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( Mayumi Toyama ),( Yasuyuki Okuma ),( Mitsutoshi Yamamoto ),( Kenichi Kashihara ),( Kazuto Yoshda ),( Hidemoto Saiki ),( Tetsuya Maeda ),( Yoshio Tsuboi ),( Takeo Nakayama ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Parkinson`s disease (PD) is increasingly recognized as multidimensional disorder. In addition to classic motor symptoms, patients have a variety of non-motor symptoms (NMS) that substantially affect quality of life (QoL). However, the prevalence of NMS and the relative impact of non-motor symptoms on QoL in PD have not been well documented in Japanese PD patients. In this study, we have the following objectives: 1) To determine the prevalence of NMS in Japanese PD patients. 2) To study the impact of NMS on the QoL in Japanese PD patients. Methods: This was a multi-center cross-sectional epidemiologic study. We recruited outpatients from seven Neurology departments at general hospitals across Japan between October 2010 and September 2011. A total of 824 Japanese PD patients was included in this study. NMS of patients was evaluated by Non-Motor Symptoms Scale (NMSS). Parkinson`s Disease Questionnaire-39 (PDQ-39) was used to evaluate the QoL of PD patients. Multivariate analyses were used to evaluate the direct impact of NMSs on QoL using PDQ-39, after adjusting for age, sex, disease duration, and the Unifi ed Parkinson`s Disease Rating Scale (UPDRS) Part I, Part II, Part III and Part IV. Results: The mean of total NMSS score was 37.4±35.4. The highly prevalent NMSS domains were sleep/fatigue (87.6%) and urinary (86.1%). The highly prevalent NMSS items were nocturia (72.0%) and constipation (71.6%). In multivariate analyses after adjustment for age, sex, disease duration, UPDRS Part I, Part II, Part III, and Part IV, total score of NMSS has statistical signifi cance with PDQ-39 (p=0.00, ß=0.16, Adj-R squared=0.65). Conclusions: NMS were highly prevalent in Japanese PD patients. NMS have a direct negative impact on QoL in Japanese PD patients.
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Shinya Taki,Takao Maekita,Mayumi Sakata,Kazuhiro Fukatsu,Yoshimasa Maeda,Mikitaka Iguchi,Hidefumi Ito,Masayuki Kitano 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6
Continuous duodenal levodopa/carbidopa intestinal gel delivery by a gastrostomy infusion system improves control of Parkinson’sdisease. The overall complication rates of percutaneous endoscopic gastrojejunostomy were reported to be 41% and 59% for immediateand delayed adverse events, respectively. A 72-year-old woman underwent percutaneous endoscopic gastrojejunostomy using thedelivery system noted above. Abdominal pain and vomiting occurred 3 months later. Esophagogastroduodenoscopy showed alongitudinal ulcer extending from the lower gastric body to the ileum end, with small intestinal telescoping. Colonoscopy showed alarge bezoar of food residue that was attached around the tip of the tube, reaching the ascending colon, which may have acted as ananchor. Thus, the gastric antrum and small intestine were shortened with telescoping. This complication was resolved by crushing thebezoar with forceps during colonoscopy and can be prevented by consuming a fiber-free diet and periodic exchanges of the tube usingesophagogastroduodenoscopy.
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Vy H. Nguyen,Isaac Le,Audrey Ha,Richard Hieu Le,Nicholas Ajit Rouillard,Ashley Fong,Surya Gudapati,Jung Eun Park,Mayumi Maeda,Scott Barnett,Ramsey Cheung,Mindie H. Nguyen 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.4
Background/Aims: Understanding of nonalcoholic fatty liver disease (NAFLD) continues to expand, but the relationship between race and ethnicity and NAFLD outside the use of cross-sectional data is lacking. Using longitudinal data, we investigated the role of race and ethnicity in adverse outcomes in NAFLD patients. Methods: Patients with NAFLD confirmed by imaging via manual chart review from any clinics at Stanford University Medical Center (1995–2021) were included. Primary study outcomes were incidence of liver events and mortality (overall and non-liver related). Results: The study included 9,340 NAFLD patients: White (44.1%), Black (2.29%), Hispanic (27.9%), and Asian (25.7%) patients. For liver events, the cumulative 5-year incidence was highest among White (19.1%) patients, lowest among Black (7.9%) patients, and similar among Asian and Hispanic patients (~15%). The 5-year and 10-year cumulative overall mortality was highest for Black patients (9.2% and 15.0%, respectively, vs. 2.5–3.5% and 4.3–7.3% in other groups) as well as for non-liver mortality. On multivariable regression analysis, compared to White patients, only Asian group was associated with lower liver-related outcomes (aHR: 0.83, P=0.027), while Black patients were at more than two times higher risk of both non-liver related (aHR: 2.35, P=0.010) and overall mortality (aHR: 2.13, P=0.022) as well as Hispanic patients (overall mortality: aHR: 1.44, P=0.022). Conclusions: Compared to White patients, Black patients with NAFLD were at the highest risk for overall and non-liverrelated mortality, followed by Hispanic patients with Asian patients at the lowest risk for all adverse outcomes. Culturally sensitive and appropriate programs may be needed for more successful interventions.
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