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Sogabe M.,Kagawa Prefectural Cancer Detection Center | Okahisa T.,Tokushima University | Tsujigami K.,Aoba Medical Clinic | Fukuno H.,Higashi Tokushima Medical Center | And 2 more authors.
Hepatology Research | Year: 2014

Aim: Metabolic syndrome (MS) is likely to be associated with non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD in visceral fat type MS (V-type MS) is known to be higher than in subcutaneous fat type MS (S-type MS) in men with MS, and a larger subcutaneous fat area is reported to be not associated with NAFLD in women. We elucidated differences between V-type S-type MS in Japanese women with MS. Methods: The subjects were 276 women with MS who underwent a medical checkup including abdominal ultrasonography. We examined for the prevalence of fatty liver and investigated biochemical parameters, and we also made a distinction between V-type and S-type MS. Results: Triglyceride, uric acid, alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase, the frequency of fatty liver and impaired glucose tolerance (IGT) were significantly higher in V-type MS than in S-type MS. On logistic regression analysis with NAFLD (in our study, fatty liver with ALT ≥31IU/L was defined as NAFLD) as a dependent variable, body mass index, dyslipidemia, AST and V-type MS were significant predictors of an increased prevalence of NAFLD (odds ratios [OR]=18.85, 3.119, 59.77 and 3.205; 95% confidence intervals [CI]=3.585-99.15, 1.195-8.142, 18.03-198.2 and 1.198-8.573; P<0.001, <0.05, <0.001 and <0.05, respectively). Conclusion: Women with V-type MS are more likely to have fatty liver, IGT and liver dysfunction than those with S-type MS. V-type MS is one of the significant predictors for NAFLD in Japanese women with MS. © 2013 The Japan Society of Hepatology. Source


Yamamoto Y.,Tokushima University | Yamai H.,Red Cross | Seike J.,Tokushima University | Yoshida T.,Higashi Tokushima Medical Center | And 6 more authors.
Annals of Surgical Oncology | Year: 2012

Background. The human epidermal growth factor receptor (HER) family, Ki-67 and p53 are important biomarkers for several malignancies. However, few studies have examined the role of these in prognosis and therapeutic sensitivity of esophageal squamous cell carcinoma (ESCC). The efficacy of triple-drug combination therapy with docetaxel, fluorouracil and cisplatin has recently been expected for ESCC. Methods. Subjects comprised 142 patients with ESCC who underwent operation (OP group, n = 54), neoadjuvant chemotherapy with docetaxel, fluorouracil, and cisplatin (DFP therapy) followed by operation (NAC group, n = 37) or initial systemic DFP therapy (CT group, n = 51) between January 2004 and December 2010. Immunohistochemical expressions of epidermal growth factor receptor (EGFR), HER2, HER3, Ki-67, and p53 were evaluated and compared with prognosis and sensitivity to DFP therapy. Results. Positive correlations existed between EGFR, HER2, and HER3 expressions. In the OP group, EGFR was independently associated with postoperative recurrence in multivariate analysis (P = .036). In the NAC group, EGFR correlated with pathological response to DFP therapy (P = .004). In the CT group, EGFR, HER2, and HER3 correlated with clinical response to DFP therapy and EGFR was independently associated with favorable prognosis in multivariate analysis (P = .022). Conclusion. EGFR represents a predictor of postoperative recurrence and sensitivity to triple-drug combination therapy including a taxane. EGFR-positive patients may show improved prognosis with taxane combination chemotherapy and molecular targeted therapy for HER family members. © Society of Surgical Oncology 2011. Source


Miyoshi H.,Higashi Tokushima Medical Center | Oishi Y.,Higashi Tokushima Medical Center | Mizuguchi Y.,Higashi Tokushima Medical Center | Iuchi A.,Higashi Tokushima Medical Center | And 3 more authors.
Journal of the American Society of Hypertension | Year: 2013

Our aim was to investigate the relationships between left atrial (LA) structural and functional changes and left ventricular (LV) dysfunction related to LV pressure overload in asymptomatic patients with hypertension. One hundred and twenty-six asymptomatic patients with hypertension and LV ejection fraction (EF) ≥60% were studied. Conventional, pulsed and tissue Doppler, and two-dimensional speckle-tracking echocardiography (2DSTE) were performed to seek the independent determinants for alterations in LA structure and function. LA volume index (LAVI) correlated with age, body mass index (BMI), end-diastolic ventricular septal thickness (VSth), end-diastolic LV posterior wall thickness, relative LV wall thickness (RWT), LV mass index, peak A velocity of transmitral flow, E/e', and peak systolic and early diastolic LA strains and strain rates. Peak LA strain during ventricular systole (S-LAs) correlated with age, BMI, heart rate (HR), end-systolic LV diameter, LAVI, VSth, RWT, LVEF, e', E/e', peak systolic LV radial strain, and peak early diastolic LV longitudinal strain rate. Multivariate regression analyses indicated that LV mass index, peak A velocity, E/e', and S-LAs are defined as strong predictors related to LAVI, and that BMI, HR, LAVI, and peak systolic LV radial strain are defined as strong predictors related to S-LAs. In conclusion, 2DSTE demonstrated that alterations in LA structure and function are mainly associated with LV diastolic and systolic dysfunction, respectively, in preclinical patients with hypertension. © 2013 American Society of Hypertension. All rights reserved. Source


Miyoshi H.,Higashi Tokushima Medical Center | Mizuguchi Y.,Higashi Tokushima Medical Center | Oishi Y.,Higashi Tokushima Medical Center | Iuchi A.,Higashi Tokushima Medical Center | And 3 more authors.
European Journal of Echocardiography | Year: 2011

Aims: Data are lacking on the left atrial (LA)-left ventricular (LV)-arterial coupling for evaluating the functional abnormalities in the left heart disease, whereas LA-LV or LV-arterial coupling has been recognized. This study was designed to earlier detect the abnormal LA-LV-arterial coupling using two-dimensional speckle-tracking echocardiography (2DSTE) in patients with cardiovascular risk factors and no overt cardiovascular disease. Methods and results: We studied 30 age-matched healthy individuals and 64 preclinical patients with cardiovascular risk factors, who measured carotid arterial intima-media thickness and stiffness β by M-mode ultrasonography, and strain and strain rate of the LA and LV walls by 2DSTE. The stiffness β and LA volume index (LAVI) were greater in the patient group than in the control group. However, the peak systolic LV longitudinal strain, peak systolic and early diastolic LV longitudinal strain rates, peak systolic and early diastolic LA strains and strain rates, and peak atrial systolic LA strain rate were lower in the patient group. There were correlations between the stiffness β and the age, pulse pressure, LAVI, peak early diastolic LV longitudinal strain rate, and all LA strains and strain rate variables. Multivariate regression analysis indicated that peak early diastolic LV longitudinal strain rate and peak LA strain rate during ventricular systole are defined as strong predictors related to stiffness β. Conclusion: Impaired LA and LV relaxation in the longitudinal direction are early signs of abnormal LA-LV coupling related to arterial stiffness in preclinical patients with cardiovascular risk factors. 2DSTE enables the quantitative assessment of the LA and LV function, and can be considered a sensitive tool for detecting the abnormal LA-LV-arterial coupling. © The Author 2011. Source


Miyoshi H.,Higashi Tokushima Medical Center | Oishi Y.,Higashi Tokushima Medical Center | Mizuguchi Y.,Higashi Tokushima Medical Center | Iuchi A.,Higashi Tokushima Medical Center | And 3 more authors.
Echocardiography | Year: 2013

Background Two-dimensional speckle tracking echocardiography (2DSTE) has recently been applied to evaluate left atrial (LA) function in addition to left ventricular (LV) function. However, whether 2DSTE can provide insight into LA-LV interaction related to an increase in LV pressure overload remains unknown. Methods One hundred five asymptomatic patients with hypertension were studied by conventional, pulsed and tissue Doppler, and 2DSTE. Hypertensive patients were classified into 2 groups according to the ratio of early diastolic to atrial systolic velocity (E/A) of transmitral flow: E/A ≥ 1 (n = 37) and E/A < 1 (n = 68). We used (E/peak early diastolic mitral annular motion velocity [e′])/peak systolic LA strain (S-LAs) and E/e′, as parameters of LA stiffness during ventricular systole and LV diastolic stiffness, respectively. Results The peak early diastolic LV longitudinal strain rate, and peak early diastolic LA strain and strain rate were lower in the E/A < 1 group than in the E/A ≥ 1 group. The E/e′/S-LAs and E/e′ were greater in the E/A < 1 group. In the E/A < 1 group, systolic blood pressure (SBP) correlated with LV wall thickness parameters, A, e′, E/e′, peak early diastolic LV longitudinal strain rate, and E/e′/S-LAs. Multivariate regression analysis indicated that A, E/e′, and E/e′/S-LAs were defined as strong predictors related to SBP. Conclusion In patients with hypertension, an elevation in SBP leads to increased LA stiffness during ventricular systole and LV diastolic stiffness, in association with continued and further advanced LV diastolic dysfunction. 2DSTE is considered a sensitive tool for detecting abnormal LA-LV coupling related to an increased LV pressure overload. © 2013, Wiley Periodicals, Inc. Source

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