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Okinawa, Japan

Uezu Y.,Uezu Naika Clinic | Tanaka H.,Tanaka Clinic | Yogi H.,Nanbu Hospital | Yamazato M.,Yonabaru chuo Hospital | And 8 more authors.
Journal of the Japan Diabetes Society | Year: 2012

We conducted a cross-sectional study of type 2 diabetic nephropathy prevalence and treatment goal achievement in Okinawa Nanbu in June 2008. Subjects numbering 1,279 had type 2 diabetes and were seen at 9 clinics or hospitals in Okinawa Nanbu. Their mean age was 61.9 (SD 11.8), systolic blood pressure 131.2 (14.7) mmHg, diastolic blood pressure 74.1 (10.0) mmHg, HbAlc 7.1(1.5) % (JDS), total cholesterol 195.6 (33.7) mg/dl, low-density lipoprotein (LDL) cholesterol 112.4 (29.6) mg/dl, and serum creatinine 0.95 (0.68) mg/dl. We set the treatment goal at <6.5 % for HbAlc, < 130/80 mmHg for blood pressure, and < 100 mg/dl for serum LDL cholesterol. The proportion of those achieving the treatment goal was 40.3 % for HbAlc, 37.9 % for blood pressure, and 32.1 % for lipids. The prevalence of diabetic nephropathy stage 1 was 55.4 %, stage 2 25.3 %, stage 3 16.6 %, and stage 4 2.7 %. Diabetic nephropathy prevalence above stage 2 was high in Okinawa, emphasizing the need it for detecting diabetic nephropathy early and treating it aggressively and multifactorially. Source

Kozuka C.,University of Ryukyus | Yabiku K.,University of Ryukyus | Sunagawa S.,University of Ryukyus | Ueda R.,University of Ryukyus | And 11 more authors.
Diabetes | Year: 2012

Brown rice is known to improve glucose intolerance and prevent the onset of diabetes. However, the underlying mechanisms remain obscure. In the current study, we investigated the effect of brown rice and its major component, γ-oryzanol (Orz), on feeding behavior and fuel homeostasis in mice. When mice were allowed free access to a brown rice - containing chow diet (CD) and a high-fat diet (HFD), they significantly preferred CD to HFD. To reduce hypothalamic endoplasmic reticulum (ER) stress on an HFD, mice were administered with 4-phenylbutyric acid, a chemical chaperone, which caused them to prefer the CD. Notably, oral administration of Orz, a mixture of major bioactive components in brown rice, also improved glucose intolerance and attenuated hypothalamic ER stress in mice fed the HFD. In murine primary neuronal cells, Orz attenuated the tunicamycin-induced ER stress. In luciferase reporter assays in human embryonic kidney 293 cells, Orz suppressed the activation of ER stress - responsive cis-acting elements and unfolded protein response element, suggesting that Orz acts as a chemical chaperone in viable cells. Collectively, the current study is the first demonstration that brown rice and Orz improve glucose metabolism, reduce hypothalamic ER stress, and, consequently, attenuate the preference for dietary fat in mice fed an HFD. © 2012 by the American Diabetes Association. Source

Hisama S.,Health Insurance Hitoyoshi General Hospital | Kimura M.,Health Insurance Hitoyoshi General Hospital | Nishimura T.,Health Insurance Hitoyoshi General Hospital | Matsushita H.,Health Insurance Hitoyoshi General Hospital | And 6 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2010

A 65-year-old man suffering from acute pancreatitis underwent MRI scanning, which revealed a low signal on the T1 and T2 sequences, and hypovascularity in arterial phase in the head of the pancreas. This corresponded to the area showing the absence of the lower common bile duct. FDG-PET was highly suggestive of pancreatic cancer (T4N1M0, Stage IVa) with lymph node metastasis. He was treated with systemic chemotherapy using gemcitabine (GEM) followed by radiotherapy. His symptoms gradually improved with a reduction in size of the primary lesion. The patient has been receiving systemic chemotherapy using S-1 without recurrence. Source

Sakumoto T.,Tomishiro Central Hospital | Tokunaga Y.,ALBA OKINAWA CLINIC | Tanaka H.,Tanaka Clinic | Nohara M.,Tomishiro Central Hospital | And 4 more authors.
Reproductive Medicine and Biology | Year: 2010

Obesity, which disturbs lipid and glucose metabolism, is a recent medical concern. It threatens human health and also has adverse effects on reproductive functions by causing insulin resistance/hyperinsulinemia, especially in women with polycystic ovary syndrome (PCOS). For PCOS patients to prevent these adverse effects, it is important to take into account improving their lifestyles by exercise and proper diets. The relationship between insulin resistance/hyperinsulinemia and reproductive disorders should be understood as fully as possible in order to provide effective treatment. It is well known that insulin resistance and compensatory hyperinsulinemia can be triggered by obesity with visceral fat accumulation. Hyperinsulinemia affects granulosa cells in small follicles and theca cells. This condition induces early response to luteinizing hormones on granulosa cells of small follicles and causes premature differentiation of these cells, which eventually results in anovulation. For improvement of anovulation because of hyperinsulinemia, insulin-sensitizing agents (biguanide and thiazolidinedione derivatives) are useful. Hyperinsulinemia may adversely affect the endometrial functions and environment, and evoke implantation disturbance. Treatment with an insulin-sensitizing agent (metformin) improves the levels of glycodelin, insulin-like growth factor binding protein 1, and blood flow in spiral arteries during the peri-implantation period. It supports endometrial function, improves the endometrial environment, and facilitates embryo implantation. The rate of early pregnancy loss during the first trimester is 30-50% in women with PCOS, which is threefold higher than for normal women. Metformin treatment improves the levels of insulin, the homeostasis model assessment for insulin resistance, and plasminogen activator inhibitor activity, and decreases early pregnancy loss. It goes without saying that lifestyle change is fundamental for improving reproductive performance in addition to treatment with insulin-sensitizing agents. © 2010 Japan Society for Reproductive Medicine. Source

Kusachi S.,Toho University | Sumiyama Y.,Toho University | Takahashi Y.,Showa University | Kato K.,Tanaka Clinic | And 4 more authors.
Journal of Infection and Chemotherapy | Year: 2012

Therapeutic options for postoperative infection in gastrointestinal surgery are limited. To identify new treatment alternatives, the Japan Society for Surgical Infection conducted a multicenter prospective, randomized, controlled clinical trial comparing the efficacy of intravenous ciprofloxacin (CIP IV) and intravenous meropenem (MEM IV). Between July 2005 and May 2008, the trial recruited patients who developed postoperative infection or had suspected infectious systemic inflammatory response syndrome after elective clean-contaminated gastrointestinal surgery. All patients had received prophylactic postoperative antibiotic treatment. Patients received either intravenous CIP IV 300 mgb.i.d. orMEMIV500 mgb.i.d.Atotal of 205 patients from 31 institutions were enrolled. Of these, 101 were randomized to CIP IV and 104 toMEMIV. There were 100 and 102 in the intent-to-treat (ITT)/safety population and 75 and 77 in the per-protocol (PP) population. There was no significant difference between CIP IV and MEMIV in terms of clinical efficacy, bacteriological efficacy, incidence of adverse drug reactions, duration of antimicrobial treatment, or relapse/reactivation. Overall clinical success PP population) was high in both treatment groups: 85.3% (64/75) for CIP IV and 89.6% (69/77) for MEM IV, although the non-inferiority of CIP IV was not demonstrated (difference -4.3%, 95% CI -14.8, 6.2). In patients who had undergone upper gastrointestinal surgery, success was 88.5% (23/26) for CIP IV and 85.2% (23/27) for MEM IV. Intravenous ciprofloxacin is as effective as intravenous meropenem in the empiric therapy of postoperative infection after gastrointestinal surgery. © Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases 2011. Source

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