Kanazawa-shi, Japan
Kanazawa-shi, Japan

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PubMed | Kanazawa Insurance Hospital, Saiseikai Kanazawa Hospital and Kanazawa University
Type: Journal Article | Journal: Hypertension research : official journal of the Japanese Society of Hypertension | Year: 2016

The mineralocorticoid receptor (MR) is expressed in the kidneys and in adipose tissue, and primary aldosteronism (PA) is associated with metabolic syndrome. This study assessed the effects of MR blockade by eplerenone (EPL) and spironolactone (SPL) on blood pressure (BP) and metabolic factors in patients with PA. Fifty-four patients with PA were treated with one of two MRAs, EPL (25-100 mg daily, n=27) or SPL (12.5-100 mg daily, n=27) for 12 months. Visceral (VAT) and subcutaneous adipose tissue were quantified using CT and FatScan imaging analysis software. Body mass index, homeostasis model assessment-insulin resistance (HOMA-IR), serum creatinine, potassium and lipids, urinary albumin excretion (UAE) and plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were measured before and after treatment. EPL and SPL decreased BP and increased serum potassium levels to similar degrees. PAC and PRA did not differ between the two groups. Although treatment with the MRAs did not change HOMA-IR or serum lipids, they significantly decreased UAE and VAT (P<0.05). These results suggest that EPL and SPL are effective and safe for the treatment of PA. The long-term metabolic and renal effects of these MRAs should be further investigated.


PubMed | Red Cross, Suzu General Hospital, Kanazawa Social Insurance Hospital, Komatsu Municipal Hospital and 7 more.
Type: Clinical Trial | Journal: PloS one | Year: 2014

Magnifying narrow-band imaging (M-NBI) is more accurate than white-light imaging for diagnosing small gastric cancers. However, it is uncertain whether moving M-NBI images have additional effects in the diagnosis of gastric cancers compared with still images.A prospective multicenter cohort study.To identify the additional benefits of moving M-NBI images by comparing the diagnostic accuracy of still images only with that of both still and moving images. Still and moving M-NBI images of 40 gastric lesions were obtained by an expert endoscopist prior to this prospective multicenter cohort study. Thirty-four endoscopists from ten different Japanese institutions participated in the prospective multicenter cohort study. Each study participant was first tested using only still M-NBI images (still image test), then tested 1 month later using both still and moving M-NBI images (moving image test). The main outcome was a difference in the diagnostic accuracy of cancerous versus noncancerous lesions between the still image test and the moving image test.Thirty-four endoscopists were analysed. There were no significant difference of cancerous versus noncancerous lesions between still and moving image tests in the diagnostic accuracy (59.9% versus 61.5%), sensitivity (53.4% versus 55.9%), and specificity (67.0% versus 67.6%). And there were no significant difference in the diagnostic accuracy between still and moving image tests of demarcation line (65.4% versus 65.5%), microvascular pattern (56.7% versus 56.9%), and microsurface pattern (48.1% versus 50.9%). Diagnostic accuracy showed no significant difference between the still and moving image tests in the subgroups of endoscopic findings of the lesions.The addition of moving M-NBI images to still M-NBI images does not improve the diagnostic accuracy for gastric lesions. It is reasonable to concentrate on taking sharp still M-NBI images during endoscopic observation and use them for diagnosis.Umin.ac.jp UMIN-CTR000008048.


Oe K.,Saiseikai Kanazawa Hospital | Araki T.,Saiseikai Kanazawa Hospital | Ogawa H.,Saiseikai Kanazawa Hospital | Nakashima A.,Saiseikai Kanazawa Hospital | Sato K.,Kanazawa Medical University
Journal of Infection and Chemotherapy | Year: 2010

An 80-year-old woman was admitted with dyspnea. She had been treated with oral prednisolone for bronchial asthma. She was intravenously treated with dexamethasone. On the 9th day, she presented oliguria and thrombocytopenia. She was diagnosed as dehydration and disseminated intravascular coagulation, and was treated with hydration and heparin infusion. On the 12th day, she presented macroscopic hematuria and melena. Cystoscopy revealed hemorrhagic cystitis. Bone marrow aspiration showed hemophagocytosis. Serum antigen of cytomegalovirus (CMV) was positive. CD4+ T cell count was very low (40/μL). She was diagnosed as disseminated CMV infection, and was treated with gancyclovir and immunoglobulin infusion. On the 14th day, she died of pneumonia. This is the first report of fatal CMV infection during corticosteroid therapy for bronchial asthma. © 2010 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.


Sato K.,Kanazawa Medical University | Imai T.,Saiseikai Kanazawa Hospital | Shirota Y.,Saiseikai Kanazawa Hospital | Ueda Y.,Kanazawa Medical University | Katsuda S.,Kanazawa Medical University
Pathology Research and Practice | Year: 2010

Large cell neuroendocrine carcinoma (LCNEC) is a high-grade malignant neuroendocrine tumor that was first defined in the lungs. There are six previous reports on LCNEC in the gallbladder, comprising three cases combined with another tumor and three pure LCNECs. We describe a tumor combined with LCNEC and adenocarcinoma elements arising in the gallbladder and give a review of the literature. A 68-year-old woman was diagnosed as having gallbladder wall thickening and a hepatic mass. The surgically resected tumor had a dumbbell shape with gallbladder and liver elements. Histological examination revealed LCNEC in the liver and a deep infiltrative portion of the gallbladder, as well as a well-differentiated tubular adenocarcinoma in the mucosa of the gallbladder. The pseudoglandular structures of LCNEC were marked in the transitional area. Immunoreactivities for carcinoembryonic antigen and CA19-9 as well as for chromogranin A and synaptophysin were detected in the LCNEC element. High p53-protein expression and high proliferative activity estimated by Ki-67 positivity were observed in both elements. The results suggest a close relationship between LCNEC and adenocarcinoma, and support the theory that these elements originate from common cancer stem cells. © 2009 Elsevier GmbH.


Mori K.,Houju Memorial Hospital | Yamada K.,Kanazawa University | Konno T.,Kanazawa University | Inoue D.,Kanazawa University | And 6 more authors.
Internal Medicine | Year: 2015

We herein report the case of a 65-year-old man with pericardial involvement associated with autoimmune pancreatitis. Chest CT imaging showed pericardial thickening. The patient responded to corticosteroid therapy, and the pericardial thickening resolved. Multiple organs are involved in immunoglobulin G4 (IgG4)- related disease (IgG4-RD); however, only a few cases of IgG4-related chronic constrictive pericarditis have been reported. To our knowledge, this is the first reported case of IgG4-RD with pericardial involvement at an early stage. This case indicates that recognizing pericardial complications in autoimmune pancreatitis is important and that CT imaging may be useful for obtaining the diagnosis and providing follow-up of pericardial lesions in cases of IgG4-RD. © 2015 The Japanese Society of Internal Medicine.


Katano K.,Saiseikai Kanazawa Hospital | Kakuchi Y.,Saiseikai Kanazawa Hospital | Nakashima A.,Saiseikai Kanazawa Hospital | Nakahama K.,Saiseikai Kanazawa Hospital | Kawano M.,Kanazawa University
Clinical and Experimental Nephrology | Year: 2010

A 54-year-old Japanese man entered our hospital for investigation of appetite loss. His blood pressure was 201/113 mmHg, and laboratory findings revealed renal failure and hyponatremia. On physical examination, disorientation and dysarthria were observed. Hemodialysis was performed the same day. Magnetic resonance imaging (MRI) after hemodialysis revealed swelling of the brainstem and a high signal intensity on fluid-attenuated inversion recovery (FLAIR) imaging, similar to findings of central pontine myelinolysis (CPM), which is generally irreversible. However, on an apparent diffusion coefficient (ADC) map based on diffusion-weighted MRI, higher signal intensity was observed in the area of the high signal intensity on FLAIR imaging, which is not seen in CPM. The abnormal neurological symptoms improved within a few days, and MRI findings also normalized. We diagnosed the lesion as the brainstem variant of reversible posterior leukoencephalopathy syndrome (RPLS) with uremia. ADC map was very useful in diagnosing RPLS with uremia. © 2010 Japanese Society of Nephrology.


Katano K.,Saiseikai Kanazawa Hospital | Kakuchi Y.,Saiseikai Kanazawa Hospital | Nakashima A.,Saiseikai Kanazawa Hospital | Takahashi S.,Saiseikai Kanazawa Hospital | Kawano M.,Kanazawa University
Clinical Nephrology | Year: 2011

Hepatic and/or renal cyst infection is a major complication in patients with polycystic kidney disease. In many cases, drainage of infected cysts is necessary, although accurate detection of infected cysts from among the numerous hepatic or renal cysts present is often difficult, because the findings of infected cysts on computed tomography and T1- and T2-weighted magnetic resonance imaging resemble those of normal cysts. We describe here a case of polycystic kidney disease complicated by hepatic cyst infection. On diffusion-weighted magnetic resonance imaging (DWMRI), which is occasionally used in the diagnosis of cerebral abscesses, infected hepatic cysts showed higher signal intensity than other cysts, facilitating differentiation of the cysts requiring drainage from numerous other cysts. Infected cysts showed a marked decrease of the apparent diffusion coefficient (ADC) values compared with those of normal cysts. DWMRI was very effective in detecting infected cysts in our patient and may be of value in other such cases with polycystic kidney disease. ©2011 Dustri-Verlag Dr. K. Feistle.


Oe K.,Saiseikai Kanazawa Hospital | Araki T.,Saiseikai Kanazawa Hospital | Nakashima A.,Saiseikai Kanazawa Hospital | Sato K.,Kanazawa Medical University | And 2 more authors.
Internal Medicine | Year: 2010

A 73-year-old man was admitted to our hospital because of bilateral foot pain. He was treated with thrombolysis for cerebral infarction about 5 months ago. Anticoagulants had not been used because of hemorrhagic infarction. The pulses of bilateral pedal arteries were palpable, but cyanosis was present in the bilateral toes. Laboratory data indicated azotemia and eosinophilia. Magnetic resonance imaging revealed multiple plaques of the thoracic and abdominal aorta, one of which was ulcerated. Skin biopsy proved the diagnosis of cholesterol crystal embolism (CCE). Because no invasive vascular procedure was performed, we assumed that CCE in this patient was related to thrombolysis. We should be cautious for late onset of CCE after thrombolysis. © 2010 The Japanese Society of Internal Medicine.


Araki T.,Saiseikai Kanazawa Hospital | Oe K.,Saiseikai Kanazawa Hospital | Ohira M.,Saiseikai Kanazawa Hospital
Therapeutic Research | Year: 2014

Background : The relationship between novel oral anticoagulants (NOACs) and D-dimer levels in patients with atrial fibrillation (AF) is still unclear. Therefore, this study aimed to elucidate the effect of NOACs on D-dimer levels in patients with AF. Methods and Results : Six patients with nonvalvular AF who were not treated with warfarin and whose D-dimer levels were >0.5μg/mL were administered NOACs. The D-dimer levels significantly decreased 1 month after the initiation of NOAC therapy and were maintained at lower levels (<0.5μg/mL) thereafter in all patients. Conclusion : D-dimer may be a useful marker for assessing the efficacy of NOACs in patients with AF.


Miwa S.,Saiseikai Kanazawa Hospital | Yokogawa A.,Saiseikai Kanazawa Hospital | Kobayashi T.,Saiseikai Kanazawa Hospital | Nishimura T.,Saiseikai Kanazawa Hospital | And 3 more authors.
Journal of Spinal Disorders and Techniques | Year: 2015

Background: The recurrence of lumbar disk herniation (LDH) is a major problem in the treatment of LDH. The purpose of this study was to investigate the risk factors for recurrent LDH. Methods: Between April 2005 and March 2008, 298 patients with LDH, who underwent surgical treatment, were enrolled in this study. The patients were divided into a nonrecurrent group (N group) and a recurrent group (R group). We compared their clinical parameters including age, sex, body mass index, smoking, alcohol, sports activity, occupational lifting, and occupational driving. The relationships between the variables and recurrent LDH were evaluated by univariate analysis and multiple logistic regression analysis. Results: The N group had 266 patients (89.3%) and the R group had 32 patients (10.7%). Univariate analysis showed that current smoking (P<0.001) and occupational lifting (P=0.02) significantly correlated with recurrent LDH. Multivariate analysis showed that current smoking significantly related with recurrent LDH (OR, 3.47; 95% CI, 1.55-7.80; P=0.003). Conclusions: Our study suggests that smoking cessation and restraining from lifting may significantly decrease the incidence of recurrent LDH. © 2013 Wolters Kluwer Health, Inc. All rights reserved.

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