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Tokushima-shi, Japan

Suzue M.,Tokushima Municipal Hospital | Mori K.,Tokushima Prefectural Central Hospital | Inoue M.,Tokushima Prefectural Central Hospital | Hayabuchi Y.,Tokushima University | And 2 more authors.
Journal of Echocardiography | Year: 2014

Background: The diastolic wall strain (DWS) of the left ventricle has been proposed as an indicator of left ventricular (LV) wall stiffness. The DWS is calculated as follows using M-mode echocardiography:(Formula presented.)LV posterior wall thickness at end-systole(Formula presented.)LV posterior wall thickness at end-diastole(Formula presented.)LV posterior wall thickness at end-systole(Formula presented.)Although this index is simple and clinically useful, normal values for children, including neonates, have not been reported.Methods: The DWS was measured in 235 healthy people, ranging from neonates to adults. They were classified into 8 subgroups according to their age. The DWS was compared with conventional echocardiographic parameters for left ventricle function, including shortening fraction of the left ventricle, the Tei index, E/A of mitral flow, mitral annular tissue Doppler velocity during systole (s′) and during early diastole (e′), and the E/e′ ratio.Results: The DWS in the just after birth group was 0.28 ± 0.11, which was significantly lower than that of the remaining groups (p < 0.05), except for the neonate group at 5–10 days after birth. The DWS was highest in the 1–9 years of age group, and then gradually decreased with age. Stepwise regression of various echocardiographic parameters showed that e′ was the most relevant parameter for the DWS (β = 0.64).Conclusions: Normal values for the DWS of the left ventricle change with age. The data reported in this study can be used as normal values for the DWS of the left ventricle determined by M-mode echocardiography. © 2014, Japanese Society of Echocardiography. Source

Yamada S.,Tokushima University | Shimada M.,Tokushima University | Miyake H.,Tokushima Municipal Hospital | Utsunomiya T.,Tokushima University | And 7 more authors.
Hepatology Research | Year: 2012

Aim: The aim of this study was to investigate the characteristics of super-elderly hepatocellular carcinoma (HCC) patients aged 80 years or more who underwent hepatectomy and to clarify whether elderly patients with HCC benefit from hepatectomy. Methods: Between March 1992 and December 2008, 278 patients who underwent curative hepatectomy for HCC were investigated. Super-elderly patients were defined as those aged 80 years or more. Clinicopathological data and outcomes after hepatectomy were compared between superelderly and non-super-elderly groups. Results: Preoperative parameters, such as biochemical examinations, and liver function tests in the non-super-elderly group were comparable with those of the super-elderly group (n = 11). Exceptionally, albumin level in the super-elderly group was lower than that in the non-super-elderly group (P = 0.03). Surgical data and the prevalence of postoperative complications did not differ significantly between the two groups. No mortality was observed in the super-elderly and non-super-elderly group. Conclusions: Hepatectomy for HCC was a feasible option even in super elderly patients aged 80 years or older with accurate selection. © 2011 The Japan Society of Hepatology. Source

Sone S.,Tokushima Municipal Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2015

In Japan, investigator-initiated clinical phase IV trials must follow the Ethical Guidelines for Medical and Health Research Involving Human Subjects, issued in December 2014. In addition, researchers must follow the Helsinki Declaration. In these clinical trials, academia-industry collaborations involving funding and technical support are required to develop better evidence-based medicine. Nevertheless, instances of publications reporting biases or misconduct in the research process occur frequently, which may lead to other problems due to lack of transparency. To address this issue, an institutional framework must be developed and maintained in which investigators maintain a high level of ethical adherence to protect the welfare of research subjects while carrying out research scientifically and appropriately under a conflict of interest (COI) disclosure. All authors must be seriously committed to greater responsibility, accountability, and transparency in collaborating with the industry. Source

Fujimoto C.,Tokushima Municipal Hospital | Tamura K.,Tokushima Municipal Hospital | Takeda N.,Tokushima University
Practica Oto-Rhino-Laryngologica | Year: 2016

An 80-year-old male patient with multiple laryngeal chondromas is reported. Bilateral thyroid cartilage masses were identified incidentally on CT. The masses remained constant in size over a two-year follow-up period, however, pharyngolaryngeal endoscopy at the end of two years showed submucosal swelling of the false folds of the larynx. A mass lesion measuring 15 mm in diameter in the right lamina of the thyroid cartilage was surgically resected by the cervical approach under local anesthesia. Histopathological examination showed mild proliferation of chondrocytes without nuclear atypia in a hyaline cartilage matrix, based on which the diagnosis of laryngeal chondroma was made. Another mass measuring 7 mm in diameter found in the left lamina of the thyroid cartilage was left unresected and will be followed up. Source

Chikawa T.,Tokushima Municipal Hospital | Sakai T.,Tokushima University | Sakai T.,University of California at Irvine | Bhatia N.N.,University of California at Irvine | And 6 more authors.
British Journal of Neurosurgery | Year: 2011

Surgical site infection (SSI) is an unfortunate and unpreventable complication of any surgical intervention including spinal surgery. Early deep SSI (EDSSI) after instrumented spinal fusion are particularly difficult to manage due to the implanted, and possibly infected, instrumentation. The purpose of this study is to retrospectively review patients who underwent spinal surgery, investigate the rate of EDSSI, identify patient-related and surgery-related risk factors and to assess the effectiveness of continuous indwelling irrigation on the eradication of these infections. A total of 814 patients (319 women and 495 men) who underwent spinal surgery were enrolled. Mean age at the initial surgery was 57.4 years old. Infections that penetrated the deep fascia within 1 month after the initial operation were considered as EDSSI. The rate of EDSSI, causal organisms, infection management and resolution were studied. Furthermore, we examined the patient-related and the operation-related risk factors. An overall incidence of EDSSI of 1.1% was found. In 177 patients with diabetes mellitus (DM), two patients (1.1%) developed EDSSI. In 28 patients receiving chronic haemodialysis (HD), two patients with infections (7.1%) were identified, which was statistically significantly greater than the other patient populations. Both operative time and intraoperative blood loss were significantly greater in patients with EDSSI than in non-infected patients. Furthermore, the rate of EDSSI in patients undergoing instrumented spinal fusion (3.8%) was significantly higher than that in the other patients. In the nine patients who developed EDSSI, the causal organisms were identified and treated by surgical debridement, antibiotic therapy and continuous indwelling surgical site irrigation. All infections resolved, and no recurrence has been observed at final follow-up. Removal of the instrumentation was required in only one patient. Based on our results, we believe that continuous surgical site irrigation is an effective adjunct in the surgical treatment for early SSI following spinal surgery. © 2011 The Neurosurgical Foundation. Source

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