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Satsumasendai, Japan

Nezu Y.,Tohoku Rosai Hospital | Nakaji S.,Kameda Medical Center | Fujii H.,Kameda Medical Center | Ishii E.,Kameda Medical Center | Hirata N.,Kameda Medical Center
Endoscopy | Year: 2014

We present three cases of pseudoaneurysm caused by self-expandable metal stents that formed arteriobiliary fistulas and caused hemobilia. Diagnoses were made on the basis of dynamic computed tomography or angiography. One patient died because of bleeding and cholangitis, whereas the others were successfully treated by transarterial embolization. © Georg Thieme Verlag KG Stuttgart, New York.

Ohara S.,Tohoku Rosai Hospital | Kawano T.,Tokyo Medical and Dental University | Kusano M.,Gunma University | Kouzu T.,Chiba University
Journal of Gastroenterology | Year: 2011

Background: The present survey aimed to clarify the prevalence of gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) in patients presenting with epigastric symptoms in Japan based on the Montreal definition and the Rome III criteria, respectively, and to determine the degree of overlap between the two disease entities and the validity of using these Western-developed diagnostic criteria in Japan. Methods: Patients presenting with epigastric symptoms for whom the first upper gastrointestinal endoscopy was scheduled from April through August 2007 at 55 institutions were asked to complete a questionnaire to ascertain the type, frequency, and severity of epigastric symptoms. The prevalence of esophageal mucosal damage was also determined from endoscopic findings. Results: A total of 1,076 patients were included in the analysis population. There was a high degree of coincidence for all symptoms, with the mean number of symptoms per patient of 2.8. With strict application of the Montreal and Rome III definitions, symptomatic GERD accounted for 15.6% (168 patients), whereas FD accounted for 10.3% (111 patients), and the overlap between GERD and FD symptoms was less than 10%. However, when frequency and severity alone were considered in more broadly defined criteria, the overlap between GERD and FD symptoms was 30-40%. Conclusion: A highly specific disease classification is possible when the Montreal definition and the Rome III criteria are strictly applied. On the other hand, the present survey highlighted a problem with the criteria whereby a definitive diagnosis could not be made in a substantial number of patients. This problem will require further research. © 2011 Springer.

Kusakabe T.,Tohoku Rosai Hospital
Orthopaedics and Trauma | Year: 2013

Cauda equina syndrome (CES) is a relatively uncommon but serious condition arising from a compressive lesion in the lumbar spine canal. This gives rise to a complex of symptoms including bladder dysfunction. The most common causes are disc herniation, tumour, abscess, haematoma, fracture and spinal stenosis. While clinical history and examination are important, diagnosis is usually made by imaging modalities such as MRI or CT myelography. Once diagnosed, emergency decompression surgery is necessary to prevent permanent neurological dysfunction. © 2013 Elsevier Ltd.

Shiga Y.,Tohoku University | Asano T.,Tohoku University | Kunikata H.,Tohoku University | Nitta F.,Tohoku University | And 4 more authors.
Investigative Ophthalmology and Visual Science | Year: 2014

PURPOSE. We investigated the accuracy and reproducibility of relative flow volume (RFV), a novel index of blood flow in the human retina derived from laser speckle flowgraphy (LSFG). METHODS. Pre- and postbranch retinal RFV measurements were compared in 34 retinal venous bifurcations in 34 healthy volunteers (mean age, 49.0 6 14.8 years) to determine the accuracy of RFV. Next, the coefficient of variation (COV) of RFV was determined for 30 temporal retinal arteries in a second group of 18 healthy volunteers (mean age, 30.3 6 7.7 years). Finally, laser Doppler velocimetry (LDV) data were obtained from the same study population and compared to RFV data from the retinal vessels. RESULTS. A comparison of RFV measurements in a trunk vessel of the retina and the sum of its two daughter vessels revealed a strong correlation (r = 0.98, P < 0.001). Reproducibility analysis showed that the COV for RFV was 5.9% 6 3.6%. Linear regression analysis revealed that RFV was correlated significantly with LDV measurements of mean retinal blood velocity (νmean) and retinal blood flow (FLDV, νmean, r = 0.61, P < 0.001; FLDV, r = 0.51, P = 0.004, respectively), but not significantly correlated with ocular perfusion pressure (r = 0.04, P= 0.76). CONCLUSIONS. These results suggest that RFV values obtained with LSFG can be considered an accurate and reliable index of relative blood flow in the human retina. Thus, RFV, a novel LSFG-derived variable, has potential for assessing retinal blood flow alterations in ocular disease. © 2014 The Association for Research in Vision and Ophthalmology, Inc.

Kawaguchi H.,University of Tokyo | Oka H.,University of Tokyo | Jingushi S.,Kyushu Rosai Hospital | Izumi T.,Saihaku Hospital | And 4 more authors.
Journal of Bone and Mineral Research | Year: 2010

Fibroblast growth factor 2 (FGF-2) is a potent mitogen for mesenchymal cells, and a local application of recombinant human FGF-2 (rhFGF-2) in a gelatin hydrogel has been reported to accelerate bone union in our animal studies and preparatory dose-escalation trial on patients with surgical osteotomy. We have performed a randomized, double-blind, placebo-controlled trial in which patients with fresh tibial shaft fractures of transverse or short oblique type were randomly assigned to three groups receiving a single injection of the gelatin hydrogel containing either placebo or 0.8amg (low-dosage group) or 2.4amg (high-dosage group) of rhFGF-2 into the fracture gap at the end of an intramedullary nailing surgery. Of 194 consecutive patients over 2 years, 85 met the eligibility criteria, and 70 (24 in the placebo group and 23 each in low- and high-dosage groups) completed the 24-week study. The cumulative percentages of patients with radiographic bone union were higher in the rhFGF-2-treated groups (p=.031 and.009 in low- and high-dosage group, respectively) compared with the placebo group, although there was no significant difference between low- and high-dosage groups (p=.776). At 24 weeks, 4, 1, and 0 patients in the placebo, low-dosage, and high-dosage groups, respectively, continued to show delayed union. No patient underwent a secondary intervention, and the time to full weight bearing without pain was not significantly different among the three groups (p=.567). There also was no significant difference in the profiles of adverse events among the groups. In conclusion, a local application of the rhFGF-2 hydrogel accelerated healing of tibial shaft fractures with a safety profile. © 2010 American Society for Bone and Mineral Research.

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