Saiseikai Yokohamashi Tobu Hospital

Yokohama-shi, Japan

Saiseikai Yokohamashi Tobu Hospital

Yokohama-shi, Japan
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Yamane M.,Sayama Hospital | Muto M.,Cardiovascular and Respiratory Center | Matsubara T.,Nagoya Heart Center | Nakamura S.,Kyoto Katsura Hospital | And 6 more authors.
EuroIntervention | Year: 2013

Aims: The retrograde approach to CTO is promising, but questions remain with regard to its wider application and the potential risks. This study evaluated the feasibility and efficacy of retrograde recanalisation of chronic total occlusion (CTO) of the coronary arteries. Methods and results: A total of 378 consecutive patients (previously failed PCI 32.0%) who enrolled in 27 institutions in Japan underwent retrograde recanalisation for CTO. We analysed the data on lesion characteristics, procedural materials, technique used, complications and clinical outcomes. Successful retrograde recanalisation was achieved in 70.4% and the overall procedural success was 83.6%. Collateral crossing was achieved via a septal route in 68.9%, epicardial in 27.2% and bypass grafts in 2.6%, respectively. The retrograde approach was completed with implementation of reverse CART in 42.5%, direct wire crossing in 23.1%, bilateral wiring in 22.7%, and CART in 11.7%. Major and minor collateral injuries and coronary perforations were noted in 1.3%, 10.3% and 2.9% of cases, respectively. Stroke occurred in 0.3%, QWMI and emergency PCI in 0.3% of patients with successful recanalisation. Conclusions: Wider application of retrograde CTO PCI achieved a high rate of success in recanalisation with an acceptable rate of complications in Japan. © Europa Digital & Publishing 2013. All rights reserved.

Tsuchikane E.,Toyohashi Heart Center | Yamane M.,Sayama Hospital | Mutoh M.,Saitama Prefecture Cardiovascular and Respiratory Center | Matsubara T.,Toyohashi Heart Center | And 6 more authors.
Catheterization and Cardiovascular Interventions | Year: 2013

Objectives This registry evaluated the current trends and outcomes associated with retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Background Since its introduction, several techniques and technologies have been introduced for retrograde PCI for CTO. Methods Eight hundred and one patients who underwent retrograde PCI for CTO in 28 Japanese centers between January 2009 and December 2010 were enrolled in this registry. Results Overall procedural and clinical success rates were 84.8 and 83.8%, respectively, of which, retrograde procedures accounted for 71.2 and 70.3%, respectively. The use of channel dilators increased in 2010 compared to that in 2009 (36 vs. 95.3%, P < 0.0001), attributed improving collateral channel crossing using a wire and catheter (70.6% vs. 81.1%, P = 0.0005) and increased availability of epicardial channels (27.6% vs. 36.9%). The use of the reverse controlled antegrade and retrograde tracking technique also increased (41.9 vs. 66.5%). Although these changes decreased procedure time (203.3 min vs. 187.9 min, P = 0.024), they did not significantly improve overall procedural success rate (84.1% vs. 85.3%, P = 0.63). Multivariate analysis identified age 65 years or more and lesion calcification as unfavorable factors and the use of a channel dilator as a favorable factor for retrograde procedural success. Conclusions Increased availability of channel dilators has altered strategies for retrograde PCI for CTO. However, retrograde PCI for CTO could be improved by overcoming its main obstacle of severe calcification. © 2013 Wiley Periodicals, Inc.

Chapple C.,Royal Hallamshire Hospital | Andrich D.,University College London | Atala A.,Wake forest University | Barbagli G.,Center for Urethral and Genitalia Reconstructive Surgery | And 4 more authors.
Urology | Year: 2014

In this systematic review of the literature, a search of the PubMed database was conducted to identify articles dealing with augmentation/ substitution urethral reconstruction of the anterior urethral stricture. The evidence was categorized by stricture site, surgical technique, and the type of tissue used. The committee appointed by the International Consultation on Urological Disease reviewed this data and produced a consensus statement relating to the augmentation and substitution of the anterior urethra. In this review article, the background pathophysiology is discussed. Most cases of urethral stricture disease in the anterior urethra are consequent on an ischemic spongiofibrosis. The choice of technique and the surgical approach are discussed along with the potential pros and cons of the use of a graft vs a flap. There is research potential for tissue engineering. The efficacy of the surgical approach to the urethra is reviewed. Whenever possible, a 1-stage approach is preferable from the patient's perspective. In some cases, with complex penile urethral strictures, a 2-stage procedure might be appropriate, and there is an important potential role for the use of a perineal urethrostomy in cases where there is an extensive anterior urethral stricture or where the patient does not wish to undergo complex surgery, or medical contraindications make this hazardous. It is important to have accurate outcome measures for the follow-up of patients, and in this context, a full account needs to be taken of patients' perspectives by the use of appropriate patient-reported outcome measures. The use of symptoms and a flow rate can be misleading. It is well established that with a normally functioning bladder, the flow rate does not diminish until the caliber of the urethra falls below 10F. The most accurate means of following up patients after stricture surgery are by the use of endoscopy or visualization by urethrography. Careful consideration needs to be made of the outcomes reported in the world literature, bearing in mind these aforementioned points. The article concludes with an overview of the key recommendations provided by the committee. © 2014 Elsevier Inc.

Egawa T.,Saiseikai Yokohamashi Tobu Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

A 70-year-old woman was diagnosed as having advanced lower thoracic esophageal cancer with abdominal lymph node metastases(T3N1M0, Stage III). After administering 2 courses of neoadjuvant chemotherapy with 5-fluorouracil(5- FU)( 800 mg/m2)and cisplatin(80 mg/m2), we performed curative surgery with D2 lymph node dissection. The patient could not receive adjuvant chemotherapy because of her poor performance status. After curative surgery, liver metastasis appeared in segment 8. The liver metastasis(S8)was treated with stereotactic body radiation therapy(SBRT)( 60 Gy/3 Fr). After SBRT, we administered systemic chemotherapy with docetaxel and nedaplatin as second-line chemotherapy. The patient had no recurrence for 12 months after SBRT. SBRT exhibited an excellent local therapeutic effect without any serious complications, suggesting that it is an effective treatment for liver metastasis from esophageal cancer.

Takamatsu K.,Saiseikai Yokohamashi Tobu Hospital
Japanese Journal of Clinical Urology | Year: 2015

Because of the increase of fluoroquinorone resistant bacteria after transrectal ultrasound-guided prostate biopsy, we used a single 800 mg/160 mg oral dose of sulfamethoxazole-trimethoprim which has good penetration to the prostate gland. In this study, we investigate the effectiveness of the sulfamethoxazole-trimethoprim as prophylaxis after transrectal ultrasound-guided prostate biopsy. Nine of the 380patients (2.6%) experienced the acute prostatitis. The rate of prostatitis after transrectal ultrasound- guided prostate biopsy in our study is as approximately same as previous reports.

Matsumoto S.,Saiseikai Yokohamashi Tobu Hospital | Sekine K.,Saiseikai Central Hospital | Funaoka H.,Dainippon Sumitomo | Yamazaki M.,Saiseikai Yokohamashi Tobu Hospital | And 3 more authors.
British Journal of Surgery | Year: 2014

Background: The aim of this study was to evaluate the use of intestinal fatty acid binding protein (I-FABP) and traditional biomarkers in the early diagnosis of acute intestinal ischaemia of different causes. Methods: I-FABP, white blood cell (WBC) count, C-reactive protein, base deficit, lactate, lactate dehydrogenase, aspartate aminotransferase, creatine kinase and D-dimer were measured prospectively in consecutive patients suspected of having acute intestinal ischaemia. Biomarker levels were compared in patients with vascular and non-vascular ischaemia. Results: Two hundred and eight patients with a clinical suspicion of acute intestinal ischaemia were enrolled. Vascular intestinal ischaemia was diagnosed in 24 patients (11·5 per cent), non-vascular ischaemia in 62 (29·8 per cent) and non-ischaemic disease in 122 (58·7 per cent). The levels of most biomarkers (except WBC count and creatine kinase) were significantly higher in the vascular ischaemia group than in the other groups (P < 0·010). However, none of the biomarker levels differed between patients with non-vascular intestinal ischaemia and those with non-ischaemic disease. Receiver operating characteristic (ROC) curve analysis suggested that I-FABP was best at diagnosing vascular intestinal ischaemia (area under the curve 0·88). Conclusion: Serum biomarkers may be useful in the diagnosis of vascular, but not non-vascular, intestinal ischaemia. © 2014 BJS Society Ltd.

Suzuki S.,National Cancer Center Hospital | Yamane T.,Saiseikai Yokohamashi Tobu Hospital | Mohri M.,Mohri Clinic | Kaneko A.,National Cancer Center Hospital | Kaneko A.,Teikyo University
Ophthalmology | Year: 2011

Purpose: To report the success rate, adverse events, and long-term prognosis of selective ophthalmic arterial injection (SOAI) therapy for intraocular retinoblastoma. Design: Noncomparative case series. Participants: A total of 408 eyes of 343 patients. Methods: Retrospective chart review of patients with intraocular retinoblastoma treated with SOAI using a balloon catheter and melphalan between 1988 and 2007. Main Outcome Measures: The technical success rate of SOAI (we defined success as the successful injection of melphalan into the ophthalmic artery), ocular adverse events, systemic adverse events, secondary neoplasms, eye survival, and visual acuity. Results: Selective ophthalmic arterial injection was successful in 1452 procedures of 1469 trials, and the success rate was 98.8%. Each eye received 1 to 18 rounds of SOAI. Two eyes (0.5%) developed severe orbital inflammation, and 2 eyes (0.5%) had diffuse chorioretinal atrophy. Transient periocular swelling or redness occurred in some cases. No severe systemic adverse events were detected. Transient bronchospasm occurred in 1 patient (0.3%), and transient vomiting occurred in several patients. Twelve secondary neoplasms occurred in 11 patients, and the cumulative incidence was 1.3% at 5 years, 4.8% at 10 years, and 5.8% at 15 years. The eye preservation rate was 100% in group A, 88% in group B, 65% in group C, 45% in group D, and 30% in group E according to the International Classification of Intraocular Retinoblastoma. Fifty-one percent of eyes had a visual acuity >0.5, and 36% of eyes had a visual acuity >1.0 at the last follow-up examination in cases without macular tumors. Conclusions: Selective ophthalmic arterial injection using a balloon catheter and melphalan achieved a success rate of 98.8% and was associated with few severe adverse events, including secondary neoplasms. More than half of the treated eyes were preserved, and more than half of the eyes without macular tumors maintained a visual acuity >0.5. Selective ophthalmic arterial injection is an established treatment method. We did not detect severe eye damage or severe systemic events; secondary neoplasms were seen but no more frequently than would otherwise have been expected. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2011 American Academy of Ophthalmology.

Egawa T.,Saiseikai Yokohamashi Tobu Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

Adjuvant chemotherapy with S-1 monotherapy might be insufficient for Stage IIIB highly advanced gastric cancer patients. Our retrospective study was to evaluate the feasibility and safety of adjuvant chemotherapy with S-1 plus docetaxel. S-1 (80 mg/m2) was administered orally for 2 weeks then followed by a 1-week rest period. Docetaxel (40 mg/m2) was simultaneously administered on day 1. The treatment was administered for 1 year and began 6 weeks after D2 curative surgery. Five patients tolerated adjuvant chemotherapy with S-1 plus docetaxel for 1 year (17 courses of treatment). Grade 3/4 hematological toxicities were observed in 10% patients (n=1). Grade 3/4 non-hematological toxicities were observed in 20% patients (n=2). We concluded that S-1 plus docetaxel as adjuvant chemotherapy is a promising strategy for patients with highly advanced gastric cancer.

Egawa T.,Saiseikai Yokohamashi Tobu Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

Because gastric submucosal tumors can be treated by local resection without lymph-node dissection, laparoscopic local resection is widely used to manage relatively small tumors less than 5 cm in diameter. On the other hand, single-incision laparoscopic surgery (SILS) to perform laparoscopic cholecystectomy was feasible. SILS requires only a single incision in the umbilical region; it has better cosmetic outcomes than conventional laparoscopic surgery. The relative difficulty and ease of local gastric resection depends to a large part on tumor location and morphologic characteristics. Extraluminal submucosal tumor of the stomach can be locally resected by SILS using an automated suturing device regardless of tumor location. Intraluminal tumor located in the greater curvature of the gastric body can be treated by SILS, whereas intraluminal lesions located in the lesser curvature and near the gastric cardia or pylorus are difficult to manage by SILS. Laparoscopic and endoscopic cooperative surgery (LECS) is useful for resecting an appropriate amount of tissue at any site. In patients with lesions located near the gastric cardia or pylorus, closure with an automatic suture device may be difficult. Such patients should be switched to reduced-port surgery with a coaxial port, and hand-sewn closure is useful.

Kemmochi T.,Saiseikai Yokohamashi Tobu Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

Clinical efficacy and safety were analyzed in patients with unresectable gastric cancer receiving S-1 plus CDDP(CS) therapy or S-1 plus weekly CDDP (w-CS) therapy as first-line treatment between April 2007 and December 2010. Fifteen patients received CS therapy and 17 received w-CS therapy. CS therapy was used according to the SPIRITS regimen, and w-CS therapy of S-1 80 mg/(m2·day) was administered for 2 weeks followed by a 1-week rest, with CDDP 20 mg/m2 being injected intravenously on days 1 and 8. In the CS therapy group and w-CS therapy group, the overall response rates were 33.3% and 70.1%, the median overall survival periods were 135 and 174 days (p=0.113), and the median follow- up times were 196 and 352 days (p=0.196), respectively. The w-CS therapy group showed less adverse events than did the CS therapy group. This study suggested that the w-CS regimen is a useful treatment modality showing clinical efficacy and safety for unresectable gastric cancer.

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