Toyama-shi, Japan
Toyama-shi, Japan

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Iwata M.,University of Toyama | Maeda S.,RIKEN | Kamura Y.,University of Toyama | Takano A.,Saiseikai Takaoka Hospital | And 8 more authors.
Diabetes Care | Year: 2012

OBJECTIVE - We evaluated the clinical usefulness of a genetic risk score (GRS) based on 14 well-established variants for type 2 diabetes. RESEARCH DESIGN AND METHODS - We analyzed 14 SNPs at HHEX, CDKAL1, CDKN2B, SLC30A8, KCNJ11, IGF2BP2, PPARG, TCF7L2, FTO, KCNQ1, IRS-1, GCKR, UBE2E2, and C2CD4A/B in 1,487 Japanese individuals (724 patients with type 2 diabetes and 763 control subjects). A GRS was calculated according to the number of risk alleles by counting all 14 SNPs (T-GRS) as well as 11 SNPs related to β-cell function (β-GRS) and then assessing the association between each GRS and the clinical features. RESULTS - Among the 14 SNPs, 4 SNPs were significantly associated with type 2 diabetes in the present Japanese sample (P < 0.0036). The T-GRS was significantly associated with type 2 diabetes (P = 5.9 × 10-21). Among the subjects with type 2 diabetes, the β-GRS was associated with individuals receiving insulin therapy (b = 0.0131, SE = 0.006, P = 0.0431), age at diagnosis (β = 20.608, SE = 0.204, P = 0.0029), fasting serum C-peptide level (β = 20.032, SE = 0.0140, P = 0.022), and C-peptide index (β = 20.031, SE = 0.012, P = 0.0125). CONCLUSIONS - Our data suggest that the β-GRS is associated with reduced β-cell functions and may be useful for selecting patients who should receive more aggressive β-cell-preserving therapy. © 2012 by the American Diabetes Association.


Kishimoto T.,Okayama Rosai Hospital | Gemba K.,Okayama Rosai Hospital | Fujimoto N.,Okayama Rosai Hospital | Onishi K.,Kobe Rosai Hospital | And 3 more authors.
Cancer Science | Year: 2010

A total of 152 patients with asbestos-related lung cancer recognized by the criteria of Japanese compensation law for asbestos-related diseases were examined and compared with 431 patients with non-asbestos-related lung cancer. Male comprised 96% of patients. Ages ranged from 50 to 91 years with a median of 72 years. Eighty-nine percent were smokers or ex-smokers. Almost all patients had occupational histories of asbestos exposure. The median duration of asbestos exposure was 31 years and the median latency period was 47 years. Thirty-four percent of patients exhibited asbestosis and 81% exhibited pleural plaques by radiography. Regarding asbestos particles in the lung for 73 operated or autopsied patients, 62% had more than 5,000 particles per gram. On the other hand, 100% of non-asbestos-related lung cancer patients had <5000 particles per gram with a median of 554 particles. The number of asbestos bodies in the lung, male gender, absence of symptoms, smoking index, and early stage of cancer were significantly much more than those of non-asbestos-related lung cancer. In this study, a diagnosis of asbestos-related lung cancer was made in 34% of patients by asbestosis, in 62% by presence of both pleural plaques and more than 10 years' occupational asbestos exposure, and in 4% by more than 5000 asbestos particles per gram of lung tissue. Occupational histories, duration of asbestos exposure, and pleural plaques are common categories for the recognition of asbestos-related lung cancer in Japan. © 2010 Japanese Cancer Association.


PubMed | Yatsuo General City Hospital, Toyama City Hospital, Toyama Prefectural Central Hospital, Kanazawa Medical University and 7 more.
Type: Journal Article | Journal: International journal of clinical oncology | Year: 2016

The purpose of our study was to evaluate the efficacy of a new combination antiemetic therapy consisting of palonosetron, aprepitant, and dexamethasone in gastric cancer patients undergoing chemotherapy with S-1 plus cisplatin.This prospective, multi-institutional observational study assessed patient-reported nausea, vomiting, use of rescue therapy, change of dietary intake, and Functional Living Index-Emesis (FLIE) questionnaire results. The percentages of patients showing complete response (CR; no emesis and non-use of any rescue antiemetics) and complete protection (CP; no significant nausea and non-use of any rescue antiemetics), change of dietary intake, and impact of chemotherapy-induced nausea and vomiting on daily life during the overall (0-120h after cisplatin administration), acute (0-24h), and delayed (24-120h) phases were examined. These findings were compared with our previous study, which used granisetron, aprepitant, and dexamethasone, to assess the relative effectiveness of palonosetron versus granisetron in combination antiemetic therapy.Of the 72 included patients, 66 (91.6%), 70 (97.2%), and 50 (69.1%) achieved CR, and 48 (66.7%), 61 (84.7%) and 49 (68.1%) achieved CP during in the overall, acute, and delayed phases of cisplatin administration, respectively. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 78.6% of patients maintained their quality of life. Palonosetron was not superior to granisetron in combination antiemetic therapy.Three-drug combination antiemetic therapy with palonosetron, aprepitant, and dexamethasone was tolerable in gastric cancer patients undergoing treatment with S-1 plus cisplatin. The predominance of palonosetron to granisetron was not demonstrated in this study.


PubMed | Yamaguchi Ube Medical Center, Kobe Rosai Hospital, Kawasaki Medical School, Asahi Rosai Hospital and 3 more.
Type: | Journal: Pulmonary medicine | Year: 2015

There is no detailed information about benign asbestos pleural effusion (BAPE). The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1) history of asbestos exposure; (2) presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3) the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840ng/mL, 23.9IU/L, and 1.8ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%). Asbestosis was present in 6 (5.5%) cases, rounded atelectasis was detected in 41 (37.3%) cases, and diffuse pleural thickening (DPT) was detected in 30 (27.3%) cases. One case developed lung cancer (LC) before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM) during the follow-up.


Sato T.,University of Toyama | Kameyama T.,University of Toyama | Noto T.,Saiseikai Toyama Hospital | Nakadate T.,Saiseikai Takaoka Hospital | And 3 more authors.
Journal of Thrombosis and Thrombolysis | Year: 2014

Present study aimed to investigate the impact of anti-inflammatory cytokines provoked by the hemoglobin scavenger receptor, CD163, on left ventricular (LV) functional recovery after successful reperfusion in patients with acute myocardial infarction (AMI). Intraplaque hemorrhage accelerates plaque destabilization. Extracellular hemoglobin is cleared by CD163, a macrophage scavenger receptor. This process provokes secretion of anti-inflammatory atheroprotective cytokine, interleukin (IL)-10. In 40 patients with the first AMI, coronary atherothrombotic debris was retrieved during percutaneous coronary intervention (PCI), stained with antibodies to CD163 and IL-10. LV function was determined by echocardiography before PCI and 6 months after PCI. %CD163 was defined as ratio of CD163 (+)-cells to whole cells. %IL-10 was expressed as the ratio of positively stained areas per total tissue. Patients were divided into two groups depending on the amount of CD163 (+)-cells: CD163 > 10 % (CD163high, n = 20) and CD163 ≤ 10 % (CD163low, n = 20). CD163high group had significantly higher %IL-10. Final thrombolysis in myocardial infarction (TIMI) flow grade was significantly lower in CD163high group. In subgroups with the final TIMI-3 flow (CD163high-Reflow, n = 15 and CD163low-Reflow, n = 20), the time to reperfusion, infarct size, LV dimensions and fractional shortening (%FS) before PCI were similar. Significant correlation was observed between %IL10 and changes in LV dimensions (diastole, r = -0.49, P = 0.01; systole, r = -0.65, P < 0.01) or %FS (r = 0.51, P < 0.01) at 6 months after PCI. Plaque with CD163(+)-macrophages could impair distal flow after primary PCI. However, CD163(+)-macrophages enhance the anti-inflammatory cytokine expression that aids in ventricular functional recovery if distal flow can be achieved by successful reperfusion. © 2013 Springer Science+Business Media New York.


PubMed | University of Toyama, Saiseikai Takaoka Hospital, Kamiichi General Hospital, Asahi General Hospital and 4 more.
Type: Journal Article | Journal: PloS one | Year: 2016

Several studies have demonstrated that polymorphisms within the fat-mass and obesity-associated gene (FTO) are associated with type 2 diabetes (T2D). However, whether the effects of the FTO locus on T2D susceptibility are independent of fat-mass increases remains controversial. To investigate this issue, we examined the association of FTO variants with T2D and various aspects of BMI history during adult life in a Japanese population.We genotyped SNPs within FTO (rs1121980 and rs1558902) in 760 Japanese patients with T2D who had reached a lifetime maximum BMI (BMImax) before or at the time of diagnosis and 693 control individuals with information regarding their BMImax.The BMImax showed the strongest association with T2D risk among the BMIs evaluated in this study. In the sex-combined analysis, FTO SNPs were not associated with any of the BMI variables or with T2D, but in sex-stratified analyses, both SNPs were significantly associated with the BMImax and rs1558902 was associated with T2D in men. The association of the SNPs with T2D remained significant after adjustments for the current BMI and age, whereas the T2D association of the SNP was no longer significant after adjustments for BMImax and age.These results suggest that the effects of FTO polymorphisms on T2D susceptibility in Japanese men are mediated through their effect on increasing the BMImax before or at the time of diagnosis.


PubMed | Toyama City Hospital and Toyama Rosai Hospital
Type: | Journal: Case reports in urology | Year: 2015

Adrenal cysts are rare, and their clinical management remains controversial. We report a case involving an adrenal cyst with a complicated appearance on radiological studies. Unenhanced computed tomography revealed a unilocular, noncalcified, hypoattenuating mass with a thin wall in the left adrenal gland. The lesion gradually increased in size from 10 to 50mm at two-year follow-up. On contrast-enhanced magnetic resonance imaging, a mural nodule with contrast enhancement was observed. The entire adrenal gland was excised en bloc via a lateral transperitoneal laparoscopic approach without violating the principles of surgical oncology. The pathological diagnosis was an adrenal pseudocyst. Laparoscopic adrenalectomy is a safe option for the treatment of complex adrenal cysts, while maintaining the benefits of minimal invasiveness.


Nakano M.,University of Toyama | Kawaguchi Y.,University of Toyama | Kimura T.,University of Toyama | Hirano N.,Toyama Rosai Hospital
Spine Journal | Year: 2014

Background context: There has been no study regarding the comparison between vertebroplasty and conservative treatment for osteoporotic burst fracture. Purpose: To compare the results of vertebroplasty after intravertebral cavity formation with that of conservative treatment alone. Study design: A case-control study. Methods: The vertebroplasty group included 40 consecutive patients with primary osteoporotic burst fracture who underwent vertebroplasty using calcium phosphate cement, and the control group was made up of 40 patients given conservative treatment alone who were matched for age, gender, the injury level, and the type of fracture. Two groups of patients who had no neural deficit were prospectively examined. Clinical and radiological outcomes of these two groups were compared blindly. The authors do not report any conflict of interest in this study. Outcome measures: Outcome measures included visual analog scale (VAS) of the back pain, analgesic requirements, and mobility; in a lateral radiograph, the deformity index was measured and expressed as the ratio of the vertebral body (VB) height (sum of measurements at anterior, middle, and posterior regions of VB) to the longitudinal diameter of VB. Anteroposterior height comparison was expressed as the percentage of VB height at the anterior region compared with the height at the posterior region. Each recovery rate was calculated as a percentage by the formula: (value at the examination-value before treatment)/value before treatment×100. Results: The duration of follow-up was more than 12 months (mean; 22.5 months). The mean VAS at 12 months after injury was 2.17 cm in the conservative group and 0.61 cm in the vertebroplasty group (p=.0002). The mean duration of analgesic medication required was 157.2 days in the conservative group and 21.3 days in the vertebroplasty group (p=.0048). The mean deformity index at 12 months after injury was 1.66 in the vertebroplasty group and 1.38 in the control group, and the mean recovery rate was +7.3% and -18.4%, respectively (p<.0001). Anteroposterior height comparison at 12 months after injury was 49.1% in the conservative group and 71.2% in the vertebroplasty group, and the mean recovery rate was -26.4% and +30.1%, respectively (p<.0001). One fracture in the vertebroplasty group showed delayed union until 6 months after injury. In the control group, there were six delayed union including four pseudoarthroses at over 6 months after injury that caused leg pain and were treated by conservative therapy. Conclusions: We conclude that vertebroplasty after intravertebral cavity formation provided a better clinical and radiological result than conservative treatment for osteoporotic burst fracture. © 2014 The Authors. Published by Elsevier Inc. All rights reserved.


PubMed | Takaoka City Hospital, Toyama Rosai Hospital and University of Toyama
Type: | Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society | Year: 2017

Complications of adult spinal deformity surgery are problematic in osteoporotic individuals. We compared outcomes between Japanese patients treated perioperatively with teriparatide vs. low-dose bisphosphonates.Fifty-eight osteoporotic adult Japanese female patients were enrolled and assigned to perioperative teriparatide (33 patients) and bisphosphonate (25 patients) groups in non-blinded fashion. Pre- and post-operative X-ray and computed tomography imaging were used to assess outcome, and rates were compared between the groups and according to age. Pain scores and Oswestry Disability Indices (ODI) were calculated before and 2years after surgery.Adjacent vertebral fractures and implant failure, fusion failure, and poor pain and ODI outcomes were significantly more common in the bisphosphonates group than the teriparatide group.Perioperative administration of teriparatide is more effective than that of low-dose bisphosphonates in preventing complications and maintaining fusion rates in osteoporotic Japanese females with spinal deformities undergoing surgery.


Fujimura T.,Kanazawa University | Fushida S.,Kanazawa University | Kayahara M.,Kanazawa University | Ohta T.,Kanazawa University | And 2 more authors.
Surgery Today | Year: 2010

Segmental resection of the stomach was fi rst described at the end of the 19th century by Mikulicz, who devised it to preserve the pylorus when performing gastric ulcer surgery. Although this technique was abandoned because of delayed gastric emptying, in 1967 Maki et al. developed a new improved concept of segmental gastrectomy: pylorus-preserving gastrectomy (PPG). The dramatic decrease in the occurrence of gastric ulcers limited the opportunity to perform these operations; however, PPG was then used for treating early gastric cancer, the incidence of which has increased remarkably over the last two decades. From the viewpoint of surgical oncology, a rationale to justify reducing the range of lymphadenectomy is required for preserving the curability. Therefore, we devised a new technique of transectional gastrectomy using sentinel node navigation for early gastric cancer located in the middle third of the stomach. The results of a questionnaire about postoperative symptoms and endoscopic assessment indicated the superiority of transectional gastrectomy over conventional distal gastrectomy. Future confi rmation of the sentinel node concept through a multi-institutional validation study conducted by the Japanese Society of Sentinel Node Navigation Surgery would lead to widespread adoption of transectional gastrectomy. © Springer 2010.

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