Makoto Tominaga

Yamagata University, Ямагата, Yamagata, Japan

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Publications (115)298.73 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this investigation is to examine the correlation between the HbA1c numbers used by the National Glycohemoglobin Standardization Program (NGSP) and the Japan Diabetes Society (JDS) and to validate the HbA1c cutoff values of 6.5 and 6.1 % set for the diagnosis of diabetes mellitus by the American Diabetes Association (ADA) and the JDS, respectively. NGSP HbA1c values obtained from the monthly monitoring program of the performance of the NGSP Secondary Reference Laboratories (SRLs) were provided by the NGSP. The samples used in the NGSP monitoring program were also assayed to obtain the JDS values at the Laboratory of Reference Material Institute for Clinical Chemistry Standards (ReCCS) using the KO 500 designated comparison method (DCM) calibrated with a reference material, JDS Lot 4, issued by ReCCS. The results were compared, and the correlation between the two data sets was examined by linear regression. The relationship between the NGSP SRLs values and JDS values for the monitoring program samples was as follows: NGSP = 1.029 × JDS + 0.216. For another sample, JDS Lot 4, the correlation was: NGSP = 1.029 × JDS + 0.187. The two equations are consistent with the cutoff points 6.5 and 6.1 %, used by the ADA and the JDS, respectively.
    03/2014; 6(1). DOI:10.1007/s13340-014-0173-z
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    02/2012; 3(1). DOI:10.1007/s13340-012-0069-8
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    ABSTRACT: We have reported in this journal in vitro susceptibilities of clinical isolates to antibiotics every year since 1992. In this paper, we report the results of an analysis of in vitro susceptibilities of 12,919 clinical isolates from 72 centers in Japan to selected antibiotics in 2007 compared with the results from previous years. The common respiratory pathogens, Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae maintained a high susceptibility to fluoroquinolones (FQs). The resistance of S. pyogenes to macrolides has been increasing every year and this was especially clear this year. Most strains of Enterobacteriaceae except for Escherichia coli showed a high susceptibility to FQs. Almost 30% of E. coli strains were resistant to FQs and the resistance increased further this year. FQs resistance of methicillin-resistant Staphylococcus aureus (MRSA) was approximately 95% with the exception of 45% for sitafloxacin (STFX). FQs resistance of methicillin-susceptible S. aureus (MSSA) was low at about 10%. FQs resistance of methicillin-resistant coagulase negative Staphylococci (MRCNS) was higher than that of methicillin-susceptible coagulase negative Staphylococci (MSCNS), but it was lower than that of MRSA. However, FQs resistance of MSCNS was higher than that of MSSA. FQs resistance of Enterococcus faecalis was 22.5% to 29.6%, while that of Enterococcusfaecium was more than 85% except for STFX (58.3%). In clinical isolates of Pseudomonas aeruginosa derived from urinary tract infections, FQs resistance was 21-27%, which was higher than that of P. aeruginosa from respiratory tract infections at 13-21%, which was the same trend as in past years. Multidrug resistant strains accounted for 5.6% in the urinary tract and 1.8% in the respiratory tract. Acinetobacter spp. showed high susceptibility to FQs. The carbapenem resistant strains, which present a problem at present, accounted for 2.7%. Neisseria gonorrhoeae showed high resistance of 86-88% to FQs. The results of the present survey indicated that although methicillin-resistant Staphylococci, Enterococci, E. coli, P. aeruginosa, and N. gonorrhoeae showed resistance tendencies, and other species maintained high susceptibility rates more than 90% against FQs, which have been used clinically for over 15 years.
    The Japanese journal of antibiotics 08/2009; 62(4):346-70.
  • A Hirata, M Igarashi, H Iwai, M Tominaga
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    ABSTRACT: This study investigates the effects of miglitol, an alpha-glucosidase inhibitor, on the development of balloon-injured neointimal thickening in left common carotid artery, and the changes of glucose metabolism and inflammatory responses in Wistar fatty rats, an obese-hyperglycemic animal model, and their littermates, Wistar lean rats. Miglitol was orally administered at 40 mg/100 g of high-fat diet containing 45% kcal as fat to 12-week-old rats for 29 days, and age-matched rats without the agent were used as the respective controls. Balloon catheterization in the left common carotid artery was performed on day 15, and the artery was removed on day 29. Compared with the area ratio of the neointima/media in fatty rats without treatment, those in fatty rats with miglitol and lean rats without treatment were significantly decreased to 80%. The administration of miglitol significantly decreased the levels of plasma glucose, glycoalbumin and high-sensitivity C-reactive protein, and elevated the high-density lipoprotein-cholesterol level in fatty rats. These findings suggest that miglitol could be effective for the suppression of atherogenic outcomes in diabetic Wistar fatty rat, suggesting that the agent may have clinical benefits and contribute to prevent diabetic macroangiopathy.
    Hormone and Metabolic Research 03/2009; 41(3):213-20. DOI:10.1055/s-0028-1105919 · 2.04 Impact Factor
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    ABSTRACT: This study was performed to examine the changes in rapid turnover proteins (RTPs), such as retinol-binding protein, transthyretin and transferrin, which are known nutritional parameters, during the perioperative period for digestive system operations. The study was performed with 62 subjects who underwent elective surgery of the digestive system. The RTP measurements were performed approx. seven times for each subject (approx. 20 times in total) from the preoperative period to the 14th postoperative day. For 20 subjects who exhibited no recurrence of a malignant tumor, additional measurements were performed 6 to 12 months after the operation. RTPs were measured more than 1,400 times in total for all subjects. The three types of RTPs all exhibited similar changes, but the largest change was observed for retinol-binding protein. The changes in RTPs were significantly larger than those for albumin. RTP levels were lowest on the 3rd postoperative day and gradually increased thereafter. The RTP levels recovered to approx. 80% of the preoperative values on the 14th postoperative day. In the measurements performed 6 to 12 months after the operation, the levels recovered to 90% or higher of the preoperative values. No significant differences were observed between the cases utilizing different operation methods. The administration of fresh frozen plasma had no impact on the postoperative changes. No correlation was observed between the calories obtained by oral intake during the period from the 5th to 10th postoperative days and the changes in RTPs. The study results suggested that changes in RTPs would not affected by the calories obtained by oral intake during the early postoperative days. In patients who returned to their daily life after an invasive surgery or reconstruction of the digestive tract, RTP levels were restored to the preoperative values 6 to 12 months after the operation.
    Hepato-gastroenterology 01/2009; 56(89):167-73. · 0.91 Impact Factor
  • Masahiko Igarashi, Akihiko Hirata, Makoto Tominaga
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    ABSTRACT: In September, 2007, the Japanese Ministry of Health, Labor and Welfare legislated that clinical laboratory doctors can advocate the clinical laboratory in hospitals and clinical offices. The decision was monumentous, and we, clinical laboratory physicians, can see patients from April, 2008. Although our roles and/or details have not officially been determined, we must definite the contribution of clinical laboratory doctors. One of our plans is to set up a conference room in the Division of Clinical Laboratory to explain their medical tests to patients. Laboratory data are not always explained in detail by doctors, since they are busy and do not have enough time to see patients. Subsequently, clinical laboratory physicians will be able to comply with patients' wishes for medical testing. In addition, to prevent the development of lifestyle-related diseases and their related metabolic syndrome in Japanese people, a new specified health checkup system has recently been established by the Japanese Ministry of Health, Labor and Welfare, and the system will start from April, 2008. Since more than 20 million people from 40 to 74 years old are estimated to undergo this health checkup, total quality assurance in the clinical laboratory is required to provide accurate and precise test values by the government. Therefore, our clinical laboratory physicians should play a central role to guarantee the specified health checkup system.
    Rinsho byori. The Japanese journal of clinical pathology 09/2008; 56(8):689-95.
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    ABSTRACT: Impaired glucose tolerance (IGT) is a known risk factor for cardiovascular disease, which includes stroke as well as coronary heart disease (CHD). We investigated whether IGT is a risk factor for stroke. The incidence of stroke and CHD in a cohort population (n = 2938) consisting of participants of the 1990-1997 Funagata study was assessed through interviews with the participants and their family members and reviews of death certificates and residence transfer documents through 2002. Glucose tolerance at the baseline was classified according to the criteria of the 1998 World Health Organization (normal glucose tolerance, n = 2189; IGT, n = 320; and diabetes, n = 286). The cumulative incidences among the groups were compared using the Kaplan-Meier product-limit method, and the risks of these conditions were evaluated by person-year and Cox proportional hazard methods. During the 147-month (mean, 116.5 months) follow-up, 158 (normal glucose tolerance, IGT, and diabetes: 94, 35, and 29, respectively) participants experienced a stroke and 94 (54, 16, and 24, respectively) experienced CHD. By the person-year method, IGT and diabetes were shown to be significant risk factors for stroke and CHD (odds ratio, 1.87 [95% confidence interval, 1.73-2.03] and 3.57 [3.21-3.98] for stroke; 1.53 [1.31-1.78] and 3.47 [2.91-4.14] for CHD, respectively). Cox proportional hazard analysis showed that IGT was a risk factor for stroke (age-, sex-, and hypertension-adjusted hazard ratio: 1.51 [95% confidence interval, 1.02-2.24], P = .039) but not for CHD (1.21 [0.69-2.313], .509). Impaired glucose tolerance is a risk factor for future stroke in a Japanese population.
    Metabolism 04/2008; 57(3):333-8. DOI:10.1016/j.metabol.2007.10.007 · 3.61 Impact Factor
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    ABSTRACT: To determine the relationship of metabolic syndrome and its components with retinopathy and other retinal microvascular signs in a Japanese population. The Funagata study recruited 1961 (53.3% of eligible) Japanese aged 35 or older. The metabolic syndrome was diagnosed primarily using definitions of the International Diabetes Federation. Retinopathy and retinal microvascular signs were assessed from fundus photographs. Retinal arteriolar and venular diameters were measured using a computer-assisted programme. Data were available for analysis in 1638 persons for retinopathy and retinal microvascular signs and 921 persons for retinal vessel diameters. Various components of the metabolic syndrome were associated with retinal microvascular signs: a larger waist circumference was associated with wider venular diameter and retinopathy lesions; a higher blood pressure level was associated with focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar wall reflex and narrower arteriolar diameter; and a higher triglyceride level was associated with enhanced arteriolar wall reflex. Overall, persons with the metabolic syndrome were more likely to have retinopathy (odds ratio 1.64, 95% CI: 1.02 to 2.64) and wider venular diameter 4.69 microm (95% CI: 1.20 to 8.19 microm) than persons without the metabolic syndrome. We report associations of metabolic syndrome components with retinopathy and wider venular diameter in Japanese adults. These data suggest that metabolic abnormalities, indicated by metabolic syndrome components, are associated with microvascular changes in the retina. There was no synergistic effect of the metabolic syndrome on retinal microvascular changes beyond its individual components.
    The British journal of ophthalmology 03/2008; 92(2):161-6. DOI:10.1136/bjo.2007.127449 · 2.81 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the anti-atherogenic outcomes of pioglitazone, a thiazolidinedione derivative, in type 2 diabetic patients. Eight patients with poor diabetic control were treated with 15 mg of pioglitazone for 4 months. Blood samples were collected monthly, and the levels of fasting plasma glucose (FPG), HbA1c, and lipids, such as triglycerides, total cholesterol, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol, were measured. Other parameters, including immunorecative insulin (IRI), remnant-like particle-cholesterol (RLP-C), adiponectin, plasminogen activator inhibitor type 1 (PAI-1), tumor necrosis factor (TNF)- alpha , leptin, brain natriuretic peptide (BNP), and high-sensitivity (hs)-C-reactive protein (CRP), were examined at the beginning and end of the study. In addition, clinically adverse side-effects were evaluated. Treatment with pioglitazone significantly decreased the levels of HbA1c, FPG, the homeostasis model assessment of insulin resistance (HOMA-IR) index, RLP-C, PAI-1, TNF- alpha , and hs-CRP, but not the level, IRI, lipids, or leptin. In contrast, adverse side-effects, including body weight gain, liver dysfunction and edema, were not observed during this study. These results strongly suggested that treatment with pioglitazone has a greater clinical benefit for the prevention of atherosclerosis, including coronary heart diseases, without any adverse side-effects.
    Journal of atherosclerosis and thrombosis 03/2008; 15(1):34-40. DOI:10.5551/jat.E528 · 2.77 Impact Factor
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    ABSTRACT: The present study examined the prevalence of metabolic syndrome (MetS) when the Japanese diagnostic criteria was used, the prevalence of each component in the criteria, and also the validity of the waist circumference cut-off value measured at the navel level, using the results obtained from the Japanese National Health and Nutrition Survey (NHNS) in 2003. The prevalence of MetS in 2113 subjects according to the Japanese diagnostic criteria was 22.8% (95% CI: 20.2-25.5) for males and 8.7% (7.1-10.4) for females. The prevalence for high blood pressure (HBP), dyslipidemia (DLP), high fasting blood glucose (HFG) and central obesity for males/females were 59.1% (56.0-62.2)/47.2% (44.3-50.1), 40.5% (37.3-43.6)/27.9% (25.4-30.5), 19.1% (16.6-21.6)/16.2% (14.0-18.3) and 45.9% (42.7-49.0)/17.4% (15.3-19.5), respectively. The low prevalence of MetS for females was attributed to a larger waist circumference cut-off value for females (90 cm) than for males (85 cm). Optimal waist circumference cut-off values of subjects, who fulfil at least two of HBP, DLP or HFG, estimated from the receiver operating characteristic curve were subsequently found to be 85 cm for males and 80 cm for females. Based on the new values, the prevalence of MetS was found to be 22.8% for males and 19.2% for females. The present study revealed that optimal waist circumference cut-off value was much shorter than that previously proposed in females.
    Diabetes Research and Clinical Practice 11/2007; 78(1):77-84. DOI:10.1016/j.diabres.2007.02.015 · 2.54 Impact Factor
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    ABSTRACT: This study was investigated to characterize the activation mechanism of a mitogen-activated protein (MAP) kinase superfamily in diabetes in aortae and cultured vascular smooth muscle cells (VSMCs) from rats. Male Sprague-Dawley rats were used for this procedure, and diabetes was induced by streptozotocin injection at 50 mg/kg. After 6 weeks, the thoracic aortae from normal and diabetic rats were removed for detection of the MAP kinase superfamily by immunoblot analysis. In aortae, the protein levels of extracellular signal-regulated protein kinase (ERK)-1, c-jun NH2-terminal protein kinase (JNK)-1 and -2, and p38 increased significantly more in diabetic rats than in normal rats. In contrast, phosphorylated protein levels of ERK-1 and -2, JNK-1, and p38 were significantly more elevated in diabetic rats than in normal rats. In VSMCs from normal rats, a high concentration of glucose cultured for three days significantly increased the phosphorylated protein levels of ERKs and p38, but not JNKs, without any change of these protein levels. Serum interleukin (IL)-1beta was significantly higher in diabetic rats than in normal rats. Several types of proinflammatory cytokine dose-dependently phosphorylated the levels of ERKs, JNK-1, and p38, but not JNK-2, in VSMCs from normal rats. In cells from diabetic rats, phosphorylated protein levels of ERKs and p38 were significantly elevated by IL-1beta. In addition, interferon-gamma phosphorylated the levels of ERKs in diabetic cells more than in normal cells. Our results suggest that, under diabetic conditions, the MAP kinase superfamily was activated by different pathways in the vasculature; i.e., ERKs and p38 might be mainly phosphorylated by a complex of high concentrations of glucose and of several types of proinflammatory cytokines, but the phosphorylation of JNK-1 might depend on the concentration of proinflammatory cytokines such as IL-1beta, and/or additional unknown factors, except glucose.
    Journal of atherosclerosis and thrombosis 11/2007; 14(5):235-44. DOI:10.5551/jat.E514 · 2.77 Impact Factor
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    ABSTRACT: Type 2 diabetes mellitus (DM) is a common and serious condition related with considerable morbidity. Screening for DM is one strategy for reducing this burden. In Japan National Diabetes Screening Program (JNDSP) guideline, the combined use of fasting plasma glucose (FPG) and glycated hemoglobin A1c (HbA1c) in a stepwise fashion has been recommended to identify the group of people needing life-style counseling or medical care. However, the efficacy of this program has not been fully evaluated, as an oral glucose tolerance test (OGTT) is not mandatory in the guideline. The aim of this study was to assess the validity of the screening test scenario, in which an OGTT would be applied to people needing life-style counseling or medical care on this guideline: FPG 110-125 mg/dl and HbA1c over 5.5%. Subjects were 1,726 inhabitants without a previous history of DM in the Funagata study, which is a population-based survey conducted in Yamagata prefecture to clarify the risk factors, related conditions, and consequences of DM. DM was diagnosed according to the 1999 World Health Organization criteria. The prevalence of undiagnosed DM was 6.6%. The tested screening scenario gave a sensitivity of 55.3%, a specificity of 98.4%, a positive predictive value of 70.8%, and a negative predictive value of 96.9% for undiagnosed DM. In conclusion, the screening test scenario, in which an OGTT would be followed by the combined use of FPG and HbA1c in a stepwise fashion according to the JNDSP guideline, was not effective in identifying people with undiagnosed DM.
    The Tohoku Journal of Experimental Medicine 10/2007; 213(1):25-32. DOI:10.1620/tjem.213.25 · 1.28 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the anti-atherogenic efficacy of pioglitazone, a thiazolidinedione derivative, on the change in atherogenic outcomes by comparing responder and non-responder groups in type 2 diabetic patients. Twenty-three patients with poor diabetic control were treated with 15 mg of pioglitazone for 12 months. The levels of fasting plasma glucose (FPG), HbA1c, triglycerides (TG), total cholesterol (T-Cho), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) were measured monthly, and those of remnant-like particle-cholesterol (RLP-C) and lipoprotein (a) [Lp (a)] were measured every 3 months. In Month 6, the patients were divided into two groups according to the decrease in HbA1c level: the responder group showed a decrease of > or =1%; the non-responder group, a decrease of <1%. In the responder group, the levels of FPG and HbA1c decreased significantly after Month 3. The values of the body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR) index, LDL-C, and RLP-C were significantly higher in the responder group than in the non-responder group. Although the levels of T-Cho and HDL-C were unchanged in both groups, those of TG and RLP-C were drastically reduced in the responder group. Interestingly, the relative change in Lp (a) was significantly decreased in both groups. These results strongly suggest that pioglitazone is beneficial for type 2 diabetic patients with high levels of BMI, HOMA-IR, LDL-C, and RLP-C, as it helps to prevent the progression of atherosclerosis, including coronary heart diseases.
    Diabetes Research and Clinical Practice 09/2007; 77(3):389-98. DOI:10.1016/j.diabres.2006.12.022 · 2.54 Impact Factor
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    ABSTRACT: The aim of the study was to assess the screening test properties of HbA1c for undiagnosed diabetes (DM) according to the 1999-WHO criteria and its relevance of the Japan National Diabetes Survey Cut-off points for possible and probable DM: HbA1c >or=5.6 and 6.1%. Screening properties of HbA1c predicting undiagnosed DM was examined and compared with that of fasting plasma glucose (FPG) in 1904 Funagata-town inhabitants aged 35-89 years old. The prevalence of previous DM, undiagnosed DM, and impaired glucose regulation (IGR) were 5.5, 6.0, and 18.6%, while the prevalence of probable and possible DM were 7.7 and 5.4%. The area under the receiver operating characteristic curve for undiagnosed DM was similar between HbA1c (0.856 [95% CI: 0.812-0.899]) and FPG (0.902 [0.869-0.936]). HbA1c of 5.6% gave a sensitivity of 56.5%, a specificity of 95.1%, positive and negative predictive values of 44.2 and 97.0%, and a proportion of people above the cut-off point of 8.2%. True positive tests were significantly higher with mean levels of BMI, fasting, and 2-h plasma glucose, and HbA1c, but lower with mean levels of high-density-lipoprotein cholesterol than in false negative tests. The measurement of HbA1c alone may be efficient to screen undiagnosed DM and the cut-off point of 5.6% might be proper with respect to screening tests properties for undiagnosed DM, and prediction of vascular complications in Japan.
    Diabetes Research and Clinical Practice 06/2007; 76(2):251-6. DOI:10.1016/j.diabres.2006.09.015 · 2.54 Impact Factor
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    ABSTRACT: This study investigates the mechanisms whereby angiotensin II (Ang II) signaling contributes to cell growth and glucose metabolism in cultured vascular smooth muscle cells (VSMCs) from male Wistar fatty rats (WF) and their littermates (Wistar lean rats, WL). The levels of the medial outgrowth rate of VSMCs and Ang II type-1 receptors (AT1R) in aortae from WF were more enhanced than those in aortae from WL, but the level of Ang II type-2 receptors (AT2R) was not different. A mixture of insulin and Ang II additively increased the values of [(3)H]-thymidine incorporation in WF and WL, which was inhibited by olmesartan, an AT1 receptor blockade (ARB), but not by PD123,319, an AT2 receptor blockade. Similarly, insulin and Ang II phosphorylated extracellular-regulated protein kinase 1/2, retinoblastoma tumor suppressor protein, and cyclic AMP response element binding protein, and these levels were higher in WF than in WL. In contrast, the phosphorylation was suppressed by olmesartan but not PD123,319. Insulin-stimulated Akt phosphorylation and 2-deoxy-d-glucose uptake in WF were significantly reduced by Ang II, and the reduction was ameliorated by olmesartan but not PD123,319. Differently from the result of Akt, the phosphorylation of the insulin-stimulated insulin receptor beta-subunit was not affected by Ang II, olmesartan, or PD123,319. However, the phosphorylation of insulin-stimulated insulin-related substrate (IRS)-1 was suppressed by Ang II, and the suppression was ameliorated by olmesartan, but not PD123,319, in both WF and WL. In contrast, the phosphorylation of IRS-1 on Ser(307) was elevated by the Ang II, and the elevation was suppressed by olmesartan, but not by PD123,319, in both WF and WL. These findings demonstrated that Ang II signaling contributes to cell proliferation and inhibition of the insulin signaling pathways through AT1R, but not trough AT2R, in both non-diabetic and diabetic VSMCs.
    Diabetes Research and Clinical Practice 04/2007; 75(3):267-77. DOI:10.1016/j.diabres.2006.06.032 · 2.54 Impact Factor
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    ABSTRACT: A total of 18,639 clinical isolates in 19 species collected from 77 centers during 2004 in Japan were tested for their susceptibility to fluoroquinolones (FQs) and other selected antibiotics. The common respiratory pathogens, Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae showed a high susceptible rate against FQs. The isolation rate of beta lactamase non-producing ampicillin-resistant H. influenzae was approximately three times as large as those of western countries. Most strains of Enterobacteriaceae were also susceptible to FQs. The resistance rate of Escherichia coli against FQs has however been rapidly increasing so far as we surveyed since 1994. The FQs-resistant rate in methicillin-resistant Staphylococcus aureus (MRSA) showed approximately 90% except for 36%. of sitafloxacin while FQs-resistant rate in methicillin-susceptible S. aureus (MSSA) was around 5%. The FQs-resistant rate of methicillin-resistant coagulase negative Staphylococci (MRCNS) was also higher than that of methicillin-susceptible coagulase negative Staphylococci (MSCNS), however, it was lower than that of MRSA. In Pseudomonas aeruginosa clinical isolates, 32-34% from UTI and 15-19% of from RTI was resistant to FQs. Acinetobacter spp. showed a high susceptibility to FQs. Although FQs-resistant Neisseria gonorrhoeae have not been increased in western countries, it is remarkably high in Japan. In this survey, isolates of approximately 85% was resistant to FQs.
    The Japanese journal of antibiotics 01/2007; 59(6):428-51.
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    ABSTRACT: To describe the prevalence of retinal vascular signs and their association with cardiovascular risk factors in a Japanese population. Population-based cross-sectional study. Adult persons aged 35 years or older from Funagata, Yamagata Prefecture, Japan (n = 1481). The Funagata Study is a Japanese population-based study of persons aged 35 years or older, and included 1961 nondiabetic participants (53.3% of 3676 eligible subjects). A nonmydriatic retinal photograph was taken of 1 eye to assess retinal microvascular signs. Retinal arteriolar wall signs (focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar wall reflex) and retinopathy were assessed in 1481 participants without diabetes (40.3% of eligible persons) using a standardized protocol. Using a computer-assisted method, retinal vessel diameters were measured in 921 participants with gradable retinal image (25.1% of eligible persons). Prevalence of retinal microvascular signs and their association with cardiovascular risk factors. Moderate or severe focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar wall reflex, and retinopathy were found in 8.3%, 15.2%, 18.7%, and 9.0%, respectively, of the study population. Mean (+/-standard error) values for retinal arteriolar diameter were 178.6+/-21.0 mum, and mean values (+/-standard error) for venular diameter were 214.9+/-20.6 mum. Older persons were more likely to have retinal arteriolar wall signs, retinopathy, and narrower retinal vessel diameters. After adjusting for multiple factors, each 10-mmHg increase in mean arterial blood pressure was associated with a 20% to 40% increased likelihood of retinal arteriolar signs and a 2.8-mum reduction in arteriolar diameter. Retinopathy was associated with higher body mass index and both impaired glucose tolerance and impaired fasting glucose. In nondiabetic Japanese adults, retinal arteriolar wall signs were associated with older age and increased blood pressure, whereas retinopathy was associated with older age, higher body mass index, impaired glucose tolerance, and impaired fasting glucose. These findings are comparable with data from white populations.
    Ophthalmology 09/2006; 113(8):1378-84. DOI:10.1016/j.ophtha.2006.02.052 · 6.17 Impact Factor
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    ABSTRACT: In this study we evaluated the effect of a dual blockade with enalapril and losartan on the reduction of overt macroproteinuria and its potential mechanism(s) in hypertensive patients with type 2 diabetes. Twenty-six hypertensive patients with type 2 diabetes at the baseline were administered 5 mg of enalapril once daily for 12 weeks. At the beginning of the study, the subjects were assigned to receive an add-on of 50 mg of losartan once daily or 5 mg of enalapril once daily for another 12 weeks. Blood samples were collected at the baseline, at the beginning, and at the end of the study for the measurement of laboratory parameters, and these data, including blood pressure, were compared between the two groups. Treatment with 5 mg of enalapril significantly decreased the systolic blood pressure level in both groups, and the addition of losartan and/or enalapril further decreased the levels. There was no difference in blood pressure between the two groups. However, the addition of losartan, but not enalapril, significantly decreased the urinary protein excretion level, plasma aldosterone, and hypersensitive-C-reactive protein at the end of the study. The results established that the dual blockade of angiotensin II with enalapril and losartan has a greater clinical benefit for high-risk patients with hypertension and advanced diabetic nephropathy.
    Endocrine Journal 09/2006; 53(4):493-501. DOI:10.1507/endocrj.K06-025 · 2.02 Impact Factor
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    ABSTRACT: Serum adiponectin levels are decreased in obese subjects. We examined the association of current body weight (BW) and its change with a change in serum adiponectin levels. Serum adiponectin levels at the baseline (from 1995 to 1997) and the 5-year follow-up (from 2000 to 2002) examinations were evaluated in 1003 (M/F, 425/578; age at the baseline examinations, 58.3 +/- 11.7/57.5 +/- 11.0 years) Japanese subjects from a cohort population (N = 2013) of the Funagata study. Correlations and associations of BW at the baseline examinations and changes in BW between the baseline and the follow-up examinations (deltaBW) with changes in the serum adiponectin levels in the study period (deltaAdiponectin) were examined. Stepwise regression analyses revealed a significant correlation of the deltaBW (r = -0.233 and -0.204 for men and women, respectively; r = -0.324 for the upper tertile group divided based on their body mass index in women) with the deltaAdiponectin. However, the BW at the baseline examinations was not significantly correlated in both sexes. Multiple logistic regression analyses revealed that subjects who reduced their BW by 2 kg or more were 2.56 (95% confidence interval, 1.21-5.42; P = .014) and 8.24 times (95% confidence interval, 3.59-18.9; P < .001) more likely to be in the upper tertile of the deltaAdiponectin than those who increased their BW by 2 kg or more in men and women, respectively, independent of their BW at the baseline examinations. In conclusion, we showed here that the deltaBW was strongly associated with the deltaAdiponectin in both sexes, whereas the BW at the baseline examinations was not associated with the deltaAdiponectin, at least in women.
    Metabolism 04/2006; 55(3):324-30. DOI:10.1016/j.metabol.2005.09.005 · 3.61 Impact Factor
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    ABSTRACT: Recently, organization of the nutrition support team (NST) is progressing steadily in many hospitals in Japan. In our Yamagata University Hospital, NST services were started in March, 2004. As is well known, NST is a multidisciplinary team comprised of physicians, nurses, dietitians, pharmacists, social workers and medical technologists. Here, we report the participation of medical technologists and physicians belonging to our Clinical laboratory in NST activities. From our laboratory, two medical technologists and two physicians participate in the NST and provide the following services. Firstly, nutritional assessment of proteins in serum i.e. albumin, retinol binding protein (RBP) and transthyretin (TTR) is carried out, measured as part of routine work, and, especially, the data of RBP and TTR are applied to the assessment of nutrition status around the digestive surgical operations. They are also useful to assess the effect of dietary meal, immunonutrition "Impact", which improves the malnutrition status of the pre operative patient. Secondly, a weekly "malnutrition report", including numbers of patients with malnutrition in every ward, serial graphs, and detailed comments on their movements, is reported by e-mail to NST associated departments. This report is conveniently indicates the nutritional situation of inpatients in the hospital and aids consideration of countermeasures for malnutrition in the NST meeting. Thirdly, we medical technologists also participate in making rounds, where we state our opinions on a patient's data, and, if necessary, propose to the chief physician to request additional laboratory tests. We believe that these current activities of our laboratory as part of the NST will contribute to the development of our University NST, raising the quality of nutrition support services, and resulting in improvements of malnutrition and the quality of life of patients.
    Rinsho byori. The Japanese journal of clinical pathology 02/2006; 54(1):67-72.

Publication Stats

3k Citations
298.73 Total Impact Points

Institutions

  • 1981–2009
    • Yamagata University
      • • Department of Laboratory Medicine
      • • Third Department of Internal Medicine
      • • School of Medicine
      Ямагата, Yamagata, Japan
  • 2007
    • Tokyo Women's Medical University
      • Diabetes Center
      Edo, Tōkyō, Japan
  • 1999
    • University of Pittsburgh
      • Department of Epidemiology
      Pittsburgh, PA, United States
  • 1992
    • Shinshu University
      • Division of Endocrinology and Metabolism
      Shonai, Nagano, Japan
  • 1991
    • Yamaguchi University
      • Division of Internal Medicine III
      Yamaguti, Yamaguchi, Japan