171 results match your criteria: "Okazaki Medical Center[Affiliation]"

The effect of the initial administration of suvorexant on severe sleep apnea syndrome.

Sleep Biol Rhythms

January 2025

Department of Respiratory Medicine, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan.

The purpose of this study was to evaluate how the first oral administration of suvorexant affects PSG results in patients with severe obstructive sleep apnea (OSA). Single-center, prospective study conducted in a nonrandomized, uncontrolled, unblinded fashion. Undiagnosed 64 patients with suspected OSA underwent first-night PSG, and 30 patients with severe OSA (Apnea Hypopnea Index [AHI] ≥ 30 events/h) underwent second-night PSG testing after administration of 15 mg suvorexant.

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According to the Japanese Association for Thoracic Surgery annual surgery survey, the number of aortic surgery has been increasing constantly in the last two decades, with the rates approximately doubling in each decade (5,167, 11,956, and 22,708 cases in 1999, 2009, and 2019, respectively). In 2019, aortic surgery was performed for 11,036 (49%) nondissecting unruptured aneurysm, 730 (3%) ruptured aneurysm, 6,351 (28%) acute type A aortic dissection, 1,412 (6%) chronic type A aortic dissection, 2,385 (11%) acute type B aortic dissection, and 703 (3%) chronic type B aortic dissection cases. The outcomes have been improving annually.

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In Japan, the hinotori™ surgical robot system (Medicaroid Corporation, Kobe, Japan) was approved for gastrointestinal surgeries in October 2022. This report details our initial experience performing liver resection using the hinotori™ system. Ten patients, who were assessed as cases that would benefit from the robot-assisted procedure, underwent liver resections using the hinotori™ system at Fujita Health University, Okazaki Medical Center, between August 2023 and October 2024.

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Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) reportedly decreased the new-onset atrial arrhythmias in patients with type-2 diabetes (T2DM) or heart failure (HF). This study examined the impact of SGLT2is on catheter ablation for atrial fibrillation (AF) in HF patients without T2DM.

Methods: Persistent AF (PeAF) and HF (N-terminal prohormone of brain natriuretic peptide, NT-proBNP ≥400 pg/ml) patients without T2DM undergoing catheter ablation were prospectively enrolled (n = 102).

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Introduction: Progressive supranuclear palsy (PSP) involves midbrain structures, including the red nucleus (RN), an iron-rich region that appears as a high-contrast area on quantitative susceptibility mapping (QSM). RN may serve as a promising biomarker for differentiating parkinsonism. However, RN deformation in PSP remains elusive.

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Background: We previously reported on subxiphoid uniportal thymectomy (SUT) and subxiphoid robotic thymectomy (SRT). This descriptive study aimed to evaluate the feasibility and safety of both SUT and SRT techniques.

Methods: Between March 2011 and December 2022, 268 patients underwent subxiphoid thymectomy.

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Introduction And Importance: Synovial osteochondromatosis of the shoulder joint is predominantly primary, characterized by multiple osteochondral fragments, with reports of secondary synovial osteochondromatosis being rare.

Case Presentation: The patient, a 48-year-old male, presented to our hospital with right shoulder pain persisting for several months. While there was no significant restriction in the range of motion, pain was noted during horizontal adduction and external rotation in the dependent position.

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Aim: To investigate the characteristics and prognosis of patients with advanced hepatocellular carcinoma (HCC) treated with atezolizumab and bevacizumab (Atz/Bev) who achieved a complete response (CR) according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST).

Methods: A total of 120 patients with Eastern Cooperative Oncology Group performance status (PS) 0 or 1 and Child-Pugh A at the start of Atz/Bev treatment were included. Barcelona Clinic Liver Cancer stage C was recorded in 59 patients.

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Chordoma combined with Trousseau syndrome: a case report and literature review.

J Thorac Dis

September 2024

Department of Respiratory and Critical Care Medicine, Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine (900 Hospital), Fuzhou, China.

Article Synopsis
  • - Trousseau syndrome (TS) is a serious condition characterized by spontaneous blood clots in patients with tumors, often leading to high fatality rates; it is usually associated with aggressive cancers like lung, pancreatic, and breast cancer but has not been reported in chordoma until now.
  • - A 56-year-old male with chordoma underwent various treatments for his cancer, but after experiencing chest tightness, he was diagnosed with TS following findings of pulmonary artery embolisms on a CT scan.
  • - The case highlights the need for increased awareness among clinicians regarding the risk of TS in different tumors, including chordoma, as well as the importance of identifying sensitive markers for better diagnosis and management strategies.
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  • The study aimed to compare patient preferences for local versus general anesthesia during implant removal after clavicle fracture surgery, as limited general anesthesia surgeries are available.
  • A questionnaire was conducted with 239 patients, revealing that a majority from both anesthesia groups preferred the same method for future procedures—87.1% for local and 78.9% for general anesthesia—with no significant difference in preferences.
  • Despite experiencing some pain, patients who had local anesthesia generally preferred it for future surgeries, highlighting the need for awareness of overall patient satisfaction beyond just the surgical experience.
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First case of major lung resection using the hinotori™ surgical robot system.

Gen Thorac Cardiovasc Surg

December 2024

Department of Thoracic Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki, Okazaki, Aichi, 444-0827, Japan.

We performed the first case of major lung resection using the hinotori™ surgical robot system, which is a new surgical support robot system developed in Japan. A left lower lobectomy and subcarinal lymph node dissection were performed. The operation time was 3 h and 5 min, the cockpit time (console time) was 2 h and 5 min, and the blood loss was 40 g.

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Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST-segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018 and updated in 2022. Recently, the European Society of Cardiology (ESC) published the guidelines for the management of acute coronary syndrome in 2023.

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Background: Different energy sources of balloon-based ablation for pulmonary vein isolation cause different kinds of endothelial damage and coagulation responses associated with thromboembolic risk.

Objectives: The study sought to compare the impact of different balloon-based ablation, cryoballoon ablation (CBA) and laser balloon ablation (LBA), on coagulation/fibrinolysis biomarkers and silent cerebral events (SCEs) in paroxysmal atrial fibrillation.

Methods: Paroxysmal atrial fibrillation patients who underwent pulmonary vein isolation using either CBA (n = 52) or LBA (n = 53) without radiofrequency touch-up ablation were eligible.

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Acute heart failure is an important cause of unplanned hospitalizations and poses a significant burden through increased mortality and frequent hospitalizations. Heart failure with preserved ejection fraction (HFpEF) presents as a diverse condition characterized by complex cardiovascular and non-cardiovascular pathology. This study aimed to identify distinct clinical phenotypes in acute decompensated HFpEF (ADHF) using cluster analysis and assess their prognostic significance.

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Article Synopsis
  • - This study focused on 111 patients with advanced gastric cancer who were treated with nivolumab to monitor their disease progression and evaluate treatment response using serum inflammatory markers like CRP-to-albumin ratio (CAR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR).
  • - Results indicated an overall response rate of 11.7% and a disease control rate of 44.1%, with median overall survival of 14 months and progression-free survival of 4.1 months.
  • - Changes in the inflammatory markers after therapy proved to be useful in predicting treatment response, with specific cutoff values identified for CAR, PLR, and NLR that correlated
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  • A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
  • The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
  • Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
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Background: The da Vinci™ Surgical System, recognized as the leading surgical robotic platform globally, now faces competition from a growing number of new robotic surgical systems. With the expiration of key patents, innovative entrants have emerged, each offering unique features to address limitations and challenges in minimally invasive surgery. The hinotori™ Surgical Robot System (hinotori), developed in Japan and approved for clinical use in November 2022, represents one such entrant.

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Approximately 660,000 women are diagnosed with cervical cancer annually. Current screening options such as cytology or human papillomavirus testing have limitations, creating a need to identify more effective ancillary biomarkers for triage. Here, we evaluated whether metabolomic analysis of cervical mucus metabolism could be used to identify biomarkers of cervical intraepithelial neoplasia (CIN) and cervical cancer.

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  • Adenosquamous carcinoma of the pancreas (ASCP) is a rare and serious type of cancer, making up only 1-4% of pancreatic cancers, and it doesn't respond well to treatment.
  • A 76-year-old woman with stomach pain was found to have a tumor in her pancreas that was originally deemed inoperable due to its involvement with important blood vessels.
  • After receiving chemotherapy for several months, the tumor shrank enough to allow for surgery, which was successful, and the patient had a good recovery without major issues.
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  • Herpes simplex encephalitis (HSE) can lead to serious neurological issues, and recent studies suggest the immune response in the central nervous system may play a key role in its development.
  • A study involving 176 patients suspected of having viral meningitis or encephalitis found a significant increase in the IgG index in patients who tested positive for herpes simplex virus type 1 (HSV-1) after they cleared the virus.
  • The findings indicate that elevated IgG levels can occur even after the virus is gone, suggesting an immune response that doesn't rely on antibodies, which could have implications for understanding HSE's effects on the brain.
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  • This study focused on patients with idiopathic pulmonary fibrosis (IPF) to investigate the links between sarcopenia (muscle loss) and malnutrition over a year.
  • Researchers evaluated 64 outpatients, determining sarcopenia using specific criteria and nutritional status through serum markers.
  • Findings revealed that lower serum transthyretin levels and other factors predicted negative outcomes like hospitalizations or deaths, highlighting the importance of these measurements in managing IPF patients.
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The CHADS -VASc score is a vital clinical tool for evaluating thromboembolic risk in patients with atrial fibrillation (AF). This study investigated the efficacy of the CHADS -VASc score in a cohort of 737 heterogeneous patients (mean age: 63 years) receiving care in cardiac intensive care units (CICUs), with a creatinine-based estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m upon admission and discharge.

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Objectives: The optimal indication and survival benefits of prophylactic urethrectomy (PU) during radical cystectomy remain unclear. Therefore, this study aims to evaluate the impact of urethra-preserving surgery (UPS) on oncological outcome including its recurrence patterns, and to establish an optimal urethral management strategy with a novel UPS technique in the robotic era.

Patients And Methods: We retrospectively analyzed 281 male patients with bladder cancer who received radical cystectomy (RC) (115 with and 166 without PU) at our institutions between 2010 and 2023.

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