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Takedamachi, Japan

Ono Y.,Keio University | Furukawa T.A.,National Institute of Mental Health | Okamoto Y.,Kyoto University | Nakagawa A.,Chiba University | And 4 more authors.
Psychiatry and Clinical Neurosciences | Year: 2011

Cognitive therapy/cognitive behavior therapy was introduced into the field of psychiatry in the late 1980s in Japan, and the Japanese Association for Cognitive Therapy (JACT), founded in 2004, now has more than 1500 members. Along with such progress, awareness of the effectiveness of cognitive therapy/cognitive behavioral therapy has spread, not only among professionals and academics but also to the public. The Study Group of the Procedures and Effectiveness of Psychotherapy, funded by the Ministry of Health, Labor and Welfare, has conducted a series of studies on the effectiveness of cognitive therapy/cognitive behavior therapy since 2006 and shown that it is feasible for Japanese patients. As a result, in April 2010 cognitive therapy/cognitive behavior therapy for mood disorders was added to the national health insurance scheme in Japan. This marked a milestone in Japan's psychiatric care, where pharmacotherapy has historically been more common. In this article the authors review research on cognitive therapy/cognitive behavior therapy in Japan. © 2011 The Authors. Psychiatry and Clinical Neurosciences. Source

Yamamoto Y.,Kyoto Katsura Hospital | Nagakane Y.,Red Cross | Tomii Y.,Kyoto Katsura Hospital | Akiguchi I.,Takeda Hospital
Journal of Stroke and Cerebrovascular Diseases | Year: 2016

Background: Hypertension may be the most modifiable risk factor for post-stroke cognitive impairment (PSCI). We investigated how home blood pressure (HBP) can predict PSCI as well as stroke recurrence. Methods: We studied 249 consecutive patients with noncardioembolic minor ischemic stroke including single lacunar infarct (sLI), multiple lacunae (mLI), and atherothrombotic infarction, which were tracked at our outpatient clinic. HBP was measured in the early morning (m-HBP) and just before going to bed (b-HBP). HBP categories based on systolic blood pressure were created as follows: HB1, both m-HBP and b-HBP less than 135 (mmHg); HB2, m-HBP less than or equal to135 and b-HBP less than 135; HB3, m-HBP less than 135 and b-HBP less than or equal to 135; HB4, both m-HBP and b-HBP less than or equal to 135. After 4.1 years of tracking, the patients were divided into 4 groups: Group 1, good outcome (n = 188); Group 2, the development of silent infarcts (n = 16); Group 3, the development of PSCI (n = 33); and Group 4, stroke recurrence (n = 15). Results: HB2 and HB4 (versus HB1) (hazard ratio [HR]: 6.5, P = .0068 and HR: 9.5, P = .0008, respectively) and mLI (versus sLI) (HR: 4.0, P = .021) were independently associated with Group 2. HB3 and HB4 (HR: 4.2, P = .037; HR: 5.4, P < .0001) and mLI (HR: 6.4, P < .0001) were significantly associated with Group 3. HB4 (HR: 8.1, P = .0002) and mLI (HR: 10.2, P = .0003) were significantly associated with Group 4. Clinic blood pressure (BP) was not significantly associated with any adverse groups. Conclusions: High HBP and mLI were strongly associated with PSCI as well as stroke recurrence. BP should be monitored based on HBP, especially bedtime HBP, for the prevention of PSCI. © 2016 National Stroke Association. Source

Chiba N.,Takeda Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

We report 2 patients with lung cancer accompanied by active pulmonary tuberculosis. Case1 was a 82-year-old woman with stage I A bronchioloalveolar carcinoma and tuberculosis in right upper lobe. Right upper lobectomy was performed after the histological diagnosis of lung cancer by intraoperative frozen section. Case2 was a 69-year-old man with papillary adenocarcinoma in right lower lobe and tuberculosis in bilateral upper lobe. Partial resection in right lower lobe was performed for diagnosis of lung cancer. Smear-positive tuberculosis was diagnosed by sputum examination after the operation. Post-operative anti-tuberculosis chemotherapy was added in both patients. Source

Yamamoto Y.,Red Cross | Ohara T.,Red Cross | Nagakane Y.,Red Cross | Tanaka E.,Red Cross | And 3 more authors.
Hypertension Research | Year: 2011

Although the relationships between chronic kidney disease (CKD) and cognitive impairment (CI) have been highlighted, the etiology of CI in CKD remains uncertain. Subjects comprised 224 consecutive patients with symptomatic lacunar infarction who underwent magnetic resonance imaging and ambulatory blood pressure monitoring (ABPM). Diurnal blood pressure (BP) patterns were categorized into three groups: dippers, non-dippers and risers. Lacunar infarcts (LIs), including both symptomatic and silent and diffuse white matter lesions (WMLs), were graded into three grades according to their degree. The results of kidney function were evaluated using estimated glomerular filtration rate (eGFR), categorized into three groups: stage 1, >60; stage 2, 30-60; and stage 3, <30 ml min -1 per 1.73 m 2. There were 44 patients with CI. Confluent WMLs, including WML 2 and WML 3, were found in 36 patients (81.8%), and multiple lacunae including LI 2 and LI 3 were found in 30 patients (68.1%) with CI. Age >75 years (odds ratio (OR), 5.5; P<0.05), male sex (OR, 2.8; P<0.05), non-dippers (OR, 6.3; P<0.05) and risers (OR, 5.6; P<0.05), eGFR 30-60 ml min -1 per 1.73 m 2 (OR, 2.9; P<0.05) and eGFR <30 ml min -1 per 1.73 m 2 (OR, 23.8; P<0.01), WML grade 2 (OR, 5.1; P<0.01) and WML grade 3 (OR, 45.2; P<0.001) and LI grade 2 (OR, 3.2; P<0.05) and LI grade 3 (OR, 6.4; P<0.05) were independently associated with CI. Age 75 years (OR, 4.1; P<0.05), eGFR 30-60 ml min -1 per 1.73 m 2 (OR, 3.7; P<0.05) and eGFR 30 ml min -1 per 1.73 m 2 (OR, 8.7; P<0.05) were independently associated with WML grade 3. Extensive small vessel diseases, CKD and non-dipping status were independently associated with CI. CKD appears to mainly contribute to vascular CI, whereas possibilities of overlapping with other mechanisms such as degenerative CI cannot be excluded. Strict night time BP control and renoprotective treatment may be warranted to prevent CI. © 2011 The Japanese Society of Hypertension All rights reserved. Source

Matsunaga K.,Takeda Hospital | Takasawa C.,Tohoku University | Seiji K.,Tohoku University | Takase K.,Tohoku University | And 4 more authors.
Journal of Vascular Surgery | Year: 2012

Introduction: Establishing an aneurysm model using simple and easy operative techniques is desirable to develop new endovascular treatment devices such as stent grafts. We developed an aneurysm model using the external iliac arteries (EIAs) of adult Beagles, a relatively large animal that we thought would be easy to handle, using simple and less complicated endovascular procedures. In addition, we evaluated the generated aneurysm model histologically and determined the factors that were necessary for creating more dilated aneurysms. Methods: Experimental animals consisted of 16 beagles (average weight, 14.0 kg). The animals were divided into four groups (S, E, B+S, and B+E). Eight Beagles were in the S and E groups, without balloon dilation. S group Beagles were injected with normal saline into the right EIA and served as a control group. Elastase was injected into the left EIA of the same Beagles (E group). Eight Beagles were in the B+S and B+E groups with balloon dilation. After balloon dilation, normal saline was injected into right EIA of the B+S group. Elastase was injected into the left EIA of the same Beagles (B+E). After 4 weeks, we measured the EIA diameter using abdominal ultrasound imaging from a body surface. Both sides of the EIA were harvested. We evaluated the dilation rate of the EIA diameter, and histologically, evaluated the disappearance of the internal elastic lamina, degeneration and disappearance of medial smooth muscle and the external elastic lamina, and neointimal thickening. Results: Inner diameters were dilated more in the B+E group vs the other groups. The B+E group internal elastic lamina had almost disappeared, with significantly more severe degeneration and disappearance of external elastic lamina. Conclusions: We developed a muscular artery aneurysm model using the EIA arteries of adult Beagles and a simple endovascular procedure. Histologically, internal and external elastic lamina degeneration was an important factor to create significantly dilated aneurysms in this muscular artery model. © 2012 Society for Vascular Surgery. Source

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