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Tomigusuku, Japan

Sasagawa T.,Kanazawa Medical University | Maehama T.,Tomishiro Central Hospital | Ideta K.,Chayamachi Ladies Clinic | Irie T.,Bunkamura dori Ladies Clinic
Journal of Medical Virology | Year: 2016

A multi-center study was conducted to examine 6,628 eligible Japanese women aged from 16 to 50 years for uterine cervical abnormality and HPV infection with a liquid based-cytology test and a novel HPV test using the PCR-SSOP-Luminex® method identifying 31 HPV genotypes. In 3,047 normal subjects, the overall prevalence across all HPV types was 25%, while that of the common 13 high-risk (Common-13HR) types (HPV-16, 18. 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) was 17%, and that of the definite high-risk (Definite-HR) types (HPV-16, 18. 31, 33, 35, 45, 52, and 58) was 12%. For Definite-HR, HPV-52, 16, and 58 were the most common, HPV-31 was relatively common, and HPV-18 was less common, while HPV-33, 35, and 45 were rare. Seven Definite-HR excluding HPV-45 and seven Possible-HR (HPV-39, 51, 56, 66, 68, 70, and 82) HPV types were identified as a single type infection in patients with high-grade squamous intraepithelial lesion (HSIL) or worse. The Common-13HR types were detected in 89% of subjects with HSIL, whereas either Definite-HR or Possible-HR types were detected in 95% of HSIL. These 1420 HPV types appear to be involved with HSIL or worse in Japan. The prevalences of multiple-type HPV infections were identified in roughly half of HPV-positive subjects, and decreased significantly with age in normal population and abnormal cytology groups, although the prevalences of single-type infections increased with age in the latter group. Most HPV infections are cleared for some years, while a certain HR-HPV type persists to induce HSIL. J. Med. Virol. 88:324-335, 2016. © 2015 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Yamauchi A.,Tomishiro Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

Mediastinitis caused by methicillin-resistant Staphylococcus aureus (MRSA) is a serious complication in cardio-thoracic surgery. In mediastinitis cases, acute thoracic aortic graft infection is a lethal status. We described a successful treatment of MRSA thoracic graft infection by V.A.C. ATS therapy. Ascending aortic graft replacement was performed in a 55-year-old man, and deep mediastinitis by MRSA occurred on postoperative day 6. On postoperative day 8, negative pressure wound therapy (NPWT) using a home-made system, was carried out after re-sternotomy, debridement of inflammatory tissues and irrigation. Following the 1st NPWT, V.A.C. ATS therapy was introduced. MRSA vanished from the mediastinum after V.A.C. ATS therapy, and the mediastinum was closed with the omentum. He was discharged 43 days after the 1st operation. We consider that the advantage of V.A.C. ATS therapy is "making a bed-side free status" in even mediastinitis patients, which enables active walking and reinforcement of physical strength. V.A.C. ATS therapy might be useful for the treatment of MRSA mediastinitis.

Nakashima A.,National Center for Child Health and Development | Araki R.,Saitama University | Tani H.,National Center for Child Health and Development | Ishihara O.,Saitama University | And 7 more authors.
Fertility and Sterility | Year: 2013

Objective: To evaluate the implications of assisted reproductive technologies (ART) on neonatal birth weight. Design: A retrospective study using analysis of covariance and multiple logistic regression analysis of the Japanese ART registry. Setting: Japanese institutions providing ART treatment. Patient(s): A total of 25,777 singleton neonates reaching term gestation following ART during the years 2007-2008, with 11,374 achieved through fresh embryo transfers (fresh ET) and 14,403 achieved through frozen-thawed embryo transfers (FET). Intervention(s): None. Main Outcome Measure(s): Birth weight. Result(s): The mean birth weight after FET was significantly higher compared with fresh ET and all Japanese births (3,100.7 ± 387.2 g, 3,009.8 ± 376.8 g, and 3,059.6 ± 369.6 g, respectively). The risk for low birth weight in FET was significantly lower compared with fresh ET. In fresh ET, ovarian stimulations were associated with about twofold risk of low birth weight compared with natural cycle. Regarding to the duration of embryonic culture, the risks resulting from a shorter culturing time were significantly higher compared with a longer culturing time in fresh ET. Conclusion(s): The best method of embryo transfer for fetal growth was FET after extended culturing until blastocyst stage. However, further investigations should be performed to understand the safety of ART treatment. © 2013 American Society for Reproductive Medicine, Published by Elsevier Inc.

Hashimoto M.,Tomishiro Central Hospital | Yamauchi A.,Tomishiro Central Hospital | Inoue S.,Hokkaido Prefectural Kitami Hospital
Asian Cardiovascular and Thoracic Annals | Year: 2015

Background: Postoperative atrial fibrillation occurs in 20%-60% of patients after cardiac surgery. Recently, premature atrial contraction has been considered an initiator of atrial fibrillation. This study evaluated whether the frequency of premature atrial contractions predicts the occurrence of postoperative atrial fibrillation. Methods: The subjects of this study were 70 patients with no history of atrial fibrillation who had undergone a 24-h Holter electrocardiogram before off-pump coronary artery bypass. Their records were reviewed and postoperative electrocardiograms and telemetry strips were analyzed for postoperative atrial fibrillation. Results: Postoperative atrial fibrillation was documented in 22 (31.4%) patients. The frequency of preoperative premature atrial contractions was significantly higher in the postoperative atrial fibrillation group (4128 ± 7186 vs. 69 ± 221 beats/24 h, p<0.001). The incidence of postoperative atrial fibrillation increased with the frequency of preoperative premature atrial contractions which occurred in 60% of patients in the upper 50th percentile group of preoperative premature atrial contractions. Multivariate logistic regression analysis revealed the upper 50th percentile group of preoperative premature atrial contractions (odds ratio=67; 95% confidence interval: 5.51-838; p=0.001) to be an independent predictor of postoperative atrial fibrillation. Conclusion: A high frequency of preoperative premature atrial contractions is a strong independent predictor of postoperative atrial fibrillation in off-pump coronary artery bypass. © The Author(s) 2014.

Mori S.,Clinical Research Center for Rheumatic Disease | Ueki Y.,Rheumatic and Collagen Disease Center | Akeda Y.,Osaka University | Hirakata N.,Rheumatic and Collagen Disease Center | And 4 more authors.
Annals of the Rheumatic Diseases | Year: 2013

Objectives We assessed the impact of tocilizumab (TCZ), a humanised monoclonal anti-interleukin-6 receptor antibody, on antibody response following administration of the 23-valent pneumococcal polysaccharide vaccine (PPV23). Methods A total of 190 patients with rheumatoid arthritis (RA) received PPV23. Patients were classified into TCZ (n=50), TCZ + methotrexate (MTX) (n=54), MTX (n=62) and RA control (n=24) groups. We measured serotype-specific IgG concentrations of pneumococcal serotypes 6B and 23F using ELISA and functional antibody activity using a multiplexed opsonophagocytic killing assay, reported as the opsonisation indices (OIs), before and 4.6 weeks after vaccination. Positive antibody response was defined as a 2-fold or more increase in the IgG concentration or as a .10-fold or more increase in the OI. Results IgG concentrations and OIs were significantly increased in all treatment groups in response to vaccination. The TCZ group antibody response rates were comparable with those of the RA control group for each serotype. MTX had a negative impact on vaccine efficacy. Multivariate logistic analysis confirmed that TCZ is not associated with an inadequate antibody response to either serotype. No severe adverse effect was observed in any treatment group. Conclusions TCZ does not impair PPV23 immunogenicity in RA patients, whereas antibody responses may be reduced when TCZ is used as a combination therapy with MTX.

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