Yamagata Prefectural Shinjo Hospital

Yamagata-shi, Japan

Yamagata Prefectural Shinjo Hospital

Yamagata-shi, Japan
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Shiina Y.,Yamagata Prefectural Shinjo Hospital | Ohnuki T.,Yamagata Prefectural Shinjo Hospital | Ohnuki T.,Yamagata Saisei Hospital
Archives of Gynecology and Obstetrics | Year: 2013

Purpose: This study aimed to examine the role of local uterine contractions during pregnancy depicted as asymmetric thickening of the myometrium ultrasonographically. Methods: 419 pregnant women at 12-21 weeks of gestation who visited our outpatient department were studied. These subjects visited either for regular antenatal examinations or because of ill-defined subjective symptoms. Ultrasonographic examination was conducted to detect asymmetric thickening of the uterine myometrium. Blood flow in the region of myometrial thickening was studied by color Doppler imaging. Results: Among 419 subjects, 27.38 % (112/419) patients visited our outpatient department showed asymmetric thickening of myometrium. Since cervical changes or progression to labor occurred in none of the subjects, the reviewed symptoms were considered to be benign contractions. Many women with ill-defined symptoms showed asymmetric thickenings of the myometrium (73.75 % sensitivity and 84.32 % specificity). Myometrial thickening under the placenta tended to be associated with abundant blood flow (88.46 % sensitivity and 87.21 % specificity). This different pattern of the blood flow was considered to correlate to arcuate artery resistance but did not correlate to the severity of ill-defined symptoms. Among those patients having no clinical symptoms, 53 exhibited asymmetric thickening of the myometrium. This phenomenon might be the caution of ill-defined symptoms. Conclusion: Asymmetric thickening of the uterine myometrium during pregnancy represented the ill-defined symptoms. Different patterns of blood flow images at this local contraction did not correlate to the severity of these symptoms. © 2012 Springer-Verlag Berlin Heidelberg.

PubMed | Nihonkai General Hospital, Yamagata Prefectural Shinjo Hospital and Yamagata University
Type: | Journal: Scandinavian journal of urology | Year: 2017

Urolithiasis is a common urological problem, and its incidence has been increasing worldwide, including in Japan. Relationships between stone etiology and rise in ambient temperature have been reported, but it remains unclear how age and gender affect these relationships.A retrospective examination was conducted of the medical archives of 1005 patients (aged 15 years) with acute renal colic diagnosed with urolithiasis upon image examination who consecutively visited emergency departments in three hospitals. The patients were categorized into six groups according to age:younger than 30, 30-39, 40-49, 50-59, 60-69, and 70 years and older. The net difference and fold increase in the number of patients in summer (July to September) versus in winter (December to February) were calculated.Overall, the actual number of the patients varied according to the temperature rise throughout the year and among the age groups. Net increases in the number of patients were observed in all age groups for both genders, apart from 30-39-year-old women. The age group of 50-59 years considerably outnumbered all other groups. A significant statistical correlation was detected between the fold increase and male aging using Spearmans rank correlation analysis (=0.94, p=0.017), but not in females (=-0.03, p=1).These results support a positive association between ambient temperature rise and increase in the incidence of renal colic due to urolithiasis in Japan, and indicate that aging and gender affect the association differently.

Hayashi M.,Yamagata University | Hayashi M.,Yamagata Prefectural Shinjo Hospital | Kawaguchi M.,Yamagata University | Hozumi Y.,Yamagata University | And 3 more authors.
Journal of Dermatology | Year: 2011

A 71-year-old man with no family history of skin diseases presented with a 4 month history of recalcitrant pruritic papules and nodules on the lower extremities. He had prurigo-like eruptions with tense bullae on the extensor aspect of his lower extremities with multiple adjacent milia. Toenail dystrophy was observed. Mucous membranes were not affected. Skin biopsy from the shin showed a subepidermal blister with milium. Electron microscopy from lesional and perilesional skin of the leg showed scanty, hypoplastic anchoring fibrils. We detected a heterozygous mutation in the COL7A1 gene, a G-to-A substitution in exon 87 (c.6859G>A; p.Gly2287Arg). Thus, the clinicopathological and molecular findings supported a diagnosis of dystrophic epidermolysis bullosa pruriginosa. Assessment of other relatives was not feasible. To the best of our knowledge, this is the oldest clinical onset of this unusual variant of dystrophic epidermolysis bullosa reported to date. Why the onset of skin fragility should have occurred so late is not known, but the case serves as a reminder that this particular mechanobullous disease can have a delayed presentation. © 2010 Japanese Dermatological Association.

Tamura H.,Yamagata University | Watanabe T.,Yamagata University | Hirono O.,Yamagata Prefectural Shinjo Hospital | Nishiyama S.,Yamagata University | And 7 more authors.
Journal of the American Society of Echocardiography | Year: 2010

Background: Atrial fibrillation is associated with ischemic stroke because of thrombi that form within the left atrial appendage (LAA). The aim of this study was to develop a new parameter for LAA function that is easily performed using transthoracic echocardiography (TTE). Methods: TTE and transesophageal echocardiography were performed in 106 patients with stroke. LAA wall motion velocity (TTE-LAWV) was measured using Doppler tissue imaging at the LAA tip. Results: TTE-LAWV was significantly lower in patients with atrial fibrillation and LAA thrombus than in those with atrial fibrillation and no LAA thrombus and in sinus rhythm (7.5 ± 1.9 vs 10.0 ± 3.4 and 13.8 ± 5.7 cm/s, respectively, P < .05). TTE-LAWV was significantly correlated with LAA emptying flow velocity (R = 0.462, P < .05). The multivariate logistic regression analysis showed that TTE-LAWV < 8.7 cm/s was an independent predictor of LAA thrombus formation (odds ratio, 9.473; 95% confidence interval, 1.172-76.55; P < .05). Conclusion: TTE-LAWV can noninvasively evaluate LAA dysfunction and assist in the detection of LAA thrombus. © 2010 American Society of Echocardiography.

Kanno M.,Yamagata University | Nagasawa M.,Yamagata University | Suzuki M.,Yamagata Prefectural Shinjo Hospital | Yamashita H.,Yamagata University
Japanese Journal of Ophthalmology | Year: 2010

Purpose: To measure peripapillary retinal nerve fiber layer (RNFL) thickness in healthy Japanese individuals using optical coherence tomography (OCT). Methods: OCT was used to measure the eyes of 460 healthy Japanese volunteers aged 20 to 84. One eye of each individual was selected for the statistical analysis. Results|The average circumpapillary (cp) RNFL thickness of all eyes was 111.8 ± 10.0 μm. A statistically significant negative correlation was found between the average cp RNFL thickness and age. For every decade increase in age, the average cp RNFL thickness decreased by approximately 2.2 μm. The average cp RNFL thickness was estimated to decrease by 0.18% per year. The age-associated reduction in cp RNFL thickness was particularly noted in the inferior-temporal to superior-temporal segments: Conclusions: Age-related cp RNFL loss varies according to segment. When OCT is used to evaluate cp RNFL thickness, regional and age-related differences need to be taken into consideration. © 2010 Japanese Ophthalmological Society (JOS).

Tamura H.,Yamagata University | Watanabe T.,Yamagata University | Nishiyama S.,Yamagata University | Sasaki S.,Yamagata University | And 8 more authors.
Journal of Cardiac Failure | Year: 2011

Background: Left atrial volume index (LAVI) is known to reflect the duration and severity of increased left atrial pressure caused by left ventricular (LV) diastolic dysfunction. However, the prognostic value of LAVI in patients with heart failure (HF) has not been fully investigated. Methods and Results: Transthoracic echocardiography was performed in 146 consecutive patients (78 men, 68 women; mean age 72 ± 12 y) who were hospitalized for HF. There were 45 cardiac events (32%) during a median follow-up period of 448 days. There were no significant differences in LV end-diastolic dimensions or ejection fraction between patients who did or did not have cardiac events. However, LAVI was markedly higher in patients with, than those without, cardiac events (56 ± 26 vs 44 ± 22 mL/m 2; P < .01). Kaplan-Meier analysis showed that there was a stepwise increase in risk of cardiac events with each increment of LAVI category, and LAVI >53.3 mL/m 2 correlated with the highest risk of cardiac events (log-rank test; P < .01). Multivariate Cox proportional hazard analysis showed that high LAVI was an independent predictor for cardiac events (hazard ratio 1.427; 95% confidence interval 1.024-1.934; P < .05). Conclusion: LAVI may be useful for stratification of risk in patients with HF. © 2011 Elsevier Inc. All rights reserved.

PubMed | Yamagata Prefectural Shinjo Hospital and Yamagata University
Type: Journal Article | Journal: Journal of medical ultrasonics (2001) | Year: 2016

A 78-year-old woman was referred to our hospital because of general fatigue. The electrocardiogram showed ST elevation in the I, II, aVL, and V2-V6 leads. Echocardiography showed left ventricular apical akinesis. On emergent cardiac catheterization, left ventricular basal hyperkinesis and apical akinesis without coronary artery stenosis were found. The patient was diagnosed with Takotsubo cardiomyopathy. Two-dimensional myocardial speckle tracking echocardiography was performed on admission, the 8th hospital day, and the 15th hospital day. Gradual improvement in wall motion abnormality and longitudinal peak systolic strain, peak systolic strain rate, and early diastolic strain rate from the basal to apical region of the left ventricle were observed objectively, and she achieved remission. We herein report a case of Takotsubo cardiomyopathy in which objective improvement in left ventricular contraction and relaxation was observed by 2D speckle tracking imaging and bulls eye mapping.

Hasegawa Y.,Yamagata Prefectural Shinjo Hospital | Sato M.,Yamagata Prefectural Shinjo Hospital | Igarashi A.,Yamagata Prefectural Shinjo Hospital
Japanese Journal of Anesthesiology | Year: 2012

Background: During tracheal intubation with the Airtraq® laryngoscope (AL), the tracheal tube tip sometimes impinges on the glottis or other laryngeal structures. We tested a hypothesis that Parker® flex-tip tube (PT) makes AL assisted tracheal intubation easier and faster than a conventional tube (Mallinckrod Hi-Lo® tube: HT). Methods: Study 1 Fifty patients were assigned to group PT (n=25) or group HT (n=25). After induction of general anesthesia, intubation was performed with AL. We recorded tube passage time, the number of tube impingements, circulatory changes and incidences of postoperative complications. Study 2 Twenty patients were divided into two groups and intubated either by HT or PT. We assessed the tip direction and contact points of each tube. Results: Study 1 The use of PT significantly reduced the number of tube impingements compared to HT. Tube passage time in group PT was shorter than that in group HT, but the difference was not statistically significant. Study 2 The tube tip contact with the vocal cords was more frequent with HT. Conclusions: PT significantly reduced the number of impingements. The shape of tube tip and the smaller angle of PT when fitted in AL contributed to the relative ease of tube passage.

Igarashi A.,Yamagata Prefectural Shinjo Hospital
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2011

Case 1 was a 73-year-old woman admitted to our hospital due to bilateral pneumonia with respiratory failure. Real-time reverse transcription polymerase chain reaction (RRT-PCR) analysis confirmed 2009 H1N1 influenza infection. Streptococcus pneumoniae was confirmed from sputum culture and a urine antigen test on admission. She was treated with antiviral drugs and antibiotics, and improved gradually. Case 2 was a 66-year-old woman admitted to our hospital due to suspected acute exacerbation of interstitial pneumonitis. RRT-PCR analysis confirmed 2009 H1N1 influenza infection, and methicillin-resistant Staphylococcus aureus was cultured from her sputum. Mixed pneumonia due to influenza virus, bacteria and fungus was suspected. Although she was treated with medicines for these pathogens, she died from respiratory failure. An autopsy confirmed primary viral pneumonia, Pseudomonas aeruginosa pneumonia and invasive pulmonary aspergillosis. Not only viral pneumonia, but also mixed infections due to bacteria or fungus, might influence the prognosis of 2009 H1N1 influenza infection. These cases indicate the importance of early identification of complicating pathogens and treatment in 2009 H1N1 influenza infection.

PubMed | Yamagata Prefectural Shinjo Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2015

A 65-year-old woman with a right breast tumor and right arm pain was seen in our hospital. She was diagnosed with scirrhous carcinoma (Stage IV, hormone receptor-positive, and HER2-negative) with pleural effusion and metastasis to the lung, liver, bone, and multiple lymph nodes. Systemic chemotherapy with biweekly bevacizumab and weekly paclitaxel was administered, and an opioid (oxycodone 40 mg/day) was administered for pain control. At the end of the first course, the patients pain was improved, and the opioid dose was reduced (oxycodone 20 mg/day). The patient had a partial response (PR) over 24 treatment courses (1 year 10 months), and good pain control was obtained. Bevacizumab and paclitaxel therapy successfully brought about a rapid and good response and improved the patients quality of life as palliative chemo- therapy.

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