Hokuriku Central Hospital

Oyabe, Japan

Hokuriku Central Hospital

Oyabe, Japan

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Oka R.,Hokuriku Central Hospital | Yagi K.,Kanazawa University | Hayashi K.,Kanazawa University | Kawashiri M.-A.,Kanazawa University | And 5 more authors.
Endocrine Journal | Year: 2014

The risk factors for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) have yet to be established. Our aim was to elucidate the predisposing factors for IFG and IGT in Japanese subjects with normal glucose tolerance (NGT). Using a 75 g oral glucose tolerance test (OGTT), we analyzed 604 adults with the ADA-defined NGT. Follow-up glucose tolerance status was determined by 75 g OGTT performed 3.7 yrs later. Glucose-stimulated insulin secretion (GSIS), whole body insulin sensitivity (SI) and beta cell function (BCF) were estimated by Stumvoll indices, ISIMatsuda, and a product of Stumvoll 1st and ISIMatsuda, respectively, and hepatic SI by quantitative insulin sensitivity check index. Logistic regression analysis revealed that attenuated BCF due to low GSIS was an independent risk factor for IFG. Low whole body SI was an additional risk for IGT. Male gender and high BMI were independently related to the progression to both IFG and IGT, whereas a positive diabetes family history was independently related to IGT. The worsening of glucose tolerance at large was predicted with 66% sensitivity by risk engine with GSIS, whole body SI, gender, BMI and glucose. This finding may help when implementing early intervention strategies for diabetes. © The Japan Endocrine Society.


Mabuchi H.,Kanazawa University | Nohara A.,Kanazawa University | Noguchi T.,Kanazawa University | Kobayashi J.,Kanazawa University | And 12 more authors.
Atherosclerosis | Year: 2014

Backgrounds: Familial hypercholesterolemia (FH) is an autosomal dominant disease characterized by hypercholesterolemia, tendon xanthomas, and premature coronary heart disease. FH is caused by mutations of "FH genes," which include the LDL-receptor (LDLR), apolipoprotein B-100 (APOB) or proprotein convertase subtilisin/kexin type 9 (PCSK9). We evaluated the usefulness of FH gene analysis for diagnosing homozygous FH (homo-FH), particularly in cases caused by gain-of-function (g-o-f) mutations in PCSK9 (PCSK9 E32K). Objectives: To evaluate the frequency of homo-FH caused by PCSK9 E32K compared with FH due to other genetic causes and to report the phenotypic features of homo-FH caused by PCSK9 E32K. Methods: Genomic DNA was prepared from white blood cells, and LDLR and PCSK9 mutations were identified using the Invader assay method. Results: Of the 1055 hetero-FH patients, 62 patients (5.9%) carried the PCSK9 E32K mutation, while in the 82 alleles of 41 homo-FH patients, 13 (15.9%) had double mutations of LDLR allele and PCSK9 E32K mutation. Mean plasma total cholesterol (TC) (9.93±2.95mmol/L, mean±SD) in true homo-FH cases with PCSK9 E32K or double hetero-FH cases with PCSK9 E32K and LDLR mutations were significantly lower than those in true homo-FH (18.06±4.96mmol/L) and compound heterozygous cases with LDLR mutations (14.84±1.62mmol/L). Mean plasma TC concentrations in the 59 hetero-FH cases with PCSK9 E32K (7.21±1.55mmol/L) were significantly lower than those (8.94±1.53mmol/L) in the hetero-FH by LDLR mutations. Conclusions: FH caused by PCSK9 g-o-f mutations is relatively common in Japan and causes a mild type of homo- and hetero-FH compared with FH caused by LDLR mutations. © 2014 Elsevier Ireland Ltd.


Fujisawa H.,Kanazawa University | Hasegawa M.,Kanazawa University | Ueno M.,Hokuriku Central Hospital
Journal of Clinical Neuroscience | Year: 2010

Subependymoma is a rare low-grade glioma of the central nervous system that is often asymptomatic and discovered incidentally. If symptomatic, however, its clinical features vary widely. We report and discuss the management of five surgical patients (two males and three females, 27-65 years old). All tumors developed supratentorially around the foramen of Monro, and their diameters ranged from 18 mm to 90 mm. Of the three symptomatic patients, one presented with sudden loss of consciousness despite having only a small tumor, while in contrast, another patient showed only gradual memory disturbance despite having a very large tumor (90 mm diameter). Two patients were asymptomatic but had ventricular dilatation. Gross total resection was achieved via either a transcortical (three patients) or an anterior transcallosal approach (two patients). No recurrence was observed during follow-up. We concluded that as surgery is the only curative treatment for subependymoma, and even a small tumor can present with sudden deterioration, we recommend early and total resection. © 2009 Elsevier Ltd. All rights reserved.


Oka R.,Hokuriku Central Hospital | Aizawa T.,Aizawa Hospital | Yagi K.,Kanazawa University | Hayashi K.,Kanazawa University | And 2 more authors.
Diabetic Medicine | Year: 2014

Aims: To investigate whether the elevation of liver enzymes is associated with the progression from normal to impaired glucose tolerance. Methods: A historical cohort study was conducted in 594 male workers at public schools, who had normal glucose tolerance at baseline. The progression to impaired glucose tolerance and impaired fasting glycaemia during a mean follow-up of 3.1 years was measured using an oral glucose tolerance test. Results: Overall, 141 (23.7%) subjects developed impaired glucose tolerance and 68 (11.4%) subjects developed impaired fasting glycaemia, 23 of whom had combined impaired fasting glycaemia/impaired glucose tolerance. The incidence of impaired glucose tolerance increased significantly with increasing quartiles of serum aspartate aminotransferase, alanine aminotransferase and γ-glutamyltransferase (P for trend <0.01). In Cox proportional hazards regression analysis, after adjusting for comprehensive risk factors, including plasma glucose levels, BMI and homeostatic model assessment of insulin resistance, the risk of progression to impaired glucose tolerance was significantly higher in the highest quartile of alanine aminotransferase than in the lowest quartile (hazard ratio 2.5; 95% CI 1.1-5.7). A significant association between alanine aminotransferase and the progression to impaired glucose tolerance was found after further adjustments for other liver enzymes or after the sample was limited to those with BMI < 25.0 kg/m2 or with fasting plasma glucose < 5.5 mmol/l. Conclusions: A higher level of alanine aminotransferase was independently associated with progression from normal to impaired glucose tolerance in Japanese men. The elevation of alanine aminotransferase may be a change that occurs early in the evolution of diabetes. © 2013 Diabetes UK.


Oka R.,Hokuriku Central Hospital | Yagi K.,Kanazawa University | Sakurai M.,Kanazawa Medical University | Nakamura K.,Kanazawa Medical University | And 5 more authors.
Endocrine Journal | Year: 2012

The aim of this study was to assess the changes in insulin secretion and insulin sensitivity in relation to fasting and 2-hour plasma glucose (PG) levels and to assess the independent contributions of their impairments to non-diabetic hyperglycemia. A total of 2157 Japanese workers (mean age 52.6±7.3 years and mean BMI 23.9±3.2 kg/m 2) underwent an oral glucose tolerance test (OGTT). Of these subjects, 1125 had normal glucose tolerance (NGT), 525 subjects had isolated impaired fasting glucose (IFG), 159 subjects had isolated impaired glucose tolerance (IGT), 263 subjects had combined IFG and IGT, and 85 subjects had newly diagnosed type 2 diabetes. Insulinogenic index and Matsuda insulin sensitivity index (ISI) were signifcantly attenuated in subjects with normal but slightly elevated fasting PG, or in subjects with normal but slightly elevated 2-hour PG. Whereas, InsAUC 120/GluAUC 120 was not signifcantly decreased in those subjects, and signifcant decrease of it was observed exclusively in subjects with abnormal fasting PG (≥ 106 mg/dL) or abnormal 2-hour PG (≥ 221 mg/dL). Using multiple regression analyses, both Matsuda ISI and insulinogenic index were independently correlated with PG concentrations in subjects with IFG and/or IGT, while Matsuda ISI alone was independently correlated with fasting PG concentrations in normoglycemic subjects. In conclusion, both insulinogenic index and Matsuda ISI were signifcantly attenuated in subjects with normal but slightly elevated PG. Lowering of Matsuda ISI was likely to be a strong contributor to 'elevation of fasting PG within the normal range' in this population. © The Japan Endocrine Society.


Oka R.,Hokuriku Central Hospital | Yagi K.,Kanazawa University | Sakurai M.,Kanazawa Medical University | Nakamura K.,Kanazawa Medical University | And 7 more authors.
Journal of Atherosclerosis and Thrombosis | Year: 2012

Aim: The enlargement of visceral adipose tissue (VAT) is considered to mediate the close relationship between obesity and insulin resistance. We aimed to determine whether a stronger association of VAT compared to subcutaneous adipose tissue (SAT) with insulin resistance could be confirmed and generalized in non-diabetic Japanese men and women. Methods: Participants were 912 non-diabetic Japanese (636 men and 276 women, mean age 52.4± 7.0 years, and mean BMI 24.9±3.1 kg/m2). VAT and SAT were measured through the use of computed tomography scanning. Homeostatic model for the assessment of insulin resistance (HOMAIR) and Matsuda insulin sensitivity index (ISI) were calculated based on results from the oral glucose tolerance test. Results: For both genders, subjects in higher tertiles of SAT as well as VAT showed significantly higher levels of HOMA-IR and lower levels of Matsuda ISI (p<0.001). In multiple regression analyses with VAT and SAT included in the model, only VAT, but not SAT, was independently associated with Matsuda ISI in women (p<0.001), whereas both SAT and VAT were independently associated with HOMA-IR and with Matsuda ISI in men (p<0.001). When VAT and waist circumference were jointly included in the model, only VAT, but not waist circumference, was independently associated with Matsuda ISI in women (p<0.001) but not in men. Conclusion: VAT had a stronger association with insulin resistance than SAT or waist circumference in women but not in men. BMI showed a comparable association with insulin resistance to VAT in this population.


PubMed | Hokuriku Central Hospital, Aizawa Hospital and Kanazawa University
Type: Journal Article | Journal: Diabetic medicine : a journal of the British Diabetic Association | Year: 2016

To test the hypothesis that 1-h plasma glucose in an oral glucose tolerance test is a better predictor of the development of diabetes than 2-h plasma glucose, independently of indices of insulin secretion or action in Japanese adults.A historical cohort study was conducted in 1445 Japanese workers who did not have diabetes. The association between 1-h plasma glucose and the development of Type 2 diabetes was analysed.Overall, 95 of the study participants developed Type 2 diabetes during a mean follow-up of 4.5 years. The area under the receiver-operating characteristic curve for 1-h plasma glucose for future diabetes [0.88 (95% CI 0.84-0.91)] was greater than that for 2-h plasma glucose [0.79 (95% CI 0.74-0.84)], and for insulinogenic [0.73 (95% CI 0.68-0.78)] and disposition indices [0.79 (95% CI 0.74-0.84); P < 0.05]. Compared with the first quartile, the hazard ratio for future diabetes in the fourth quartile of 1-h plasma glucose was 42.5 [95% CI 5.7-315.2 (P < 0.05)] and the hazard ratio in the fourth quartile of 2-h plasma glucose was 4.4 [95% CI 1.8-10.8 (P < 0.05)], after adjustments for covariates including fasting plasma glucose. The significance of the elevated hazard ratio in the fourth quartile of 1-h plasma glucose was maintained after adjustments for 2-h plasma glucose, insulinogenic index or disposition index, whereas the elevation of the hazard ratio in the fourth quartile of 2-h plasma glucose was diminished and was no longer significant after adjustments for 1-h plasma glucose.One-hour plasma glucose had a greater association with the future development of Type 2 diabetes than did 2-h plasma glucose, independently of oral glucose tolerance test-derived indices of insulin action in a Japanese population.


PubMed | Hokuriku Central Hospital
Type: Journal Article | Journal: Clinical anatomy (New York, N.Y.) | Year: 2016

The 1998 edition of Terminologia Anatomica introduced some currently used clinical anatomical terms for the pelvic connective tissue or subserous layer. These innovations persuaded the present author to consider a format in which the clinical anatomical terms could be reconciled with those of gross anatomy and incorporated into a single anatomical glossary without contradiction or ambiguity. Specific studies on the subserous layer were undertaken on 79 Japanese women who had undergone surgery for uterine cervical cancer, and on 26 female cadavers that were dissected, 17 being formalin-fixed and 9 fresh. The results were as follows: (a) the subserous layer could be segmentalized by surgical dissection in the perpendicular, horizontal and sagittal planes; (b) the segmentalized subserous layer corresponded to 12 cubes, or ligaments, of minimal dimension that enabled the pelvic organs to be extirpated; (c) each ligament had a three-dimensional (3D) structure comprising craniocaudal, mediolateral, and dorsoventral directions vis--vis the pelvic axis; (d) these 3D-structured ligaments were encoded morphologically in order of decreasing length; and (e) using these codes, all the surgical procedures for 19th century to present-day radical hysterectomy could be expressed symbolically. The establishment of clinical anatomical terms, represented symbolically through coding as demonstrated in this article, could provide common ground for amalgamating clinical anatomy with gross anatomy. Consequently, terms in clinical anatomy and gross anatomy could be reconciled and compiled into a single anatomical glossary.


PubMed | Hokuriku Central Hospital
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2016

A 76-year-old man was referred to our department for an abnormal shadow on a chest X-ray. Computed tomography showed an aberrant artery arising from the descending thoracic aorta to the basal segment of the left lung. The aberrant artery was dilated and tortuous, and its wall had remarkable calcifications. Bronchial branching to the basal segment of the left lung were normal. The diagnosis of anomalous systemic arterial supply to normal basal segment was established, and division of the aberrant artery and left lower lobectomy were performed successfully. His postoperative course was uneventful, and he was discharged on the 14th postoperative day. We describe herein a rare case of the elderly patient surgically treated for this disease along with a brief review of the literatures.


PubMed | Hokuriku Central Hospital and Kanazawa University
Type: Journal Article | Journal: Journal of cardiovascular electrophysiology | Year: 2015

Myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM) usually shows a patchy distribution, which may not be detected by pathological Q waves on 12-lead ECGs. Fragmented QRS complexes (fQRS) reflect intraventricular conduction delay and can be a marker of myocardial fibrosis. We assessed whether fQRS show better correlation with myocardial fibrosis than pathological Qwaves in HCM.This cross-sectional study included 108 patients with HCM who underwent 12-lead ECG and cardiac magnetic resonance imaging with late gadolinium enhancement (LGE-CMR). The number of leads with pathological Q waves was not correlated with the extent of LGE measured at any different standard deviations (SDs) (2, 4, 6, 8, and 10 SD), whereas the number of leads with fQRS showed the best correlation with LGE at 6 SD (r = 0.32, P = 0.0008). Further, the number of leads with fQRS was an independent predictor for the extent of LGE at 6 SD. fQRS showed higher accuracy for detecting myocardial fibrosis defined by LGE at 6 SD than pathological Q waves; the overall sensitivity, specificity, and accuracy of fQRS were 40%, 80%, and 64%, respectively, whereas those of pathological Q waves were 7%, 97%, and 60%, respectively. fQRS in lateral leads showed the highest accuracy (75%), followed by inferior leads (59%) and anterior leads (57%), for detecting LGE at 6 SD in the corresponding left ventricular segment.These findings suggest that fQRS may have a substantially higher sensitivity and diagnostic accuracy compared with pathological Q waves for detecting myocardial fibrosis in HCM.

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