Tokyo Postal Services Agency Hospital

Tokyo, Japan

Tokyo Postal Services Agency Hospital

Tokyo, Japan
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Chihara Y.,Sensory Medical | Chihara Y.,Raffles Hospital | Chihara Y.,Tokyo Postal Services Agency Hospital | Sato A.,Nihon University | And 6 more authors.
Experimental Brain Research | Year: 2013

First-generation H1-antihistamines are known to cause fatigue and drowsiness, due to their poor receptor selectivity and their high penetration rate of the blood-brain barrier. However, little is known about the effects of first-generation H1-antihistamines on postural stability. The purpose of this study was to evaluate the effects of d-chlorpheniramine on postural stability using posturography with and without foam rubber. A double-blind study with three parallel groups was conducted. Twenty-seven healthy young volunteers (mean age 21.9 years) were recruited and orally administered d-chlorpheniramine, 2 or 4 mg, or placebo. Postural sway was measured every hour up to 8 h after administration. Two-legged stance tasks were performed by each subject in four conditions: eyes open or eyes closed and with or without foam rubber. Inter-group comparisons showed that the group receiving 4-mg d-chlorpheniramine showed significantly larger sway in the eyes open with foam rubber condition (visual and vestibular information available, somatosensory information reduced). Inter-subject analysis in the 4-mg d-chlorpheniramine group showed that the effect of d-chlorpheniramine on postural control was variable. Our results suggest that among the three main sensory systems responsible for postural control (visual, vestibular, and somatosensory), d-chlorpheniramine may have a larger effect on the visual and/or vestibular systems in susceptible individuals. © 2013 Springer-Verlag Berlin Heidelberg.


Kitamoto A.,Kyoto University | Kitamoto T.,Kyoto University | Nakamura T.,National Defense Medical College | Matsuo T.,University of Tsukuba | And 25 more authors.
Journal of Atherosclerosis and Thrombosis | Year: 2016

Aim: Visceral fat accumulation contributes to the development of metabolic syndrome. As visceral fat accumulation increases, adiponectin levels decrease; therefore, adiponectin provides a link between visceral fat accumulation and metabolic disorders. Genome-wide association studies (GWASs) have identified genetic variations in the cadherin 13 (CDH13) gene that are associated with adiponectin levels. Methods: We investigated whether single nucleotide polymorphisms (SNPs) in CDH13 was associated with adiponectin levels and metabolic syndrome traits independent of the visceral fat area (VFA), as measured using computed tomography (CT) in 945 Japanese individuals. Results: We found that three CDH13 SNPs reported by recent GWASs (i.e., rs3865188, rs4783244, and rs12051272) were significantly associated with higher adiponectin levels (P<1×10-14), even after adjustment for VFA. However, these adiponectin-inducing alleles of CDH13 SNPs were significantly associated with traits consistent with deteriorating metabolic symptoms, such as higher fasting insulin, homeostasis model assessment–insulin resistance (HOMA-IR) scores, and triglycerides and lower highdensity lipoprotein (HDL)-cholesterol levels, similar to increasing VFA and decreasing adiponectin levels. Conclusion: These results suggested that CDH13 SNPs cause an adiponectin-resistant status to compensate for increasing adiponectin levels and could result in the deterioration of metabolic syndrome traits. © 2016, Japan Atherosclerosis Society. All rights reserved.


Hotta K.,Kyoto University | Kitamoto A.,Kyoto University | Kitamoto T.,Kyoto University | Mizusawa S.,Kyoto University | And 30 more authors.
Journal of Atherosclerosis and Thrombosis | Year: 2013

Aim: Visceral fat accumulation plays an integral role in morbidity and mortality rates by increasing the risk of developing metabolic disorders such as type 2 diabetes, dyslipidemia, and hypertension. New genetic loci associated with fat distribution, measured by waist-hip ratios and computed tomography (CT), have recently been identified by genome-wide association studies in European-descent populations. This study used CT to investigate whether single nucleotide polymorphisms (SNPs) that confer susceptibility to fat distribution are associated with visceral fat area (VFA) and subcutaneous fat area (SFA) in the Japanese population. Methods: We measured the VFAs and SFAs of 1424 obese Japanese subjects (BMI ≥25 kg/m2, 635 men and 789 women) that were genotyped at 15 SNPs, namely, TBX15 rs984222, DNM3 rs1011731, LYPLAL1 rs4846567, GRB14 rs10195252, NISCH rs6784615, ADAMTS9 rs6795735, CPEB4 rs6861681, LY86 rs1294421, VEGFA rs6905288, RSPO3 rs9491696, NFE2L3 rs1055144, ITPR2 rs718314, HOXC13 rs1443512, ZNRF3 rs4823006 and THNSL2 rs1659258. Results: The G-allele of LYPLAL1 rs4846567 was borderline associated with an increased ratio of VFA to SFA (V/S ratio; p=0.0020). LYPLAL1 rs4846567 had a stronger effect on the V/S ratio in women (p=0.0078) than in men (p= 0.12); however, neither result was significant after Bonferroni correction for multiple comparisons. NISCH rs6784615 was nominally associated with increased VFA (p=0.040) and V/S ratio (p= 0.020). The other SNPs analyzed were not significantly associated with body mass index (BMI), VFA, or SFA. Conclusion: Our results suggest that LYPLAL1 rs4846567 and NISCH rs6784615 may influence fat distribution in the Japanese population.


Hotta K.,Kyoto University | Kitamoto T.,Kyoto University | Kitamoto A.,Kyoto University | Mizusawa S.,Kyoto University | And 26 more authors.
Journal of Human Genetics | Year: 2011

Metabolic syndrome is defined as a cluster of multiple risk factors, including central obesity, dyslipidemia, hypertension and impaired glucose tolerance, that increase cardiovascular disease morbidity and mortality. Genetic factors are important in the development of metabolic syndrome, as are environmental factors. However, the genetic background of metabolic syndrome is not yet fully clarified. There is evidence that obesity and obesity-related phenotypes are associated with variations in several genes, including NEGR1, SEC16B, TMEM18, ETV5, GNPDA2, BDNF, MTCH2, SH2B1, FTO, MAF, MC4R, KCTD15, SCG3, MTMR9, TFAP2B, MSRA, LYPLAL1, GCKR and FADS1. To investigate the relationship between metabolic syndrome and variations in these genes in the Japanese population, we genotyped 33 single-nucleotide polymorphisms (SNPs) in 19 genes from 1096 patients with metabolic syndrome and 581 control individuals who had no risk factors for metabolic syndrome. Four SNPs in the FTO gene were significantly related to metabolic syndrome: rs9939609 (P=0.00013), rs8050136 (P=0.00011), rs1558902 (P=6.6 × 10 -5) and rs1421085 (P=7.4 × 10 -5). rs3764220 in the SCG3 gene (P=0.0010) and rs2293855 in the MTMR9 gene (P=0.0015) were also significantly associated with metabolic syndrome. SNPs in the FTO, SCG3 and MTMR9 genes had no SNP × SNP epistatic effects on metabolic syndrome. Our data suggest that genetic variations in the FTO, SCG3 and MTMR9 genes independently influence the risk of metabolic syndrome. © 2011 The Japan Society of Human Genetics All rights reserved.


Ohtsuki M.,Jichi Medical University | Terui T.,Nihon University | Ozawa A.,Tokai University | Morita A.,Nagoya City University | And 9 more authors.
Journal of Dermatology | Year: 2013

The clinical use of adalimumab and infliximab, human anti-tumor necrosis factor (TNF)-α monoclonal antibodies, for psoriasis began in January 2010. In January 2011, ustekinumab, a human anti-interleukin-12/23p40 (IL-12/23p40) monoclonal antibody, was newly approved as the third biologic with an indication for psoriasis. While all of these biologics are expected to exhibit excellent therapeutic effect for psoriasis and to contribute to the improvement of quality of life in patients, these drugs require careful safety measures to prevent adverse drug reactions, such as serious infections. The new guidance, an English version prepared by revising the Japanese Guidance/Safety Manual for Use of Biologics for Psoriasis 2011 (in Japanese), is intended to provide up-to-date, evidence-based recommendations and safety measures on the use of biologics, and describes the optimal use of the three biologics, medical requirements for facilities for using biologics, details of safety measures against reactivation of tuberculosis and hepatitis B virus infection, and recommendable combination therapies with biologics. © 2013 Japanese Dermatological Association.


Hotta K.,RIKEN | Nakamura M.,RIKEN | Nakamura T.,National Defense Medical College | Nakamura T.,RIKEN | And 28 more authors.
Journal of Human Genetics | Year: 2010

The predominant risk factor of metabolic syndrome is intra-abdominal fat accumulation, which is determined by waist circumference and waist-hip ratio measurements and visceral fat area (VFA) that is measured by computed tomography (CT). There is evidence that waist circumference and waist-hip ratio in the Caucasian population are associated with variations in several genes, including neurexin 3 (NRXN3), transcription factor AP-2β (TFAP2B), methionine sulfoxide reductase A (MSRA), lysophospholipase-like-1 (LYPLAL1), fat mass and obesity associated (FTO) and melanocortin 4 receptor (MC4R) genes. To investigate the relationship between VFA and subcutaneous fat area (SFA) and these genes in the recruited Japanese population, we genotyped 8 single-nucleotide polymorphisms (SNPs) in these 6 genes from 1228 subjects. Multiple regression analysis revealed that gender, age, and rs1558902 and rs1421085 genotypes (additive model) in FTO were significantly associated with body mass index (BMI; P=0.0039 and 0.0039, respectively), SFA (P=0.0027 and 0.0023, respectively) and VFA (P=0.045 and 0.040, respectively). However, SNPs in other genes, namely, NRXN3, TFAP2B, MSRA, LYPLAL1 and MC4R were not significantly associated with BMI, SFA or VFA. Our data suggest that some SNPs, which were identified in genome-wide studies in the Caucasians, also confer susceptibility to fat distribution in the Japanese subjects. © 2010 The Japan Society of Human Genetics All rights reserved.


Shimizu J.,University of Tokyo | Hatanaka Y.,Teikyo University | Hasegawa M.,University of Tokyo | Iwata A.,University of Tokyo | And 12 more authors.
Neurology | Year: 2010

Background: Interferon-β-1b (IFNβ-1b) has been used to prevent exacerbation of relapsing-remitting multiple sclerosis (RRMS) including optic-spinal multiple sclerosis (OSMS) in Japan. We encountered 2 patients with OSMS with unexpectedly severe exacerbation soon after the initiation of IFNβ-1b therapy. The experience urged us to retrospectively review the patients with RRMS who had been treated with IFNβ-1b to identify similar cases. Methods: At neurologic departments of 9 hospitals, the medical records of 56 patients with RRMS were reviewed to identify those who showed severe exacerbation soon after the initiation of IFNβ-1b therapy. Results: Of 56 patients with RRMS, we identified 7 who experienced severe exacerbation (exacerbation with increased scores of Expanded Disability Status Scale ≧7.0) within 90 days of the initiation of IFNβ-1b therapy. In all 7 patients, the exacerbations after the initiation of IFNβ-1b therapy were more severe than those experienced by the individual patients before the use of IFNβ-1b, and seemed to have occurred unexpectedly in a short time after the initiation of INFβ-1b therapy. A retrospective analysis revealed that all 7 patients had antibodies toward aquaporin 4, and the clinical features of all 7 patients after the exacerbation were consistent with those of neuromyelitis optica (NMO) spectrum. Conclusions: Our study suggests that IFNβ-1b may trigger severe exacerbation in patients with the NMO spectrum. In INFβ-1b therapy, cases in NMO spectrum should be carefully excluded. Copyright © 2010 by AAN Enterprises, Inc.


Omura G.,Saitama University | Fukuoka O.,Tokyo Postal Services Agency Hospital | Suzuki M.,Gunma Prefectural Cancer Center
Journal of Otolaryngology of Japan | Year: 2010

We report a case of primary syphilis with initial lower-lip sclerosis. 54-year-old man seen for a left lower-lip lesion was found in serological testing to have elevated syphilis-rapid plasma regain (STS-RPR) and treponema pallidum lipid antigen (TPLA), diagnosed as primary syphilis. Following four weeks of 1500 mg/day amoxicillin administration, the lesion had almost disappeared. Serological data had improved to within the negative range six months after antibiotic treatment started. This case underscores the need to recognize syphilis of the lip even in the outpatient setting.


Chihara Y.,University of Tokyo | Chihara Y.,University of Sydney | Chihara Y.,Tokyo Postal Services Agency Hospital | Iwasaki S.,University of Tokyo | And 10 more authors.
Acta Oto-Laryngologica | Year: 2012

Conclusions: Inferior vestibular neuritis (IVN) is a relatively minor subtype of vestibular neuritis (VN) and its clinical characteristics are unique. Objectives: To clarify clinical characteristics of IVN in comparison with conventional VN. Methods: This was a retrospective case series review. Caloric responses and cervical vestibular evoked myogenic potential (cVEMP) responses were measured in 71 patients with VN. The patients were classified into three groups: (1) IVN group, who showed only asymmetrical cVEMP responses; (2) superior VN (SVN) group, who showed only asymmetrical caloric responses; (3) total VN (TVN) group, who showed asymmetrical responses in both tests. The clinical records of time course of subjective symptoms (duration of attack, duration of hospitalization, and time to remission) were reviewed and other profiles (age, sex, affected side, acute symptoms, and sequelae) were evaluated. Results: Of the 71 patients with VN, 13 (18%) were classified as having IVN. The mean age and time to remission of patients with IVN (44.2 ± 4.8 years, 0.9 ± 0.5 months) were significantly lower and shorter, respectively, than those of patients with TVN (57.3 ± 2.5 years, 4.9 ± 4.7 months). There were no significant differences in other symptoms and profiles among the three groups. No patients with IVN showed benign paroxysmal positional vertigo as a sequela. © 2012 Informa Healthcare.


Komiyama S.,Teikyo University | Nakahara H.,Teikyo University | Yagi M.,Tokyo Postal Services Agency Hospital | Murofushi T.,Teikyo University | Murofushi T.,Tokyo Postal Services Agency Hospital
Equilibrium Research | Year: 2014

We report herein on a case of disequilibrium due to central nervous disorders with a good response to acetazolamide. A 51-year-old woman presented with episodic disequilibrium and vertigo. Her symptoms began when she was a child. Her symptoms were worsened by positional change or physical exercise, lasting for several hours. She also had migraine-like headaches. Her family history was unremarkable. On examination, she showed gaze-evoked nystagmus, direction-fixed right beating positional nystagmus with down-beating nystagmus. Electronystagmography revealed saccadic pursuit, impaired optokinetic nystagmus, and disorders of visual suppression in caloric tests, suggesting central nervous disorders. MRI showed slight cerebellar atrophy without downward displacement of the cerebellar tonsil through the foramen magnum. Although she did not have family history, we clinically diagnosed her as having episodic ataxia type 2 (EA-2). She took acetazolamide (250 mg) per day. The frequency and intensity of her symptoms dramatically decreased. When we see a patient with episodic disequilibrium due to central nervous disorders, we should take EA-2 into account.

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