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Nishigaki M.,University of Tokyo | Tokunaga-Nakawatase Y.,University of Tokyo | Nishida J.,Social Insurance Chuo General Hospital | Kazuma K.,University of Tokyo
Journal of Genetic Counseling | Year: 2014

The aim of this study is to investigate the effect of diabetes genetic counseling on attitudes toward diabetes and its heredity in relatives of type 2 diabetes patients. This study was an unmasked, randomized controlled trial at a medical check-up center in Japan. Subjects in this study are healthy adults between 30 and 60 years of age who have a family history of type 2 diabetes in their first degree relatives. Participants in the intervention group received a brief genetic counseling session for approximately 10 min. Genetic counseling was structured based on the Health Belief Model. Both intervention and control groups received a booklet for general diabetes prevention. Risk perception and recognition of diabetes, and attitude towards its prevention were measured at baseline, 1 week and 1 year after genetic counseling. Participants who received genetic counseling showed significantly higher recognition about their sense of control over diabetes onset than control group both at 1 week and 1 year after the session. On the other hand, anxiety about diabetes did not change significantly. The findings show that genetic counseling for diabetes at a medical check center helped adults with diabetes family history understand they are able to exert control over the onset of their disease through lifestyle modification. © 2014 National Society of Genetic Counselors, Inc. Source

Suzuki Y.,Toho University | Motoya S.,Sapporo Kosei General Hospital | Takazoe M.,Social Insurance Chuo General Hospital | Kosaka T.,Yamakawa Clinic | And 3 more authors.
Journal of Crohn's and Colitis | Year: 2013

Background and aims: Current treatments for Japanese patients with active Crohn's disease have not proved optimal, and new treatment options are required. The present study therefore evaluated the efficacy and tolerability of oral budesonide in Japanese patients with mild-to-moderate active Crohn's disease. Methods: In this multicentre, double-blind, randomized, parallel-group, Phase II study, patients (18-65. years) with baseline Crohn's Disease Activity Index (CDAI) score. ≥. 200 were randomized to once-daily (od) oral budesonide 9. mg or 15. mg, or matching placebo, for 8. weeks. Concomitant therapy with sulfasalazine or 5-aminosalicylic acid, and nutritional therapy, was allowed. The rate of remission (defined as CDAI score. ≤. 150) after 8. weeks' treatment (primary variable), health-related quality of life (assessed using the Inflammatory Bowel Disease Questionnaire [IBDQ]), and tolerability were assessed. Results: 77 patients were randomized and 63 completed the study. The proportion of budesonide-treated patients with remission after 8. weeks' treatment was higher compared with placebo (23.1%, 28.0%, and 11.5% for budesonide 9. mg, 15. mg, and placebo, respectively; no significant difference). The mean change from baseline to week 8 in CDAI total score (-. 48.0, -. 58.2, and -. 27.2, respectively) and IBDQ total score (10.8, 23.2, and 6.5, respectively) was greater for budesonide-treated patients than placebo recipients. While budesonide 9. mg and 15. mg demonstrated similar efficacy, budesonide 9. mg caused fewer drug- and glucocorticosteroid-related adverse events and less adrenal suppression. © 2012 European Crohn's and Colitis Organisation. 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

Okada Y.,Yokohama Institute | Okada Y.,University of Tokyo | Yamazaki K.,RIKEN | Umeno J.,RIKEN | And 14 more authors.
Gastroenterology | Year: 2011

Background & Aims: There are many genetic factors that are associated with both ulcerative colitis (UC) and Crohn's disease (CD). However, genetic factors that have distinct effects on UC and CD have not been examined. Methods: We performed a comparative genome-wide association study (GWAS) and a replication study using data from 748 patients with UC and 979 with CD, selected from a Japanese population. We conducted high-resolution (4-digit) genotyping of human leukocyte antigen (HLA) alleles in patients with UC and CD and additional 905 healthy individuals (controls). We performed haplotype-based analysis using data from the GWAS and HLA alleles to associate them with UC or CD. Results: The comparative GWAS and the replication study identified significant associations in the major histocompatibility complex region at 6p21 with UC and CD (rs9271366, P = 1.6 × 1070; odds ratio [OR] = 4.44). Haplotype-based analysis in the major histocompatibility complex region showed that HLA-Cw (*)1202-B (*)5201-DRB1 (*)1502 haplotype was significantly associated with increased risk of UC compared with CD (P = 1.1 × 10-33; OR = 6.58), accounting for most of the associations observed in the GWAS. Compared with the controls, this HLA haplotype significantly increases susceptibility to UC (P = 4.0 × 10-21; OR = 2.65), but reduces risk for CD (P = 1.1 × 10-7; OR = 0.40). Distinct effects of this HLA haplotype on UC and CD were independent of other HLA alleles and haplotypes (P = 2.0 × 10-19 and P = 7.2 × 10-5, respectively). Conclusions: The HLA-Cw (*)1202-B (*)5201-DRB1 (*)1502 haplotype increases susceptibility to UC but reduces risk for CD, based on a GWAS of a Japanese population. © 2011 AGA Institute. Source

Hatada Y.,Social Insurance Chuo General Hospital
Gastroenterological Endoscopy | Year: 2010

Aphthoid ulceration has been regarded as an early macroscopic feature of Crohn's disease (CD) and ulcerative colitis (UC). The important endoscopic findings in this condition are (1) redness and/or white coated change of the ulceration, (2) elevation of the area around the aphthae, and (3) the distributions of the aphthae. Indigo carmine dye spraying is useful for the careful observation of such ulcers. The characteristic findings in the case of early lesions in CD are mild elevation with central depression of the affected surface or ulceration and longitudinal distribution of ulcers, but these findings are not unique to inflammatory bowel disease. Histological findings such as non-caseating epithelioid granulomas provide colonoscopists useful information for the diagnosis of CD. When only aphthous lesions are detected, it is necessary to confirm the diagnosis of IBD, especially CD, on the basis of findings in the upper gastrointestinal tract and small intestine and extraintestinal manifestations. Source

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