Nara-shi, Japan
Nara-shi, Japan

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Shirone N.,Takai Hospital | Shinkai T.,Nara Medical University | Yamane T.,Institute of Biomedical Research and Innovation | Uto F.,Takai Hospital | And 7 more authors.
Annals of Nuclear Medicine | Year: 2012

Objective 2- [ 18F]fluoro-2-deoxy-D-glucose (FDG) is known to accumulate in benign conditions such as infection and inflammation as well as in malignancy. Vaccination may cause transient inflammation of lymph nodes, which may induce false-positive findings on FDG-positron emission tomography (PET) imaging. This study investigated the influence of influenza vaccination on FDG-PET/CT imaging in normal subjects. Methods Between November 2008 and March 2009, a total of 172 examinees underwent FDG-PET/CT during an annual cancer-screening program at our hospital, 83 of whom had a history of recent non-adjuvanted seasonal influenza vaccination. They were asked the date and injection site of the vaccination. Examinees were divided into 2 groups based on the interval after vaccination using a cutoff value of 7 days (1 week). Two double boardcertified nuclear medicine physicians and radiologists visually interpreted the FDG-PET/CT images with reference to PET/CT fusion and CT images and checked the location and the number of abnormal accumulations by consensus reading. Results Intervals between vaccination and FDG-PET were less than 7 days in 5 examinees, and 7 days or more in 78 examinees. Unexpected accumulations were visualized in 4 examinees in the axilla and medial upper arm, and all of them belonged to the group who underwent vaccination less than 7 days previously. In the second group there was no abnormal FDG accumulation. Conclusions Recent influenza vaccination before FDGPET/ CT examination may cause ipsilateral axillary lymph node accumulations, especially within several days after vaccination. Questionnaires about vaccination can help to avoid false interpretation of FDG avid axillary lymph nodes. © The Japanese Society of Nuclear Medicine 2012.


Okamoto N.,Nara Medical University | Tomioka K.,Nara Medical University | Saeki K.,Nara Medical University | Morikawa M.,Sakai City Mental Health Center | And 3 more authors.
Journal of the American Geriatrics Society | Year: 2012

Objectives To investigate the relationship between swallowing problems and the number of remaining teeth in healthy elderly people. Design Cross-sectional. Setting Nara, Japan. Participants Three thousand six hundred sixty-three male and female volunteers aged 65 and older who were living independently were analyzed. Measurements Swallowing problems were defined operationally using a questionnaire and the 30-mL water swallow test. Data were collected on the number of remaining teeth, maximum bite force, occlusal status, presence or absence of oral dryness, and medical history. Results The prevalence of swallowing problems was 15.1% (n = 554) in this population. A positive correlation was observed between the number of remaining teeth and maximum bite force. The number of remaining teeth was categorized according to tertiles. Multiple logistic regression analysis revealed that the adjusted odds ratios for 0 to 13 or 14 to 24 remaining teeth to 25 to 32 remaining teeth for swallowing problems were 2.04 (95% confidence interval (CI) = 1.60-2.60) and 1.31 (95% CI = 1.02-1.70), respectively. Significant increases in these odds ratios were found in a trend test (P <.001). Conclusion Tooth loss is associated with swallowing problems. Having fewer teeth inhibits masticatory ability, which disturbs the execution of smooth swallowing. Preventive measures against tooth loss at a younger age may be effective at reducing the risk of laryngeal penetration and aspiration at an older age. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.


Mibu H.,Nara Medical University | Mibu H.,Nara Prefectural Gojyo Hospital | Tanaka N.,Nara Medical University | Hosokawa Y.,Nara Medical University | And 6 more authors.
World Journal of Urology | Year: 2015

Purpose: The change in functional renal volume (FRV) has an absolute influence on renal function after nephrectomy (Nx) or nephron-sparing surgery (NSS). In this study, we prospectively examined whether the postoperative renal function following Nx and NSS could be accurately predicted and assessed the reproducibility of our newly developed 3-D image reconstruction system (Kashihara) to measure the FRV. Methods: We enrolled 98 patients who underwent Nx and 41 patients who underwent NSS from April 2006 to September 2009 to predict postoperative FRV and renal function. FRV was measured before and after (1 month and 1 year) renal surgery. The postoperative estimated glomerular filtration rate (eGFR) was predicted from the preoperative eGFR calculated from the serum creatinine (sCr) level and the ratio of the postoperative/preoperative FRV. To assess the reproducibility and accuracy of our newly developed 3-dimensional (3-D) image reconstruction system, FRV was measured by five examiners using images obtained by CT (five cases) and MRI (five cases). Results: Significant correlation was found both for FRV and for renal function between the predictive values and the actually measured values at 1 month and 1 year after surgery, not only in the Nx group, but also in the NSS group. The accuracy and reproducibility could be confirmed both with CT and MRI studies. Conclusions: The postoperative FRV and renal function could be predicted preoperatively using a 3-D image reconstructive system, preoperative routine diagnostic imaging, and preoperative sCr level. © 2015, Springer-Verlag Berlin Heidelberg.


Shiota T.,Saiseikai Nara Hospital | Torimoto K.,Nara Medical University | Momose H.,Hoshigaoka Medical Center | Nakamuro T.,Saiseikai Nara Hospital | And 4 more authors.
BMC Research Notes | Year: 2014

Conclusions: Anticholinergic medicines can cause cognitive impairment in elderly people, and attention should be paid to cognition when elderly overactive bladder patients are treated with anticholinergic medicines.Case presentation. The first case was a 79-year-old female patient to whom imidafenacin (0.2 mg) was administered daily to control her frequent micturition and urgency. She was taking the following medicines: etizolam, triazolam, captopril, bisoprolol, and amlodipine besylate. Her Hasegawa dementia rating scale-revised was impaired from 26/30 to 17/30 and recovered to 25/30 after the imidafenacin treatment was stopped. The second case was an 82-year-old female patient to whom imidafenacin (0.2 mg) was administered daily for frequent micturition and urgency. She was taking the following medicines: losartan potassium and clenbuterol. Her Hasegawa dementia rating scale-revised decreased from 28/30 to 19/30 and recovered to 24/30 after the imidafenacin treatment was stopped. In our patients who were taking multiple medicines, there is a possibility that medicines other than anticholinergics may have caused cognitive impairment. We need to keep in mind that many elderly people take multiple medicines because of comorbidity.Background: Cognitive impairment is one of the side effects of using anticholinergic medicines for overactive bladder; however, its incidence has not been fully reported. We experienced two elderly Japanese patients with overactive bladder who had temporary cognitive impairment caused by anticholinergic medicines. © 2014Shiota et al.; licensee BioMed Central Ltd.


Taniguchi A.,Nara Medical University | Takakura Y.,Nara Medical University | Sugimoto K.,Nara Medical University | Sugimoto K.,Saiseikai Nara Hospital | And 6 more authors.
Journal of Bone and Joint Surgery - Series B | Year: 2012

The purpose of this study was to evaluate the clinical results of a newly designed prosthesis to replace the body of the talus in patients with aseptic necrosis. Between 1999 and 2006, 22 tali in 22 patients were replaced with a ceramic prosthesis. A total of eight patients were treated with the first-generation prosthesis, incorporating a peg to fix into the retained neck and head of the talus, and the remaining 14 were treated with the second-generation prosthesis, which does not have the peg. The clinical results were assessed by the American Orthopaedic Foot and Ankle Society ankle/hindfoot scale. The mean follow-up was 98 months (18 to 174). The clinical results of the first-generation prostheses were excellent in three patients, good in one, fair in three and poor in one. There were, however, radiological signs of loosening, prompting a change in design. The clinical results of the second-generation prostheses were excellent in three patients, good in five, fair in four and poor in two, with more favourable radiological appearances. Revision was required using a total talar implant in four patients, two in each group. Although the second-generation prosthesis produced better results, we cannot recommend the use of a talar body prosthesis. We now recommend the use of a total talar implant in these patients. ©2012 British Editorial Society of Bone and Joint Surgery.


Okahashi K.,Saiseikai Nara Hospital | Fujisawa Y.,Nara Shin | Sugimoto K.,Nara Prefectural Nara Hospital | Tanaka Y.,Nara Medical University
Techniques in Knee Surgery | Year: 2010

High tibial osteotomy was carried out in 136 knees of 107 patients (25 men with 33 knees and 82 women with 103 knees) with medial gonarthrosis at our hospital between 1988 and 2008. The average age of the patients at the time of the osteotomy was 62 years (range, 44 to 84). Second-look arthroscopy was carried out in 30 knees of 26 patients 14 months after the osteotomy (range, 3 to 40). The series included 6 men with 6 knees and 20 women with 24 knees. The average age of the patients at the time of the second-look procedure was 61 years (range, 53 to 76). The Fujisawa classification was used for the arthroscopic grading of osteoarthritis. Thirty knees of 26 patients participating in the follow-up arthroscopic examination showed grade-joint cartilage destruction on both the medial femoral and tibial condyles at the initial arthroscopy. At the second-look arthroscopy, the medial femoral condyles were classified as Grade II in 5 knees, Grade III in 23 knees, Grade IV in 2 knees; the medial tibial condyles were classified as Grade II in 7 knees, Grade III in 20 knees, and Grade IV in 3 knees. Improvement of the joint cartilage status was confirmed on the medial femoral condyle in 28 knees (93.3%) and on the medial tibial condyle in 27 knees (90%). Histologic examination showed that regenerated cartilage after the HTO was hyaline-like cartilage in 6 cases. Copyright © 2010 by Lippincott Williams & Wilkins.


Nakano S.,Saiseikai Nara Hospital | Takekoshi H.,Obihiro University of Agriculture and Veterinary Medicine | Takekoshi H.,Hokkaido Medicinal Plant Research Institute | Nakano M.,Obihiro University of Agriculture and Veterinary Medicine | And 2 more authors.
Plant Foods for Human Nutrition | Year: 2010

Pregnancy anemia and pregnancy-induced hypertension (PIH) are common and potentially dangerous disorder in human pregnancy, and nutritional status of pregnant women is one of the leading causes. Chlorella contains large quantities of folate, vitamin B-12 and iron, and can help improve anemia and hypertensive disorder. Our objective was to investigate the preventive effects of Chlorella supplement on pregnancy anemia and PIH in Japanese pregnant women. A total of 70 pregnant women were placed into the control group (n=38) or the Chlorella group (n=32). The subjects in the Chlorella group were supplemented daily from 12th-18th wk of gestation until delivery with 6 g of Chlorella supplement. The proportion of anemic (hemoglobin level <11 g/dL) subjects in the Chlorella group were significantly lower compared with the control group at the second and third trimesters. Additionally, in the Chlorella group, the incidences of proteinuria and edema, signs of PIH, were significantly lower during the third trimester. These results suggest that Chlorella supplementation significantly reduces the risk of pregnancy associated anemia, proteinuria and edema. Chlorella supplement may be useful as a resource of natural folate, vitamin B-12 and iron for pregnant women. © Springer Science+Business Media, LLC 2009.


Katayama M.,Senri Chuou Hospital | Katayama M.,Kobe University | Naritomi H.,Director of Senri Chuou Hospital | Nishio H.,Kobe University | And 4 more authors.
Kobe Journal of Medical Sciences | Year: 2011

Spinal muscular atrophy (SMA) type 2 is a motor neuron disease that leads to severe congenital muscle atrophy. The majority of adult patients are at risk of death due to respiratory failure. Here, we report on two patients with SMA type 2 who repeatedly developed bronchitis and pneumonia. The patient in Case 1 was a 48-year-old female lacking exon 7 of the survival motor neuron gene (SMN) 1. The patient in Case 2 was a 37-year-old female lacking exons 7 and 8 in SMN 1 and exon 5 in the neuronal apoptosis inhibitory protein (NAIP) gene. We applied continuous positive airway pressure (CPAP) in both cases because their data on polysomnography showed obstructive sleep apnea (OSA). CPAP treated their respiratory symptoms as well as those due to OSA. Moreover, CPAP stabilized the respiratory condition of Case 1 for seven years and seven months and that of Case 2 for five years and four months. These findings suggest that CPAP alone can achieve long-term improvement in the respiratory condition in patients with SMA type2.


PubMed | Saiseikai Nara Hospital
Type: Controlled Clinical Trial | Journal: Plant foods for human nutrition (Dordrecht, Netherlands) | Year: 2010

Pregnancy anemia and pregnancy-induced hypertension (PIH) are common and potentially dangerous disorder in human pregnancy, and nutritional status of pregnant women is one of the leading causes. Chlorella contains large quantities of folate, vitamin B-12 and iron, and can help improve anemia and hypertensive disorder. Our objective was to investigate the preventive effects of Chlorella supplement on pregnancy anemia and PIH in Japanese pregnant women. A total of 70 pregnant women were placed into the control group (n = 38) or the Chlorella group (n = 32). The subjects in the Chlorella group were supplemented daily from 12th-18th wk of gestation until delivery with 6 g of Chlorella supplement. The proportion of anemic (hemoglobin level < 11 g/dL) subjects in the Chlorella group were significantly lower compared with the control group at the second and third trimesters. Additionally, in the Chlorella group, the incidences of proteinuria and edema, signs of PIH, were significantly lower during the third trimester. These results suggest that Chlorella supplementation significantly reduces the risk of pregnancy associated anemia, proteinuria and edema. Chlorella supplement may be useful as a resource of natural folate, vitamin B-12 and iron for pregnant women.

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