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Kario K.,Jichi Medical University | Ando S.-I.,Fukuokaken Saiseikai Futsukaichi Hospital | Kido H.,Meimai Central Hospital | Nariyama J.,Osaka General Hospital of West Japan Railway Company | And 7 more authors.
Journal of Clinical Hypertension | Year: 2013

The Ambulatory Blood Pressure Control and Home Blood Pressure (Morning and Evening) Lowering By N-Channel Blocker Cilnidipine (ACHIEVE-ONE) trial is a large-scale clinical study on blood pressure (BP) and pulse rate (PR) in the real world with use of cilnidipine, a unique L/N-type Ca channel blocker, possessing a suppressive action on increased sympathetic activity in patients with essential hypertension. The effects of cilnidipine on morning hypertension were examined. The authors examined 2319 patients treated with cilnidipine for 12weeks. Clinic systolic BP (SBP) decreased by 19.6mm Hg from 155.0mm Hg, whereas morning SBP decreased by 17.0mm Hg from 152.9mm Hg after 12-week cilnidipine treatment. Cilnidipine reduced both morning SBP and PR more markedly in patients with higher baseline morning SBP (-3.2mm Hg and -1.3beats per minute in the first quartile of morning SBP, -30.9mm Hg and -3.2beats per minute in the fourth quartile), and also reduced both morning PR and SBP more markedly in patients with higher baseline morning PR (0.6beats per minute and -15.6mm Hg in <70beats per minute, and -9.7beats per minute and -20.2mm Hg in ≥85beats per minute). Cilnidipine significantly reduced BP and PR in hypertensive patients at the clinic and at home, especially with higher BP and PR in the morning. © 2012 Wiley Periodicals, Inc. Source


Shimizu S.,Osaka General Hospital of West Japan Railway Company | Kobayashi T.,Kitasato University | Tomioka H.,Osaka General Hospital of West Japan Railway Company | Ohtsu K.,Fukuoka University | And 2 more authors.
Journal of Gastroenterology | Year: 2016

Background: Mesenteric phlebosclerosis (MP) is a rare disease characterized by venous calcification extending from the colonic wall to the mesentery, with chronic ischemic changes from venous return impairment in the intestine. It is an idiopathic disease, but increasing attention has been paid to the potential involvement of herbal medicine, or Kampo, in its etiology. Until now, there were scattered case reports, but no large-scale studies have been conducted to unravel the clinical characteristics and etiology of the disease. Methods: A nationwide survey was conducted using questionnaires to assess possible etiology (particularly the involvement of herbal medicine), clinical manifestations, disease course, and treatment of MP. Results: Data from 222 patients were collected. Among the 169 patients (76.1 %), whose history of herbal medicine was obtained, 147 (87.0 %) used herbal medicines. The use of herbal medicines containing sanshishi (gardenia fruit, Gardenia jasminoides Ellis) was reported in 119 out of 147 patients (81.0 %). Therefore, the use of herbal medicine containing sanshishi was confirmed in 70.4 % of 169 patients whose history of herbal medicine was obtained. The duration of sanshishi use ranged from 3 to 51 years (mean 13.6 years). Patients who discontinued sanshishi showed a better outcome compared with those who continued it. Conclusions: The use of herbal medicine containing sanshishi is associated with the etiology of MP. Although it may not be the causative factor, it is necessary for gastroenterologists to be aware of the potential risk of herbal medicine containing sanshishi for the development of MP. © 2016 Japanese Society of Gastroenterology Source


Kario K.,Jichi Medical University | Nariyama J.,Osaka General Hospital of West Japan Railway Company | Kido H.,Meimai Central Hospital | Ando S.-I.,Fukuoka University | And 5 more authors.
Journal of Clinical Hypertension | Year: 2013

The authors examined the effect of cilnidipine, a unique L/N-type calcium channel blocker, on abnormal nocturnal blood pressure (BP) dipping in Japanese hypertensive patients in the real world. The Ambulatory Blood Pressure Control and Home Blood Pressure (Morning and Evening) Lowering by N-Channel Blocker Cilnidipine (ACHIEVE-ONE), a large-scale clinical study, was designed to evaluate the effects of cilnidipine in daily medical practice. Among the study, 24-hour ambulatory BP data were obtained from 615 patients and classified according to their nocturnal dipping status as extreme dippers, dippers, nondippers, or risers. A 12-week treatment with cilnidipine significantly reduced 24-hour BP in all groups (P<.001). Changes in nocturnal systolic BP (SBP) from baseline were -17.9 mm Hg from 154.6 mm Hg in risers and -11.9 mm Hg from 142.1 mm Hg, -6.6 mm Hg from 128.5 mm Hg, and 0.1 mm Hg from 115.8 mm Hg in nondippers, dippers, and extreme dippers, respectively. Changes from baseline in nocturnal SBP reduction rate were 8.2% in risers (P<.001) but -7.0% in extreme dippers (P<.001), while no change was observed in the nighttime SBP reduction rate for the total patients (-0.2%±9.6%, P=617). Cilnidipine partially, but significantly, restored abnormal nocturnal dipping status toward a normal dipping pattern in hypertensive patients. © 2013 Wiley Periodicals, Inc. Source


Fukui M.,Kyoto Prefectural University of Medicine | Tanaka M.,Kyoto Prefectural University of Medicine | Toda H.,Oike Clinic | Okada H.,Kyoto Prefectural University of Medicine | And 6 more authors.
Diabetic Medicine | Year: 2012

Aims Serum androgen concentration is reported to be low in patients with Type2 diabetes. There have been no studies comparing andropausal symptoms such as sleep disturbance, depression, erectile dysfunction and lower urinary tract symptoms simultaneously between men with Type2 diabetes and subjects without diabetes. Methods We compared andropausal symptom scores such as the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, the International Index of Erectile Function and the International Prostate Symptom Score in 296 men with Type2 diabetes and in 267 subjects without diabetes. Furthermore, we evaluated relationships of andropausal symptom scores to various anthropometric factors and compared andropausal symptom scores according to diabetic complications in men with Type2 diabetes. Results Andropausal symptom scores such as the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, the International Index of Erectile Function and the International Prostate Symptom Score were 4.2±2.6 vs. 5.0±3.3, P<0.01 by unpaired Student's t-test, 34.8±8.2 vs. 38.4±9.3, P<0.0001, 11.5±6.4 vs. 9.9±6.9, P<0.01 and 7.3±6.7 vs. 9.0±7.1, P<0.01 in subjects without diabetes and in patients with diabetes, respectively. The Pittsburgh Sleep Quality Index was higher in patients with neuropathy than without. The Self-Rating Depression Scale was higher in patients with advanced retinopathy. The International Index of Erectile Function was lower in patients with advanced retinopathy and nephropathy. The International Index of Erectile Function was lower and the International Prostate Symptom Score was higher in patients with cardiovascular disease than without. Conclusions Our data demonstrated that men with Type2 diabetes have higher prevalence of andropausal symptoms, especially those with diabetic complications. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK. Source


Fujii T.,Nara Medical University | Ishida E.,Osaka General Hospital of West Japan Railway Company | Shimada K.,Nara Medical University | Hirao K.,Hirao Hospital | And 3 more authors.
Cancer Investigation | Year: 2014

In order to study multiple contiguous prostate cancer lesions, we constructed computer-assisted, three-dimensional models of multifocal prostate cancer specimens obtained by radical prostatectomy. We then examined the genetic heterogeneity among the specimens by DNA microarray analysis. Cancer foci with high Gleason patterns were found to occur de novo, whereas those with low Gleason patterns occurred contiguously with cancers of low Gleason patterns. Three-dimensional analysis showed that distinct, noncontiguous cancerous foci were genetically independent and multicentric. In contrast some contiguous multifocal lesions had the same genetic origin. © 2014 Informa Healthcare USA, Inc. Source

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