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JaLCDOI 10.18926/AMO/47013
FullText URL 65_5_315.pdf
Author Wang, Lei| Kaku, Haruki| Huang, Peng| Xu, Kexin| Yang, Kai| Zhang, Jiheng| Li, Ming| Xie, Liping| Wang, Xiaofeng| Sakai, Akiko| Watanabe, Masami| Nasu, Yasutomo| Shimizu, Kenji| Kumon, Hiromi| Na, Yanqun|
Abstract Deficiencies in the human DNA repair gene WRN are the cause of Werner syndrome, a rare autosomal recessive disorder characterized by premature aging and a predisposition to cancer. This study evaluated the association of WRN Leu1074Phe (rs1801195), a common missense single nucleotide polymorphism in WRN, with prostate cancer susceptibility in Chinese subjects. One hundred and forty-seven prostate cancer patients and 111 male cancer-free control subjects from 3 university hospitals in China were included. Blood samples were obtained from each subject, and the single nucleotide polymorphism WRN Leu1074Phe was genotyped by using a Snapshot assay. The results showed that WRN Leu1074Phe was associated with the risk of prostate cancer in Chinese men and that the TG/GG genotype displayed a decreased prevalence of prostate cancer compared with the TT genotype (OR=0.58, 95%CI:0.35-0.97, p=0.039). Through stratified analysis, more significant associations were revealed for the TG/GG genotype in the subgroup with diagnosis age <_ 72 yr (OR=0.27, 95%CI:0.12-0.61, p=0.002) and in patients with localized diseases (OR=0.36, 95%CI:0.19-0.70, p=0.003). However, no statistically significant difference was found in the subgroup with age >72 yr or in patients with advanced diseases. We concluded that the genetic variant Leu1074Phe in the DNA repair gene WRN might play a role in the risk of prostate cancer in Chinese subjects.
Keywords polymorphism prostatic neoplasms single nucleotide susceptibility WRN
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-10
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 315
End Page 323
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037267
Web of Science KeyUT 000296116400005
JaLCDOI 10.18926/AMO/47012
FullText URL 65_5_307.pdf
Author Shiraki, Teruo| Saito, Daiji|
Abstract Factors contributing to the sex difference of in-hospital mortality after acute myocardial infarction (MI) are still unknown. We compared the clinical characteristics on admission and in-hospital outcome of consecutive 1,354 patients with acute MI between the 2 sexes. Age on admission was about 7 years older in women than in men. In-hospital death was significantly more frequent in women. Pulmonary congestion and hypertension were more likely in women with higher serum levels of total cholesterol and LDL cholesterol. A higher prevalence of current smoking and inferior wall involvement and lower serum HDL cholesterol level were observed in man. After adjusting for age, adverse in-hospital mortality for women was observed in both younger and older patients. Multivariate logistic regression analysis demonstrated that age, location of infarction, recanalization and serum C-reactive protein (CRP) concentration were independent predictors for in-hospital mortality for overall patients, while age and recanalization were independent predictors for male gender, and pulmonary congestion and serum CRP concentration were independent predictors for female gender. In-hospital outcome after acute MI was worse in women. A multivariate logistic regression model revealed that the sexually different factors affected in-hospital mortality in females.
Keywords sex difference acute myocardial infarction inferior infarction in-hospital mortality age difference
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-10
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 307
End Page 314
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037267
Web of Science KeyUT 000296116400004
JaLCDOI 10.18926/AMO/47011
FullText URL 65_5_299.pdf
Author Itani, Miki| Yamamoto, Yuji| Doi, Yusuke| Miyaishi, Satoru|
Abstract Postmortem degradation of DNA was quantitatively estimated. Brain, liver, kidney and muscle samples were obtained from sacrificed rats left at 20℃ or 4℃. The quantity of DNA was measured by real-time PCR using a primer set for a sequence in the Rsrc 1 gene. When the quantity of amplified DNA using 10ng Human Genomic DNA was defined as 100 RFU, the quantities in the brain, liver, kidney and skeletal muscle (each 2μg of dry weight) on the day of sacrifice were 253±11, 338±22, 556±14 and 531±12 Relative Fluorescence Units (RFU), respectively (mean±S.E., n=5). The quantity of amplified DNA decreased to below 10 RFU in 1-3 weeks in the liver, kidney and skeletal muscle at 20℃, while that in the brain was more than 10 RFU for six weeks, demonstrating the usefulness of the brain as a sample for DNA analysis of decaying corpses. It was suggested that quantifying the amplified DNA in the brain at 20℃ and in the liver at 4℃ as well as the ratio of the quantity of amplified DNA in the liver to the brain at 4℃ might be useful for diagnosing time of death. This study provides the first quantitative analysis of the postmortem progress of DNA degradation in the corpse.
Keywords DNA degradation postmortem interval personal identification
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-10
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 299
End Page 306
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037266
Web of Science KeyUT 000296116400003
JaLCDOI 10.18926/AMO/47010
FullText URL 65_5_287.pdf
Author Hiraki, Takao| Gobara, Hideo| Mimura, Hidefumi| Toyooka, Shinichi| Fujiwara, Hiroyasu| Yasui, Kotaro| Sano, Yoshifumi| Iguchi, Toshihiro| Sakurai, Jun| Tajiri, Nobuhisa| Mukai, Takashi| Matsui, Yusuke| Kanazawa, Susumu|
Abstract The application of radiofrequency ablation for the treatment of lung cancer by our group at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences began in June 2001, and in the present report, we review our 10-year experience with this treatment modality at Okayama University Hospital. The local efficacy of radiofrequency ablation for the treatment of lung cancer depends on tumor size and the type of electrode used, but not on tumor type. An important factor for the prevention of local failure may be the acquisition of an adequate ablative margin. The combination of embolization and radiation therapy enhances the local efficacy. Local failure may be salvaged by repeating the radiofrequency ablation, particularly in small tumors. Survival rates after radiofrequency ablation are quite promising for patients with clinical stage I non-small cell lung cancer and pulmonary metastasis from colorectal cancer, hepatocellular carcinoma, and renal cell carcinoma. The complications caused by radiofrequency ablation can be treated conservatively in the majority of cases. However, attention should be paid to rare but serious complications. This review shows that radiofrequency ablation is a promising treatment for patients with lung cancer.
Keywords radiofrequency ablation lung cancer local efficacy survival complication
Amo Type Review
Publication Title Acta Medica Okayama
Published Date 2011-10
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 287
End Page 297
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037265
Web of Science KeyUT 000296116400002
JaLCDOI 10.18926/AMO/47009
FullText URL 65_5_279.pdf
Author Miyoshi, Ko| Kasahara, Kyosuke| Miyazaki, Ikuko| Asanuma, Masato|
Abstract Almost all mammalian cells carry one primary cilium that functions as a biosensor for chemical and mechanical stimuli. Genetic damages that compromise cilia formation or function cause a spectrum of disorders referred to as ciliapathies. Recent studies have demonstrated that some pharmacological agents and extracellular environmental changes can alter primary cilium length. Renal injury is a well-known example of an environmental insult that triggers cilia length modification. Lithium treatment causes primary cilia to extend in several cell types including neuronal cells;this phenomenon is likely independent of glycogen synthase kinase-3β inhibition. In renal epithelial cell lines, deflection of the primary cilia by fluid shear shortens them by reducing the intracellular cyclic AMP level, leading to a subsequent decrease in mechanosensitivity to fluid shear. Primary cilium length is also influenced by the dynamics of actin filaments and microtubules through the levels of soluble tubulin in the cytosol available for primary cilia extension. Thus, mammalian cells can adapt to the extracellular environment by modulating the primary cilium length, and this feedback system utilizing primary cilia might exist throughout the mammalian body. Further investigation is required concerning the precise molecular mechanisms underlying the control of primary cilium length in response to environmental factors.
Keywords primary cilium length lithium cyclic AMP soluble tubulin intraflagellar transport
Amo Type Review
Publication Title Acta Medica Okayama
Published Date 2011-10
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 279
End Page 285
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037264
Web of Science KeyUT 000296116400001
JaLCDOI 10.18926/AMO/46853
FullText URL 65_4_269.pdf
Author Hidaka, Noriaki| Suemaru, Katsuya| Takechi, Kenshi| Li, Bingjin| Araki, Hiroaki|
Abstract We previously showed that inhibition of repeated electroconvulsive shock (ECS)-induced seizures through 7-day administration of anti-epileptic drugs suppressed the impairment of spontaneous alternation behavior in the Y-maze test in rats. To clarify the precise mechanism(s), we investigated the effect of valproate on such impairment and examined the levels of brain-derived neurotrophic factor (BDNF) and c-Fos protein in the prefrontal cortex and the hippocampus 24h after the last administration of ECS. Seven-day intraperitoneal (i.p.) administration of valproate (400mg/kg) suppressed the impairment of spontaneous alternation behavior. Repeated ECS increased the BDNF protein levels in the hippocampus and prefrontal cortex in the presence or absence of valproate, indicating that the increase in BDNF protein levels resulted from electrical stimulation. c-Fos protein levels were significantly decreased in the hippocampal dentate gyrus after repeated ECS, but valproate had no significant effect on decreased c-Fos protein levels. Valproate+ECS significantly increased the c-Fos protein levels of the prefrontal cortex compared with the ECS group. These findings suggest that the inhibitory effect of valproate on repeated ECS-induced impairment of spontaneous alternation behavior may be linked to the prefrontal cortex.
Keywords electroconvulsive shock-induced seizure spontaneous alternation behavior valproate brain-derived neurotrophic factor c-Fos
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 269
End Page 277
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860534
Web of Science KeyUT 000294236700008
JaLCDOI 10.18926/AMO/46852
FullText URL 65_4_265.pdf
Author Kojima, Katsuhide| Kato, Katsuya| Oto, Takahiro| Mitsuhashi, Toshiharu| Shinya, Takayoshi| Sei, Tetsuro| Okumura, Yoshihiro| Sato, Shuhei| Miyoshi, Shinichiro| Kanazawa, Susumu|
Abstract To determine the effectiveness of living-donor lobar lung transplantation (LDLLT), it is necessary to predict the recipient's postoperative lung function. Traditionally, Date's formula, also called the segmental ratio, has used the number of lung segments to estimate the forced vital capacity (FVC) of grafts in LDLLT. To provide a more precise estimate of graft FVC, we calculated the volumes of the lower lobe and total lung using three-dimensional computed tomography (3D-CT) and the volume ratio between them. We calculated the volume ratio in 52 donors and tested the difference between the segmental volume ratios with a one-tailed t-test. We also calculated the predicted graft FVC in 21 LDLLTs using the segmental ratio pFVC(c) and the volume ratio pFVC(v), and then found the Pearson's correlation coefficients for both pFVC(c) and pFVC(v) with the recipients' actual FVC (rFVC) measured spirometrically 6 months after surgery. Significant differences were found between the segmental ratio and the average volume ratio for both sides (right, p=0.03;left, p=0.0003). Both pFVC(c) and pFVC(v) correlated significantly with rFVC at 6 months after surgery (p=0.007 and 0.006). Both the conventional and the volumetric methods provided FVC predictions that correlated significantly with measured postoperative FVC.
Keywords living-donor lobar lung transplantation 3D-CT volumetry
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 265
End Page 268
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860533
Web of Science KeyUT 000294236700007
JaLCDOI 10.18926/AMO/46851
FullText URL 65_4_259.pdf
Author Ogata, Yoshiko| Aoe, Keisuke| Hiraki, Akio| Murakami, Kazuo| Kishino, Daizo| Chikamori, Kenichi| Maeda, Tadashi| Ueoka, Hiroshi| Kiura, Katsuyuki| Tanimoto, Mitsune|
Abstract The objective of this study was to evaluate the utility of the determination of adenosine deaminase (ADA) level in pleural fluid for the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) in Japan, a country with intermediate incidence of tuberculosis (TB). We retrospectively reviewed the clinical records of 435 patients with pleural effusion and investigated their pleural ADA levels as determined by an auto analyzer. ROC analysis was also performed. The study included patients with MPE (n=188), TPE (n=124), benign nontuberculous pleural effusion (n=94), and pleural effusion of unknown etiology (n=29). The median ADA level in the TPE group was 70.8U/L, which was significantly higher than that in any other groups (p<0.05). The area under the curve (AUC) in ROC analysis was 0.895. With a cut-off level for ADA of 36U/L, the sensitivity, specificity, positive predictive value, and negative predictive value were 85.5%, 86.5%, 69.7%, and 93.6%, respectively. As many as 9% of patients with lung cancer and 15% of those with mesothelioma were false-positive with this ADA cutoff setting. Although the ADA activity in pleural fluid can help in the diagnosis of TPE, it should be noted that some cases of lung cancer or mesothelioma show high ADA activity in geographical regions with intermediate incidence of TB, in contrast to high prevalence areas.
Keywords pleural effusion adenosine deaminase tuberculosis lung cancer mesothelioma
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 259
End Page 263
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860532
Web of Science KeyUT 000294236700006
JaLCDOI 10.18926/AMO/46850
FullText URL 65_4_247.pdf
Author Watanabe, Naomi| Shikata, Kenichi| Shikata, Yasushi| Sarai, Kei| Omori, Kazuyoshi| Kodera, Ryo| Sato, Chikage| Wada, Jun| Makino, Hirofumi|
Abstract Inflammatory processes are involved in the pathogenesis of diabetic nephropathy. The aim of this study was to clarify the role of mitogen-activated protein kinase (MAPK) pathways for induction of intercellular adhesion molecule-1 (ICAM-1) expression in glomerular endothelial cells under diabetic conditions. We examined the expression of ICAM-1 in the kidneys of experimental diabetic rats. Human glomerular endothelial cells (GE cells) were exposed to normal glucose concentration, high glucose concentration (HG), or high mannitol concentration (HM), and then the expression of the ICAM-1 protein and the phosphorylation of the 3 subfamilies of mitogen-activated protein kinase (MAPK) were determined using Western blot analysis. Next, to evaluate the involvement of MAPKs in HG- or HM-induced ICAM-1 expression, we preincubated GE cells with the inhibitors for ERK, p38 or JNK 1h prior to the application of glucose or mannitol. Expression of ICAM-1 was increased in the glomeruli of diabetic rats. Both HG and HM induced ICAM-1 expression and phosphorylation of ERK1/2, p38 and JNK in GE cells. Expression of ICAM-1 was significantly attenuated by inhibitors of ERK, p38 and JNK. We conclude that activation of ERK1/2, p38 and JNK cascades may be involved in ICAM-1 expression in glomerular endothelial cells under diabetic conditions.
Keywords diabetic nephropathy ICAM-1 ERK p38 MAPK JNK
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 247
End Page 257
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860531
Web of Science KeyUT 000294236700005
JaLCDOI 10.18926/AMO/46849
FullText URL 65_4_239.pdf
Author Cho, Yong-Pil| Kwon, Tae-Won| Kwon, Sun U.| Chae, Won-Young| Kim, Geun-Eun|
Abstract We described 9 consecutive patients who underwent operative carotid artery exploration with attempted carotid endarterectomy (CEA) for symptomatic internal carotid artery (ICA) occlusion. Indications for this surgery based on vascular imaging included segmental occlusion of the proximal ICA and also extensive occlusion of the distal ICA in selected patients in whom color-flow duplex ultrasound showed a poorly echogenic or anechoic thrombus with a flow void, suggestive of an acute thrombus. CEA was performed successfully to restore blood flow in all 9 patients:CEA in 5 and CEA with Fogarty thrombectomy in 4. Postoperative magnetic resonance (MR) angiography confirmed that revascularization had been successful in all 9 patients, and MR imaging displayed improved perfusion in 4 patients. Despite the lack of a generalized efficacy of surgical revascularization for symptomatic ICA occlusion, our study demonstrated that preoperative vascular imaging allows the selection of patients who may benefit from CEA.
Keywords internal carotid artery occlusion carotid endarterectomy vascular imaging
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 239
End Page 245
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860530
Web of Science KeyUT 000294236700004
JaLCDOI 10.18926/AMO/46848
FullText URL 65_4_231.pdf
Author Shien, Tadahiko| Doihara, Hiroyoshi| Nishiyama, Keiko| Masuda, Hiroko| Nogami, Tomohiro| Ikeda, Hirokuni| Taira, Naruto|
Abstract Combined low-dose therapy of oral capecitabine (Xeloda) and cyclophosphamide (XC) has been demonstrated to be useful for long-term control of lesions in patients with metastatic breast cancer (MBC) and is aimed at symptomatic alleviation and prolongation of survival. Here, a retrospective review was conducted of MBC patients administered XC at the Okayama University Hospital (OUH), to evaluate responses to XC, adverse events and time to progression (TTP). Twenty patients with MBC received XC between 2006 and 2009. With the exception of 2 elderly patients who were over the age of 70 at the initial examination, all of the patients had received prior treatment with an anthracycline and/or a taxane. No complete response (CR) cases were observed, but partial response (PR) was achieved in 6 patients (30%) and SD in 9 (45%), of whom 5 (20%) sustained SD status for >12 months. The median TTP was 6 months (range:3-27 mo.). Three patients developed Grade 3 adverse events (diarrhea, nausea and stomatitis), but no other patients developed adverse reactions causing interruption of the therapy. XC was safe even in previously treated and elderly MBC patients;moreover, it yielded remarkable clinical responses.
Keywords metastatic breast cancer metronomic chemotherapy
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 231
End Page 237
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860529
Web of Science KeyUT 000294236700003
JaLCDOI 10.18926/AMO/46847
FullText URL 65_4_225.pdf
Author Miura, Masanobu| Naka, Toru| Miyaishi, Satoru|
Abstract Postmortem changes in myoglobin concentrations in blood and organs were investigated using an enzyme immunoassay by animal experiments in combination with immunohistochemical staining of human cases. Blood myoglobin concentrations were found to increase drastically within a very short time after death. Those in striated muscle, however, did not change by day 14 postmortem. Myoglobin content in the liver and kidney increased slightly by day 5 postmortem, and more obviously by day 7 or later. However, almost no change was observed by day 5 in the kidney when the renal artery and vein had been ligated just after death. In the thyroid gland and the lung, the myoglobin content markedly increased by day 7 postmortem, with the logarithmical values rising nearly linearly as the time after death passed. In the thyroid gland, concentrations reached the level of the striated muscle. The mechanisms of postmortem myoglobin increase in organs are thought to be direct diffusion from the striated muscle and/or distribution through the blood. To estimate the postmortem interval, the determination of myoglobin content in the thyroid gland or the lung appears to be useful.
Keywords myoglobin postmortem diffusion postmortem distribution postmortem interval
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 225
End Page 230
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860528
Web of Science KeyUT 000294236700002
JaLCDOI 10.18926/AMO/46846
FullText URL 65_4_219.pdf
Author Yamashita, Toru| Abe, Koji|
Abstract Reperfusion with recombinant tissue plasminogen activator (tPA) sometimes causes catastrophic hemorrhagic transformation (HT) in the ischemic brain. Consequently, the application of tPA has been strictly limited. Recent studies have indicated that matrix metalloproteinases (MMPs), especially MMP-9, play a critical role in blood brain barrier (BBB) disruption in the ischemic brain, leading to brain edema and HT. In the ischemic brain, free radicals and exogenous tPA itself can trigger MMP-9 activation through several signaling pathways containing LDL receptor-related protein (LRP) and proteinase-activated receptor 1 (PAR1). Therapeutic targeting of free radicals and MMP-9/t-PA related signaling pathways might be promising approaches to minimizing catastrophic HT in acute stroke patients. We provide an overview of the available scientific reports to improve our understanding of the mechanisms leading to HT, and highlight recent progress in the development of new therapeutic strategies for preventing HT in the post-stroke brain.
Keywords cerebral ischemia hemorrhagic transformation activator free radical matrix metalloproteinase-9
Amo Type Review
Publication Title Acta Medica Okayama
Published Date 2011-08
Volume volume65
Issue issue4
Publisher Okayama University Medical School
Start Page 219
End Page 223
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21860527
Web of Science KeyUT 000294236700001
JaLCDOI 10.18926/AMO/46635
FullText URL 65_3_215.pdf
Author Waseda, Koichi| Tanimoto, Yasushi| Hasegawa, Kenjiro| Miyahara, Nobuaki| Nojima, Daisuke| Ikeda, Genyo| Kanehiro, Arihiko| Okada, Chiharu| Kimata, Yoshihiro| Tanimoto, Mitsune|
Abstract Churg-Strauss syndrome (CSS) is a granulomatous necrotizing vasculitis of unknown etiology associated with bronchial asthma. Despite affecting small to medium-sized vessels, necrosis of the digits due to vasculitis is extremely rare. We report a case of CSS with necrosis of the toe tips. A 37-year-old woman with asthma, who had been diagnosed with CSS 2 years ago, was admitted to our hospital with an exacerbation of CSS. The patient had a high grade fever and complained of abdominal pain and numbness of the lower extremities. Blood examination revealed marked eosinophilia. The fever pattern, abdominal pain and blood eosinophilia showed improvement by combination treatment with prednisolone and cyclophosphamide. However, the color of her right toe tips changed, and necrosis finally resulted despite antithrombotic therapy. Arteriography showed narrowing of the dorsalis pedis artery and of the more peripheral arteries of her right leg. Stump plasty with negative pressure dressing therapy for the toe tips, but not amputation, was done to preserve the leg function. While numbness of the extremities remained, no recurrence of necrosis was seen. Clinicians need to be aware that rare complications of CSS, including necrosis of the digits, can occur.
Keywords bronchial asthma Churg-Strauss syndrome eosinophilia necrosis of toe tips stump plasty
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2011-06
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 215
End Page 218
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709721
Web of Science KeyUT 000292017500010
JaLCDOI 10.18926/AMO/46634
FullText URL 65_3_211.pdf
Author Nakanishi, Kazuo| Yamane, Kentarou| Tanaka, Masato| Misawa, Haruo| Saiga, Kenta| Ozaki, Toshifumi|
Abstract Here we report a case of surgery for kyphosis of the thoracolumbar spine in an elderly patient, in whom surgery was performed because the patient had developed intractable digestive symptoms. The case was that of a 76-year-old female with complaints of back pain and dysphagia. When videofluoroscopic examination (VF) of swallowing was performed in the cardia of the stomach, images that indicated stagnation and the reflux of food were observed. It was easier for the patient to swallow food in the extension position. We performed corrective fusion of the posterior spine. After the surgery, the kyphosis angle was improved to 27°, the patient's back pain was alleviated, and it became easier for the patient to swallow food. VF also showed that the patient's difficulties with the passage of food had improved. We believe that surgery is a good treatment option for cases of kyphosis with digestive symptoms and deteriorating activities of daily living (ADL), even in the absence of pain and paralysis. VF is also useful for performing evaluations before and after surgery.
Keywords kyphosis dysphagia videofluoroscopic examination of swallowing (VF) fusion
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2011-06
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 211
End Page 214
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709720
Web of Science KeyUT 000292017500009
JaLCDOI 10.18926/AMO/46633
FullText URL 65_3_205.pdf
Author Akavipat, Phuping| Sookplung, Pimwan| Kaewsingha, Pranee| Maunsaiyat, Patcharin|
Abstract To identify the diagnostic properties of the Full Outline of Unresponsiveness (FOUR) score and the discharge outcome, 318 patients were studied. The evaluators rated the patients on admission or when they had mental status alteration with the FOUR score. The course of treatment was determined based on the clinical. The mortality rate and Glasgow Outcome Scale were recorded. Adjusted regression models and prognostic performance were tested by calculation of the receiver operating characteristic curve. One-hundred and twenty-two patients (40.1%) had a poor outcome defined as a Glasgow Outcome Scale score from 3-5, and 38 patients (12.5%) died. The area under the characteristic curve (AUC) for poor outcome and in-hospital mortality were 0.88 (95% CI, 0.83-0.92) and 0.92 (95% CI, 0.87-0.97). The cut-off point of 14 showed sensitivity and specificity of the total FOUR score predicting poor outcomes at 0.77 (95% CI, 0.69-0.84) and 0.95 (95% CI, 0.90-0.97), while the cut-off point of 10 showed the values for in-hospital mortality at 0.71 (95% CI, 0.55-0.83) and 0.93 (95% CI, 0.90-0.96). The total FOUR score showed satisfactory prognostic value for predicting outcome. The cut-off points for the poor outcome and in-hospital mortality are 14 and 10, respectively.
Keywords consciousness evaluation mortality outcome Full Outline of Unresponsiveness (FOUR)
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-06
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 205
End Page 210
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709719
Web of Science KeyUT 000292017500008
JaLCDOI 10.18926/AMO/46632
FullText URL 65_3_199.pdf
Author Endo, Michiko| Nakanishi, Yumiko| Miyatake, Nobuyuki|
Abstract Using the homeostasis model assessment (HOMA) index, we investigated the link between insulin resistance and lifestyle in Japanese female university students. We used data for 57 Japanese female university students (21.0±0.8 years) who were enrolled in a cross-sectional investigation study. We performed full blood examinations, and anthropometric parameters, nutrient oral intake and daily step counts were measured. The mean HOMA index for the subjects was 1.3±0.6, and 12 subjects were over the level of 1.6, which is considered to indicate insulin resistance in Japan. The HOMA index was positively correlated with abdominal circumference (r=0.542, p<0.0001), triglycerides, low density lipoprotein (LDL) cholesterol and systolic blood pressure. In addition, the HOMA index was negatively correlated with n-3 fatty acid and positively correlated with the n-6/n-3 fatty acid ratio (r=0.304, p=0.0216). Daily step count was negatively correlated with the HOMA index, but not at a significant level (r=-0.237, p=0.0809). Higher HOMA index in some Japanese female university students was noted, and that was associated with lifestyle, especially n-6/n-3 fatty acid ratio of nutrient oral intake.
Keywords the homeostasis model assessment (HOMA) index lifestyle n-6/n-3 fatty acid ratio female university students
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-06
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 199
End Page 204
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709718
Web of Science KeyUT 000292017500007
JaLCDOI 10.18926/AMO/46631
FullText URL 65_3_193.pdf
Author Kawaura, Akihiko| Tanida, Noritoshi| Akiyama, Junichi| Nonaka, Kouji| Mizutani, Masatoshi| Sawada, Kenji| Nakagawa, Kimie| Tsugawa, Naoko| Izumi, Keisuke| Ii, Kunio| Okano, Toshio| Takeda, Eiji|
Abstract Sixty-three male 5-week-old Syrian hamsters received the carcinogen N-nitrosobis(2-oxopropyl)amine (BOP) s.c. in 5 weekly injections (the first, 70mg/kg body, and the remaining, 20mg/kg each). The hamsters that received BOP were given intragastric administration of 0.2ml of medium chain triglyceride (MCT) with or without 0.04μg of 1α-hydroxyvitamin D3 [1α(OH)D3] through a feeding tube for 12 weeks. Thus, 3 groups were assigned:Group 1;BOP alone (n=20), Group 2;BOP+MCT (n=18) and Group 3;BOP+1α(OH)D3 (n=25). The mean body weight of Group 3 was lower than those of Groups 1 and 2 at the end of the experiment (p<0.001,Tukey-Kramer HSD test). At the end of week 12, all surviving hamsters were put to sleep. The incidences of liver tumors were 80%, 72% and 32% in Groups 1, 2 and 3, respectively. The incidence of tumors in Group 3 was significantly lower than in Group 1 and Group 2 (p<0.05, χ2-test). All tumors were cholangiocarcinoma. These results indicated that BOP-induced cholangiocarcinogenesis was suppressed by the supplemental administration of 1α(OH)D3.
Keywords 1α-hydroxyvitamin D3 N-nitrosobis(2-oxopropyl)amine cholangiocarcinogenesis Syrian hamsters
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-06
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 193
End Page 197
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709717
Web of Science KeyUT 000292017500006
JaLCDOI 10.18926/AMO/46630
FullText URL 65_3_185.pdf
Author Watanabe, Kumi| Okada, Ayumi| Okabe, Nobuyuki| Onishi, Masaru| Morishima, Tsuneo|
Abstract The purpose of this study was to investigate the psychological needs of children and adolescents with eating disorders (ED) directed toward their mothers. Patients with ED have low self-assertion and various abnormal eating behaviors. Therefore, mothers face difficulty in understanding their children's psychological needs, and the mother-child relationship is sometimes strained. We developed a One-Message Question (OMQ)-structured interview. The OMQ was easy to answer, and it helped the patients with ED. We examined the relationship between psychological needs and illness phase of the children and adolescents, and we discuss the viability of implementing the OMQ in clinical settings. The subjects were 23 patients and their parents. Their parents were just asked about the patients' background. The mean age of the patients was 15.8 years, and the average age of ED onset was 13.5 years. The EDs were anorexia nervosa (n=20) and bulimia nervosa (n=3). The phases of patients' illness were identified as anorexic (n=5), bulimic (n=7), chronic (n=3), and stable (n=8). All subjects provided specific responses to the OMQ-structured interview. Data analyses revealed the following seven categories of patients' psychological needs directed toward their mothers:attachment, cooperation in meeting their goals, longing for love, changing attitude toward family members, respect for self-reliance, expression of apology, and expression of appreciation. These findings suggested that the OMQ-structured interview may prove useful for mothers to understand their children's psychological needs and may encourage positive interactions as a foundation for future recovery.
Keywords family support mother-child relationships eating disorders in children and adolescents interview methods team approach
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-06
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 185
End Page 192
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709716
Web of Science KeyUT 000292017500005
JaLCDOI 10.18926/AMO/46629
FullText URL 65_3_179.pdf
Author Teramen, Hirotake| Tsukuda, Kazunori| Tanaka, Norimitsu| Ueno, Tsuyoshi| Kubo, Takafumi| Ando, Midori| Soh, Junichi| Asano, Hiroaki| Pass, Harvery I.| Toyooka, Shinichi| Miyoshi, Shinichiro|
Abstract Suppression of p21 has been implicated in the genesis and progression of many human malignancies. DNA methylation is an important mechanism of gene silencing in human malignancies. In this study, we examined the expression status and aberrant methylaion of p21 in lung cancers and malignant pleural mesotheliomas (MPM). We used 12 small cell lung cancer (SCLC) cell lines, 13 non-small cell lung cancer (NSCLC) cell lines, 50 primary NSCLCs, 6 MPM cell lines and 10 primary MPMs. The expression and methylation of p21 was examined by reverse transcription-PCR (RT-PCR), Western blotting and methylation-specific PCR (MSP) assay. Loss of p21 protein expression was observed in 7 SCLC cell lines (58.3%), 5 NSCLC cell lines (38.5%) and 3 MPM cell lines (50%) while mRNA expression was lost in 2 SCLC cell lines (16.7%), 2 NSCLC cell lines (15.4%) and none of the MPM cell lines. Aberrant methylation of p21 was found in 8.3% of SCLC cell lines, 30.2% of NSCLCs and 6.3% of MPMs. Among primary NSCLCs, methylation in adenocarcinomas was significantly more frequent than in squamous cell carcinomas. Loss of p21 expression was frequently observed in lung cancers and MPMs and aberrant methylation was one of the mechanisms of suppression of p21, especially in NSCLCs.
Keywords p21 methylation lung cancer mesothelioma
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-06
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 179
End Page 184
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709715
Web of Science KeyUT 000292017500004