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Toyama-shi, Japan

Toge M.,Toyama City Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 61-year-old man was pointed out a solitary nodule located in the left lung (S9) measuring 18 × 29 mm in size along with lymphadenopathy by chest computed tomography (CT). Positron emission tomography( PET) scan showed a positive sign corresponding to the nodule[ standardized uptake value (SUV) max 5.8]. No diagnostic material was obtained from the transbronchial tumor biopsy, since it was difficult to rule out malignancy, surgical biopsy was performed with sampling of mediastinal lymph nodes. Histopathological examination showed marked infiltration of inflammatory cells, many of which were demonstrated to be immunoglobulin (Ig) G4-positive plasma cells by immunohistochemical staining. Hence, IgG4-related inflammatory pseudotumor of the lung was diagnosed.

Segawa M.,Toyama City Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 36-year-old man was admitted to our hospital for examination of a nodular shadow in the left lung. Chest 3-dimensional computed tomography (3D-CT) revealed a pulmonary arteriovenous fistula (PAVF) of 21 mm in diameter composed of the feeding artery (A4) and the draining vein (V4) in the left S4. Abdominal enhanced CT revealed multiple hepatic arteriovenous fistula. Brain CT revealed a cavernous hemangioma in right occipital cerebrum. He had a family history, habitual epistaxis, and oral telangiectasia and was diagnosed as Rendu-Osler-Weber disease (hereditary hemorrhagic telangiectasia:HHT). According to his family history, PAVF was likely to be a risk factor of brain infarction and abscess, and the wedge resection of the lingual lobe was performed to remove PAVF.

Hagino H.,Tottori University | Sawaguchi T.,Toyama City Hospital | Endo N.,Niigata University | Ito Y.,Tottori University | And 2 more authors.
Calcified Tissue International | Year: 2012

We investigated the incidence of additional fractures and the rate of prescription of osteoporotic pharmacotherapy after an initial hip fracture. We surveyed female patients aged 65 and over who sustained their first hip fracture between January 1, 2006, and December 31, 2007, treated at 25 hospitals in five geographic areas in Japan. Data for 1 year after the first hip fracture were collected from medical records, and questionnaires were mailed to all patients. In total, 2,663 patients were enrolled, and 335 patients were excluded based on exclusion criteria. The analysis was performed on 2,328 patients. During the 1-year follow-up period 160 fractures occurred in 153 patients and 77 subsequent hip fractures occurred in 77 patients. The incidence of all additional fractures among patients who sustained their first hip fracture was 70 (per 1,000 person-year) and that for second hip fracture was 34. In comparison to the general population, women ≥65 years of age who sustained an initial hip fracture were four times as likely to sustain an additional hip fracture. Antiosteoporosis pharmacotherapy was prescribed for 436 patients (18.7%), while 1,240 patients (53.3%) did not receive any treatment during the 1-year period. Patients who have sustained one hip fracture have a higher risk of a second hip fracture compared to the general population, and most of these women receive no pharmaceutical treatment for osteoporosis. © 2011 Springer Science+Business Media, LLC.

Fukui N.,Clinical Research Center | Watanabe Y.,Teikyo University | Nakano T.,Tamana Central Hospital | Sawaguchi T.,Toyama City Hospital | Matsushita T.,Teikyo University
Journal of Orthopaedic Trauma | Year: 2012

Objectives: To investigate the predictors of functional outcome and changes in the basic activities of daily living in older adults who sustained hip fractures, considering the level of ambulatory ability before injury. Design: A prospective observational cohort study. Setting: One university hospital and 13 community teaching hospitals. Patients: A consecutive cohort of 650 patients who underwent surgery for a hip fracture between December 2004 and January 2006. Main Outcome Measures: Recovery of ambulatory ability and independence in activities of daily living 6 and 12 months after surgery. Results: Ambulatory ability recovered to the prefracture level in approximately half of the patients 6 months after surgery, and those ratios changed little in the next 6 months. In patients who were community ambulators before fractures, the independence in bathing before fractures was a strong predictor of ambulatory ability after surgery, but this was not the case in the former household ambulator group. The attainment of assisted ambulation with a walking cane at hospital discharge was a reliable predictor of ambulatory ability in both former community ambulator and household ambulator groups. Conclusions: Ambulatory ability after hip fractures was considered to be determined within 6 months after surgery. There was some difference in prognostic factors for ambulatory ability according to the level of mobility before fractures. The attainment of single cane (T-cane) gait at hospital discharge can serve as a reliable predictor of ambulatory ability after fractures, irrespective of the level of mobility before the injury. Copyright © 2012 by Lippincott Williams & Wilkins.

Background: Many studies have investigated tricuspid annular plane systolic excursion (TAPSE) as a longitudinal right ventricular (RV) contraction. The aim of this study was to clarify the mechanism of RV systolic function compared with longitudinal and radial RV contractions in healthy children. Methods and Results: A total of 815 consecutive healthy children and adolescents were enrolled. We measured TAPSE on M-mode echocardiography as a longitudinal RV contraction. RV wall displacement (RVWD) toward the center of the left ventricle (LV) was measured in the short-axis view on M-mode echocardiography. RV stroke volume (RVSV) was obtained using pulse Doppler echocardiography as an indicator of RV global systolic function. RVSV and TAPSE had a positive but non-linear correlation with a definite inflection point around 15 mm of TAPSE. Subjects were stratified into 2 groups according to TAPSE (≤15 mm or >15 mm). In subjects with TAPSE ≤15 mm, RVWD and TAPSE were identified as independent predictors of RVSV. In contrast, in subjects with TAPSE >15 mm, TAPSE were identified as an independent predictor of RVSV. Conclusions: Normal RV contraction pattern shifts from radial to longitudinal directions at approximately 15 mm of TAPSE. RVSV is primarily generated by longitudinal contraction, but in neonates, RVSV is supported not only by longitudinal contraction but also by radial contraction.

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