Takasaki General Medical Center

Takasaki, Japan

Takasaki General Medical Center

Takasaki, Japan
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PubMed | Takasaki General Medical Center, Sapporo Kosei General Hospital, Hiroshima University, Kumamoto Shinto General Hospital and 9 more.
Type: | Journal: Journal of gastroenterology | Year: 2016

DCV-TRIO, a fixed-dose combination of daclatasvir (pangenotypic NS5A inhibitor), asunaprevir (NS3/4A protease inhibitor), and beclabuvir (non-nucleoside NS5B inhibitor), has achieved high rates of sustained virologic response at post-treatment Week 12 (SVR12) in phase 3 studies.In this phase 3 study, DCV-TRIO for 12weeks and daclatasvir plus asunaprevir (DUAL) for 24weeks were studied in Japanese patients infected with HCV genotype 1 (99% genotype 1b).SVR12 rates 95% were achieved in both treatment-naive (N=152) and interferon-experienced (N=65) cohorts treated with DCV-TRIO for 12weeks and were comparable across patient subgroups, including patients aged 65years and those with cirrhosis. DUAL recipients (N=75) had an SVR12 rate of 87%. In the absence of baseline resistance-associated polymorphisms at positions NS5A-Y93H or -L31, SVR12 rates were 98% with DCV-TRIO or DUAL. Among genotype 1b-infected patients with baseline Y93H or L31 polymorphisms, 35/38 (92%) DCV-TRIO recipients, and 7/16 (44%) DUAL recipients achieved SVR12. Adverse events, mostly liver related, led to treatment discontinuation in 10% of DCV-TRIO recipients. In this group, SVR12 was achieved by 3/9 patients who discontinued before Week 4 and by 12/12 patients who completed 4weeks of DCV-TRIO. Treatment-related serious adverse events occurred in 4 and 3% of DCV-TRIO and DUAL recipients, respectively. Seven patients (9%) discontinued DUAL due to adverse events. No deaths occurred.SVR12 was achieved by 96% of Japanese patients with HCV genotype 1 infection after 12weeks of treatment with the DCV-TRIO regimen. DCV-TRIO and DUAL exhibited comparable safety profiles.


PubMed | Gunma Prefectural Cardiovascular Center, Gunma University, Takasaki General Medical Center and Fujioka General Hospital
Type: Controlled Clinical Trial | Journal: European journal of nuclear medicine and molecular imaging | Year: 2016

Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients.In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) < 60 min/ml per 1.73 m(2)] undergoing stress (99m)Tc-tetrofosmin SPECT for suspected or possible ischemic heart disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT.During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n=7; non-fatal myocardial infarction, n=3; hospitalization for heart failure, n=13; cerebrovascular accident, n=1; need for revascularization, n=38; and renal failure, i.e., hemodialysis initiation, n=7). ESV and SSS were associated with CDs (p<0.05), and eGFR and SDS were associated with MACCREs (p<0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p<0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p<0.05).Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD.


Muller U.,University of Leipzig | Matsuo Y.,University of Leipzig | Matsuo Y.,Takasaki General Medical Center | Matsuo Y.,Gunma University | And 5 more authors.
Metabolism: Clinical and Experimental | Year: 2013

Background The noninvasive measurement of endothelial function is a very powerful tool to assess cardiovascular disease. Especially in children this is not an easy task, and therefore an easy method like the Endo-Pat device is helpful. Due to the still existing uncertainties of the validity of endothelial measurement by the Endo-PAT device in children, we thought to analyze the correlation between endothelial functional measurement by Endo-PAT, and the capability of HDL to modify nitric oxide (NO) production by phosphorylation of endothelial nitric oxide synthase at the stimulatory site (Ser1177) and the inhibitory site (Thr495). Methods The reactive hyperemic index (RHI) was measured in 11 school children by the Endo-PAT device. HDL was isolated by ultracentrifugation, and the capability to stimulate eNOS phosphorylation was assessed in cell culture. Results A close correlation between the RHI and the eNOS-Ser1177 phosphorylation (r = 0.66, p = 0.02) and the eNOS-Thr495 phosphorylation (r = -0.60, p = 0.04) was detected. Conclusion The results obtained in our limited study performed in healthy children supports the validity of endothelial function measurement in children using the Endo-PAT device. Nevertheless, studies measuring FMD and the RHI index need to confirm the strength of the Endo-Pat device also in children. © 2013 Elsevier Inc.


Tamaki T.,Gunma University | Ishikawa H.,Gunma University | Takahashi T.,Gunma University | Tamaki Y.,Gunma Prefectural Cancer Center | And 7 more authors.
Brachytherapy | Year: 2012

Purpose: To compare the efficacy and the incidence of complications of high-dose-rate (HDR) and low-dose-rate (LDR) intraluminal brachytherapy (IBT) boost after external beam radiation therapy in patients with superficial esophageal cancer. Methods and Materials: Fifty-four consecutive patients with Stage I thoracic esophageal squamous cell carcinoma who were treated with definitive radiotherapy using IBT between 1991 and 2007 were studied retrospectively. LDR-IBT and HDR-IBT were performed for 19 and 35 patients, respectively. After external beam radiation therapy of 56-60. Gy with a conventional fractionation, LDR-IBT (5. Gy × 2) or HDR-IBT (3. Gy × 3) was given within 2 weeks. The median follow-up was 47 months (7-151 months). Results: Overall, the 5-year overall survival, cause-specific survival (CSS), and locoregional control (LRC) rates were 61%, 86%, and 79%, respectively. The 5-year overall survival, CCS, and LRC rates did not differ significantly between the LDR-IBT and HDR-IBT groups (68% vs. 58% (p= 0.50), 83% vs. 85% (p= 0.63), and 84% vs. 75% (p= 0.42), respectively). Salvage treatment was given in 8 locally recurrent patients, and 6 patients were rescued. The Grade ≥2 late morbidities of esophagus and heart/lung were observed in 5 patients (4 in the LDR-IBT group and 1 in the HDR-IBT group) and 2 patients (one from each group), respectively. Conclusions: In view of the safety profile and effectiveness, our results encourage the continued adoption of HDR-IBT as radiation boost in medically inoperable or elderly superficial esophageal cancer patients undergoing definitive radiotherapy. © 2012 American Brachytherapy Society.


Matsuo Y.,University of Leipzig | Matsuo Y.,Takasaki General Medical Center | Matsuo Y.,Gunma University | Oberbach A.,University of Leipzig | And 13 more authors.
Obesity | Year: 2013

Objective HDL regulates endothelial function via stimulation of nitric oxide production. It is documented that endothelial function is impaired in obese adolescents, and improved by lifestyle interventions (LI). Design and Methods HDL function in obese adolescents and the impact of LI or Roux-en-Y gastric bypass surgery (RYGB) was assessed. HDL was isolated from 14 adolescents with normal body mass index (HDLcontrol), 10 obese (HDL obese) before and after 6 month LI, and five severe obese adolescents before and one year after RYGB. HDL-mediated phosphorylation of endothelial nitric oxide synthase (eNOS)-Ser1177, eNOS-Thr495, and PKC-ßII was evaluated. In addition the HDL proteome was analyzed. Results HDLobese-mediated eNOS-Ser1177 phosphorylation was reduced, whereas eNOS-Thr495 phosphorylation increased significantly when compared to HDLcontrol. No impact of obesity was observed on PKC-ßII phosphorylation. LI and RYGB had no impact on HDL-mediated phosphorylation of eNOS and PKC-ßII. A principle component plot analysis of the HDL particle separated controls and severe obese, whereas the interventions did not trigger sufficient differences to the HDL proteome to permit distinction. Conclusion These results demonstrated that HDL-function is impaired in obese adolescents, and that LI or RYGB did not correct this dysfunction. This might be an argument for developing earlier prevention strategies in obese adolescents to avoid HDL dysfunction. Copyright © 2013 The Obesity Society.


Mangner N.,University of Leipzig | Matsuo Y.,University of Leipzig | Matsuo Y.,Takasaki General Medical Center | Matsuo Y.,Gunma University | And 2 more authors.
Endocrine | Year: 2013

It is well documented in the current literature that chronic heart failure is often associated with cachexia, defined as involuntary weight loss of 5 % in 12 month or less. Clinical studies unraveled that the presence of cachexia decreases significantly mean survival of the patient. At the molecular level mainly myofibrillar proteins are degraded, although a reduced protein synthesis may also contribute to the loss of muscle mass. Endocrine factors clearly regulate muscle mass and function by influencing the normally precisely controlled balance between protein breakdown and protein synthesis The aim of the present article is to review the knowledge in the field with respect to the role of endocrine factors for the regulation of cachexia in patients with CHF and deduce treatment perspectives. © 2012 Springer Science+Business Media, LLC.


PubMed | Takasaki General Medical center, Niigata University and Mie University
Type: | Journal: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis | Year: 2016

We evaluated the diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 232 patients with suspected DIC without hematopoietic injury or infection. The diagnoses of the patients were as follows: DIC (n = 116), pre-DIC (n = 54), and non-DIC (n = 63). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic analysis. The area under the curve and odds ratio for the global coagulation test (GCT) scores in the diagnosis of DIC were high, whereas those for the diagnosis of DIC and pre-DIC were low, suggesting that the addition of a reduced platelet count (RPC), antithrombin (AT), and soluble fibrin (SF)/thrombin AT (TAT) complex was required to diagnose DIC and pre-DIC. When the GCT score with the RPC, AT, and TAT/SF values was used, the cutoff DIC score for the diagnosis of DIC or DIC and pre-DIC was 6 points. For predicting the outcome, a scoring system that used the GCT result was useful, but the addition of RPC, AT, or SF/TAT was not. The modified diagnostic criteria of JSTH, which included the GCT score and the RPC, AT, and TAT/SF values, were useful for diagnosing both DIC and pre-DIC.


Yamagishi T.,Takasaki General Medical Center
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

A 67-year-old female was operated upon because of transthoracic echocardiograms revealing a 13 x 8 mm mass in right atrium. However, there was no mass and was prominent crista terminalis (CT) instead. CT is the largest and strongest fibromuscular bundle in the right atrium, which separates primitive right atrium from the venous sinus. Prominent CT can mimic right atrial mass on transthoracic echocardiography. It was difficult to make a differential diagnosis because prominent CT formed a bridge-like shape in this case. To obtain certain diagnosis, transesophageal echocardiography (TEE) is necessary, and prevalence of three-dimensional (3D)-TEE is expected to improve the accuracy of diagnosis. We report this case as a pitfall of the diagnosis for the right atrial mass.


PubMed | Juntendo University and Takasaki General Medical Center
Type: Journal Article | Journal: Journal of Alzheimer's disease : JAD | Year: 2016

Patients presenting with the classical idiopathic normal pressure hydrocephalus (iNPH) triad often show additional parkinsonian spectrum signs. Accurate differential diagnosis strongly influences the long-term outcome of cerebrospinal fluid (CSF) shunting.The aim of this study was to find potential CSF microRNA (miRNA) biomarkers for NPH mimics with parkinsonian syndromes that can reliably distinguish them from iNPH patients.Two cohorts of 81 patients (cohort 1, n=55; cohort 2, n=26) with possible iNPH who were treated in two centers between January 2011 and May 2014 were studied. In both cohorts, CSF samples were obtained from patients clinically diagnosed with iNPH (n=21 and n=10, respectively), possible iNPH with parkinsonian spectrum (PS) (n=18, n=10, respectively), possible iNPH with Alzheimers disease (AD) (n=16), and non-affected elderly individuals (NC) (n=6). Athree-step qRT-PCR analysis of the CSF samples was performed to detect miRNAs that were differentially expressed in the groups.The expression of hsa-miR-4274 in CSF was decreased in both cohorts of PS group patients (cohort 1: p<0.0001, cohort 2: p<0.0001), and was able to distinguish PS from iNPH with high accuracy (area under the curve=0.908). The CSF concentration of hsa-miR-4274 also correlated with the specific binding ratio of ioflupane (123I) dopamine transporter scan (r=-0.494, p=0.044). By contrast, the level of hsa-miR-4274 was significantly increased in the PS group after CSF diversion.Levels of CSF hsa-miR-4274 can differentiate PS from patients with iNPH, AD, and NC. This may be clinically useful for diagnostic purposes and predicting shunt treatment responses.


PubMed | Takasaki General Medical Center
Type: Case Reports | Journal: Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

A 67-year-old female was operated upon because of transthoracic echocardiograms revealing a 13 x 8 mm mass in right atrium. However, there was no mass and was prominent crista terminalis (CT) instead. CT is the largest and strongest fibromuscular bundle in the right atrium, which separates primitive right atrium from the venous sinus. Prominent CT can mimic right atrial mass on transthoracic echocardiography. It was difficult to make a differential diagnosis because prominent CT formed a bridge-like shape in this case. To obtain certain diagnosis, transesophageal echocardiography (TEE) is necessary, and prevalence of three-dimensional (3D)-TEE is expected to improve the accuracy of diagnosis. We report this case as a pitfall of the diagnosis for the right atrial mass.

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