Niigata-shi, Japan
Niigata-shi, Japan

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Iwata M.,University of Toyama | Maeda S.,RIKEN | Kamura Y.,University of Toyama | Takano A.,Saiseikai Takaoka Hospital | And 8 more authors.
Diabetes Care | Year: 2012

OBJECTIVE - We evaluated the clinical usefulness of a genetic risk score (GRS) based on 14 well-established variants for type 2 diabetes. RESEARCH DESIGN AND METHODS - We analyzed 14 SNPs at HHEX, CDKAL1, CDKN2B, SLC30A8, KCNJ11, IGF2BP2, PPARG, TCF7L2, FTO, KCNQ1, IRS-1, GCKR, UBE2E2, and C2CD4A/B in 1,487 Japanese individuals (724 patients with type 2 diabetes and 763 control subjects). A GRS was calculated according to the number of risk alleles by counting all 14 SNPs (T-GRS) as well as 11 SNPs related to β-cell function (β-GRS) and then assessing the association between each GRS and the clinical features. RESULTS - Among the 14 SNPs, 4 SNPs were significantly associated with type 2 diabetes in the present Japanese sample (P < 0.0036). The T-GRS was significantly associated with type 2 diabetes (P = 5.9 × 10-21). Among the subjects with type 2 diabetes, the β-GRS was associated with individuals receiving insulin therapy (b = 0.0131, SE = 0.006, P = 0.0431), age at diagnosis (β = 20.608, SE = 0.204, P = 0.0029), fasting serum C-peptide level (β = 20.032, SE = 0.0140, P = 0.022), and C-peptide index (β = 20.031, SE = 0.012, P = 0.0125). CONCLUSIONS - Our data suggest that the β-GRS is associated with reduced β-cell functions and may be useful for selecting patients who should receive more aggressive β-cell-preserving therapy. © 2012 by the American Diabetes Association.


Omura T.,University of Toyama | Shimada Y.,University of Toyama | Nagata T.,University of Toyama | Okumura T.,University of Toyama | And 6 more authors.
Oncology Reports | Year: 2014

S-1 has been recommended as adjuvant chemotherapy in patients after curative surgery for gastric cancer. However, some patients suffer recurrence even after S-1 adjuvant chemotherapy. The present study was conducted to find a predictive marker of the efficacy of S-1 adjuvant chemotherapy. We examined the microRNA (miRNA) expression of 35 patients who underwent S-1 adjuvant chemotherapy after curative surgery (R0) for pathological stage II or III gastric cancer. miRNAs were extracted from formalin-fixed, paraffin-embedded specimens for analysis and miRNA expression was examined using miRNA oligo chips. Fifteen patients relapsed and 20 did not over 5 years. Five miRNAs (miR-92b, 422a, 4732-5p, 4758-3p and 221) were highly expressed according to the tumor/normal (T/N) ratio in the patients who relapsed but not in those who did not relapse (P-value <0.05) by microarray analysis. If tumors showed high expression of 4 miRNAs (miR-92b, 422a, 4732-5p and 4758-3p) their positive predictive value of relapse was 93.8% and negative predictive value was 92.3%. In this case, their disease-free survival rate and overall survival rate were very poor. Our findings indicate that miR-92b, miR-422a, miR-4732-5p and miR-4758-3p are closely associated with relapse following S-1 adjuvant chemotherapy in gastric cancer.


PubMed | Asahi University, Itoigawa General Hospital, University of Toyama and Saiseikai Toyama Hospital
Type: Journal Article | Journal: Oncology reports | Year: 2013

S-1 has been recommended as adjuvant chemotherapy in patients after curative surgery for gastric cancer. However, some patients suffer recurrence even after S-1 adjuvant chemotherapy. The present study was conducted to find a predictive marker of the efficacy of S-1 adjuvant chemotherapy. We examined the microRNA (miRNA) expression of 35 patients who underwent S-1 adjuvant chemotherapy after curative surgery (R0) for pathological stage II or III gastric cancer. miRNAs were extracted from formalin-fixed, paraffin-embedded specimens for analysis and miRNA expression was examined using miRNA oligo chips. Fifteen patients relapsed and 20 did not over 5 years. Five miRNAs (miR-92b, 422a, 4732-5p, 4758-3p and 221) were highly expressed according to the tumor/normal (T/N) ratio in the patients who relapsed but not in those who did not relapse (P-value <0.05) by microarray analysis. If tumors showed high expression of 4miRNAs (miR-92b, 422a, 4732-5p and 4758-3p) their positive predictive value of relapse was 93.8% and negative predictive value was 92.3%. In this case, their disease-free survival rate and overall survival rate were very poor. Our findings indicate that miR-92b, miR422a, miR-4732-5p and miR-4758-3p are closely associated with relapse following S-1 adjuvant chemotherapy in gastric cancer.


Sato T.,University of Toyama | Kameyama T.,University of Toyama | Ohori T.,Itoigawa General Hospital | Matsuki A.,Itoigawa General Hospital | Inoue H.,University of Toyama
Journal of Atherosclerosis and Thrombosis | Year: 2014

Aim: Epicardial adipose tissue (EAT) is a pathogenic fat depot that may be associated with coronary atherosclerosis and cardiovascular events. Because eicosapentaenoic acid (EPA) has been reported to exert cardiovascular protective effects, we aimed to assess the effects of EPA on the volume of visceral adipose tissue, including EAT and abdominal visceral adipose tissue (AVAT), using multislice computed tomography (CT).Methods: In 30 patients with coronary artery diseases (9 women; mean age, 67.2±5.4 years), EAT and AVAT volumes were compared between the control group (n = 15, conventional therapy) and the EPA group (n = 15, conventional therapy plus purified EPA 1800 mg/day) during a six-month period. EAT was defined as any pixel that had CT attenuation of -150 to -30 Hounsfield units (HU) within the pericardial sac.Results: After the six-month follow-up, the serum EPA level increased from 59.9±18.8 to 177.2±33.3 μg/mL in the EPA group (p<0.01), but no increase was noted in the control group. Similarly, the EPA/arachidonic acid (AA) ratio increased from 0.39±0.12 to 1.22±0.28 in the EPA group (p<0.01), with no significant increase in the control group. The AVAT and EAT volumes decreased in the EPA group but were unchanged in the control group (AVAT, -11.6±17.0 vs. +8.8±13.6 cm2, p<0.01; EAT, -7.3±8.3 vs. +8.7±8.8 cm3, p<0.01). Moreover, the change in the AVAT volume nega- tively correlated with the change in EPA (r =-0.58, p<0.01) and EPA/AA levels (r =-0.53, p<0.01). A similar negative correlation in these parameters was also observed for the EAT volume.Conclusions: Oral intake of purified EPA appears to be associated with reductions in EAT and AVAT volumes. © 2014, Japan Atherosclerosis Society. All rights reserved.


Sato T.,Itoigawa General Hospital | Kameyama T.,University of Toyama | Inoue H.,University of Toyama
Journal of Diabetes and its Complications | Year: 2014

Background HbA1c level represents mean blood glycemic control. 1,5-Anhydro-d-glucitol (1,5-AG) level reflects glycemic fluctuations, a strong risk factor for the development of macroangiopathy. The present study investigated the relationship between serum 1,5-AG levels and macroangiopathy in patients with type 2 diabetes. Methods A total of 115 consecutive patients with type 2 diabetes, aged 45-79 years, were included. HbA1c, 1,5-AG, and lipid profile were measured. Carotid maximum intima-media thickness (IMT) and plaque score (PS) were determined by carotid sonography. An 1,5-AG level < 14.2 μg/mL was used as a predictor of a post-challenge 2-h blood glucose level > 200 mg/dL. Patients were divided into four groups: A (n = 32), HbA1c≥6.5% and 1,5-AG < 14.2 μg/mL; B (n = 23), HbA1c ≥ 6.5% and 1,5-AG ≥ 14.2 μg/mL; C (n = 24), HbA1c < 6.5% and 1,5-AG < 14.2 μg/mL; and D (n = 36), HbA1c < 6.5% and 1,5-AG ≥ 14.2 μg/mL. Results HbA1c level had significant positive correlation with IMT and PS. 1,5-AG level had a significant negative correlation with PS. PS was significantly higher in group C than in group D, but similar to that in group B. In multivariate analysis, HbA1c (β = 0.27, p = 0.03) and 1,5-AG (β = - 0.24, P = 0.04) were independent determinants of PS. Conclusions 1,5-AG level might provide additional information to identify macroangiopathy of patients with type 2 diabetes, especially in those with excellent HbA1c levels. © 2014 Elsevier Inc.


PubMed | University of Toyama and Itoigawa General Hospital
Type: Comparative Study | Journal: Journal of diabetes and its complications | Year: 2014

HbA1c level represents mean blood glycemic control. 1,5-Anhydro-d-glucitol (1,5-AG) level reflects glycemic fluctuations, a strong risk factor for the development of macroangiopathy. The present study investigated the relationship between serum 1,5-AG levels and macroangiopathy in patients with type 2 diabetes.A total of 115 consecutive patients with type 2 diabetes, aged 45-79 years, were included. HbA1c, 1,5-AG, and lipid profile were measured. Carotid maximum intima-media thickness (IMT) and plaque score (PS) were determined by carotid sonography. An 1,5-AG level < 14.2 g/mL was used as a predictor of a post-challenge 2-h blood glucose level > 200 mg/dL. Patients were divided into four groups: A (n=32), HbA1c 6.5% and 1,5-AG<14.2 g/mL; B (n=23), HbA1c 6.5% and 1,5-AG 14.2 g/mL; C (n=24), HbA1c < 6.5% and 1,5-AG <14.2 g/mL; and D (n=36), HbA1c < 6.5% and 1,5-AG 14.2 g/mL.HbA1c level had significant positive correlation with IMT and PS. 1,5-AG level had a significant negative correlation with PS. PS was significantly higher in group C than in group D, but similar to that in group B. In multivariate analysis, HbA1c (=0.27, p=0.03) and 1,5-AG (=-0.24, P=0.04) were independent determinants of PS.1,5-AG level might provide additional information to identify macroangiopathy of patients with type 2 diabetes, especially in those with excellent HbA1c levels.


PubMed | Takaoka City Hospital and Itoigawa General Hospital
Type: | Journal: Case reports in neurological medicine | Year: 2015

We recently experienced two patients with stroke-like symptoms and ascending aortic dissection (AAD) in our outpatient department. Both patients were transferred to our hospital presenting with neurological deficit such as hemiparesis and conjugate deviation. They did not complain from any chest or abdominal pain. Their MRI did not show fresh infarction or main branch occlusion. A chest CT image showed AAD. The former patient was immediately transferred to a tertiary hospital and the latter received conservative management in the cardiovascular department. Discussion. As neither patient was experiencing any pain, we initially diagnosed them with ischemic stroke and began treatment. Fortunately, bleeding complications did not occur. In such cases, problems are caused when intravenous tissue plasminogen activator (t-PA) injection is administered with the aim of reopening the occluded intracranial arteries. In fact, patients with AAD undergoing t-PA injection have been reported to die from bleeding complications without any recognition of the dissection. These findings suggest that confirmation using carotid ultrasound, carotid MR angiography, and a D-dimer test is crucial and should be adopted in emergency departments.


Tazawa K.,Itoigawa General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

A 94-year-old female patient presenting with vomiting and hematemesis, was transferred to our hospital. On a chest computed tomography (CT) image, mediastinal emphysema was seen with a little amount of bilateral pleural effusion, therefore, a diagnosis of spontaneous esophageal rupture was made. It took 6 hours to make a definite diagnosis of this disease, and conservative therapies were done including administration of antibiotics and proton-pump inhibitor. The patient was able to drink water on 4th hospital day, and was discharged on 19th hospital day. At about 2 months after the onset, a gastrointestinal fiberscope showed just only scar at the lower thoracic esophagus.


Tazawa K.,Itoigawa General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

We report a case of left traumatic diaphragmatic hernia in the postoperative state of the lung cancer. A 68-year-old man underwent video-assisted partial resection of the left lung for lung cancer. One year after the operation, he experienced an accident of falling from a tree. Chest radiograph and chest computed tomography revealed the stomach herniating into the left thoracic cavity. An emergent operation was performed by the abdominal approach. The stomach was returned into the abdominal cavity, and the hiatus in the central tendon of the left diaphragm was primarily sutured. The postoperative course was uneventful.


PubMed | Itoigawa General Hospital
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

We report a case of left traumatic diaphragmatic hernia in the postoperative state of the lung cancer. A 68-year-old man underwent video-assisted partial resection of the left lung for lung cancer. One year after the operation, he experienced an accident of falling from a tree. Chest radiograph and chest computed tomography revealed the stomach herniating into the left thoracic cavity. An emergent operation was performed by the abdominal approach. The stomach was returned into the abdominal cavity, and the hiatus in the central tendon of the left diaphragm was primarily sutured. The postoperative course was uneventful.

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