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PubMed | Yamato Takada Municipal Hospital
Type: Case Reports | Journal: Hinyokika kiyo. Acta urologica Japonica | Year: 2015

A 57-year-old man with fever-up and multiple nodules in the peripheral area of the lungs on the chest CT was referred to the department of respiratory medicine of our hospital for further examination. The whole body CT disclosed a space-occupying lesion in the left frontal lobe of his brain, an irregular mass in the left kidney, and swelling of paraaortic lymph nodes. A pathological diagnosis could not be made from the results of the bronchoscopic examination and percutaneous needle biopsy for the renal mass. Left nephrectomy and lymph node dissection were carried out because of possible renal malignancy with distant metastases. The renal lesion was diagnosed as xanthogranulomatous pyelonephritis histopathologically. After the nephrectomy, the multiple lung nodules disappeared spontaneously leaving scars in some lesions. Septic pulmonary embolism was highly suspected on the basis of the clinical course. The brain nodule also decreased in size significantly and is currently under careful surveillance.


Minematsu A.,Kio University | Hazaki K.,Osaka Electro-Communication University | Harano A.,Yamato Takada Municipal Hospital | Okamoto N.,Nara Medical University | Kurumatani N.,Nara Medical University
Obesity Research and Clinical Practice | Year: 2016

Objective This study examined differences in physical function according to body mass index (BMI) in elderly Japanese individuals. Methods Participants (1754 men and 1795 women aged ≥65 years) were divided into the following five BMI groups: low BMI (≤20.0), low-medium BMI (20.1-22.5), medium BMI (22.6-25.0), medium-high BMI (25.1-27.5) and high BMI (≥27.6). Physical function was measured according to BMI and sex, and associations between BMI and physical function were examined. Results Compared with the medium BMI group, handgrip strength (HGS), knee extension torque (KET), and knee flexion torque (KFT) were significantly lower in both sexes in the low BMI group, while KET and KFT were significantly higher among men in the high BMI group. One-leg standing time (OLST) with open eyes was significantly shorter among men in the high BMI group than in the medium BMI group. The high BMI group was significantly inferior to the medium BMI group in 10 m gait time (10MGT), OLST, and maximum one-step length to height ratio among women. All physical functions, except for 10MGT in men, were associated with BMI adjusted age and/or sex. Muscle strength showed a positive association with BMI in both sexes. There was a stronger association between BMI and physical performance in women compared to men. Conclusion We found that BMI influences a variety of factors related to muscle strength and physical performance. Our findings may help contribute to the prevention of mobility impairments in elderly Japanese individuals. © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.


PubMed | Yamato Takada Municipal Hospital, Tezukayama University, Nara Medical University and Osaka Electro-Communication University
Type: Journal Article | Journal: The journals of gerontology. Series A, Biological sciences and medical sciences | Year: 2015

Tooth loss induces changes to the anatomy of the oral cavity. We hypothesized that tooth loss may disturb smooth swallowing in healthy elderly people. The purpose of this study was to investigate the effect of tooth loss on the development of swallowing problems in an independent elderly population.This was a 5-year prospective cohort study conducted in Nara, Japan. Included in this analysis were 1,988 community residents aged 65 years or older without swallowing problems at baseline. The participants were classified into quartile groups according to the number of remaining teeth at the baseline survey: 0-12, 13-22, 23-26, and 27-32 teeth. A decrease in the number of teeth during the survey was calculated by subtracting follow-up number from baseline number. Main outcome was the development of swallowing problems at follow-up.During follow-up, 312 individuals developed swallowing problems. After adjustment for confounding factors by multiple logistic regression analysis, the odds ratios for developing swallowing problems in participants with 13-22 or 0-12 teeth were 2.42 (95% confidence interval [CI], 1.61-3.63) and 2.49 (95% CI, 1.68-3.69), respectively, compared to participants with 27-32 teeth, demonstrating a significant relationship. The odds ratio of per 1 tooth decrease over 5 years was 1.08 (95% CI, 1.02-1.13), showing a significant association.Swallowing problems due to aging are more likely to develop in individuals with fewer teeth.


PubMed | Yamato Takada Municipal Hospital, Nara Medical University, Osaka Electro-Communication University and Kio University
Type: Journal Article | Journal: Obesity research & clinical practice | Year: 2016

This study examined differences in physical function according to body mass index (BMI) in elderly Japanese individuals.Participants (1754 men and 1795 women aged 65 years) were divided into the following five BMI groups: low BMI (20.0), low-medium BMI (20.1-22.5), medium BMI (22.6-25.0), medium-high BMI (25.1-27.5) and high BMI (27.6). Physical function was measured according to BMI and sex, and associations between BMI and physical function were examined.Compared with the medium BMI group, handgrip strength (HGS), knee extension torque (KET), and knee flexion torque (KFT) were significantly lower in both sexes in the low BMI group, while KET and KFT were significantly higher among men in the high BMI group. One-leg standing time (OLST) with open eyes was significantly shorter among men in the high BMI group than in the medium BMI group. The high BMI group was significantly inferior to the medium BMI group in 10m gait time (10MGT), OLST, and maximum one-step length to height ratio among women. All physical functions, except for 10MGT in men, were associated with BMI adjusted age and/or sex. Muscle strength showed a positive association with BMI in both sexes. There was a stronger association between BMI and physical performance in women compared to men.We found that BMI influences a variety of factors related to muscle strength and physical performance. Our findings may help contribute to the prevention of mobility impairments in elderly Japanese individuals.


PubMed | Yamato Takada Municipal Hospital and Hoshigaoka Medical Center
Type: Case Reports | Journal: Hinyokika kiyo. Acta urologica Japonica | Year: 2014

A 38-year-old man visited our hospital complaining of lower urinary tract symptoms. He had undergone extracorporeal shockwave lithotripsy to remove a right renal stone two times when he was 24 years old. Since examinations revealed right staghorn calculi and a giant bladder stone, vesicolithotomy was carried out. The removed stone measured 95 75 55 mm and weighed 250 g. We hypothesized that a fragment of the upper urinary tract stone had reached the bladder which could not be discharged spontaneously, and grew in the bladder. After the operation, uroflowmetry and voiding cystourethrography were performed and the results indicated no abnormalities in the lower urinary tract function.


Park K.,Yamato Takada Municipal Hospital | Nishiwaki F.,Yamato Takada Municipal Hospital | Nishiwaki F.,Kitano Hospital | Kabashima K.,Kyoto University | Miyachi Y.,Kyoto University
Case Reports in Dermatology | Year: 2013

Introduction: Polyacrylamide hydrogel has been considered a safe and biocompatible soft tissue filler, and it has been widely used in cosmetic procedures. However, recent studies have revealed some complications with polyacrylamide filler injections. Case Report: We present the case of foreign-body granulomas of the glabella, which subsequently formed an infectious ulcer 3 years after a polyacrylamide injection. An immunohistochemical evaluation of the foreign-body granulomas was performed in order to study the relationship between foreign-body granulomas and immune response. Conclusion: We believe that our analysis of foreign-body granulomas 1 and 3 years after a filler injection may contribute to revealing the mechanism of chronic and intractable infections after filler injections. © 2013 S. Karger AG, Basel.


PubMed | Yamato Takada Municipal Hospital, Matsuzaka Chuo General Hospital, Nara Medical University, Tane General Hospital and Nara Prefecture General Medical Center
Type: | Journal: BMC research notes | Year: 2016

The aim of this study is to investigate the prognostic relevance of the best objective response of metastatic target lesions during sunitinib treatment in patients with metastatic renal cell carcinoma.Radiographic analysis of the best objective response according to the Response Evaluation Criteria in Solid Tumors was assessed in 50 patients. Clinicopathological characteristics including the Heng risk classification and sunitinib-related adverse reactions were compared among four patient subgroups [complete response or partial response (CR/PR), stable disease (SD), progressive disease (PD), and those without treatment evaluation (NE)]. Kaplan-Meier and Cox proportional regression analyses of progression-free survival and overall survival were performed to identify prognostic variables.The best objective response was CR/PR in 12 (24%) patients, SD in 22 (44%), PD in 6 (12%), and NE in 10(20%). The incidence of hypertension and hypothyroidism was associated with a better objective response. Progression-free survival was 15.0, 9.2, 6.8, and 2.2months in the CR/PR, SD, PD, and NE groups, respectively (P=0.0004, log-rank test), while the corresponding median overall survival was 59.7, 24.2, 17.1, and 18.1months, respectively (P=0.007). Multivariate analysis revealed that hazard ratios for risk of death of the SD, PD, and NE groups were 4.51 (P=0.06), 7.93 (P=0.02), and 4.88 (P=0.04), respectively, as compared to the CR/PR group.Our findings suggested that the best objective response of target lesions was a prognostic marker for both progression-free survival and overall survival in sunitinib treatment. Furthermore, the incidence of sunitinib-induced hypertension was associated with a longer progression-free survival.


Furukawa N.,Nara Medical University | Nishioka K.,Yamato Takada Municipal Hospital | Noguchi T.,Yamato Takada Municipal Hospital | Kajihara H.,Yamato Takada Municipal Hospital | Horie K.,Yamato Takada Municipal Hospital
Case Reports in Oncology | Year: 2014

We report a case of port-site metastasis after laparoscopic surgery for borderline mucinous ovarian tumors (mBOTs) without spillage and review the related literature. The patient was a 50-year-old nulligravida who presented with abdominal distension. Magnetic resonance imaging showed a 20 × 10-cm multilocular mass with various signal intensities. The wall and septa of the mass were neither thick nor enhanced. A laparoscopy was performed. An intact left ovarian tumor was observed. The weight of the tumor was 1,540 g. The final diagnosis was stage IA intestinal-type mBOT, so the patient did not undergo adjuvant therapy. Twenty-six months after surgery, the patient presented with a 3 × 5-cm palpable mass on the umbilicus. Biopsy of the mass revealed mucinous adenocarcinoma and computed tomography showed a 3.5 × 4.0-cm mass at the umbilicus without additional metastases. A laparotomy was performed and no metastasis in the peritoneal cavity was observed by gross examination. An umbilical mass resection, hysterectomy, right salpingo-oophorectomy, appendectomy, and partial omentectomy were performed. Hematoxylin and eosin-stained sections of the umbilical mass revealed glands of varying size infiltrating the stroma, immunohistologic staining for cytokeratin 7 was positive, and cytokeratin 20 was negative, but no other metastases were observed. The patient was diagnosed with port-site metastasis and invasive recurrence of mBOT. She underwent six cycles of adjuvant paclitaxel and carboplatin therapy. Large ovarian tumors should be carefully extracted without spillage of the tumor contents to prevent port-site metastasis, despite the low incidence. © 2014 S. Karger AG, Basel.


Park K.,Yamato Takada Municipal Hospital | Park K.,Nara Medical University | Ommori R.,Nara Medical University | Imoto K.,Nara Medical University | Asada H.,Nara Medical University
Journal of Dermatological Science | Year: 2014

Background: Epidermal growth factor receptor inhibitors (EGFRIs) have developed as one of the potential treatment options for various kinds of cancers. Although a variety of dermatological adverse reactions such as follicular acneiform eruptions is commonly encountered, the mechanism of the reactions remains unclear. Objectives: We investigated the effects of EGFRIs on the expression of human β-defensins against staphylococci to study the pathomechanism of cutaneous adverse reactions caused by EGFRIs. Methods: We investigated the expressions of human β-defensins 1, 2, and 3 (hBD1, 2, and 3) from staphylococci-stimulated normal human epidermal keratinocytes (NHEKs) cultured with or without the effects of two EGFRIs, gefitinib and erlotinib. We stimulated NHEKs with the supernatant of Staphylococcus aureus (S. aureus) and S. epidermidis and the live staphylococci. We measured hBDs in the culture supernatants of NHEKs by enzyme-linked immunosorbent assay (ELISA). Results: EGFRIs did not suppress the expressions of hBD1 and 3 induced by S. aureus. In contrast, EGFRIs suppressed the expressions of hBD2 and 3 induced by S. epidermidis. Conclusion: EGFRIs may cause cutaneous adverse effects through selectively perturbing innate immune responses induced by commensal and pathogenic bacteria. © 2014 Elsevier Ireland Ltd.


PubMed | Yamato Takada Municipal Hospital and Nara Medical University
Type: | Journal: Case reports in obstetrics and gynecology | Year: 2015

Phosphoglyceride crystal deposition disease (PGDD) is a rare disease entity that is characterized by phosphoglyceride crystal deposition that stimulates the formation of masses in soft tissue scars or bones. We report a case of PGDD in the pelvic soft tissues that recurred after initial surgical treatment. A 50-year-old woman was referred to our hospital for the evaluation of pelvic masses that were observed on an abdominal ultrasound. Magnetic resonance imaging (MRI) revealed masses in the pelvic region, with the largest being 10cm in diameter. The masses were diagnosed as ovarian malignant tumors, and an exploratory laparotomy was performed. Operative findings revealed them to be foreign body granulomas, and the patient was diagnosed with PGDD. The patient had a history of cesarean delivery at the age of 24 years. PGDD is extremely rare, but it should be considered in the differential diagnosis of abdominal masses in patients with a history of abdominal surgery.

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