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Deno M.,Keio University | Tashiro M.,Showa University | Miyashita M.,Tohoku University | Asakage T.,University of Tokyo | And 6 more authors.
Psycho-Oncology | Year: 2012

Objective: Although social support has been recognized as an important factor in the quality of life of head and neck cancer patients, there has been little investigation of the buffering effect of social support on these patients' social distress or of the coping skill of self-efficacy. The aim of this study was to examine how social support and self-efficacy mediate the relationship between social distress and emotional distress in head and neck cancer patients. Methods: Two hundred twenty-five head and neck cancer patients completed our questionnaire (effective response rate, 92.2%). Of these, 129 (57.3%) had facial disfigurement. These participants responded to questions about perception of social distress, social support, self-efficacy, and emotional distress (depression and anxiety). We used structural equation modeling for statistical analysis. Results: The fit indices of this model were excellent (χ 2 (7) = 9.147, p = 0.242, goodness of fit index (GFI) = 0.981, adjusted goodness of fit index (AGFI) = 0.922, comparative fit index (CFI) = 0.993, root mean square error of approximation (RMSEA) = 0.049). Self-efficacy strongly buffered the negative influence of social distress on emotional distress. Social support from family members did not have a direct or indirect influence on emotional distress. Social support from friends was related to lower social distress and higher emotional distress. Conclusions: Our findings suggest that self-efficacy might confound the relationship between social support and emotional distress, and that different sources of social support might play different roles in the mediation of social distress on emotional distress. © 2010 John Wiley & Sons, Ltd.


Fukamizu S.,Tokyo Metropolitan Hiroo Hospital | Sakurada H.,Tokyo Metropolitan Health and Medical Treatment Corporation | Hayashi T.,Tokyo Metropolitan Hiroo Hospital | Hojo R.,Tokyo Metropolitan Hiroo Hospital | And 6 more authors.
Journal of Cardiovascular Electrophysiology | Year: 2013

Introduction: Macroreentrant atrial tachycardia (MRAT) has been described most frequently in patients with prior cardiac surgery. Left atrial tachycardia and flutter are common in patients who undergo atrial fibrillation ablation; however, few reports describe left atrial MRAT involving the regions of spontaneous scarring. Here, we describe left atrial MRAT in patients without prior cardiac surgery or catheter ablation (CA) and discuss the clinical and electrophysiological characteristics of tachycardia and outcome of CA. Methods and Results: An electrophysiological study and CA were performed in 6 patients (3 men; age 76 ± 6 years) with MRAT originating from the left atrial anterior wall (LAAW). No patient had a history of cardiac surgery or CA in the left atrium. Spontaneous scars (areas with bipolar voltage ≤ 0.05 mV) were observed in all patients. The activation map showed a figure-eight circuit with loops around the mitral annulus (4 counterclockwise and 2 clockwise) and a low-voltage area with LAAW scarring. The mean tachycardia cycle length was 303 ± 49 milliseconds. The conduction velocity was significantly slower in the isthmus between the scar in the LAAW and the mitral annulus than in the lateral mitral annulus (0.17 ± 0.05 m/s vs 0.94 ± 0.35 m/s; P = 0.003). Successful ablation of the isthmus caused interruption of the tachycardia and rendered it noninducible in all patients. Conclusion: Spontaneous LAAW scarring is an unusual cause of MRAT, showing activation patterns with a figure-eight configuration. Radiofrequency CA is a feasible and effective treatment in such cases. © 2012 Wiley Periodicals, Inc.


Kohno Y.,Tokyo Medical and Dental University | Maruyama M.,Tokyo Metropolitan Health and Medical Treatment Corporation | Matsuoka Y.,National Institute of Mental Health | Matsushita T.,Saitama University | And 2 more authors.
Psycho-Oncology | Year: 2010

To characterize gastrointestinal cancer survivors' ability to psychologically adjust, we examined the relationship between psychological characteristics (quality of life (QOL), anxiety, depression, and post-traumatic stress symptoms) and self-efficacy (perceived ability to initiate coping strategies). Forty-seven subjects (32 males and 15 females) were recruited from outpatient clinics or general surgical wards after readmission for therapy unrelated to cancer. All had undergone treatment for gastrointestinal cancer. Japanese version of the Functional Assessment of Cancer Therapy-General (FACT-G), Japanese version of Hospital Anxiety and Depression Scale (HADS), Japanese version of Impact of Event Scale-Revised (IES-R), and The Self-Efficacy Scale for Advanced Cancer (SEAC) were administered. Correlation analyses revealed a statistically significant positive correlation between three subscales of SEAC and QOL (total of FACT-G value) and a significant negative correlation between anxiety, depression (the total of HADS value), post-traumatic stress symptoms (the total of IES-R value), and SEAC. In multiple regression analysis, the influence from Affect Regulation Efficacy (subscale of SEAC) was the largest in anxiety and post-traumatic stress symptoms while the influence from Activities of Daily Living Efficacy (subscale of SEAC) was the largest in QOL and depression. Our findings revealed that a strong relationship between self-efficacy and psychological adjustment, and that there should be several psychological intervention forms performed at various treatment stages to enhance self-efficacy in this population of gastrointestinal cancer survivors. These results also imply the effectiveness of interventions on self-efficacy for gastrointestinal cancer survivors and the influence of psychological factors such as QOL, anxiety, depression, and post-traumatic stress symptoms. Copyright © 2009 John Wiley & Sons, Ltd.


Aoki N.,Bethlehem Garden Hospital | Okada T.,Tokyo Metropolitan Health and Medical Treatment Corporation
Japanese Journal of Neurosurgery | Year: 2016

The authors have developed percutaneous subdural tapping as a minimally invasive treatment, particularly for aged patients with chronic subdural hematomas. This treatment modality, however, has been considered to be unsuitable for multilobuled hematomas. Therefone a new technique is proposed to remove the remote hematomas by additional injection of oxygen into the primary hematoma cavity. The possible mechanism of this pathological process based on this treatment is also discussed. © 2016, Japanese Congress of Neurological Surgeons. All rights reserved.


Takahashi T.,Tokyo Metropolitan Health and Medical Treatment Corporation | Takahashi T.,Laboratory of Molecular Epidemiology for Infectious Agents | Sunaoshi K.,Laboratory of Molecular Epidemiology for Infectious Agents | Sunakawa K.,Kitasato University | And 3 more authors.
Clinical Microbiology and Infection | Year: 2010

Streptococcus dysgalactiae ssp. equisimilis (SDSE) is increasingly being identified as a pathogen responsible for invasive and non-invasive infections. We compared the clinical features of invasive SDSE infections with those of invasive infections caused by Streptococcus pyogenes (group A streptococcus (GAS)) and Streptococcus agalactiae (group B streptococcus (GBS)). Active surveillance for invasive SDSE, GAS and GBS was maintained over 1 year at 142 medical institutions throughout Japan. Clinical information was collected together with isolates, which were characterized microbiologically. Two hundred and thirty-one invasive SDSE infections were identified, 97 other patients had infections with GAS, and 151 had infections with GBS. The median age of the SDSE patients was 75 years; 51% were male and 79% had underlying diseases. Forty-two SDSE patients (19%) presented to the emergency department. Among the 150 patients (65%) for whom follow-up was completed, 19 (13%) died and eight (5%) had post-infective sequelae (poor outcome). Insufficient white blood cell responses (<5000 cells/μL) and thrombocytopenia on admission each suggested significantly higher risk of poor outcome (ORs 3.6 and 4.5, respectively). Of 229 isolates, 55 (24%) showed an stG6792 emm type, which was significantly associated with poor outcome (OR 2.4). Clinical manifestations of invasive SDSE infections were distinct from those of invasive GBS infections. Primary-care doctors should consider invasive SDSE infections when treating elderly patients. © 2009 The Authors. Journal Compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.


OBJECTIVES & SUBJECTS: The change in IGRA (interferon-gamma release assay, with QuantiFERON-TB Gold, QFT) responses was followed up for one year in a group of contacts of healthcare workers who had been exposed to tuberculosis (TB) infection for a relatively short period in a hospital. The observation was made of a total of 59 close contacts of the index case, where 16 showed positive QFT-conversion and 7 showed the intermediate response ranging 0.1 to 0.35 IU/mL. Three of the conversion cases developed active TB. 67% of the QFT conversions occurred within 2 months of exposure and the others between 2 to 9 months. Those having converted later than 2 months after the exposure showed generally weaker QFT responses than the earlier converters. In response to the treatment to converters (either to latent TB infection or to active TB), 80% of the cases reversed to negative or intermediate. The geometric means of the response values for ESAT-6 and CFP-10 also showed significant decline over the treatment time. The time profile of responses in the intermediate responders revealed an obviously distinct pattern from that of the negative responders with the values remaining uniformly at very low level throughout, which suggests that this group includes somehow exceptional responders either with or without infection.


Ando M.,Tokyo Metropolitan Health and Medical Treatment Corporation
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

It is common to use systemic chemotherapy, instead of hepatic arterial infusion (HAI) of 5-fluorouracil (5-FU) or other cytotoxic agents, for unresectable hepatic metastases in colorectal cancer patients. Nevertheless, systemic administration of anticancer agents such as FOLFOX or FOLFIRI is sometimes difficult to continue for infirm patients. A 71-year-old female who had undergone sigmoidectomy for sigmoid colon cancer received HAI for 12 months because of big bilobar hepatic metastases and poor performance status. Thereafter, a two-stage hepatectomy(first, left lobe: second, S7+8 and S5) was performed successfully. She has been alive for 2.5 years after the first operation but with two small lung metastases in the left lobe. Because of bad performance status and her weak social and familial conditions, treatment with standard systemic chemotherapy could not be continued. In such cases, HAI should be performed if the metastases are limited to the liver.


Asami R.,Tokyo Metropolitan Health and Medical Treatment Corporation.
Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases | Year: 2010

We studied the relationship between features of beta-hemolytic streptococci (n = 45) isolated from blood in adult invasive infection and the clinical background factors observed from January 2001 through August at a hospital for the elderly. The meanage of subjects having invasive streptococcal infection with 22 invasive Streptococcus dysgalactiae subspecies equisimilis (SDSE) strains, 2 S. pyogenes isolates, and 21 S. agalactiae (GBS) was 80 years, and 85.7% and 86.4% had underly diseases in the GBS and SDSE infections. SDSE-infected were mainly emergency woman outpatients and GBS infected were mainly man inpatients. The clinical syndrome involved pneumonia, urosepsis, and cellulitis. GBS mortality was 14.3% and SDSE mortality 27.3%. Compared to survivors, nonsurvivors had more thrombocytopenia and marked serum C-reactive protein elevation when blood culture were performed. No difference was seen in white blood cell count between bath groups. Our observations suggest that blood culture should be obtained before antimicrobials administration in elderly individuals with underlying illness who are seen at the emergency department and have laboratory blood data suggestive of infectious disease.


Takasaki J.,Tokyo Metropolitan Health and Medical Treatment Corporation
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

Purpose: Radiofrequency ablation(RFA) is minimally invasive and is easy to perform. In the RFA procedure, puncture and passing of the electrical current are painful. Therefore, some facilities use general anesthesia for RFA. In order to evaluate the use of general anesthesia for RFA of hepatocellular carcinoma, a questionnaire survey was conducted. Methods: With the cooperation of Tokyo liver-tomo-no-kai(Tokyo Liver Association), a questionnaire survey was conducted for patients who underwent RFA. In the survey, data on the following were obtained "type of anesthesia used", "number of RFA treatment points", "duration of treatment", "length of impact of pain", and "if you need to receive RFA treatment again, how would you feel about this." Results: The ratio of local anesthesia (LA) to general anesthesia (GA) was 113:24. The ratios of the numbers of patients who felt pain to those who felt no pain were 64:49 (LA) and 0:24 (GA). The ratios of the patients who wished to not receive RFA again to the patients who were comfortable with receiving RFA were 65:45 (LA) and 4:20 (GA). Conclusion: GA achieves better pain control compared to LA, and the patients who receive GA have greater tolerance of RFA.


PubMed | Tokyo Metropolitan Health and Medical Treatment Corporation
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2017

We report a case of resection of a paraaortic lymph node recurrence, wherein complete response to bevacizumab was observed. Our patient was a 50-year-old woman who had a paraaortic lymph node recurrence during adjuvant chemotherapy with FOLFOX 6 months after surgery for sigmoid colon cancer. She was treated with chemotherapy consisting of FOLFOX plus bevacizumab/FOLFIRI plus bevacizumab, which suppressed progression of the periaortic lymph node recurrence. She underwent surgery for the paraaortic lymph node recurrence, and the pathologic result was complete response. We report that bevacizumab was effective for her paraaortic lymph node recurrence.

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