1.Hetzer's Procedure for Ebstein's Anomaly in an Adult
Hiroyuki Nagahama ; Yasunori Fukushima ; Takuya Fukuda ; Takahiro Hayase ; Makoto Yoshioka
Japanese Journal of Cardiovascular Surgery 2006;35(1):57-59
Ebstein's anomaly is a rare congenital heart disease. A 51-year-old man was hospitalized due to Ebstein's anomaly with severe congestive heart failure. He underwent Hetzer's procedure for tricuspid valve incompetence and right atrial isolation technique to restore the sinus rhythm. The postoperative course was uneventful, he was discharged from the hospital on the 21st day after the operation. The cardiothoracic ratio reduced from 74% before the operation to 60%. And his New York Heart Association functional class also improved from III to I after discharge. Hetzer's procedure for tricuspid valve repair in Ebstein's anomaly restructures the valve mechanism at the level of the true tricuspid annulus by using the most mobile leaflet for valve closure without placation of the atrialized chamber. We thus conclude that Hetzer's procedure, with anatomical evaluation of the malformed tricuspid valves before or during the operation, is beneficial as a simple and reproducible method for the repair of certain cases of Ebstein's anomaly.
2.Prevalence patterns of alcohol consumption and factors associated with problematic drinking on remote islands of Okinawa, Japan: a cross-sectional study
Journal of Rural Medicine 2020;15(2):50-56
Objective: This study aims to investigate the drinking behavior on the remote islands of Okinawa Prefecture.Patients/Materials and Method: This was a cross-sectional study conducted with residents of Okinawa Prefecture’s small, isolated islands. Between October 1 and December 3, 2014, island residents over 20 years of age who visited island clinics for an annual health checkup or influenza vaccination were recruited. An anonymous entry survey was administered to those who provided their consent. The survey included information on age, sex, presence or absence of drinking, age at drinking initiation, smoking status, comorbidities, and family and social background. The Alcohol Use Disorder Identification Test (AUDIT) was used to assess alcohol consumption. Participant characteristics were analyzed descriptively, and logistic regression analysis was conducted to assess relationships between the high-risk drinking group (AUDIT score ≥10 points) and other measured variables (age, sex, age at drinking initiation, smoking, residence, and employment status).Results: Compared to the results of a national survey in 2013, there was a significantly higher prevalence of male island residents who drank ≥40 g of alcohol per day and female island residents who drank ≥20 g/day, levels which are considered risk factors for lifestyle diseases. Among both male and female island residents, there were significantly higher proportions of those with AUDIT scores ≥8 points, referred to as high-risk drinkers, and those with AUDIT scores ≥20, individuals considered to have probable alcohol dependence, as compared to the results of the national survey. In a logistic regression analysis, factors related to high-risk drinking included younger age, male sex, smoking history, inoccupation, and underage drinking initiation.Conclusion: This is the first report on drinking behavior among inhabitants of Okinawa’s remote islands. The degree of alcohol consumption is serious and must be recognized as a regional health problem.
3.Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair
Takaki IMAI ; Masafumi GOTOH ; Keiji FUKUDA ; Misa OGINO ; Hidehiro NAKAMURA ; Hiroki OHZONO ; Naoto SHIBA ; Takahiro OKAWA
Clinics in Shoulder and Elbow 2021;24(2):80-87
Background:
Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR.
Methods:
Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups.
Results:
Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (P<0.0001). Comparisons between the two groups were not significantly different, except for SF-36 “general health perception” (P<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema.
Conclusions
CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.
4.Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair
Takaki IMAI ; Masafumi GOTOH ; Keiji FUKUDA ; Misa OGINO ; Hidehiro NAKAMURA ; Hiroki OHZONO ; Naoto SHIBA ; Takahiro OKAWA
Clinics in Shoulder and Elbow 2021;24(2):80-87
Background:
Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR.
Methods:
Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups.
Results:
Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (P<0.0001). Comparisons between the two groups were not significantly different, except for SF-36 “general health perception” (P<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema.
Conclusions
CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.
5.Study on Adherence and Safety of Patients Taking Molnupiravir Capsules
Yukiko FUKUDA ; Kouichi HOSOMI ; Shouhei OKANO ; Takahiro YAMAGUCHI ; Hirohisa SHINDOU ; Daichi OKUDA ; Takashi MURATA
Japanese Journal of Social Pharmacy 2024;43(1):40-47
To assess the safety of molnupiravir capsules (MOV) and the adherence of patients taking these capsules, we conducted a survey of patients who were dispensed MOV at the Maruzen Pharmacy from January 1st to September 30th, 2022. In the survey, a sample of 134 patients were requested to complete a questionnaire, from whom we received 56 responses (response rate: 41.8%). Among the respondents, 11 (19.6%) failed to complete their medication, and those aged 60 years or older tended to have poor adherence (P<0.001). Apart from age, we detected no statistical differences with respect to other assessed factors (gender, capsule size, occurrence of side effects, and evaluation of pharmacist’s explanations). Side effects were reported by 11 individuals (19.6%) taking the drug, although these were mainly consistent with those that have been reported in clinical trials. In addition, 20 individuals (35.7%) experienced COVID-19 after-effects after taking MOV. When requested to evaluate pharmacies and pharmacists, five individuals (8.9%) reported feeling dissatisfied. Although the results obtained in this survey are based on a limited number of patients, they do reveal a concerning lack of adherence among patients over 60 years of age; and there are needs for future improvements in the size of MOV capsules.
6.A Case of Superior Mesenteric Vein Thrombosis That Was Difficult to Diagnose and Caused Acute Deterioration
Yasuhiro IIZUKA ; Keita FUKUDA ; Yuta SUGIYAMA ; Taro SHIMIZU ; Minami ENDOH ; Masako UEDA ; Fumio GOTO ; Takahiro KAWAMURA
Journal of the Japanese Association of Rural Medicine 2018;67(2):159-
A 68-year-old man presented with abdominal pain, vomiting, and diarrhea. He was admitted with a provisional diagnosis of acute gastroenteritis based on physical examination, blood tests, ultrasonography, and plain computed tomography. Despite treatment with fasting and fluid replacement, cardiopulmonary arrest occurred the following morning. All attempts at resuscitation failed and the patient died. Pathological autopsy revealed the presence of clots within the superior mesenteric vein, which was diagnosed as superior mesenteric vein thrombosis. This rare disease often manifests with only nonspecific symptoms and is typically difficult to diagnose. Because delayed diagnosis may lead to unfavorable outcomes, it is important to include this disease in the differential diagnosis of abdominal pain.
7.Malnutrition and inflammation status in nonobese patients with inflammatory bowel disease are associated with nonalcoholic fatty liver disease: a retrospective study
Takahiro NAGATA ; Sadahiro FUNAKOSHI ; Daisuke MORIHARA ; Satoshi SHAKADO ; Keiji YOKOYAMA ; Kazuhide TAKATA ; Takashi TANAKA ; Atsushi FUKUNAGA ; Ryo YAMAUCHI ; Hiromi FUKUDA ; Hiroki MATSUOKA ; So IMAKIIRE ; Hideto SAKISAKA ; Satoshi MATSUOKA ; Nobuaki KUNO ; Koichi ABE ; Hideki ISHIBASHI ; Shinya ASHIZUKA ; Fumihito HIRAI
Intestinal Research 2023;21(4):471-480
Background/Aims:
The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in patients with IBD.
Methods:
We retrospectively identified and enrolled patients with IBD diagnosed with or without NAFLD by undergoing abdominal computed tomography (CT) at our institution between 2005 and 2020. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of nonobese patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters.
Results:
Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In nonobese patients (defined as patients with a body mass index <25 kg/m2), C-reactive protein (CRP; P<0.001) and alanine aminotransferase (P=0.018) levels were higher and the albumin level (P=0.005) and prognostic nutritional index (PNI; P=0.002) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P<0.001) and the CRP level was negatively correlated (P=0.001) with the hepatosplenic ratio. However, in the NAFLD combined group, PNI (P<0.05) and CRP values (P<0.001) were improved over time after CT imaging by continuing IBD treatment.
Conclusions
Worsening nutritional and inflammatory status in IBD patients is associated with complications of NAFLD. Diagnosis of NAFLD in IBD patients using CT imaging might be useful not only for early detection of NAFLD but also in assessing the need for therapeutic intervention for IBD.
8.Association between human T cell leukemia virus 1 (HTLV-1) infection and advanced periodontitis in relation to hematopoietic activity among elderly participants: a cross-sectional study.
Yuji SHIMIZU ; Hirotomo YAMANASHI ; Masayasu KITAMURA ; Reiko FURUGEN ; Takahiro IWASAKI ; Hideki FUKUDA ; Hideaki HAYASHIDA ; Koji KAWASAKI ; Kairi KIYOURA ; Shin-Ya KAWASHIRI ; Toshiyuki SAITO ; Atsushi KAWAKAMI ; Takahiro MAEDA
Environmental Health and Preventive Medicine 2019;24(1):42-42
BACKGROUND:
We reported that human T cell leukemia virus 1 (HTLV-1) infection is positively associated with atherosclerosis. Recent evidence has revealed a close association of periodontitis with atherosclerosis, endothelial dysfunction, and disruption of the microcirculation. However, the association between HTLV-1 and advanced periodontitis has not been investigated to date. Since hematopoietic activity is closely linked to endothelial maintenance activity and is known to decline with age, we hypothesized that the state of hematopoietic activity influenced the association between HTLV-1 and advanced periodontitis in elderly participants.
METHODS:
A cross-sectional study was performed including 822 elderly participants aged 60-99 years who participated in a dental health check-up. Advanced periodontitis was defined as a periodontal pocket ≥ 6.0 mm. Participants were classified as having low or high hematopoietic activity according to the median values of reticulocytes.
RESULTS:
HTLV-1 infection was positively related to advanced periodontitis among participants with lower hematopoietic activity (lower reticulocyte count), but not among participants with higher hematopoietic activity (higher reticulocyte count). The adjusted odds ratio (95% confidence interval) considering potential confounding factors was 1.92 (1.05-3.49) for participants with a lower reticulocyte count and 0.69 (0.35-1.36) for participants with a higher reticulocyte count.
CONCLUSIONS
Among elderly participants, the association between HTLV-1 infection and advanced periodontitis is influenced by hematopoietic activity. Since hematopoietic activity is associated with endothelial maintenance, these findings provide an efficient tool for clarifying the underlying mechanism of the progression of periodontitis among elderly participants.
Aged
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Aged, 80 and over
;
Cross-Sectional Studies
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Female
;
HTLV-I Infections
;
physiopathology
;
Hematopoiesis
;
physiology
;
Human T-lymphotropic virus 1
;
physiology
;
Humans
;
Japan
;
epidemiology
;
Male
;
Middle Aged
;
Odds Ratio
;
Periodontitis
;
epidemiology
;
virology
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Prevalence
;
Risk Factors
9.Association between human T cell leukemia virus type-1 (HTLV-1) infection and advanced periodontitis in relation to atherosclerosis among elderly Japanese: a cross-sectional study.
Yuji SHIMIZU ; Hirotomo YAMANASHI ; Masayasu KITAMURA ; Reiko FURUGEN ; Takahiro IWASAKI ; Hideki FUKUDA ; Hideaki HAYASHIDA ; Koji KAWASAKI ; Kairi KIYOURA ; Shin-Ya KAWASHIRI ; Toshiyuki SAITO ; Atsushi KAWAKAMI ; Takahiro MAEDA
Environmental Health and Preventive Medicine 2019;24(1):81-81
BACKGROUND:
Human T cell leukemia virus type-1 (HTLV-1) stimulates inflammation activity. Our previous study revealed a positive association between asymptomatic HTLV-1 infection and advanced periodontitis among elderly Japanese individuals with low levels of hematopoietic activity (reflected by reticulocyte levels). Since low hematopoietic activity has been correlated with low-grade inflammation and low-grade inflammation is associated with atherosclerosis, the status of atherosclerosis could, in turn, determine the nature of this association.
METHODS:
To this end, a cross-sectional study of 907 elderly Japanese individuals (aged 60-99 years), who had participated in dental health check-up during the period 2016-2018, was conducted. Advanced periodontitis was defined as periodontal pocket ≥ 6.0 mm.
RESULTS:
Among the study population, 295 (32.5%) were found to have atherosclerosis defined as a carotid intima-media thickness (CIMT) of ≥ 1.1 mm. HTLV-1 infection was positively associated with advanced periodontitis in participants with atherosclerosis, but no significant associations were observed among the participants without atherosclerosis. The known risk factors' (including reticulocyte and CIMT) adjusted odds ratio (OR) and 95% confidence interval (CI) of advanced periodontitis were OR 2.01 and 95% CI 1.06-3.81 for participants with atherosclerosis and OR 0.61 and 95% CI 0.34-1.12 for participants without atherosclerosis.
CONCLUSION
This study found a significant association between HTLV-1 infection and advanced periodontitis among elderly Japanese with atherosclerosis. However, this association is absent in individuals without atherosclerosis, suggesting that atherosclerosis might act as a determinant in the association between HTLV-1 infection and advanced periodontitis among elderly Japanese.
10.Association between high psychological distress and poor oral health-related quality of life (OHQoL) in Japanese community-dwelling people: the Nagasaki Islands Study.
Ai SEKIGUCHI ; Shin-Ya KAWASHIRI ; Hideaki HAYASHIDA ; Yuki NAGAURA ; Kenichi NOBUSUE ; Fumiaki NONAKA ; Hirotomo YAMANASHI ; Masayasu KITAMURA ; Koji KAWASAKI ; Hideki FUKUDA ; Takahiro IWASAKI ; Toshiyuki SAITO ; Takahiro MAEDA
Environmental Health and Preventive Medicine 2020;25(1):82-82
BACKGROUND:
We investigated the association between psychological distress and oral health status/oral health-related quality of life (OHQoL) in Japanese community-dwelling people.
METHODS:
We conducted a cross-sectional study using data from the Nagasaki Islands Study. A total of 1183 (455 men and 728 women) has been analyzed in this study. Psychological distress was measured using the Kessler Psychological Distress Scale (K6). Oral health status was measured by dental examination. The OHQoL was measured using the General Oral Health Assessment Index (GOHAI). We defined the total score of ≥5 points on the K6 as high psychological distress (high-K6 group).
RESULTS:
The multiple linear regression analysis to identify the GOHAI showed that gender, K6, the total number of teeth, the number of dental caries, and visiting a dental clinic within the past 6 months significantly associated with the GOHAI. Among all of these variables, high-K6 (≥ 5) was a substantial contributing factor of the GOHAI (β = - 0.23, 95% Cl - 2.31 to -1.41, p < 0.0001).
CONCLUSIONS
It is likely that the individual with high psychological distress was strongly related to poor OHQoL even in the general population.
Aged
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Cross-Sectional Studies
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Dental Caries/epidemiology*
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Female
;
Humans
;
Independent Living/statistics & numerical data*
;
Japan/epidemiology*
;
Linear Models
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Male
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Middle Aged
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Oral Health/statistics & numerical data*
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Quality of Life/psychology*
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Sex Factors
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Stress, Psychological/epidemiology*