Papers by teruyoshi amagai
Case Reports in Gastroenterology
The hepatocellular carcinoma (HCC) with intrahepatic and bone metastasis shows poor survival of a... more The hepatocellular carcinoma (HCC) with intrahepatic and bone metastasis shows poor survival of averagely 3 months. The bone metastasis and HCC itself might cause cancer-associated pain. An intrathecal (IT) analgesia might contribute to improve QOL and prolong surviving time (ST). A 71-year-old male presented with temperature and appetite loss continuing for 2 months. He looked pale and malaise. Computed tomography and tumor markers elevation confirmed diagnosis of HCC stage IV. To treat him, molecularly targeted therapy was started but abandoned because of side effects of life-threatening convulsions and loss of consciousness. Since this time, pain control strategy was planned as advance care plan. After dermal and oral opioids were administered, IT analgesia was introduced to conquer uncontrollable pelvic pain due to metastatic osteolytic lesions. Owing to IT analgesia against severe cancer-related pain, he had lived for 46 months. Comparing with reviews in which average ST is 3 m...
Radiology Case Reports, 2021
An emphysematous cystitis s a rare urinary tract infectious disease and fatal unless any treatmen... more An emphysematous cystitis s a rare urinary tract infectious disease and fatal unless any treatments. The case was a 97-year-old female presented with knee pain after falling with coexistence of macroscopic hematuria and pyuria. The ultrasonography examined on the same day showed a hyperechoic bladder-ring appearance bordering bladder wall which was re-was reconfirmed by computed tomography by air bubble collection on the circumferential bladder wall. We conclude and emphasize as the leaning point that emphysematous cystitis is raised as a differential diagnosis when ultrasonography showed the pathognomonic as hyperechoic bladder-ring appearance bordering bladder wall.
Aims: To test our hypothesis that swallowing capacity evaluated at admission is associated with p... more Aims: To test our hypothesis that swallowing capacity evaluated at admission is associated with poorly improving Activities of Daily Living (ADL) in older adult inpatients and that they must be target of earlier nutritional intervention including nutritional counseling conducted by registered dietitians. Methods: Recruited subjects were consecutive all inpatients aged ≥ 65 years old admitted to a single hospital met without exclusion criteria. After dividing included subjects by with the International Dysphagia Diet Standardization Initiative Functional Diet Scale (IDDSI-FDS) score <7 (low) vs. ≥ 7 (high) at admission, all collected data was compared to draw which patients must be target of intensive nutritional intervention to achieve relevant outcome. Results: 95 patients out of 167 were included with lowvs. high-IDDSI score (n=24 vs. 71, respectively). FOIS and IDDSI score in low-group showed significantly smaller ADL change measured by differences between Barthel Index (BI) b...
Journal of the Japanese Society of Pediatric Surgeons, 2011
... Takayuki; Dept. of Pediatric Surgery, Ibaraki Children's Hospital. Hirai Misako; Dept. o... more ... Takayuki; Dept. of Pediatric Surgery, Ibaraki Children's Hospital. Hirai Misako; Dept. of Pediatric Surgery, Ibaraki Children's Hospital. Muraji Toshihiro; Dept. of Pediatric Surgery, Ibaraki Children's Hospital. Urita Yasuhisa; Dept. of Pediatric Surgery, Tsukuba University. Komuro ...
Journal of the Japanese Society of Pediatric Surgeons, 1991
Jomyaku Keicho Eiyo, 2005
Radiology Case Reports, 2022
A 79 years male with fishbone-induced acute appendicitis was treated surgically with laparoscopic... more A 79 years male with fishbone-induced acute appendicitis was treated surgically with laparoscopic procedure. In preoperative diagnostic study, 3-dimensional multidetector-computed tomography (3D-MDCT) demonstrated the foreign body in the appendix and 3D-reconstructed images seemed fishbone with sharp-pointed dorsal fin directing to the tip of the appendix. With these findings, surgical indication of appendectomy was confirmed and laparoscopic appendectomy was performed. He made a full recovery and was discharged in a satisfactory condition following 7 days of post-operative treatment. From this case experience, 3D-MDCT seems helpful to visualize details of foreign bodies in the appendix, and valuable to confirm surgical indication of complicated acute appendicitis.
Aim: To test the hypothesis that demographics, Pre-Pressure Injury (PI) nutrition care are associ... more Aim: To test the hypothesis that demographics, Pre-Pressure Injury (PI) nutrition care are associated with severe Hospital-Acquired PI (HAPI) in older adult patients. Methods: The study was conducted under a retrospective observational design in all consecutive patients admitted to a single general hospital during 24 months between July 2014 and June 2016. The inclusion criterion was a new PI developed after admission. Exclusion criteria were: 1) no PI at admission or during hospitalization, 2) PI already present at admission, 3) hospitalization extending beyond the end of the study period, 4) missing data, 5) serum creatinine and/or total bilirubin >1.5 mg/dl, 6) death within 14 days after PI development. Data collection: 1) demographics-sex, age, body mass index (BMI), Charlson comorbidity index; 2) PI parameters-severity of PI scored by NPUAP and DESIGN-R score, 3) laboratory parameters -hemoglobin, serum albumin (Alb), C-reactive protein; 4) nutrition parametersdaily energy a...
Background: Malnutrition is frequently observed in patients with Chronic Obstructive Pulmonary Di... more Background: Malnutrition is frequently observed in patients with Chronic Obstructive Pulmonary Disease (COPD). However, the effects of decreased caloric consumption on disease severity have not been determined. Objective: To examine the hypothesis that increased incidence of COPD-related symptoms is associated with lower energy intake in malnourished COPD patients. Design and Setting: A cross-sectional study at a single institute. Participants: Patients with older than 18 years of age who visited the outpatient COPD clinic at a single institute were eligible. Measurements: Subjects were divided into two groups to categorize high and low Daily Energy Intake (DEI) using three strategies, with daily caloric cutoff thresholds of 25, 30 and 35 kcal/kg to distinguish high-DEI patients from low-DEI patients. All data was compared between higherDEI and lower-DEI patients using each threshold to examine whether lower energy intake is associated with COPD symptom severity and frequency and to...
Journal of the Japanese Society of Pediatric Surgeons, 1993
Radiology Case Reports, 2022
An invasive aspergillosis (IA) primarily occurs among immunocompromised patients. Recently with a... more An invasive aspergillosis (IA) primarily occurs among immunocompromised patients. Recently with an influenzae infection prevalently spreading, influenzae-associated invasive aspergillosis (IAIA) has been reported occasionally. By contrast, neuroleptic malignant syndrome (NMS) occurs rarely in psychiatric patients who are treated with Olanzapine. We report a 43 years old male with psychiatric disorder who had developed IAIA followed by NMS and cerebral hemorrhage as the result of aspergillus invasion to cerebral vessels. He had also super-infection of COVID-19, 13 months later to be saved completely after invasive mechanical respiratory supports. From clinical aspects, we would emphasize that it is of importance to find earlier co-occurrence of IAIA patients with cerebral hemorrhage due to secondary infectious vasculopathy of IA.
Nutrition in Clinical Practice, 2021
The American Society for Parenteral and Enteral Nutrition (ASPEN) Position Paper focus is on appl... more The American Society for Parenteral and Enteral Nutrition (ASPEN) Position Paper focus is on applying the 4 ethical principles for clinician's decision-making in the use of artificially administered nutrition and hydration (AANH) for adult and pediatric patients. These basic principles are (1) autonomy, respect the patient's healthcare preferences; (2) beneficence, provide healthcare in the best interest of the patient; (3) nonmaleficence, do no harm; and (4) justice, provide all individuals a fair and appropriate distribution of healthcare resources. Preventing and resolving ethical dilemmas is addressed, with an emphasis on a collaborative, interdisciplinary approach. Optimizing early communication and promoting advance care planning, involving completion of an advance directive, including designation of a surrogate decision-maker, are encouraged. Clinicians achieve respect for autonomy when they incorporate the patient, family, community, country, geographical, and presumed cultural values and religious belief considerations into ethical decision-making for adults and children with a shared decision-making process. These discussions should be guided by the 4 ethical principles. Hospital committees and teams, limited-time trials, clinician obligation with conflicts, and forgoing of AANH are addressed. Specific patient conditions are addressed because of the concern for potential ethical issues: coma, decreased consciousness, and dementia; advanced dementia; cancer; eating disorders; and end-stage disease/terminal illness. Incorporated in the Position Paper are ethical decisions during a pandemic and a legal summary involving ethical issues. International authors presented the similarities and differences within their own country or region and compared them with the US perspective.
Case Reports in Gastroenterology, 2021
An isolated superior mesenteric artery (SMA) dissection (ISMAD) is extremely rare among visceral ... more An isolated superior mesenteric artery (SMA) dissection (ISMAD) is extremely rare among visceral artery dissections. Its diagnosis is made by abdominal contrast CT scan which shows SMA occlusion partially or completely. The ISMAD is classified into 6 types: type I–V has partial occlusion and treated medically using antiplatelets or anticoagulants. On the other hand, type VI has complete occlusion and must be treated by urgent surgical operation. We present a 67-year-old female who presented with sudden onset abdominal pain and melena. An urgent contrast CT revealed type VI ISMAD. She underwent 3 staged operations as follows: (1) first, as laparotomy showed pale color in almost the extensive length of the small intestine, arterial bypassing of SMA was undertaken using SMA to the right common iliac artery bypass; (2) as the second-look operation on the next day, the terminal ileum was resected, and the remaining small intestine was able to be preserved. However, when the abdomen was t...
Journal of Nutrition & Health, 2016
Background: Blenderized diets have been widely adopted as nutritional support, particularly for p... more Background: Blenderized diets have been widely adopted as nutritional support, particularly for patients receiving formulae via an enteral route. Although the viscosity of thickened formulae is a determinant of adverse events, no study has examined the viscosity of blenderized diets. Aim: To examine the viscosity and temperature of four types of blenderized diet. Methods: Four types of rice porridge were prepared: rice porridge (RP) (Method 1); rice porridge with 0.5% alpha-amylase (RPA) (Method 2); rice porridge with 0.5% alpha-amylase and 0.5% thickener (RPAT) (Method 3); and rice porridge with 0.5% alpha-amylase and 0.5% thickener frozen overnight and defrosted (RPATFD) (Method 4). The viscosity and temperature of these four types of blenderized diet were measured for 30 minutes with a B-type viscometer. Results: The viscosity of blenderized diets over 30 minutes increased with decreasing temperature with Methods 1, 3, and 4. With Method 2, viscosity at 5 minutes was significantly lower than that with Method 1 (p <0.05). Moreover, unlike the other three methods, viscosity with Method 2 decreased significantly over the 30 minutes (p <0.05). This phenomenon might have been related to the activation of added amylase. Viscosity during the 30 minutes was within the range of 3,500-10,000 mPa.s, which is reported acceptable in clinical settings. Overnight freezing and defrost of the blenderized diet in Method 4 appeared to stably maintain the viscosity within the likely acceptable range achieved with Method 3. Conclusion: The addition of 0.5% thickener with 0.5% alphaamylase, either alone or followed by overnight freezing followed by defrosting, appeared to stably maintain the viscosity of a blenderized diet within the range likely acceptable in clinical settings. These findings might aid in the development of clinically usable blenderized diets.
Biomedical Journal of Scientific & Technical Research, 2019
with CI and that an energy management set at 75% of target was associated with better outcome. He... more with CI and that an energy management set at 75% of target was associated with better outcome. Here, target of energy intake (TEI) was set at 25 kcal / kg of actual body weight / day according to the statement of guidelines provided by American Society for Parenter al and Enteral Nutrition [3], and European Society for Parenteral and Enteral Nutrition [4]. Then if our hypothesis was correct, then examine that the cutoff point of TEI exists to maximize better outcomes. To test our hypotheses, all data was collected and analyzed in patients with CI and CH admitted to stroke care unit (SCU) in a single tertiary institute. Methods All consecutive acute stroke patients, admitted to a single institution between January and June 2015, were enrolled as subjects of the study. They were divided into two groups, diagnosed with CH or CI as primary diagnosis. The exclusion criteria were:
In Vivo, 2018
Background/Aim: Breast cancer survivors in adjuvant therapy, frequently experience the estrogen d... more Background/Aim: Breast cancer survivors in adjuvant therapy, frequently experience the estrogen deficiency with genitourinary symptoms mostly represented by recurrent bacterial cystitis. The objective of the present study was to evaluate the effectiveness of N-acetylcysteine, D-mannose and Morinda citrifolia fruit extract (NDM), when associated to antibiotic therapy, in reducing the persistence of recurrent cystitis in this risk population. Patients and Methods: Sixty breast cancer survived women with recurrent cystitis were retrospectively examined. Group 1, comprised of 40 patients treated with antibiotic therapy associated with NDM lasting for six months, Group 2 comprised of 20 patients treated with antibiotics alone. Results: The use of NDM in combination with antibiotic therapy showed a significant reduction in positive urine cultures, compared to antibiotics alone. Subjects of Group 1 rather than those of Group 2, showed improvement in symptoms score of urgency, frequency, urge incontinence, recurrent cystitis, bladder and urethral pain. Conclusion: In breast cancer survived women affected by genitourinary discomfort, the combination of NDM and antibiotic therapy showed a greater efficacy in reducing urinary tract infections and urinary discomfort with respect to antibiotic use only.
Journal of International Medical Research, 2018
ObjectiveThis study was performed to determine the cut-off point of the Functional Independence M... more ObjectiveThis study was performed to determine the cut-off point of the Functional Independence Measure (FIM) to discriminate patients with acute stroke who develop adverse events during their stay in a stroke care unit (SCU).MethodsAll consecutive patients with stroke admitted to a single institute from January to March 2015 were enrolled. They were divided into two groups according to their average daily energy intake in the SCU: ≥66% or <66% of the target (high- and low-energy group, respectively). A receiver operating characteristic curve was used to determine the cut-off point of the FIM to predict adverse events in patients with acute stroke.ResultsThe length of stay in the SCU was significantly longer and the serum C-reactive protein level (CRP) was significantly higher in the low- than high-energy group (7 vs. 4 days and 2.15 vs. 0.20 mg/dL, respectively). The total FIM score cut-off value was 63 points.ConclusionsAn energy intake of <66% of the target was associated w...
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Papers by teruyoshi amagai