Acta Medica Nagasakiensia
Print ISSN : 0001-6055
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Acta Medica Nagasakiensia
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ORIGINAL ARTICLES
  • Kazumi Yamabe, Takahiro Nishida, Yoshihiko Ide, Sumihisa Honda
    2019 Volume 63 Issue 1 Pages 1-10
    Published: 2019
    Released: January 23, 2020
    JOURNALS FREE ACCESS
    Background: Although the 100-mL water swallowing test (WST) is used to measure swallowing capacity (SC), volume per swallow (VS), time per swallow (TS), and the presence/absence of choking signs, the performance of each indicator is not clearly understood. The purpose of this study was to identify the relationship between performance in each indicator in the 100-mL WST and risk factors for dysphagia in community-dwelling older adults. Methods: Participants included 304 Japanese community-dwelling older adults aged ≥65 years. We investigated participant characteristics including age, sex, body mass index (BMI), medical history, number of prescribed medications, laryngeal function (maximum phonation time [MPT]), subjective dysphagia (the 10-item eating assessment tool [EAT-10]), and all indicators of the 100-mL WST. We compared each of the four indicators in the 100-mL WST and investigated their relationship with potential risk factors for dysphagia. Results: Multivariate analyses showed that age, BMI, MPT, and EAT-10 were independently associated with SC. Age, sex, BMI, and EAT-10 were independently associated with VS. BMI, MPT, and EAT-10 were independently associated with TS. Men were more likely to have choking signs in the 100-mL WST than women. Conclusions: These findings indicated that all of three quantitative indicators in the 100-mL WST may predict the risk of sarcopenic dysphagia. Moreover, the presence of choking signs in men suggested the risk of aspiration. We propose that SC and choking signs in the 100-mL WST could be a simple and useful dysphagia assessment tool for community-dwelling older people.
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  • Ayaka Kinoshita, Hiroko Hayashi, Natsuho Kusano, Shun Inoue, Toshimits ...
    2019 Volume 63 Issue 1 Pages 11-25
    Published: 2019
    Released: January 23, 2020
    JOURNALS FREE ACCESS
    Background: The incidence of hepatocellular carcinoma (HCC) with fatty liver disease has been increasing, and the sympathetic nervous system may be involved in hepatocarcinogenesis in such cases. Here we analyzed the impact of neuropeptide Y (Npy), which is released from sympathetic nerve endings, on hepatocarcinogenesis in different nutritional settings. Methods: Hepatocellular carcinoma was induced by an intraperitoneal injection of diethylnitrosamine (DEN) in male C57BL6/J mice null for Npy gene (Npy −/−) and their haplotype (Npy +/–) as a control (Ctrl). The mice were subjected to one of three dietary regimens: ad libitum feeding with a standard diet (AL) or a high-fat diet (HFD), or 30% dietary-restricted feeding (DR). Results: The occurrence and growth of HCC were accelerated in the Npy −/− mice, particularly in the AL and HFD conditions. Steatosis was promoted at 28 wks in the Npy −/− mice; steatohepatitis was not exacerbated in the Npy−/− mice at 28 or 48 wks. The alterations in the TNFα- and IL-6-mRNA expression levels and phosphorylated NF-κB and ERK1/2 levels in the liver at 28 wks did not support the current paradigm of a steatohepatitis-HCC sequence. By contrast, the DR inhibited steatohepatitis and then hepatocarcinogenesis even in the Npy −/− mice, although the Npy −/−-DR mice displayed peculiar findings, i.e., the activation of TNFα-NF-κB signaling, a possible protective mechanism against the elevated cell proliferation and genotoxic stresses. Conclusions: Npy exerts an inhibitory effect on the occurrence and growth of HCC, particularly in overnutrition. Npy is also dispensable for the tumor-inhibiting effect of DR. The activation of Npy could be a promising target for the prevention of HCC.
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  • Kenji Takasaki, Mariko Terakado, Yasushi Makimoto, Tetsuya Iseki, Fumi ...
    2019 Volume 63 Issue 1 Pages 27-40
    Published: 2019
    Released: January 23, 2020
    JOURNALS FREE ACCESS
    Objective: To describe the situation of Japanese cedar (JC) and Japanese cypress pollens in Nagasaki prefecture based on a 30-year data series ranging from 1990 to 2019. Methods: The data of JC and Japanese cypress pollens at eight measurement sites in Nagasaki prefecture was retrospectively studied. A one-way analysis of variance was used to determine annual differences among the eight sites. Simple regression analyses were used to detect annual increasing or decreasing trends in the scattering of JC and Japanese cypress pollens at each of the eight sites. Results: JC pollen scattering began in early to mid-February and ended between late March and mid-April, while Japanese cypress pollen scattering began in mid-March to early April and ended in mid- to late April. Positive correlations between the total counts of JC pollens and year were observed in four measurement sites, while a positive correlation between the total count of Japanese cypress pollens and year was found in Goto city. Regional differences were statistically observed in the annual mean JC pollen values. Conclusions: Because these data are extremely meaningful, the work of Nagasaki Association of Medical Technologists and Nagasaki Medical Association is necessary for the future treatment of patients with JC and/or Japanese cypress pollinosis.
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  • Takuro Miyazaki, Tetsuya Sakai, Shuntaro Sato, Tomoshi Tsuchiya, Keita ...
    2019 Volume 63 Issue 1 Pages 41-48
    Published: 2019
    Released: January 23, 2020
    JOURNALS FREE ACCESS
    Background: The aim of this study was to evaluate preoperative pain catastrophizing scale (PCS) for predicting post-thoracotomy pain in patients with non-small-cell lung cancer. Methods: We previously conducted a randomized open control trial that was published under the title “Is early postoperative administration of pregabalin beneficial for patients with lung cancer?” This is a report of analysis of that trial’s secondary endpoint using PCS. PCS were obtained before surgery, on 1 and 7 days and at 1 and 3 months after surgery. Results: The study cohort comprised 67 patients. Postoperative pain scored on a numeric rating scale (NRS) was significantly less 3 months after surgery (p<0.001). Total PCS and all three subcategory scores were significantly less 3 months after surgery (p<0.001). The cohort was divided into a low PCS score (≦25) group of 32 and a high ( >25) PCS score group of 35 according to the median preoperative PCS score. None of the assessed patient characteristics, including age, sex, body mass index, type of surgical procedure and lymph node dissection, operation time, bleeding, duration of chest tube insertion, and consumption of analgesia differed significant between these groups. The NRS scores on postoperative day 1 (p=0.33), day 7 (p=0.50), 1 month (p=0.31) and 3 months (p=0.18) did not differ significantly between the groups. Multiple logistic regression analyses was performed to predict the postoperative significant pain intensity (NRS≧3) at any postoperative period found that preoperative PCS was not the significant factor. Conclusions: PCS scores did not predict acute or chronic postoperative thoracotomy pain.
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  • Nobuhiro Ito, Satoshi Watanabe, Hiroyuki Mishima, Akira Kinoshita, Mas ...
    2019 Volume 63 Issue 1 Pages 49-53
    Published: 2019
    Released: January 23, 2020
    JOURNALS FREE ACCESS
    Infantile myofibromatosis (IM) is a benign fibrous tumor of infancy and childhood. A genome-wide linkage analysis and wholeexome sequencing were performed on a pedigree of familial cases, and a mutation in exon 12 of the gene for platelet-derived growth factor receptor beta (PDGFRB) (NM_002609), c.1681C > T p.R561C was identified. This is the first case in a Japanese pedigree, and we detected the mutation of IM in the family by whole-exome sequencing supported by a genome-wide linkage analysis. A wide spectrum of phenotypes was observed among the affected family members despite all having the same mutation. Recently, an additional mutation on the gene for receptor protein tyrosine phosphatase gamma (PTPRG), an enzyme dephosphorylating PDGFRB, was proposed to explain the full phenotypic penetrance in the affected family members with the PDGFRB mutation. However, it is still hypothesized that an additional PDGFRB mutation develops to full activation of PDGFRB in cells that have been primed by p.R561C. The pedigree in this study showed a wide spectrum of phenotypes, suggesting that a second hit, such as with other mutations contributing to PDGFRB phosphorylation, would be necessary to induce IM.
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