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Kawachinagano, Japan

Kato M.,Osaka University | Nishida T.,Osaka University | Yamamoto K.,Toyonaka Municipal Hospital | Hayashi S.,Toyonaka Municipal Hospital | And 15 more authors.
Gut | Year: 2013

Background: After endoscopic submucosal dissection (ESD) of early gastric cancer (EGC), patients are at high risk for synchronous or metachronous multiple gastric cancers. Objective: To elucidate the time at which multiple cancers develop and to determine whether scheduled endoscopic surveillance might control their development. Design: A multicentre retrospective cohort study from 12 hospitals was conducted. Patients with EGC who underwent ESD with en bloc margin-negative curative resection were included. Synchronous cancer was classified as concomitant cancer or missed cancer. The cumulative incidence of metachronous cancers and overall survival rate were calculated using the Kaplan-Meier method. Results: From April 1999 to December 2010, 1258 patients met the inclusion criteria. Synchronous or metachronous multiple cancers were detected in 175 patients (13.9%) during a mean of 26.8 months. Among the 110 synchronous cancers, 21 were missed at the time of the initial ESD. Many of the missed lesions existed in the upper third of the stomach and the miss rate was associated with the endoscopist's inexperience (<500 oesophagogastroduodenoscopy cases). The cumulative incidence of metachronous cancers increased linearly and the mean annual incidence rate was 3.5%. The incidence rate did not differ between patients with or without Helicobacter pylori eradication. Four lesions (0.32%) were detected as massively invading cancers during the follow-up. Conclusions: Nineteen per cent of synchronous cancers were not detected until the initial ESD. The incidence rate of metachronous cancer after ESD was constant. Scheduled endoscopic surveillance showed that almost all recurrent lesions were treatable by endoscopic resection. Source

Study Design: Review article. Objective: To discuss indications and timing of surgery for patients with significant ossification of the posterior longitudinal ligament (OPLL) who show no or only mild myelopathic symptoms. Summary of Background Data: Among patients with cervical spinal cord injury, the incidence of patients with OPLL is relatively high, and most had no obvious symptoms of cervical myelopathy. Methods: These topics were discussed on the basis of clinical practice guidelines for ossification of the posterior longitudinal ligament as published in 2005 by the Japanese Orthopaedic Association and the Committee on Research into OPLL under the auspices of the Ministry of Health, Labor and Welfare. Results: No evidence supports the usefulness of surgery for patients with significant OPLL without or with only mild cervical myelopathy. Conclusion: "Prophylactic" surgery for patients with significant OPLL without or with only mild cervical myelopathy cannot be recommended on the basis of the existing evidence. Copyright © 2012 Lippincott Williams & Wilkins. Source

Wada Y.,Research Institute for Maternal and Child Health | Tajiri M.,Research Institute for Maternal and Child Health | Tajiri M.,Japan Science and Technology Agency | Ohshima S.,Osaka Minami Medical Center
Journal of Proteome Research | Year: 2010

Profiling of oligosaccharide structures is widely utilized for both identification and evaluation of glycobiomarkers, and site-specific profiling of N-linked glycans of glycoproteins is conducted by mass spectrometry of glycopeptides, However, our knowledge of mucin-type O-glycans including site occupancy and profile variance, as well as attachment sites, is quite limited. Saccharide compositions and site-occupancy of O-glycans were calculated from the signal intensity of glycopeptide ions in the mass spectra and tandem mass spectra from electron transfer dissociation. The results for two major plasma glycoproteins, lgA1 and hemopexin, representing clustered and scattered O-glycan attachments, respectively, indicated that the variability in modifications among individuals is so small as to justify rigorous standards enabling reliable detection of disease-related alterations. Indeed, this method revealed a novel abnormality associated with rheumatoid arthritis: a significant decrease in the -acetylgalactosamine content of lgA1 O-glycans, indicating that the glycosylation abnormality is not limited to hypogalactosylation of lgG N-glycans in chronic inflammatory conditions. © 2010 Amarican Chemical Society. Source

Saeki Y.,Osaka Minami Medical Center | Matsui T.,NHO Sagamihara Hospital | Saisho K.,NHO Miyakonojo Hospital | Tohma S.,NHO Sagamihara Hospital
Expert Review of Clinical Immunology | Year: 2012

In this review, recent changes in both treatments and outcomes of rheumatoid arthritis (RA) in Japan were analyzed by viewing the National Database of Rheumatic Diseases by iR-net, one of the largest clinical databases for RA patients in Japan. Regarding drug therapy, the use of methotrexate has been continuously increasing and has established a place as an anchor drug in the treatment of RA among other nonbiologic disease-modifying antirheumatic drugs; however, the dosage used is still significantly less compared with that of western countries. In addition to methotrexate, the use of tacrolimus has increased gradually. The most prominent observed change is a rapid increase in the use of biologics, which rose to stardom in the treatment of RA in Japan and western countries. These changes in drug therapy could allow us to control RA disease activity more tightly. In line with this, the outcomes of patients with RA in Japan have been improving continuously, both clinically and functionally. Subsequently, the use of both NSAIDs and corticosteroids has decreased. In addition, overall rates of joint operations related to RA have also decreased; in particular, a significant decrease was noticed in the incidence of joint replacement and synovectomy. Overall, the trends in treatments and subsequent outcomes for RA in Japan have exactly followed those seen in western countries. © 2012 Expert Reviews Ltd. Source

Ebina K.,Osaka University | Hashimoto J.,Osaka Minami Medical Center | Shi K.,Osaka University | Kashii M.,Osaka University | And 2 more authors.
Osteoporosis International | Year: 2014

Summary: Patients with rheumatoid arthritis showed greater response to 18-month administration of daily teriparatide especially in the increase of bone formation markers at 1 month and femoral neck bone mineral density at 18 months compared to postmenopausal osteoporosis patients.Introduction: The aim of this study was to evaluate the effects of 18-month administration of daily teriparatide (TPTD) in osteoporosis patients with rheumatoid arthritis (RA) by comparing that of postmenopausal osteoporosis patients (Porosis).Methods: The effects of TPTD were examined between RA (n = 70; age 68.4 years; disease activity score assessing 28 joints with CRP [DAS28-CRP] 2.8; rheumatoid factor [RF] positivity 75.5 %) with 77.1 % of prior bisphosphonate (BP), 84.3 % of oral prednisolone (PSL) (4.4 mg/day at baseline), 25.7 % of biologics, and Porosis (n = 62; age 71.3 years) with 77.4 % of prior BP.Results: Femoral neck (FN) bone mineral density (BMD) increase at 18 months was significantly greater in RA compared to Porosis (4.7 vs. 0.7 %, P = 0.038), whereas it was 9.7 versus 7.9 % (P = 0.736) in the lumbar spine (LS). The increase of bone formation markers (bone alkaline phosphatase [bone ALP] and N-terminal type I procollagen propeptide [PINP]) at 1 month were all significantly greater in RA compared to Porosis. A multivariate logistic regression analysis revealed that the significant indicator of 18-month BMD increase in RA was a 3-month increase of under-carboxylated osteocalcin (ucOC) for LS (β = 0.446, P = 0.005) and baseline ucOC for FN (β = 0.554, P = 0.001), in which both showed significant negative correlation with baseline PSL dose.Conclusions: RA showed greater response to daily TPTD administration, especially in the increase of bone formation markers at 1 month and FN BMD increase at 18 months compared to Porosis. © 2014, International Osteoporosis Foundation and National Osteoporosis Foundation. Source

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