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Tokai Journal of Experimental and Clinical Medicine

Ryuzo Deguchi, Koichi Shiraishi, Yoshitaka Arase, Makiko Dekiden, Hideo Shimada, Hiroshi Miyakita, Takashi Ogimi, Kazunori Myojin, Tetsuya Mine
A 74-year-old woman undergoing outpatient follow-up for reflux esophagitis and atrophic gastritis tested positive for Helicobacter pylori and underwent primary eradication therapy with lansoprazole (LPZ) 30 mg, amoxicillin (AMPC) 750 mg, and clarithromycin (CAM) 200 mg twice daily for 1 week in August 2012. A urea breath test (UBT) after this treatment revealed that eradication had failed. Secondary eradication therapy was carried out with esomeprazole (EPZ) 20 mg, AMPC 750 mg, and metronidazole (MNZ) 250 mg twice daily for 1 week, but this also failed...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Tetsuya Urano, Naoki Hayama, Jun Tanaka, Yukihiro Horio, Masako Sato, Shigeaki Hattori, Genki Takahashi, Fuminari Takahashi, Tomoe Takeuchi, Kazuki Harada, Hiroto Takiguchi, Hiromi Tomomatsu, Katsuyoshi Tomomatsu, Takahisa Takihara, Kyoko Niimi, Tsuyoshi Oguma, Takuya Aoki, Go Ogura, Naoya Nakamura, Koichiro Asano
We report a case of multifocal micronodular pneumocyte hyperplasia (MMPH) in a patient with tuberous sclerosis complex, in whom the lung nodules increased in the number and size over the course of 8 years. We diagnosed MMPH following a lung biopsy performed during video-assisted thoracic surgery. In most of the previously reported cases, the number and size of lung nodules is unchanged during the clinical course. Our case is the first report of progressive disease in pathologically proven MMPH.
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Hitoshi Ichikawa, Jin Imai, Hajime Mizukami, Shuji Uda, Soichiro Yamamoto, Eiji Nomura, Takuma Tajiri, Norihito Watanabe, Hiroyasu Makuuchi
We report a case of amoebic appendicitis without colitis symptoms. Acute appendicitis is commonly encountered by gastroenterologists in their daily practice. The number of cases of amoebiasis increases annually in Japan, and is thought to be associated with an increase in sexually transmitted disease or travel to endemic areas. However, acute amoebic appendicitis is rare and the prognosis is very poor compared to nonamoebic appendicitis. In our case, appendectomy was performed immediately after onset, and the patient was discharged without complications...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Kana Oiwa, Mitsutomo Kohno, Ryo Hashimoto, Tomoki Nakagawa, Ryota Masuda, Noboru Nishiumi, Kichizo Kaga, Masayuki Iwazaki
OBJECTIVES: As a less invasive alternative to bronchoalveolar lavage (BAL), bronchoscopic microsampling (BMS) was developed to identify molecules present in the epithelial lining fluid (ELF) of the distal airways. Here, we evaluated the utility of BMS for serial collection of ELF in a canine lung transplant model. METHODS: ELF was collected hourly by BMS up to 5 hours after reperfusion in a canine left lung transplant model. Tumor necrosis factor (TNF)-α levels in ELF were measured using an enzyme-linked immunosorbent assay and were compared with those in BAL fluid...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Kazuo Suzuki, Masahiko Kato, Shinichi Matsuda, Mariko Nukaga, Mayumi Enseki, Hideyuki Tabata, Kota Hirai, Yoshiyuki Yamada, Kenichi Maruyama, Yasuhide Hayashi, Hiroyuki Mochizuki
OBJECTIVE: Viral infections and sensitization to aeroallergens are major factors in the exacerbation of asthma and its development during early childhood. However, the cytokine profiles and eosinophil activation status linked to the association between viral infections and sensitization to aeroallergens are incompletely understood. Here we investigated respiratory viruses, serum eosinophil cationic protein (ECP), and various cytokines/chemokines in acute exacerbation of childhood asthma...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Yusuke Kabeya, Akira Shimada, Nobuhiro Tsukada, Yoshihito Atsumi, Megumu Higaki
OBJECTIVE: The present study investigated the association of having diabetes with length of stay and hospital costs for elderly patients with pneumonia who were admitted to an acute-care hospital in Japan. METHODS: Based on the inpatient administrative claims database of an acute-care hospital in central Tokyo between 2010 and 2013, 753 patients aged ≥ 65 years who were admitted to the hospital presenting with pneumonia and discharged alive were analyzed. The association was analyzed using a negative binomial model, having adjusted for age, sex, body mass index, dyspnea grade, functional evaluation of feeding, use of mechanical ventilation, and use of renal replacement therapy...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Tetsuya Urano, Munetaka Haida, Shunichiro Izumi, Yutaka Imai, Koichiro Asano, Tadashi Abe
OBJECTIVE: The objective of the present study is to conduct a retrospective analysis comparing graduate-entry program (GEP) and school-leaver-entry program (SEP) students from the perspective of scholastic achievements from admission through the national examination for medical practitioners. METHODS: The number of students who repeated one or more years, because of their poor results on examinations, the scores of graduation examinations, and the pass rates for the national examination for medical practitioners were compared, retrospectively, over the last 8 academic years between GEP and SEP students at Tokai University School of Medicine...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Kazuhide Takeyama, Yosuke Suzuki, Masanobu Yoshikawa, Toshiyasu Suzuki
OBJECTIVE: To investigate the usefulness of the perfusion index (PI) in the early detection of high spinal subarachnoid block (SAB) for cesarean section (CS). METHOD: SAB was applied in patients of CS. The patients was subdivided into two groups, according to the highest level of block: the Ce group (cervical spine level) and the Th group (thoracic spine level). The PI values in the finger and toe, and vital signs were measured at pre- and post-SAB in both groups together with SAB level...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Jun Yamamoto, Mitsutomo Kohno, Naoko Izawa, Toshinari Ema, Tai Hato, Ikuo Kamiyama, Takashi Ohtsuka, Masazumi Watanabe
OBJECTIVE: Fibrin sealants are used to close surgical pleural defects, but may detach, causing a postoperative air-leak. We investigated a new means of applying fibrin glue for closing pleural defects. METHODS: Pleural defects (10-mm and 4-mm diameters, respectively) were created in swine and rats via thoracotomy. They were sealed by a) injection of a fibrinogen solution into the lung parenchyma after instillation of a thrombin solution onto the pleural defect (group A), b) fibrinogen and thrombin spray (group B), c) fibrinogen instillation and a thrombin-dipped polyglycolic acid sheet (group C), or d) fibrin glue-coated collagen fleece (group D)...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Haruihiro Sato, Ryota Masuda, Masayuki Iwazaki, Chie Inomoto, Sunao Shoji, Yoshiyuki Robert Osamura
BACKGROUND: Substernal thyrotoxic multinodular goiter (MNG) shows signs and symptoms as a result of compression of adjacent organs and thyrotoxicosis. However, acute airway obstruction is rarely caused by substernal thyrotoxic MNG. CASE REPORT: We have described a 56-year-old Japanese woman who demonstrated acute airway obstruction because of compression of the airway by substernal thyrotoxic MNG. She had been diagnosed with substernal thyrotoxic MNG 6 years back...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Mari Nakamura, Koichiro Yoshioka, Mari Amino, Eiichi Watanabe, Toshiharu Fujii, Tadashi Hashida, Daisuke Fujibayashi, Shigetaka Kanda, Yoshinori Kobayashi, Teruhisa Tanabe, Yuji Ikari
OBJECTIVE: The aim of this study was to investigate the significance of late potential (LP) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). METHOD: We enrolled 135 consecutive patients with ACS admitted to Tokai University Hospital from February to December 2012. Twenty-four hour high-resolution ambulatory electrocardiogram was performed between post-PCI procedure and hospital discharge. The patients were divided into the LP-positive (33 patients) and LP-negative (102 patients) groups, and the relationship between LP and re-hospitalization was prospectively investigated...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Masayuki Oki, Akihiro Ueda, Ayumi Tsuda, Hidetaka Yanagi, Hideki Ozawa, Atsushi Takagi
Infection with non-typhoidal Salmonella often results in a self-limited acute gastroenteritis. Extra-intestinal Salmonella infection is relatively rare and occurs predominantly in infants and adults with significant underlying conditions. We describe a 54-year-old Japanese man with a history of heavy alcohol consumption and daily contact with a dog, who developed bacteremia complicated by vertebral osteomyelitis, spinal epidural abscess, and meningitis, due to Salmonella enterica serotype Enteritidis. This case suggests that Salmonella should be considered as an etiologic pathogen in adult patients with perivertebral infection or meningitis...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Tadashi Hashida, Koichiro Yoshioka, Shigetaka Kanda, Daisuke Fujibayashi, Mari Amino, Yuji Ikari
Pulmonary vein isolation (PVI) with radio-frequency catheter ablation (RFCA) is effective therapy for the patients with paroxysmal atrial fibrillation (pAF). However, it is not easy to predict relapse of pAF. Approximately 70% pAF patients were maintained sinus rhythm for 1 year after PVI in Japan. In this study, all of the cases were underwent chest computed tomography (CT) to check for the morphology and positional relationship of the left atrium. We detected relapse cases that exhibited spur formation in the thoracic vertebrae...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Takashi Yasuda, Yuka Kodera, Kazuyuki Iijima, Atsushi Mizuma, Kentaro Tokuoka, Hirohisa Okuma, Shunya Takizawa, Yasuhisa Kitagawa, Shigeru Nogawa
OBJECTIVE: Cerebral white matter lesions (WMLs) have been frequently observed on MRI in patients with migraine. We investigated characteristics of WMLs in migraine and tried to determine the relationship between its causal mechanism and arteriosclerosis. METHODS: A head MRI was performed in juvenile migraine patients. The distributions of deep and periventricular WMLs were separately studied in the anterior and posterior circulation. Grading was conducted according to the Fazekas classification...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Masakazu Nagaoka, Naoko Tsumuraya, Masaki Nie, Yuji Ikari
The occurrence of allergy to iodinated contrast in certain patients may prevent the use of percutaneous coronary intervention (PCI) in such cases. We present a 53-year-old male with a history of allergic reaction to iodinated contrast who successfully underwent intravascular ultrasound (IVUS) guided PCI. Stent size was determined based on IVUS. After PCI, stent expansion and a lack of edge dissection or incomplete apposition were confirmed by IVUS. Thus, PCI without contrast injection under IVUS may be feasible in selected patients with allergy to iodinated contrast...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Masahiro Nitta, Akio Hoshi, Taro Higure, Yuki Shimizu, Nobuyuki Nakajima, Kazuya Hanai, Yoshiaki Kawamura, Toshiro Terachi
A 28-year-old man was hospitalized with advancing paraplegia. Under the diagnosis of Guillain-Barre syndrome, steroid pulse therapy was administered and plasmapheresis was performed. However, the paraplegia gradually progressed. Subsequently, a spinal cord tumor was revealed by magnetic resonance imaging (MRI). The pathological diagnosis, obtained by open biopsy, confirmed a mixed germ cell tumor in the spinal cord. Multiple lung and lymph nodes metastases were also detected upon computed tomography, along with increased serum alpha-fetoprotein (33...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Yuji Koyama, Kayako Nitta, Michi Tochikura, Takashi Kasahara, Yutaka Kametsu, Minoru Toyokura, Yoshihisa Masakado
Bickerstaff's brainstem encephalitis is an autoimmune disease with the primary lesion situated in the brainstem and three cardinal signs: ophthalmoplegia; ataxia; and impaired consciousness. A 68-year-old man was started on rehabilitation exercise 3 months after onset of Bickerstaff's brainstem encephalitis, due to remnant dysarthria and dysphagia (Functional Oral Intake Scale, level 5) after the cardinal signs of Bickerstaff's brainstem encephalitis resolved. Exercise involved using a straw in the anterior midline between the dorsal tongue and hard palate...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Mitsunobu Otsuru, Takayuki Aoki, Yoshihide Ota, Miho Takahashi, Masahiro Uchibori, Kenichi Aoyama, Yusuke Kondo
We report a rare case with a solitary fibrous tumor of the cheek. A 73-year-old male with cheek swelling referred to our hospital. At the initial visit, a movable tumor measuring 20 × 15 mm was palpable. Therefore, the patient underwent excisional biopsy of the tumor under general anesthesia. Immunohistochemical staining showed the tumor cells to be positive for CD34, without organization of spindle cells into any discernible pattern, leading to a diagnosis of solitary fibrous tumor. The patient is now being carefully followed...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Genta Kanai, Takatoshi Kakuta, Takashi Hirukawa, Chizuko Okamatsu, Masafumi Fukagawa
We report a case of peritoneal mesothelioma discovered in a patient during peritoneal dialysis. The patient was a 55-year-old woman who had no history of asbestos exposure. Owing to end-stage kidney failure, she had been undergoing peritoneal dialysis for over 8 years, and she had been diagnosed with encapsulating peritoneal sclerosis. She was admitted to the hospital for intestinal obstruction. Three months later, she noticed an enlarging mass in the epigastric region. Computed tomography showed a 10-cm mass originating in the abdominal wall that had invaded the liver...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
Ushio Hanai, Tadashi Akamatsu, Megumi Kobayashi, Yotaro Tsunoda, Kenichi Hirabayashi, Tanehumi Baba, Hideki Atsumi, Mitsunori Matsumae
INTRODUCTION: The prognosis of malignant peripheral nerve sheath tumor (MPNST) with neurofibromatosis type 1 (NF-1) is worse than that of a solitary MPNST, because of the tumor size and location difficult to resect completely. We experienced a case of MPNST in the occipital region with NF-1. CASE REPORT: A 59-year-old woman presented with NF-1 and an MPNST of the occipital region. We performed wide excision involving the occipital bone, and reconstructed with a titanium plate and a free latissimus dorsi muscle flap...
September 20, 2016: Tokai Journal of Experimental and Clinical Medicine
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