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Nagano-shi, Japan

Murata T.,Diabetes Center | Okazaki K.,Clinical Research Institute for Endocrine and Metabolic Disease | Yanagisawa K.,Sapporo City General Hospital | Yamada K.,Kenichi Yamada Internal Medicine Clinic | And 15 more authors.
Diabetes Technology and Therapeutics | Year: 2013

Aim: Glucagon is recommended to treat severe hypoglycemia in nonhospital environments, when a patient with type 1 diabetes mellitus (T1DM) is unconscious and unable to eat or drink. However, the actual possession rate of glucagon in Japan has not been investigated. Subjects and Methods: We recruited 208 T1DM patients older than 15 years of age. The patients were treated at 16 hospitals and clinics in different regions of Japan. Answers were obtained using a self-Administered questionnaire about the possession, the experience of usage, and the preference to possess glucagon after reading what is glucagon and when it is used. A stepwise logistic regression analysis was performed to assess the influence of various factors on the possession of glucagon. Results: The possession rate of glucagon was 15.9%, and the rate of those who had experience of using glucagon to treat severe hypoglycemia was 6.0%. The rate of preference to possess glucagon at home after reading the description of glucagon was 39.0%. The possession of glucagon was significantly associated with results of the Glucagon Knowledge Test (odds ratio=24.1; 95% confidence interval, 3.2-183.3; P=0.002) and the history of severe hypoglycemia within 1 year (odds ratio=4.8; 95% confidence interval, 2.0-12.0; P=0.001). Conclusions: Glucagon as a measure to treat severe hypoglycemia was underutilized among T1DM patients in Japan. © Copyright 2013, Mary Ann Liebert, Inc. 2013. Source


Sasaki H.,Asama General Hospital | Kokubun T.,Juntendo University
Case Reports in Ophthalmology | Year: 2014

A 47-year-old man presented at the Ophthalmology Department of Saku City Asama General Hospital complaining of hyperemia and pain after industrial sodium hydroxide (approx. 40% concentration) had entered his left eye. With an epithelial defect of the bulbar and palpebral conjunctiva, ischemia of the inferior third of the limbal conjunctiva, a total corneal epithelial defect and mild corneal stromal opacity, the damage was determined as Roper-Hall grade III. 2% rebamipide ophthalmic suspension, which is used for dry eye disease, was administered 4 times a day followed by conventional treatment for serious alkali injury. The corneal epithelial defect was resolved, and there were no side effects. The effectiveness of 2% rebamipide ophthalmic suspension in both the repair and improvement of the damage in the conjunctival and corneal epithelia, and its anti-inflammatory effect suggest that it may be an effective treatment not only for dry eye disease but also for alkali ocular damage. © 2014 S. Karger AG, Basel. Source


Sasaki H.,Asama General Hospital | Takano T.,Juntendo University | Murakami A.,Juntendo University
Clinical and Experimental Ophthalmology | Year: 2013

Background: The most common treatment for congenital lacrimal duct obstruction is standard probing without dacryoendoscopy. However, the lacrimal duct cannot be observed in this procedure. If the probing procedure allows the observation of the lacrimal duct, it could be more successful and safer. To use endoscopic probing to view the lacrimal duct in cases of congenital lacrimal duct obstruction 6 months post-surgery and to evaluate the condition of the lumen while simultaneously performing direct endoscopic probing. Design: This is a retrospective, non-comparative case series. Participants: The study participants were 10 children aged 14-74 months, including three children with bilateral obstruction. In total, 13 congenital lacrimal duct obstruction were probed. Methods: The patients underwent direct endoscopic probing with dacryoendoscopy instead of blind probing, that is, standard probing without dacryoendoscopy under brief total anaesthesia. Main Outcome Measures: During the procedure, outcomes were assessed as the endoscope reached the nasal cavity. A successful probing outcome was defined as an absence of tearing and discharge. Results: Twelve congenital lacrimal duct obstruction were successfully treated by direct endoscopy, whereas one was not. There were various sites of obstruction and various conditions such as oedematous thickening of the mucosa of the lacrimal duct and fibrous tissue because of chronic inflammation. The subjective outcome from their parents by telephonic interview was obtained. Epiphora disappeared in 12/13 (92.3%) of the eyes treated by endoscopy; however, 5/13 (38.5%) of the patients reported occasional discharge from the eyes. Conclusions: Direct endoscopic probing is effective and safe to treat cases of congenital lacrimal duct obstruction in children. © 2013 Royal Australian and New Zealand College of Ophthalmologists. Source


Inada T.,Tochigi Cancer Center | Yoshida M.,International University of Health and Welfare | Ikeda M.,Asama General Hospital | Yumiba T.,Osaka Kosei Nenkin Hospital | And 6 more authors.
World Journal of Surgery | Year: 2014

Background: Proximal gastrectomy with esophagogastrostomy (PGEG) has been widely applied as a comparatively simple method. In this study, we used a questionnaire survey to evaluate the influence of various surgical factors on post-operative quality of life (QOL) after PGEG. Methods: In this post-gastrectomy syndrome assessment study, we analyzed QOL in 2,368 cases. Among these, 193 had undergone proximal gastrectomy and 115 had undergone PGEG. The Post-Gastrectomy Syndrome Assessment Scale (PGSAS)-45 is a questionnaire consisting of 45 items, including the SF-8, the Gastrointestinal Symptom Rating Scale (GSRS), and other symptom items seemed to be specific to post-gastrectomy. The 23 symptom items were composed of seven symptom subscales (SS), including esophageal reflux, abdominal pain, and meal-related distress. These seven SS, total symptom score, ingested amount of food per meal, necessity for additional meals, quality of ingestion SS, ability to work, dissatisfaction with symptoms, dissatisfaction with the meal, dissatisfaction with working, dissatisfaction with daily life SS and change in body weight were evaluated as main outcome measures. In PGEG cases, we evaluated the influence on QOL of various surgical factors, such as procedures to prevent gastroesophageal regurgitation and size of the remnant stomach. Results: The scores for esophageal reflux and dissatisfaction with the meal were higher in patients who had not undergone an anti-reflux procedure. In most cases, the preserved remnant stomach was more than two-thirds the size of the pre-operative stomach. When comparing patients with a remnant stomach two-thirds the pre-operative size and those with more than three-quarters, the diarrhea SS and necessity for additional meals scores were lower in the group with more than three-quarters. The indigestion, constipation, and abdominal pain subscales, and the total symptom score, were higher in patients who had not undergone pyloric bougie than in those who had. Conclusion: These results indicated that QOL was better in patients with a large remnant stomach. Procedures to prevent gastroesophageal reflux, and the use of pyloric bougie as a complementary drainage procedure, were considered effective ways to reduce the deterioration of QOL. © 2014 Société Internationale de Chirurgie. Source


Takiguchi N.,Chiba Cancer Center | Takahashi M.,Yokohama Municipal Citizens Hospital | Ikeda M.,Asama General Hospital | Inagawa S.,University of Tsukuba | And 7 more authors.
Gastric Cancer | Year: 2015

Background: Although proximal gastrectomy (PG) is widely accepted as a function-preserving operation for early upper-third gastric cancer, postoperative disorders, such as reflux or gastric stasis, have often been pointed out. From the perspective of postoperative disorder, the choice of total gastrectomy (TG) or PG for such cancers is still controversial. By using the newly developed Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, the quality of life after TG and PG was compared.Methods: The PGSAS-45 consists of 45 items composed of the SF-8 and GSRS scales and 22 new items. The main outcomes are measured by seven subscales (SS) covering symptoms, physical and mental component summary (SF-8), meals (amount and quality), ability to work, dissatisfaction for daily life, and change in body weight. A total of 2,368 eligible questionnaires were acquired from 52 institutions. From these, 393 patients with TG and 193 patients with PG were selected and compared.Results: The PG was better than TG in terms of body weight loss (TG 13.8 % vs. PG 10.9 %; p = 0.003), necessity for additional meals (2.4 vs. 2.0; p < 0.001), diarrhea SS (2.3 vs. 2.0; p = 0.048), and dumping SS (2.3 vs. 2.0; p = 0.043). There were no differences in the other main outcome measures.Conclusions: Proximal gastrectomy appears to be valuable as a function-preserving procedure for early upper-third gastric cancer. © 2014, The International Gastric Cancer Association and The Japanese Gastric Cancer Association. Source

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