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Volume 225 (2011)
- Issue 4 Pages 225-
- Issue 3 Pages 145-
- Issue 2 Pages 77-
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Volume 225, Issue 3
November
Displaying 1-12 of 12 articles from this issue
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Regular Contributions
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Sanae Noguchi, Hisashi Masugata, Shoichi Senda, Kaori Ishikawa, Hiromi ...2011 Volume 225 Issue 3 Pages 145-151
Published: 2011
Released on J-STAGE: September 30, 2011
JOURNAL FREE ACCESSHeart failure has been divided into heart failure with preserved left ventricular (LV) ejection fraction (EF) and heart failure with reduced EF, because the pathophysiologies of the two conditions are different. Cardio-ankle vascular index (CAVI) is a new indicator of arterial stiffness, and the most conspicuous feature of CAVI is its independence of blood pressure at the time of measurement. Arterial stiffness has been considered to increase LV afterload, which requires special care to avoid the onset of heart failure. We compared the correlation of arterial stiffness as assessed by CAVI to LV function in 44 hypertensive patients with preserved EF (EF: 71 ± 7%) and 31 patients with reduced EF (48 ± 8%). All of patients with reduced EF had history of both hypertension and myocardial infarction. Using Doppler echocardiography, LV diastolic and systolic function was evaluated by measuring peak early diastolic mitral annular velocity (e') and global LV peak systolic longitudinal strain (GPSLS), respectively. In patients with preserved EF, CAVI was correlated with e' (r = −0.313, p = 0.038), but not with GPSLS (r = 0.207). By contrast, CAVI was correlated with GPSLS (r = 0.604, p < 0.001) as well as e' (r = −0.393, p = 0.029) in patients with reduced EF. Thus, patients with reduced EF showed a closer correlation of arterial stiffness to LV function compared with patients with preserved EF. Therefore, hypertensive patients with reduced EF require a stricter regimen for treating arterial stiffness than their counterparts with preserved EF.View full abstractDownload PDF (711K) -
Marijana Miskovic, Tanja Lalic, Danijela Radivojevic, Sanja Cirkovic, ...2011 Volume 225 Issue 3 Pages 153-159
Published: 2011
Released on J-STAGE: October 05, 2011
JOURNAL FREE ACCESSSpinal muscular atrophy (SMA) is the second most frequent autosomal recessive disease characterized by degeneration of the anterior horn cells of the spinal cord, leading to muscular atrophy. SMA is classified into three types according to disease severity and age-onset: severe (type I), intermediate (type II) and mild (type III). Deletions in the survival motor neuron (SMN) gene, located in the chromosome region 5q11.2- 5q13.3, are major determinants of SMA phenotype. Extended deletions that include the neuronal apoptosis inhibitory protein (NAIP) gene may correlate with the severtity of SMA. SMN gene is present in two highly homologous copies, SMN1 and SMN2, but only deletions of the SMN1 gene (exons 7 and 8 or exon 7) are responsible for clinical manifestations of SMA. Here, we present the deletion profiling of SMN1 and NAIP genes in 89 children with SMA from Serbia: 52 patients with type I, 26 with type II, and 11 with type III. The homozygous deletion of the SMN1 gene was confirmed in 72 of 89 (81%) patients, being the most frequent in SMA type I (48/52): 68 patients (94.4%) with deletion of exons 7 and 8 and 4 patients (5.6%) with deletion of exon 7. The extended deletion including the NAIP gene was detected in 18 of 89 (20.2%) patients, mostly affected with type I. This study has revealed the lower incidence of deletions in the SMN1 and NAIP genes in families with SMA in Serbia and will provide important information for genetic counselling in these families.View full abstractDownload PDF (467K) -
Dong-Liang Hu, Edward K Maina, Katsuhiko Omoe, Fumio Inoue, Minoru Yas ...2011 Volume 225 Issue 3 Pages 161-169
Published: 2011
Released on J-STAGE: October 05, 2011
JOURNAL FREE ACCESSStaphylococcus aureus is a leading cause of human disease in the hospital setting and the community. Superantigenic toxin-producing methicillin-resistant Staphylococcus aureus (MRSA) is currently important for nosocomial infections and food-borne diseases worldwide because of its global spreading and difficulty in therapy. Superantigenic toxins can bypass normal antigen presentation and have strong T cell mitogenic activity, leading to massive release of proinflammatory cytokines and contributing to the severity of S. aureus sepsis. In this study, a total of 131 MRSA isolates from patients in the University Hospital were searched for staphylococcal cassette chromosome mec (SCCmec) genes and the staphylococcal superantigenic toxin genes by multiplex polymerase chain reactions. The MRSA isolates were classified into SCCmec type II (74.8%), type I (13.0%), type IV (3.8%), type V (2.3%), and type I and type II (3.8%). MRSA isolates (102/131) also carried a number of superantigenic toxin genes including staphylococcal enterotoxin (se) and toxic shock syndrome toxin-1 (tst-1) genes. The most frequent superantigen gene profile (55/131, 42.0%) of the MRSA isolates includes staphylococcal enterotoxin C (sec), seg, sei, staphylococcal enterotoxin-like L (sell), selm, seln, selo, and tst-1. Furthermore, SCCmec type I or type II MRSA isolates more frequently harbor sec, seg, sei, sell, selm, seln, selo, and tst-1 genes, compared to other types of MRSA. These results indicate that the selected superantigenic toxin genes are linked to SCCmec type I and type II. The coexistence of these toxins and the SCCmec genes in S. aureus may contribute to the biological fitness and pathogenicity of MRSA.View full abstractDownload PDF (643K) -
Jiyoon Sung, Jae Hyun Chang, Wook-Jin Chung, Ji Yong Jung, Sun Young N ...2011 Volume 225 Issue 3 Pages 171-177
Published: 2011
Released on J-STAGE: October 05, 2011
JOURNAL FREE ACCESSCoronary artery plaque is related to development of coronary artery disease (CAD), and chronic kidney disease is associated with CAD. However, the association of renal dysfunction (RD) with coronary artery plaque characteristics has not been fully elucidated. We evaluated the association between RD and coronary artery plaque characteristics in patients with suspected CAD, who underwent multislice computed tomographic angiography (CTA). A total of 918 patients were classified into 4 groups: group with no plaque (NP) (48.9%), group with calcified plaque (CP) (16.0%), group with noncalcified plaque (NCP) (22.4%), and group with mixed plaque (MP) (12.7%). NCP is considered as rupture-prone soft plaque, and CP as more stable lesion. The mean of estimated glomerular filtration rate (eGFR) was 82.5 ± 15.4 mL/min/1.73m2, and the prevalence of RD (defined as eGFR < 60 mL/min/1.73m2) was 6.3%. The prevalence of RD was 3.3% in the NP group, 10.2% in the CP group, 5.3% in the NCP group, and 14.5% in the MP group (P < 0.001 by ANOVA tests). The adjusted odds ratio for RD was 3.38 (95% confidence interval, 1.27 - 9.04) for the MP group, compared with the NP group. The presence of RD showed an independent association with the MP counts (r = 0.155, P < 0.001); however, there was no association between RD and other plaque characteristics. In conclusion, RD is associated with MP rather than CP or NCP, compared with NP, which may reflect one of the developmental processes of CAD in patients with RD.View full abstractDownload PDF (411K) -
Shu-Qiang Li, Yong Zhou, Yong Wang, Yuan Liu, Dong-Hua Geng, Jin-Gang ...2011 Volume 225 Issue 3 Pages 179-186
Published: 2011
Released on J-STAGE: October 15, 2011
JOURNAL FREE ACCESSType 2 diabetes mellitus (T2DM) is an endocrine disorder that is rapidly growing in prevalence within China and throughout the world. Roux-en-Y gastric bypass (RYGB) surgery, widely used in the treatment of obesity, has been recognized as an effective and long-term treatment for T2DM in recent years. However, the underlying mechanisms responsible for glycemic control remain unclear. This study was designed to investigate the roles of insulin receptor substrates (IRSs) in glucose tolerance and insulin resistance following RYGB surgery. Goto-Kakizaki (GK) rats, a model of T2DM, were randomly allocated into three groups: RYGB surgery, sham surgery, and control (10 animals/group). Wistar rats were also used as non-diabetic control. Daily food intake, body weight, glucose and insulin were measured pre- and post-operatively. Insulin receptor substrate 1 (IRS-1) and insulin receptor substrate 2 (IRS-2) content, the main subtypes of IRSs, were measured in skeletal muscle, adipose tissue and liver using western immunoblot analyses on postoperative day 28. Following surgery, RYGB-treated rats showed markedly improved oral glucose tolerance, as judged by lower peak and area-under-the-curve glucose values (p < 0.01 vs. GK or GK sham). Improved insulin resistance was also observed in RYGB-treated rats. Western immunoblot analyses showed that IRS-1 and its phosphorylation levels were significantly increased in skeletal muscle and adipose tissues in RYGB group (p < 0.01 vs. GK or GK sham), whereas IRS-2 levels were downregulated in liver. These findings suggest that improvements in glucose tolerance and insulin resistance following RYGB surgery are associated with upregulation of IRS-1.View full abstractDownload PDF (2193K) -
Jung-Kyu Choi, Min-Young Kim, Jong-Koo Kim, Jong-Ku Park, Sung-Soo Oh, ...2011 Volume 225 Issue 3 Pages 187-193
Published: 2011
Released on J-STAGE: October 15, 2011
JOURNAL FREE ACCESSChronic sleep deprivation is increasingly common in industrialized societies. Short sleep duration has been associated with a number of negative health outcomes. The objectives of this study were to investigate the association between self-reported sleep duration and the presence of metabolic syndrome (combination of central obesity, triglyceride, high density lipoprotein, blood pressure, fasting plasma glucose) in adults during midlife. The Korean Genomic Rural Cohort (KGRC) is a cohort study of aged 40 to 70 years in rural Korea. This study focuses on the prevalence, incidence, and risk factors for chronic degenerative disorders, such as hypertension, diabetes, osteoporosis, respiratory diseases, and metabolic syndrome. The baseline sample of participants in the KGRC study was recruited in 2005-2006 (phase 1). Respondents were followed until 2008-2009 (phase 2). The final sample included 1,107 subjects: 386 males (34.9%) and 721 females (65.1%). The incidence rate of metabolic syndrome in our sample was 18.4% (21.2% for males and 16.9% for females). Subjects sleeping < 6 hours a day (HR: 1.798; 95% CI: 1.06-3.05) were significantly more likely to experience metabolic syndrome than participants sleeping 6 to 7.9 hours a day after controlling for potential covariates (age, body mass index, menopause, smoking, alcohol and physical activity). Shorter sleep duration was associated with the high incidence of metabolic syndrome among females only. In conclusion, shorter sleep duration may be a significant risk factor for the development of metabolic syndrome in women.View full abstractDownload PDF (371K) -
Kyoko Yamamoto, Yasuhiro Komatsu, Hiroyuki Yamamoto, Hiroko Izumo, Kyo ...2011 Volume 225 Issue 3 Pages 195-202
Published: 2011
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDiabetes and chronic kidney disease (CKD) which are risk facters of cardiovascular disease, are increasing global public health problems. Microalbuminuria is an early sign of progressive cardiovascular and renal disease in individuals with or without diabetes. Screening for microalbuminuria and early treatment are recommended for patients with increased cardiovascular and renal risk factors. However, the procedure used to measure urinary albumin is expensive. Alternatively, the measurement of total urinary protein is simple and inexpensive. Thus, we aimed to establish a method that could predict the presence of microalbuminuria by measuring the total protein-to-creatinine ratio. Spot urine samples were obtained from 150 patients with diabetes mellitus, and the total protein-to-creatinine ratio and the albumin-to-creatinine ratio (ACR) were measured. There was a significant positive correlation between the protein-to-creatinine ratio and the ACR (r = 0.95). The presence of albuminuria (both micro- and macroalbuminuria) could be predicted from the value of the protein-to-creatinine ratio in more than 90% of patients. A receiver-operating characteristic curve analysis revealed that the protein-to-creatinine ratio had a sensitivity and a specificity of 90.8% and 91.9%, respectively, for the detection of albuminuria and a cutoff value of 0.091 g/g creatinine. These results suggest that screening for microalbuminuria can be replaced by the detection of the protein-to-creatinine ratio, which may be cost-effective for patients with cardiovascular risks as well as for the general population.View full abstractDownload PDF (623K) -
Yuka Yamazaki, Yuki Kozono, Ryo Mori, Eiji Marui2011 Volume 225 Issue 3 Pages 203-209
Published: 2011
Released on J-STAGE: October 26, 2011
JOURNAL FREE ACCESSDespite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about ‘The challenges related to female physicians' resignations’. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce.View full abstractDownload PDF (621K) -
Takako Tobiume, Mitsuru Shiota, Masahiko Umemoto, Yasushi Kotani, Hiro ...2011 Volume 225 Issue 3 Pages 211-214
Published: 2011
Released on J-STAGE: October 29, 2011
JOURNAL FREE ACCESSMost cases of ovarian torsion require emergency surgery; the ovary has become necrotic and cannot be conserved. Preoperative determination of the ovarian necrosis extent is difficult but it may increase the likelihood of the ovary conservation. In this study, we retrospectively evaluated the findings in ovarian torsion among patients with ovarian tumors who underwent emergency surgery at a single hospital for possible preoperative indicators of ovarian viability. We thus evaluated 77 patients who were intraoperatively diagnosed with torsion of ovarian tumor between 1995 and 2010. These patients were classified into three groups depending on the postoperative histopathological findings: necrotic, congestive, and normal. Preoperative C-reactive protein (CRP) level, leukocyte count, and body temperature, along with tumor size, degree of torsion, time from the onset of abdominal pain to surgery, and incidence of acute abdomen were compared among the three groups. The sensitivity, specificity, and positive and negative predictive values of the preoperative serum CRP levels for ovarian necrosis were calculated. The CRP level, degree of torsion, and time from the onset of abdominal pain to surgery were significantly higher in the necrotic group than in the normal group. The sensitivity and specificity of the CRP level for necrosis were 35% and 83%, respectively, and positive and negative predictive values were 38% and 82% respectively. The potential for ovary conservation in suspected ovarian torsion should be greater if the tumor is non-malignant, the time from the onset of abdominal pain to operation is short, and the CRP level is < 0.3 mg/dl.View full abstractDownload PDF (443K) -
Yasuhiro Yamamoto, Yasunari Takakuwa, Makoto Kuroda, Hiroatsu Nakashim ...2011 Volume 225 Issue 3 Pages 215-220
Published: 2011
Released on J-STAGE: October 29, 2011
JOURNAL FREE ACCESSTransformed sarcomas rarely arise from bone infarct lesions, although the majority of bone sarcomas are primary in origin. However, the pathogenesis of the condition is unknown. In this report, we describe a malignant fibrous histiocytoma with a p53 gene mutation. A 59-year-old woman complained of having pain in her left knee for three months. Plain radiographs of the distal metaphysis of her left femur revealed an ill-defined lytic lesion, which was consistent with a malignant tumor in the infarct lesion. An open biopsy specimen did not show any evidence of malignancy. Immunohistochemical examination of the biopsy specimen failed to show p53 protein-positive cells. However, a mutation in the p53 gene was detected when polymerase chain reaction/single-strand conformation polymorphism (PCR-SSCP) analysis was performed. A functionally relevant p53 missense mutation in codon 273 of exon 8 [CGT (Arg) —> CAT (His)] was confirmed by direct sequencing. We concluded that this lesion was a malignant bone tumor arising from the bone infarct lesion, and we thus performed a wide resection. The histopathological diagnosis of the resected specimen was that it was a malignant fibrous histiocytoma associated with bone infarction. Immunohistochemistry revealed that the tumor cells were positive for the p53 protein. To our knowledge, our patient is the first patient having a bone infarct-associated sarcoma with a p53 gene mutation. Identification of the p53 mutation helps in diagnosing the malignant transformation of the bone infarct lesion. One pathogenesis of this condition may be a mutation in the p53 gene.View full abstractDownload PDF (1325K)
Letter to the Editor
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Arzu Dursun, Aysegül Zenciroglu, Nurullah Okumus2011 Volume 225 Issue 3 Pages 221
Published: 2011
Released on J-STAGE: October 28, 2011
JOURNAL FREE ACCESSDownload PDF (202K) -
Jun Chen2011 Volume 225 Issue 3 Pages 223
Published: 2011
Released on J-STAGE: October 28, 2011
JOURNAL FREE ACCESSDownload PDF (261K)
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