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Volume 214 (2008)
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- Issue 3 Pages 165-
- Issue 2 Pages 89-
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Volume 214, Issue 1
January
Displaying 1-10 of 10 articles from this issue
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Regular Contributions
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Keitaro Yamada, Yutaka Yamamoto, Atsushi Uchiyama, Reiko Ito, Yusuke A ...2008 Volume 214 Issue 1 Pages 1-5
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSNeonatal disseminated herpes simplex virus (HSV) infection with acute liver failure (ALF) and neonatal hemophagocytic lymphohistiocytosis (HLH) are severe diseases. We recently experienced a male infant with HLH and ALF induced by HSV type 1 (HSV-1). The infant, born at 39 weeks of gestation by normal delivery, developed a fever on day 4. On day 9, laboratory investigations showed progressive liver dysfunction and coagulopathy, and the serum ferritin was excessively elevated. Furthermore, the blood levels of interleukin (IL)-6, IL-10, and interferon-gamma were also elevated. HSV-1 DNA was detected in the serum and cerebrospinal fluid by the real-time PCR method. A diagnosis of HLH was established based upon the following criteria: fever, splenomegaly, cytopenia (two cell lines), serum ferritin (> 500 μg/l) and hypofibrinogenemia (< 150 mg/dl). High-dose acyclovir therapy, steroid pulse therapy using methylprednisolone, high-dose gamma globulin therapy and a blood transfusion were given. The patient recovered without neurological deficit. Neonatal disseminated HSV infections may be complicated by the development of HLH and hypercyokinemia. If HLH is suspected, not only high-dose acyclovir therapy but also anti-cytokine therapy should be considered.View full abstractDownload PDF (204K) -
Short Bowel Syndrome: Amelioration of Diarrhea after Vagotomy and Pyloroplasty for Peptic HemorrhageMichael Safioleas, Michael Stamatakos, Panagiotis Safioleas, Ahmad Dia ...2008 Volume 214 Issue 1 Pages 7-10
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSAcute mesenteric ischemia is a rare symptomatic manifestation of arteriosclerosis. Prognosis crucially depends on rapid diagnosis and surgical management to prevent or at least minimize the bowel infarction. The length of the small bowel is considered to be between 3 and 8 m, and a normal bowel function can be maintained even after resection of its one third. But loss of a major part (> 60%) can lead to malnutrition and death. However, patients, who survived an extended intestinal resection due to improved postoperative care (intensive care unit and parenteral nutrition), develop short bowel syndrome. This phenomenon is a medical problem, and several surgical techniques have been used to slow down intestinal transit time or to increase the area of absorption. All these procedures have controversial outcomes and are still on different experimental levels; namely, they cannot be recommended for routine use. In our report of a patient suffering from short bowel syndrome, vagotomy and pyloroplasty were performed to repair a sudden peptic hemorrhage. This operation cured bleeding peptic ulcer and also palliated the diarrhea, a main clinical manifestation of short bowel syndrome. In this study, our aim is to emphasize the favorable clinical outcome of vagotomy concerning a principal manifestation of short bowel syndrome, such as diarrhea. To the best of our knowledge, the present study is the first report showing the vagotomy as a possible procedure for the treatment of diarrhea, although this occurrence has no clear explanation. We also discuss the management of short bowel syndrome.View full abstractDownload PDF (452K) -
Laura Pérez-Campos-Mayoral, Alejandro Ruiz-Argüelles, Beat ...2008 Volume 214 Issue 1 Pages 11-16
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESST-cell acute lymphoblastic leukemia is the most common form of cancer in children. Lectins are proteins or glycoproteins from plants or animals that recognize oligossacharides on the cell surface and have been used to characterize the structural changes of oligosaccharides in leukemias. In this study, we used the lectin from the freshwater prawn Macrobrachium (M. rosenbergii), specific for acetyl groups in sialylated glycans, because increased sialylation of glycoproteins and glycolipids has been identified in lymphoblastic leukemias. We compared the specificity of the M. rosenbergii lectin for lymphoblastic leukemias with the specificities of the lectins from Triticum vulgaris, Solanum tuberosum, Arachis hipogaea, and Phytolacca americana. By morphologic and phenotype characterization with a panel of monoclonal antibodies, we identified four types of leukemias from 106 leukemia patients: 11 cases of T-cell acute lymphoblastic leukemia, 61 cases of B-cell acute lymphoblastic leukemia, 24 cases of acute myeloblastic leukemia, and 10 cases of acute biphenotypic leukemia. As determined by cytofluorometric assays, nine of the eleven cases with T-cell acute lymphoblastic leukemia (8 ± 3 years old) were specifically identified with the lectin from M. rosenbergii. In contrast, only six cases of B-cell leukemia, one case of myeloblastic leukemia, and 2 cases of biphenotypic leukemia were identified with this M. rosenbergii lectin. The other lectins tested showed no capacity to differentiate, in a significant manner, any of the four types of leukemias tested. Thus, the lectin from M. rosenbergii could be considered a useful tool for the diagnosis and study of T-cell acute lymphoblastic leukemia.View full abstractDownload PDF (337K) -
Hale Karapolat, Sibel Eyigor, Mehdi Zoghi, Sanem Nalbantgil, Tahir Yag ...2008 Volume 214 Issue 1 Pages 17-25
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSQuality of life is an important outcome measure in patients with end-stage heart failure waiting for heart transplantation. The purpose of this study was to investigate the relationship between aspects of quality of life and physiological and psychosocial variables in patients with end-stage heart failure. A total of 123 patients participated in the study. The functional status was assessed with New York Heart Association (NYHA) functional classification, a 6-minute walk test (6 MWT) and peak oxygen uptake (pVO2). Health related quality of life (HRQOL) was measured with Medical Outcomes Study, 36-item Short Form Survey (SF-36), and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used to assess psychological symptoms. A significant relationship was found between HRQOL (SF-36 and MLHFQ) and functional status (NYHA, 6 MWT and pVO2) (p < 0.05). Psychological symptoms (BDI) were associated with HRQOL (p < 0.05). In addition to clinical derangements, functional limitation and psychological distress can lead to limitations in activities of daily life through impairment of quality of life. It would be helpful to evaluate psychological symptoms and quality of life in patients with end-stage heart failure besides routine clinical evaluations.View full abstractDownload PDF (226K) -
Hideaki Komiya, Yuko Masubuchi, Yutaka Mori, Naoko Tajima2008 Volume 214 Issue 1 Pages 27-37
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSChildhood obesity is a medical and social problem in Japan. The number of obese children has been increasing steadily since 1980 according to a survey on school health statistics. However, more simple and reliable criteria for assessment of obesity in children are required. The aim of this study was to establish gender- and age-specific body mass index (BMI) cutoff values for evaluation of obesity in school-aged children. A total of 100,587 elementary school, junior and senior high school students, aged 6 to 17 years, comprised the study population, in whom BMI was measured. The BMI cutoff values were calculated by using the receiver operating characteristic (ROC) analysis in the degree of obesity of 20% or greater as definition of obesity. The validity of the determined cutoff values of BMI was then compared with the Rohrer index, the International Obesity Task Force (IOTF) data and the percentile method. The sensitivity and specificity of the BMI cutoff values were over 93% in both boys and girls of all ages, thereby providing criteria that are highly diagnostic in all ages. The Rohrer Index and BMI 95th percentile values tended to underestimate obesity, while the IOTF criteria tended to overestimate it. In conclusion, the BMI cutoff values determined in the present study enable us to detect obese individuals with extremely high precision, and thus may represent an instrument with superior diagnostic capabilities to those of the existing instruments currently being used forassessment of pediatric obesity.View full abstractDownload PDF (316K) -
Shiori Azuma, Masahiro Kohzuki, Shuichi Saeki, Mayumi Tajima, Kaoru Ig ...2008 Volume 214 Issue 1 Pages 39-50
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSPatients with malocclusion, especially those in need of surgical correction, have lower health related quality of life (HRQOL) and higher anxiety. We investigated the changes of HRQOL and psychological status following jaw surgery in the patients with facial deformities. Thirty-one adult orthodontic patients admitted to Tohoku University Hospital and diagnosed as malocclusion requiring jaw surgery were recruited for the study. The severity of malocclusion was assessed by Severity Score (SS) which is based on their cephalometric radiographs. They were divided into three groups according to the severity of malocclusion, i.e. Low-SS, Moderate-SS and High-SS. The subjects also completed a generic HRQOL (entire body health) instrument, and three disease-specific oral HRQOL instruments. HRQOL and psychological status of the patients were assessed before (T1) and at debonding of multibracketed appliances after surgery (T2). SS in each group significantly decreased to normal occlusion level (SS = 0-1). Oral function significantly improved from 11.8 ± 5.4 to 5.9 ± 4.3 in the Low-SS (p < 0.01), from 13.7 ± 6.5 to 8.8 ± 5.1 in the Moderate-SS (p < 0.05), and from 14.7 ± 6.7 to 7.8 ± 5.7 in the High-SS (p < 0.01). The patients after the surgical correction had improved disease-specific HRQOL and state anxiety irrespective of the severity before surgery, although the generic HRQOL, trait anxiety and depression were equal to that before the surgery. Furthermore, both postoperative anxiety and HRQOL were estimated by the preoperative anxiety and HRQOL. These results indicated that jaw surgery markedly improved the disease-specific HRQOL and psychological status in the present patients. We therefore suggest that assessments of the HRQOL and psychological status before treatment might predict the HRQOL and psychological status after the treatment to a certain extent.View full abstractDownload PDF (345K) -
Yoshihiro Abe, Hitoshi Ishikawa, Akira Fukao2008 Volume 214 Issue 1 Pages 51-59
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSOsteoporosis has reached epidemic proportions. This situation has stimulated the development of biochemical markers to assist in assessing osteoporotic risk and monitoring treatment efficacy. Biochemical markers for assessing the level of bone resorption have been developed during the last few decades. One of the most widely used bone resorption markers is cross-linked N-terminal telopeptides (NTX). Measurements of urinary and serum NTX provide indications of the level of bone resorption during osteoporosis treatment. However, it remains unclear whether urinary or serum NTX measurements show better efficacy for assessing osteoporosis treatment effects during the early phase of treatment. Therefore, the primary aim of the present study was to compare the efficacies of urinary and serum NTX measurements for assessing the level of bone resorption during the early stage of osteoporosis treatment. We enrolled 43 postmenopausal Japanese women in an open-label randomized placebo-controlled trial. Overall, 21 women in the osteoporosis treatment group and 19 women in the placebo group completed the study. There was a significant reduction in urinary NTX in the treatment group, which was detectable as early as 4 weeks and maintained until 16 weeks, compared with the placebo group. On the other hand, serum NTX did not show a significant reduction in the treatment group compared with the placebo group until 16 weeks. These results indicate that urinary NTX measurements are more sensitive and show higher efficacy than serum NTX measurements for assessing treatment effect during the early phase of osteoporosis treatment in postmenopausal women.View full abstractDownload PDF (273K) -
Shih-Chao Kang, Hsuan-Ming Tsao, Chien-Ting Liu, Chin-Lin Perng, Shinn ...2008 Volume 214 Issue 1 Pages 61-67
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSAcute pyelonephritis causes hospitalization and is a commonly-ignored cause of death in geriatric patients. It has been well studied in young-adult populations but rarely in geriatric populations. The aim of our study was to analyze the characteristics of acute pyelonephritis in geriatric patients. The electronic admission records of a community hospital in northeastern Taiwan were retrospectively screened from July 1, 2003 to June 30, 2006. The basic characteristics, laboratory findings and infectious microorganisms of all subjects were evaluated. Sixty-five subjects (mean age 71.6 ± 4.9 years; range 65-84 years) and 73 admission records contributed by them were enrolled. These 65 subjects, including one who died in hospital, were predominantly female (52 subjects; 80%). Twenty-two subjects (33.8%) had co-existing diabetes mellitus, 9 subjects (13.8%) had co-existing tumors, and 19 subjects (29.2%) had a history of intra-abdominal surgery. The admission records revealed right kidney involvement (52.1%), co-existing urolithiasis (50.7%) and admission to wards of internal medicine (57.5%). Urological procedures were performed on 20 (27.4%) of all 73 admission records. Escherichia coli was the most common infecting microorganism (19.2% of all records; 42.4% of records with positive microorganism culture). Hemoglobin < 10 g/dl was a significant predictive factor for both hospital stay > 7 days and serum creatinine > 2.0 mg/dl (p = 0.003 and 0.002, respectively). Positive microorganism culture was also a significant predictive factor for hospital stays > 7 days (p < 0.001). In our geriatric patients with acute pyelonephritis, low hemoglobin levels implied co-existing renal insufficiency and prolonged hospitalization. Positive microorganism culture also implied prolonged hospitalization.View full abstractDownload PDF (357K) -
Takashi Ohba, Naoyuki Kurokawa, Kunihiko Nakai, Miyuki Shimada, Keita ...2008 Volume 214 Issue 1 Pages 69-78
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSMercury in hair is a generally accepted biomarker of methylmercury exposure, and permanent waving has been reported to affect the mercury concentration in hair. We conducted an experimental-field study to examine the changes in the mercury concentration in hair induced by treatments such as permanent waving, straightening and coloring. Hair samples were collected from 19 female subjects enrolled before and after hair treatment by a beautician during each visit to a beauty saloon. A total of 38 pair samples were cut in 1-cm segments from the proximal end up to 10 cm, and then as 2-cm segments up to the distal end thereafter. Each segment was analyzed for total mercury concentration by cold-vapor atomic absorption spectrometry. Permanent waving decreased mercury concentration for most of the segments except for the proximal two segments and the 8-9 cm segment from the proximal end. Nevertheless the average mercury concentration of 3-cm segments from the proximal end showed no significant decrease by permanent waving. Since females usually have hair longer than 3 cm, hair samples subjected to permanent waving may give lower mercury exposure estimates when the full-length hair strands are analyzed. However, analyzing the proximal 3-cm segment of hair samples does not give lower mercury exposure estimates. Assuming that hair samples are collected from puerperal women around the time of delivery, the 3-cm segments represent fetal exposure to methylmercury during the third trimester when fetuses are most vulnerable to methylmercury exposure. Therefore, mercury concentrations in the proximal segment of maternal hair collected in the right time can be a good biomarker of fetal methylmercury exposure.View full abstractDownload PDF (217K) -
Shiho Terai, Katsunori Iijima, Katsuaki Kato, Naohiro Dairaku, Tatsuhi ...2008 Volume 214 Issue 1 Pages 79-87
Published: 2008
Released on J-STAGE: January 19, 2008
JOURNAL FREE ACCESSMucosa-associated lymphoid tissue (MALT) lymphomas are localized primarily in the gastrointestinal tract and are characterized by an indolent nature and favorable outcome with specific therapy. Gastric MALT lymphomas are closely linked to Helicobacter pylori (H. pylori) infection, for which eradication therapy is recognized as an effective primary treatment for the disease. However, there is little information about long-term outcomes after the therapy. In the present study, we elucidated the long-term outcomes of 74 patients (70 H. pylori-positive and 4 negative cases) followed up by endoscopy at least 12 months after exclusive eradication therapy alone. The median follow-up period was 46 months. When the remission status was estimated at the time point of 12 months post-eradication, the numbers of patients with complete remission (CR), histologically residual disease with macroscopic normalization (hRD), partial remission with more than 50% tumor reduction (PR) or no response (NR) were 56, 12, 2 and 4, respectively. During follow-ups of over 12 months post-eradication, 11 of the 12 hRD cases were belatedly induced to CR but one CR case histologically relapsed into hRD. One of the 2 PR cases eventually turned into hRD 20 months later. Therefore, 66 CR, 3 hRD, 1 PR, and 4 NR cases (including 3 H. pylori-negative) were identified at the last follow-up of the present study. All 74 patients were followed up without any second-line therapies, but none exhibited disease progression. Thus, the long-term outcome of localized gastric MALT lymphoma after H. pylori eradication therapy was favorable. A watch and wait strategy may be a reasonable approach for hRD since the majority might be in the process of turning into delayed CR.View full abstractDownload PDF (266K)
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