Publications by authors named "Takashi Matsuoka"

61 Publications

Influence of Liquid on the Tooth Surface on the Accuracy of Intraoral Scanners: An In Vitro Study.

J Prosthodont 2021 Apr 7. Epub 2021 Apr 7.

Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan.

Purpose: To assess the influence of liquid attached on the tooth surfaces on the accuracy (trueness and precision) of intraoral scanners and the effectiveness of the drying method (using compression air) to exclude the influence of liquid on the scanning results.

Materials And Methods: A mandibular jaw model was scanned using an industrial computed tomography scanner to obtain a reference model. A scanning platform was designed to simulate three specific tooth surface states (dry, wet, blow-dry). Two kinds of liquids (ultra-pure water and artificial saliva) were used for the test. Two intraoral scanners (Trios 3 and Primescan) were used to scan the mandibular jaw model 10 times under each condition. All scanning data were processed and analyzed using dedicated software (Geomagic Control 2015). Trueness and precision comparison were conducted within the 12 groups of 3D models divided based on different intraoral scanners and liquids used under each condition. The root mean square (RMS) value was used to indicate the difference between the aligned virtual models. The color maps were used to evaluate and observe the deviation distribution patterns. The 3-way ANOVA (condition, intraoral scanner, liquid) followed by the Tukey test were used to assess precision and trueness. The level of significance was set at 0.05.

Results: The mean RMS values obtained from wet condition were significantly higher than those of the dry and blow-dry condition (p < 0.001, F = 64.033 for trueness and F = 54.866 for precision), which indicates less accurate trueness and precision for wet condition. For two different types of liquids, the mean RMS value was not significantly different on trueness and precision. The deviations caused by liquid were positive and mainly distributed in the pits and fissures of the occlusal surface of posterior teeth, the interproximal area of the teeth, and the margin of the abutments.

Conclusions: Liquid on the tooth surface could affect intraoral scanning accuracy. Blow-dry with a three-way syringe can reduce scanning errors. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1111/jopr.13358DOI Listing
April 2021

AUTHOR REPLY.

Urology 2021 Feb;148:158

Department of Urology, Kobe City Medical Centre General Hospital, Kobe, Japan.

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http://dx.doi.org/10.1016/j.urology.2020.08.097DOI Listing
February 2021

Effect of Continued Perioperative Anticoagulant Therapy on Bleeding Outcomes Following Robot-assisted Radical Prostatectomy.

Urology 2021 Feb 25;148:151-158. Epub 2020 Nov 25.

Department of Urology, Kobe City Medical Centre General Hospital, Kobe, Japan.

Objective: To assess the impact of continued perioperative anticoagulant drug administration on bleeding and complications in patients undergoing robot-assisted radical prostatectomy.

Methods: Between January 2014 and January 2020, 620 patients with prostate cancer underwent robot-assisted radical prostatectomies and were retrospectively reviewed. Fourteen patients who discontinued antithrombotic therapy were excluded. Among the 606 included patients, 31 continued anticoagulant therapy during the perioperative phase (anticoagulant group). The anticoagulant group outcomes were compared with those of patients who continued clopidogrel and prasugrel (thienopyridine group = 13), aspirin monotherapy (aspirin group = 61), and no chronic antithrombotic agent (control group = 501). The primary outcome was the incidence of bleeding complications requiring transfusion, additional intervention, or readmission. Secondary outcomes were the incidence of thrombotic complications, estimated blood loss, and overall complication rates.

Results: Among the 31 patients in the anticoagulant group, 20 (65%) used directed oral anticoagulants, 11 (35%) used warfarin, and 5 used combined aspirin. Only 1 (3%) patient in the anticoagulant group required postoperative transfusion, and none required additional interventions or readmission. No significant differences were detected between the anticoagulant and other groups (anticoagulant vs thienopyridine, aspirin, and control groups) regarding bleeding complications (3% vs 8%, P = .51; 0%, P = .34; 0.4%, P = .17, respectively), thrombotic complications (3% vs 0%, P = .70; 2%, P = .56; 0.2%, P = .11, respectively), estimated blood loss (200 vs 100 mL, P = .63; 175 mL, P = .64; 165 mL, P = .74, respectively), or other high-grade complications (6% vs 0%, P = .49; 2%, P = .26; 3%, P = .24, respectively).

Conclusion: Perioperative continuation of anticoagulant use is feasible for patients undergoing robot-assisted radical prostatectomy.
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http://dx.doi.org/10.1016/j.urology.2020.08.095DOI Listing
February 2021

Increase in the Lipopolysaccharide Activity and Accumulation of Gram-Negative Bacteria in the Stomach With Low Acidity.

Clin Transl Gastroenterol 2020 07;11(7):e00190

Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan.

Introduction: Lipopolysaccharides (LPSs) of Gram-negative bacteria (GNB) are highly toxic and induce inflammation. Therefore, we investigated both the LPS activity and composition of GNB in the gastric fluid (GF) to assess the potential toxicity of them accumulated in the stomach.

Methods: GF and saliva samples were obtained from 158 outpatients who were undergoing upper gastrointestinal endoscopy and 36 volunteers using a nasogastric tube. The LPS activity was measured by assay kits including recombinant Factor C or Limulus amebocyte lysate. To assess the bacterial composition in the samples, a 16S ribosomal DNA-based operational taxonomic unit analysis was performed. We focused on the genera representing >0.1% of the whole microbiota.

Results: We found a high LPS activity in the GF samples with weak acidity (approximately > pH 4), whereas little/no activity in those with strong acidity (approximately < pH 2). Spearman test also demonstrated a close correlation between pH and LPS in those samples (r = 0.872). The relative abundance of GNB in the saliva showed no significant difference between the subject groups with weak- and strong-acidity GF. In addition, in the subjects whose GF acidity was weak, the GNB abundance in the GF was almost the same as that in the saliva. By contrast, in the subjects whose GF acidity was strong, the GNB abundance in the GF was significantly lower than that in the saliva.

Discussion: GNB that have recently moved from the oral cavity might account for the prominent LPS activity in a stomach with weak acidity.
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http://dx.doi.org/10.14309/ctg.0000000000000190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386353PMC
July 2020

Estimation of frequency difference at which stream segregation precedes temporal integration as reflected by omission mismatch negativity.

Biol Psychol 2020 03 22;151:107848. Epub 2020 Jan 22.

Department of Neuropsychiatry, Fukushima Medical University, Hikarigaoka 1, Fukushima, Japan.

Both stream segregation and temporal integration are considered important for auditory scene analysis in the brain. Several previous studies have indicated that stream segregation may precede temporal integration when both processes are required. In the present study, we utilized mismatch negativity (MMN)-which reflects automatic change detection-to systematically estimate the threshold of the frequency difference at which stream segregation occurs prior to temporal integration when these functions occur together during a state of inattention. Electroencephalography (EEG) data were recorded from 22 healthy Japanese men presented with six blocks of alternating high pure tones (high tones) and low pure tones (low tones). Only high tones were omitted with 5 % probability in all blocks. Our results indicated that stream segregation should cancel temporal integration of close sounds, as indicated by omission-MMN elicitation, when the frequency difference is 1000 Hz or larger.
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http://dx.doi.org/10.1016/j.biopsycho.2020.107848DOI Listing
March 2020

Genetic abnormalities in a large cohort of Coffin-Siris syndrome patients.

J Hum Genet 2019 Dec 17;64(12):1173-1186. Epub 2019 Sep 17.

Asahikawa-Kosei General Hospital, Hokkaido, Japan.

Coffin-Siris syndrome (CSS, MIM#135900) is a congenital disorder characterized by coarse facial features, intellectual disability, and hypoplasia of the fifth digit and nails. Pathogenic variants for CSS have been found in genes encoding proteins in the BAF (BRG1-associated factor) chromatin-remodeling complex. To date, more than 150 CSS patients with pathogenic variants in nine BAF-related genes have been reported. We previously reported 71 patients of whom 39 had pathogenic variants. Since then, we have recruited an additional 182 CSS-suspected patients. We performed comprehensive genetic analysis on these 182 patients and on the previously unresolved 32 patients, targeting pathogenic single nucleotide variants, short insertions/deletions and copy number variations (CNVs). We confirmed 78 pathogenic variations in 78 patients. Pathogenic variations in ARID1B, SMARCB1, SMARCA4, ARID1A, SOX11, SMARCE1, and PHF6 were identified in 48, 8, 7, 6, 4, 1, and 1 patients, respectively. In addition, we found three CNVs including SMARCA2. Of particular note, we found a partial deletion of SMARCB1 in one CSS patient and we thoroughly investigated the resulting abnormal transcripts.
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http://dx.doi.org/10.1038/s10038-019-0667-4DOI Listing
December 2019

[A Case of Renal Oncocytosis with Bilateral Multiple Renal Masses].

Hinyokika Kiyo 2019 Apr;65(4):111-116

The Department of Pathology, Kobe City Medical Center General Hospital.

A 63-year-old man with microscopic hematuria underwent contrast-enhanced CT, which showed multiple bilateral renal masses. Percutaneous biopsy results indicated renal oncocytosis. The tumors remained unchanged for 3 years. Renal oncocytosis is a very rare tumor, but it is an established disease entity characterized by numerous oncocytic tumors and diffuse (sporadic) renal parenchymal epithelial oncocytic changes on an analysis histopathology. Although renal oncocytosis can be sporadic or part of Birt-Hogg-Dube syndrome (BHDS), our case did not associate with BHDS because of absence of lung cyst.
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http://dx.doi.org/10.14989/ActaUrolJap_65_4_111DOI Listing
April 2019

Group A streptococcus endocarditis in children: 2 cases and a review of the literature.

BMC Infect Dis 2019 Jan 31;19(1):102. Epub 2019 Jan 31.

Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Department of General Pediatrics, Okinawa, Japan.

Background: Infective endocarditis (IE) is defined as endocarditis caused by microorganisms (bacteria or fungi) involving either the heart or great vessels. The clinical course of IE can be complicated by cardiac dysfunction and bacterial embolization to virtually any organ. Staphylococcus aureus and viridans group streptococci are the most common causative organisms, whereas group A Streptococcus (GAS) is less common. Although some GAS serotypes have been associated with severe disease, there are few reports of IE associated with GAS serotypes. Here, we report two cases of GAS endocarditis and review the associated literature.

Case Presentations: Patient 1 was a previously healthy 14-year-old girl who developed bacteremia and disseminated intravascular coagulation secondary to left foot cellulitis. She was administered intravenous antibiotics. Two of three blood cultures grew Streptococcus pyogenes (T6 M6, emm6.104). Three days later, a new systolic ejection murmur was heard and echocardiography showed mitral regurgitation with mitral valve vegetation. Because of the resultant severity of the mitral regurgitation, she underwent mitral valve repair after 10 weeks of antibiotic treatment. Patient 2 was a 17-month old boy who presented with a fever. He had a history of spontaneous closure of a ventricular septal defect (VSD). He was started on intravenous antibiotics for possible bacteremia. Two consecutive blood cultures with an interval of more than 12 h grew S. pyogenes (T4 M4, emm4.0). Five days later, echocardiography showed vegetation on a membranous ventricular septal aneurysm. The patient responded well to antibiotics, and recovered fully with no complications.

Conclusions: Although both patients developed GAS endocarditis, patient 1 did not have any predisposing conditions for IE, and patient 2 had a only a low-risk predisposing condition, a VSD that had closed spontaneously at five months of age. We found twelve reports in the literature of GAS endocarditis with information on serotypes. All patients in these reports had GAS endocarditis caused by serotypes generally associated with milder infections, but no specific risk trends were identified. A greater accumulation of cases is necessary to more clearly elucidate the association between GAS IE and specific serotypes.
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http://dx.doi.org/10.1186/s12879-019-3736-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357504PMC
January 2019

[Evaluation of Lymphoceles by CT Scan Early after Robot-Assisted Radical Prostatectomy].

Hinyokika Kiyo 2018 Jun;64(6):261-264

The Department of Urology, Kobe City Medical Center General Hospital.

We report the incidence and characteristics of lymphoceles after robot-assisted radical prostatectomy (RARP). Computed tomography was performed on 79 patients one month after RARP or when symptoms appeared. The lymphocele was defined as a cystic lesion over 10 mm in diameter. Symptomatic and asymptomatic lymphoceles were identified in 25% (20/79) of all cases, and in 40.9% (18/44) of the cases with lymph node dissection (LND). Symptomatic lymphoceles were identified in 2.5% (2/79) of all cases. Lymphoceles were significantly associated with LND, pathological stage over T3, longer period of indwelling drain tube,and higher volume fluid of drain tube (p<0.05). In conclusion, lymphoceles are quiet common after RARP. However, they rarely become symptomatic.
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http://dx.doi.org/10.14989/ActaUrolJap_64_6_261DOI Listing
June 2018

[A Case of Chromophobe Renal Cell Carcinoma Associated with Birt-Hogg-Dubé Syndrome].

Hinyokika Kiyo 2018 Mar;64(3):107-110

The Department of Urology, Kobe City Medical Center General Hospital.

A 61-year-old man with a left renal mass, which was detected by ultrasound during a routine health examination, was referred to our department. The patient had a surgical history of two pneumothorax operations, and the patient's brother also had a history of pneumothorax surgery. A case of Birt-Hogg-Dubé (BHD) syndrome was suspected based on patient history. The pathological diagnosis of the resected tumor, which used robot-assisted laparoscopic partial nephrectomy, was determined to be chromophobe renal cell carcinoma (grade 2, pT1a). BHD syndrome was confirmed by genetic testing, where a nonsense mutation of exon 9 in the FOLLICULIN (FLCN) gene was detected. The patient is currently alive 10 months after surgery.
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http://dx.doi.org/10.14989/ActaUrolJap_64_3_107DOI Listing
March 2018

Childhood leptospirosis in an industrialized country: Population-based study in Okinawa, Japan.

PLoS Negl Trop Dis 2018 03 8;12(3):e0006294. Epub 2018 Mar 8.

Department of General Pediatrics, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.

Leptospirosis is considered underdiagnosed because of its nonspecific presentation and lack of proper understanding of its epidemiology. Early diagnosis and treatment are crucial. However, few data are available on confirmed leptospirosis cases in children in industrialized countries. We therefore aimed to describe epidemiologic and clinical characteristics of laboratory-confirmed childhood leptospirosis in Okinawa, Japan. We reviewed the national surveillance data of pediatric leptospirosis in Okinawa, Japan from January 2003 through December 2015. The database included all of laboratory-confirmed leptospirosis diagnosed at the only central laboratory for leptospirosis in the region. There were 44 children (0-20 years of age) with laboratory-confirmed leptospirosis. Of these, 90% were male, 91% were 10-20 years of age, and 96% of cases occurred in August and September. The number of laboratory-confirmed patients ranged from 0 to 11 per year (mean: 3.3 per year), and the estimated annual rate was 1.0 per 100,000 pediatric populations. In all cases, the presumed infection route was recreational exposure to river water. Commonly observed manifestations include fever (95%), myalgia (52%), and conjunctival suffusion (52%). Childhood leptospirosis in Okinawa, Japan occurred predominantly in teenage boys after freshwater exposure in summer, and most patients had characteristic conjunctival suffusion. Cohort studies would be helpful to better understand more detailed clinical manifestations in association with prognosis.
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http://dx.doi.org/10.1371/journal.pntd.0006294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860792PMC
March 2018

Mental distress and health-related quality of life among type 1 and type 2 diabetes patients using self-monitoring of blood glucose: A cross-sectional questionnaire study in Japan.

J Diabetes Investig 2018 Sep 1;9(5):1203-1211. Epub 2018 Apr 1.

Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan.

Aims/introduction: The present multicenter, cross-sectional survey was initiated to evaluate self-monitoring of blood glucose (SMBG)-associated mental distress among patients with diabetes.

Materials And Methods: The survey was carried out in patients with type 1 diabetes and type 2 diabetes using SMBG recruited from 42 medical institutions. Profiles of Mood States 2 and diabetes therapy-related quality of life questionnaires were used to evaluate mood status and health-related quality of life. Two original questionnaires were also developed to evaluate SMBG 'importance,' 'painfulness' and 'confidence' among patients, and to evaluate physician attitudes to SMBG use.

Results: Questionnaires from 517 type 1 diabetes and 1,648 type 2 diabetes patients showed that 46.0% of type 1 diabetes and 37.5% of type 2 diabetes patients reported 'painfulness,' and that these patients reporting 'painfulness' showed significantly higher Profiles of Mood States 2 scores, lower diabetes therapy-related quality of life scores and higher glycated hemoglobin compared with those not reporting 'painfulness,' whereas the number of their daily SMBG tests were comparable. Patients reporting 'painfulness' also reported that SMBG use was significantly less important. Whether or not patients recognized the importance of SMBG use was well correlated with the frequency of physicians checking patient diaries.

Conclusions: Type 1 diabetes and type 2 diabetes patients reporting 'painfulness' in SMBG use had more mental distress, lower health-related quality of life and higher glycated hemoglobin regardless of their number of daily SMBG tests. The importance of SMBG use was recognized less by patients experiencing pain, and the importance of SMBG use was recognized more in medical institutions in which physicians regularly checked SMBG diaries to provide meaningful feedback to patients in clinical settings.
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http://dx.doi.org/10.1111/jdi.12827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123045PMC
September 2018

Cross-Sectional Imaging of Boundary Lubrication Layer Formed by Fatty Acid by Means of Frequency-Modulation Atomic Force Microscopy.

Langmuir 2017 10 29;33(40):10492-10500. Epub 2017 Sep 29.

Department of Chemistry, Kobe University 1-1 Rokkodai-cho, Nada-ku, Kobe, Hyogo 657-8501, Japan.

To observe in situ the adsorption of fatty acid onto metal surfaces, cross-sectional images of the adsorption layer were acquired by frequency-modulation atomic force microscopy (FM-AFM). Hexadecane and palmitic acid were used as the base oil and typical fatty acid, respectively. A Cu-coated silicon wafer was prepared as the target substrate. The solvation structure formed by hexadecane molecules at the interface between the Cu substrate and the hexadecane was observed, and the layer pitch was found to be about 0.6 nm, which corresponds to the height of hexadecane molecules. This demonstrates that hexadecane molecules physically adsorbed onto the surface due to van der Waals forces with lying orientation because hexadecane is a nonpolar hydrocarbon. When hexadecane with palmitic acid was put on the Cu substrate instead of pure hexadecane, an adsorption layer of palmitic acid was observed at the interface. The layer pitch was about 2.5-2.8 nm, which matches the chain length of palmitic acid molecules well. This indicates that the original adsorption layer was monolayer or single bilayer in the local area. In addition, a cross-sectional image captured 1 h after observation started to reveal that the adsorbed additive layer gradually grew up to be thicker than about 20 nm due to an external stimulus, such as cantilever oscillation. This is the first report of in situ observation of an adsorbed layer by FM-AFM in the tribology field and demonstrates that FM-AFM is useful for clarifying the actual boundary lubrication mechanism.
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http://dx.doi.org/10.1021/acs.langmuir.7b02528DOI Listing
October 2017

Alteration in the gastric microbiota and its restoration by probiotics in patients with functional dyspepsia.

BMJ Open Gastroenterol 2017 1;4(1):e000144. Epub 2017 May 1.

Laboratory for Infectious Diseases, Tokai University School of Medicine, Isehara City, Japan.

Objective: The objective of this study was to comparatively analyse the gastric fluid (GF) microbiota between patients with functional dyspepsia (FD) and healthy controls (HC), and to assess the effect of probiotics on the microbiota.

Design: Twenty-four Japanese patients with FD who met the Rome III definition and 21 age-matched and gender-matched HC volunteers were enrolled. The patients with FD had been treated with LG21, a probiotic strain. The GF was sampled after an overnight fast using a nasogastric tube. The bile acids concentration was determined by ELISA. The V3-V4 region of 16S rRNA gene was amplified using bacterial DNA from the GF, and then about 30 000 high-quality amplicons per sample were grouped into operational taxonomic units for analyses.

Results: The ratio of GF samples in which the bile acids were detectable was significantly greater in the FD than in the HC groups. In the bacterial composition analysis at the phylum level, the GF microbiota had a > abundance and an absence of in the FD group, in contrast, the GF microbiota had a < abundance and the presence of in the HC group. Probiotic therapy in patients with FD shifted the composition of the GF microbiota to that observed in the HC volunteers.

Conclusions: Alteration in the GF microbiota was found in patients with FD compared with HC volunteers. Reflux of the small intestinal contents, including bile acid and intestinal bacteria, to the stomach was suggested to induce a bacterial composition change and be involved in the pathophysiology underlying FD. Probiotics appear effective in the treatment of FD through the normalisation of gastric microbiota.

Trial Registration Number: UMINCTR 000022026; Results.
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http://dx.doi.org/10.1136/bmjgast-2017-000144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508964PMC
May 2017

[Risk Factors for Mortalityin Patients with Urosepsis].

Hinyokika Kiyo 2017 May;63(5):195-199

The Department of Urology, Kobe City Medical Center General Hospital.

Urosepsis is not uncommon and sometimes causes a critical condition including death. We retrospectivelyanaly zed the risk factors for mortalityin urosepsis. We treated 80 patients as urosepsis from 2010 to 2014 in our hospital. Five patients (6%) died within 30 days of hospitalization. The median age of the patients who died of urosepsis was 92 years (range, 83-95 years). The main causes of urosepsis were complicated pyelonephritis in 4 patients and emphysematous pyelonephritis in one. In the subgroup analysis of elderly patients over 75 years old, bad performance status and lower serum albumin were significantlyrelated to mortality(p =0.033, 0.046). The elderlypatients, especiallywith bad performance status and lower serum albumin, are more likelyto die.
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http://dx.doi.org/10.14989/ActaUrolJap_63_5_195DOI Listing
May 2017

Divergent clinical outcomes of alpha-glucosidase enzyme replacement therapy in two siblings with infantile-onset Pompe disease treated in the symptomatic or pre-symptomatic state.

Mol Genet Metab Rep 2016 Dec 18;9:98-105. Epub 2016 Nov 18.

Showa University Northern Yokohama Hospital, Children Medical Center, Yokohama, Kanagawa, Japan.

Pompe disease is an autosomal recessive, lysosomal glycogen storage disease caused by acid α-glucosidase deficiency. Infantile-onset Pompe disease (IOPD) is the most severe form and is characterized by cardiomyopathy, respiratory distress, hepatomegaly, and skeletal muscle weakness. Untreated, IOPD generally results in death within the first year of life. Enzyme replacement therapy (ERT) with recombinant human acid alpha glucosidase (rhGAA) has been shown to markedly improve the life expectancy of patients with IOPD. However, the efficacy of ERT in patients with IOPD is affected by the presence of symptoms and cross-reactive immunologic material (CRIM) status. We have treated two siblings with IOPD with ERT at different ages: the first was symptomatic and the second was asymptomatic. The female proband (Patient 1) was diagnosed with IOPD and initiated ERT at 4 months of age. Her younger sister (Patient 2) was diagnosed with IOPD at 10 days of age and initiated ERT at Day 12. Patient 1, now 6 years old, is alive but bedridden, and requires 24-hour invasive ventilation due to gradually progressive muscle weakness. In Patient 2, typical symptoms of IOPD, including cardiac failure, respiratory distress, progressive muscle weakness, hepatomegaly and myopathic facial features were largely absent during the first 12 months of ERT. Her cardiac function and mobility were well-maintained for the first 3 years, and she had normal motor development. However, she developed progressive hearing impairment and muscle weakness after 3 years of ERT. Both siblings have had low anti-rhGAA immunoglobulin G (IgG) antibody titers during ERT and have tolerated the treatment well. These results suggest that initiation of ERT during the pre-symptomatic period can prevent and/or attenuate the progression of IOPD, including cardiomyopathy, respiratory distress, and muscle weakness for first several years of ERT. However, to improve the long-term efficacy of ERT for IOPD, new strategies for ERT for IOPD, e.g. modifying the enzyme to enhance uptake into skeletal muscle and/or to cross the blood brain barrier (BBB), will be required.
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http://dx.doi.org/10.1016/j.ymgmr.2016.11.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121151PMC
December 2016

Gastric microbiota in the functional dyspepsia patients treated with probiotic yogurt.

BMJ Open Gastroenterol 2016 16;3(1):e000109. Epub 2016 Sep 16.

Laboratory for Infectious Diseases , Tokai University School of Medicine , Isehara , Japan.

Objective: To investigate the structure of the gastric microbiota in functional dyspepsia (FD) and its role in the pathophysiology.

Design: We compared the basic physiological properties of the gastric fluid (GF) and the structure of the microbiota in the GF of 44 healthy control (HC) participants and 44 patients with FD. We then treated the patients with FD with a yogurt containing a probiotic strain of OLL2716 (LG21 yogurt) and investigated the effects on the bacteriological parameters and symptoms to examine the relationship between them.

Results: The volume of GF recovered from the stomach after overnight fasting was greater in the patients with FD than in the HCs, and decreased in the patients with FD whose symptoms were improved by the LG21 yogurt treatment. An analysis using a terminal restriction fragment polymorphism method demonstrated that the overall structure of the bacterial community and the abundance of genus in the GF of the patients in the FD group were significantly different from those in the HC group. In the patients with FD, this bacteriological change was restored by treatment with LG21 yogurt. A significant inverse correlation was found between the abundance of and the severity of postprandial distress-like symptoms in patients with FD who received LG21 yogurt.

Conclusions: Significant dysbiosis was found in the GF microbiota of patients with FD and considered to be involved in the pathogenesis. The abundance of genus in the GF may be used as a biomarker of the efficacy of the treatment of FD.

Trial Registration Number: UMINCTR000022026.
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http://dx.doi.org/10.1136/bmjgast-2016-000109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051319PMC
September 2016

Clinical characteristics of patients aged 65 and older with newly developed type 1 diabetes: An analysis of elderly patients at our hospital.

Nihon Ronen Igakkai Zasshi 2016 ;53(2):143-51

Department of Diabetic Medicine, Kurashiki Central Hospital.

Aim: We herein investigated the clinical features of elderly patients with newly developed type 1 diabetes with respect to onset age, frequency of islet-associated antibodies, and other clinical markers.

Methods: One hundred and ninety-nine patients aged 65 and older with new-onset diabetes, who were admitted to our hospital between July 2000 and June 2013, were classified into 4 types of diabetes. In addition, 85 patients with newly diagnosed type 1A diabetes among all age ranges admitted during the same period were divided into two groups: a younger group (less than 65 years, n=71) and an elderly group (65 years and older, n=14). Clinical features including mode of onset, frequency of islet-associated antibodies, and serum C-peptide (CPR) levels were compared between these groups. The elderly group was further divided into two age groups (less than 75 years, n=7; 75 years and older, n=7), and the frequency of autoantibodies was compared.

Results: The patients (n=199) were classified into type 1 (n=16, 8%), type 2 (n=155, 78%), pancreatic (n=22, 11%), and other type (n=6, 3%) diabetes. Between the younger and elderly groups with type 1 diabetes, no significant difference in the CPR levels, frequency of autoantibodies, or other clinical features were observed. Positivity for IA-2 antibody was higher in the younger group (53.5%) than in the elderly group (35.7%), however, it was also considerably high (57.1%) in the oldest age group (75 years and older).

Conclusions: Type 1 diabetes may develop in the elderly, and an IA-2 antibody test may be useful for diagnosing type 1 diabetes in older patients.
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http://dx.doi.org/10.3143/geriatrics.53.143DOI Listing
March 2018

[Two Cases of Oncocytic Papillary Renal Cell Carcinoma].

Hinyokika Kiyo 2016 Apr;62(4):187-91

The Department of Urology, Kobe City Medical Center General Hospital.

Oncocytic papillary renal cell carcinoma isa variant of papillary renal cell carcinoma (PRCC). We herein report two cases treated with retroperitoneoscopic partial nephrectomy. Histologically, tumor cells of both cases exhibit round and regular nuclei with CK7 positive areas in the cytoplasm typical of TYPE1 PRCC and eosinophilic granular cytoplasm with E-cadherin positive areas in the cytoplasmic membrane, which indicates TYPE2 PRCC. Out of 46 cases reported in the literature, only one died of disease, which reveals its low malignant potential.
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April 2016

A reliable serum C-peptide index for the selection of an insulin regimen to achieve good glycemic control in obese patients with type 2 diabetes: an analysis from a short-term study with intensive insulin therapy.

Diabetol Int 2016 Sep 6;7(3):235-243. Epub 2015 Oct 6.

Diabetes Division, Department of Internal Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602 Japan.

Insulin regimens achieving favorable glycemic control in patients with type 2 diabetes are expected to closely relate to residual insulin secretory ability. We herein attempted to identify a reliable C-peptide immunoreactivity (CPR) index as an insulin secretory marker that would contribute to the selection of an appropriate insulin regimen for patients with type 2 diabetes. We near-normalized blood glucose in 246 obese patients with type 2 diabetes using our protocol (which included short-term intensive insulin therapy, IIT), and administered an oral hypoglycemic agent (OHA). Based on responsiveness to OHA, patients were classified into three therapy groups: non-insulin therapy ( = 78), basal-insulin supported oral therapy (BOT) ( = 109), and multiple daily insulin injection (MDI) therapy ( = 59). Glucagon-loading CPR increment (ΔCPR), fasting CPR (FCPR), CPR2h after breakfast (CPR2h), ratio of FCPR to fasting plasma glucose (CPI), CPI2h after breakfast (CPI2h), and secretory unit of islets in transplantation (SUIT) were assessed with receiver operating characteristic (ROC) and multiple logistic analyses to discriminate the MDI group from the other therapy groups. ROC analysis revealed that CPR2h had the greatest area under the curve and specificity. Multiple logistic analysis identified CPR2h and CPI2h as the most significant explanatory variables for identifying patients assigned to the MDI group. A postprandial serum CPR marker such as CPR2h or CPI2h was shown to be the best index for predicting an appropriate insulin regimen to achieve good glycemic control in obese patients with type 2 diabetes.
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http://dx.doi.org/10.1007/s13340-015-0239-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224994PMC
September 2016

Proximal Junctional Failure After Long-Segment Instrumentation for Degenerative Lumbar Kyphosis With Ankylosing Spinal Disorder.

Spine (Phila Pa 1976) 2015 Jun;40(12):E740-3

From the Department of Orthopaedic Surgery, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan.

Study Design: Case report.

Objective: We report a case of proximal junctional failure at the ankylosed, but not the mobile, junction after segmental instrumented fusion for degenerative lumbar kyphosis with ankylosing spinal disorder.

Summary Of Background Data: Proximal junctional failure (PJF) and proximal junctional kyphosis (PJK) are important complications that occur subsequent to long-segment instrumentation for correction of adult spinal deformity. Thus far, most studies have focused on the mobile junction as a site at which PJK/PJF can occur, and little is known about the relationship between PJK/PJF and ankylosing spinal disorders such as diffuse idiopathic skeletal hyperostosis.

Methods: The patient was an 82-year-old female with degenerative lumbar kyphosis. She had abnormal confluent hyperostosis in the anterior longitudinal ligaments from Th5 to Th10. The patient was treated operatively with spinal instrumented fusion from Th10 to the sacrum.

Results: Four weeks subsequent to initial surgery, the patient developed progressive lower extremity paresis caused by the uppermost instrumented vertebrae fracture (Th10) and adjacent subluxation (Th9). Extension of fusion to Th5 with decompression at Th9-Th10 was performed. However, the patient showed no improvement in neurological function.

Conclusion: PJF can occur at the ankylosing site above the uppermost instrumented vertebrae after long-segment instrumentation for adult spinal deformity. PJF in the ankylosed spine may cause severe fracture instability and cord deficit. The ankylosed spine should be integrated into the objective determination of materials contributing to the appropriate selection of fusion levels.

Level Of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000000894DOI Listing
June 2015

Immediate Reduction of a Retro-odontoid Synovial Cyst Following Lateral Atlantoaxial Joint Puncture and Arthrography: A Case Report.

Spine (Phila Pa 1976) 2015 May;40(10):E609-12

From the Department of Orthopedic Surgery, Japanese Red Cross Society, Himeji Hospital, Hyogo, Japan.

Study Design: Case report.

Objective: We report on a case with a retro-odontoid synovial cyst, and the immediate reduction of the cyst was confirmed after lateral atlantoaxial joint puncture and arthrography.

Summary Of Background Data: Retro-odontoid synovial cysts are rare diseases located posteriorly to a dense axis. Because most reports have focused on surgical treatment, only a few have examined nonsurgical treatment. However, several months are required after nonsurgical treatment until cyst regression.

Methods: A 52-year-old female presented with atlantoaxial instability. She complained of neck pain and numbness in her hands. Magnetic resonance imaging revealed a retro-odontoid synovial cyst. Lateral atlantoaxial joint puncture and arthrography were performed.

Results: Two days after treatment, the patient showed significant improvement in the numbness of her hands, and a follow-up magnetic resonance imaging revealed an immediate reduction in the cyst. During a 4.5-year follow-up period, no recurrence of the clinical symptoms occurred.

Conclusion: Lateral atlantoaxial joint puncture may immediately reduce retro-odontoid synovial cysts, and the lateral atlantoaxial joint has a communication channel with the retro-odontoid synovial cyst via the atlantodental joint. Once disappearance of the cyst is confirmed, an acceptable long-term outcome can be achieved with nonsurgical treatment even in cases with atlantoaxial instability.

Level Of Evidence: N/A.
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http://dx.doi.org/10.1097/BRS.0000000000000855DOI Listing
May 2015

Postprandial serum C-peptide value is the optimal index to identify patients with non-obese type 2 diabetes who require multiple daily insulin injection: Analysis of C-peptide values before and after short-term intensive insulin therapy.

J Diabetes Investig 2013 Nov 30;4(6):618-25. Epub 2013 May 30.

Diabetes Division Department of Internal Medicine Kurashiki Central Hospital Kurashiki Okayama Japan.

Aims/introduction: Type 2 diabetes is a progressive disease characterized by a yearly decline in insulin secretion; however, no definitive evidence exists showing the relationship between decreased insulin secretion and the need for insulin treatment. To determine the optimal insulin secretory index for identifying patients with non-obese type 2 diabetes who require multiple daily insulin injection (MDI), we evaluated various serum C-peptide immunoreactivity (CPR) values.

Materials And Methods: We near-normalized blood glucose with intensive insulin therapy (IIT) over a 2-week period in 291 patients with non-obese type 2 diabetes, based on our treatment protocol. After improving hyperglycemia, we challenged with oral hypoglycemic agent (OHA), and according to the responsiveness to OHA, patients were classified into three therapy groups: OHA alone (n = 103), basal insulin plus OHA (basal insulin-supported oral therapy [BOT]; n = 56) and MDI (n = 132). Glucagon-loading CPR increment (ΔCPR), fasting CPR (FCPR), CPR 2 h after breakfast (CPR2h), the ratio of FCPR to FPG (CPI), CPI 2 h after breakfast (CPI2h) and secretory unit of islets in transplantation (SUIT) were submitted for the analyses. Receiver operating characteristic (ROC) and multiple logistic analyses for these CPR indices were carried out.

Results: Many CPR values were significantly lower in the MDI group compared with the OHA alone or BOT groups. ROC and multiple logistic analyses disclosed that post-prandial CPR indices (CPR2h and CPI2h) were the most reliable CPR markers to identify patients requiring MDI.

Conclusions: Postprandial CPR level after breakfast is the most useful index for identifying patients with non-obese type 2 diabetes who require MDI therapy.
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http://dx.doi.org/10.1111/jdi.12103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020258PMC
November 2013

Postoperative deep surgical-site infection after instrumented spinal surgery: a multicenter study.

Global Spine J 2013 Jun 15;3(2):95-102. Epub 2013 Apr 15.

Department of Orthopaedic Surgery, Toneyama Hospital, Osaka, Japan.

A retrospective survey revealed 37 cases (1.1%) of deep surgical-site infection (SSI) among 3,462 instrumented spinal surgeries between 2004 and 2008. Excluding 8 patients who were unclassifiable, we categorized 29 patients into 3 groups of similar backgrounds-thoracolumbar degenerative disease (the DEG group; n = 15), osteoporotic vertebral collapse (the OVC group; n = 10), and cervical disorders (the cervical group; n = 4)-and investigated the key to implant salvage. Final respective implant retention rates for the groups were 40, 0, and 100%, with the OVC group having the worst rate (p < 0.01). In the DEG group with early infection, those whose implants were retained had lower body temperatures, lower white blood cell counts, and a lower rate of discharge at the time of SSI diagnosis (p < 0.05). Implant retention may be affected by initial spinal pathology. In the DEG group, debridement before drainage may be advantageous to implant salvage.
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http://dx.doi.org/10.1055/s-0033-1343072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854595PMC
June 2013

A Case of Mild Encephalopathy with a Reversible Splenial Lesion Associated with G5P[6]Rotavirus Infection.

Case Rep Pediatr 2013 13;2013:197163. Epub 2013 Nov 13.

Division of Pediatric Neurology & General, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Japan.

We report a case of mild encephalopathy with a reversible splenial lesion (MERS) associated with acute gastroenteritis caused by rotavirus (RV) infection. The patient (male, 4 years and 3 months old) was admitted to our hospital for diarrhea and afebrile seizures. Head MRI revealed a hyperintense signal in the splenium of the corpus callosum on DWI and a hypointense signal on the ADC-map. After awakening from sedation, the patient's disturbance of consciousness improved. On day 5 after admission of the illness, the patient was discharged from the hospital in a good condition. Electroencephalography on day 2 after admission was normal. On day 8 of admission, head MRI revealed that the splenial lesion had disappeared. RV antigen-positive stools suggested that RV had caused MERS. This RV genotype was considered to be G5P[6]; it may have spread to humans as a strain reassortment through substitution of porcine RV into human RV gene segments. This extremely rare genotype was detected first in Japan and is not covered by existing vaccines; this is the first sample isolated from encephalopathy patients. Few reports have investigated RV genotypes in encephalopathy; we believe that this case is valuable for studying the relationship between genotypes and clinical symptoms.
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http://dx.doi.org/10.1155/2013/197163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845239PMC
December 2013

[A case of prostate carcinosarcoma successfully treated with combined modality therapy].

Hinyokika Kiyo 2013 Nov;59(11):749-52

The Department of Urology, Kyoto University Hospital.

A 58-year-old man was referred to our hospital with dysuria and elevation of prostate specific antigen (38.0 ng/ml). Prostate surface was smooth and elastic hard on digital rectal examination. Transrectal ultrasound (TRUS) indicated irregular boundary and low echoic area of the prostate. Prostate biopsy specimen included the components of adenocarcinoma (Gleason score 9) and sarcoma. The tumor had extended to the rectum and metastasized to bilateral obturator lymph nodes and right ischial bone (cT4N1M1b). We started hormone therapy for the adenocarcinoma component followed by total pelvic exenteration with colostomy and ileal conduit diversion for the sarcoma component. In addition, pelvic cavity and the bone metastasis were irradiated. The patient was free of recurrence at four and a half years after surgery.
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November 2013

[Experience of transobturator sling for iatrogenic male stress urinary incontinence].

Hinyokika Kiyo 2013 Aug;59(8):479-83

The Department of Urology, Kyoto University Graduate School of Medicine, Japan.

We performed transobturator sling (TOS) surgery for iatrogenic stress urinary incontinence (SUI) in 7 men. Assessment with the International Consultation Society Incontinence Questionnaire Short Form revealed that complete continence, significant improvement, and no change of incontinent status were observed in two, three, and two patients, respectively, at one year after surgery. Of the three patients with significant improvement, two patients obtained a pad-free status. Both of the two patients without improvement had a past history of salvage radiation therapy for biochemical recurrence after radical prostatectomy before TOS surgery. The severity of SUI seems not to be associated with the outcome of TOS surgery. TOS surgery can be one of the surgical options for iatrogenic male SUI.
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August 2013

Urinary retention in a female patient caused by a urethral venous thrombus with massive edema.

Int J Urol 2013 Aug 17;20(8):842-4. Epub 2012 Dec 17.

Department of Urology, Kurashiki Central Hospital, Okayama, Japan.

Female urinary retention is rarely caused by an unknown condition. In such a case, common causes including neurogenic, anatomical, traumatic and iatrogenic voiding dysfunction are excluded. Both the radiological and histological findings specific to the condition remain unclear. We herein report a 75-year-old woman in whom a large venous mass and massive edema at the proximal urethra caused urinary outlet obstruction based on magnetic resonance images and histological findings. Ultrasonography and cystoscopy showed a urethral mass lesion protruding into the bladder neck. Fat-suppressed T2-weighted and gadolinium-enhanced T1-weighted magnetic resonance images suggested thrombosed veins with massive edema under the urethral mucosa. Transurethral resection of the mass lesion was carried out, and histopathological analysis proved the presence of thrombosed large veins. The patient regained normal urination, and the mass lesion did not recur. Thrombosed venous mass with edema at the proximal urethra might be an important cause of atypical urinary retention in women.
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http://dx.doi.org/10.1111/iju.12056DOI Listing
August 2013

[Heparin as bridging anticoagulant and antiplatelet therapy during the perioperative period].

Hinyokika Kiyo 2012 May;58(5):223-6

The Department of Urology, Kurashiki Central Hospital.

Anticoagulant and antiplatelet medications are commonly used for the treatment and prevention of cardiovascular diseases. We studied 84 patients who received heparin as a bridging anticoagulant and antiplatelet therapy during the perioperative period. Hospitalization was extended for adjusting anticoagulant and antiplatelet drugs and also bleeding complications in the perioperative period. There were 25 instances of bleeding complications (29.7%) in this study. These complications mainly occurred when anticoagulant and antiplatelet medications were restarted in the postoperative period. In transurethral surgery, patients taking warfarin and antiplatelet drugs (aspirin or ticlopidine) had a statistically significant increase in bleeding complications compared to patients taking warfarin alone. We compared 51 cases of transurethral resection of bladder tumor, transurethral resection of the prostate holium laser enucleation of the prostate, nephroureterectomy and percutaneous nephrolithotomy with heparinization were compared to 692 cases with no heparinization. The heparinization group had a statistically significant longer hospitalization period and an increase in bleeding complications. There was one instance of thromboembolism (1.2%) in our series. This involved stent thrombosis of a patient who had drug-eluting stent in the left anterior descending coronary artery. She died three days postoperatively. The number of patients taking anticoagulant and/or antiplatelet drugs is predicted to increase in the future due to aging of the population. Guidelines for the management of anticoagulant and antiplatelet therapy in the urological period are considered necessary.
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May 2012

[Case of rectal migratin of mesh after TVM (tension-free vaginal mesh) operation].

Nihon Hinyokika Gakkai Zasshi 2011 Nov;102(6):726-30

The Department of Urology, Kurashiki Central Hospital.

A 64-year-old woman presented with recto-cutaneous fistula after tension-free vaginal mesh reconstruction using polypropylene mesh for pelvic organ prolapse. Eleven months after the operation, an ulcerative lesion with stools smell secretion developed in the left hip. Magnetic resonance imaging and colonoscopy revealed a migration of the left arm of the mesh and a recto-cutaneous fistula. The patient underwent excision of the infected mesh and rectal wall closure together with transient colostomy. After 8 months, colonoscopy revealed a new migration of the mesh in the rectum, which was also removed. The colostomy was closed one year later and rectal erosion has not reccurred since then. The possibility of developing a rare but severe mesh-related complication as presented here should always be kept in mind.
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http://dx.doi.org/10.5980/jpnjurol.102.726DOI Listing
November 2011