Seirei Mikatahara Hospital

Shizuoka-shi, Japan

Seirei Mikatahara Hospital

Shizuoka-shi, Japan
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Ando M.,St. Mary's College | Morita T.,Seirei Mikatahara Hospital | Miyashita M.,Tohoku University | Sanjo M.,Toho University | And 2 more authors.
Journal of Pain and Symptom Management | Year: 2010

Context: Some bereaved families experience low spiritual well-being, such as lack of meaning of life or purpose and psychological distress like severe depression. Objectives: The primary aim of this study was to investigate the effects of the Bereavement Life Review on the spiritual well-being of bereaved family members. The secondary aim was to investigate the effects of this therapy on depression. Methods: Participants were 21 bereaved family members who lost loved ones in various palliative care units in Japan. They received the Bereavement Life Review, which consisted of two sessions for about 60 minutes each. In the first session, a bereaved family member reviewed memories with a clinical psychologist and answered some question. After the first session, the clinical psychologist made an album. In the second session, the family member and the clinical psychologist confirmed the accuracy of the contents of the album. The duration of the therapy was two weeks. The family member was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) scale and the Beck Depression Inventory®-II (BDI-II) pre- and postintervention. Results: FACIT-Sp scores increased from 19.9 ± 5.8 to 22.8 ± 5.1 (Z = -2.2, P = 0.028 by Wilcoxon signed-rank test) and BDI scores decreased from 10.8 ± 7.7 to 6.8 ± 5.8 (Z = -3.0, P = 0.003). Conclusions: The Bereavement Life Review has the potential to improve spiritual well-being and decrease depression of bereaved family members. A further study with more participants is required to confirm the present findings. © 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Shimizu Y.,National Cancer Center Hospital | Miyashita M.,Tohoku University | Morita T.,Seirei Mikatahara Hospital | Sato K.,Tohoku University | And 2 more authors.
Journal of Pain and Symptom Management | Year: 2014

Context Bereaved family members witnessing a patient's death rattle often experience distress. However, the benefits of specific care measures aimed at decreasing death rattle-associated family distress have not yet been evaluated. Objectives To clarify death rattle-related emotional distress levels among family members and their perceptions of the need for death rattle care improvement and explore the factors influencing both these issues. Methods A cross-sectional questionnaire survey of bereaved family members of cancer patients was conducted in 95 palliative care units in June 2007. Results Six hundred sixty-three questionnaires were mailed out, and 390 (61%) responses were analyzed. Among these, 181 (46%) respondents experienced death rattle. Of these, 66% reported high distress levels and 53% perceived a strong need for improved death rattle care. Factors influencing high distress levels were the gender (female) of family members, unawareness about death rattle being a natural phenomenon, and their fear and distressing interpretations of death rattle. Factors influencing perceptions of a strong need for improved care were the gender (male) of family members, severity of death rattle, death rattle-associated discomfort to patients, family members' experiences of inadequate nursing care (e.g., repositioning) and insufficient consultation about suctioning, and their perception of uncomfortable smells. Conclusion To decrease family-perceived distress, medical staff should alleviate patient symptoms and suffering with a comprehensive care strategy, try to decrease uncomfortable smells, and communicate with family members to address distressing interpretations and fears. © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All.

Miyashita M.,University of Tokyo | Miyashita M.,Tohoku University | Morita T.,Seirei Mikatahara Hospital | Sato K.,University of Tokyo | And 3 more authors.
Journal of Pain and Symptom Management | Year: 2015

Context End-of-life (EOL) cancer care in general hospitals and home care has not previously been evaluated in Japan. Objectives This study aimed to evaluate EOL cancer care from the perspective of bereaved family members in nationwide designated cancer centers, inpatient palliative care units (PCUs), and home hospices in Japan. Methods We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members of cancer patients in March 2008 for 56 designated cancer centers and in June 2007 for 100 PCUs and 14 home hospices. Outcomes were overall care satisfaction, structure and process of care (Care Evaluation Scale), and achievement of a good death (Good Death Inventory). Results In designated cancer centers, PCUs, and home hospices, 2794 (response rate 59%), 5312 (response rate 69%), and 292 (response rate 67%) bereaved family members participated, respectively. Mean scores for overall care satisfaction were high for all places of death, at 4.3 ± 1.2 for designated cancer centers, 5.0 ± 1.2 for PCUs, and 5.0 ± 1.0 for home hospices. Designated cancer centers showed significantly lower ratings than PCUs and home hospices for structure and process of care and achievement of a good death (P = 0.0001 each). Home hospices were rated significantly higher than PCUs for achievement of a good death (P = 0.0001). Conclusion The main findings of this study were: 1) overall, bereaved family members were satisfied with end-of-life care in all three places of death; 2) designated cancer centers were inferior to PCUs and home hospices and had more room for improvement; and 3) home hospices were rated higher than PCUs for achieving a good death, although home hospices remain uncommon in Japan. © 2015 American Academy of Hospice and Palliative Medicine. All rights reserved.

Choi J.,University of Tokyo | Miyashita M.,Tohoku University | Hirai K.,Osaka University | Sato K.,University of Tokyo | And 3 more authors.
Supportive Care in Cancer | Year: 2010

Purpose The aim of this study was to clarify factors related to the preference of place for end-of-life cancer care and death, from the perspective of the bereaved family. Methods In June 2007, in Japan, a cross-sectional anonymous questionnaire, which included a well-validated scale of component factors of hospice outcome, was administered to the bereaved family members (N=294) of cancer patients who had died at home at least 6 months ago. Participants were recruited from 14 home hospices across the nation. We asked the preference of place for end-of-life care and death. Results Fifty-eight percent of participants preferred home settings for end-of-life care and 68% preferred to die at home. Multivariate logistic regression identified: (1) males, participant who had other caregivers, a higher-good death concept, and those who experienced mastery as a consequence of caregiving were more likely to prefer home for end-of-life cancer care and (2) males, participant who had other caregivers, and experienced reprioritization as a consequence of caregiving and those who were enrolled in home hospice services for more than 60 days were more likely to prefer to die at home. Conclusions Home hospice services need to be developed in Japan so that family support programs can be initiated early enough to support the family burden of household maintenance and caring for the patient. Quality improvement of home hospice services will support patients and families through end-of-life care and facilitate a good death at home. © Springer-Verlag 2009.

PubMed | Matsue City Hospital, Tohoku University, Osaka University, Ashiya Municipal Hospital and 5 more.
Type: Journal Article | Journal: BMC palliative care | Year: 2017

The Care Evaluation Scale (CES1.0) was designed to allow bereaved family members to evaluate the structure and process of care, but has been associated with a high frequency of misresponses. The objective of this study was to develop a modified version of CES1.0 (CES2.0) that would eliminate misresponses while maintaining good reliability and validity.We conducted a cross-sectional questionnaire survey by mail in October 2013. The participants were bereaved family members of patients who died from cancer in seven institutions in Japan. All family members were asked to complete CES2.0, the short form CES1.0, items on overall care satisfaction, the Family Satisfaction with Advanced Cancer Care (FAMCARE) Scale, the Patient Health Questionnaire-9 (PHQ-9) and the Brief Grief Questionnaire (BGQ). To examine test-retest reliability, all participants were asked to complete a second CES2.0.Of 596 questionnaires sent, 461 (77%) were returned and 393 (66%) were analyzed. In the short form CES1.0, 17.1% of the responses were identified as misresponses. No misresponses were found in CES2.0. We identified 10 CES2.0 subscales similar to those in CES1.0 using exploratory factor analysis. Cronbachs alpha was 0.96, and the intraclass correlation coefficient was 0.83. Correlations were found between CES2.0 and overall satisfaction (r=0.83) and FAMCARE (r=0.58). In addition, total CES2.0 scores were negatively correlated with the PHQ-9 (r=-0.22) and BGQ (r=-0.10).These results suggest that CES2.0 eliminated misresponses associated with CES1.0 while maintaining good reliability and validity and greatly improving test-retest reliability.

Matsushima S.,Seirei Mikatahara Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2011

A 66-year-old man was found to have a very small ground-glass opacity in the apex of the left lung. Because the ground-glass opacity had slightly enlarged after 2 years, video-assisted thoracic surgery (VATS) biopsy was performed. The histological findings showed the alveolar spaces to be filled with PAS-positive granular materials, so pulmonary alveolar proteinosis was diagnosed. Although his bronchoalveolar lavage fluid (BALF) did not have a milky appearance, his serum and BALF GM-CSF autoantibody and serum KL-6 levels were elevated. Asymptomatic pulmonary alveolar proteinosis may appear as very small ground-grass opacities.

Kuhn E.,Johns Hopkins University | Ayhan A.,Seirei Mikatahara Hospital | Bahadirli-Talbott A.,Johns Hopkins University | Zhao C.,University of Pittsburgh | And 2 more authors.
American Journal of Surgical Pathology | Year: 2014

Uterine and ovarian undifferentiated carcinomas (UCs) are often associated with low-grade endometrioid carcinomas (EMCs) and are characterized by a solid growth pattern and a lack of appreciable features of differentiation. As compared with pure EMC, UC is highly malignant, and the molecular pathogenesis that leads to disease aggressiveness remains largely unknown. This study interrogates the molecular pathogenesis of UCs by comparing the molecular alterations between the UC and the EMC components. A total of 20 UCs were studied, 12 of which contained both UC and EMC components. Mutation analysis was performed for the genes commonly mutated in EMC, and immunohistochemistry was used to determine the expression pattern of β-catenin and PTEN. Sequencing analysis revealed that UCs harbored somatic mutations in PIK3CA (50%), CTNNB1 (30%), TP53 (30%), FBXW7 (20%), and PPP2R1A (20%). All somatic mutations detected in EMCs were also present in concurrent UCs. Moreover, additional somatic mutations were detected in the UC component in 5 (42%) cases with concurrent EMC and UC. Concordance of immunostaining pattern for β-catenin and PTEN was recorded in all 12 matched EMCs and UCs, except 4 cases in which nuclear accumulation of β-catenin staining was detected in one of the components but not in the other. Our findings support a clonal relationship between EMCs and their associated UCs. Additional molecular genetics alteration, including mutations of CTNNB1, PPP2R1A, and TP53, may contribute to tumor progression from EMC to UC. © 2014 by Lippincott Williams and Wilkins.

Sugiura Y.,Seirei Mikatahara Hospital | Nishizawa S.,University of Occupational and Environmental Health Japan
Neurologia Medico-Chirurgica | Year: 2011

A 68-year-old man presented with an extremely rare extracranial arteriovenous fistula (AVF) involving the inferior petroclival vein (IPCV) with retrograde venous drainage into an ophthalmic vein through the anterior condylar confluence and inferior petrosal sinus manifesting as ocular symptoms. The AVF was successfully treated by selective transvenous embolization with platinum coils. AVF involving the IPCV should be recognized as a possible extracranial lesion manifesting as clinical symptoms similar to cavernous sinus dural AVF.

Kuhn E.,Johns Hopkins University | Ayhan A.,Seirei Mikatahara Hospital | Shih I.-M.,Johns Hopkins University | Seidman J.D.,Washington Hospital Center | Kurman R.J.,Johns Hopkins University
Modern Pathology | Year: 2014

Brenner tumors are ovarian tumors, usually benign, containing epithelium that resembles transitional epithelium. As with other epithelial tumors there exist frankly malignant tumors and tumors that display greater proliferation than the benign Brenner tumors but lack destructive infiltrative growth, and these have been designated 'atypical proliferative' (borderline) Brenner tumors. There have been no well-documented cases of atypical proliferative Brenner tumors that have exhibited malignant behavior. Based on shared morphologic features it is generally believed that atypical proliferative Brenner tumors develop from benign Brenner tumors. The aim of the present study was to confirm this impression by investigating the immunohistochemical and molecular genetic features of benign and atypical proliferative Brenner tumors. Immunohistochemical staining for p16, fluorescence in-situ hybridization (FISH) for CDKN2A (p16-encoding gene) and mutational analysis of the genes commonly mutated in ovarian tumors were performed. p16 immunostaining was positive in the epithelial component of 12 (92%) of 13 benign Brenner tumors, but completely negative in all 7 atypical proliferative Brenner tumors. FISH identified homozygous deletion of CDKN2A in the epithelial component of all atypical proliferative Brenner tumors, but CDKN2A was retained in all benign Brenner tumors. Two PIK3CA somatic mutations were detected in the stromal component in 1 (5%) of 20 Brenner tumors and 3 somatic mutations (1 in KRAS and 2 in PIK3CA) were identified in the atypical epithelial component of 2 (29%) of 7 atypical proliferative Brenner tumors. In summary, our findings suggest that loss of CDKN2A and, to a lesser extent, KRAS and PIK3CA somatic mutations have a role in the progression of a benign to an atypical proliferative Brenner tumor.

Hoshino T.,Seirei Mikatahara Hospital | Hamada N.,Seirei Mikatahara Hospital | Seki A.,Seirei Mikatahara Hospital | Ogawa H.,Seirei Mikatahara Hospital
Auris Nasus Larynx | Year: 2012

Myxomas were found in the outer ear canal of a 66-year-old female and a 51-year-old male. Both tumors were soft and sessile and located at the antero-superior part of the external auditory canal near the eardrum. Profuse, clear mucus was seen when the tumor ruptured or was incised. Histology showed spindle-shaped and stellate cells in myxoid extracellular matrix. CT images revealed a small bone defect adjacent to the tumor in the meatal bone. This bony defect was confirmed during surgery. The bony defects seen in both cases may have something to do with the genesis of the tumor. We found only 5 sporadic cases, including ours, reported in the English literature. As myxoma of the outer ear canal is also reported in 18 patients as a symptom of Carney's complex, we must check for accompanying symptoms of the complex such as spotty skin pigmentation, endocrine tumors, or schwannoma. Total removal of the tumor is necessary to prevent recurrence. © 2012 Elsevier Ireland Ltd.

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