Toshima Hospital

Itabashi-ku, Japan

Toshima Hospital

Itabashi-ku, Japan
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Adachi T.,Toshima Hospital
Uirusu | Year: 2015

The outbreak of Ebola virus disease, reported in West Africa in 2014, has become the largest ever one in the history. Tremendous efforts by all the parties concerned are now bringing this epidemic closer to the end, while observing a large number of cases and deaths, including health care workers.This paper features five questions:1. Why did it emerge in West Africa?2. Why has it spread so wide and intensely?3. Why were so many health care workers infected?4. Why is it being brought under control?5. Would it emerge and spread in Japan in the same way?Ebola virus transmits through human acts such as caregiving of the sick and attending a funeral, therefore an epidemic is not likely to subside naturally, but intentional interventions are needed to terminate its transmission. Who the outbreak response is meant for, either patients, the general public in the affected countries, or international communities, also determines its success or failure.


Adachi T.,Toshima Hospital
Neuro-Ophthalmology Japan | Year: 2015

Various microorganisms, including bacteria, viruses, fungi, protozoa, and parasites, produce a variety of signs and symptoms. History taking and physical examination are the basis of diagnosis in infectious diseases, followed by laboratory confirmation of causative agents. Infectious diseases can be diagnosed by careful neuro-ophthalmologic examination. Infections in the central nervous system show a clinical picture of brain abscess, encephalitis, or meningitis, and localized lesions may additionally reveal site-specific neuro-ophthalmologic findings. Even systemic infections may have characteristic neuro-ophthalmologic signs. Careful examination is the key to true diagnosis.


Fowler R.A.,University of Toronto | Fischer W.A.,University of North Carolina at Chapel Hill | Lamontagne F.,Université de Sherbrooke | Jacob S.,University of Washington | And 19 more authors.
American Journal of Respiratory and Critical Care Medicine | Year: 2014

The largest ever Ebola virus disease outbreak is ravaging West Africa. The constellation of little public health infrastructure, low levels of health literacy, limited acute care and infection prevention and control resources, densely populated areas, and a highly transmissible and lethal viral infection have led to thousands of confirmed, probable, or suspected cases thus far. Ebola virus disease is characterized by a febrile severe illness with profound gastrointestinal manifestations and is complicated by intravascular volume depletion, shock, profound electrolyte abnormalities, and organ dysfunction. Despite no proven Ebola virus-specific medical therapies, the potential effect of supportive care is great for a condition with high baseline mortality and one usually occurring in resource-constrained settings.Withmore personnel, basic monitoring, and supportive treatment, many of the sickest patientswith Ebola virus disease do not need to die. Ebola virus disease represents an illness ready for a paradigmshift in care delivery and outcomes, and the profession of critical care medicine can and should be instrumental in helping this happen. Copyright © 2014 by the American Thoracic Society.


PubMed | Toshima Hospital, Tokyo Metropolitan Hiroo Hospital and National Institute of Neuroscience
Type: | Journal: Case reports in psychiatry | Year: 2016

The case study of an elderly man having persecutory delusions and bizarre complaints at the first psychiatric interview is reported. The patient complained: I have no sense of time and I have no sense of money. He refused nursing care. He had delusions centered on himself including that of his own death, which were difficult to diagnose but suggested the possibility of Cotards syndrome. We assumed that the man was depressed and treated him for depression. However, as a result of this treatment he became temporarily manic but finally recovered completely. After his recovery, we learnt the patients past history of hospitalization for psychiatric problems, and based on that history he was diagnosed as suffering from a bipolar I disorder. The lack of typical symptoms of depression and the remarkable depersonalization and derealization in this patient made it difficult to infer a depressive state. Nevertheless, being attentive to his strange feelings related to the flow of time would have helped us to make an accurate diagnosis earlier.


Nakajima N.,Japan National Institute of Infectious Diseases | Sato Y.,Japan National Institute of Infectious Diseases | Katano H.,Japan National Institute of Infectious Diseases | Hasegawa H.,Japan National Institute of Infectious Diseases | And 17 more authors.
Modern Pathology | Year: 2012

Twenty autopsy cases with 2009 pandemic influenza A (2009 H1N1) virus infection, performed between August 2009 and February 2010, were histopathologically analyzed. Hematoxylin-eosin staining, immunohistochemistry for type A influenza nucleoprotein antigen, and real-time reverse transcription-PCR assay for viral RNA were performed on formalin-fixed and paraffin-embedded specimens. In addition, the D222G amino acid substitution in influenza virus hemagglutinin, which binds to specific cell receptors, was analyzed in formalin-fixed and paraffin-embedded trachea and lung sections by direct sequencing of PCR-amplified products. There were several histopathological patterns in the lung according to the most remarkable findings in each case: acute diffuse alveolar damage (DAD) with a hyaline membrane (four cases), organized DAD (one case), acute massive intra-alveolar edema with variable degrees of hemorrhage (three cases), neutrophilic bronchopneumonia (five cases) and tracheobronchitis with limited histopathological changes in alveoli (four cases). In two cases, the main findings were due to preexisting disease. Influenza virus antigen was only detected in the respiratory tract in 10 cases by immunohistochemistry. The antigen was detected in type II pneumocytes (three cases) in the epithelial cells of the trachea, bronchi and glands (six cases), and in the epithelial cells in both of the above (one case). The four cases with acute DAD presented with antigen-positive type II pneumocytes. In one case, the D222G substitution was detected in the lung as a major sequence, although 222D was prominent in the trachea, suggesting that selection of the viral clones occurred in the respiratory tract. In five cases, the pathogenesis of 2009 H1N1 was confirmed to be viral infection in pneumocytes, which caused severe alveolar damage and fatal viral pneumonia. Further studies on both host and viral factors in autopsy or biopsy materials will be essential to elucidate the other pathogenic factors involved in influenza virus infection. © 2012 USCAP, Inc. All rights reserved.


Kawakami M.,Keio University | Nakayama C.,Toshima Hospital | Liu M.,Keio University
Brain Impairment | Year: 2016

Objective: The aims of the study were to: (1) test the reliability, validity, and responsiveness of our originally developed desire to void scale (DVS); and (2) investigate the time course of the DV after stroke during the post-acute phase. Methods: DVS was tested by having two independent raters assess the scale and calculating the weighted kappa. To evaluate its concurrent validity, Pearson's correlation coefficients between DVS and the bladder management item of the Functional Independence Measure (FIM) were calculated. A prospective analysis of the time course of the DVS and its relationships with age, sex, stroke type, paretic side, and the FIM score in 103 patients hospitalised in a rehabilitation ward was then performed. To quantify its responsiveness, standardised response means during the recovering phase of stroke were obtained. To predict discharge DVS scores from demographic characteristics and admission status, multiple regression analysis was performed. Results: The DVS had satisfactory inter- and intra-rater reliabilities. The standardised response means for DVS from admission to discharge was .58. The discharge DVS improved significantly when compared with the admission DVS. Stroke type, admission DVS, and cognition scores of the FIM were independent predictors of discharge DVS. Copyright © Australasian Society for the Study of Brain Impairment 2016


Tanikawa S.,Toshima Hospital
[Rinshō ketsueki] The Japanese journal of clinical hematology | Year: 2012

Blastic plasmacytoid dendritic cell neoplasm is a rare but clinically aggressive tumor known to be derived from the precursors of plasmacytoid dendritic cells with frequent cutaneous involvement. Though the majority of patients initially respond to multi-agent chemotherapy, most cases without hemopoietic stem cell transplantation relapse within a year. We describe a case of a 71-year-old man with a dark-purple subcutaneous nodule (5×3 cm) under his right auricle. Histologic examination of the excisional biopsy specimen revealed a diffuse proliferation of blast cells with irregular nuclei, fine chromatin and one to several small nucleoli in the dermis extending to the subcutaneous soft tissues. The tumor cells expressed CD123, CD56, CD4, CD7, LCA, and TdT but not CD3, CD20, CD79a, CD10, CD68, CD163, myeloperoxidase (MPO), or naphthol-ASD-chloroacetate (ASD-Ch) esterase. A diagnosis of blastic plasmacytoid dendritic cell neoplasm was made. He did not have any other lesions except for the solitary skin nodule. He had refractory cytopenia with multilineage dysplasia (RCMD) and renal dysfunction. It was difficult for him to receive hemopoietic stem cell transplantation because of his advanced age and renal dysfunction. We had previously experienced successful treatment with ABVD chemotherapy for interdigitating dendritic cell sarcoma after ineffective CHOP chemotherapy. The plasmacytoid dendritic cell is one of the precursor cells of the interdigitating dendritic cell. Therefore we tried to apply ABVD therapy to him. The first course of ABVD induced complete remission. Although the therapies were reduced and postponed because of various complications, he is now in complete remission that has lasted for 21 months. Although previously not reported, ABVD therapy is useful for patients with blastic plasmacytoid dendritic cell neoplasm who cannot receive hemopoietic stem cell transplantation.


PubMed | Toshima Hospital
Type: Case Reports | Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology | Year: 2012

Blastic plasmacytoid dendritic cell neoplasm is a rare but clinically aggressive tumor known to be derived from the precursors of plasmacytoid dendritic cells with frequent cutaneous involvement. Though the majority of patients initially respond to multi-agent chemotherapy, most cases without hemopoietic stem cell transplantation relapse within a year. We describe a case of a 71-year-old man with a dark-purple subcutaneous nodule (53 cm) under his right auricle. Histologic examination of the excisional biopsy specimen revealed a diffuse proliferation of blast cells with irregular nuclei, fine chromatin and one to several small nucleoli in the dermis extending to the subcutaneous soft tissues. The tumor cells expressed CD123, CD56, CD4, CD7, LCA, and TdT but not CD3, CD20, CD79a, CD10, CD68, CD163, myeloperoxidase (MPO), or naphthol-ASD-chloroacetate (ASD-Ch) esterase. A diagnosis of blastic plasmacytoid dendritic cell neoplasm was made. He did not have any other lesions except for the solitary skin nodule. He had refractory cytopenia with multilineage dysplasia (RCMD) and renal dysfunction. It was difficult for him to receive hemopoietic stem cell transplantation because of his advanced age and renal dysfunction. We had previously experienced successful treatment with ABVD chemotherapy for interdigitating dendritic cell sarcoma after ineffective CHOP chemotherapy. The plasmacytoid dendritic cell is one of the precursor cells of the interdigitating dendritic cell. Therefore we tried to apply ABVD therapy to him. The first course of ABVD induced complete remission. Although the therapies were reduced and postponed because of various complications, he is now in complete remission that has lasted for 21 months. Although previously not reported, ABVD therapy is useful for patients with blastic plasmacytoid dendritic cell neoplasm who cannot receive hemopoietic stem cell transplantation.


PubMed | Japan National Institute of Infectious Diseases, Saitama City Hospital and Toshima Hospital
Type: Journal Article | Journal: Virus genes | Year: 2016

In late August 2014, dengue cases were reported in Japan, and a total of 162 cases were confirmed. In the present study, the envelope (E) gene sequences of 12 specimens from the dengue patients were determined. A dengue virus serotype 1 (DENV1) strain (D1/Hu/Shizuoka/NIID181/2014), which was clearly different from the first reported strain (D1/Hu/Saitama/NIID100/2014), was identified, although the other 11 specimens showed the same nucleotide sequences as D1/Hu/Saitama/NIID100/2014. The E gene sequences of two different strains were compared with those of nine DENV1 strains of imported cases in Japan in 2014. Phylogenetic analysis based on the E gene sequences showed that the D1/Hu/Saitama/NIID100/2014 strain was closely related to a strain isolated from an imported case from Singapore. Although no strain closely related to D1/Hu/Shizuoka/NIID181/2014 was found in these imported strains, the strain was closely related to isolates in Thailand and Taiwan in 2009. These data indicate that the dengue cases in Japan were caused by two different dengue virus strains that entered Japan through different means.


PubMed | Toshima Hospital
Type: Journal Article | Journal: Uirusu | Year: 2016

The outbreak of Ebola virus disease, reported in West Africa in 2014, has become the largest ever one in the history. Tremendous efforts by all the parties concerned are now bringing this epidemic closer to the end, while observing a large number of cases and deaths, including health care workers.This paper features five questions:1. Why did it emerge in West Africa?2. Why has it spread so wide and intensely?3. Why were so many health care workers infected?4. Why is it being brought under control?5. Would it emerge and spread in Japan in the same way?Ebola virus transmits through human acts such as caregiving of the sick and attending a funeral, therefore an epidemic is not likely to subside naturally, but intentional interventions are needed to terminate its transmission. Who the outbreak response is meant for, either patients, the general public in the affected countries, or international communities, also determines its success or failure.

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