Shibahara H.,Sagamihara Kyodo Hospital |
Shibahara N.,Hashimoto Minami Internal Medicine Clinic
Journal of Nephrology | Year: 2010
Background: The detailed mechanisms and treatment methods of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) are not fully understood. We conducted a prospective study in CHF patients manifesting CKD to examine if AST-120 (Kremezin) improves cardiac and renal functions. Methods: Twenty outpatients with CHF manifesting moderate CKD (serum creatinine 1.3-2.0 mg/dL) were studied. The patients had received AST-120 at a dosage of 6 g/day in combination with existing medications for 24 months. Some parameters of kidney and heart function were monitored. Also the cumulative length of hospital stay and number of admissions for the 2-year periods before and after initiation of AST-120 treatment were calculated. Results: Results of renal function tests, atrial natriuretic peptide, edema, cardiothoracic ratio and hospital stay indicated significant improvements in patients treated with AST-120. The length of hospital stay and number of admissions both decreased significantly during the 2 years of AST-120 treatment compared with the 2 years before treatment, from 39.7 ± 12.9 days to 4.14 ± 2.5 days, and from 0.79 ± 0.21 admissions to 0.21 ± 0.11 admissions, respectively. Conclusions: AST-120 contributes to the improvement of cardiac and renal functions, and consequently improves the quality of life of patients. © 2010 Società Italiana di Nefrologia.
Kaseda K.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital |
Kaseda K.,Sagamihara Kyodo Hospital |
Horio H.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital |
Harada M.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital |
Hishima T.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
World Journal of Surgical Oncology | Year: 2014
Solitary papilloma of the lung is thought to be a rare benign epithelial tumor, and complete surgical resection is currently the standard treatment for this pathology. However, some cases of papilloma have reportedly shown malignant potential. We report two cases of solitary glandular papilloma of the peripheral lung that were treated by thoracoscopic partial resection. The first patient presented with a nodular lesion in the lower lobe of the left lung that was detected on a follow-up chest computed tomography (CT) scan after treatment for laryngeal cancer. Partial lung resection was performed by video-assisted thoracoscopic surgery. In the second patient, a nodular lesion was incidentally identified in the lower lobe of the left lung during a health check-up. Partial lung resection was again performed by video-assisted thoracoscopic surgery. The postoperative course in both cases was uneventful, and no recurrences have been observed as of 44 months and 41 months postoperatively, respectively. To the best of our knowledge, malignant transformation has been reported both with the squamous type and the mixed type of solitary papilloma of the lung. The glandular variant has shown no tendency toward local recurrence after local excision and has no apparent malignant potential. Local excision is thus recommended for solitary glandular papilloma in order to preserve pulmonary function. © 2014 Kaseda et al.; licensee BioMed Central Ltd.
Kawabata M.,National Institute of Fitness and Sports in Kanoya |
Kawabata M.,Sagamihara Kyodo Hospital |
Shima N.,Tokai Gakuen University |
Hamada H.,National Institute of Fitness and Sports in Kanoya |
And 2 more authors.
European Journal of Applied Physiology | Year: 2010
Intra-abdominal pressure (IAP) is closely related to breathing behavior during lifting. Abdominal muscles contribute to both IAP development and respiratory function. The purpose of this study was to examine whether spontaneous breath volume and IAP altered with increased isometric lifting effort, and to compare the effect of different abdominal muscle strengths on these parameters. Maximal IAP during the Valsalva maneuver (maxIAP) and maximal isometric trunk flexor strength were measured in 10 highly trained judo athletes (trained) and 11 healthy men (controls). They performed isometric lifting with 0 (rest), 30, 45, 60, 75, 90, and 100% of maximal lifting effort (MLE). Natural inspiratory and expiratory volumes were calculated from air-flow data immediately before and after the start of lifting. IAP, measured using an intra-rectal pressure transducer during lifting, was normalized by maxIAP (%maxIAP). Trained athletes had higher maxIAP and stronger trunk flexor muscles than controls. A significant main effect of lifting effort was found on %maxIAP and respiratory volume. An interaction (lifting effort by group) was found only for %maxIAP. No significant group main effect or interaction was found for respiratory volume. Inspiratory volume increased significantly from tidal volume to above 60 and 45% of MLE in trained athletes and controls, respectively. Expiratory volume decreased significantly from tidal volume at above 30% of MLE in both the groups. These results suggest that spontaneous breath volume and IAP development are coupled with increased lifting effort, and strong abdominal muscles can modify IAP development and inspiratory behavior during lifting. © Springer-Verlag 2010.
Nakayama T.,Sagamihara Kyodo Hospital |
Nakayama T.,Keio University |
Ohtsuka T.,Keio University |
Kazama A.,Sagamihara Kyodo Hospital |
Watanabe K.,Sagamihara Kyodo Hospital
Annals of Thoracic and Cardiovascular Surgery | Year: 2012
We report a rare case of classic pulmonary blastema (CPB) without recurrence for 3 years after the operation. A 70-year-old man presented with cough and sputum for a month. Chest computed tomography (CT) showed a 5cm-sized mass in the right middle lobe. Bronchoscopic examination was performed, and the mass was suspected as adenocarcinoma of the lung. Right middle lobectomy and lymph node dissection were performed. The pathologic histology diagnosis was classic pulmonary blastoma, a subtype of biphasic pulmonary blastoma. © 2011 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery. All rights reserved.
Kawabata M.,Sagamihara Kyodo Hospital |
Shima N.,Tokai Gakuen University |
Nishizono H.,National Institute of Fitness and Sports in Kanoya
European Journal of Applied Physiology | Year: 2014
Methods: Eleven healthy men performed quick dynamic deadlifting using 30, 45, 60 and 75 % of the isometric maximal lifting effort (iMLE). IAP was measured using an intrarectal pressure transducer. The spontaneous respiratory volume was calculated from air flow data using pneumotachography. The lifting motion onset was determined from the hip joint motion using an electrogoniometer.Purpose: Intra-abdominal pressure (IAP) and breathing behaviour are important preparative pre-lifting actions for functional stability during lifting. This study aimed to examine spontaneous changes in the peak rate of IAP development (Rate-IAP), peak IAP (Peak-IAP), the time of Rate- and Peak-IAP occurrence and respiratory volume in response to dynamic load lifting.Results: From 30 to 75 % of the iMLE, Rate-IAP occurred early from 2 ± 28 to −179 ± 16 ms (P < 0.01), whereas Peak-IAP occurred late from 165 ± 31 to 82 ± 23 ms (P = 0.12) relative to the lifting motion onset. Rate-IAP increased from 224 ± 47 to 507 ± 69 mmHg/s (P < 0.01), whereas Peak-IAP increased from 37 ± 8 to 90 ± 11 mmHg (P < 0.01) at 30–75 % of the iMLE. Rate-IAP strongly correlated with Peak-IAP at each lifting load (r = 0.94–0.97). Relative to the resting tidal volume, the inspiratory volume during pre-lifting significantly increased above 60 % of the iMLE, whereas expiratory volume significantly decreased at all lifting loads.Conclusions: Preparative pre-lifting behaviours alter IAP and breathing and are co-ordinated by the lifting load magnitude. These behaviours appear to be functionally important for dynamic lifting. © 2014, Springer-Verlag Berlin Heidelberg.
Mihara T.,Yokohama City University |
Itoh H.,International University of Health and Welfare |
Hashimoto K.,Sagamihara Kyodo Hospital |
Goto T.,Yokohama City University
Anesthesia and Analgesia | Year: 2013
Background: Obturator nerve block is performed on patients who undergo transurethral resection of inferolateral bladder tumors to prevent thigh adductor muscle contraction. However, other than the tumor site, we have no criteria to judge whether this block is necessary in all patients. Moreover, it is difficult to predict the efficacy of obturator nerve block before resection. To solve these problems, we have devised a trans-resectoscope stimulation technique that involves delivering several single-twitch electrical stimuli to the inside wall of the bladder via a resectoscope to elicit contraction of the thigh adductor muscle. Methods: Trans-resectoscope stimulation was performed in 51 cases on 45 patients for which urologists had requested obturator nerve block. If no thigh adductor muscle contraction was observed with trans-resectoscope stimulation (i.e., negative result), tumor resection was performed without further investigation. If the result was positive, we performed obturator nerve block or administered a muscle relaxant until the result turned negative. Positive or negative responses to the initial trans-resectoscope stimulation and thigh adductor muscle contraction during subsequent resection were recorded. Results: The initial trans-resectoscope stimulation result was negative in 29 of the 51 cases (57%). In these cases, tumor resection was allowed to proceed, and no thigh adductor muscle contraction occurred (rate of incidence [95% confidence interval]: 0% [0%-5.7%]). In cases with a positive initial trans-resectoscope stimulation result (22/51 or 43%), we performed an obturator nerve block or administered a muscle relaxant after which we once again stimulated to verify the lack of adductor response before proceeding with the resection, and no thigh adductor muscle contraction was observed during resection. Conclusions: Trans-resectoscope stimulation is beneficial not only to predict the need to block the contraction of the thigh adductor during tumor resection but also to avoid unnecessary obturator nerve block. © 2013 International Anesthesia Research Society.
PubMed | National Center for Global Health and Medicine, Sagamihara Kyodo Hospital and Keio University
Type: | Journal: Radiation oncology (London, England) | Year: 2015
We report the feasibility and treatment outcomes of image-guided three-dimensional conformal arc radiotherapy (3D-CART) using a C-arm linear accelerator with a computed tomography (CT) on-rail system for localized prostate cancer.Between 2006 and 2011, 282 consecutive patients with localized prostate cancer were treated with in-room CT-guided 3D-CART. Biochemical failure was defined as a rise of at least 2.0 ng/ml beyond the nadir prostate-specific antigen level. Toxicity was scored according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0.A total of 261 patients were analyzed retrospectively (median follow-up: 61.6 months). The median prescribed 3D-CART dose was 82 Gy (2 Gy/fraction, dose range: 78-86 Gy), and 193 of the patients additionally received hormonal therapy. The 5-year overall survival rate was 93.9 %. Among low-, intermediate-, and high-risk patients, 5-year rates of freedom from biochemical failure were 100, 91.5 and 90.3 %, respectively. Rates of grade 2-3 late gastrointestinal and genitourinary toxicities were 2.3 and 11.4 %, respectively. No patient experienced late grade 4 or higher toxicity.In-room CT-guided 3D-CART was feasible and effective for localized prostate cancer. Treatment outcomes were comparable to those previously reported for intensity-modulated radiotherapy.
PubMed | Tokai University and Sagamihara Kyodo Hospital
Type: Journal Article | Journal: Cardiovascular intervention and therapeutics | Year: 2016
A 60year-old man presenting with chest pain was diagnosed with acute ST-elevated myocardial infarction. An emergency coronary angiography showed distal left circumflex artery (LCX) occlusion. The ostium of the right coronary artery (RCA) was not detectable. Following primary percutaneous coronary intervention in the occluded LCX, we confirmed that RCA region was fed from both LAD and LCX. Coronary computed tomography showed similar findings. This single coronary artery anomaly is extremely rare and cannot be categorized according to the established classification system.
PubMed | Sagamihara Kyodo Hospital and Keio University
Type: | Journal: Journal of cardiothoracic surgery | Year: 2015
The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer.We reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter.In all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (785 years vs 699 years, P=0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.940.15 vs. 0.810.11, P=0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95 % confidence interval 1.5-3.5; P=0.0002) and age (1-year increase; odds ratio 1.2, 95 % confidence interval 1.1-1.3; P=0.03) were found to be independent predictors of postoperative cardiopulmonary complications.A finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery.
PubMed | Sagamihara Kyodo Hospital
Type: | Journal: World journal of surgical oncology | Year: 2015
A 45-year-old female was diagnosed as having lung adenocarcinoma harboring an anaplastic lymphoma kinase (ALK) rearrangement, stage IV (T2bN3M1b). She was treated with crizotinib as second-line chemotherapy. The clinical stage after crizotinib treatment was ycT2aN0M0, stage IB. We performed a left lower lobectomy and lymph node dissection aimed at local control and pathological confirmation of the remaining tumor. The final pathological stage was ypT2aN2M0, stage IIIA with Ef 1b. To the best of our knowledge, this is the first case report of surgical resection in ALK rearrangement-positive lung adenocarcinoma after crizotinib treatment.