Inazawa City Hospital

Inazawa, Japan

Inazawa City Hospital

Inazawa, Japan
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Yatsuya H.,Fujita Health University Hospital | Yatsuya H.,Nagoya University | Nihashi T.,Nagoya University | Li Y.,Nagoya University | And 12 more authors.
Obesity Research and Clinical Practice | Year: 2014

Background To examine the association of intrahepatic fat with homeostasis model assessment-insulin resistance (HOMA-IR), a marker of insulin resistance, in Japanese adults, and whether intrahepatic fat is associated with insulin resistance independent of waist circumference and other measures of obesity. Methods Fifty-three individuals aged 37-69 were studied. Spectrum obtained using a 3-T magnetic resonance imager was analysed with LCModel to quantify intrahepatic fat. Blood levels of insulin, glucose and other biochemical markers were obtained after 8 h or more fasting. Percent body fat was estimated by a bioelectrical impedance analyzer. HOMA-IR and intrahepatic fat content were log-transformed in the analysis. Results We found a positive correlation between intrahepatic fat and HOMA-IR, which was independent of the anthropometric measures of obesity. In contrast, significant and positive correlations of body mass index, percent body fat, and waist circumference with HOMA-IR were largely explained by their associations with intrahepatic fat. Intrahepatic fat was positively associated with alanine transaminase and triglycerides even after adjustment for HOMA-IR. Conclusion Intrahepatic fat was associated with insulin resistance independent of age, sex, and measures of obesity in Japanese adults. Hypertriglyceridemia and liver injury may directly occur subsequent to intrahepatic fat accumulation. © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.


Ozaki N.,Nagoya University | Nomura Y.,Inazawa City Hospital | Kondo K.,Anjo Kosei Hospital | Oiso Y.,Nagoya University
European Journal of Internal Medicine | Year: 2010

Objective: In a previous study involving 18 hypertensive patients with type 2 diabetes mellitus, we found that replacement of valsartan and candesartan by telmisartan significantly improved insulin sensitivity and significantly increased serum adiponectin levels in the patients. We investigated the effects of 3 angiotensin II type 1 receptor blockers (ARBs)-telmisartan, candesartan, and valsartan-on metabolic parameters in hypertensive patients with type 2 diabetes. Methods: A total of 308 hypertensive patients with diabetes were enrolled in our multicentre, randomized, open-label study. The patients received 40 mg telmisartan, 8 mg candesartan, or 80 mg valsartan for 3 months, and the data of 227 patients (telmisartan: n = 74, candesartan: n = 79, and valsartan: n = 74) were analysed. Results: The systolic and diastolic blood pressures significantly decreased in all the groups at the end of the study; the decrease was comparable among the 3 groups. The changes in fasting plasma glucose, fasting insulin, glycated haemoglobin (HbA1c), total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, adiponectin, free fatty acids, high-sensitivity C-reactive protein (hs-CRP), and plasminogen activator inhibitor-1 (PAI-1) were comparable between the 3 groups. Telmisartan and candesartan administration tended to lower urinary albumin excretion. Conclusions: Low dose telmisartan had a neutral effect on metabolic dysfunction in hypertensive patients with type 2 diabetes; the effect produced by 40 mg telmisartan was comparable with that of 8 mg candesartan and 80 mg valsartan. Failure to detect metabolic differences among the various ARB treatments could have been due to the low statistical power of the study design. © 2010 European Federation of Internal Medicine.


Sugiura K.,Nagoya University | Takemoto A.,Yamaguchi University | Yamaguchi M.,Yamaguchi University | Takahashi H.,Asahikawa University | And 23 more authors.
Journal of Investigative Dermatology | Year: 2013

Generalized pustular psoriasis (GPP) is a rare inflammatory skin disease that can be life-threatening. Recently, it has been reported that familial GPP is caused by homozygous or compound heterozygous mutations of IL36RN. However, the majority of GPP cases are sporadic and it is controversial whether IL36RN mutations are a causative/predisposing factor for sporadic GPP. We searched for IL36RN mutations in two groups of GPP patients in the Japanese population in this study: GPP without psoriasis vulgaris (PV), and GPP with PV. Eleven cases of GPP without PV (GPP alone) and 20 cases of GPP accompanied by PV (GPP with PV) were analyzed. Surprisingly, 9 out of 11 cases of GPP alone had homozygous or compound heterozygous mutations in IL36RN. In contrast, only 2 of 20 cases of GPP with PV had compound heterozygous mutations in IL36RN. The two cases of GPP with PV who had compound heterozygous mutations in IL36RN are siblings, and both cases had PV-susceptible HLA-A*0206. We determined that GPP alone is a distinct subtype of GPP and is etiologically distinguished from GPP with PV, and that the majority of GPP alone is caused by deficiency of the interleukin-36 receptor antagonist due to IL36RN mutations. © 2013 The Society for Investigative Dermatology.


Nakajima S.,Inazawa City Hospital | Nakajima S.,Yokkaichi Minucipal Hospital | Matsunaga M.,Inazawa City Hospital | Shibata M.,Inazawa City Hospital | And 7 more authors.
Journal of the Japan Diabetes Society | Year: 2014

A 35-year-old woman with type 1 diabetes was admitted to our hospital after reporting general fatigue, palpitations and diplopia in February 20xy. At 15 years of age, she was started on treatment with insulin therapy for type 1 diabetes. Five years later, she received a diagnosis of myasthenia gravis (MG'. On admission, a blood test showed apparent Graves' disease, and the patient's glycemic control was poor. Therefore, we began treatment with an insulin pump in addition to thymectomy for MG followed by the administration of tacrolimus and prednisolone as immunosuppressive therapy. Thereafter, tight glycemic control was maintained with adjustments to the basal injection rate. The patient was therefore given a diagnosis of type 3 polyglandular autoimmune syndrome complicated by type 1 diabetes mellitus, MG and Graves' disease in which the difficult to control diabetes was successfully managed with an insulin pump.


Iwata T.,Showa University | Iwata T.,Inazawa City Hospital | Yoshida T.,Showa University | Teranishi M.,Showa University | And 5 more authors.
Thyroid Research | Year: 2011

Background: Pendred syndrome (PDS) is an autosomal recessive disorder characterized by sensorineural hearing impairment and variable degree of goitrous enlargement of the thyroid gland with a partial defect in iodine organification. The thyroid function phenotype can range from normal function to overt hypothyroidism. It is caused by loss-of-function mutations in the SLC26A4 (PDS) gene. The severity of the goiter has been postulated to depend on the amount of dietary iodine intake. However, direct evidence has not been shown to support this hypothesis. Because Slc26a4-null mice have deafness but do not develop goiter, we fed the mutant mice a control diet or an iodine-deficient diet to evaluate whether iodine deficiency is a causative environmental factor for goiter development in PDS. Methods. We evaluated the thyroid volume in histological sections with the use of three-dimensional reconstitution software, we measured serum levels of total tri-iodothyronine (TT3) and total thyroxine (TT4) levels, and we studied the thyroid gland morphology by transmission electron microscopy. Results: TT4 levels became low but TT3 levels did not change significantly after eight weeks of an iodine-deficient diet compared to levels in the control diet animals. Even in Slc26a4-null mice fed an iodine-deficient diet, the volume of the thyroid gland did not increase although the size of each epithelial cell increased with a concomitant decrease of thyroid colloidal area. Conclusions: An iodine-deficient diet did not induce goiter in Slc26a4-null mice, suggesting that other environmental, epigenetic or genetic factors are involved in goiter development in PDS. © 2011 Iwata et al; licensee BioMed Central Ltd.


Suzuki O.,Inazawa City Hospital | Ishii H.,Nagoya University | Kobayashi S.,Inazawa City Hospital
Journal of International Medical Research | Year: 2011

The effects of 24 weeks' treatment with an angiotensin 2 receptor blocker (ARB)/ diuretic combination drug were investigated in an open-label study of 61 patients with stabilized chronic heart failure. Renin-angiotensin-aldosterone system inhibitors were replaced with a tablet containing hydrochlorothiazide 6.25 mg plus candesartan 8 mg, administered orally, once daily, in patients with systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg while under optimal treatment. Both SBP and DBP declined significantly during the ARB/diuretic combination treatment. Diuretics administered previously were discontinued during the study period in 15 patients, decreasing the number of drugs being taken. During ARB/diuretic combination treatment, the blood urea nitrogen level worsened but no significant changes were noted in potassium or estimated glomerular filtration rate, which had been a matter of concern. Additionally, the level of brain natriuretic peptide, an indicator of the severity of heart failure, was improved, indicating effectiveness and safety of the ARB/diuretic combination drug. © 2011 Field House Publishing LLP.


Shibata M.,Inazawa City Hospital | Nakajima S.,Inazawa City Hospital | Itoh M.,Inazawa City Hospital | Takefuji S.,Inazawa City Hospital | And 5 more authors.
Journal of the Japan Diabetes Society | Year: 2015

A 66-year-old type 2 diabetic man had been treated with oral hypoglycemic agents since 1991. In 2003, he was introduced to our hospital, and insulin therapy with sulfonylurea was started. The recent HbA1c levels ranged between 6 % and 7 %. In January 2011, he complained of diplopia, left ocular pain, ptosis and a disturbance of eye movement. Following examinations by an ophthalmologist and neurosurgeon using MRI, he was diagnosed with diabetic mononeuropathy (left oculomotor palsy) and prescribed beraprost. Three months later, the diplopia, left ocular ptosis and disturbance of eye movement induced by the oculomotor palsy improved. However, the left ocular pain persisted, and treatment with pregabalin and carbamazepine was prescribed. Despite receiving this therapy, the patient's pain worsened, and repeat MRI was performed. The cavernous sinus was visualized and found to have a carotid-cavernous sinus fistula on MRA, and his symptoms improved after performing endovascular treatment. This is a rare caseoftype 2 diabetes complicated by a carotid-cavernous sinus fistula that required differentiation from diabetic mononeuropathy (oculomotor palsy).


Tanahashi K.,Nagoya University | Sugiura K.,Nagoya University | Takeichi T.,Nagoya University | Takeichi T.,Inazawa City Hospital | And 4 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2013

Background Mutations in LIPH are a cause of autosomal recessive woolly hair (ARWH). Homozygous c.736T>A (p.Cys246Ser), and compound heterozygous c.736T>A and c.742C>A (p.His248Asn) have been reported in 5 and 7 Japanese children with ARWH respectively. The severity of hypotrichosis is known to be able to change in the clinical course, and the mutation patterns of LIPH do not always correlate with the severity of hypotrichosis in ARWH caused by other mutation sites of LIPH. However, all 12 Japanese children previously reported to have ARWH have shown similar severity of hypotrichosis. Objective In this study, we investigated the clinical features and molecular basis of ARWH in patients including three adults (three adults and two children) from five non-related Japanese families. Methods Five families of Japanese origin that presented with woolly hair were studied. The phenotype was confirmed by clinical examination. Direct automated DNA sequencing of the LIPH gene was performed to identify the mutations in our probands. Results All patients had had woolly hair since birth. Homozygous c.736T>A mutations were found in four patients, including three adult cases, and compound heterozygous c.736T>A and c.742C>A mutations were found in one child patient. The two adults and two children had only sparse scalp hair, although one adult woman had mild hypotrichosis with long hairs. Conclusion Some patients with homozygous c.736T>A can have a mild hypotrichosis phenotype with long hairs in adulthood. © 2012 European Academy of Dermatology and Venereology.


PubMed | Inazawa City Hospital
Type: | Journal: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences | Year: 2010

We report a new treatment for excessive spasticity using an endovascular technique. A 52-year-old woman with intractable spasticity of the hip joints and abdominal muscles was treated with an injection of 70% alcohol into Adamkiewiczs artery, which destroyed the spinal cord fed by Adamkiewiczs artery and cut the reflex arcs of excessive spasticity. Immediately after the treatment a significant change was noticed in muscle tonicity of the lower extremities, and intractable spasticity disappeared. Skin necrosis and muscle damage occurred because of the alcohol that leaked into the muscle branch of the subcostal artery. However, these complications could be treated by simple necrotomy. No recurrence was observed during the follow-up period. We believe this endovascular treatment will become a new strategy for excessive spasticity arising from spinal cord injury.


PubMed | Inazawa City Hospital
Type: Journal Article | Journal: The Journal of international medical research | Year: 2011

The effects of 24 weeks treatment with an angiotensin 2 receptor blocker (ARB)/diuretic combination drug were investigated in an open-label study of 61 patients with stabilized chronic heart failure. Renin-angiotensin-aldosterone system inhibitors were replaced with a tablet containing hydrochlorothiazide 6.25 mg plus candesartan 8 mg, administered orally, once daily, in patients with systolic blood pressure (SBP) 140 mmHg or diastolic blood pressure (DBP) 90 mmHg while under optimal treatment. Both SBP and DBP declined significantly during the ARB/diuretic combination treatment. Diuretics administered previously were discontinued during the study period in 15 patients, decreasing the number of drugs being taken. During ARB/diuretic combination treatment, the blood urea nitrogen level worsened but no significant changes were noted in potassium or estimated glomerular filtration rate, which had been a matter of concern. Additionally, the level of brain natriuretic peptide, an indicator of the severity of heart failure, was improved, indicating effectiveness and safety of the ARB/diuretic combination drug.

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