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Tsukuba, Japan

Komeno M.,Tsukuba Gakuen Hospital | Tanaka S.,Tsukuba Gakuen Hospital | Murashita H.,Tsukuba Gakuen Hospital | Hara A.,University of Tsukuba
Practica Oto-Rhino-Laryngologica | Year: 2010

Parotid gland metastasis from renal cell carcinoma is extremely rare and this case is, to our knowledge, the first presenting such bilateral parotid gland metastasis. A 70-year-old man who had undergone left radical nephrectomy one year before reported painless swelling in the bilateral parotid glands, found in computed tomography, magnetic resonance imaging, and 99mTc pertechnetate scintigraphy to be a vascular tumor of the superficial gland lobe. Superficial parotidectomy preserving the facial nerve were conducted bilaterally under general anesthesia. The histopathological diagnosis was metastatic renal cell carcinoma. Subsequent examination showed multiple metastases to the right kidney, lung, and pancreas, necessitating molecular target drug (Sunitinib) treatment. Parotid gland metastasis is found as an initial symptom of renal cell carcinoma or may be found during renal cell carcinoma treatment. Renal cell carcinoma metastasis must thus be considered in the case of a parotid mass.

Hirose Y.,Tsukuba Gakuen Hospital | Tabuchi K.,University of Tsukuba | Wada T.,University of Tsukuba | Hara A.,University of Tsukuba
Oto-Rhino-Laryngology Tokyo | Year: 2013

The clinical records of inpatients treated at the University of Tsukuba Hospital, the Department of Otolaryngology, from January 2001 to December 2011 were reviewed. The total number of inpatients was 2,956. Neoplastic diseases were the most common, and the number of malignant neoplasms was 1,260 (42.6% of all cases). The affected sites were distributed as follows: pharynx, 22.7%; larynx, 15.5%; tongue and oral cavity, 5.5%; salivary glands, 8.6%; neck, 8.4%; nasal and paranasal sinuses, 14.7%; ear, 22.5%; others, 2.0%.

Fujita M.,Tsukuba Gakuen Hospital | Sato K.,Glaxosmithkline | Nishioka H.,Glaxosmithkline | Sakai F.,Saitama International Headache Center
Cephalalgia | Year: 2014

Objective: The objective of this article is to evaluate the efficacy and tolerability of two doses of oral sumatriptan vs placebo in the acute treatment of migraine in children and adolescents. Background: Currently, there is no approved prescription medication in Japan for the treatment of migraine in children and adolescents. Methods: This was a multicenter, outpatient, single-attack, double-blind, randomized, placebo-controlled, parallel-group study. Eligible patients were children and adolescents aged 10 to 17 years diagnosed with migraine with or without aura (ICHD-II criteria 1.1 or 1.2) from 17 centers. They were randomized to receive sumatriptan 25 mg, 50 mg or placebo (1:1:2). The primary efficacy endpoint was headache relief by two grades on a five-grade scale at two hours post-dose. Results: A total of 178 patients from 17 centers in Japan were enrolled and randomized to an investigational product in double-blind fashion. Of these, 144 patients self-treated a single migraine attack, and all provided a post-dose efficacy assessment and completed the study. The percentage of patients in the full analysis set (FAS) population who report pain relief at two hours post-treatment for the primary endpoint was higher in the placebo group than in the pooled sumatriptan group (38.6% vs 31.1%, 95% CI: -23.02 to 8.04, p=0.345). The percentage of patients in the FAS population who reported pain relief at four hours post-dose was higher in the pooled sumatriptan group (63.5%) than in the placebo group (51.4%) but failed to achieve statistical significance (p=0.142). At four hours post-dose, percentages of patients who were pain free or had complete relief of photophobia or phonophobia were numerically higher in the sumatriptan pooled group compared to placebo. Both doses of oral sumatriptan were well tolerated. No adverse events (AEs) were serious or led to study withdrawal. The most common AEs were somnolence in 6% (two patients) in the sumatriptan 25 mg treatment group and chest discomfort in 7% (three patients) in the sumatriptan 50 mg treatment group. Conclusions: There was no statistically significant improvement between the sumatriptan pooled group and the placebo group for pain relief at two hours. Oral sumatriptan was well tolerated. © 2013 International Headache Society.

Fujita M.,Tsukuba Gakuen Hospital | Fujita M.,Headache Care Center for Children and Adolescents | Fujiwara J.,Kinu Medical Association Hospital
No To Hattatsu | Year: 2011

We investigated whether the graphic headache diary is useful for diagnosing headache types in children, especially suffering from chronic daily headaches. Our study involved 109 children who completed the diaries for more than 3 weeks. The headache diary was a modified version of that used in the study by Sakai et al. Of 109, 84 had migraine, 15 had tension-type headache and 10 had both tension-type headache and migraine from the questionnaire and the first interview. The diary disclosed that 20 children, initially diagnosed as having migraine, had co-existing chronic tension-type headache with a variety of psychosocial problems. The graphic headache diary seems to be helpful for headache diagnosis and awareness of stress in children who suffered from strong and persistent headaches. Our study suggested that the graphic headache diary is useful not only for diagnosing headache types in children but also for finding out problems in school and/or family.

Kurihara Y.,University of Tsukuba | Hitomi S.,University of Tsukuba | Oishi T.,Tokyo Medical University | Kondo T.,Tsuchiura Kyodo General Hospital | And 3 more authors.
Journal of Infection and Chemotherapy | Year: 2013

Although Proteus mirabilis is a common human pathogen, bacteremia caused by the organism, especially strains producing extended-spectrum beta-lactamase (ESBL), has rarely been investigated. We examined 64 cases of P. mirabilis bacteremia identified in the Minami Ibaraki Area, Japan, between 2001 and 2010 and compared the characteristics of cases with ESBL-producing and ESBL-non-producing strains (13 and 51 cases, respectively). All ESBL-producing strains with the gene encoding the CTX-M-2-group were genetically nonidentical. Isolation of ESBL-producing strains was significantly associated with onset in a hospital (p = 0.030), receiving hemodialysis (p = 0.0050), and previous antibiotic use within 1 month (p = 0.036; especially penicillin and/or cephalosporin (p = 0.010) and fluoroquinolone (p = 0.0069)). Isolation was also associated with inappropriate antibiotic therapy on the 1st and 4th days (p = 0.011 and 0.032, respectively) but not with mortality on the 30th day. These findings indicate that, for P. mirabilis bacteremia, isolation of ESBL-producing strains causes delay of initiating appropriate antimicrobial therapy but may not be associated with mortality. © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.

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