attempted to minimize discrepancies between laboratories through standardization of HTLV-1 qPCR in a collaborative study. TL-Om1 cells that harbor the HTLV-1 provirus were serially diluted with peripheral blood mononuclear cells to prepare a candidate standard. By statistically evaluating the proviral loads of the standard and those determined using in-house qPCR methods at each laboratory, we determined the relative ratios of the measured values in the laboratories to the theoretical values of the TL-Om1 standard. The relative ratios of the laboratories ranged from 0.84 to 4.45. Next, we corrected the proviral loads of the clinical samples from HTLV-1 carriers using the relative ratio. As expected, the overall differences between the laboratories were reduced by half, from 7.4-fold to 3.8-fold on average, after applying the correction. HTLV-1 qPCR can be standardized using TL-Om1 cells as a standard and by determining the relative ratio of the measured to the theoretical standard values in each laboratory.


Shimizu S.,Osaka General Hospital of West Japan Railway Company | Kobayashi T.,Kitasato University | Tomioka H.,Osaka General Hospital of West Japan Railway Company | Ohtsu K.,Fukuoka University | And 2 more authors.
Journal of Gastroenterology | Year: 2016

Background: Mesenteric phlebosclerosis (MP) is a rare disease characterized by venous calcification extending from the colonic wall to the mesentery, with chronic ischemic changes from venous return impairment in the intestine. It is an idiopathic disease, but increasing attention has been paid to the potential involvement of herbal medicine, or Kampo, in its etiology. Until now, there were scattered case reports, but no large-scale studies have been conducted to unravel the clinical characteristics and etiology of the disease. Methods: A nationwide survey was conducted using questionnaires to assess possible etiology (particularly the involvement of herbal medicine), clinical manifestations, disease course, and treatment of MP. Results: Data from 222 patients were collected. Among the 169 patients (76.1 %), whose history of herbal medicine was obtained, 147 (87.0 %) used herbal medicines. The use of herbal medicines containing sanshishi (gardenia fruit, Gardenia jasminoides Ellis) was reported in 119 out of 147 patients (81.0 %). Therefore, the use of herbal medicine containing sanshishi was confirmed in 70.4 % of 169 patients whose history of herbal medicine was obtained. The duration of sanshishi use ranged from 3 to 51 years (mean 13.6 years). Patients who discontinued sanshishi showed a better outcome compared with those who continued it. Conclusions: The use of herbal medicine containing sanshishi is associated with the etiology of MP. Although it may not be the causative factor, it is necessary for gastroenterologists to be aware of the potential risk of herbal medicine containing sanshishi for the development of MP. © 2016 Japanese Society of Gastroenterology

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