Ryūgasaki, Japan
Ryūgasaki, Japan

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Kurihara Y.,University of Tsukuba | Hitomi S.,University of Tsukuba | Oishi T.,Tokyo Medical University | Kondo T.,Tsuchiura Kyodo General Hospital | And 3 more authors.
Journal of Infection and Chemotherapy | Year: 2013

Although Proteus mirabilis is a common human pathogen, bacteremia caused by the organism, especially strains producing extended-spectrum beta-lactamase (ESBL), has rarely been investigated. We examined 64 cases of P. mirabilis bacteremia identified in the Minami Ibaraki Area, Japan, between 2001 and 2010 and compared the characteristics of cases with ESBL-producing and ESBL-non-producing strains (13 and 51 cases, respectively). All ESBL-producing strains with the gene encoding the CTX-M-2-group were genetically nonidentical. Isolation of ESBL-producing strains was significantly associated with onset in a hospital (p = 0.030), receiving hemodialysis (p = 0.0050), and previous antibiotic use within 1 month (p = 0.036; especially penicillin and/or cephalosporin (p = 0.010) and fluoroquinolone (p = 0.0069)). Isolation was also associated with inappropriate antibiotic therapy on the 1st and 4th days (p = 0.011 and 0.032, respectively) but not with mortality on the 30th day. These findings indicate that, for P. mirabilis bacteremia, isolation of ESBL-producing strains causes delay of initiating appropriate antimicrobial therapy but may not be associated with mortality. © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.


PubMed | Namegata District General Hospital, Ibaraki Prefectural University of Health Sciences and Ryugasaki Saiseikai Hospital
Type: Journal Article | Journal: Journal of rural medicine : JRM | Year: 2015

PATIENTs with secondary hyperparathyroidism caused by chronic kidney disease (CKD) develop secondary osteoporosis, which increases fracture risk. We report a case of insufficiency fractures complicated by secondary osteoporosis caused by chronic renal failure and gastrectomy.A 78-year-old man with a medical history of nephrotic syndrome and gastric cancer experienced an occult intertrochanteric fracture of his left femur after falling.Ten days after the first fracture, the patient was treated with hemodialysis for acute uremic symptoms. Eight weeks after this fracture, he sustained a right insufficiency acetabular fracture and was treated with total hip arthroplasty (THA).For patients with CKD, effective fracture prevention is difficult. THA with reconstruction of the acetabulum was an effective therapy in a patient with nontraumatic central fracture dislocation of the hip.


PubMed | Tsukuba Gakuen Hospital, University of Tsukuba, Tsukuba Medical Center Hospital, Tsuchiura Kyodo General Hospital and 2 more.
Type: Journal Article | Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy | Year: 2015

We examined prevalence of high-level aminoglycoside resistance (HLAR) in Enterococcus faecalis and Enterococcus faecium causing invasive infection in the Minami Ibaraki Area. Ten strains of both species each, recovered from the blood or the cerebrospinal fluid between 2003 and 2014, were randomly selected every year. High-level resistance to gentamicin (HLR-GM) and streptomycin (HLR-SM) was detected in 34% (41 of 120 strains) and 18% (21) of E.faecalis and 9% (11) and 39% (48) of E.faecium, respectively. In comparisons of the proportions among three four-year periods, HLR-SM among E.faecium was significantly lower in the 2011-2014 period. All strains with HLR-GM were positive for the aac(6)-Ie-aph(2)-Ia gene. The ant(6)-Ia gene was detected in all with HLR-SM except for one E.faecalis strain. The present study showed that prevalence of HLR-GM among E.faecalis and E.faecium causing invasive infection in this area was nearly equivalent to that described in previous studies in Japan and that proportions of strains with HLAR did not vary during the study period except for that of HLR-SM among E.faecium.


PubMed | University of Tsukuba, Seirei Hamamatsu General Hospital and Ryugasaki Saiseikai Hospital
Type: | Journal: Epilepsy & behavior case reports | Year: 2015

Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patients seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst.


Onizawa Y.,Ryugasaki Saiseikai Hospital | Noguchi E.,University of Tsukuba | Okada M.,University of Tsukuba | Sumazaki R.,University of Tsukuba | Hayashi D.,Ryugasaki Saiseikai Hospital
Journal of Allergy and Clinical Immunology: In Practice | Year: 2016

Background: Although exclusive breastfeeding at least 4 to 6 months has been recommended to prevent IgE-mediated cow's milk allergy (IgE-CMA), early introduction of food allergens has received a lot of attention in recent years for the prevention of food allergies. Objectives: We aimed to determine whether IgE-CMA is associated with a feeding pattern in early infancy. Methods: In a case-control study, we retrospectively compared the patient background, past history of atopic dermatitis, bronchial asthma, family history of allergic diseases, feeding patterns in early infancy, and the reason for choosing early infancy feeding patterns of patients with IgE-CMA with age- and sex-matched healthy controls using a questionnaire completed by their mothers. To minimize the influence of confounders, we also compared patients with IgE-CMA with those with IgE-mediated egg allergy (IgE-EA). Results: A total of 51 patients with IgE-CMA were compared with 102 controls (1:2 matching) and 32 unmatched patients with IgE-EA. In a multivariable logistic regression analysis, the adjusted odds ratio of delayed (started more than 1 month after birth) or no regular cow's milk formula (less than once daily) was 23.74 (95% CI, 5.39-104.52) comparing the CMA group with the Control group, and 10.16 (95% CI, 2.48-41.64) comparing the CMA group with the EA group. Only 3 (6.5%), 2 (4.8%), and 3 (14.3%) mothers in the CMA group, the Control group, and the EA group chose "To prevent allergic disease" as a reason for choosing exclusive or almost exclusive breastfeeding in the first month of life, respectively. Conclusions: The early introduction of cow's milk formula is associated with lower incidence of IgE-CMA. © 2016 American Academy of Allergy, Asthma & Immunology.


Hasegawa Y.,University of Tsukuba | Hasegawa Y.,Ryugasaki Saiseikai Hospital | Okamoto F.,University of Tsukuba | Nakano S.,Ryugasaki Saiseikai Hospital | And 2 more authors.
Journal of Cataract and Refractive Surgery | Year: 2013

Purpose To compare the Acrysof IQ toric intraocular lens (IOL) and the Acrysof IQ aspheric nontoric IOL and evaluate the effect of preoperative corneal astigmatism orientation on results. Setting Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. Design Comparative case series. Methods This retrospective chart review comprised patients with cataract and preoperative corneal astigmatism between 1.0 diopter (D) and 2.5 D having toric IOL (toric group) or aspheric nontoric IOL (nontoric group) implantation. Eyes were grouped depending on the preoperative axis of corneal astigmatism; that is, with the rule (WTR), against the rule (ATR), and oblique. Preoperative and postoperative analyses included uncorrected (UDVA) and corrected (CDVA) distance visual acuities and cylindrical power preoperatively and 3 months postoperatively. Results The postoperative CDVA was not significantly different between the 2 IOLs; however, the postoperative UDVA was significantly better in the toric group than in the nontoric group (P<.0001). The postoperative residual cylindrical power was significantly smaller in the toric group (P<.0001). In eyes with ATR and oblique astigmatism, the mean postoperative UDVA was significantly better in the toric group, whereas there were no differences between the 2 groups in patients with WTR astigmatism. Conclusions There was significant improvement in postoperative cylinder and UDVA with toric IOLs compared with nontoric IOLs. With a superior corneal incision, the benefits of astigmatism correction with the toric IOL were more significant in patients with ATR and oblique astigmatism than in those with WTR astigmatism. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. © 2013 ASCRS and ESCRS.


Watabe H.,University of Tsukuba | Sato A.,University of Tsukuba | Hoshi T.,University of Tsukuba | Obara K.,Ryugasaki Saiseikai Hospital | And 2 more authors.
Heart and Vessels | Year: 2013

Coronary stent loss during percutaneous coronary intervention is rare and is often associated with significant morbidity. Several retrieval techniques, overlying stent deployment and crushing, and surgical removal can be used to deal with a stent lost in the coronary system. We successfully treated a dislodged and mechanically distorted coil stent stuck within a previously implanted drug-eluting stent (DES) by stent-crush technique. This case might provide insight into the mechanisms responsible for the longitudinal fragility of cobalt alloy and coil-structure stents and stent fracture of DES. In the DES era, careful attention should be paid to such complications when attempting to deliver a stent to a distal vessel through a pre-existing DES. © 2012 Springer.


PubMed | University of Tsukuba and Ryugasaki Saiseikai Hospital
Type: Journal Article | Journal: Surgical case reports | Year: 2016

An 8-month-old boy with a left-sided incarcerated inguinal hernia involving the appendix, cecum, and terminal ileum was successfully managed via an inguinal approach during an emergency operation. A mobile cecum seemed to have contributed to the left-sided incarceration. Only 13 similar cases with the left-sided Amyands hernia have been reported in the literature.


PubMed | University of Tsukuba, Tsukuba Medical Center Hospital and Ryugasaki Saiseikai Hospital
Type: Journal Article | Journal: Oncology letters | Year: 2016

Renal cell carcinoma (RCC) may metastasize to mediastinal lymph nodes without any abdominal lymph node involvement. The present study describes an autopsy-proven case of RCC presenting with a large mediastinal mass; the case had been previously misdiagnosed as small cell lung carcinoma due to imaging analysis results, an elevated serum level of neuron-specific enolase and the presence of small atypical cells with a high nuclear/cytoplasmic ratio. Despite RCC occurrence being rare, it should be considered in the differential diagnosis, particularly when a mass located in the kidneys presents with metastases to the mediastinal lymph nodes, even if there is no involvement of the abdominal lymph nodes and the primary lesion is of a small size.


PubMed | University of Tsukuba and Ryugasaki Saiseikai Hospital
Type: Journal Article | Journal: The journal of allergy and clinical immunology. In practice | Year: 2016

Although exclusive breastfeeding at least 4 to 6 months has been recommended to prevent IgE-mediated cows milk allergy (IgE-CMA), early introduction of food allergens has received a lot of attention in recent years for the prevention of food allergies.We aimed to determine whether IgE-CMA is associated with a feeding pattern in early infancy.In a case-control study, we retrospectively compared the patient background, past history of atopic dermatitis, bronchial asthma, family history of allergic diseases, feeding patterns in early infancy, and the reason for choosing early infancy feeding patterns of patients with IgE-CMA with age- and sex-matched healthy controls using a questionnaire completed by their mothers. To minimize the influence of confounders, we also compared patients with IgE-CMA with those with IgE-mediated egg allergy (IgE-EA).A total of 51 patients with IgE-CMA were compared with 102 controls (1:2 matching) and 32 unmatched patients with IgE-EA. In a multivariable logistic regression analysis, the adjusted odds ratio of delayed (started more than 1 month after birth) or no regular cows milk formula (less than once daily) was 23.74 (95% CI, 5.39-104.52) comparing the CMA group with the Control group, and 10.16 (95% CI, 2.48-41.64) comparing the CMA group with the EA group. Only 3 (6.5%), 2 (4.8%), and 3 (14.3%) mothers in the CMA group, the Control group, and the EA group chose To prevent allergic disease as a reason for choosing exclusive or almost exclusive breastfeeding in the first month of life, respectively.The early introduction of cows milk formula is associated with lower incidence of IgE-CMA.

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