1.Three Cases of Somatoform Disorder Considered as "Hontonki" Disease, Successfully Treated with Keishikakeito
Takeharu CHIJIWA ; Takashi ITO ; Masataka SUGAO ; Shoko SENDA ; Ken OKAWARA ; Shigeru EBISAWA ; Takeshi OUJI ; Hirohumi SHIMADA
Kampo Medicine 2010;61(6):840-846
We report three cases with somatoform disorder which were considered as “Hontonki” disease, successfully treated with keishikakeito. Case1 was a 34-year old male who was suffering from headache and palpitation. He said ‘Something pierces and it goes up from the chest to the head.' We considered his complaint as Hontonki disease and administered keishikakeito. After one week, the headache disappeared and four weeks later, palpitation and tinnitus were definitely improved. Case2 was a 22-year old male. His complaints were excessive strain and general fatigue. Because he had coldness of lower extremities and spasmodic headache, we interpreted these symptoms Hontonki disease and administered keishikakeito. After that these symptoms and his psychological test scores improved markedly. Case 3 was a 75-year old female. Severe headache and palpitations presented after remodeling her home. Three weeks later taking keishikakeito, her symptoms had disappeared dramatically. Recently, Hontonki disease are often compared with panic disorder, and it is possible that some somatoform disorder cases include Hontonki disease. It is important to consider the possibility of Hontonki disease behind the physical complaints such as headache and palpitation, when we use keishikakeito.
3.Four Cases Treated by Daikenchuto to the Patients with Recurrent Aspiration Pneumonia in Tube Feeding
Ryo FUKATANI ; Shigeru EBISAWA ; Takeharu CHIJIWA ; Takeshi OJI ; Ken OKAWARA ; Hirobumi SHIMADA ; Takashi ITOH ; Shoko SENDA ; Akira NAKAHARA
Kampo Medicine 2010;61(3):313-318
We administered daikenchuto to the patients having recurrent aspiration pneumonia with tube feeding, who had good responses. Case 1 : A 94-year-old-man with congestive heart failure suffering from recurrent aspiration pneumonia even after percutaneous endoscopic gastrostomy (PEG) placement : following daikenchuto administration, he did not suffer from pneumonia, and his general condition became stable. Case 2 : An 80-year-old-man suffering from severe pneumonia after PEG placement, and experiencing recurrent pneumonias after treatment with antibiotics:following daikenchuto administration, we did not find gastric contents in his oral cavity as before, and his general condition became stable. Case 3 : An 85-year-old-man with congestive heart failure and cerebral infarction also suffering from aspiration pneumonia : a nasogastric tube was placed, but he suffered from recurring pneumonias with tube feeding. After administering daikenchuto, he did not suffer from pneumonia and was discharged from the hospital. Case 4 : An 81-year-old-man with recurrent pneumonia and congestive heart failure : after treatment with antibiotics, we placed a PEG tube because of his severe anorexia caused by oral feeding difficulties. In order to prevent aspiration pneumonia, we administered daikenchuto prophylactically. He subsequently developed very little fever until his discharge to a nursing home.
4.Autoimmune Pancreatitis Developing Remarkable Collateral Circulation Around the Pancreas
Koji Hattori ; Yuko Onuki ; Mayumi Kondo ; Nahoko Mochizuki ; Keiji Koshibu ; Yukihito Minato ; Tatsuo Shiigai ; Satoshi Yoshida ; Ken Shimada
Journal of Rural Medicine 2005;1(2):2_36-2_41
A 65-year-old man was referred to our hospital in April 2003 with a pancreas tumor detected by a thorough medical checkup. Computed tomography (CT) showed swelling of the pancreatic body and tail, and magnetic resonance cholangiopancreatography (MRCP) showed only the main pancreatic duct in the head of the pancreas. Diagnosing autoimmune pancreatitis, we observed the patient without medication. However, one year later CT showed stenosis of the splenic artery and portal vein accompanied by development of collateral circulation around the pancreas. He had no symptoms, and CT showed no changes in the pancreatic swelling.;;He was admitted to our hospital on January 6, 2005, presenting with a history of jaundice which first appeared on January 1, 2005, and increased collateral circulation around the pancreas with pancreatic swelling were seen on CT. We started prednisolone therapy at 40 mg/day for exacerbation of autoimmune pancreatitis. Serum bilirubin levels improved from 11.9 mg/dl to 2.5 mg/dl, and pancreatic swelling also improved four weeks after starting therapy.;;We present a rare case of autoimmune pancreatitis that developed marked collateral circulations.
X-Ray Computed Tomography
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Pancreatitis
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Collateral Circulation
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Pancreatic polypeptide, avian
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Swelling
5.Surgical Management and Follow-up Study of Cardiac Lesion Complicating Myocardial Infarction.
Tadashi ISOMURA ; Shigemitsu SUZUKI ; Kouichi HISATOMI ; Hiroto INUZUKA ; Akio HIRANO ; Hideyuki KASHIKIE ; Shoujirou SHIMADA ; Ken-ichi KOSUGA ; Kiroku OHISHI
Japanese Journal of Cardiovascular Surgery 1991;20(6):1065-1068
Thirty six patients with post-infarction complications underwent operation, and the postoperative and late follow-up results were analyzed. There were post-infarction ventricular septal perforation (VSP) in 9 patients and left ventricular aneurysm formation in 27 patients. The operative indications were poor physical work capacity in 13, cardiogenic shock or severe congestive heart failure in 10, left ventricular thrombus in 7, severe ventricular arrhythmia in 6, and repeated angina in 6. Left ventricular aneurysmectomy was performed in 14 patients and VSP closure was in 8. Coronary arteries were simultaneously bypassed in 14 patients. Three patients were died of sudden postoperative arrhythmia 10 days, 55 days and four years after operation. All survivors except two patients with preoperative massive cerebral infarction or prolonged heart failure were in New York Heart Association Class I or II in their late postoperative periods. However, five patients in whom the significant coronary lesion had not been bypassed or the bypassed grafts had occluded complained of mild angina after operation. Postoperative arrhythmia was one of major factors in the late results and simultaneous coronary artery bypass grafting was important to improve the symptoms in the late postoperative periods.
6.Role of UCP2 Expression after Hepatic Warm Ischemia-Reperfusion in the Rat.
Mizuki NINOMIYA ; Ken SHIRABE ; Mitsuo SHIMADA ; Takahiro TERASHI ; Yoshihiko MAEHARA
Gut and Liver 2011;5(4):486-492
BACKGROUND/AIMS: The role of uncoupling protein-2 (UCP2) in the liver is currently unclear. Emerging evidence suggests a relationship between UCP2 and oxidative stress. In the present study, we tested the hypothesis that UCP2 expression in the liver might change during warm ischemia-reperfusion (I/R) according to oxidative stress. METHODS: Wistar rats were subjected to 40 (short ischemia) or 90 (long ischemia) minutes of partial lobar ischemia followed by 4 hours of reperfusion. UCP2 expression in the ischemic and nonischemic lobes was assessed using reverse transcription-polymerase chain reaction and immunohistochemistry. Malondialdehyde concentrations in the liver tissue were also compared. RESULTS: Malondialdehyde concentrations in the ischemic lobes were significantly higher in the long ischemia group. In the ischemic lobes of the short ischemia group, UCP2 protein expression was induced in hepatocytes, which did not express the protein prior to treatment, and the expression levels were higher than in the long ischemia group. The intralobular distribution of UCP2 seemed to correlate inversely with that of the necrotic area. UCP2 expression was observed, even in nonischemic lobes with similar intralobular heterogeneity. CONCLUSIONS: UCP2 was induced in hepatocytes after warm I/R. Although the primitive role of UCP2 expression may be cytoprotective in nature, its actual protective effect in hepatic I/R may be minimal
Animals
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Hepatocytes
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Immunohistochemistry
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Ion Channels
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Ischemia
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Liver
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Malondialdehyde
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Mitochondrial Proteins
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Oxidative Stress
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Rats
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Rats, Wistar
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Reperfusion
7.Evaluation of Sagittal Spine-Pelvis-Lower Limb Alignment in Elderly Women with Pelvic Retroversion while Standing and Walking Using a Three-Dimensional Musculoskeletal Model.
Ken SASAKI ; Michio HONGO ; Naohisa MIYAKOSHI ; Toshiki MATSUNAGA ; Shin YAMADA ; Hiroaki KIJIMA ; Yoichi SHIMADA
Asian Spine Journal 2017;11(4):562-569
STUDY DESIGN: In vivo biomechanical study using a three-dimensional (3D) musculoskeletal model for elderly individuals with or without pelvic retroversion. PURPOSE: To evaluate the effect of pelvic retroversion on the sagittal alignment of the spine, pelvis, and lower limb in elderly females while standing and walking. OVERVIEW OF LITERATURE: Patients with hip–spine syndrome have concurrent hip-joint and spine diseases. However, the dynamic sagittal alignment between the hip joint and spine has rarely been investigated. We used a 3D musculoskeletal model to evaluate global spinopelvic parameters, including spinal inclination and pelvic tilt (PT). METHODS: A total of 32 ambulant females (mean age=78 years) without assistance were enrolled in the study. On the basis of the radiographic measurement for PT, participants were divided into the pelvic retroversion group (R-group; PT≥20°) and the normal group (N-group; PT<20°). A 3D musculoskeletal motion analysis system was used to analyze the calculated value for the alignment of spine, pelvis, and lower limb, including calculated (C)-PT, sagittal vertical axis (C-SVA), pelvic incidence, lumbar lordosis, T1 pelvic angle (C-TPA), as well as knee and hip flexion angles while standing and walking. RESULTS: While standing, C-PT and C-TPA in the R-group were significantly larger than those in the N-group. Hip angle was significantly smaller in the R-group than in the N-group, unlike knee angle, which did not show difference. While walking, C-SVA and C-TPA were significantly increased, whereas C-PT decreased compared with those while standing. The maximum hip-flexion angle was significantly smaller in the R-group than in the N-group. There was a significant correlation between the radiographic and calculated parameters. CONCLUSIONS: The 3D musculoskeletal model was useful in evaluating the sagittal alignment of the spine, pelvis, and leg. Spinopelvic sagittal alignment showed deterioration while walking. C-PT was significantly decreased while walking in the R-group, indicating possible compensatory mechanisms attempting to increase coverage of the femoral head. The reduction in the hip flexion angle in the R-group was also considered as a compensatory mechanism.
Aged*
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Animals
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Extremities*
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Female
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Head
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Hip
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Hip Joint
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Humans
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Incidence
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Knee
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Leg
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Lordosis
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Lower Extremity
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Pelvis
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Spine
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Walking*
8.Clinical impact of C-reactive protein to albumin ratio of the 7th postoperative day on prognosis after laparoscopic colorectal cancer surgery
Masahiro KATAOKA ; Kuniyuki GOMI ; Ken ICHIOKA ; Takuya IGUCHI ; Tomoki SHIROTA ; Arano MAKINO ; Ko SHIMADA ; Kiyotomi MARUYAMA ; Motohiro MIHARA ; Shoji KAJIKAWA
Annals of Coloproctology 2023;39(4):315-325
Purpose:
C-reactive protein to albumin ratio (CAR) has been utilized as a prognostic factor in various carcinomas. We investigated the relationship between preoperative, postoperative day (POD) 1, and POD 7 CARs and the prognosis of patients with colorectal cancer (CRC).
Methods:
Three hundred twenty patients with CRC who underwent laparoscopic radical resection between May 2011 and December 2016 were enrolled. Patients were selected into 2 groups, high CAR and low CAR (n=72/group), based on preoperative, POD 1, and POD 7 CARs. The relapse-free survival (RFS) and overall survival (OS) were compared between groups using propensity score matching.
Results:
The high CAR group had a significantly worse RFS (P<0.001) and OS (P=0.002) at POD 7 than those in the low CAR group. However, in preoperative and POD 1 analysis, no differences were observed.
Conclusion
In patients with CRC, CAR of POD 7 was a significant prognostic factor.
9.Genetic aberrations on the short arm of chromosome 8 (8p) in tongue carcinomas.
Akiyuki MURANO ; Kanae ONO ; Hirofumi KOIKE ; Yosuke ENDO ; Ken SHIMADA ; Kenshi KAWASAKI ; Hitomi NOMURA ; Masashi SHIIBA ; Katsuhiro UZAWA ; Hideki TANZAWA
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2012;38(2):121-126
Aberrations on the short arm of chromosome 8 (8p) are frequently observed in several human cancers. In this study, 20 squamous cell carcinoma (SCC) specimens from the tongue were examined in order to evaluate the role of 8p in SCC of the tongue. Microsatellite analysis using 14 markers demonstrated two commonly deleted regions (CDRs) on 8p. Reverse transcription-polymerase chain reaction (RT-PCR) revealed frequent down-regulation of the FEZ1 gene, mapped to 8p22, and frequent over-expression of the cathepsin B gene, mapped to 8p-21-22. These results suggested that genetic aberrations are involved in the development of SCC of the tongue. However, no significant relationship was observed to be established between the genetic alterations and clinicopathological features. Thus, further investigation is necessary in order to clarify the clinical role of 8p in carcinoma of the tongue.
Arm
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Carcinoma, Squamous Cell
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Cathepsin B
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Chromosomes, Human, Pair 8
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Down-Regulation
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Humans
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Loss of Heterozygosity
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Microsatellite Repeats
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Tongue
10.Does Heparin Flush Help to Maintain Patency of Indwelling Peripheral Catheters?
Satoru Shikata ; Takeshi Seta ; Toshihiko Shimada ; Tsuyoshi Kawakami ; Kenji Maeda ; Ken Takahashi ; Hiroshi Ikai ; Akiko Kawatsu ; Eiji Kaneshiro ; Kunihiko Matsui ; Tatsuya Sakai ; Yoshinori Noguchi ; Hiroshi Koyama ; Takuro Shimbo ; Tsuguya Fukui
General Medicine 2003;4(1):17-20