All issues
Volume 213 (2007)
- Issue 4 Pages 283-
- Issue 3 Pages 187-
- Issue 2 Pages 105-
- Issue 1 Pages 1-
Volume 213, Issue 2
October
Displaying 1-10 of 10 articles from this issue
- |<
- <
- 1
- >
- >|
Regular Contributions
-
Shin-ichi Demura, Takayoshi Yamada2007 Volume 213 Issue 2 Pages 105-111
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSDynamic balance ability related to maintaining postural stability during movement is closely tied to fall risk in the elderly. The functional reach (FR) test has been developed to evaluate their dynamic balance. Although a simple and new FR test using an elastic stick has been proposed by modifying the above original FR test, the abilities related to both FR tests are judged to differ because of the large difference in the testing method. This study aimed to compare center of gravity fluctuation, muscle activity and functional reach distance as measured by the original FR test and the elastic stick FR test. First, reach distance, back/forth and right/left moving distance of the center of gravity, and activity of the lower leg muscles (soleus and tibialis anterior) were compared between both tests based on data obtained from 30 young male adults. All parameters except for the right/left moving distance were significantly larger in the elastic stick FR test. Next, the reach distance was examined in both FR tests using 53 elderly subjects; it was significantly longer in the elastic stick FR test, but showed no significant sex difference. The reach distance in both tests was significantly shorter (about 7 cm) in the elderly than in young adults. In conclusion, the elastic stick FR test involves greater leg muscle strength exertion and forward transferring of the center of gravity as compared with the original FR test. Because the elastic stick FR test relates largely to leg muscle function and equilibrium function, it may be more useful for evaluating the dynamic balance ability of the elderly.View full abstractDownload PDF (288K) -
Tayyareci Yelda, Umman Berrin, Sezer Murat, Oncul Aytac, Besisik Sevgi ...2007 Volume 213 Issue 2 Pages 113-120
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSThe stem cell transplantation is emerging as a potential therapeutic modality for patients with heart failure. It has been demonstrated that intracoronary stem cell transplantation had beneficial effects on left ventricular perfusion and contractile functions. We hypothesized that patients with end-stage ischemic cardiomyopathy, who are candidates for heart transplantation, could also benefit from autologous intracoronary stem cell transplantation. We performed a prospective, open-labeled study in 10 patients with end-stage ischemic cardiomyopathy, who were on the waiting list for heart transplantation. Each patient received bone marrow-derived mononuclear cell infusion via balloon catheter in the target vessel, which had been revascularized by percutaneous intervention and was patent before the procedure. Clinical and laboratory evaluations, a treadmill exercise test, echocardiography, and single photon emission tomography (SPECT) were performed to the patients at baseline and 6 months after stem cell infusion. At 6-month follow-up of the eight patients who were able to complete the study, we revealed a significant increase in ejection fraction (from 30.0 ± 6.6% to 36.2 ± 7.3%; p = 0.001) in echocardiographic evaluation. SPECT evaluation also displayed a reduction in infarct area (50.4 ± 16.1% to 44.1 ± 12.5%; p = 0.003). Both myocardial oxygen consumption (p = 0.001) and metabolic equivalents (p = 0.001) were significantly increased at 6-month follow-up. These results demonstrate that intracoronary stem cell transplantation ameliorates heart failure symptoms and improves left ventricular function and perfusion. Therefore intracoronary stem cell transplantation may be used as an alternative treatment option for heart transplant candidates.View full abstractDownload PDF (431K) -
Yousuke Takemura, Reiko Atsumi, Tsukasa Tsuda2007 Volume 213 Issue 2 Pages 121-127
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSMany textbooks indicate the desirability of using specific medical interview behaviors to obtain information from patients, although little evidence has been presented. The aim of this study is to investigate the relationships between the use of medical interview behaviors and the amount of information obtained. The behaviors studied included: open-ended questions, facilitation (comments or interviewer behavior that encourages the patient to continue talking), the open-to-closed cone (the gradual narrowing of focus from an initial nondirective approach to a more direct exploration), summarization (providing the patient with an explicit verbal summary of the information gathered thus far), and surveying problems. The subjects were 315 patients who visited an outpatient facility. These medical interviews were videotaped and reviewed by a trained rater using the Takemura Medical Interview Rating Scale, which was developed to assess the use of particular medical interview behaviors and to measure the amount of information obtained from patients regarding their chief physical complaints. Significant positive relationships were found between three particular interview behaviors and the amount of information obtained: facilitation, the open-to-closed cone, and summarization. These positive relationships were still present after adjusting for other medical interview behaviors used, and after adjusting for the time duration of the medical interviews (F = 15.3, p < 0.0001; F = 40.1, p < 0.0001; F = 5.57, p = 0.019, respectedly). This study reveals a positive relationship between three specific medical interview behaviors (facilitation, the open-to-closed cone, and summarization) and the amount of information obtained in a real clinical practice setting.View full abstractDownload PDF (304K) -
Nebil Attia, Amel Nakbi, Maha Smaoui, Raja Chaaba, Philippe Moulin, So ...2007 Volume 213 Issue 2 Pages 129-137
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSReverse cholesterol transport (RCT) is the pathway, by which the excess of cholesterol is removed from peripheral cells to the liver. An early step of RCT is the efflux of free cholesterol from cell membranes that is mediated by high-density lipoproteins (HDL). Phospholipid transfer protein (PLTP) transfers phospholipids between apolipoprotein-B-containing lipoproteins (i.e., chylomicrons and very low-density lipoproteins) and HDL. PLTP contributes to the HDL maturation and increases the ability of HDL to extract the cellular cholesterol. It is known that RCT is impaired in type 2 diabetic patients, especially when cardiovascular complication is associated with. In this study, we measured the serum capacity that promotes cellular cholesterol efflux and the plasma PLTP activity in type 2 diabetic patients with coronary artery disease (CAD) (n = 35), those without CAD (n = 24), and 35 healthy subjects as a sex- and age-matched control. In patients with CAD, plasma triglyceride level was higher compared to controls (p < 0.01) and HDL-cholesterol was lower (p < 0.01 vs control and the patients without CAD). In diabetic patients with or without CAD, PLTP activity was consistently increased, compared to controls, while cellular cholesterol efflux activity was decreased by 20% (p < 0.001) or 13.5% (p < 0.01), respectively. In conclusion, plasma PLTP activity was increased in type 2 diabetic patients with or without CAD, which could impair cellular cholesterol removal and might accelerate atherosclerosis in diabetic patients.View full abstractDownload PDF (339K) -
Kenya Saji, Yoshihiro Fukumoto, Jun Suzuki, Shigefumi Fukui, Jun Nawat ...2007 Volume 213 Issue 2 Pages 139-148
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSHeart failure is the most common cardiovascular disease with high mortality and morbidity. Both enhanced microtubule polymerization and cardiomyocyte apoptosis are involved in the pathogenesis of heart failure. However, the link between the two mechanisms remains to be elucidated. In this study, we thus address this important issue in cultured cardiomyocytes from Wistar rats in vitro and in angiotensin II (ATII)-infused rats in vivo. Confocal microscopy examination showed that in cultured rat cardiomyocytes, micrographic density of microtubules was increased by paclitaxel, a microtubule-polymerizing agent, and decreased by colchicine, a microtubule-depolymerizing agent, but not affected by ATII, isoproterenol, or tumor necrosis factor-α alone. Immunoblotting analysis showed that Bax/Bcl-2 ratio, which is associated with the activation of caspase-3, was significantly increased in ATII-stimulated cultured cardiomyocytes in vitro and in ATII-infused rats in vivo, both of which were inhibited by co-treatment with colchicine. Caspase-3 and TUNEL assay to detect apoptosis in vitro demonstrated that paclitaxel or ATII alone significantly enhanced and their combination further accelerated cardiomyocyte apoptosis, which was again significantly inhibited by colchicine. Caspase-3 and TUNEL assay in vivo also demonstrated that ATII infusion significantly increased myocardial apoptosis and that co-treatment with colchicine significantly suppressed the apoptosis. In conclusion, these results indicate that a microtubule-depolymerizing agent could be a potential therapeutic strategy for treatment of heart failure.View full abstractDownload PDF (467K) -
Masashi Koto, Hirohiko Tsujii, Naoyoshi Yamamoto, Hideki Nishimura, Sh ...2007 Volume 213 Issue 2 Pages 149-156
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSRadiation pneumonitis (RP) is one of the most common dose-limiting toxicities in thoracic X-ray radiotherapy (XRT). Dosimetric factors are used for prediction of the occurrence of RP after XRT. Carbon-ion radiotherapy (CRT) is a promising modality because of its excellent dose localization and high biological effect on tumors. This study aims to analyze the relationship between dosimetric factors developed for XRT and the incidence of RP in patients with stage I non-small cell lung cancer (NSCLC) after CRT. We examined 80 inoperable patients with NSCLC. The ranges of the daily fraction sizes and the total doses were from 3.3 to 8.8 GyE and from 59.4 to 95.4 GyE, respectively. These doses were successfully delivered with acceptable toxicity; ≥ grade 2 RP was observed in 8 patients (10%). The severity of RP was graded within 6 months of the initiation of CRT using the Radiation Therapy Oncology Group criteria. These results indicate the excellent dose distribution of CRT. We then compared the dosimetric data of the 8 patients developed ≥ grade 2 RP with those of 72 patients developed ≤ grade 1 RP. Dosimetric factors useful for predicting RP in XRT, such as the percentage of the computed tomography-defined total lung volume receiving > 5, > 20, and > 30 GyE, and mean lung dose, were not predictive factors for RP after CRT. The dosimetric factors used for XRT are not applicable for CRT in patients with NSCLC. The dosimetric factors for CRT remain to be developed.View full abstractDownload PDF (394K) -
Yoko Goto, Masahiro Kohzuki, Makiko Meguro, Hajime Kurosawa2007 Volume 213 Issue 2 Pages 157-166
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSChronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation, which results in exertional dyspnea and physical disability. Subsequently, those cause a difficulty in performing routine activities of daily living and affect their health-related quality of life (HRQOL). Lung volume reduction surgery (LVRS) has been reported to be an effective treatment for selected patients with advanced COPD to improve pulmonary function, lung mechanics, exercise tolerance, and dyspnea. However, the long-term effects of LVRS on HRQOL have not been fully investigated. Therefore the effects of LVRS on generic and disease-specific HRQOL were assessed in patients with COPD following LVRS for 36 months. Nineteen patients (65.1 ± 7.0 [mean ± S.D.] years old) who underwent pulmonary rehabilitation plus LVRS (LVRS group), and 8 patients (67.2 ± 5.8 years old) who did pulmonary rehabilitation but not LVRS (Medical group) were studied. In both groups, optimal medication was given throughout this period. Generic HRQOL and disease-specific HRQOL were evaluated before rehabilitation, and 3, 12, 24, and 36 months after LVRS. Following LVRS, the generic HRQOL was significantly improved and the disease-specific HRQOL was maintained up to 36 months. In Medical group, disease-specific HRQOL rapidly deteriorated. In conclusion, the long-term effects of LVRS on HRQOL in COPD patients were maintained up to 36 months compared with Medical group. Both generic and disease-specific HRQOL changed differently, suggesting the importance of both assessments especially in long-term follow up.View full abstractDownload PDF (378K) -
Dang Duc Anh, Phan Le Thanh Huong, Kiwao Watanabe, Nguyen Thu Nguyet, ...2007 Volume 213 Issue 2 Pages 167-172
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSAcute lower respiratory infection (ALRI), primarily pneumonia, is the leading cause of death in children under the age of five. Bacterial ALRI is preceded by asymptomatic bacterial colonization. Bacterial colonization, therefore, may have an important role in the development of pneumonia in children. This case-control study was conducted in order to determine if intense bacterial colonization was increased in the nasopharynx of pediatric patients with ALRI. One hundred-sixty four pediatric patients with ALRI and 70 healthy children < 5 years of age were enrolled in Hanoi, Vietnam between 2001 and 2002. Bacterial pathogens were isolated from nasopharyngeal secretions and quantitatively cultured. Of 164 patients, 91 were diagnosed as having radiological pneumonia (PN group) and 73 as having acute bronchitis (AB group). Intense growth of any bacterial pathogen (≥ 106 colony-forming units/ml) was highest in the PN group (49.4%), followed by the AB group (28.8%), with healthy children having the lowest (17.1%). Patients with intense bacterial growth were more likely to develop pneumonia, but not acute bronchitis, than were patients with light or no bacterial growth. The results of this case-control study suggest that the vertical spread of intense bacterial pathogens colonized in the nasopharynx to the lower airway leads to bacterial pneumonia in children under the age of five.View full abstractDownload PDF (260K) -
Ibrahim Sari, Zubeyir Acar, Zekeriya Nurkalem, Nevzat Uslu, Vedat Davu ...2007 Volume 213 Issue 2 Pages 173-180
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSContoversy exists about the optimal operation time of the patients with left main coronary artery (LMCA) stenosis. We therefore, aimed to investigate the effect of waiting time on in-hospital morbidity and mortality in patients with LMCA stenosis and identify the risk factors associated with adverse cardiovascular events before and during surgery. One hundred seventy six patients with LMCA stenosis were divided into two groups according to the time period between coronary angiography and coronary artery bypass surgery (group 1: ≤ 7 days, 94 patients; and group 2: > 7 days, 82 patients). Primary end points were death and major adverse cardiac event (MACE): in-hospital death, sustained ventricular tachycardia or ventricular fibrillation development, postoperative stay in the intensive care > 48 hrs and in hospital > 9 days. Demographic and clinical characteristics of patients in groups 1 and 2 were comparable. There was no difference between the two groups in terms of in-hospital morbidity, mortality and MACE. When we analyzed the differences between the patients with and without MACE, the patients who experienced MACE were older (p = 0.001), and had higher degree of LMCA stenosis (p = 0.01), higher degree of right coronary artery stenosis (p = 0.02), higher blood urea level (p = 0.003), and higher incidence of unstable angina or myocardial infarction within 2 weeks (p = 0.001). Independent risk factors for MACE were unstable angina or myocardial infarction within 2 weeks, age more than 70 years and stenosis more than 75% in the LMCA. These results suggest that preoperative clinical status but not waiting time predicts in-hospital surgical outcomes in LMCA stenosis.View full abstractDownload PDF (301K) -
Futoshi Nagasaki, Hirofumi Niitsuma, Yoshiyuki Ueno, Jun Inoue, Takayu ...2007 Volume 213 Issue 2 Pages 181-186
Published: 2007
Released on J-STAGE: October 01, 2007
JOURNAL FREE ACCESSHepatitis B virus (HBV) infection remains to be one of the most prevailing infection in the world, causing chronic liver diseases. Although lamivudine has been effective to suppress HBV replication, longer durations of administration can lead to the emergence of drug-resistant mutant viruses, followed by reactivation of hepatic inflammation (breakthrough hepatitis). Moreover, the optimal period of administration as well as the effects of anti-viral nucleot(s)ide such as lamivudine, adefovir, and entecavir, has not been established. To evaluate the efficacy of the anti-viral effects of entecavir for lamivudine-resistant HBV, we administered entecavir sequentially in four patients with chronic HBV infection, who demonstrated the emergence of lamivudine-resistant HBV and histological active hepatitis. The antiviral effects were evaluated by the serum viral loads and biochemical laboratory data. After follow-up periods of more than 36 months, we found high incidence in the emergence of entecavir resistant mutants (3/4, i.e., 75%). An additional mutation at the 184th amino acid, different from the previously reported lamivudine-resistant mutations (80th, 180th, and 204th), seemed to have a close relationship with the induction of entecavir-resistant mutants at least for Japanese HBV genotype C. Our observation draws attention to the possibility that the usage of entecavir for lamivudine-resistant HBV could promptly induce entecavir-resistant mutations in addition to lamivudine-resistance.View full abstractDownload PDF (292K)
- |<
- <
- 1
- >
- >|