1.Laboratory practice in transfusion medicine for medical students and physicians at Okayama University Hospital
Kazuma IKEDA ; Haruko SUGIYAMA ; Tohru IKEDA ; Naomi ASANO ; Hiroaki OGO ; Tomoko MIYOSHI ; Hitomi KATAOKA ; Takaaki MIZUSHIMA ; Yoshio NAKAMURA ; Nobuchika KUSANO ; Hiroki OKADA ; Koji OCHI ; Norio KOIDE
Medical Education 2010;41(1):51-53
1) All students but 1 correctly typed the ABO blood groups, but only 33.2% of students and 63.9% of physicians properly performed cross-matching.
2) Most failures in cross-matching were due to the inability to detect allogeneic antibodies, but 5.2% of students and 2.9% of physicians failed to detect ABO mismatching.
3) Although laboratory practice is suggested to help students to solidify knowledge and comprehend principles, achieving an official goal of residency - gaining competence in performing and interpreting cross-matching independently - appeared difficult.
2.Pulmonary stenosis after arterial switch operation for complete transposition of the great arteries(TGA).
Tadashi IKEDA ; Yoshio YOKOTA ; Fumio OKAMOTO ; Akira SHIMIZU ; Shogo NAKAYAMA ; Shuichi MATSUNO ; Shigehiro OHTANI ; Katsushi ODA ; Seiichiro MAKINO
Japanese Journal of Cardiovascular Surgery 1989;19(1):7-12
Pulmonary stenosis is the most frequent problem after arterial switch operation for TGA. We experienced four cases of late severe pulmonary stenosis out of twelve patients. All four had supravalvular stenosis either at anastomotic site or at previously banded segment. One patient had associated valvular stenosis and another had bilateral branch stenosis. It is possible that valvular stenosis was due to retraction of equine pericardial patch and branch stenosis was due to overdistension. All four cases were successfully reoperated on 13∼39 months after switch operation. To prevent late pulmonary stenosis, we now alter technique of switch operation in two points. First, the great arteries are anastomosed with interrupted U-shaped sutures from outside of the vessels in whole circumference. Second, both coronary arteries are transferred with punched-out method to save tissue of Valsalva sinus, and the defects are closed with autologous pericardial patch.
3.Reoperation of Obstructed Extracardiac Valved Conduits.
Shogo NAKAYAMA ; Yoshio YOKOTA ; Fumio OKAMOTO ; Shuichi MATSUNO ; Tadashi IKEDA ; Shigehiro OHTANI ; Kouji NAKANISHI ; Hideaki NISHIMORI ; Seiichiro MAKING ; Eiji YOSHIKAWA
Japanese Journal of Cardiovascular Surgery 1991;20(5):851-856
Obstruction of right ventricle-pulmonary artery bioprosthetic valved conduits can result from valvular degeneration and calcification or neointimal peel formation. From 1968 through 1989, 38 patients underwent repair of congenital heart malformation with a porcine xenograft extracardiac valved conduits from right ventricle to pulmonary artery. Of 27 patients who survived after initial repair, 14 patients (8 males and 6 females) were reoperated for conduit obstructions. Ages of patients at the reoperation ranged 5 to 20yr (mean age 11.8±3.6yr) and the interval between initial repair and reoperation ranged 3 to 9yr (mean 6.6±1.7yr). The obstructed conduits were replaced with mechanical valved conduits (4 patients), nonvalved conduits (7 patients) or outflow patches (3 patients). In a half of patients, obstructions occured at multiple levels within the conduits. Obstructions mainly resulted from valvular degeneration, neointimal peel formation and anastomotic narrowings. There was no operative death but one late death due to the infective endocarditis. The systolic pressure ratio of right ventricle to left ventricle (or aorta) decreased from 0.81±0.13 preoperatively to 0.48±0.10 postoperatively. From our experience, it is recommended to use adequate sized bioprosthetic valued conduits for patients' body weight at the initial repair and replace obstructed conduits to the large sized nonvalved conduit at reoperation if possible.
4.Association Between Body Mass Index and Functional Dyspepsia in Young Japanese People
Yasunori YAMAMOTO ; Shinya FURUKAWA ; Junichi WATANABE ; Aki KATO ; Katsunori KUSUMOTO ; Eiji TAKESHITA ; Yoshio IKEDA ; Naofumi YAMAMOTO ; Katsuhiko KOHARA ; Yuka SAEKI ; Yoichi HIASA
Journal of Neurogastroenterology and Motility 2022;28(2):276-282
Background/Aims:
Evidence regarding the association between body mass index (BMI) and functional dyspepsia (FD) in the Asian population is limited.Further, no study has evaluated this issue in young people in Asian and Western populations. Thus, we aim to investigate this issueamong young Japanese people.
Methods:
The study subjects comprised of 8923 Japanese university students. BMI was divided into 4 categories (quartiles) on the basis of thestudy subjects’ distribution (lowest, low, moderate, and high [reference]). The definition of lean, normal, overweight, and obesewas BMI < 18.5 kg/m2 , 18.5 ≤ BMI < 25 kg/m2 (reference), 25 kg/m2 ≤ BMI < 30 kg/m2 , and 30 kg/m2 ≤ BMI, respectively. The definition of FD was based on the Rome III criteria.
Results:
The prevalence of FD was 1.9% in this cohort. The lowest BMI was independently associated with FD after adjustment (adjusted odds ratio [OR], 2.88; 95% confidence interval [CI], 1.46-3.67); P for trend = 0.001). The lowest BMI was independently associated with FD in women but not in men (OR, 2.94; 95% CI, 1.59-5.77; P for trend = 0.001). Leanness was independently associated with FD in total and in women but not in men (total: adjusted OR, 2.01; 95% CI, 1.40-2.86) and women (OR, 2.19; 95% CI, 1.35-3.45). However,interaction analysis showed no significant difference for sex.
Conclusions
Among young Japanese people, BMI may be independently inversely associated with FD. Leanness may be an independent associated factor for FD in the young Japanese women.
5.Association Between Eating Behavior, Frequency of Meals, and Functional Dyspepsia in Young Japanese Population
Yasunori YAMAMOTO ; Shinya FURUKAWA ; Junichi WATANABE ; Aki KATO ; Katsunori KUSUMOTO ; Teruki MIYAKE ; Eiji TAKESHITA ; Yoshio IKEDA ; Naofumi YAMAMOTO ; Katsuhiko KOHARA ; Syuichi SAHEKI ; Yuka SAEKI ; Yoichi HIASA
Journal of Neurogastroenterology and Motility 2022;28(3):418-423
Background/Aims:
Functional dyspepsia (FD) may be a common digestive disease worldwide and reduces the quality of life of patients. However, only a few studies have investigated the association between eating behavior and FD. The purpose of this cross-sectional study is to examine the association between eating behavior and prevalence of FD in a young Japanese cohort.
Methods:
In this study, we enrolled 8923 Japanese university students. FD is diagnosed based on the Rome III criteria. Eating habits and frequency of meals were investigated using a self-administered questionnaire.
Results:
The FD subjects had a younger mean age, a lower body mass index, and a lower proportion of men compared to the non-FD subjects.An independent positive association between skipping breakfast and/or lunch and FD was found (adjusted ORs were 1.60 [95% CI, 1.10-2.32] for breakfast and 2.52 [95% CI, 1.04-5.18] for lunch). Skipping dinner, extra meals (snacks) or midnight snacks was not associated with FD. The prevalence of FD in subjects eating 1, 2, and 3 meals per day was 4.8%, 2.2%, and 1.7%, respectively. The frequency of meals was independently inversely associated with prevalence of FD (adjusted ORs were 1 per day: 2.72 [95% CI, 1.19-5.42], and 2 per day: 1.69 [95% CI, 1.16-2.43], P for trend = 0.001).
Conclusions
In the young Japanese people, the frequency of meals may be independently inversely associated with prevalence of FD. In particular, skipping breakfast and/or lunch was associated with the prevalence of FD.
6.Multimorbidity of Allergic Diseases Is Associated With Functional Gastrointestinal Disorders in a Young Japanese Population
Yasunori YAMAMOTO ; Shinya FURUKAWA ; Teruki MIYAKE ; Junichi WATANABE ; Yukihiro NAKAMURA ; Yoshihiro TAGUCHI ; Tetsuya YAMAMOTO ; Aki KATO ; Katsunori KUSUMOTO ; Osamu YOSHIDA ; Eiji TAKESHITA ; Yoshio IKEDA ; Naofumi YAMAMOTO ; Yuka SAEKI ; Osamu YAMAGUCHI ; Yoichi HIASA
Journal of Neurogastroenterology and Motility 2024;30(2):229-235
Background/Aims:
Although certain allergic diseases have been reported to be associated with the prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS), it is unclear whether the presence of multiple allergic diseases further increases the prevalence of FD and IBS.The aim of this study is to determine this issue in young people.
Methods:
A cohort of 8923 Japanese university students was enrolled and diagnoses of FD and IBS were confirmed using Rome III criteria.Allergic disorders diagnosed at medical institutions were obtained by means of a self-administered questionnaire.
Results:
The prevalence of FD, IBS, and their overlap was found to be 1.9%, 6.5%, and 1.1%, respectively. Pollen allergy was independently positively correlated with FD, IBS, and overlap of FD and IBS. Allergic rhinitis was positively linked to IBS. Drug allergy was positively associated with FD. The presence of multiple allergic diseases was positively correlated with FD and IBS (FD: adjusted OR for 2 allergic diseases: 1.95 [95% CI, 1.24-2.98], P for trend = 0.003; and IBS: adjusted OR for 1 allergic disease: 1.40 [95% CI, 1.15-1.69], 2 allergic diseases 1.47 [95% CI, 1.12-1.91], and 3 or more allergic diseases: 2.22 [95% CI, 1.45-3.28], P for trend = 0.001). Additionally, the concomitant existence of multiple allergic diseases was also demonstrated to have a trend that correlated with the overlap of FD and IBS (P for trend = 0.018).
Conclusion
Allergic disease multimorbidity is positively correlated with the prevalence of FD and IBS in a young population.
7.Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease
Teruki MIYAKE ; Shinya FURUKAWA ; Bunzo MATSUURA ; Osamu YOSHIDA ; Masumi MIYAZAKI ; Akihito SHIOMI ; Ayumi KANAMOTO ; Hironobu NAKAGUCHI ; Yoshiko NAKAMURA ; Yusuke IMAI ; Mitsuhito KOIZUMI ; Takao WATANABE ; Yasunori YAMAMOTO ; Yohei KOIZUMI ; Yoshio TOKUMOTO ; Masashi HIROOKA ; Teru KUMAGI ; Eiji TAKESITA ; Yoshio IKEDA ; Masanori ABE ; Yoichi HIASA
Diabetes & Metabolism Journal 2024;48(3):440-448
Background:
Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.
Methods:
This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%.
Results:
Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.
Conclusion
Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.
8.Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease
Teruki MIYAKE ; Shinya FURUKAWA ; Bunzo MATSUURA ; Osamu YOSHIDA ; Masumi MIYAZAKI ; Akihito SHIOMI ; Ayumi KANAMOTO ; Hironobu NAKAGUCHI ; Yoshiko NAKAMURA ; Yusuke IMAI ; Mitsuhito KOIZUMI ; Takao WATANABE ; Yasunori YAMAMOTO ; Yohei KOIZUMI ; Yoshio TOKUMOTO ; Masashi HIROOKA ; Teru KUMAGI ; Eiji TAKESITA ; Yoshio IKEDA ; Masanori ABE ; Yoichi HIASA
Diabetes & Metabolism Journal 2024;48(3):440-448
Background:
Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.
Methods:
This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%.
Results:
Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.
Conclusion
Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.
9.Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease
Teruki MIYAKE ; Shinya FURUKAWA ; Bunzo MATSUURA ; Osamu YOSHIDA ; Masumi MIYAZAKI ; Akihito SHIOMI ; Ayumi KANAMOTO ; Hironobu NAKAGUCHI ; Yoshiko NAKAMURA ; Yusuke IMAI ; Mitsuhito KOIZUMI ; Takao WATANABE ; Yasunori YAMAMOTO ; Yohei KOIZUMI ; Yoshio TOKUMOTO ; Masashi HIROOKA ; Teru KUMAGI ; Eiji TAKESITA ; Yoshio IKEDA ; Masanori ABE ; Yoichi HIASA
Diabetes & Metabolism Journal 2024;48(3):440-448
Background:
Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.
Methods:
This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%.
Results:
Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.
Conclusion
Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.
10.The albumin to globulin ratio is associated with clinical outcome in Japanese patients with ulcerative colitis
Sen YAGI ; Shinya FURUKAWA ; Kana SHIRAISHI ; Teruki MIYAKE ; Kazuhiro TANGE ; Yu HASHIMOTO ; Shogo KITAHATA ; Tomoe KAWAMURA ; Tomoyuki NINOMIYA ; Kenichirou MORI ; Seiyuu SUZUKI ; Naozumi SHIBATA ; Hidehiro MURAKAMI ; Katsuhisa OHASHI ; Aki HASEBE ; Hideomi TOMIDA ; Yasunori YAMAMOTO ; Eiji TAKESHITA ; Yoshio IKEDA ; Yoichi HIASA
Annals of Coloproctology 2023;39(2):155-163
Purpose:
The albumin-to-globulin ratio (AGR) is a recognized chronic inflammation marker. No evidence regarding the relationship between AGR level and ulcerative colitis (UC) exists. The aim of this study was to evaluate the association between AGR and clinical outcomes among Japanese subjects with UC.
Methods:
The study subjects consisted of 273 Japanese individuals with UC. AGR was divided into 4 categories (low, moderate, high, and very high). The definition of complete mucosal healing (MH) was based on the Mayo endoscopic subscore of 0. Clinical remission (CR) was defined as no rectal bleeding and no abnormally high stool frequency (<3 times per day).
Results:
The percentage of MH was 26.4%. High AGR and very high AGR were significantly positively correlated with CR (adjusted odds ratio [OR], 5.85; 95% confidence interval [CI], 2.52–14.18 and adjusted OR, 4.97; 95% CI, 2.14–12.04) and complete MH (adjusted OR, 4.03; 95% CI, 1.56–11.51 and adjusted OR, 5.22; 95% CI, 1.97–14.89), respectively after adjustment for confounding factors (P for trend=0.001). Only in the low C-reactive protein (CRP) group (≤0.1 mg/dL), very high AGR was significantly positively correlated with complete MH but not CR (adjusted OR, 4.38; 95% CI, 1.06–21.77; P for trend=0.017). In the high CRP group, no correlation between AGR and complete MH was found.
Conclusion
Among Japanese patients with UC, AGR may be independently positively correlated with complete MH. In particular, among UC patients with low CRP, AGR might be a useful complementary marker for complete MH.