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Ozawa T.,Sato Hospital | Wachi E.,Tsuboi Hospital
Gastroenterological Endoscopy | Year: 2012

A 83-year-old man who had undergone endoscopic mucosal resection (EMR) for gastric cancer 35 month previously was admitted to our hospital complaining of sudden epigastric pain and vomiting. Abdominal computed tomography showed a large tumor in the duodenum. Esophagogastroduodenoscopy (EGD) showed drawn folds from the gastric body into pyloric side, and no tumor was seen in the stomach. After pushing the scope gently, a good view was obtained with EGD which showed fresh blood in the duodenal bulb. When the endoscope was returned to the stomach, a type 0-I protrusion of about 30 mm had appeared in the anterior wall of the middle stomach. The diagnosis of early gastric cancer complicated by ball valve syndrome (BVS) was made. Endoscopic submucosal dissection (ESD) was chosen because of bleeding and fibrosis and we were able to perform an en-bloc resection with no complications. Histological examination revealed papillary and tubular adenocarcinoma with an invasion depth of pT1b1 (SM 300 μm). Vascular permeation was positive (V1) and moderate fibrosis was noted in the submucosal layer. Only 5 cases have been reported including our case in which gastric cancer complicated with BVS was resected endoscopically. Source


Yanik T.,Nippon Medical School | Kursungoz C.,Nippon Medical School | Sutcigil L.,Sato Hospital | Ak M.,Tohoku University
Journal of Clinical Psychopharmacology | Year: 2013

The use of antipsychotic drugs has started a new era in the treatment of psychotic disorders. Nevertheless, they cause complications in the long-term treatment, which is mainly weight gain. In this study, we investigated circulating levels of hypothalamic neuropeptides, which are related to appetite regulation, neuropeptide Y (NPY), α-melanocyte-stimulating hormone (α-MSH), cocaine- and amphetamine-regulated transcript (CART), and leptin, in first-attack psychotic patients who were treated with an atypical antipsychotic drug, risperidone, for 4 weeks. We used a case-control association design to compare the neuropeptides in the control group versus before and after treatment of the patient group. Samples were obtained from psychotic patients who were admitted to the Psychiatry Outpatient Clinics, Gulhane School of Medicine, Ankara, Turkey. When compared with the control group, NPY and α-MSH plasma levels of psychotic patients were severely reduced, and the CART levels were substantially increased when they were first diagnosed (before treatment). However, the patients' body mass index and circulating leptin levels were markedly high after the treatment. Circulating levels of those neurohormones were not significantly changed between before and after treatment of the patients. These data demonstrate that peripheral α-MSH and NPY, although reflecting only secretion from peripheral organs, nevertheless, may provide an insight into the patients sympathetic tone and also suggest change of their appetite regulation. α-Melanocyte-stimulating hormone, NPY, and CART plasma levels may be used as a predictor of weight gain in the early treatment of the patients along with the leptin levels. Source


Kawanobe H.,Albion Co. | Hagiya K.,Albion Co. | Someya T.,Albion Co. | Obuchi S.,OMS Medical Laboratory CO. | And 3 more authors.
Japanese Pharmacology and Therapeutics | Year: 2016

Objectives: A single blind test was performed to verify the safety of Extract Rose Drink (hereinafter referred to as ERD) and its efficacy in improving menopausal symptoms and relieving fatigue, when it is taken by drinking in the morning and evening for 60 days. Methods: Seventeen Japanese women (35-55 years old) were instructed to drink one bottle of ERD in every morning and evening for 60 days. A questionnaire survey for menopause symptoms, GHQ-30 survey, keratin observation, skin moisture measurement, urine analysis, hematologic test and special hormone test (ACTH, LH, FSH, Cortisol, serotonin, estradiol) were performed on Day 0 (the first day of the drinking period), Day 30 and Day 60. Results: In the questionnaire survey, 3 of 17 test-subjects showed subjective comprehensive improvement, and 12 of the remaining 14 showed no change. In GHQ-30 survey, 9 test-subjects who were judged to be "mentally unhealthy" on Day 0 were judged to be "mentally healthy" on Day 60. Although some differences were observed in subjective symptoms among the test-subjects, GHQ-30 survey revealed the improvement more objectively. Thus drinking ERD was assessed to have a tendency to improve subjective menopausal symptoms. As for keratinization, the state was improved in 16 of 17 test-subjects mostly depending on the number of times of drinking. The skin moisture increased in all test-subjects. Recovery of disordered skin barrier function is known to be inhibited by chronic stress. Therefore, state of the skin is considered to have been improved as a result of reduced chronic stress owing to drinking ERD. Conclusions: The hematologic data and skin observations suggested that the chronic stress was reduced by intake of ERD. Further, the questionnaire surveys showed improved depressive symptoms. Based on these results, ERD is considered effective in improving depressive state and recovering fatigue although the degree varies with each person's constitution. Furthermore, no changes were noted in blood pressure, heart rate, urinalysis, or hematologic data, showing that ERD is a product having high safety. Source


Ozawa T.,Sato Hospital | Wachi E.,Tsuboi Hospital
Gastroenterological Endoscopy | Year: 2012

A 12-year-old man who had been diagnosed as having a mild clinical stage of the segmental type ulcerative colitis (UC) was maintained with medical therapy. He was admitted complaining of epigastric pain and vomiting after four months. Endoscopic examination showed redness, small white erosions, a diffuse edematous mucosa-like crack with spontaneous bleeding in the entire stomach. Redness was seen in the duodenum, with small white erosions, edematous mucosa and swollen villi. Biopsied specimen revealed numerous inflammatory cells and neutrophils were obtained from a similar crypt abscess in the mucosa. Involvement of Helicobacter pylori and drugs could be ruled out in this case, so it was strongly suspected to be associated with UC. After administration of prednisolone and 5-aminosalicylic acid (750 mg , three times daily) ground to powder, his symptoms and endoscopic abnormalities all disappeared and the histological findings also significantly improved. There have been no reported cases of diffuse ulcerative upper-gastrointestinal mucosal inflammation in segmental type of UC except our case. Source


Takahashi S.,Osaka City University | Hoshino M.,Osaka City University | Takayama K.,Seikeikai Hospital | Iseki K.,Sato Hospital | And 8 more authors.
Osteoporosis International | Year: 2016

Summary: This study demonstrated the predictive values of radiological findings for delayed union after osteoporotic vertebral fractures (OVFs). High-signal changes on T2WI were useful findings. Introduction: The purpose of the present study is to determine predictive radiological findings for delayed union by magnetic resonance imaging (MRI) and plain X-rays at two time points in the acute phase of OVFs. Methods: This multicenter cohort study was performed from 2012 to 2015. A total of 218 consecutive patients with OVFs ≤2 weeks old were enrolled. MRIs and plain X-rays were performed at the time of enrollment and at 1- and 6-month follow-ups. Signal changes on T1-weighted imaging (T1WI) were classified as diffuse low-, confined low-, or no-signal change; those on T2WI were classified as high (similar to the intensity of cerebrospinal fluid), confined low-, diffuse low-, or no-signal change. The angular motion of the fractured vertebral body was measured with X-rays. Results: A total of 153 patients completed the 6-month follow-up. A high-signal change on T2WI was most useful in predicting delayed union. Sensitivity, specificity, and positive predictive values were 53.3, 87.8, and 51.6 % at enrollment and 65.5, 84.8, and 51.4 % at the 1-month follow-up, respectively. The positive predictive value increased to 62.5 % with observation of high- or diffuse low-signal changes at both enrollment and the 1-month follow-up. The cutoff value of vertebral motion was 5 degrees. Sensitivity and specificity at enrollment were 52.4 and 74.1 %, respectively. Conclusions: This study demonstrated the radiological factors predicting delayed union after an OVF. T2 high-signal changes showed the strongest association with delayed union. Consecutive MRIs were particularly useful as a differential tool to predict delayed union following OVFs. © 2016 International Osteoporosis Foundation and National Osteoporosis Foundation Source

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