1.Clinical Statistical Study of 121 Patients with Laryngeal Cancer
Iwao YOSHIOKA ; Shigeru KOSHIBA ; Hiroshi MATSUMIYA ; Hiroshi TAGUCHI
Journal of the Japanese Association of Rural Medicine 2014;63(1):9-18
Laryngeal cancer is a malignant disease that occurs at a high incidence rate as compared with other forms of cancer of the head and neck, and its treatment is commonly conducted at a regional central hospital from diagnosis to recovery. In this study, we summarized the outcomes of first-line treatment for laryngeal cancer over the past 10 years at our hospital. The subjects consisted of 121 patients who received a first-line treatment for squamous cell carcinoma of the larynx between January 2000 and April 2010. Of these, 115 were male and six were female, with a mean age of 67.9 years. There were 56 cases of stage I laryngeal cancer, 30 of stage II, 14 of stage III, and 21 of stage IVa. Cases of stage IVc cancer with distal metastasis were excluded. The disease-specific 5-year survival rate was 100% in stage I, 81.8% in stage II, 100% in stage III, and 72.5% in stage IVa, respectively. Moreover, the laryngeal preservation rates was 93.7% in stage I, 69.4% in stage II, 34.2% in stage III, and 42.6% in stage IVa, respectively. Although the disease-specific 5-year survival rate in stage III was 100%, the laryngeal preservation rate was the lowest at 34.2%. In cases of stage III cancer, although the survival rate was certainly high when total laryngectomy was performed, we believe that in the future, radiation therapy and partial laryngectomy should be introduced to preserve the larynx. There were only three cases of stage II subglottic cancer in which both the laryngeal preservation rate and survival were low.
2.Effects of hypoxic exposure and endurance exercise training on the oxidative potentials of soleus muscle fibers and motoneurons in the rat.
HIDEKI MORII ; SAKIYA YAMASAKI ; HIROSHI OKAMOTO ; AKIHIKO ISHIHARA ; SADAYOSHI TAGUCHI
Japanese Journal of Physical Fitness and Sports Medicine 1993;42(2):122-129
Thirty (n=30) seven week old male Sprague-Dawley rats were divided into six groups of five rats (n=5) in each group. The groups were designated Sc=sea level controls; St=sea level trained; Fc=hypoxic exposed (16% O2) controls; Ft =hypoxic exposed (16% O2) trained; Pc=intermittent hypoxic exposed (18%, 16%, 14%, 16%, 18% O2 for two days each) controls; and Pt=intermittent hypoxic exercise trained. Exercise training consisted of 45min/day running on a rat treadwheel for 24 consecutive days. Fiber type distribution, succinate dehydrogenase (SDH) activity and glycogen content of the soleus muscle and the oxidative enzyme activity of the motoneurons of the soleus were measured in each group after the 24 days of hypoxic exposure and exercise training. In comparison to each training group's control the glycogen concentration of the soleus muscle was increased (P<0.05) regardless of hypoxic exposure. Only the intermittently hypoxic exercise trained group (Pt) demonstrated a fiber type shift of slow-twitch oxidative to fast-twitch oxidative glycolytic fibers. Neither hypoxia or exercise training altered the oxidative enzyme capacity of the soleus motoneurons.
3.Effects of acupuncture treatment for menstrual pain.-Study by Ringheaded thumbtack needle-
Sazu YOSHIMOTO ; Reina TAGUCHI ; Kenji IMAI ; Hiroshi KITAKOUJI
Journal of the Japan Society of Acupuncture and Moxibustion 2009;59(4):406-415
[Objective]We examined the effects of acupuncture treatment at Sanyinjiao (SP6) on menstrual pain in female students. In addition, the correlation between the effects of acupuncture treatment and the neurosis were evaluated.
[Methods]Fifty-one female students were participated in this study as the subject. Acupuncture treatment using Ringheaded thumbtack needle were performed to bilateral SP6 for the three months. Non-treatment periods for three months were set in before and after acupuncture period, respectively. Patients received the Ringheaded thumbtack needle through four days in a week. The effectiveness of treatment was evaluated using the categorical scale for the severity of menstrual pain accompany with numbers of taking drugs for analgesic. To evaluate the correlation between effects of acupuncture and neurosis, the tendency of neurosis was confirmed by cornel medical index (CMI) and the perimenstrual symptoms were confirmed by menstrual distress questionnaire (MDQ).
[Results]Twenty-seven subjects were analyzed for evaluation in this present study. During Ringheaded thumbtack needle treatment periods (acupuncture periods), menstrual pain had reduced into 48%of subjects. The number of taking drugs for analgesic was decreased with the reduction of severity of menstrual pain during acupuncture periods (p<0.05). The correlation between the effect of acupuncture and the tendency of neurosis were observed. Acupuncture improved the menstrual pain in the subjects who belong to category I and/or II of CMI. However, no remarkable changes were observed in the III and/or IV subjects of CMI. Furthermore, the high score of fives specific pain into MDQ (shoulder pain, headache, etc) and negative feelings factor were obtained in subjects who accompany with strong menstrual pain still after acupuncture
[Discussion]These findings suggest that menstrual pain was reduced by Ringheaded thumbtack needle to bilateral SP6. Additionally this result was influenced by a psychological factor and/or some kind of pain which is not only menstrual pain.
4.Effects of electroacupuncture on menstrual cycle at puberty
Reina TAGUCHI ; Sazu YOSHIMOTO ; Kenji IMAI ; Hiroshi KITAKOJI
Journal of the Japan Society of Acupuncture and Moxibustion 2012;62(2):148-156
[Objective]To clarify the effects of electroacupuncture (EA) on the menstrual cycle at puberty, we investigated whether or not EA influences the menstrual cycle, the number of ovulations, and the duration of the high-temperature phase. Also we investigated the improvement of menstrual disorder and changes in body mass index (BMI) by EA treatment.
[Methods]Twenty-five female students participated in this study.
Non-treatment periods from three to four months were evaluated before EA treatment. During treatment, EA was performed once a week. We compared the menstrual cycle, the number of ovulations, and the duration of the high temperature phase for non-treatment and EA treatment periods. To evaluate the relation between BMI and improvement of menstrual disorder by EA, female students were divided into two groups, improvement or not-improvement group.
[Results]Twenty female students were analyzed in this study. In those with extended periods of amenorrhea, the menstrual cycle became significantly shorter during EA (P< 0.001). In those with polymenorrhea, the menstrual cycle became significantly longer during EA (P< 0.05), reaching a normal cycle length. Improvement of the menstrual cycle was found in 30.0%of the subjects. However, an increase in the number of ovulations and extended duration of the high temperature phase were found in 20.0%and 25.0%of the subjects, respectively. Although BMI did not vary significantly between the improvement and the not-improvement groups, the percentage of those with normal weight tended to be higher in the improvement group than in the not-improvement group.
[Conclusion]These findings suggest that EA influences follicular growth. However, it had been thought that EA could not influence ovulation or affect luteal function. Additionally, when BMI is nearly normal, it appears more likely that acupuncture is effective for menstrual disorder at puberty.
5.Project for recycle of the plastic needle tube at Center of Acupuncture Science of Meiji University of Integrative Medicine.
Kenji IMAI ; Youichi MINAKAWA ; Syusaku OMIYA ; Sazu OSHIMOTO ; Hiroshi TANIGUCHI ; Reina TAGUCHI ; Hiroyuki TSURU ; Hiroshi KITAKOJI
Journal of the Japan Society of Acupuncture and Moxibustion 2009;59(2):134-135
6.Early Experience with the 19-mm Medtronic Mosaic Porcine Bioprosthesis for Small Aortic Annuli
Hiroshi Kagawa ; Yoshimasa Sakamoto ; Hiroshi Okuyama ; Shinichi Ishii ; Shingo Taguchi ; Kazuhiro Hashimoto
Japanese Journal of Cardiovascular Surgery 2008;37(1):1-5
A study was conducted to evaluate the clinical and hemodynamic performance of the 19-mm Medtronic Mosaic Valve (MMV) in the aortic position, which is a third-generation stented porcine bioprosthesis. Between 2003 and 2006, 9 patients underwent AVR using the 19-mm MMV. None of the patients were suitable for a 19-mm Perimount bioprosthetic valve due to having a small annulus and sinotubular junction. The patients included 3 men and 6 women with a mean age of 73.2±4.97 years and mean body surface area of 1.35±0.11m2. Preoperatively, 8 patients were in New York Heart Association class II and 1 was in class III. The reason for surgery was aortic stenosis in 8 patients and aortic regurgitation due to infective endocarditis in 1 patient. Four patients had chronic renal failure and were on hemodialysis, while 1 patient had Crohn's disease. Concomitant coronary artery bypass grafting was performed in 3 patients, and tricuspid valve annuloplasty was done in 1 patient. The follow-up period was 12.0±7.71 months. No deaths occurred, but there was 1 cerebral infarction. Postoperatively, the peak pressure gradient decreased from 81.3±32.7 to 40.3±16.3mmHg (p<0.01). The mean pressure gradient also decreased significantly from 48.8±11.6mmHg to 23.9±9.32mmHg (p<0.01). Left ventricular end-diastolic diameter was 47.9±3.82mm preoperatively and 45.1±7.53mm postoperatively, showing no significant change. The left ventricular mass index also improved from 217.3±46.9 to 160±54.9g/m2 (p<0.05). The ejection fraction was 72.0±8.93% preoperatively and 67.6±6.37% postoperatively, showing no difference. Although the postoperative indexed effective orifice area (EOAI) was 0.90±0.11cm2/m2, mild patient-prosthesis mismatch (EOAI 0.77cm2/m2) was noted in 1 patient. In conclusion, the early clinical and hemodynamic performance of the 19-mm MMV in small elderly patients was acceptable.
7.Mitral Valve Plasty in the Active Phase of Infective Endocarditis with Intracerebral Mycotic Aneurysms and Abscesses in the Brain and Lower Limb
Hiroshi Kagawa ; Kazuhiro Hashimoto ; Yoshimasa Sakamoto ; Hiroshi Okuyama ; Shinichi Ishii ; Shingo Taguchi
Japanese Journal of Cardiovascular Surgery 2007;36(1):19-22
A 38-year-old woman was referred to our hospital for treatment of infective endocarditis associated with abscesses in the brain and the left lower limb. A causative organism had not been detected by serial blood cultures. Preoperative brain CT revealed mycotic aneurysms and echocardiography showed a mobile vegetation (8mm in size) on the anterior leaflet of the mitral valve. We performed resection of the vegetation together with a small triangle of the anterior leaflet, after which the margins of the defect were approximated. Then bilateral Kay procedures and reinforcement with autologous pericardium were done to obtain proper coaptation. The patient's fever, left lower limb pain, and intracerebral mycotic aneurysms resolved after surgery. The brain abscess also became smaller. Mitral valve plasty should sometimes be considered in the active phase of endocarditis, even in patients with cerebral complications and without congestive heart failure.
8.Variations in the Value of Electric Resistivity to the Command Points (the terminal points, the source points and the connecting points) in Vertigo
Hiroshi SAWADA ; Makiko TAGUCHI ; Norio WATABE ; Reiko TAKIZAWA ; Mitsushi TAKENOUCHI ; Misao TAKENOUCHI
Journal of the Japan Society of Acupuncture and Moxibustion 1982;32(1):48-53
Every disorder makes an appearance on the command points in the extremities. Taking three command points, we examined variations of electric resistivity in vertigo.
The termal point showed low level in general, whereas the connecting was high, especially in the lower extremities. Post treatment it had a tendency to get the mean.
About the laterality we were able to improve their instability, but were not able to establish whether it was effective or not.
Vertigo made an appearance on various meridians and points.
9.Surgical Management of Perivalvular Leakage after Mitral Valve Replacement
Yoshimasa Sakamoto ; Kazuhiro Hashimoto ; Hiroshi Okuyama ; Shinichi Ishii ; Shingo Taguchi ; Takahiro Inoue ; Hiroshi Kagawa ; Kazuhiro Yamamoto ; Kiyozo Morita ; Ryuichi Nagahori
Japanese Journal of Cardiovascular Surgery 2008;37(1):13-16
Perivalvular leakage (PVL) is one of the serious complications of mitral valve replacement. Between 1991 and 2006, 9 patients with mitral PVL underwent reoperation. All of them had severe hemolytic anemia before surgery. The serum lactate dehydrogenase (LDH) level decreased from 2,366±780 IU/l to 599±426 IU/l after surgery. The site of PVL was accurately defined in 7 patients by echocardiography. PVL occurred around the posterior annulus in 3 patients, anterior annulus in 2, anterolateral commissure in 1, and posteromedial commissure in 1. The most frequent cause of PVL was annular calcification in 5 patients. Infection was only noted in 1 patient. In 4 patients, the prosthesis was replaced, while the leak was repaired in 5 patients. There was one operative death, due to multiple organ failure, and 4 late deaths. The cause of late death was cerebral infarction in 1 patient, subarachnoid hemorrhage in 1, sudden death in 1, and congestive heart failure (due to persistent PVL) in 1. Reoperation for PVL due to extensive annular calcification is associated with a high mortality rate and high recurrence rate, making this procedure both challenging and frustrating for surgeons.
10.A "Primary Care Course" Curriculum in Undergraduate Medical Education (A Revised Plan).
Akitsugu OJIMA ; Yutaka HIRANO ; Rikio TOKUNAGA ; Takanobu IMANAKA ; Kensuke HARADA ; Seishi FUKUMA ; Junichi SUZUKI ; Hiroshi HAMADA ; Masahiko HATAO ; Susumu TANAKA ; Shigetoshi TAGUCHI ; Daizo USHIBA
Medical Education 1991;22(4):242-248