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Emergency Care Center

Emergency medical care is one of the highest priorities at Hiroo Hospital. The Emergency Care Center handles the most serious cases from a wide geographical area, including the Izu and Ogasawara Islands, in addition to parts of the Tokyo Metropolis such as the Shibuya, Meguro, Shinagawa, and Minato wards.

Since its establishment in 2002, the ER has been accepting approximately 90 cases per month on average through hotline calls from the Tokyo Fire Department, and maintains a high acceptance rate. As the number of patients with conditions such as serious trauma, burns, drug overdose, and acute abdomen has been increasing, there has been a smooth transition from standard comprehensive diagnosis at the ER to specialist care.

The emergency care service for isolated islands not only accepts patients via aircraft, but also provides diagnostic aid through an image transmission system and dispatches emergency doctors.


Emergency Care

In association with the establishment of gTokyo ER Hiroo,h the Emergency Care Department was also established. It accepts primary, secondary, and tertiary emergency patients to promote the safety and security of the citizens of Tokyo as a new organization providing gcomprehensive emergency careh in coordination with the Emergency Care Center.

The Emergency Care Department provides primary care for primary and secondary emergency patients, mainly at night and on holidays, with 3 full-time doctors on duty from the fields of internal medicine, surgery, and pediatrics.

Since the Emergency Care Department provides emergency management rather than general practice care, treatment mainly consists of first aid and the order of seeing patients may change depending on symptoms. If specialized treatment needs to be continued, a patient may be transferred, depending on the bed status. However, doctors from 11 different specialties and duty doctors from the Emergency Care Center are available for back-up and provide a high standard of medical care.


Hematology

The Hematology Department provides chemotherapy and radiotherapy for hematological malignancies such as malignant lymphoma and multiple myeloma, and also provides diagnosis and treatment for a wide range of blood diseases, including myelodysplastic syndrome, aplastic anemia, pernicious anemia, and idiopathic thrombocytopenic purpura.

Please consult us/obtain a referral to be examined by a hematology specialist if your health checkup reveals an abnormality of your blood or if you have anemia of unknown cause.


Diabetes and Endocrinology

The Diabetes and Endocrinology Department provides medical care for endocrine diseases involving the thyroid gland, pituitary gland, and adrenal gland, as well as for lifestyle-related adult diseases such as diabetes, hypertension, hyperlipidemia, and obesity. It also investigates the causes of fatigue and palpitations.

This department also excels at the diagnosis and treatment of hypertension and arteriosclerosis.


Gastroenterology

The Gastroenterology Department handles various gastrointestinal diseases, including diseases of the liver, gallbladder and pancreas. Its range is the widest among all of the internal medicine departments.

Endoscopy is used in many examinations and procedures for gastrointestinal diseases (esophagus, stomach, duodenum, small intestine, large intestine) ranging from screening examination to endoscopic surgery (mucosal resection or submucosal dissection). If you think endoscopic examination will be painful, transnasal endoscopy or endoscopic examination with intravenous sedatives can be employed so that you feel more comfortable. Single-balloon endoscopy is now available for small intestinal disease, and its use is increasing recently.

Various diseases of the liver, gallbladder, and pancreas are treated, with procedures ranging from examinations to chemotherapy for cancer.

Special outpatient care is provided for liver diseases such as hepatitis C, as well as for Helicobacter pylori eradication therapy and constipation.

Joint conferences by the departments managing digestive organs (Endoscopy Center, Gastroenterology Department, and Gastrointestinal Surgery Department) provide the best treatment for each patient.


Nephrology

The Nephrology Department provides medical care for diseases related to the kidneys, including acute or chronic nephritis, acute renal failure/acute kidney injury (AKI), chronic kidney disease (CKD), nephrotic syndrome, diabetic kidney disease, hereditary kidney disease, hypertensive nephrosclerosis, kidney disease associated with connective tissue diseases, and many others. Please consult the Nephrology Department if any of the following symptoms are applicable.

(1) An abnormality such as proteinuria or hematuria was detected in a urine test.

(2) An abnormality related to renal function (high creatinine, high or low sodium or potassium) was detected in a blood test.

(3) You have progressive swelling of the hands or face.

(4) You have been told that you have high blood pressure.

(5) You have been told that you should start hemodialysis or peritoneal dialysis.

(6) You are being treated for diabetes and were told that you have proteinuria or reduced renal function.

(7) You are currently undergoing hemodialysis or peritoneal dialysis and a complication has been pointed out, and/or you are in poor physical condition.

The dialysis room has been renovated. The Nephrology Department provides various acute blood purification therapies in collaboration with the Emergency Care Center (a major feature of Hiroo Hospital), the Respiratory Medicine Department, and the Cardiovascular Surgery Department.


Neurology

The Neurology Department is an internal medicine department that treats diseases of the peripheral nerves and muscles, in addition to disease of the central nervous system (brain and spinal cord). Full-time neurologists are available to make a precise diagnosis and provide appropriate treatment.

By collaborating with other medical institutions and community welfare facilities, the Neurology Department also provides medical care for acute and chronic diseases that is tailored for each patient.

Diseases treated
The Neurology Department provides medical care for a wide range of diseases, such as headache (e.g., tension headache, migraine, or cluster headache), neurodegenerative diseases (e.g., Parkinsonfs disease, advanced supranuclear palsy, corticobasal degeneration, multiple system atrophy, spinocerebellar degeneration, dementia with Lewy bodies, frontotemporal lobar degeneration, or amyotrophic lateral sclerosis), cerebrovascular disease (cerebral infarction or transient ischemic attacks), epilepsy, essential tremor, Guillain-Barre syndrome, chronic inflammatory demyelinating neuropathy, multiple sclerosis, and myasthenia gravis.

Specific symptoms
Please consult the Neurology Department at any time if you are worried about symptoms of stroke or Parkinsonfs disease, such as headache, dizziness, weakness in one arm or leg, sudden loss of sensation in your hands or feet, tremor of your hands or feet, stammering, slow movement, sudden loss of vision, double vision, difficulty walking, and sudden loss of consciousness.

Special examinations (e.g., head CT/MRI, RI scans [cerebral blood flow scintigraphy, MIBG myocardial scintigraphy, or DAT scan], carotid artery ultrasound, electroencephalography [brain wave examination], electromyography, or peripheral nerve conduction velocity examination) will be conducted as needed for diagnosis and treatment.


Respiratory Medicine

The Respiratory Medicine Department of Hiroo Hospital was established as a base hospital for air pollution-related diseases in Tokyo and has treated patients with chronic obstructive pulmonary disease (COPD: emphysema or chronic bronchitis) and bronchial asthma. Currently, it provides medical care for patients with chronic respiratory failure who need home oxygen therapy and/or home mechanical ventilation.

Hiroo Hospital gives the highest priority to emergency medical care. We not only treat patients in the emergency outpatient setting, but also proactively introduce primary care doctors when symptoms show aggravation at night or on weekends. Severe asthma and severe pneumonia occur more often among elderly patients. For such patients, the Respiratory Medicine Department provides team-based medical care to prevent physical deconditioning through a combination of drug therapy, nutritional management, and early introduction of rehabilitation.

Local base hospitals have many patients with lung cancer, and the Respiratory Medicine Department provides high-level specialized medical services in close collaboration with the Thoracic Surgery Department and Radiology Department. We treat elderly patients, especially those with complications, without causing deterioration of their quality of life.

Providing medical care for patients from isolated islands is also an important mission of Hiroo Hospital. We proactively handle all respiratory medicine in the islands, especially near-drowning accidents, severe asthma, severe pneumonia, and aggravation of COPD.

On Monday afternoons, we provide a special outpatient service for sleep apnea syndrome, which has been attracting attention in recent years (an average of 120 cases per month in 2011). We have recently introduced all-night polysomnography and we have a test system. Since sleep apnea syndrome is known to be associated with metabolic syndrome, collaboration with the Diabetes Department and Cardiology Department is important. We have the distinct advantages of a general hospital, which allows collaboration within one facility for various purposes such as providing nutritional guidance to creating a mouthpiece together with the Oral Surgery Department.

The Kampo medicine outpatient service (Wednesday and Friday afternoons) provides treatment for patients by combining Eastern medicine and Western medicine.

As described above, the Respiratory Medicine Department of Hiroo Hospital aims to provide the latest medical care along with detailed explanations according to the needs of each patient with respiratory disease.

We also aim to improve cooperation by holding regular clinicopathological review meetings centered on chest imaging diagnosis with the Surgery Department, the Radiology Department, and the Examination Department, and inviting doctors from neighborhood medical associations.


Cardiology

The Cardiology Department provides medical care for all cardiac, large vessel, and peripheral vascular diseases with a special emphasis on emergency medical care, ischemic heart disease, heart failure, and arrhythmia.

Emergency medical care is provided 24 hours a day as we are one of the Tokyo CCU hospitals.

For management of ischemic heart disease, we proactively perform percutaneous transluminal coronary angioplasty or stenting of occluded or narrowed arteries in patients with acute myocardial infarction or angina pectoris, and good results are achieved. In recent years, we have also provided evaluation of the coronary arteries by using coronary CT that causes less physical stress for patients.

We donft just handle myocardial infarction, but also heart failure due to cardiomyopathy, myocarditis, valvular disease, and pulmonary embolism. We provide treatment using drug therapy, intra-aortic balloon pumping, and percutaneous cardiopulmonary support devices.

We also conduct Holter monitoring, signal-averaged electrocardiography, and electrophysiological testing for diagnosis and treatment of arrhythmias, and we perform pacemaker implantation (we can implant a pacemaker that allows MRI) for bradycardia and provide anti-arrhythmic medication or catheter ablation for tachycardia. We have introduced the latest devices, such as a system for understanding cardiac anatomy using intracardiac ultrasound and an ablation catheter that allows tip load monitoring, so that we can provide ever safer and more effective treatment.

For patients with severe ventricular arrhythmias or out-of-hospital cardiac arrest, we conduct insertion of an implantable cardioverter-defibrillator (ICD), which is the most reliable method for preventing sudden death.

For patients with severe heart failure that not uncontrolled by drug therapy, we conduct insertion of a biventricular pacing cardiac resynchronization therapy defibrillator (CRT-D).

The number of patients is increasing each year, and we are one of the busiest centers in Tokyo for catheter ablation and ICD insertion.

On April 1, 2012, Hiroo Hospital was acknowledged as a training facility for arrhythmia specialists by the Japanese Heart Rhythm Society.

We proactively provide treatment for peripheral vascular disease. Narrowing of blood vessels in the leg is suspected if there are symptoms such as intermittent claudication (pain in the leg [especially in the calf] when walking) or the leg pulses are weak. The Cardiology Department also conducts catheter therapy for the leg vessels. In addition, we provide stenting for carotid artery stenosis in collaboration with cerebrovascular surgeons.

It is a feature of Hiroo Hospital that severe diseases can be treated in close collaboration with the Cardiovascular Surgery Department. Refer patients to us if you have difficulty diagnosing or treating cardiac disease (including suspected cardiac disease) or peripheral vascular disease.


Neuro-Psychiatry

The Neuropsychiatry Department mainly treats mood disorders such as depression, impairment of thinking such as difficulty thinking clearly, and cognitive impairment such as memory loss. Among new patients, approximately one quarter each have stress-related disorders (neuroses) and mood disorders (manic depression or depression), followed by dementia and schizophrenia. Of the conditions that need hospitalization, mood disorders occupy approximately one third, followed by schizophrenia.

Features of the Neuropsychiatry Department are: (1) an open ward for hospitalization that is designed to provide both refuge and protection, (2) provision of high-level psychiatric care in a hospital environment by utilizing a large number of staff with a wide variety of specialties, and (3) provision of psychiatric care for patients who also need physical management or imaging tests by utilizing the facilities of the general hospital.


Pediatric

The Pediatric Department of Hiroo Hospital participates in the Tokyo ER. While focusing on general pediatric diseases in collaboration with local pediatricians, we provide specialist medical care for pediatric allergic diseases, obesity, metabolic syndrome, and neuropsychiatric disorders. Hiroo Hospital is certified for these specialties by the major academic societies in Japan. We not only provide treatment for pediatric diseases, but also engage in activities that promote child health.

Pediatric allergic diseases
We treat bronchial asthma and food allergies. We conduct food tolerance testing (requires short-term hospitalization) for children with food allergies, respiratory function testing for children with asthma, and skin prick testing. We provide emergency care for asthma and anaphylactic shock caused by food allergies. We are certified as an educational facility by the Japanese Society of Allergology.

Chronic pediatric diseases and metabolic syndrome
We conduct complete examination and provide lifestyle guidance for chronic diseases such as obesity, hyperlipidemia, hypertension, and diabetes. We can also make a diagnosis of early childhood arteriosclerosis by using vascular ultrasound and electroencephalography (brain wave test). We are certified by the Japan Society for the Study of Obesity as a special facility for obesity and can provide specialist medical care for obesity and metabolic syndrome.

Pediatric cardiac disease
We provide diagnosis and treatment for congenital heart diseases and arrhythmias, as well as follow-up for school heart examinations, and diagnosis and treatment for Kawasaki disease. We can conduct echocardiography.

Pediatric psychiatric and neurological disorders
We provide advice and treatment regarding delayed development of movement or speech, as well as for epilepsy, school truancy, psychosomatic diseases, and developmental disorders. Patients need to be examined by a doctor before making an appointment for psychological consultation.


Surgery (Gastrointestinal, Breast, and Respiratory Surgery)

The Surgery Department provides surgical treatment, especially for benign and malignant tumors of the digestive system, breast, and respiratory system. Our features include:
1) Minimally invasive surgery (laparoscopic or thoracoscopic surgery).
2) Rapid treatment (complete assessment and surgery within 1 ? 2 weeks after referral for malignancy).
3) Emergency care.

Treatment of malignancies such as colon cancer and stomach cancer is at the heart of our department. Introduction of minimally invasive surgery such as laparoscopic surgery has led to reduced postoperative pain and a shorter duration of hospitalization. We provide safe and precise minimally invasive surgery, mainly by surgeons who are certified by the Japan Society for Endoscopic Surgery.

Malignancy may require chemotherapy (anticancer drugs) before or after surgery. In such cases, treatment is provided by staff experienced in chemotherapy, and we have the advantage of smoothly conducting both surgery and chemotherapy.

Emergency care is our priority, and we provide primary to tertiary emergency care 24 hours a day. We accept various emergency conditions, particularly acute abdomen, trauma, and spontaneous pneumothorax. The doctors on call respond promptly during regular working hours, while doctors are on duty at night and on holidays. Medical care is provided by several teams and a comprehensive support system has been established so that serious cases are managed centrally.

As a facility certified by various academic societies, we provide high-level medical care and also educate specialists.

Specialists in various areas safely provide the latest in quality surgical treatment for every disease. Patients can feel safe with us.


Cardiovascular Surgery

The Cardiovascular Surgery Department is certified as a base training hospital and conducts various operations in the field of cardiovascular surgery (except for heart transplantation). As an emergency supporting hospital for the acute aortic network, we have implemented a system for prompt treatment of aortic dissection or ruptured aortic aneurysm, which are highly urgent conditions.

Diseases that are treated:

Angina pectoris and myocardial infarction
Angina pectoris is a state of ischemia or oxygen lack affecting the heart muscle because a vessel (coronary artery) that provides nutrition to the heart has become partially narrowed. Myocardial infraction occurs when the narrowing progresses until there is no blood flow and part of the heart muscle dies. Currently, 40,000 people die from acute myocardial infarction annually, and treatment before the onset of infarction is needed.

Valvular heart disease
There are four valves in the heart. Blood returning to the heart from the body goes through the tricuspid valve and the pulmonary valve to reach the lungs, where it becomes oxygenated red blood and returns to the heart again. Subsequently, it goes through the mitral valve and the aortic valve and is sent out to the body. Heart valves normally only open in one direction, and thus regulate blood flow. Stenosis is a condition where a valve cannot open sufficiently and regurgitation is a condition where the valve also opens in the opposite direction, and these conditions are collectively called valvular heart disease. Although the symptoms and features differ depending on which valve has stenosis or regurgitation, eventually the lungs and heart become strained and symptoms such as shortness of breath occur. Although symptoms of valvular heart disease can be improved to some degree by medication, surgery is necessary when this condition progresses.

Aortic diseases (e.g., aortic aneurysm)
The aorta is the major vessel carrying blood from the heart to the body.

If part of the aorta becomes weak due to arteriosclerosis or some other reason, it may start to swell like a balloon. When this occurs in the chest, it is called a thoracic aortic aneurysm, while it is called an abdominal aortic aneurysm if it occurs in the abdomen. Aortic aneurysm is a serious disease because an aneurysm can gradually become larger and the walls thinner until it suddenly ruptures and causes major hemorrhage.

This disease is normally asymptomatic and not associated with pain. When pain occurs, it means that the aneurysm has ruptured or almost ruptured (impending rupture).

It is difficult to prevent rupture with medications, and treatment is necessary before rupture occurs.

Peripheral vascular disease (e.g., arteriosclerosis obliterans)
Arteriosclerosis obliterans (ASO) is a disease in which a limb vessel becomes narrow due to arteriosclerosis and distal blood flow becomes insufficient. While arteriosclerosis can affect vessels anywhere in the body, such as blood vessels in the brain or heart 1), arteriosclerosis occurring in the legs is called ASO.

Patients can be tested without being hospitalized and can receive information about their disease and treatment methods.

A leg with poor blood flow is cold and pain occurs after walking a little. If such symptoms are not treated and blamed on aging (the average age of patients in the Cardiovascular Surgery Department is 70 years), the symptoms will progress (stage III/IV disease) and amputation of the foot or leg may become necessary.

If you have the above symptoms, we recommend seeing a cardiovascular surgeon immediately.


Orthopedic Surgery

The Orthopedic Surgery Department handles many cases of emergency trauma, including multiple trauma with fractures of the spine, pelvis, and extremities. In collaboration with the Orthopedic Surgery Department of the University of Tokyo, we operate a center for the diagnosis and treatment of peripheral neurotrauma and diseases such as brachial plexus injury, and we have established a special outpatient section for peripheral nerve surgery.

In addition, we conduct joint replacement for various disorders of the cervical spine and lumbar spine, as well as for disorders of joints such as the hip joint and knee joint.

We are ready to provide transfusion with autologous blood in situations other than emergency surgery.


Rehabilitation

The Rehabilitation Department aims to assist patients to recover from disabilities as much as possible to improve their quality of life. The range of disabilities treated is wide. Hiroo Hospital provides rehabilitation that is tailored to the disability and condition of each patient.

Hiroo Hospital gives the highest priority to emergency medical care. So, the Rehabilitation Department puts special emphasis on acute rehabilitation, which has been attracting attention recently. We provide locomotor rehabilitation, cerebrovascular event rehabilitation, and respiratory rehabilitation services that are mainly for inpatients. Since locomotor rehabilitation is one of the main objectives of Hiroo Hospital, the emphasis is on acute rehabilitation for trauma patients. Additionally, in collaboration with the peripheral nerve surgery/disease diagnosis and treatment center of the Orthopedics Department at this hospital, we provide postoperative rehabilitation for neurotrauma such as brachial plexus injury, which requires a high level of expertise. In relation to patients with cerebrovascular disease, which is our main medical care objective, the main type of cerebrovascular rehabilitation we provide is rehabilitation during the acute phase because it is considered to be critical for recovery from stroke. In collaboration with the Respiratory Medicine Department, we provide respiratory rehabilitation for inpatients with chronic obstructive pulmonary disease (COPD: emphysema or chronic bronchitis) and assist respiratory patients to improve their quality of life.


Neurosurgery

Providing care 24 hours a day for 365 days a year.
Currently, care at the Neurosurgery Department is provided by three neurosurgeons and one senior resident, with support from Juntendo University and the Self-Defense Forces Central Hospital as needed. This system allows us to respond to requests by local patients, as well as requests from regional medical institutions about their patients.

Treatment is selected according to the patientfs symptoms (intravascular surgery or craniotomy).
Under the Tokyo ER system, the Neurosurgery Department provides primary to tertiary emergency care for various cranial diseases, such as cerebrovascular disease, brain tumors, and head trauma, which is available 24 hours a day for 365 days a year. Especially for subarachnoid hemorrhage, where the quality of treatment deeply influences the survival of patients, we are able to provide either intravascular treatment (coiling) or craniotomy (clipping) at any time according to the symptoms of our patients. With advances in intravascular surgery, more medical institutions have been selecting intravascular treatment as first-line therapy for subarachnoid hemorrhage in recent years, and we have been proactively providing first-line intravascular treatment for subarachnoid hemorrhage in cooperation with the cerebrovascular treatment team of Juntendo University since 2003. Intravascular surgery is not suitable for some patients, so craniotomy is conducted instead. The outcome of both methods is favorable and nearly equivalent.

Using the latest facilities to provide high-level and safer care
By utilizing the latest treatment facilities, we aim to provide high-level and safer care with a smaller burden on the patient.

In December 2007, we introduced a new angiography device to further enhance intravascular treatment. This new device employing flat panel technology allows us to obtain significantly better high-resolution images compared to older devices, so we can achieve high-level and safer intravascular treatment.

For patients with brain tumors, we provide stereotactic radiation therapy that enables pinpoint treatment instead of conducting craniotomy. Unlike craniotomy, stereotactic radiation therapy is a method that achieves the objective of gdestroying the tumor without causing painh. The procedure is completed in one session with only intravenous infusion as pretreatment, and patients can walk back to the ward after the procedure and eat dinner in a normal way. The duration of hospitalization is 3 ? 4 days. Although the procedure is best suited for metastatic brain tumors, the outcome with other brain tumors has also been favorable.

Muscle spasm
We provide botulinum therapy for muscle spasm.

Paralysis of the limbs is the most commonly observed sequel of stroke, and it is often associated with gtightness of the muscles.h

This gtightness of the musclesh sometimes makes rehabilitation difficult to perform.

Among various methods, we provide botulinum therapy.

Muscle spasm is reduced by injecting botulinum toxin produced by the bacterium Clostridium botulinum into the contracted muscle(s).

By reducing muscle spasm with botulinum therapy and performing rehabilitation at the same time, patients may be able to carry out daily activities more easily.


Plastic and Reconstructive Surgery

The Plastic and Reconstructive Surgery Department treats deformity and functional impairment at any site from head to foot. We mainly perform cosmetic surgery for patients with (1) trauma, (2) skin/subcutaneous tumors, (3) congenital anomalies, (4) reconstruction after tissue loss, (5) intractable ulcers, and (6) functional impairment.

(1) Trauma: We accept patients with serious trauma, such as burns, facial fractures, finger amputation, or limb avulsion, with the cooperation of the emergency medical center. As a member of the Tokyo Burn Unit Association, we accept patients with extensive severe burns. We provide a comprehensive service from resuscitation in the acute phase to treatment that improves function and cosmesis in order to allow the patient to return to society. Mild burns and other trauma are managed while taking into account cosmetic results, and treatment is provided to heal wounds neatly. We also provide consultation for trauma patients who have been treated at other institutions, as well as for surgical scars, scar contractures, and other deformities.

(2) Skin/subcutaneous tumors: We provide treatment for tumor of the entire body surface (benign or malignant). The Plastic and Reconstructive Surgery Department excels at tissue transfer procedures and we conduct tumor resection and reconstructive surgery while taking into account functional and cosmetic aspects even when a large lesion must be removed. We also conduct surgery for small tumors by methods that maximize the cosmetic outcome and simultaneously start treatment for the scar.

(3) Congenital anomalies: We treat congenital abnormalities of the body surface (especially limbs and face), umbilical hernia, accessory breast tissue, and birth marks.

(4) Reconstruction after tissue loss: We conduct cosmetic/functional repair for tissue loss/deformity due to trauma or following mastectomy or resection of head and neck cancer (primary or secondary) by methods such as microsurgery (using an operating microscope).

(5) Intractable ulcers: We treat bedsores and chronic ulcers due to obstruction of blood flow.

(6) Others: We conduct surgery for moles, ptosis, hircismus (excessive underarm sweating), and inverted nipples that is covered by health insurance.


Dermatology

While providing overall dermatological treatment, the Dermatology Department puts special emphasis on dermatologic surgery.

We provide a wide range of treatment from excision of small lumps to epidermization.

We provide comprehensive care from diagnosis to treatment (including chemotherapy after surgery) for skin malignancies (skin cancer).

We use a dermoscope (an instrument like a magnifying glass) to support diagnosis of skin tumors. If you are worried about skin lesions, we recommend you to be examined like having a health check.

We perform excision of facial moles and carbon dioxide laser treatment for warts on the hands and feet.

Patients with inflammatory diseases such as herpes zoster and cellulitis often need to be hospitalized for treatment, and we always accept patients for emergency hospitalization.

For patients with severe atopic dermatitis, we can provide an inpatient education program that includes instructions on lifestyle modification while treating the skin disease with ointments.

We are approved for using TNF-alpha blocker therapy to treat intractable psoriasis certified by the Japanese Dermatological Association. Please consult the Dermatology Department at any time if you are worried about treatments of psoriasis.


Urology

We provide care for diseases of the urinary tract (kidneys, ureters, bladder, and urethra), male genital organs (prostate gland, testes, and penis), and adrenal glands. We provide conservative medical treatment including drug therapy and surgical treatment including endoscopic surgery. Currently, two full-time doctors are in charge of medical care for inpatients and outpatients. We provide treatment that takes the quality of life of our patients into account.

Please visit the Urology Department outpatient clinic if you have blood in your urine, if hematuria was pointed out at a health checkup, if you are a man who needs to urinate frequently/finds it difficult to urinate, if you were told that your PSA is high, or if you are a woman who needs to urinate frequently or has leakage of urine. We have been proactively providing treatment for local people.


Obstetrics and Gynecology

As emergency care is our priority, we handle gynecologic emergencies such as ectopic pregnancy and torsion of ovarian cyst.

For patients with neoplastic diseases, especially gynecologic cancer, we provide preoperative chemotherapy for advanced tumors, surgical treatment including para-aortic lymph node dissection, and chemotherapy jointly with the Radiology Department. (We conduct laparoscope-assisted surgery for benign diseases, depending on the condition.)

The Obstetrics Department has aimed to create an environment that allows comfortable delivery. Therefore, we have expanded the space available for coping with contractions to provide room for husbands and other family members to accompany women in labor, and we have included chairs and beds for family members.

As a part of the project to promote rooftop greenery under the Tokyo green policy, we have created a 250 square meter green garden (sun garden) above the Obstetrics Department and Pediatric Department.

Based on the philosophy of gpatient-centered medical careh and in accordance with the Tokyo patientfs bill of right, the obstetrics ward provides services such as a coin-operated washing machine and a sink for washing hair, as well as a memorial message card with a picture of the mother, husband, and new baby taken on the day of birth, while also providing kangaroo care and parenting classes.

Please note that we do not care for premature babies since we do not have an NICU.


Ophthalmology

The Ophthalmology Department provides a full range of ophthalmology services, including surgery for cataracts, corneal/ conjunctival diseases, and vitreoretinal diseases. We have a relatively high number of patients from distant regions, including the remote islands.

When performing cataract surgery, we proactively correct astigmatism.
We conduct small incision phacoemulsification in almost all patients, ranging from healthy patients to those with systemic complications. If astigmatism needs to be corrected, we insert a toric lens (an intraocular lens for astigmatism). Cataract surgery usually requires hospitalization for three days and two nights, although patients with family or work commitments may go home on the day of surgery and patients who are physically disabled or from a distant place may stay longer on request.

One of our focuses is caring for patients from the islands, and patients from Izu or Ogasawara Island who wants cataract surgery are hospitalized immediately if possible, taking into account transportation access. Surgery is performed on Tuesdays and Thursdays. Patients who want to undergo surgery should call the Ophthalmology outpatient clinic (03-3444-1181) and visit us on either Monday or Wednesday so that they can be hospitalized for surgery on the next day.

For vitreous surgery, a small-incision vitreous surgery system has been introduced.
In addition to retinal detachment and diabetic retinopathy, the indications for vitreous surgery have been expanded to improvement of vision in patients with macular disease. We have devised a method for preventing complications by using 25 gauge small-incision vitreous surgery. We have also introduced optical coherence tomography (OCT) to focus on macular disease.

We perform intravitreal injection of anti-VEGF drugs.
The indications for intravitreal injection of anti-VEGF drugs have been expanded to include retinal vein occlusion and diabetic retinopathy associated with macular edema and choroidal neovascularization due to pathological myopia. We offer advice on the optimal management according to your disease state.

We perform diagnosis and treatment of uveitis.
Difficult cases are managed in collaboration with Tokyo Medical and Dental University.

We provide diagnosis and treatment for corneal diseases.
We not only treat infections, but also manage bullous keratopathy and corneal dystrophy. We also remove corneal opacities in patients with band dystrophy.


Otolaryngology

We manage the full range of ear, nose, and throat diseases. In addition to conservative treatment, we proactively conduct surgery on the head and neck region. Please consult us since we accept patients who require inpatient treatment for conditions such as sudden deafness, facial nerve palsy, Menierefs disease, and nasal bleeding (epistaxis).

We hold a general outpatient clinic in the morning and a special outpatient clinic in the afternoon on weekdays. An appointment is required for consultation, so please make one in advance before visiting us.


Radiology

The Radiology Department performs rapid imaging diagnosis by three doctors, as well as preparing accurate reports based on discussion among three doctors.

We use two 64-row multi-detector computed tomography units for CT scanning. We improve our diagnostic performance by constructing 3-D images to selective visualize parts of the coronary arteries, cerebral vessels, bones, etc. The 64-row CT unit can perform scans rapidly and is very effective in relation to Hiroo Hospitalfs commitment to emergency medical care.

A 1.5 Tesla unit is used for MRI. It has high diagnostic performance for diseases of the brain, heart/vessels, liver/gallbladder/pancreas, pelvic viscera, and bones/joints. At Hiroo Hospital, imaging is managed by certified MRI technicians.

MRI contributes to collaboration in community health care by providing excellent images and accurate and prompt reports.

We also provide imaging services that require specialist experience such as isotope studies, angiography (IVR), and contrast gastrointestinal examinations.

For treatment of malignancies, radiation therapy is conducted by a part-time radiologist using a linac device.


Dentistry and Oral Surgery

The Dentistry and Oral Surgery Department provides dental services for medically compromised patients/patients with disabilities and oral surgery. We proactively provide inpatient treatment, depending on the situation.

(Treatment provided)
ƒOral surgery„
Surgery is mainly performed for oral and maxillofacial malignancies, and may be accompanied by treatment at the Radiology Department.

Oral and maxillofacial reconstruction is perfomed jointly with the Plastic and Reconstructive Surgery Department of this hospital, taking into account functional and cosmetic aspects.

Patients can be hospitalized immediately for the treatment of oral and maxillofacial trauma and odontogenic infection.

Fracture of the jaw can be treated by open reduction and fixation using an intraoral plate.

ƒDentistry for medically compromised patients and patients with disabilities„
Our priority is providing treatment for patients with systemic diseases such as heart disease, hypertension, or diabetes undergoing procedures like tooth extraction or pulp extirpation.

As a part of our services for medically compromised patients or patients with disabilities, we provide dental treatment under intravenous anesthesia with propofol (target-controlled infusion method). The bispectral index (brain monitor) is used for better regulation of anesthesia. Intravenous sedation is also used to reduce the stress of oral surgery in some patients with heart disease, patients with a strong gag reflex, and patients with a history of fainting or hyperventilation during dental treatment.

(Treatment provided)
ƒOral surgery„
Complicated dental procedures, including extraction of wisdom teeth, wisdom tooth transplantation, and management of cellulitis or inflammation in the oral and maxillofacial area, jaw arthritis and temporomandibular joint dislocation, and stomatitis and oral mucosal disease.

Fracture of the jaw or tooth loss due to trauma, tooth fracture, conservative therapy for benign/malignant maxillofacial tumors, and surgical therapy.
Jaw deformity, iliac transplantation for cleft lip.

ƒDentistry for medically compromised patients and patients with disabilities„
Patients requiring careful systemic management
Dental treatment for patients with disabilities


Anesthesiology

We have been placing equal emphasis on anesthesia or emergency/intensive care, and we have also recently started to focus on postoperative pain relief and pain control. However, the pain clinic is currently only available for inpatients.


Endoscopic center

The Endoscopic Center includes doctors from the Gastroenterology Department, Gastrointestinal Surgery Department, and Pulmonology Department. We conduct about 4,000 endoscopic examinations each year, including upper/lower gastrointestinal endoscopy, bronchoscopy, and endoscopic retrograde cholangiopancreatography (ERCP). As a tertiary emergency hospital, we see many patients with gastrointestinal bleeding and the number of emergency endoscopies performed each year reaches 400 when secondary emergencies and hospital-acquired cases are combined.

In recent years, various endoscopic treatments have become popular, and we proactively conduct endoscopic polypectomy, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD) for early caner and polyps. Additionally, we provide a wide range of treatment for various diseases, including endoscopic variceal ligation (EVL), endoscopic injection sclerotherapy (EIS), endoscopic sphincterotomy (EST), endoscopic stenting for esophageal cancer and bile duct cancer, endoscopic balloon dilatation for esophageal stenosis, and emergency hemostasis for gastrointestinal bleeding.

Also, as part of our efforts to promote health care coordination, we accept direct requests for upper/lower gastrointestinal endoscopy from doctors belonging to local medical associations.



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