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Takaoka, Japan

Seki S.,University of Toyama | Kawaguchi Y.,University of Toyama | Nakano M.,Takaoka City Hospital | Yasuda T.,University of Toyama | And 3 more authors.
Journal of Orthopaedic Science | Year: 2015

Background: In cervical myelopathy, significant findings are seen in flexion–extension MRI due to the increased likelihood of cord compression during neck extension. In addition, a high intramedullary signal on T2-weighted MR images has been reported to be a prognostic factor in this condition. However, the relationship between Japanese Orthopaedic Association (JOA) scores and the signal intensity in preoperative cervical flexion–extension T2-weighted images has not been evaluated. The purpose of this study was to evaluate whether preoperative flexion–extension MRI may be used to predict surgical outcomes in patients with cervical myelopathy. Methods: A total of 121 patients who underwent surgery for cervical myelopathy were included. All patients underwent preoperative cervical flexion–extension MRI followed by cervical decompression surgery, with or without spinal fusion, and postoperative follow-up for at least 2 years. Pre- and postoperative (2 years after surgery) JOA scores were recorded, and the degree of postoperative improvement was calculated. The relationship between intramedullary signal intensity on preoperative cervical dynamic MRI findings and degree of clinical recovery was examined. Results: Patients with a high intramedullary signal on the extension MRI had significantly better neurological recovery than those with a high signal on the flexion MRI (p < 0.000005). There was no significant difference in neurological recovery between patients with and without a high intramedullary signal on extension MRI. Conclusions: A preoperative high intramedullary signal on flexion MRI was associated with a poor surgical outcome, while no such association was seen with extension MRI. © 2015, The Japanese Orthopaedic Association. Source

Arahata M.,Nanto Municipal Hospital | Tajiri K.,University of Toyama | Nomoto K.,University of Toyama | Tsuneyama K.,University of Toyama | And 2 more authors.
International Archives of Allergy and Immunology | Year: 2013

A 64-year-old female with advanced liver cirrhosis who had never experienced severe infections presented in 2004 with general malaise. At the time, her serum showed low levels of immunoglobulin (Ig) M (11 mg/dl) with high levels of both IgG (2,942 mg/dl) and IgA (808 mg/dl). Because serum levels of IgG and IgA in previous cases of selective IgM deficiency were normal, this case could have a novel immunological mechanism. By 2006, serum IgM was undetectable (<5 mg/dl). Liver biopsy showed liver cirrhosis from autoimmune hepatitis. She had no other autoimmune diseases or hematological malignancies. She developed hepatocellular carcinoma (HCC) several times and died of liver failure. Immunological analyses performed before the first diagnosis of HCC showed polyclonal γ-globulin elevation, normal chromosome and normal gene rearrangement of immunoglobulin heavy chain Cμ. Peripheral blood showed low count B cells with few surface IgM-positive B lymphocytes, but the percentages of T cell subsets were normal. Expression of activation-induced cytidine deaminase (AID), which plays a critical role in immunoglobin class switching, was found to be overexpressed in the HCC tissue and B cells in bone marrow. This phenomenon could account for the clinical and immunological features of this case. In conclusion, we propose a novel type of selective IgM deficiency in association with the overexpression of AID. © 2012 S. Karger AG, Basel. Source

Kayano D.,Kanazawa University | Michigishi T.,Nanto Central Hospital | Ichiyanagi K.,Takaoka City Hospital | Inaki A.,Kanazawa University | Kinuya S.,Kanazawa University
Clinical Nuclear Medicine | Year: 2010

A 61-year-old woman after total thyroidectomy for papillary thyroid cancer underwent I-131 therapy. Focal uptake was seen in the chest on whole body imaging. SPECT/CT delineated I-131 accumulation in an isodense mediastinal lesion which was histologically diagnosed as a thymic cyst. I-131 uptake in a thymic cyst is rare and should be included in the gamut of false-positive entities of I-131 scintigraphy. Copyright © 2010 by Lippincott Williams & Wilkins. Source

Oyama K.,Kanazawa University | Fushida S.,Kanazawa University | Kaji M.,Toyama Prefectural Central Hospital | Takeda T.,Public Central Hospital of Matto Ishikawa | And 14 more authors.
Journal of Gastroenterology | Year: 2013

Background: We aimed to evaluate the efficacy of a new combination antiemetic therapy comprising aprepitant, granisetron, and dexamethasone in gastric cancer patients undergoing chemotherapy with cisplatin and S-1. Methods: Gastric cancer patients scheduled to receive their first course of chemotherapy with cisplatin (60 mg/m2) and S-1 (80 mg/m2) were treated with a new combination antiemetic therapy aprepitant, granisetron, and dexamethasone on day 1; aprepitant and dexamethasone on days 2 and 3; and dexamethasone on day 4. The patients reported vomiting, nausea, use of rescue therapy, and change in the amount of diet intake, and completed the Functional Living Index-Emesis (FLIE) questionnaire. The primary endpoint was complete response (CR; no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after cisplatin administration). The secondary endpoints included complete protection (CP; CR plus no significant nausea); change in the amount of diet intake; and the impact of chemotherapy-induced nausea and vomiting (CINV) on daily life during the overall, acute (0-24 h), and delayed (24-120 h) phases. Results: Fifty-three patients were included. CR was achieved in 88.7, 98.1, and 88.7 % of patients in the overall, acute, and delayed phases, respectively. The corresponding rates of CP were 67.9, 96.2, and 67.9 %. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 79.5 % of patients reported "minimal or no impact of CINV on daily life". Conclusions: Addition of aprepitant to standard antiemetic therapy was effective in gastric cancer patients undergoing treatment with cisplatin and S-1. © 2013 Springer Japan. Source

Tajiri K.,University of Toyama | Shimizu Y.,Takaoka City Hospital | Tokimitsu Y.,University of Toyama | Tsuneyama K.,University of Toyama | Sugiyama T.,University of Toyama
Internal Medicine | Year: 2012

Here, we report an elderly man with acute-on-chronic hepatitis accompanied by massive ascites. He showed elevated serum transaminase and anti-nuclear antibody (ANA) levels. Liver biopsy showed diffuse multinucleated giant hepatocytes with interface hepatitis, and he recovered with administration of azathioprine in addition to corticosteroids. Follow-up liver biopsy after recovery showed improvement of hepatic inflammation and reduction of giant hepatocyte formation. The patient is receiving low-dose orticosteroid maintenance therapy and he has remained healthy for 8 years to date. Active immunosuppressive treatment may be beneficial in patients with adult syncitial giant cell hepatitis (AGCH). © 2012 The Japanese Society of Internal Medicine. Source

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