Showing papers by "Kazuo Hara published in 2009"
TL;DR: From these results the contribution of these seven loci in conferring susceptibility to type 2 diabetes is considered minor in the Japanese population, if they are present.
Abstract: Aims/hypothesis
Additional susceptibility loci for type 2 diabetes have been identified by a meta-analysis of genome-wide association studies (GWASs) in European populations. To examine further the roles of these new loci, we performed a replication study for the association of these single-nucleotide polymorphism (SNP) loci with the disease in three independent Japanese populations.
32 citations
TL;DR: This paper describes ‘‘how I do it and when I use (and do not use) EUS-FNA’’ with a special reference to current indications and contraindications of the technique, highlighting the differences in approach in Japan compared to the West.
17 citations
TL;DR: Gem citabine chemotherapy showed similar survival benefit compared to 5-fluorouracil- and gemcitabine-based chemoradiotherapy in locally advanced unresectable PC.
Abstract: Although a randomized controlled trial for locally advanced pancreatic cancer (PC) has demonstrated a survival advantage for treatment with gemcitabine alone, chemoradiotherapy remains the treatment of choice for locally advanced disease in Japan. The aim of this study was to compare the survival benefits associated with gemcitabine and concurrent chemoradiotherapy in locally advanced unresectable PC. Seventy-seven patients with locally advanced unresectable PC were retrospectively enrolled from April 2001 to December 2006. All cases were histologically proven, and patients received gemcitabine chemotherapy (n = 30) or concurrent chemoradiotherapy (based on 5-fluorouracil, n = 28, or gemcitabine, n = 19, as a radiosensitizer) at Aichi Cancer Center Hospital. Patients who received chemoradiotherapy had significantly better performance status than those who had chemotherapy. Tumor response was 0% for chemotherapy and 13% chemoradiotherapy, but survival benefit was similar among patients in the chemotherapy group (overall response (OS) 12 months; progression-free survival (PFS), 3 months) and those in the chemoradiotherapy group (OS, 13 months; PFS, 5 months). Two-year survival was 21% for chemotherapy patients and 19% for chemoradiotherapy patients. Severe toxicities (Grade 3–4 National Cancer Institute-Common Toxicity Criteria, version 3.0) were significantly more frequent for chemoradiotherapy than for chemotherapy. Gemcitabine chemotherapy showed similar survival benefit compared to 5-fluorouracil- and gemcitabine-based chemoradiotherapy.
9 citations
TL;DR: The Japanese guideline of JSH 2009 recommends that the antihypertensive drugs primarily administered to patients with diabetes mellitus and metabolic syndrome should be selected from angiotensin-converting enzyme inhibitors (ACEI) or angiotsin-receptor blockers (ARB).
Abstract: ypertension is one of the major risk factors of cardiovascular diseases. In Japan as well as in western countries, the number of obese individuals with hypertension has been rapidly increasing. It has been demonstrated that visceral obesity causes qualitative and quantitative abnormalities in adipokines, thus leading to the condition that is defined as metabolic syndrome.1 The main aim of lowering blood pressure is to prevent cardiovascular diseases. The results of previous trials indicate that the amount of blood pressure reduction, not the class of drugs, is the major determinant of reduction in cardiovascular risk;2 all the antihypertensive drugs have both positive indications and contraindications according to the condition under which they are used. Therefore, appropriate antihypertensive drugs should be selected based on various factors, including positive indications, conditions that require careful use of drugs and the presence or absence of complications. The Japanese guideline of JSH 2009 recommends that the antihypertensive drugs primarily administered to patients with diabetes mellitus and metabolic syndrome should be selected from angiotensin-converting enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB).3 In case an amount of one class of antihypertensive drug is not sufficient to lower blood pressure, the dose should be increased or a low dose of an antihypertensive drug from a different class should be used concomitantly.4 However, there is not a lot of evidence as to which combination is better than other combinations in a specific condition such as metabolic syndrome.
2 citations
TL;DR: EUS-FNAでは悪性所見を認めず，またUS-TCBにてlymphoplasmacytic sclerosing pancreatitisになり得ると考えられた．
Abstract: 症例は41歳，女性．腹部の鈍痛，褐色尿，および左眼瞼腫大を主訴に当院紹介となった．血液検査にて高IgG4血症，腹部CTにてびまん性膵腫大および膵内胆管壁肥厚，ERPにて主膵管のびまん狭細像，FDG-PETで膵へのFDGのびまん性集積を認め，自己免疫性膵炎が疑われた．EUS-FNAでは悪性所見を認めず，またUS-TCBにてlymphoplasmacytic sclerosing pancreatitisを認め，自己免疫性膵炎と診断した．また，ステロイド投与後3日目にFDG-PETを施行し治療前と比較したところ，膵および膵外病変はともにFDG集積の著明な低下を認めた．ステロイド治療前後のFDG-PET検査は，自己免疫性膵炎における早期の治療効果判定，および癌との早期鑑別診断に有用な検査法になり得ると考えられた．
TL;DR: It is claimed that the ovarian-like stroma contains “vulnerable material” from several species.
Abstract: 症例は50歳代，女性．糖尿病と体重減少で2007年9月に前医を受診，膵尾部に嚢胞性腫瘍を指摘され精査加療目的で当院紹介．US，CT，EUSで膵尾部から腹側に突出する径8cm，比較的厚い被膜を有する嚢胞を認めた．嚢胞と膵の境界部には2cm大の充実性腫瘤が存在し，脾静脈は閉塞し，膵後面結合織への浸潤が疑われた．以上の所見から，浸潤性粘液性嚢胞腺癌を第一に考え，10月膵体尾部·脾切除，横行結腸切除，左腎部分切除を施行した．切除割面で嚢胞は単房性で，嚢胞壁に連続して3.5cmの結節が存在した．病理所見では充実性部分は管状腺癌の所見で，癌は3/4周にわたり嚢胞壁に沿って浸潤，また脾静脈，横行結腸，腎被膜にも浸潤していた．嚢胞上皮は腺腫∼癌の所見を認めたがovarian-like stromaは認めなかった．本例の病態としては浸潤性粘液性嚢胞腺癌，膵管内腫瘍由来浸潤癌，通常型膵癌+貯留嚢胞の可能性が考えられたが，いずれかに決定できる所見は得られなかった．