Shimatsu A.,National Hospital Organization Kyoto Medical Center |
Teramoto A.,Nippon Medical School |
Teramoto A.,Tokyo Rosai Hospital |
Hizuka N.,Tokyo Women's Medical University |
And 3 more authors.
Endocrine Journal | Year: 2013
The somatostatin analog lanreotide Autogel has proven to be efficacious for treating acromegaly in international studies and in clinical practices around the world. However, its efficacy in Japanese patients has not been extensively evaluated. We examined the dose-response relationship and long-term efficacy and safety in Japanese patients with acromegaly or pituitary gigantism. In an open-label, parallel-group, dose-response study, 32 patients (29 with acromegaly, 3 with pituitary gigantism) received 5 injections of 60, 90, or 120 mg of lanreotide Autogel over 24 weeks. Four weeks after the first injection, 41% of patients achieved serum GH level of <2.5 ng/mL and insulin-like growth factor-I (IGF-I) level was normalized in 31%. Values at Week 24 were 53% for GH and 44% for IGF-I. Dose-dependent decreases in serum GH and IGF-I levels were observed with dose-related changes in pharmacokinetic parameters. In an open-label, long-term study, 32 patients (30 with acromegaly, 2 with pituitary gigantism) received lanreotide Autogel once every 4 weeks for a total of 13 injections. Dosing was initiated with 90 mg and adjusted according to clinical responses at Weeks 16 and/or 32. At Week 52, 47% of patients had serum GH levels of <2.5 ng/mL and 53% had normalized IGF-I level. In both studies, acromegaly symptoms improved and treatment was generally well tolerated although gastrointestinal symptoms and injection site induration were reported. In conclusion, lanreotide Autogel provided early and sustained control of elevated GH and IGF-I levels, improved acromegaly symptoms, and was well tolerated in Japanese patients with acromegaly or pituitary gigantism. © The Japan Endocrine Society.
Ogawa M.,Jichi Medical University |
Suzuki Y.,Tokyo Rosai Hospital |
Endo Y.,Tokyo Rosai Hospital |
Kawamoto T.,University of Occupational and Environmental Health Japan |
Kayama F.,Jichi Medical University
Industrial Health | Year: 2011
Intake of foods and drinks containing benzoic acid influences the urinary hippuric acid (HA) concentration, which is used to monitor toluene exposure in Japan. Therefore, it is necessary to control the intake of benzoic acid before urine collection. Recently, some reports have suggested that components of coffee, such as chlorogenic, caffeic, and quinic acids are metabolized to HA. In this study, we evaluated the influence of coffee intake on the urinary HA concentration in toluene-nonexposed workers who had controlled their benzoic acid intake, and investigated which components of coffee influenced the urinary HA concentration. We collected urine from 15 healthy men who did not handle toluene during working hours, after they had consumed coffee, and we measured their urinary HA concentrations; the benzoic acid intake was controlled in these participants during the study period. The levels of chlorogenic, caffeic, and quinic acids in coffee were analyzed by LC-MS/MS. Urinary HA concentration increased significantly with increasing coffee consumption. Spectrophotometric LC-MS/MS analysis of coffee indicated that it contained chlorogenic and quinic acids at relatively high concentrations but did not contain benzoic acid. Our findings suggest that toluene exposure in coffee-consuming workers may be overestimated.
Fukusumi M.,Tokyo Rosai Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2011
A 67-year-old woman with a history of non-tuberculous mycobacteriosis due to Mycobacterium avium in 2002 and 2006 was admitted because of low-grade fever and cavitary lesions in both lungs on chest computed tomography (CT). Bronchial brushing cytology by bronchoscopy did not yield mycobacterium. Her serum antineutrophil cytoplasmic antibodies (MPO-ANCA) level was elevated and PR3 ANCA was negative. A surgical lung biopsy revealed basophilic necrosis with cavitary lesions and necrotizing vasculitis compatible with Wegener granulomatosis (WG). In the resected specimen, several hyalinizing nodules with caseous necrosis, probably associated with previous mycobacterium infection, were also seen. Because her disease was limited to the lungs, we successfully treated her with corticosteroids and methotrexate. WG is considered to be a type of ANCA-associated vasculitis, and microbial infections have been associated with initiation and relapse of WG. This case clearly demonstrated that lesions of WG occurred after mycobacterial infection in the lung. We believe that this case was ANCA production in association with bacterial infection.
Ishii Y.,Nippon Medical School |
Tahara S.,Nippon Medical School |
Teramoto A.,Tokyo Rosai Hospital |
Morita A.,Nippon Medical School
Neurologia Medico-Chirurgica | Year: 2014
In recent years, resections of midline skull base tumors have been conducted using endoscopic endonasal skull base (EESB) approaches. Nevertheless, many surgeons reported that cerebrospinal fluid (CSF) leakage is still a major complication of these approaches. Here, we report the results of our 42 EESB surgeries and discuss the advantages and limits of this approach for resecting various types of tumors, and also report our technique to overcome CSF leakage. All 42 cases involved midline skull base tumors resected using the EESB technique. Dural incisions were closed using nasoseptal flaps and fascia patch inlay sutures. Total removal of the tumor was accomplished in seven pituitary adenomas (33.3%), five craniopharyngiomas (62.5%), five tuberculum sellae meningiomas (83.3%), three clival chordomas (100%), and one suprasellar ependymoma. Residual regions included the cavernous sinus, the outside of the intracranial part of the internal carotid artery, the lower lateral part of the posterior clivus, and the posterior pituitary stalk. Overall incidence of CSF leakage was 7.1%. Even though the versatility of the approach is limited, EESB surgery has many advantages compared to the transcranial approach for managing midline skull base lesions. To avoid CSF leakage, surgeons should have skills and techniques for complete closure, including use of the nasoseptal flap and fascia patch inlay techniques. © 2014, Neurol Med Chir (Tokyo). All rights received.
Hattori Y.,Nippon Medical School |
Tahara S.,Nippon Medical School |
Ishii Y.,Nippon Medical School |
Kitamura T.,Nippon Medical School |
And 5 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013
Context: IgG4-related hypophysitis is a novel clinical disease entity, which is typically complicated by hypopituitarism. Objective: The objective of the study was to describe a novel case of IgG4-related hypophysitis without pituitary insufficiency and summarize the current relevant literature. Patient and Methods: A55-year-old Japanese man presented with an enlarged pituitary gland and bitemporal hemianopsia. Endocrine studies revealed normal pituitary function, although his serum IgG4 level was high. The patient underwent a transsphenoidal biopsy of the pituitary gland, and the pathological tissues were consistent with IgG4-related hypophysitis. Oral prednisolone therapy was started, and after 6 months, his serum IgG4 level decreased and visual field improved. Conclusion: We described the first case of IgG4-related hypophysitis without pituitary insufficiency. However, further case collection is needed to characterize the pathophysiology of IgG4-related hypophysitis. Copyright © 2013 by The Endocrine Society.
Yao T.,Juntendo University |
Shiono S.,Tokyo Rosai Hospital
Digestive Endoscopy | Year: 2016
It is well known that there are discrepancies in the diagnosis of gastrointestinal neoplasia between Western and Japanese pathologists. In the West, colorectal cancer (CRC) is defined by invasion through the muscularis mucosa into the submucosa, especially depending on the presence of desmoplasia. In Japan, however, CRC is defined based on a combination of nuclear and architectural abnormalities, regardless of invasion status. As a result, intramucosal carcinoma is diagnosed as high-grade dysplasia and even intramucosal carcinoma with poorly differentiated component is classified as 'Tis' in the West. It is logical and reasonable that the term 'T1' is used to currently describe intramucosal carcinoma. Use of the term 'high-grade dysplasia' for intramucosal CRC is outdated. In order to determine appropriate clinical treatment of CRC, the various risk factors of metastasis should be fully evaluated. With improved contributions and communication between pathologists and clinicians, overtreatment and inadequate follow up can be avoided. The discrepancies in the diagnosis of CRC between Western and Japanese pathologists may be addressed by an increase in East-West exchange. In addition, in the future, molecular analysis may also be useful for establishment of standardized diagnostic criteria of CRC. © 2015 Japan Gastroenterological Endoscopy Society.
Tojima H.,Tokyo Rosai Hospital
Japanese Journal of Chest Diseases | Year: 2016
Respiratory infectious diseases are caused by various pathogens and show various clinical presentations. Because most respiratory infections are spread by the airborne droplet and contact routes, surgical masks and good hand hygiene are necessary precautions. It should be noted that airborne infections include tuberculosis, in which case, airflow control and N95 masks are required. The time between the patient's admission and the start of treatment represents the highest risk for the spread of pathogens in the hospital. Consequently, environmental control, such as proper ventilation in the room, and the use of standard personal protective measures are essential.
Koyama F.,Tokyo Rosai Hospital
Nihon rinsho. Japanese journal of clinical medicine | Year: 2014
While suicides in Japan decreased slightly to about 28,000 in 2012, there were still nearly 30,000 suicides, many of which suffered from mental illness, such as depression. Suicide among the working age society is reduced somewhat in the 50s, and a major issue relates to suicide prevention measures for young people less than 30-years old. Previous studies have shown that depression is closely related with the duration of sleep deprivation. Furthermore, we have shown a significant correlation with insomnia, depression, fatigue, and chronic pain, i.e., lifestyle-related diseases. We are attempting to establish a method for early detection of depression based upon an interview regarding the sleep of workers, and plan to apply this prophylaxis method to occupational health practice.
Tanaka S.,International University of Health and Welfare |
Tashiro T.,International University of Health and Welfare |
Gomi A.,Jichi Medical University |
Ujiie H.,Tokyo Rosai Hospital
Neurologia Medico-Chirurgica | Year: 2011
A newly designed hydroxyapatite (HA) spacer for cervical laminoplasty is provided with a hole through which the titanium miniplate is passed. A new method of unilateral open-door laminoplasty with titanium miniscrew and miniplate through this HA spacer is described. Twenty-two patients with cervical stenotic disorders were treated by this procedure. Only the predominantly affected side of the laminae is exposed. The supraspinous and interspinous ligaments and the deep muscle layer in the contralateral side are left intact. A 4-mm wide gutter near the intervertebral joint is made and contralateral hinges are made under the deep muscle layer with minimum detachment of these muscles. The opened lamina is fixed with the titanium miniplate passed through the hole in the newly designed HA spacer. Mean operative time for the 22 operations was 193.5 minutes. Mean enlargement of the minimum spinal canal diameter was 50.9%. Neurological outcomes after 3 months were evaluated according to the Japanese Orthopaedic Association (JOA) scoring. Mean recovery rate of JOA score by Hirabayashi's method was 49.5%. Only 2 patients reported postoperative axial neck pain. Our method for unilateral open-door laminoplasty provides adequate decompression and tight fixation of laminae, and is less invasive to the posterior supporting elements of cervical spine. © 2011 by The Japan Neurosurgical Society.
Tojima H.,Tokyo Rosai Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2010
A tuberculosis infection-control program is based on a 3-level hierarchy of measures, including administrative, environmental, and respiratory protection. The most important level of tuberculosis controls is the use of administrative measures to reduce the risk of exposure to patients who might have infectious tuberculosis. In 126 patients tuberculosis was given diagnosed in our hospital over 10 years, and 51 patients among them had bacilli-positive sputum smears, of whom 26 were given diagnoses after admission, and 15 patients of these, in whom tuberculosis was not strongly suspected on admission, were considered to be at risk of nosocomial infection. The mean age of these 15 patients was 66.3 years, and 9 of them were given diagnoses of pneumonia. Duration until tuberculosis diagnosis was within 3 days in 11 patients, 4 to 7 days in 2, and more than 8 days in 2 patients. Twelve patients were admitted from the emergency room or belonged to other departments than respiratory medicine. We believe that it is important to consider tuberculosis when deciding about admission, in order not to delay diagnosis. Furthermore, ventilation of general rooms must be sufficient when dealing with the unexpected admission of patients with tuberculosis, and ability of health-care workers to use N95 respirators should be confirmed.