Kukichūō, Japan
Kukichūō, Japan

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Sengoku R.,Jikei University School of Medicine | Sengoku R.,Tokyo Metropolitan Geriatric Hospital | Matsushima S.,Jikei University School of Medicine | Murakami Y.,Saiseikai Kurihashi Hospital | And 6 more authors.
Internal Medicine | Year: 2014

We herein report that the clinical, laboratory, and radiographic features and positron emission tomography (PET) imaging may provide valuable clues to the pathogenesis of cerebral amyloid angiopathy (CAA)associated encephalopathy, which currently remains unclear. We herein describe two cases of encephalopathy with CAA, with an emphasis on PET imaging with11C-Pittsburgh compound B (11C-PiB) and18Ffluorodeoxyglucose (18F-FDG). One case of Alzheimer’s disease for which a brain biopsy was performed showed CAA-related inflammation. Another case that had developed sudden sensory aphasia presented with posterior reversible encephalopathy syndrome-like vasogenic edema in the left temporal region with11C-PiB uptake and microhemorrhages.11C-PiB and18F-FDG PET are useful for detecting CAA-associated encephalopathy, including atypical CAA cases. © 2014 The Japanese Society of Internal Medicine.


Ando M.,Juntendo University | Funayama M.,Juntendo University | Li Y.,Juntendo University | Kashihara K.,Okayama Kyokuto Hospital | And 15 more authors.
Movement Disorders | Year: 2012

Vacuolar protein sorting 35 (VPS35) was recently reported to be a pathogenic gene for late-onset autosomal dominant Parkinson's disease (PD), using exome sequencing. To date, VPS35 mutations have been detected only in whites with PD. The aim of the present study was to determine the incidence and clinical features of Asian PD patients with VPS35 mutations. We screened 7 reported nonsynonymous missense variants of VPS35, including p.D620N, known as potentially disease-associated variants of PD, in 300 Japanese index patients with autosomal dominant PD and 433 patients with sporadic PD (SPD) by direct sequencing or high-resolution melting (HRM) analysis. In addition, we screened 579 controls for the p.D620N mutation by HRM analysis. The p.D620N mutation was detected in 3 patients with autosomal dominant PD (1.0%), in 1 patient with SPD (0.23%), and in no controls. None of the other reported variants of VPS35 were detected. Haplotype analysis suggested at least 3 independent founders for Japanese patients with p.D620N mutation. Patients with the VPS35 mutation showed typical tremor-predominant PD. We report Asian PD patients with the VPS35 mutation. Although VPS35 mutations are uncommon in PD, the frequency of such mutation is relatively higher in Japanese than reported in other populations. In VPS35, p.D620N substitution may be a mutational hot spot across different ethnic populations. Based on the clinical features, VPS35 should be analyzed in patients with PD, especially autosomal dominant PD or tremor-predominant PD. © 2012 Movement Disorder Society.


Takara A.,Saiseikai Kurihashi Hospital | Ogawa H.,Tokyo Women's Medical University | Endoh Y.,Saiseikai Kurihashi Hospital | Mori F.,Tokyo Women's Medical University | And 6 more authors.
Cardiovascular Diabetology | Year: 2010

Background: The long-term prognosis of diabetic patients with acute myocardial infarction (AMI) treated by acute revascularization is uncertain, and the optimal pharmacotherapy for such cases has not been fully evaluated.Methods: To elucidate the long-term prognosis and prognostic factors in diabetic patients with AMI, a prospective, cohort study involving 3021 consecutive AMI patients was conducted. All patients discharged alive from hospital were followed to monitor their prognosis every year. The primary endpoint of the study was all-cause mortality, and the secondary endpoint was the occurrence of major cardiovascular events. To elucidate the effect of various factors on the long-term prognosis of AMI patients with diabetes, the patients were divided into two groups matched by propensity scores and analyzed retrospectively.Results: Diabetes was diagnosed in 1102 patients (36.5%). During the index hospitalization, coronary angioplasty and coronary thrombolysis were performed in 58.1% and 16.3% of patients, respectively. In-hospital mortality of diabetic patients with AMI was comparable to that of non-diabetic AMI patients (9.2% and 9.3%, respectively). In total, 2736 patients (90.6%) were discharged alive and followed for a median of 4.2 years (follow-up rate, 96.0%). The long-term survival rate was worse in the diabetic group than in the non-diabetic group, but not significantly different (hazard ratio, 1.20 [0.97-1.49], p = 0.09). On the other hand, AMI patients with diabetes showed a significantly higher incidence of cardiovascular events than the non-diabetic group (1.40 [1.20-1.64], p < 0.0001). Multivariate analysis revealed that three factors were significantly associated with favorable late outcomes in diabetic AMI patients: acute revascularization (HR, 0.62); prescribing aspirin (HR, 0.27); and prescribing renin-angiotensin system (RAS) inhibitors (HR, 0.53). There was no significant correlation between late outcome and prescription of beta-blockers (HR, 0.97) or calcium channel blockers (HR, 1.27). Although standard Japanese-approved doses of statins were associated with favorable outcome in AMI patients with diabetes, this was not statistically significant (0.67 [0.39-1.06], p = 0.11).Conclusions: Although diabetic patients with AMI have more frequent adverse events than non-diabetic patients with AMI, the present results suggest that acute revascularization and standard therapy with aspirin and RAS inhibitors may improve their prognosis. © 2010 Takara et al; licensee BioMed Central Ltd.


Ohtake H.,Yamagata University | Kawamura H.,Sanyudo Hospital | Matsuzaki M.,Hoshi General Hospital | Yokoyama E.,Sanyudo Hospital | And 3 more authors.
Annals of Diagnostic Pathology | Year: 2010

Only 17 cases of oncocytic adrenocortical carcinoma have been reported in the English literature. Here, we report an incidental case of oncocytic adrenocortical carcinoma. The patient was a 69-year-old man with the chief complaint of abdominal pain. Abdominal computed tomography revealed a left adrenal tumor. No hormonal symptoms were observed. The excised tumor was whitish, encapsulated, and 75 × 60 × 45 mm in size. Large polygonal tumor cells were arranged in a generally diffuse architecture and exhibited abundant eosinophilic granular cytoplasm. Nuclear atypia with atypical mitotic figures and capsular and sinusoidal invasions were observed. The tumor cells were immunopositive for vimentin, neuron-specific enolase, and synaptophysin but not for α-inhibin, melan A, or p53. Diffuse and strong immunopositivity with an antimitochondrial antibody proved that this tumor was truly oncocytic. Upon review of previous cases of oncocytic adrenocortical tumors, we reconsidered the diagnostic findings of the potential for malignancy. © 2010 Elsevier Inc. All rights reserved.


Suto C.,Saiseikai Kurihashi Hospital | Suto C.,Tokyo Women's Medical University | Morinaga M.,Saiseikai Kurihashi Hospital | Morinaga M.,Tokyo Women's Medical University | And 4 more authors.
Infection and Drug Resistance | Year: 2012

Objective: To determine the trends of conjunctival sac bacterial flora isolated from patients prior to cataract surgery. Subjects and methods: The study comprised 579 patients (579 eyes) who underwent cataract surgery. Specimens were collected by lightly rubbing the inferior palpebral conjunctival sac with a sterile cotton swab 2 weeks before surgery, and then cultured for isolation of bacteria and antimicrobial sensitivity testing. The bacterial isolates and percentage of drug-resistant isolates were compared among age groups and according to whether or not patients had diabetes mellitus, hyperlipidemia, dialysis therapy, oral steroid use, dry eye syndrome, or allergic conjunctivitis. Results: The bacterial isolation rate was 39.2%. There were 191 strains of Gram-positive cocci, accounting for the majority of all isolates (67.0%), among which methicillin-sensitive coagulase-negative staphylococci was the most frequent (127 strains, 44.5%), followed by methicillin-resistant coagulase-negative staphylococci (37 strains, 12.7%). All 76 Gram-positive bacillary isolates (26.7%) were from the genus Corynebacterium. Among the 16 Gram-negative bacillary isolates (5.9%), the most frequent was Escherichia coli (1.0%). The bacterial isolation rate was higher in patients. >60 years old, and was lower in patients with dry eye syndrome, patients under topical treatment for other ocular disorders, and patients with hyperlipidemia. There was no significant difference in bacterial isolation rate with respect to the presence/ absence of diabetes mellitus, steroid therapy, dialysis, or a history of allergic conjunctivitis. Methicillin-resistant coagulase-negative staphylococci showed a significantly higher detection rate in diabetic patients than nondiabetic patients (20.3% versus 7.0%, P < 0.05). The percentage of all isolates resistant to levofloxacin, cefmenoxime, and tobramycin was 14.0%, 15.2%, and 17.9%, respectively, with no significant differences among these drugs. Conclusion: The high bacterial isolation rate in patients. >60 years old and the high methicillinresistant coagulase-negative staphylococci isolation rate in patients with diabetes are important to consider for prevention of perioperative infections. © 2012 Suto et al, publisher and licensee Dove Medical Press Ltd.


Matsumoto T.,Saiseikai Kurihashi Hospital | Matsumoto T.,Tokyo Women's Medical University | Kanzaki M.,Tokyo Women's Medical University | Amiki M.,Saiseikai Kurihashi Hospital | And 5 more authors.
European Journal of Cardio-thoracic Surgery | Year: 2012

Objectives: Several types of practical three-dimensional (3D) imaging software programs are available, including those attached to computed tomographic devices. Three different software programs (Advantage Workstation Volume Share 4, OsiriX and CTTRY) were used to generate 3D images on the basis of imaging data obtained by 64-slice multidetector-row computed tomography in the same patient. Methods: Surgery was then performed referring to these 3D images in five patients. The characteristics, advantages, disadvantages and utility in the operative field of the images generated with each software program were compared with respect to actual operative findings. Results: There were no marked differences in vascular images at the segmental level among the software programs, and all three were considered useful for surgery. However, vascular images at the subsegmental level differed among the three programs. Conclusions: The depiction of blood vessels at the subsegmental level lacked accuracy when compared with operative findings. © The Author 2011. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


Matsuura K.,Nojima Hospital | Suto C.,Tokyo Women's Medical University | Suto C.,Saiseikai Kurihashi Hospital | Inoue Y.,Tottori University | And 3 more authors.
Journal of Ocular Pharmacology and Therapeutics | Year: 2014

Purpose: To assess the safety of intracameral injection of moxifloxacin (MFLX) using the total replacement technique [bag and chamber (BC) flushing]. Methods: The anterior chamber including the area behind the intraocular lens was irrigated and replaced using BC flushing. In Group A, 36 patients received balanced salt solution irrigation in the right eye and intracameral MFLX (150 μg/mL: 33-fold dilution of 0.5% eye drops) in the left eye. In Group B, 33 patients received intracameral MFLX in the right (500 μg/mL: 10-fold dilution) and left eyes (150 μg/mL: 33-fold dilution). Visual acuity, intraocular pressure, corneal endothelial cell density, corneal thickness, and foveal thickness were recorded before and up to 3 months after surgery. Results: In either group, there were no statistically significant differences between the right and left eyes with respect to visual acuity, intraocular pressure, corneal endothelial cell count, and foveal thickness before and at 3 months after surgery. There was no difference in corneal thickness before and at 3 months after surgery. In patients who received 500 μg/mL MFLX during surgery, central corneal thickness at 1 week after surgery was significantly reduced. Conclusions: In the present study, there was no adverse effect associated with intracameral injection of 150-500 μg/mL MFLX. Moreover, our results supported the safety of BC flushing. Thus, BC flushing, which can irrigate the inside of the capsular bag and attain stable antibiotic concentrations, appears to be a favorable technique for intracameral injection of MFLX. © 2014 Mary Ann Liebert, Inc.


Suto C.,Saiseikai Kurihashi Hospital | Suto C.,Tokyo Women's Medical University | Shimamura E.,Tokyo Women's Medical University | Watanabe I.,Saiseikai Kurihashi Hospital
Journal of Cataract and Refractive Surgery | Year: 2015

Purpose To compare the measurements and intraocular lens (IOL) power calculations obtained with an optical biometer (AL-Scan) and partial coherence interferometry (PCI) device (IOLMaster 500), and to evaluate the accuracy of the Camellin-Calossi IOL formula in virgin eyes. Setting Saiseikai Kurihashi Hospital, Saitama, Japan. Design Prospective comparative study. Methods Measurements were compared from 262 patients (450 eyes) scheduled for cataract surgery. Axial length (AL), keratometry (K), anterior chamber depth (ACD), and number of eyes that were successfully measured were compared. Comparisons were performed of the residual postoperative refractive error with the SRK/T, Haigis, and Camellin-Calossi IOL formulas with optical biometer data. The IOL constant was optimized for 81 eyes that had iSertMicro 251 IOL implantation. Results The mean difference in AL between biometers was -0.012 mm ± 0.031 (SD) (P <.0001). Correlation coefficients (r) for AL, keratometry, and ACD were 0.9997, 0.9836, and 0.9571, respectively. The calculated IOL constant for the Camellin-Calossi formula was 119.3. The optimized IOL constant for the SRK/T was 118.8, the same as that of the User Group for Laser Interference Biometry for the PCI device. For the Haigis formula, only a0 was optimized, and it was 1.390. After optimizing the A-constant for the Camellin-Calossi formula, the residual postoperative refractive error of the Camellin-Calossi formula was not statistically significantly different in comparison to those obtainied with the Haigis and SRK/T formulas. Conclusion Ocular biometry measurements were equivalent for both devices, indicating that the AL-Scan can be used for routine preoperative cataract assessment. The predictive accuracy of the Camellin-Calossi formula included in the optical biometer was equivalent to common IOL formulas for virgin eyes. © 2015 ASCRS and ESCRS.


PubMed | Tokyo Women's Medical University and Saiseikai Kurihashi Hospital
Type: | Journal: International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition | Year: 2016

Hemodialysis patients are prone to malnutrition because of diet or many uremic complications. The objective of this study is to determine whether thiamine deficiency is associated with regular dialysis patients.To determine whether thiamine deficiency is associated with regular dialysis patients, we measured thiamine in 100 patients undergoing consecutive dialysis.Average thiamine levels were not low in both pre-hemodialysis (50.1 75.9 ng/mL; normal range 24 - 66 ng/mL) and post-hemodialysis (56.4 61.7 ng/mL). In 18 patients, post-hemodialysis levels of thiamine were lower than pre-hemodialysis levels. We divided the patients into two groups, the decrease (thiamine/pre thiamine < 0; - 0.13 0.11) group (n = 18) and the increase (thiamine/pre thiamine> 0; 0.32 0.21)) group (n = 82). However, there was no significance between the two groups in Kt/V or type of dialyzer. Patients were dichotomized according to median serum thiamine level in pre-hemodialysis into a high-thiamine group ( 35.5 ng/mL) and a low-thiamine group (< 35.4 ng/mL), and clinical characteristics were compared between the two groups. The low-thiamine value group (< 35.4 ng/ml; 26.8 5.3 ng/ml) exhibited lower levels of serum aspartate aminotransferase and alanine aminotransferase than the high-thiamine value group ( 35.4 ng/ml; 73.5 102.5 ng/ml) although there was no significance in nutritional marker, Alb, geriatric nutritional risk index , protein catabolic rate and creatinine generation rate.In our regular dialysis patients, excluding a few patients, we did not recognize thiamine deficiency and no significant difference in thiamine value between pre and post hemodialysis.


PubMed | Saiseikai Kurihashi Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2017

We report the case of a 78-year-old man with liver metastases from rectal cancer treated with hepatectomy after 14 months of chemotherapy. This was the fourth hepatic recurrence after hepatectomy. Distant metastasis of colorectal cancer can be considered for resection, if it can be an R0 resection; however, there is no consensus regarding the timing and extent of resection. Although a study has shown the efficacy of perioperative chemotherapy for resectable liver metastasis from colorectal cancer, the regimen and duration of chemotherapy has not been established yet. It is important that an adequate treatment should be selected for each case, such as chemotherapy as systemic therapy and surgery as local therapy.

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