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Moriguchi, Japan

Ishikawa H.,Kyoto Prefectural University of Medicine | Mutoh M.,National Cancer Center Research Institute | Suzuki S.,Nagoya City University | Tokudome S.,Nagoya City University | And 25 more authors.
Gut | Year: 2014

Objective: To evaluate the influence of low-dose, enteric-coated aspirin tablets (100 mg/day for 2 years) on colorectal tumour recurrence in Asian patients with single/multiple colorectal tumours excised by endoscopy. Design: A double-blinded, randomised, placebo-controlled multicentre clinical trial was conducted. Participants: 311 subjects with single/multiple colorectal adenomas and adenocarcinomas excised by endoscopy were enrolled in the study (152 patients in the aspirin group and 159 patients in the placebo group). Enrolment began at the hospitals (n=19) in 2007 and was completed in 2009. Results: The subjects treated with aspirin displayed reduced colorectal tumourigenesis and primary endpoints with an adjusted OR of 0.60 (95% CI 0.36 to 0.98) compared with the subjects in the placebo group. Subgroup analysis revealed that subjects who were non-smokers, defined as those who had smoked in the past or who had never smoked, had a marked reduction in the number of recurrent tumours in the aspirin-treated group. The adjusted OR for aspirin treatment in non-smokers was 0.37 (CI 0.21 to 0.68, p<0.05). Interestingly, the use of aspirin in smokers resulted in an increased risk, with an OR of 3.44. In addition, no severe adverse effects were observed in either group. Conclusions: Low-dose, enteric-coated aspirin tablets reduced colorectal tumour recurrence in an Asian population. The results are consistent with those obtained from other randomised controlled trials in Western countries. © 2014 BMJ Publishing Group Ltd & British Society of Gastroenterology.

Okamoto T.,Tokyo Womens Medical University | Morimoto S.,Tokyo Womens Medical University | Ikenoue T.,Moriguchi Keijinkai Hospital | Furumatsu Y.,Osaka University | Ichihara A.,Tokyo Womens Medical University
American Journal of Nephrology | Year: 2014

Background: Obesity is an independent risk factor for morbidity and mortality in cardiovascular diseases not only in the general population, but also in hemodialysis (HD) patients. We previously reported that an increased visceral fat area (VFA) determined using computed tomography (CT) scans was associated with atherosclerosis in HD patients. However, whether a high VFA is associated with increased cardiovascular mortality in HD patients remains unknown. Therefore, we investigated the relationship between VFA and prognosis in HD patients. Methods: VFA was estimated in 126 patients on maintenance HD using CT scans. These patients were followed for 60 months. Results: Kaplan-Meier analysis revealed that the cardiovascular survival rate was significantly lower in the high-VFA group, with a VFA of 71.5 cm2 or greater, than in the low-VFA group, with a VFA of less than 71.5cm2. In univariate Cox proportional hazards analyses, age, albumin, low-density lipoprotein cholesterol, cardio-thoracic ratio and VFA above 71.5 cm2 were significantly correlated with cardiovascular deaths. In multivariate analyses testing these factors as dependent variables, VFA above 71.5 cm 2 was estimated to be an independent predictor of cardiovascular deaths. Conclusion: These results suggest that an increased VFA is a stronger risk factor for cardiovascular deaths in HD patients. Measuring VFA may be recommended for predicting the risk of cardiovascular diseases in HD patients. © 2014 S. Karger AG, Basel.

Kimata H.,Moriguchi Keijinkai Hospital
European Journal of Gastroenterology and Hepatology | Year: 2010

Background/Objective: Alteration of intestinal flora was involved in the pathogenesis of atopic dermatitis. Patients with atopic dermatitis were less colonized with Lactobacilli or Bifidobacterium, whereas they were more colonized with Staphylococcus aureus or Enterobacteria. Consequently, fecal levels of bacterial metabolite (polyamines) were reduced. In contrast, stress also induced intestinal mucosal dysfunction against bacteria and impaired intestinal barrier function. We studied the effect of relaxation by viewing humorous films on fecal flora and fecal levels of polyamines. Methods: Twenty-four healthy individuals and 24 Patients with atopic dermatitis either viewed seven control nonhumorous films or seven humorous films sequentially for 7 days. Before and after viewing, feces were obtained, and fecal flora and fecal levels of polyamines were assessed. Results: Neither viewing humorous films nor viewing control nonhumorous films had any effect on healthy individuals. In contrast, viewing humorous films (i) increased colonization with lactobacilli and bifidobacterium, (ii) decreased colonization with S. aureus and Enterobacteria, and (iii) increased fecal levels of polyamines; whereas viewing control nonhumorous films failed to do so in Patients with atopic dermatitis. Conclusion: Viewing humorous films may modulate fecal levels of polyamines by restoring intestinal flora in atopic dermatitis. © 2010 Wolters Kluwer Health | Lippincott.

Matsuzawa T.,Saitama Medical UniversitySaitama | Ishida H.,Saitama Medical UniversitySaitama | Yoshida S.,University of Tokyo | Isayama H.,University of Tokyo | And 11 more authors.
Gastrointestinal Endoscopy | Year: 2015

Background Endoscopic self-expandable metal stent placement has been used as an alternative to surgery for malignant colorectal obstruction; however, factors affecting its clinical outcome are unclear. Objective To clarify the short-term safety and efficacy of endoscopic self-expandable metal stent placement for malignant colorectal obstruction and to identify factors associated with its clinical and technical failure. Design Prospective clinical cohort study. Setting Fourteen academic centers and 32 community hospitals. Patients A total of 513 consecutive patients with malignant colorectal obstruction. Intervention Endoscopic self-expandable metal stent placement, sharing of stent placement methods among participating facilities. Main Outcome Measurements The primary endpoint was clinical success, defined as symptom and radiological finding resolution within 24 hours. Secondary endpoints were technical success and adverse events. The follow-up period was 7 days. Results The clinical and technical success rates were 95.5% and 97.9%, respectively. Major adverse events included perforation (2.1%), stent migration (1.0%), and stent occlusion (0.8%). The main causes of perforation were the procedure itself (0.8%) and comorbidities (obstructive colitis and impending perforation) not apparent before stent placement (0.6%). Extrinsic tumor origin was independently associated with the clinical failure after stent placement (odds ratio 4.23; 95% confidence interval, 1.21-14.79; P =.02). Stricture marking trended toward a negative association with technical failure (P =.09). Limitations Noncomparative study. Conclusion Strict inclusion criteria and stricture marking may improve the technical and clinical success of stent placement. © 2015 American Society for Gastrointestinal Endoscopy.

Kinugasa K.,Hoshigaoka Medical Center | Hamada M.,Hoshigaoka Medical Center | Yoneda K.,Moriguchi Keijinkai Hospital | Matsuo T.,Hoshigaoka Medical Center | And 2 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2015

Purpose: The purpose was to evaluate the cross-sectional area changes in hamstring tendon autografts up to 5 years after the anatomic triple-bundle anterior cruciate ligament (ACL) reconstruction. Methods: A total of 178 MRI scans from 139 patients (35 males, 104 females, mean age 30.4 years) with the anatomic triple-bundle ACL reconstructions were obtained to evaluate the cross-sectional area of the ACL grafts. They were classified into seven groups according to the period from reconstruction to MRI evaluation: Group –2 months (m.), Group 3–6 m., Group 7–12 m, Group 1–2 years (y.), Group 2–3 y., Group 3–4 y., and Group 4 y.–. Intra-operatively, the cross-sectional area of the graft was measured directly using a custom-made area micrometre. Post-operatively, the cross-sectional area of the grafts’ mid-substance was measured with oblique axial MRI slices perpendicular to the long axis of the grafts using a digital radiology viewing program. The percent increase in the cross-sectional area was calculated by dividing the post-operative cross-sectional area by the intra-operative cross-sectional area. Results: The mean percent increase in the cross-sectional area in Groups –2 m., 3–6 m., 7–12 m., 1–2 y., 2–3 y., 3–4 y., and 4 y.– was 105.7 ± 14.0, 134.9 ± 20.0, 137.3 ± 27.8, 129.4 ± 22.2, 124.1 ± 20.4, 117.8 ± 16.9, and 117.1 ± 17.2 %, respectively. The percent increase in Groups3–6 m., 7–12 m., and 1–2 y. was significantly greater than in Group –2 m., while that in Group4 y.– was significantly less than in Group7–12 m.Conclusions: The cross-sectional area of the hamstring tendon autografts after the anatomic triple-bundle ACL reconstruction increases over time up to 1 year post-operatively, decreases gradually thereafter, and reaches plateau at around 3 years.Level of evidence: Retrospective case series, Level IV. © 2015 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)

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