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Inazawa, Japan

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.

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.

Sugiura K.,Nagoya University | Takemoto A.,Yamaguchi University | Yamaguchi M.,Yamaguchi University | Takahashi H.,Asahikawa University | And 22 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 | Matsunaga M.,Inazawa City Hospital | Shibata M.,Inazawa City Hospital | Kusada N.,Inazawa City Hospital | And 6 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.

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).

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