Admission with metabolic disorder is a useful predictor of the 1-year prognosis for patients with unstable angina, but not for patients with acute myocardial infarction: East-Osaka Acute Coronary Syndrome Registry
Hoshida S.,Yao Municipal Hospital |
Teragaki M.,Wakakusa Daiichi Hospital |
Lim Y.-J.,Kawachi General Hospital |
Mishima M.,Kawachi General Hospital |
And 6 more authors.
Coronary Artery Disease | Year: 2011
BACKGROUND: For patients with acute myocardial infarction (AMI), several studies have examined the relationship between the metabolic syndrome and prognostic outcome. However, few studies have revealed an association between the metabolic syndrome and clinical outcomes in patients with unstable angina (UA). This study compared the differences in the usefulness of recognizing metabolic disorders for the prediction of a 1-year prognosis in patients with UA and AMI. METHODS: The study cohort consisted of 1173 patients with a mean age of 67 years. The focus was on general prognostic factors and five metabolic disorders (body mass index; hypertension; blood glucose/diabetes mellitus; and, serum concentrations of triglycerides and high-density lipoprotein cholesterol) at the time of admission. RESULTS: According to multivariate logistic regression analysis, metabolic scores on admission positively related to 1-year mortality or major adverse cardiovascular events (MACE) for patients with UA, but not for those with AMI, with an increase in either all-causes mortality or MACE being associated with the degree of metabolic dysfunction. No other general prognostic factors were related to either 1-year mortality or MACE in patients with UA. By contrast, general prognostic factors such as age and the Killip classification had a positive effect on 1-year mortality or on MACE for the patients with AMI. CONCLUSION: Accumulation of the effects of each metabolic disorder may affect mortality and MACE for patients with UA. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Hirose M.,Osaka City University |
Hirose M.,Wakakusa Daiichi Hospital |
Yamanaka H.,Wakakusa Daiichi Hospital |
Ishikawa E.,Wakakusa Daiichi Hospital |
And 2 more authors.
Diabetes Research and Clinical Practice | Year: 2011
Introduction: The in-hospital sliding scale (Sc) to determine the insulin dose was changed to a carbohydrate counting sliding scale (CSc). Blood glucose levels before and after the change were compared. Methods: The Sc was used in 32 patients in July and August 2009 (Sc group) and the CSc was used in 32 patients in September and October 2009 (CSc group). The blood glucose levels recorded before breakfast, lunch, and supper for 14 days were analyzed. The overall and daily mean of all blood glucose data were compared between the 2 groups. Results: The overall blood glucose level was significantly lower in the CSc group than in the Sc group (p< 0.001). The percentage of blood glucose level below 199. mg/dL was 47% in the Sc group and 59% in the CSc group. The daily blood glucose level in the Sc group was 203-229. mg/dL until day 14, while the daily mean blood glucose level decreased significantly to 186. mg/dL on day 4 in the CSc group and remained in the 176-200. mg/dL range on subsequent days (p= 0.049). Conclusions: The CSc is easy to use, safe and useful in controlling the blood glucose level. © 2011 Elsevier Ireland Ltd.
Maeda I.,Osaka City University |
Maeda I.,Osaka City General Hospital |
Hayashi T.,Osaka City University |
Sato K.K.,Osaka City University |
And 11 more authors.
Nephrology Dialysis Transplantation | Year: 2012
Background Indication of tonsillectomy in IgA nephropathy is controversial. The purpose of this study was to examine the efficacy of tonsillectomy on remission and progression of IgA nephropathy. Methods We conducted a single-center 7-year historical cohort study in 200 patients with biopsy-proven IgA nephropathy. Study outcomes were clinical remission defined as disappearance of urine abnormalities at two consecutive visits, glomerular filtration rate (GFR) decline defined as 30 GFR decrease from baseline and GFR slope during the follow-up. Results Seventy of the 200 patients received tonsillectomy. Tonsillectomy was associated with increased incidence of clinical remission (P = 0.01, log-rank test) and decreased incidence of GFR decline (P = 0.01, log-rank test). After adjustment for age and gender, hazard ratios in tonsillectomy were 3.90 (95 confidence interval 2.46-6.18) for clinical remission and 0.14 (0.02-1.03) for GFR decline. After further adjustment for laboratory (baseline mean arterial pressure, GFR, 24-h proteinuria and hematuria score), histological (mesangial score, segmental sclerosis or adhesion, endocapillary proliferation and interstitial fibrosis) or treatment variables (steroid and reninangiotensin system inhibitors), similar results were obtained in each model. Even after exclusion of 69 steroid-treated patients, results did not change. GFR slopes in tonsillectomy and non-tonsillectomy groups were 0.60 ± 3.65 and-1.64 ± 2.59 mL/min/1.73 m2/year, respectively. In the multiple regression model, tonsillectomy prevented GFR decline during the follow-up period (regression coefficient 2.00, P = 0.01). Conclusion Tonsillectomy was associated with a favorable renal outcome of IgA nephropathy in terms of clinical remission and delayed renal deterioration even in non-steroid-treated patients. © 2012 The Author.
Sugimori Y.,Wakakusa Daiichi Hospital |
Tanaka S.,Wakakusa Daiichi Hospital |
Nishimura T.,Nishimura Oral and Maxillofacial Surgery Clinic |
Yamamoto A.,Osaka City University |
And 4 more authors.
Magnetic Resonance in Medical Sciences | Year: 2013
Purpose: We investigated the ability to detect the articular disk and joint effusion of the temporomandibular joint (TMJ) of a method of dual echo volumetric isotropic turbo spin echo acquisition (DE-VISTA) additional fusion images (AFI). Methods: DE-VISTA was performed in the 26 TMJ of 13 volunteers and 26 TMJ of 13 patients. Two-dimensional (2D) dual echo turbo spin echo was performed in the 26 TMJ of 13 volunteers. On a workstation, we added proton density-weighted images (PDWI) and T2 weighted images (T2WI) of the DE-VISTA per voxel to reconstruct DE-VISTA-AFI. Two radiologists reviewed these images visually and quantitatively. Results: Visual evaluation of the articular disk was equivalent between DE-VISTA-AFI and 2D-PDWI. The sliding thin-slab multiplanar reformation (MPR) method of DE-VISTA-AFI could detect all articular disks. The ratio of contrast (CR) of adipose tissue by the articular disk to that of the articular disk itself was significantly higher in DE-VISTA-AFI than DE-VISTA-PDWI (P<0.05) in patients and volunteers with closed or open mouth. In volunteers, the CR between adipose tissue and the disk on DE-VISTA-AFI was marginally significant to that on 2D-PDWI at opened mouth (P=0.071) and not significantly different (P=0.18) from that at closed mouth. Joint effusion could be identified in DE-VISTA-AFI in all 8 joints that had joint effusion in DE-VISTA-T2WI but in only 3 of those joints in 2D-T2WI. The CR of joint effusion to adipose tissue on DE-VISTA-AFI did not differ significantly from that on DE-VISTA-PDWI. However, using DE-VISTA-T2WI in addition to DE-VISTA-PDWI, we could visually identify joint effusion on DE-VISTA-AFI that could not be identified on DE-VISTA-PDWI alone. Conclusion: DE-VISTA-AFI can depict the articular disk and a small amount of joint effusion by the required plane of MPR using the sliding thin-slab MPR method. © 2013 Japanese Society for Magnetic Resonance in Medicine.
Tsujimoto Y.,Wakakusa Daiichi Hospital |
Ryoke K.,Wakakusa Daiichi Hospital |
Yamagami N.,Wakakusa Daiichi Hospital |
Uchio Y.,Wakakusa Daiichi Hospital |
Tanaka S.,Wakakusa Daiichi Hospital
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2015
To evaluate the capability of the "Soap-Bubble" maximum intensity projection (MIP) processing technique in visualisation of extensor tendons of the hand, 36 intact subjects and seven patients with surgically confirmed extensor tendon rupture were examined. Three-dimensional T1-weighted turbo spin echo (3DT1TFE) MRI was performed using a sensitivity encoding flex coil, followed by Soap-Bubble MIP processing. For patients with extensor tendon ruptures, MRI findings and intraoperative findings were compared. As results, with only 3DT1TFE sequence, the entire extensor tendons that run along the arch of the hand were not shown on one image, but were visualised with addition of Soap-Bubble MIP. Although delineation of the extensor pollicis longus was poor in 27/43 subjects, it was much improved by the combination of water-suppression technique. MRI findings and intraoperative findings agreed in all patients. Soap-Bubble MIP processing with addition of water-suppression technique is considered useful for visualising the extensor tendons of the hand.
Nozaki K.,The University of Shimane |
Mori R.,The University of Shimane |
Ryoke K.,Wakakusa Daiichi Hospital |
Uchio Y.,The University of Shimane
Clinical Biomechanics | Year: 2012
Background: For secure tendon repair, while core suture materials have been previously investigated, the optimum material for peripheral sutures remains unclear. Methods: Transected bovine gastrocnemius tendons were repaired by 2-strand side-locking loop technique using no.2 braided polyblend polyethylene thread for the core suture. Then, 8-strand peripheral cross-stitches were added using either 2-0 rigid sutures (braided polyblend polyethylene) or USP 2-0-sized elastic sutures (nylon). The holding area of each peripheral suture was set at either 3 × 1 mm (shallow holding) or 6 × 2 mm (deep holding). Therefore, 4 groups were compared (the shallow-rigid, deep-rigid, shallow-elastic, and deep-elastic groups). The gap formation, ultimate tensile strength, and suture migration state were measured after 500 cyclic loadings (from 10 to 200 N). Methods: The shallow-rigid group had inferior outcomes compared to the other groups. Although the deep-rigid group had the smallest gap and highest ultimate strength, all peripheral sutures had failure prior to core suture rupture. The two elastic groups showed no significant differences, irrespective of the size of the holding area. Suture migration did not occur in the two elastic groups until the ultimate strength was reached and the core suture ruptured. Interpretation: Depending on the suturing method, rigid suture material may not be appropriate for peripheral sutures, when accompanying rigid core suture material. If peripheral sutures can be made with accurate deep holding, rigid suture material will provide favorable outcome. However, in other cases, elastic suture material is considered best for supporting a rigid core suture, as elasticity is another important factor for peripheral sutures. © 2011 Elsevier Ltd. All rights reserved.
Eguchi J.,Wakakusa Daiichi Hospital
Gastroenterological Endoscopy | Year: 2013
A 61-year-old man visited our clinic with sudden onset of hiccups and vomiting. Following an initial diagnosis of reflux esophagitis, several medications were commenced However, his symptoms worsened, and other symptoms such as appetite loss, sore throat and chestpain appeared during swallowing. He was therefore admitted to our hospital. An upper gastrointestinal series of the esophagus showed a beaded appearance and suggested diffuse esophageal spasms. Although the symptoms were refractory to the medications, they improved remarkabley following a stellate ganglion block.
Yamagami N.,The University of Shimane |
Yamamoto S.,The University of Shimane |
Tsujimoto Y.,Wakakusa Daiichi Hospital |
Uchio Y.,The University of Shimane
Archives of Orthopaedic and Trauma Surgery | Year: 2013
Introduction: Malunited intra-articular fracture of the proximal inter-phalangeal (PIP) joint sometimes causes problems, such as range of motion (ROM) limitation in the joint or lack of digital dexterity; however, the treatment method has not yet been established. We report a juvenile case of osteochondral autograft tranplantation to treat a malunited intra-articular fracture of the middle finger. Case report: A 14-year-old boy was injured at the right middle finger by a baseball impact and underwent conservative treatment. At 5 months after the injury, he complained of continuing pain and restricted ROM. Plain X-ray and CT images showed a bony defect in the articular surface of the PIP joint of the right middle finger. He was diagnosed with malunited intra-articular fracture of the PIP joint and underwent surgical treatment. First, through a palmar incision, a columnar-shaped drill hole was made at the recipient site of osteochondral defect. Then a cylindrical osteochondral plug, 4.5 mm in diameter, harvested from the knee, was inserted into the recipient hole and press-fitted. One year after surgery, the patient has neither pain nor ROM limitation of the finger and the knee joint. MRI showed smooth articular surface of the PIP joint. Discussion: The benefits of our method include use of articular cartilage as a reconstruction material, availability for a relatively large cartilage defect, and stability of the autograft for the press-fitting method, which enable early mobilization exercise after surgery. © 2012 The Author(s).
Shimomura S.,Hyogo College of Medicine |
Ikeda N.,Hyogo College of Medicine |
Saito M.,Hyogo College of Medicine |
Ishii A.,Hyogo College of Medicine |
And 13 more authors.
Hepatology International | Year: 2011
Purpose: This study investigates the usefulness of long-term interferon (IFN) therapy following radiofrequency ablation (RFA) for HCV-associated hepatocellular carcinoma (HCC). Methods: This is a retrospective observational study. Patients underwent pegylated IFN-α/ribavirin combination therapy for 48 weeks and then were maintained on IFN-α administration on average for 68 weeks (mean total duration 116 weeks). Patients who underwent IFN monotherapy were maintained on IFN administration on average for 78 weeks. Results: There were biases in the background factors between the IFN and non-IFN groups. Therefore, a covariate adjustment was performed using the propensity score. An analysis of 20-matched patients from each group showed the 5-year cumulative survival rate was higher in the IFN group than in the non-IFN group (100 and 76%, respectively), and the 3-year cumulative recurrence rate was significantly lower in the IFN group than in the non-IFN group (38.0 and 64.2%, respectively). In 14 patients (i.e., IFN responders), the serum alanine aminotransferase (ALT) level remained normalized at 30 IU/mL or lower, regardless of disappearance of serum HCV RNA. In these patients, the cumulative recurrence rate was low, the hazard ratio was 0.158 (95% confidence interval = 0.045-0.561, P = 0.004), and the serum albumin level was retained. Conclusion: These results show the importance of maintaining the liver function and suggest that long-term IFN administration after RFA inhibits recurrence and contributes to an improved outcome in patients (in particular, IFN responders) who initially develop HCC. © 2010 Asian Pacific Association for the Study of the Liver.
PubMed | Wakakusa Daiichi Hospital
Type: Journal Article | Journal: Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine | Year: 2013
We investigated the ability to detect the articular disk and joint effusion of the temporomandibular joint (TMJ) of a method of dual echo volumetric isotropic turbo spin echo acquisition (DE-VISTA) additional fusion images (AFI).DE-VISTA was performed in the 26 TMJ of 13 volunteers and 26 TMJ of 13 patients. Two-dimensional (2D) dual echo turbo spin echo was performed in the 26 TMJ of 13 volunteers. On a workstation, we added proton density-weighted images (PDWI) and T2 weighted images (T2WI) of the DE-VISTA per voxel to reconstruct DE-VISTA-AFI. Two radiologists reviewed these images visually and quantitatively.Visual evaluation of the articular disk was equivalent between DE-VISTA-AFI and 2D-PDWI. The sliding thin-slab multiplanar reformation (MPR) method of DE-VISTA-AFI could detect all articular disks. The ratio of contrast (CR) of adipose tissue by the articular disk to that of the articular disk itself was significantly higher in DE-VISTA-AFI than DE-VISTA-PDWI (P<0.05) in patients and volunteers with closed or open mouth. In volunteers, the CR between adipose tissue and the disk on DE-VISTA-AFI was marginally significant to that on 2D-PDWI at opened mouth (P=0.071) and not significantly different (P=0.18) from that at closed mouth. Joint effusion could be identified in DE-VISTA-AFI in all 8 joints that had joint effusion in DE-VISTA-T2WI but in only 3 of those joints in 2D-T2WI. The CR of joint effusion to adipose tissue on DE-VISTA-AFI did not differ significantly from that on DE-VISTA-PDWI. However, using DE-VISTA-T2WI in addition to DE-VISTA-PDWI, we could visually identify joint effusion on DE-VISTA-AFI that could not be identified on DE-VISTA-PDWI alone.DE-VISTA-AFI can depict the articular disk and a small amount of joint effusion by the required plane of MPR using the sliding thin-slab MPR method.