Ishikawa T.,Saiseikai Niigata Daini Hospital
World Journal of Gastroenterology | Year: 2012
The prognosis of hepatocellular carcinoma (HCC) depends on tumor extension as well as hepatic function. Hepatic functional reserve is recognized as a factor affecting survival in the treatment of HCC; the Child- Pugh classification system is the most extensively used method for assessing hepatic functional reserve in patients with chronic liver disease, using serum albumin level to achieve accurate assessment of the status of protein metabolism. However, insufficient attention has been given to the status of amino acid (AA) metabolism in chronic liver disease and HCC. Fischer's ratio is the molar ratio of branched-chain AAs (BCAAs: leucine, valine, isoleucine) to aromatic AAs (phenylalanine, tyrosine) and is important for assessing liver metabolism, hepatic functional reserve and the severity of liver dysfunction. Although this ratio is difficult to determine in clinical situations, BCAAs/tyrosine molar concentration ratio (BTR) has been proposed as a simpler substitute. BTR correlates with various liver function examinations, including markers of hepatic fibrosis, hepatic blood flow and hepatocyte function, and can thus be considered as reflecting the degree of hepatic impairment. This manuscript examines the literature to clarify whether BTR can serve as a prognostic factor for treatment of HCC. © 2012 Baishideng. All rights reserved.
Ishikawa T.,Saiseikai Niigata Daini Hospital
World Journal of Gastroenterology | Year: 2013
Hepatocellular carcinoma (HCC) is the most common malignancy and the third leading cause of cancer death worldwide. Chronic infection with hepatitis B virus (HBV) and hepatitis C virus accounts for approximately 75%-80% of HCC cases worldwide. In particular, chronic HBV infection is a predominant risk factor for HCC in Asia and Africa. Hepatic resection and radiofrequency ablation are increasingly used for the curative treatment of HCC, and good local control can be achieved. However, the high rate of recurrence is a major obstacle to improving prognosis. A high viral load of HBV DNA is the most important correctable risk factor for recurrence. Furthermore, interferon and/or nucleotide analogues may decrease HBV DNA. Therefore, these drugs may decrease recurrence. In this article, treatment strategies for HBV-related HCC are described in order to reduce recurrence and improve survival. © 2013 Baishideng Publishing Group Co., Limited. All rights reserved.
Suzuki K.,Saiseikai Niigata Daini Hospital
Journal of the Japan Diabetes Society | Year: 2013
We assessed the effectiveness of a simple self-monitored blood glucose device with a function that displays whether the blood glucose level is high or low in different colors (C device). In the first intervention phase, we switched patients from a conventional monochrome-display device to the C device and evaluated the consequences of the switch in diabetics. Two months after switching, we noted an improvement in the patients' awareness of their blood glucose levels. In the second intervention phase, patients were randomly assigned to either an intervention group (56 patients; 60.7 ± 14.8 years of age) in which they entered their blood glucose level according to color using color educational tools, or a non-intervention group (56 patients: 61.0 ± 14.6 years of age) in which patients only measured their blood glucose levels, then the patients' behavioral changes and HbAlc levels were evaluated. As a result, the proportion of patients with behavioral changes in the intervention group was 14 % higher compared to the non-intervention group, while their HbAlc levels were also 0.25 % lower (P<0.01). This suggests that the introduction of the C device and educational intervention with colors using the C device were effective for achieving an improvement in the treatment of diabetes.
Ando N.,Saiseikai Niigata Daini Hospital
Neuro-Ophthalmology Japan | Year: 2012
Psychological care is important in the beginning of a low-vision care plan. If the patient is able to recognize the physician's understanding and concern, the patient can better trust his physician and benefit from the care. Therefore, the physician should be able to recognize the patient's difficulties and empathize with the patient' s situation in order to develop a good relationship between the patient and the medical staff and to initiate the low-vision care smoothly.
Suzuki K.,Saiseikai Niigata Daini Hospital |
Aizawa Y.,Niigata University
Clinical and Experimental Hypertension | Year: 2011
The aim of this study was to evaluate which administration timing of valsartan provides satisfactory blood pressure (BP) control, once daily in the morning, once daily in the evening, or twice daily in total 160 mg. Hypertensive patients with mild-to-moderate diabetic nephropathy were enrolled, but those with more than three anti-hypertensive agents, renal insufficiency (serum creatinine ≥ 3 mg/dL), or hepatic insufficiency were excluded. They were randomized to receive valsartan 160mg once daily in the morning, valsartan 160 mg once daily in the evening, or valsartan 80 mg twice daily for 12 weeks according to a three-period crossover design. Office blood pressure (OBP), home blood pressure (HBP) self-measured by patients, and urinary albumin excretion adjusted by creatinine excretion (UAE) were measured every 12 weeks. In 34 patients, (male: 18, mean age: 57.5 ± 10.3), valsartan with ether all administration timing demonstrated significant reductions in OBP and HBP compared to baseline: valsartan 160 mg once daily in the morning:-12.2/-9.5 mmHg (p < 0.01); valsartan 160 mg once daily in the evening:-14.2/-10.3 mmHg (p < 0.01); valsartan 80 mg twice daily:-15.0/-10.2 mmHg (p < 0.01) There was no statistically significant differences in a decrease in OBP and HBP, and reduction of UAE among three administration timing. In conclusion, these data indicate that the efficacy on BP-lowering does not depend on administration timing of valsartan in patients with diabetic nephropathy. © 2011 Informa Healthcare USA, Inc.