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Tatsuya Fujii,Seiji Ohtori,Koshi Takana,Sumihisa Orita,Gen Inoue,Nobuyasu Ochiai,Kazuki Kuniyoshi,Yasuchika Aoki,Tetsuhiro Ishikawa,Masayuki Miyagi,Hiroto Kamoda,Miyako Suzuki,Yoshihiro Sakuma,Gou Kub 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.5
Purpose: Opioids improve pain from knee and hip osteoarthritis (OA) and decreasethe functional impairment of patients. However, there is a possibility that opioids induce analgesia and suppress the physiological pain of OA in patients, thereby inducing the progression of OA changes in these patients. The purpose of the current study was to investigate the possibility of progressive changes in OA among patients using opioids. Materials and Methods: Two hundred knee or hip OA patients were evaluated in the current prospective, randomized, active-controlledstudy. Patients were randomized 1:1:1 into three parallel treatment groups: loxoprofen, tramadol/acetaminophen, and transdermal fentanyl groups. Medicationwas administered for 12 weeks. Pain scores and progressive OA changes on X-ray films were evaluated. Results: Overall, pain relief was obtained by all three groups. Most patients did not show progressive OA changes; however, 3 patients in the transdermal fentanyl group showed progressive OA changes during the 12 weeks of treatment. These 3 patients used significantly higher doses than others in the transdermal fentanyl group. Additionally, the average pain score for these 3 patientswas significantly lower than the average pain score for the other patients in the transdermal fentanyl group. Conclusion: Fentanyl may induce progressive changes in knee or hip OA during a relatively short period, compared with oral Non-Steroidal Anti-Inflammatory Drugs or tramadol.
Akira Mitsuhashi,Yuji Habu,Tatsuya Kobayashi,Yoshimasa Kawarai,Hiroshi Ishikawa,Hirokazu Usui,Makio Shozu 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.6
Objective: The present study investigated long-term outcomes of medroxyprogesteroneacetate (MPA) plus metformin therapy in terms of control of atypical endometrial hyperplasia(AEH) and endometrial cancer (EC), and post-treatment conception. Methods: We retrospectively analyzed 63 patients (42 with EC; 21 with AEH) who underwentfertility-sparing management using MPA plus metformin. MPA (400 mg/day) and metformin(750–2,250 mg/day) were administered to achieve complete response (CR). Metformin wasadministered until conception, even after MPA discontinuation. Results: Of the total patients, 48 (76%) had a body mass index (BMI) ≥25 kg/m2 and 43 (68%)showed insulin resistance. Sixty-one patients (97%) achieved CR within 18 months. CR ratesat 6, 8–9, and 12 months were 60%, 84%, and 90%, respectively. During a median followupperiod of 57 months (range, 13–115 months), relapse occurred in 8 of 61 patients (13.1%)who had achieved CR. Relapse-free survival (RFS) in all patients at 5 years was 84.8%. Uponunivariate analysis, patients with BMI ≥25 kg/m2 had significantly better prognoses than didthose with BMI <25 kg/m2 (odds ratio=0.19; 95% confidence interval=0.05–0.66; p=0.009). Overall pregnancy and live birth rates per patient were 61% (19/31) and 45% (14/31), respectively. Conclusions: MPA plus metformin is efficacious in terms of RFS and post treatmentconception. Moreover, metformin may be more efficacious for patients with BMI ≥25 kg/m2.
Clinical Characteristics of Esophageal Motility Disorders in Patients With Heartburn
( Satsuki Takahashi ),( Tomoaki Matsumura ),( Tatsuya Kaneko ),( Mamoru Tokunaga ),( Hirotaka Oura ),( Tsubasa Ishikawa ),( Ariki Nagashima ),( Wataru Shiratori ),( Naoki Akizue ),( Yuki Ohta ),( Atsu 대한소화기기능성질환·운동학회 2021 Journal of Neurogastroenterology and Motility (JNM Vol.27 No.4
Background/Aims Esophageal motility disorders (EMDs) contribute to the pathophysiology of gastroesophageal reflux disease. However, the causes of EMDs and their impact on gastroesophageal reflux disease-associated symptoms remain unknown. This study aims to elucidate clinical features associated with various types of EMDs in patients with heartburn symptoms. Methods Of the 511 patients who underwent high-resolution manometry, 394 who were evaluated for heartburn symptoms were examined. Patients subjected to high-resolution manometry were classified into 4 groups: outflow obstruction group, hypermotility group, hypomotility group, and normal motility group. Symptoms were evaluated using 3 questionnaires. Patient characteristics and symptoms for each EMD type were compared with those of the normal motility group. Results Of the 394 patients, 193 (48.9%) were diagnosed with EMDs, including 71 with outflow obstruction, 15 with hypermotility, and 107 with hypomotility. The mean dysphagia score was significantly higher in each of the 3 EMD groups compared with those with normal motility. The mean acid reflux and dyspepsia scores were significantly lower in the outflow obstruction group (P < 0.05). The mean body mass index and median Brinkman index were significantly higher in the hypermotility group (P = 0.001 and P = 0.018, respectively), whereas the mean diarrhea and constipation scores were significantly lower in the hypomotility group (P < 0.05). Conclusions The results of our study indicate that different EMDs have distinct characteristics. Cigarette smoking and high body mass index were associated with esophageal hypermotility. Assessment of the dysphagia symptom scores may help identify patients with EMDs. (J Neurogastroenterol Motil 2021;27:545-554)
Cortical astrocytes rewire somatosensory cortical circuits for peripheral neuropathic pain
Kim, Sun Kwang,Hayashi, Hideaki,Ishikawa, Tatsuya,Shibata, Keisuke,Shigetomi, Eiji,Shinozaki, Youichi,Inada, Hiroyuki,Roh, Seung Eon,Kim, Sang Jeong,Lee, Gihyun American Society for Clinical Investigation 2016 The Journal of clinical investigation Vol.126 No.5
<P>Long-term treatments to ameliorate peripheral neuropathic pain that includes mechanical allodynia are limited. While glial activation and altered nociceptive transmission within the spinal cord are associated with the pathogenesis of mechanical allodynia, changes in cortical circuits also accompany peripheral nerve injury and may represent additional therapeutic targets. Dendritic spine plasticity in the S1 cortex appears within days following nerve injury; however, the underlying cellular mechanisms of this plasticity and whether it has a causal relationship to allodynia remain unsolved. Furthermore, it is not known whether glial activation occurs within the S1 cortex following injury or whether it contributes to this S1 synaptic plasticity. Using in vivo 2-photon imaging with genetic and pharmacological manipulations of murine models, we have shown that sciatic nerve ligation induces a re-emergence of immature metabotropic glutamate receptor 5 (mGluR5) signaling in S1 astroglia, which elicits spontaneous somatic Ca2+ transients, synaptogenic thrombospondin 1 (TSP-1) release, and synapse formation. This S1 astrocyte reactivation was evident only during the first week after injury and correlated with the temporal changes in S1 extracellular glutamate levels and dendritic spine turnover. Blocking the astrocytic mGluR5-signaling pathway suppressed mechanical allodynia, while activating this pathway in the absence of any peripheral injury induced long-lasting (>1 month) allodynia. We conclude that reawakened astrocytes are a key trigger for S1 circuit rewiring and that this contributes to neuropathic mechanical allodynia.</P>
An Ultra-precision Electronic Clinometer for Measurement of Small Inclination Angles
Tan, Siew-Leng,Kataoka, Satoshi,Ishikawa, Tatsuya,Ito, So,Shimizu, Yuuki,Chen, Yuanliu,Gao, Wei,Nakagawa, Satoshi The Korean Society of Manufacturing Technology Eng 2014 한국생산제조학회지 Vol.23 No.6
This paper describes an ultra-precision electronic clinometer, which is based on the capacitive-based fluid type, for detection of small inclination angles. The main parts of the clinometer low-noise electronics are two capacitance measurement circuits for converting the capacitances of the capacitors of the clinometer into voltages, and a differential amplifier for obtaining the difference of the capacitances, which is proportional to the input inclination angle. A 16 bit analog to digital (AD) converter is also embedded into the same circuit board, whose output is sent to a PC via RS-232C, for achieving a small noise level down to tens of ${\mu}v$. A compensation method, which is referred to as the delay time method for shortening the stabilization time of the sensor was also discussed. Experimental results have shown the possibility of achieving a measurement resolution of $0.0001^{\circ}$ as well as the quick measurement with the delay time method.
Therapeutic Potential of Natural Product-Based Oral Nanomedicines for Stroke Prevention
Tatsushi Mutoh,Tomoko Mutoh,Yasuyuki Taki,Tatsuya Ishikawa 한국식품영양과학회 2016 Journal of medicinal food Vol.19 No.6
Cerebral stroke is the leading cause of death and permanent disability in elderly persons. The impaired glucose and oxygen transport to the brain during ischemia causes bioenergetic failure, leading to oxidative stress, inflammation, bloodbrain barrier dysfunction, and eventually cell death. However, the development of effective therapies against stroke has been hampered by insufficient oral absorption of pharmaceuticals and subsequent delivery to the brain. Nanotechnology has emerged as a new method of treating cerebral diseases, with the potential to fundamentally change currently available therapeutic approaches using compounds with low bioavailability. This perspective review provides an overview of the therapeutic potential of oral nanomedicines for stroke, focusing on novel natural product-loaded delivery system with potent antioxidant and anti-inflammatory effects.