Sumitomo Hospital

Ōsaka, Japan

Sumitomo Hospital

Ōsaka, Japan

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Matsuzawa Y.,Sumitomo Hospital | Funahashi T.,Osaka University | Nakamura T.,Kawasaki Hospital
Journal of Atherosclerosis and Thrombosis | Year: 2011

Although abdominal obesity or visceral obesity is considered to be one of the components of metabolic syndrome and to have an important role in a cluster of cardiovascular risks, there is no consensus about the definition and diagnostic criteria for this syndrome, probably because there is considerable disagreement about the location and definition of abdominal obesity or visceral obesity. In this review article, the important role of visceral fat accumulation in the development of a variety of lifestyle-related diseases is shown, including cardiovascular disease based on our clinical studies using CT scans, and the mechanism of these disorders is discussed, focusing on adipocytokines, especially adiponectin. The importance of diagnosing metabolic syndrome, in which visceral fat accumulation plays an essential role in the development of multiple risk factors, should be emphasized because lifestyle modification for the reduction of visceral fat may be very effective for the reduction of risks of this type, namely metabolic syndrome in the narrow sense.


Matsuzawa Y.,Sumitomo Hospital | Matsuzawa Y.,Osaka University
Proceedings of the Japan Academy Series B: Physical and Biological Sciences | Year: 2010

Although obesity is a major background of life style-related diseases such as diabetes mellitus, lipid disorder, hypertension and cardiovascular disease, the extent of whole body fat accumulation does not necessarily the determinant for the occurrence of these diseases. We developed the method for body fat analysis using CT scan and established the concept of visceral fat obesity, in other word metabolic syndrome in which intra-abdominal visceral fat accumulation has an important role in the development of diabetes, lipid disorder, hypertension and atherosclerosis. In order to clarify the mechanism that visceral fat accumulation causes metabolic and cardiovascular diseases, we have analyzed gene expression profile in subcutaneous adipose tissue and visceral adipose tissue. From the analysis, we found that adipose tissue, especially visceral adipose tissue expressed abundantly the genes encoding bioactive substances such as cytokines, growth factors and complements. In addition to known bioactive substances, we found a novel collagen-like protein which we named adiponectin. Adiponectin is present in plasma at a very high concentration and is inversely associated with visceral fat accumulation. Adiponectin has anti-diabetic, antihypertensive and anti-atherogenic properties and recent studies revealed that this protein has an anti-inflammatory and anti-oncogenic function. Therefore hypoadiponectinemia induced by visceral fat accumulation should become a strong risk factor for metabolic and cardiovascular diseases and also some kinds of cancers. In this review article, I would like to discuss the mechanism of life style-related diseases by focusing on the dysregulation of adiponectin related to obesity, especially visceral obesity. © 2010 The Japan Academy.


Funahashi T.,Osaka University | Matsuzawa Y.,Sumitomo Hospital
Best Practice and Research: Clinical Endocrinology and Metabolism | Year: 2014

Adiponectin is an adipocyte-derived plasma protein with cardio-vasculo-protective and anti-diabetic properties. Plasma adiponectin levels are low in patients with the cardiometabolic syndrome (a cluster of multiple risk factors based on visceral fat accumulation). Routine measurement of plasma adiponectin may be useful to encourage life-style changes. © 2013 Elsevier Ltd. All rights reserved.


Kihara S.,Osaka University | Matsuzawa Y.,Sumitomo Hospital
Current Cardiovascular Risk Reports | Year: 2015

The increase in obesity and cardiovascular disease (CVD) is a major problem in developed countries. As a consequence, metabolic syndrome, a disorder that links obesity and CVD, is becoming an important health concern. The underlying mechanisms of metabolic syndrome are considered to be excess visceral fat accumulation and insulin resistance. Visceral adipose tissue essentially takes up and stores excess energy and buffers against hyperglycemia and hyperlipidemia. However, excess visceral fat accumulation causes dysregulation of various adipocyte-derived bioactive molecules (adipocytokines), which leads to chronic systemic low-grade inflammation and CVD. The reduction of visceral fat through lifestyle modification is a potentially useful strategy for the prevention of CVD. Waist circumference is a good surrogate marker of visceral fat accumulation and is useful for monitoring the results of lifestyle changes. Moreover, adipocytokines are useful biomarkers and therapeutic targets for obesity-induced CVD. © 2015, Springer Science+Business Media New York.


Sawa M.,Osaka University | Ueno C.,Osaka University | Gomi F.,Sumitomo Hospital | Nishida K.,Osaka University
Retina | Year: 2014

Purpose: To describe the incidence and characteristics of neovascularization in fellow eyes of Japanese patients with unilateral retinal angiomatous proliferation (RAP). Methods: We retrospectively studied patients with unilateral RAP in one center between 2003 and 2010. The minimal follow-up time was 2 years. The prevalence rates of soft drusen and reticular pseudodrusen in the fellow eyes at the first visit were examined in color fundus photographs and optical coherence tomography images. Stepwise analysis was performed to identify a correlation between the incidence of RAP in the fellow eyes and age, gender, follow-up time, soft drusen, and reticular pseudodrusen. Results: Twenty eyes were included in this study. The mean follow-up time was 49 months (range, 24-108 months). At the first visit, soft drusen was seen in 19 eyes (95%) and reticular pseudodrusen in 11 eyes (55%). Neovascular age-related macular degeneration developed in 10 eyes, including RAP in 9 eyes (45%) and polypoidal choroidal vasculopathy in 1 eye (5%). Stepwise analysis showed that reticular pseudodrusen and longer follow-up time were correlated significantly (P = 0.0384 and P = 0.0341, respectively) with the incidence of RAP. Conclusion: Bilateral RAP developed in almost half of the eyes initially diagnosed with unilateral RAP and the incidence increased with time. Reticular pseudodrusen is a risk factor for bilateral RAP. © by Ophthalmic Communications Society, Inc. Unauthorized reproduction of this article is prohibited.


Asao K.,Osaka University | Gomi F.,Osaka University | Gomi F.,Sumitomo Hospital | Sawa M.,Osaka University | Nishida K.,Osaka University
Retina | Year: 2014

PURPOSE:: To evaluate the effects of additional anti-vascular endothelial growth factor (VEGF) therapy for eyes with a retinal pigment epithelial (RPE) tear after anti-VEGF therapy and treated with additional anti-VEGF injections for recurrent or persistent exudative change. PATIENTS AND METHODS:: Ten eyes (10 patients) followed up for >12 months after a recurrent RPE tear were evaluated retrospectively. The RPE tears on fundus autofluorescence images were measured and changes in the best-corrected visual acuity were evaluated. RESULTS:: Patients were followed up for >12 months (mean, 27.3; range, 13-44 months). During 12 months of follow-up, additional anti-VEGF injections (mean, 3.3; range, 1-7) were administered. The mean size of the RPE tear at the onset was 6.5 mm (range, 1.3-16.3 mm). At 12 months, the RPE tear increased in size >20% in 5 eyes and remained unchanged or decreased in the remaining half of eyes. The mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.43 at the time the RPE tear developed and 0.85 at 12 months. The RPE tear grade and age were prognostic factors for best-corrected visual acuity at 12 months. CONCLUSION:: Under continued anti-VEGF therapy, RPE tears may be stable in size and visual acuity could be maintained in some eyes; however, the visual acuity prognosis is still unsatisfactory in nonresponsive eyes. © 2013 Ophthalmic Communications Society, Inc.


Kishida K.,Osaka University | Funahashi T.,Osaka University | Matsuzawa Y.,Sumitomo Hospital | Shimomura I.,Osaka University
Annals of Medicine | Year: 2012

Atherosclerosis, the underlying cause of atherosclerotic cardiovascular disease (ACVD), develops due not only to a single cardiovascular risk factor but to a variety of complex factors. The concept of the multiple cardiometabolic risk factor clustering syndrome has been proposed as a highly atherogenic state, independent of hypercholesterolemia and smoking. Body fat distribution, especially visceral fat accumulation, is a major correlate of a cluster of diabetogenic, atherogenic, prothrombotic, and proinflammatory metabolic abnormalities referred to as the metabolic syndrome, with dysfunctional adipocytes and dysregulated production of adipocytokines (hypoadiponectinemia). Medical research has focused on visceral adiposity as an important component of the syndrome in Japanese subjects with a mild degree of adiposity compared with Western subjects. For the prevention of ACVD at least in Japan, it might be practical to stratify subjects with multiple risk factors for atherosclerotic cardiovascular disease based on visceral fat accumulation. Visceral fat reduction through health promotion programs using risk factor-oriented approaches may be effective in reducing ACVD events, as well as producing improvement in risks and hypoadiponectinemia. This review article discusses visceral adiposity as a key player in the syndrome. Visceral fat reduction with life-style modification is a potentially useful strategy in the prevention of ACVD in patients with the metabolic syndrome. © 2012 Informa UK, Ltd.


Suzuki M.,Osaka University | Gomi F.,Sumitomo Hospital | Hara C.,Osaka University | Sawa M.,Osaka University | Nishida K.,Osaka University
Retina | Year: 2014

PURPOSE:: To investigate the characteristics of central serous chorioretinopathy complicated by focal choroidal excavation (FCE) using fundus angiography and optical coherence tomography (OCT). METHODS:: A retrospective single-institution study. We reviewed the charts of 7 eyes of 7 patients (5 men, 2 women; mean age, 56.9 ± 9.8 years) with central serous chorioretinopathy complicated by FCE using fundus angiography and OCT. RESULTS:: In six of the seven eyes, the points of leakage were at the edge of FCE on OCT. All FCE lesions were hypofluorescent from early to late phase on indocyanine green angiography. All eyes had late-phase hyperfluorescence on indocyanine green angiography secondary to choroidal vascular hyperpermeability around the FCE lesion. Five fellow eyes also had choroidal vascular hyperpermeability. The mean subfoveal choroidal thicknesses by swept source high-penetration OCT were 377 μm and 333 μm in the fellow eyes, a difference that did not reach significance (P = 0.21). CONCLUSION:: Fundus angiography and OCT showed that choroidal circulatory disruption and atrophic retinal pigment epithelium at the FCE lesion might be related to central serous chorioretinopathy complicated by FCE.© Ophthalmic Communication society,Inc.


Misaki S.,Sumitomo Hospital
[Rinshō ketsueki] The Japanese journal of clinical hematology | Year: 2012

An 81-year-old male had been diagnosed with Waldenström macroglobulinemia (WM) eight years previously and had thus been administered appropriate treatment. Left chylothorax later developed at 3 years and 8 months after the initial diagnosis. He was hospitalized with severe anemia, general fatigue, and appetite loss one year prior to this presentation and died due to a severe fungal infection. Autopsy revealed the presence of 1,300 ml chylothorax and infiltration of lymphoplasmacytic lymphoma (LPL) cells throughout his entire body. LPL cells were found to have invaded the excitation conducting system in the heart. In an evaluation of a resected lung tissue specimen of pneumothorax, subpleural infiltrated lymphoid cells were observed to show immunohistochemical positivity for IgM and bcl-2. Although these lymphoid cells were initially considered to be non-neoplastic lymphocytes, they were later determined to be LPL cells, which thus induced dilatation and proliferation of the lymph vessels. Chylothorax complications in patients with WM are rare events and only six such cases have so far been reported. The present case is considered to be an instructive one in which autopsy suggested the invasion of LPL cells to be involved in the development of arrhythmia, pneumothorax, and chylothorax before death.


Matsuzawa Y.,Sumitomo Hospital
Current Pharmaceutical Design | Year: 2010

Recent studies revealed that adipose tissue is not only an energy storing organ, but is a kind of endocrine organ which secretes a variety of bioactive substances, so-called adipokines or adipocytokines. Visceral fat accumulation is associated with hypersecretion of adipocytokines such as tumor necrosis factor-alpha and plasminogen activator inhibitor-1 which may regulate inflammatory and atherogenic diseases. Adiponectin is a relatively new adipocytokine which we discovered in 1996 and has anti-diabetic, anti-atherogenic and anti-inflammatory properties. Adiponectin is present in plasma at a very high concentration, but in contrast to other adipocytokines, its production is reduced in subjects with visceral fat accumulation and the plasma levels are negatively correlated with visceral adiposity. Hypoadiponectinemia induced by visceral fat accumulation is closely associated with type 2 diabetes, lipid disorders, hypertension and also certain inflammatory diseases. In this review, the mechanisms of obesity-related diseases including nonalcoholic fatty liver disease will be discussed from the aspect of important roles of adipocytokines, especially adiponectin. © 2010 Bentham Science Publishers Ltd.

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