Yokosuka General Hospital Uwamachi

Yokosuka, Japan

Yokosuka General Hospital Uwamachi

Yokosuka, Japan
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Nishida K.,Yokosuka General Hospital Uwamachi | Kato T.,Yokosuka General Hospital Uwamachi | Lefor A.K.,Jichi Medical University | Suganuma T.,Yokosuka General Hospital Uwamachi
International Journal of Surgery Case Reports | Year: 2017

Introduction Intestinal malrotation is a congenital abnormality which occurs due to a failure of the normal 270° rotation of the midgut. The non-rotation type is usually asymptomatic and discovered incidentally on imaging studies. Intestinal malrotation accompanied by colon cancer is extremely rare. Presentation of case A 53-year-old male presented with postprandial abdominal discomfort. Colonoscopy showed a 14 mm polyp in the sigmoid colon and endoscopic polypectomy was performed. Pathological evaluation revealed an adenocarcinoma invading the submucosa more than 1000 μm with positive vertical and horizontal margins. A contrast enhanced computed tomography scan showed an anatomic variant of the ileocolic and inferior mesenteric arteries originating from a common channel branching from the abdominal aorta. Laparoscopic sigmoid colon resection was performed. The patient did well post operatively. Discussion The usual trocar placement for laparoscopic left side colectomy was used, and we found no difficulties intraoperatively. To secure safe ligation, the divisions of the common channel branching from the abdominal aorta were exposed as in a usual D3 dissection, and the inferior mesenteric artery was ligated after confirmation of the bifurcation of the ileocolic and inferior mesenteric artery. Conclusion To the best of our knowledge, this is the first report of laparoscopic resection of a sigmoid colon cancer with intestinal malrotation. It was performed without difficulty using the usual trocar placement, with appropriate attention to the variant in vascular anatomy. © 2017 The Author(s)


Tarao K.,Taraos Gastroenterological Clinic | Tanaka K.,Yokohama City University | Nozaki A.,Yokohama City University | Sato A.,Yokohama City University | And 6 more authors.
World Journal of Hepatology | Year: 2017

AIM To survey the efficacy and safety of dual therapy with daclatasvir and asunaprevir in the elderly hepatitis C virus (HCV) patients multicentricity. METHODS Interferon-ineligible/intolerant patients and non-responders to previous pegylated-interferon/ribavirin therapy with chronic HCV genotype 1b infection were enrolled. Child B, C cirrhotic patients were excluded.Patients received oral direct acting antiviral treatment consisting of 60 mg daclatasvir once daily plus 200 mg asunaprevir twice daily for 24 wk. We divided the patients into two groups of 56 elderly patients (≥ 75 years-old) and 141 non-elderly patients (< 75 years old) and compared the efficacy and safety. RESULTS Ninety-one point one percent of elderly patients and 90.1% of non-elderly patients achieved sustained virological response at 24 wk (SVR24). In the former, 1.8% experienced viral breakthrough, as compared with 3.5% in the latter (not significant). Adverse events occurred in 55.4% of the former and 56.0% of the latter. In the former, 7 cases (12.5%) were discontinued due to adverse events, and in the latter 9 cases were discontinued (6.4%, not significant). CONCLUSION Dual therapy with daclatasvir and asunaprevir achieved the same high rates of SVR24 in HCV elderly patients without more adverse events than in the non-elderly patients. © The Author(s) 2017.


PubMed | Tokyo Bay Urayasu Ichikawa Medical Center, Yokosuka General Hospital Uwamachi and Jichi Medical University
Type: | Journal: Case reports in surgery | Year: 2014

Nonocclusive mesenteric ischemia (NOMI) is one type of acute mesenteric ischemia. Colonic pseudoobstruction, known as Ogilvie syndrome, is a disorder defined by colonic distension in the absence of mechanical obstruction. A relationship between these diseases has not yet been reported, based on a review of the literature. We report a patient with NOMI secondary to Ogilvie syndrome. An 82-year-old woman reported three days of intermittent abdominal pain. Plain computed tomography scan showed colonic obstruction at the rectosigmoid colon. Colonoscopy was performed that showed a large amount of stool and no evidence of tumor or other physical causes of obstruction. We diagnosed the patient with Ogilvie syndrome and continued nonoperative management. On the third hospital day, she complained of abdominal distension. A repeat CT scan showed pneumatosis intestinalis in the small bowel and ascending colon, with portal venous gas. Emergency laparotomy was performed with diagnosis of mesenteric ischemia. Intraoperatively, there were multiple skip ischemic lesions in the small intestine and cecum. We resected the ischemic bowel and performed a distal jejunostomy. Her residual small bowel measured just 20cm in length. Postoperatively, her general status gradually improved. She was discharged with total parenteral nutrition and a small amount of enteral nutrition.


Nishida K.,Yokosuka General Hospital Uwamachi | Kato T.,Yokosuka General Hospital Uwamachi | Yuzaki I.,Yokosuka General Hospital Uwamachi | Suganuma T.,Yokosuka General Hospital Uwamachi
IDCases | Year: 2016

Edwardsiella tarda (E. tarda) is a rare human pathogen; however, the overall mortality of bacteremia is reported to be up to 50%. Here, we describe a case of cholangitis with E. tarda bacteremia who had a pancreatoduodenectomy for a locally advanced gastric cancer. He was successfully treated using a cefmetazole, a second generation cephalosporin for 14 days. To the best of our knowledge, this is the first case report about E. tarda bacteremia after biliary reconstruction. © 2016 The Authors


Osawa T.,Yokosuka General Hospital Uwamachi
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2011

A 69-year-old man who had had a history of abnormal chest radiograph was admitted. Chest computed tomography showed an 18 x 18 mm apparently-circumscribed mass in the right posterior-basal segment. We performed right lower lobe wedge resection via video-assisted thoracic surgery to establish a definitive diagnosis. The mass was an apparently-circumscribed, gray and solid tumor, the microscopic findings of which included diffuse proliferation of plasma cells with an abnormal profile. Immunohistochemical staining revealed IgG-kappa light chain monoclonality. Absence of M protein in the serum and urine was confirmed. Bone-marrow puncture and positron-emission tomography revealed normal findings. Thus a diagnosis of extramedullary plasmacytoma (EMP) of the lung was made. We report trends of the immunoglobulin isotype of EMP in Japan. Since it has been reported that some of the cases in EMP progress to multiple myeloma (MM), careful observation and follow-up is needed hereafter. In the present case, no recurrence or progress to MM was observed within the first year after surgery.


Nishimoto H.,Yokosuka General Hospital Uwamachi | Nishimoto H.,Kitasato University | Takahashi Y.,Aichi Medical University | Kakizaki H.,Aichi Medical University
Ophthalmic Plastic and Reconstructive Surgery | Year: 2013

PURPOSE:: To examine the relationship of horizontal lower eyelid laxity, frequency of involutional entropion occurrence, and age of Asian patients. METHODS:: Three hundred seventy-six Japanese patients were examined (age range, 3-95 years). The horizontal laxity was examined with a pinch test. A pinch test of >8 mm was judged as positive. The percentage of entropion eyelids was calculated, and pinch tests were also performed. The percentage of entropion eyelids in the total positive pinch test eyelids was calculated. RESULTS:: A positive pinch test first appeared around 40 years of age and increased with age: 7.4% at 50 to 59 years, 8.5% at 60 to 69 years, 18.1% at 70 to 79 years, 37.9% at 80 to 89 years, and 50.0% at ≥90 years. The entropion first appeared around 60 years of age. All patients demonstrated unilateral entropion with a positive pinch test. The percentage of entropion occurrence showed an increase with age: 1.7% at 60 to 69 years, 2.6% at 70 to 79 years, 5.2% at 80 to 89 years, and 8.3% at ≥90 years. The percentage of entropion eyelids in the total positive pinch test eyelids was 20.0% at 60 to 69 years, 14.3% at 70 to 79 years, 13.6% at 80 to 89 years, and 16.7% at ≥90 years, and no significant difference was found among all ages (p = 0.985). CONCLUSIONS:: Lower eyelid horizontal laxity and involutional entropion occurrence increased with age, and the latter was similar over ages when the pinch test was >8 mm. © 2013 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc..


PubMed | Yokosuka General Hospital Uwamachi and Jichi Medical University
Type: | Journal: Case reports in surgery | Year: 2017

Diverticulitis in the terminal ileum is uncommon. Past reports suggested that conservative therapy may be feasible to treat terminal ileum diverticulitis without perforation; however, there is no consensus on the therapeutic strategy for small bowel diverticulitis. We present a 37-year-old man who was referred to our hospital for sudden onset of abdominal pain and nausea. He was diagnosed with diverticulitis in the terminal ileum by computed tomography (CT). Tazobactam/piperacillin hydrate (18g/day) was administered. The antibiotic treatment was maintained for 7 days, and the symptoms disappeared after the treatment. Thirty-eight days after antibiotic therapy, he noticed severe abdominal pain again. He was diagnosed with diverticulitis in terminal ileum which was flare-up of inflammation. He was given antibiotic therapy again. Nine days after antibiotic therapy, laparoscopy assisted right hemicolectomy and resection of 20cm of terminal ileum were performed. Histopathology report confirmed multiple ileal diverticulitis. He was discharged from our hospital 12 days after the surgery. Colonoscopy was performed two months after the surgery and it revealed no finding suggesting inflammatory bowel disease. Surgical treatment should be taken into account as a potential treatment option to manage the diverticulitis in the terminal ileum even though it is not perforated.


PubMed | Yokosuka General Hospital Uwamachi
Type: Case Reports | Journal: Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology | Year: 2011

The present article documents a case of Fusobacterium sepsis with a transient anticardiolipin antibody increase in an otherwise healthy 24-year-old patient. He was presented to the emergency room with headache and fever. His temperature was 39.5C, laboratory results revealed a white blood count of 15.210(3)/l and C reactive protein 22.6 mg/dl. The patient was admitted. Chest X-ray showed the infiltrate in bilateral lower lung area. He received 400 mg of clarithromycin per day. His all symptoms did not change. On the 8(th) day in the hospital, the patients antibiotics were switched to pazufloxacin. Chest and abdominal CT scan showed some irregular patchy nodules of around 1 cm in diameter in the bilateral lower lung fields and a round low density lesion 3 cm in diameter in the right upper segment (S8) in the liver. Blood culture revealed Fusobacterium necrophorum. On the 10(th) day, the antibacterial agent was changed from pazufloxacin to ampicillin sulbactam. On the 17(th) day, we added clindamycin. As a result his temperature gradually returned to normal. It is reported that the titer of anticardiolipin antibody increases in the sepsis patients caused by Fusobacterium necrophorum. As his symptoms disappeared, his titer of anticardiolipin antibody also decreased. So we considered he had a transient anticardiolipin titer increase.


PubMed | Yokosuka General Hospital Uwamachi
Type: Case Reports | Journal: Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society | Year: 2011

A 69-year-old man who had had a history of abnormal chest radiograph was admitted. Chest computed tomography showed an 18 x 18 mm apparently-circumscribed mass in the right posterior-basal segment. We performed right lower lobe wedge resection via video-assisted thoracic surgery to establish a definitive diagnosis. The mass was an apparently-circumscribed, gray and solid tumor, the microscopic findings of which included diffuse proliferation of plasma cells with an abnormal profile. Immunohistochemical staining revealed IgG-kappa light chain monoclonality. Absence of M protein in the serum and urine was confirmed. Bone-marrow puncture and positron-emission tomography revealed normal findings. Thus a diagnosis of extramedullary plasmacytoma (EMP) of the lung was made. We report trends of the immunoglobulin isotype of EMP in Japan. Since it has been reported that some of the cases in EMP progress to multiple myeloma (MM), careful observation and follow-up is needed hereafter. In the present case, no recurrence or progress to MM was observed within the first year after surgery.


PubMed | Yokosuka General Hospital Uwamachi
Type: | Journal: IDCases | Year: 2016

Edwardsiella tarda (E. tarda) is a rare human pathogen; however, the overall mortality of bacteremia is reported to be up to 50%. Here, we describe a case of cholangitis with E. tarda bacteremia who had a pancreatoduodenectomy for a locally advanced gastric cancer. He was successfully treated using a cefmetazole, a second generation cephalosporin for 14days. To the best of our knowledge, this is the first case report about E. tarda bacteremia after biliary reconstruction.

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