Yamatotakada, Japan
Yamatotakada, Japan

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Nakamura Y.,Yamatotakada Municipal Hospital | Yon T.,Kyoto University | Kato T.,Yamatotakada Municipal Hospital | Nakayama H.,Yamatotakada Municipal Hospital | Okamura R.,Yamatotakada Municipal Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2016

A 70-year-old woman was diagnosed with cStage IV gastric cancer with diffuse intra-tumoral calcifications. She underwent systemic chemotherapy with an S-1/cisplatin regimen. However, as the disease progressed after 5 courses of the regimen, a secondary S-1/docetaxel regimen was administered. The target lesions showed complete response after 6 courses of this regimen, and surgery with curative intent was planned. The patient underwent total gastrectomy because no factors that would compromise the curative intent were observed during laparotomy. Postoperatively, the disease showed pathological complete response to chemotherapy.


Sugawara Y.,Yamatotakada Municipal Hospital | Okamura R.,Yamatotakada Municipal Hospital | Taniguchi S.,Nara Medical University
Journal of Medical Case Reports | Year: 2016

Background: Left atrial thrombi have traditionally been treated with heparin and warfarin, and many physicians have limited experience with direct oral anticoagulants such as apixaban. Furthermore, the efficacy of apixaban for the treatment of left atrial thrombi has not been established. We experienced a case of left atrial thrombus formation before breast cancer surgery, which was resolved by apixaban. Case presentation: Computed tomography for a 74-year-old Japanese woman with breast cancer incidentally revealed a left atrial mass with a root before the breast surgery. The mass was surgically removed and determined to be a thrombus. Before the breast surgery, transthoracic echocardiography was performed again, and the left atrial thrombus had recurred within only 14 days. It resolved after administration of apixaban. Conclusions: A left atrial thrombus might recur within a very short time. Apixaban might be an alternative to warfarin in patients with breast cancer and left atrial thrombus. © 2016 The Author(s).


Yoh T.,Yamatotakada Municipal Hospital | Okamura R.,Yamatotakada Municipal Hospital | Nobuto Y.,Yamatotakada Municipal Hospital | Wada S.,Yamatotakada Municipal Hospital | And 3 more authors.
Hepato-Gastroenterology | Year: 2014

Background/Aims: The timing of a laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) remains controversial. Traditionally, LC for AC is performed within 3 days. We designed this study so that the cut-off time of LC for AC was within 7 days of admission, based on severity. Methodology: A total of 103 patients were divided into 2 groups: patients undergoing LC within 7 days of admission [early LC (ELC), n = 41] and patients undergoing LC between 8 days and 5 weeks of admission [delayed LC (DLC), n = 62]. The outcomes compared were complication rate, conversion rate, postoperative hospital days, and operation time. Statistical analyses were performed in mild, moderate and all AC cases. Results: Of all AC cases, successful LC was performed in 93 patients, and no significant difference was observed between the 2 groups. In DLC for moderate AC, percutaneous cholecystectomy (PC) with or without endoscopic nasal bile drainage (ENBD) was performed more frequently than ELC. Conclusions: DLC had no advantage over ELC. ELC for AC is preferable in cost-effect. Even if the operation cannot be scheduled early, proper initial treatment, including percutaneous cholecystectomy with or without endoscopic nasal bile drainage for moderate AC, enables DLC a safe option. © H.G.E. Update Medical Publishing S.A.


Shigematsu H.,Yamatotakada Municipal Hospital | Yoneda M.,Yamatotakada Municipal Hospital | Tanaka Y.,Nara Medical University
Asian Spine Journal | Year: 2014

We report a very rare case of negative pressure pulmonary edema (NPPE) that occurred immediately after anterior cervical discectomy and fusion (ACDF). The patient was a 25-year-old man who sustained a facet fracture-dislocation of C5 during a traffic accident. After ACDF, he developed NPPE and needed mechanical ventilation. Fortunately, he recovered fully within 24 hours. NPPE is a rare postoperative complication that may occur after cervical spine surgery. The aims of this report are to present information regarding the diagnosis and emergent treatment of NPPE, and to review the previous literature regarding this serious complication. © 2014 by Korean Society of Spine Surgery.


Yoh T.,Yamatotakada Municipal Hospital | Wada S.,Yamatotakada Municipal Hospital | Kobayashi A.,Yamatotakada Municipal Hospital | Nakamura Y.,Yamatotakada Municipal Hospital | And 3 more authors.
International Journal of Surgery Case Reports | Year: 2013

INTRODUCTION: Because splenic cysts are rare, a definitive treatment regime for these cysts remains unclear. We report a case of a large multilocular splenic cyst with elevated carbohydrate antigen 19-9 (CA19-9) levels, which was successfully treated with laparoscopic splenectomy. PRESENTATION OF CASE: A 22-year-old female was admitted to our hospital with severe left upper abdominal pain. Serum CA19-9 level was mildly elevated (65 U/ml). Computed tomography revealed a 25-cm long spleen with multilocular cystic lesions, for which an emergency laparoscopic splenectomy was performed. Histological findings revealed that the lesion was a benign true cyst, and immunostaining analyses showed that the epithelium was CA19-9-positive. DISCUSSION: Although some spleen-preserving approaches have been reportedly used, splenic cyst recurrence usually occurs in true cyst cases, wherein the cyst is incompletely removed. Most reported cases of splenic cysts producing CA19-9 are true cysts. CONCLUSION: The treatment approach should be decided on the basis of the type, shape, location, and even CA19-9 levels of the splenic cyst. © 2013 Surgical Associates Ltd.


Shigemats H.,Yamatotakada Municipal Hospital | Koizumi M.,Nara Medical University | Yoneda M.,Yamatotakada Municipal Hospital | Iida J.,Nara Medical University | And 2 more authors.
Asian Spine Journal | Year: 2013

Study Design: Prospective study. Purpose: The main purpose of this study was to clarify the range of magnification errors on digital plain radiographs and to determine if there is a correlation between the body mass index (BMI) of a patient and the magnification error. Overview of Literature: Most clinicians currently use digital plain radiography. This new method allows one to access images and measure lengths and angles more easily than with the past technologies. In addition, conventional plain radiography has magnification errors. Although few articles mention magnification errors in regards to digital radiographs, they are known to have the same errors. Methods: We used plain digital radiography and magnetic resonance imaging (MRI) to acquire images of the cervical spine with the goal of evaluating magnification errors by measuring the anteroposterior vertebral body lengths of C2 and C5. The magnification error (ME) was then calculated: ME=(length on radiograph-length on MRI)/length on MRI ×100 (%). The correlation coefficient between the magnification error and BMI was obtained using Pearson's correlation analysis. Results: Average magnification errors in C2 and C5 were approximately 18.5%±5.4% (range, 0%-30%) and 20.7%±6.3% (range, 1%-32%). There was no positive correlation between BMI and the magnification error. Conclusions: There were magnification errors on the digital plain radiographs, and they were different in each case. Maximum magnification error differences were 30% (C2) and 31% (C5). Based on these finding, clinicians must pay attention to magnification errors when measuring lengths using digital plain radiography. © 2013 by Korean Society of Spine Surgery.


PubMed | Yamatotakada Municipal Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

A 70-year-old woman was diagnosed with cStage IV gastric cancer with diffuse intra-tumoral calcifications. She underwent systemic chemotherapy with an S-1/cisplatin regimen. However, as the disease progressed after 5 courses of the regimen, a secondary S-1/docetaxel regimen was administered. The target lesions showed complete response after 6 courses of this regimen, and surgery with curative intent was planned. The patient underwent total gastrectomy because no factors that would compromise the curative intent were observed during laparotomy. Postoperatively, the disease showed pathological complete response to chemotherapy.


PubMed | Yamatotakada Municipal Hospital
Type: Journal Article | Journal: Annals of vascular diseases | Year: 2014

We performed divided saphenectomy (DS) for varicose vein in ambulatory surgery with minimal incisions. Under tumescent local anesthesia, this procedure ligates all perforators in the thigh, preserving a route of venous drainage, and reduces bruising by ligating all tributaries. Also, DS does not need any special surgical instrument. Subcutaneous inguinal hemorrhage was observed in 4.9% (3/61), mild bruises were observed in 19.7% (12/61), and saphenous nerve neuralgia was 1.6% (1/61). Wound infection, deep venous thrombosis, and edema were not observed. DS is a minimally invasive, simple, and cost-effective procedure.


PubMed | Nara Medical University and Yamatotakada Municipal Hospital
Type: Journal Article | Journal: Asian spine journal | Year: 2013

Prospective study.The main purpose of this study was to clarify the range of magnification errors on digital plain radiographs and to determine if there is a correlation between the body mass index (BMI) of a patient and the magnification error.Most clinicians currently use digital plain radiography. This new method allows one to access images and measure lengths and angles more easily than with the past technologies. In addition, conventional plain radiography has magnification errors. Although few articles mention magnification errors in regards to digital radiographs, they are known to have the same errors.We used plain digital radiography and magnetic resonance imaging (MRI) to acquire images of the cervical spine with the goal of evaluating magnification errors by measuring the anteroposterior vertebral body lengths of C2 and C5. The magnification error (ME) was then calculated: ME=(length on radiograph-length on MRI)/length on MRI 100 (%). The correlation coefficient between the magnification error and BMI was obtained using Pearsons correlation analysis.Average magnification errors in C2 and C5 were approximately 18.5%5.4% (range, 0%-30%) and 20.7%6.3% (range, 1%-32%). There was no positive correlation between BMI and the magnification error.There were magnification errors on the digital plain radiographs, and they were different in each case. Maximum magnification error differences were 30% (C2) and 31% (C5). Based on these finding, clinicians must pay attention to magnification errors when measuring lengths using digital plain radiography.


PubMed | Nara Medical University and Yamatotakada Municipal Hospital
Type: Journal Article | Journal: Journal of medical case reports | Year: 2016

Left atrial thrombi have traditionally been treated with heparin and warfarin, and many physicians have limited experience with direct oral anticoagulants such as apixaban. Furthermore, the efficacy of apixaban for the treatment of left atrial thrombi has not been established. We experienced a case of left atrial thrombus formation before breast cancer surgery, which was resolved by apixaban.Computed tomography for a 74-year-old Japanese woman with breast cancer incidentally revealed a left atrial mass with a root before the breast surgery. The mass was surgically removed and determined to be a thrombus. Before the breast surgery, transthoracic echocardiography was performed again, and the left atrial thrombus had recurred within only 14days. It resolved after administration of apixaban.A left atrial thrombus might recur within a very short time. Apixaban might be an alternative to warfarin in patients with breast cancer and left atrial thrombus.

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