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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.


Fujimoto N.,Okaama Rosai Hospital | Aoe K.,National Hospital Organization | Oizumi S.,Hokkaido University | Kozuki T.,National Hospital Organization | And 4 more authors.
Japanese Journal of Lung Cancer | Year: 2014

Objective. We evaluated the usefulness of assessing the hyaluronic acid (HA) level in pleural fluid for the differential diagnosis of malignant pleural mesothelioma (MPM).Method. The data regarding the pleural fluid HA concentration were retrospectively collected from Rosai Hospitals and related facilities in Japan.Reult. A total of 860 cases were examined, which included 139 cases of MPM, 76 of benign asbestos pleurisy (BAP), 324 of lung cancer (LC), 74 of other malignant conditions (OMC), 120 of infectious pleuritis (IP), 11 of collagen diseases (CD) and 116 cases had other conditions. The median (range) HA concentrations in the pleural fluid were 76,650 (211-33,000,000) ng ml in the MPM cases, 28,000 (165-152,000) ng ml in the BAP, 19,000 (800-134,000) ng ml in the LC, 12,200 (900-157,200) ng ml in the OMC, 23,400 (900-230,000) ng ml in the IP, 17,800 (9,000-80,800) ng ml in the CD and 11,575 (23-90,000) ng ml in patients with other diseases. The HA levels were significantly higher in MPM cases than in the patients with other diseases. The receiver operating characteristics (ROC) analysis revealed an area under the ROC curve value of 0.818 (95% confidence interval, 0.772-0.864) for the differential diagnosis of MPM. With a cut-off value of 100,000 ng ml, the sensitivity was 44.5% and the specificity was 98.2%. These results indicate that MPM should be strongly suspected in cases with an elevated concentration of pleural fluid HA.Conclusion. The pleural fluid HA concentrations might be useful for the differential diagnosis of MPM. © 2014 The Japan Lung Cancer Society.


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


Yamamoto E.,Yokosuka General Hospital Uwamachi | Fukae T.,Yokosuka General Hospital Uwamachi | Kawai Y.,Yokosuka General Hospital Uwamachi | Kamio M.,Yokosuka General Hospital Uwamachi | And 5 more authors.
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 39.5°C, laboratory results revealed a white blood count of 15.2×10 3/μl 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 patient's 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. © 2011 The Japan Society for Clinical Immunology.


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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