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Japanese Clinical Medicine

Masaaki Yokoyama, Hiroaki Ohnishi, Kouki Ohtsuka, Satsuki Matsushima, Yasuo Ohkura, Junji Furuse, Takashi Watanabe, Toshiyuki Mori, Masanori Sugiyama
BACKGROUND: The aim of this study was to identify the unique molecular characteristics of biliary tract cancer (BTC) for the development of novel molecular-targeted therapies. MATERIALS AND METHODS: We performed mutational analysis of KRAS, BRAF, PIK3CA, and FBXW7 and immunohistochemical analysis of EGFR and TP53 in 63 Japanese patients with BTC and retrospectively evaluated the association between the molecular characteristics and clinicopathological features of BTC...
2016: Japanese Clinical Medicine
Yuya Nakamura, Masahiro Inagaki, Mayumi Tsuji, Toshihiko Gocho, Kazuaki Handa, Hitomi Hasegawa, Akihiko Yura, Tomoko Kawakami, Isao Ohsawa, Yoshikazu Goto, Hiromichi Gotoh, Yuji Kiuchi
BACKGROUND: Because of the potential anti-inflammatory effects, linagliptin, a therapeutic dipeptidyl peptidase-4 inhibitor, is used as an effective drug for diabetic patients for whom inflammation is a prognosis-related factor. We investigated the anti-inflammatory mechanism of linagliptin using seven markers. METHODS: We pretreated human umbilical vein endothelial cells (HUVECs), with linagliptin and lipopolysaccharide (LPS). The cytosolic fractions were evaluated for protein kinase A (PKA), protein kinase B (PKB), protein kinase C (PKC), ratio of reactive oxygen species (ROS) and Cu/Zn superoxide dismutase (SOD), activator protein 1 (AP-1), and adenosine 3',5'-cyclic monophosphate (cAMP)...
2016: Japanese Clinical Medicine
Ayumi Yoshimura, Tetsuya Kibe, Kaori Irahara, Norio Sakai, Kenji Yokochi
A case of late-infantile Krabbe disease in a patient who presented with developmental regression and spastic quadriplegia in late infancy is reported. Brain magnetic resonance imaging (MRI) at 11 months of age showed predominant corticospinal tract involvement, which usually appears in adult Krabbe disease. Galactocerebrosidase activity in lymphocytes and skin fibroblasts was very low. Genetic testing revealed compound heterozygous mutations of the galactocerebrosidase (GALC) gene, c.635_646 delinsCTC and c...
2016: Japanese Clinical Medicine
Noriko Satoh-Asahara, Hiroto Ito, Tomoyuki Akashi, Hajime Yamakage, Kazuhiko Kotani, Daisuke Nagata, Kazuyuki Nakagome, Mitsuhiko Noda
PURPOSE: Depression is frequently observed in people with diabetes. The purpose of this study is to develop a tool for individuals with diabetes and depression to communicate their comorbid conditions to health-care providers. METHOD: We searched the Internet to review patient-held medical records (PHRs) of patients with diabetes and examine current levels of integration of diabetes and depression care in Japan. RESULTS: Eight sets of PHRs were found for people with diabetes...
2016: Japanese Clinical Medicine
Shunji Suzuki
We examined the prevalence of specific perinatal complications of monochorionic-diamniotic twin pregnancies in cases without any abnormal findings until the second trimester of pregnancy. This was a retrospective cohort study performed at a tertiary perinatal center in Tokyo, Japan. There were 88 cases of uncomplicated monochorionic-diamniotic twin pregnancies at 28 weeks of gestation. In five of them (5.7%), there were serious complications associated with placental circulatory imbalance between the twins during the third trimester of pregnancy...
2016: Japanese Clinical Medicine
Yoshinori Osaki, Yoshitaka Hayashi, Yoshinori Nakagawa, Katsumi Yoshida, Hiroshi Ozaki, Hiroshi Fukazawa
Familial dysalbuminemic hyperthyroxinemia (FDH) is a familial autosomal dominant disease caused by mutation in the albumin gene that produces a condition of euthyroid hyperthyroxinemia. In patients with FDH, serum-free thyroxine (FT4) and free triiodothyronine (FT3) concentrations as measured by several commercial methods are often falsely increased with normal thyrotropin (TSH). Therefore, several diagnostic steps are needed to differentiate TSH-secreting tumor or generalized resistance to thyroid hormone from FDH...
2016: Japanese Clinical Medicine
Mie Tonoike, Miyako Kishimoto, Mayumi Yamamoto, Tetsu Yano, Mitsuhiko Noda
Abnormal glucose tolerance during pregnancy is associated with perinatal complications. We used continuous glucose monitoring (CGM) in pregnant women with glucose intolerance to achieve better glycemic control and to evaluate the maternal glucose fluctuations. We also used CGM in women without glucose intolerance (the control cases). Furthermore, the standard deviation (SD) and mean amplitude of glycemic excursions (MAGE) were calculated for each case. For the control cases, the glucose levels were tightly controlled within a very narrow range; however, the SD and MAGE values in pregnant women with glucose intolerance were relativity high, suggesting postprandial hyperglycemia...
2016: Japanese Clinical Medicine
Hiroko Katayama, Daisuke Tachibana, Akihiro Hamuro, Takuya Misugi, Koka Motoyama, Tomoaki Morioka, Shinya Fukumoto, Masanori Emoto, Masaaki Inaba, Masayasu Koyama
OBJECTIVE: The aim of this study was to compare glucose intolerance in the antenatal and the postpartum periods using a 75-g oral glucose tolerance test (OGTT) in the Japanese women with gestational diabetes mellitus (GDM) using a retrospective design. PATIENTS AND METHODS: Data were obtained from 85 Japanese women with GDM who delivered from April 2011 through April 2015 and who underwent an OGTT 6-14 weeks postpartum. The women were divided into two groups based on the results of the postpartum OGTT: one group with normal glucose tolerance (NGT) and the other with impaired glucose tolerance (IGT) as well as impaired fasting glucose (IFG)...
2015: Japanese Clinical Medicine
Akihiro Hamuro, Daisuke Tachibana, Takuya Misugi, Hiroko Katayama, Koji Ozaki, Yuji Fujino, Nakamura Yoshihiro, Haruo Shintaku, Masayasu Koyama
OBJECTIVE: This study measured serum and follicular fluid (FF) levels of biopterin, neopterin, vascular endothelial growth factor (VEGF), and macrophage colony-stimulating factor (M-CSF) in patients receiving mild ovarian stimulation for oocyte retrieval. PATIENTS AND METHODS: Infertile patients who underwent ovarian stimulation were divided into the following: Group 1, no oocyte retrieval (n = 12), and Group 2, retrieval of more than four oocytes (n = 13). Median total gonadotropin dose in both groups was 150 IU...
2015: Japanese Clinical Medicine
Ken Shimamoto, Masatoshi Kawana
OBJECTIVE: Heart rate variability (HRV) has been reported to be an independent predictor of all-cause and sudden cardiac death in patients with heart failure. In the aging heart, however, both autonomic and cardiac functions appear to be altered. We assessed the relationship between aging and responsiveness of HRV and ventricular remodeling to beta-adrenergic blockade therapy in patients with heart failure and reduced ejection fraction (HFREF). METHODS: Twenty-eight clinically stable patients with chronic heart failure, sinus rhythm, and left ventricular ejection fraction <50% as confirmed by echocardiography were included...
2015: Japanese Clinical Medicine
Hiromi Hamamoto, Koji Nakanishi, Mitsuhiko Noda
We attempted to examine whether withdrawal from insulin therapy is or is not possible with administration of additional alogliptin and identify the contributing factors. The subjects were 43 adult patients with type 2 diabetes undergoing insulin therapy after admission. After glucotoxicity was removed, 25 mg alogliptin was additionally administered. Insulin was reduced by 15.6 ± 13.0 units (mean ± SD), and 17 patients (39.5%) completely withdrew from insulin therapy. Several factors were compared between the two groups of patients: those who could withdraw from insulin therapy and those who could not...
2015: Japanese Clinical Medicine
Noriko Nishikawa, Masahiro Nagai, Tomoaki Tsujii, Win T Kyaw, Nachi Tanabe, Hirotaka Iwaki, Hayato Yabe, Rina Ando, Masahiro Nomoto
The number of patients with late-onset myasthenia gravis (MG) among patients ≥50 years has been increasing recently. We encountered three patients who developed elderly-onset MG at a particularly advanced age (≥80 years). All were female and positive for anti-acetylcholine receptor antibodies. About 4 years have passed since MG onset in all three patients and symptoms have been controlled without recurrence using a combination of oral low-dose prednisolone and tacrolimus. As many cases of elderly-onset MG do not require strong immunosuppression, we recommend minimum immunosuppressive treatment to avoid adverse events, particularly in patients at an advanced age of ≥80 years...
2015: Japanese Clinical Medicine
Saiko Kato-Okada, Hiromichi Suzuki, Tsutomu Inoue, Tomohiro Kikuta, Hirokazu Okada
INTRODUCTION: Recently, Henoch-Schönlein purpura (HSP) has been observed in elderly people, although it was believed to be uncommon in these subjects. The increased risks of developing end-stage renal disease (ESRD) in adults in comparison with children were highlighted by different studies; however, limited data are available on the treatment of HSP nephritis in adults. METHODS: Between 2002 and 2008, five elderly Japanese patients (>65 years old) (mean age, 68 years, ranging from 65 to 72) with severe forms of HSP nephritis were entered into a prospective study to evaluate prednisolone therapy on the outcome of nephropathy in terms of clinical symptoms and histopathological changes...
2015: Japanese Clinical Medicine
Tomoko Nakagawa, Daisuke Tachibana, Kohei Kitada, Yasushi Kurihara, Hiroyuki Terada, Masayasu Koyama, Yukari Sakae, Yoshiki Morotomi, Shiho Nomura, Mika Saito
Fetal intestinal volvulus without malrotation is a rare, life-threatening disease. Left untreated, hemorrhage from necrotic bowel tissue will lead to severe fetal anemia and even intrauterine death. We encountered a case of fetal intestinal volvulus causing severe anemia, which was diagnosed postnatally and successfully treated with surgical intervention.
2015: Japanese Clinical Medicine
Kiyoaki Tsukahara, Ray Motohashi, Hiroki Sato, Minoru Endo, Yuri Ueda, Kazuhiro Nakamura
OBJECTIVES: The purpose of this prospective, randomized study was to evaluate the effects of a diet containing eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), gamma-linolenic acid (GLA), and antioxidants in head and neck cancer surgery patients with free-flap reconstruction. METHODS: In this randomized, prospective study, 62 patients with head and neck cancers were assigned to receive a general control diet (Ensure(®) H; Abbott Japan, Tokyo, Japan) or the study diet (Oxepa(®); Abbott Japan) containing EPA, DHA, GLA, and antioxidants (eg vitamins A, E, and C)...
2014: Japanese Clinical Medicine
Yasushi Kawano, Tomoko Hirakawa, Masakazu Nishida, Akitoshi Yuge, Mitsutake Yano, Kaei Nasu, Hisashi Narahara
Mayer-Rokitanski-Kuster-Hauser (MRKH) syndrome is a rare disease. A 27-year-old woman was admitted for primary amenorrhea and cyclic pelvic pain. Magnetic resonance imaging (MRI) revealed bilateral Müllerian remnants with functioning endometrium and a pelvic mass considered to be an endometriotic cyst. Bilateral Müllerian remnants were removed, and right ovarian cystectomy was performed at laparoscopic surgery. Accurate evaluation before the operation and informed consent are necessary to treat patients with MRKH syndrome...
2014: Japanese Clinical Medicine
Hiroki Yokoyama, Koichi Hirao, Kohei Yamaguchi, Mariko Oishi, Gendai Lee, Noriharu Yagi, Hiroshi Takamura, Atsunori Kashiwagi
OBJECTIVE: Liraglutide (glucagon-like peptide-1 [GLP-1] receptor agonist) and sitagliptin (dipeptidyl peptidase-4 inhibitor) are approved in Japan for treating type 2 diabetes mellitus (T2DM). We compared the efficacy and safety of adding liraglutide or sitagliptin to a sulfonylurea in Japanese T2DM patients. METHODS: Patients aged 18 to <80 years with hemoglobin A1c (HbA1c; National Glycohemoglobin Standardization Program [NGSP]) of 6.9-9.4%, body mass index ≤35 kg/m(2), and treatment with a sulfonylurea and/or one or two non-sulfonylurea oral antidiabetic drugs for greater than or equal to eight weeks before enrollment were eligible...
2014: Japanese Clinical Medicine
Satoru Sakuma, Daisuke Tokuhara, Hiroshi Otsubo, Tsunekazu Yamano, Haruo Shintaku
BACKGROUND: The time course of cytokine dynamics after seizure remains controversial. Here we evaluated the changes in the levels and sites of interleukin (IL)-1β expression over time in the hippocampus after seizure. METHODS: Status epilepticus (SE) was induced in adult Wistar rats by means of intraperitoneal injection of kainic acid (KA). Subsequently, the time courses of cellular localization and IL-1β concentration in the hippocampus were evaluated by means of immunohistochemical and quantitative assays...
2014: Japanese Clinical Medicine
Satoshi Otsu, Yoshinori Hirashima, Kazuo Nishikawa, Hiroyuki Sakashita, Ryotaro Morinaga, Koichiro Watanabe, Kuniaki Shirao
This study was conducted to investigate the toxicity and efficacy of modified FOLFOX6 plus bevacizumab in patients with metastatic colorectal cancer with particular regard to oxaliplatin-induced neuropathy. Toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) (version 3.0). The evaluation was especially focused on grade 2 oxaliplatin-induced neuropathy. The estimated median treatment time to occurrence of grade 2 sensory neuropathy was 7.3 months...
2014: Japanese Clinical Medicine
Minoru Endo, Kiyoaki Tsukahara, Kazuhiro Nakamura, Ray Motohashi, Mamoru Suzuki
Only seven cases of osteoma arising in the middle turbinate have been reported to date. We report the eighth case, involving osteoma in the middle turbinate of a child. This young boy was initially examined at the age of nine for the main complaint of nasal obstruction. Although a large osteoma with a maximum diameter of 30 mm was observed on computed tomography (CT), the patient was only observed because of the wishes of the family. At 13 years, he was again examined, as a result of worsening of the nasal obstruction...
2014: Japanese Clinical Medicine
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