Sasebo Municipal General Hospital

Sasebo, Japan

Sasebo Municipal General Hospital

Sasebo, Japan
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Kawano H.,Nagasaki University | Kawano H.,Nagasaki Rosai Hospital | Inoue K.,Kokura Memorial Hospital | Matsumoto Y.,Nagasaki Rosai Hospital | And 10 more authors.
Internal Medicine | Year: 2016

Drug-eluting stents (DES) are widely used for the treatment of coronary artery disease, and a sirolimuseluting stent (SES; Cypher) was the first DES introduced into clinical practice. Although pathological reactions of coronary arteries to SES have been described in autopsy cases, there are few reports regarding calcification of the coronary arteries after SES implantation. The present report describes the findings of an autopsy conducted 16 months after SES implantation that showed remarkable persistent calcification. In addition, previously reported pertinent pathological findings are also described. © 2016 The Japanese Society of Internal Medicine.

Itoh K.,Hospital East | Kinoshita T.,Nagoya University | Watanabe T.,National Cancer Center Hospital | Yoshimura K.,Center for Cancer Control and Information Services | And 22 more authors.
International Journal of Hematology | Year: 2010

The Japan Clinical Oncology Group conducted two multicenter phase II trials in 200 patients with advanced Hodgkin lymphoma (HL) in the 1990s. Among 181 patients whose histopathological specimens were available and reviewed by 6 hematopathologists, 167 (92.3%) were diagnosed with HL. Five-year overall survival (OS) among these 167 patients was 88.3%, including 89.2% among nodular sclerosis and 82.2% among mixed cellularity cases. International prognostic score was not closely associated with OS. Seven unfavorable prognostic factors for OS on univariate analysis were male, B symptoms, clinical stage of III or IV, elevated serum LDH, elevated alkaline phosphatase, elevated β2-microglobulin, and pathological subtype (mixed cellularity and lymphocyte depletion). On multivariate analysis, male [HR 3.30 (95% CI 1.15-9.52, p = 0.027)] and elevated serum LDH [HR 2.41 (95% CI 1.07-5.43, p = 0.034)] were independent factors for OS. Based on these prognostic factors, the 5-year OS was 95.7% in the low-risk group (no adverse factor), 87.9% in the intermediate-risk group (1 adverse factor) and 73.3% in the high-risk group (2 adverse factors). This simple prognostic model for HL warrants further validation studies. © 2010 The Japanese Society of Hematology.

Yamao T.,Nagasaki Municipal Hospital | Yamao T.,Sasebo Municipal General Hospital | Isomoto H.,Nagasaki University | Kohno S.,Nagasaki University | And 4 more authors.
Surgical Endoscopy and Other Interventional Techniques | Year: 2010

Background: This study aimed to evaluate the feasibility, safety, and follow-up results of endoscopic papilletomy (ESP) with pancreatic and biliary duct stent placement for ampullary tumors. The therapeutic approach to benign ampullary tumors remains unsettled. The ESP procedure is a curative treatment option for benign papillary tumors, but ESP raises concerns about a relatively high risk for procedure-related complications such as pancreatitis. A pancreatic stent may protect against complications. Methods: Between September 2000 and June 2008, 36 patients with ampullary tumors confined to the mucosa and no intraductal tumor growth underwent ESP. The preprocedural diagnostic tools included endoscopic ultrasound, transpapillary intraductal ultrasound, and endoscopic retrograde cholangiopancreatography. Pancreatic and biliary stent placement was attempted if feasible. Endoscopic follow-up evaluation was conducted periodically as surveillance for recurrence. Results: En bloc ESP was achieved for 94% of lesions with a median size of 14 mm. There were 26 adenomas including 4 high-grade intraepithelial neoplasias (HGINs), 5 carcinomas in adenoma, and 3 intramucosal cancers. Complete resections with tumor-free lateral and basal margins was achieved for 81% of the cases. During the median follow-up period of 14 months, there was one recurrent adenoma, which was successfully eradicated by a repeat ESP. A pancreatic stent was placed in 35 cases and a biliary stent in 29 cases. Mild acute pancreatitis and bleeding, managed endoscopically, occurred in 3 cases each (8%). Conclusion: The ESP procedure can be feasible for benign ampullary adenoma, HGIN, and noninvasive cancer without intraductal tumor growth. Prophylactic stent placement in the pancreatic and bile ducts may reduce procedure-related complications. © 2009 Springer Science+Business Media, LLC.

Kawano H.,Nagasaki Rosai Hospital | Kawano H.,Nagasaki University | Matsumoto Y.,Nagasaki Rosai Hospital | Matsumoto Y.,Sasebo Municipal General Hospital | And 8 more authors.
Internal Medicine | Year: 2014

The rupture of spontaneous dissecting coronary artery pseudoaneurysms is rare, and no standard therapy has yet been established for this condition. This report describes a case of a ruptured spontaneous dissecting coronary artery pseudoaneurysm in a patient with cardiac tamponade that was successfully treated with emergent implantation of a covered stent. © 2014 The Japanese Society of Internal Medicine.

Satake M.,Red Cross | Yamada Y.,Sanwa Central Hospital | Atogami S.,Sasebo Municipal General Hospital | Yamaguchi K.,Japan National Institute of Infectious Diseases
Leukemia and Lymphoma | Year: 2015

Human T-lymphotropic virus type 1 (HTLV-1) is highly endemic in the Kyushu/Okinawa region of Japan. A nationwide investigation verified the frequency of HTLV-1 carriers among first-time blood donors and the occurrence of newly diagnosed adult T-cell leukemia/lymphoma (ATL) cases from 2007 through 2008. After adjusting for differences in capture rate between areas, the age-, sex- and area-specific incidence of ATL among carriers was determined. Annual ATL incidence among 10 000 carriers was 7.7 and 8.7 for the Kyushu and non-Kyushu/Okinawa regions, respectively. The incidence increased sharply for men from their 40s to their 70s, but the rate in females remained unchanged through their 40s to 70s. ATL incidence in middle- Aged females was still low, even if female carrier frequency was assumed to be identical to that of males. Patients with ATL in their 60s and 70s will comprise two-thirds of all patients with ATL for the next 15 years in Japan. © 2015 Informa UK, Ltd.

Kawano H.,Nagasaki Rosai Hospital | Kawano H.,Nagasaki University | Arakawa S.,Nagasaki Rosai Hospital | Arakawa S.,Nagasaki University | And 9 more authors.
Geriatrics and Gerontology International | Year: 2014

Aim: We evaluated the effect of pimobendan, a positive inotropic agent, in elderly patients with frequent readmission as a result of heart failure despite conventional therapy. Methods: Pimobendan was given to five male patients with severe chronic heart failure (New York Heart Association class III-IV) (age range 69-89 years; mean 78±8 years; ischemic cardiomyopathy in three cases, dilated cardiomyopathy in two cases) who required repeated admission for heart failure despite conventional therapy with angiotensin inhibitors, beta-blockers, diuretics and anti-arrhythmic agents. After the addition of pimobendan at a dose of 1.25-3.75mg/day, we evaluated serum levels of brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), septal e′ and left ventricular end-diastolic diameter (LVDD) by echocardiography, as well as readmission rates for more than 2 years. Results: The serum level of BNP significantly decreased after treatment with pimobendan, although its level returned to pretreatment levels after 2 years. LVEF significantly improved after the treatment, with the improvement continuing beyond the 2 years, although LVDD did not change after treatment. Septal e′ significantly improved after the treatment, although its level returned to pretreatment levels at 2 years after the treatment. Readmission rates significantly decreased for 2 years after the treatment, although one patient required cardiac resynchronization therapy for severe heart failure, and another patient required cardiac pacemaker implantation for sick sinus syndrome 2 years after adding pimobendan. Conclusions: Pimobendan in conjunction with conventional therapy for heart failure decreases the readmission rate in elderly patients with severe heart failure for at least 2 years. © 2013 Japan Geriatrics Society.

Kawano H.,Nagasaki University | Kawano H.,Nagasaki Rosai Hospital | Ikeda T.,Nagasaki Rosai Hospital | Shimazaki K.,Nagasaki Rosai Hospital | And 4 more authors.
Internal Medicine | Year: 2013

Prader-Willi Syndrome (PWS) is a rare genetic disorder characterized by physical, psychological and physiological abnormalities. Obesity and related cardiovascular diseases are a common problem in adult patients with PWS. This report describes a case of adult PWS with heart failure associated with marked obesity and sleep-disordered breathing that was successfully treated with oxygen therapy, adaptive servoventilation, medications, diet therapy and rehabilitation. © 2013 The Japanese Society of Internal Medicine.

Watanabe T.,National Hospital Organization Nagasaki Medical Center | Tanaka F.,National Hospital Organization Nagasaki Medical Center | Oku R.,National Hospital Organization Nagasaki Medical Center | Takahashi H.,Nagasaki University | Kitaoka K.,Sasebo Municipal General Hospital
Practica Oto-Rhino-Laryngologica | Year: 2011

We report a case of unilateral inner ear malformation that presenting with recurrent meningitis and bilateral deafness. A 8-months-old boy with congenital left-side hearing impairment, diagnosed in newborn screening, suffered bacterial meningitis twice within 7 months of birth, becoming bilateral totally deaf there after. Temporal bone computed tomography (CT) indicated left-side inner ear malformation, Mondini dysplasia, and a cerebrospinal fluid (CSF) fistula. CSF from a stapes footplate defect was repaired surgically. Cochlear implantation was successful in the right ear 3 months after the first operation. In the 14 months since the second operation, he has had no bacterial meningitis and has begun speaking two-word sentences. Early diagnosis and prompt surgical intervention are thus crucial in avoiding meningitis sequelae.

Muroya T.,Sasebo Municipal General Hospital | Ikeda S.,Nagasaki University | Yamasa T.,Sasebo Municipal General Hospital | Koga S.,Nagasaki University | And 4 more authors.
Medical Science Monitor | Year: 2010

Background: Peripartum cardiomyopathy (PPCM) is a rare complication characterized by heart failure that arises between the last month of pregnancy and the first 5 months after delivery. The etiology of this disorder has not been clarified due to its low incidence. We describe two patients with PPCM and elevated antibody titers to influenza virus in paired sera that were recovered by high doses of intravenous immune globulin. Case Report: Case 1. One day before delivery by cesarean section, a 32-year-old woman developed PPCM that was immediately improved after the administration of a total cumulative dose of 1.7 g/kg immunoglobulin together with intra-aortic balloon pumping and percutaneous cardiopulmonary support. Antibody titers to influenza virus subtypes A and B were elevated in paired sera from this patient. Case 2. Four days postpartum, a 29-year-old woman developed PPCM and a total of 2.0 g/kg immunoglobulin recovered her cardiac function. The antibody titer to influenza virus subtype B was elevated in paired sera from this patient. Evidence of myocarditis was absent in endomyocardial specimens from both patients. Conclusions: These cases suggest that viral infection including influenza contributes to PPCM and that high doses of immunoglobulin constitute an effective treatment for this disorder. © Med Sci Monit, 2010.

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