Hirosaki Medical Journal
Online ISSN : 2434-4656
Print ISSN : 0439-1721
Volume 64 , Issue 1
Showing 1-8 articles out of 8 articles from the selected issue
Original Article
  • Koichi Shibutani, Fumiyasu Tsushima, Shinya Kakehata, Hiroyuki Miura, ...
    2013 Volume 64 Issue 1 Pages 1-14
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
    Purpose: To evaluate the clinical efficacy and safety of preoperative percutaneous transhepatic portal vein embolization (PVE) with an ipsilateral approach, using microfibrillar collagen (MFC) as an embolic material for carcinomas of the biliary tract and liver metastases of colorectal carcinoma.
    Materials and methods: PVE using MFC was performed in 35 consecutive patients (29 men and 6 women; mean age 64 years, range 44–81 years) with small estimated future liver remnants (FLRs) after planned major hepatectomy. Patient malignancies included bile duct carcinoma (n = 20), gallbladder carcinoma (n = 5), and metastases of colorectal carcinoma (n = 8). In one patient preoperatively diagnosed with gallbladder carcinoma, the pathological diagnosis of xanthogranulomatous cholecystitis was confirmed after resection. PVE was performed with ultrasound guidance (ipsilateral approach, 35; contralateral approach, 1). Total liver volume (TLV) and FLR changes, hypertrophy ratio before and after PVE, and procedure-related complications were analyzed retrospectively.
    Results: PVE was successful in all patients. There were no major procedure-related complications. Mean absolute FLR volume increased significantly (p < 0.001) from 434 to 524 cm³, as did the standardized FLR to TLV ratio (p < 0.001), from a mean of 37.9% to 46.1%. The mean ratio of standardized FLR increase was 8.2%. The hypertrophy ratio was 23%. In the group receiving selective embolization in a centripetal direction, the increase in FLR/TLV ratio was 9.5%, while the hypertrophy ratio was 27%. Neither puncture-related complications nor deterioration of liver function were observed.
    Conclusion: MFC was a safe and effective embolic material for preoperative PVE in patients with hepatobiliary malignancies, resulting in sufficient hypertrophy of FLRs.
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  • Minoru Osanai, Yoko Saito, Kazuhiko Oyu, Junichi Ishida, Mitsue Sato, ...
    2013 Volume 64 Issue 1 Pages 15-28
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
        We evaluated the effect of tube voltage and tube current on image quality and radiation dose in coronary computed tomography angiography (CCTA) with phantom. The phantom was constituted with ball and tubes, both filled with diluted contrast medium (ball: 120HU, tube: 300, 350 and 400HU). The phantom was scanned at 120kV, 100kV and 80kV with beating at 70bpm. The tube currents were changed from 300 to 400mA with every 25mA. Contrast-to-noise ratio (CNR) was calculated. We also performed assessment of image quality, especially noise and sharpness. The radiation dose was also evaluated. The CT numbers at 100kV and 80kV were 1.18~1.37 and 1.49~1.71-times higher than those at 120kV with normal type phantom. There was no significant difference in CNR between 120kV and 100kV. At 80kV both CNR and image score were lower than others. The contrast of tube and soft plaque were also evaluated, and those at 100kV and 120kV were almost same. Compared with 120kV, radiation dose decreased to about 60% and 30% at 100kV and 80kV respectively. In conclusion, with 100kV setting the radiation dose could be reduced without degradation of image quality, and it is suggested that low tube voltage technique is also useful in CCTA.
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  • Yuichi Sakamoto, Kouji Narita, Akio Nakane
    2013 Volume 64 Issue 1 Pages 29-40
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
        Obesity leads to a state of chronic inflammation associated with increased levels of proinflammatory cytokines including interleukin-1β (IL-1β) that plays a critical role in host defense against Staphylococcus aureus infection. In this study, we investigated host defense against skin S. aureus infection in high-fat diet (HFD)-induced non-diabetic obesity by focusing on IL-1β production from subcutaneous adipose tissue derived-macrophages (SATDMs). Bacterial numbers in skin lesions of HFD-fed mice were higher than those of normal-fat diet (ND)-fed control mice on day 3 after subcutaneous S. aureus infection. IL-1β production from SATDMs of HFD-fed mice was less than that of ND-fed mice after stimulation with formalin-killed S. aureus and ATP. In addition, NLRP3 mRNA expression and protein level of activated caspase-1 in SATDMs of HFD-fed mice were lower than those of ND-fed mice after stimulation. Conversely, IL-1β production, NLRP3 mRNA expression and protein level of activated caspase-1 from visceral adipose tissue-derived macrophages of HFD-fed mice were higher than those of ND-fed mice. These results suggest that reduced IL-1β production in SATDMs of HFD-fed obese mice might be involved in impairment of host defense against skin S. aureus infection.
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  • Michiko Uchiyama, Shirou Itagaki, Sachiko Kanazawa, Kazuhiro Hosoi, Ka ...
    2013 Volume 64 Issue 1 Pages 41-49
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
        Recently, it has been reported that brain penetrating angiotensin-converting enzyme (ACE) inhibitors such as captopril can reduce the incidence of Alzheimer's disease in elderly hypertensive patients. Pneumonia is the reported cause of death in a high proportion of Alzheimer's disease patients. It has been reported that aspiration pneumonia in ambulatory Alzheimer's disease patients is significantly and independently associated with intake of neuroleptics. Substance P (SP) is associated with swallowing function and elevating serum SP in patients contributes to decrease the risk of aspiration pneumonia. Substance P is a neuropeptide and is a substrate of ACE. We have found that pumpkin, one of the major local products of Aomori prefecture, contains an ACE inhibitor (nicotianamine). The aim of this study was to elucidate whether pumpkin supplementation in the diet improves memory function and serum SP concentration. We found that pumpkin improved memory function of rat. On the other hand, serum SP concentration was not increased by pumpkin supplementation in the diet.
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  • Shirou Itagaki, Michiko Uchiyama, Sachiko Kanazawa, Kazuhiro Hosoi, Ka ...
    2013 Volume 64 Issue 1 Pages 50-57
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
        A dietary approach to ingest food factors from diet is important to prevent lifestyle-related diseases, such as obesity, hypertension and dyslipidemia. Among these diseases, hypertension has been well established as a leading risk factor for both cardiovascular disease and mortality in general. Angiotensin- Converting Enzyme (ACE) plays a key role in the regulation of blood pressure by conversion of the inactive decapeptide angiotensin I to vasoactive octapeptide angiotensin II, as well as by inactivation of the vasodilator bradykinin. The aim of this study is to identify the ACE Inhibitors in the local products of Aomori prefecture. We identified an ACE inhibitor (nicotianamine) from pumpkin.
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  • Shirou Itagaki, Masakiyo Kudo, Takenori Niioka, Michiko Uchiyama, Sach ...
    2013 Volume 64 Issue 1 Pages 58-64
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
        In the support to vancomycin (VCM) therapeutic drug monitoring (TDM) and dosage regimen for children, predicted serum concentration of VCM is frequently different from measured serum concentration of VCM. The aim of this study was to elucidate the gap between predicted value and measured value of serum concentration of VCM, and to improve the predictability of serum concentration of VCM. Initial serum concentration and clearance of VCM were estimated using adult population pharmacokinetic parameters of VCM (A-PPK parameters) and children population pharmacokinetic parameters of VCM (P-PPK parameters). Analysis of predictability using age differences demonstrated that mean prediction error (ME), mean absolute prediction error (MAE) and root mean squared error (RMSE) of initial serum concentration and clearance of VCM estimated by A-PPK were significantly smaller than those by P-PPK. This finding indicated that predictability of initial serum concentration and clearance of VCM using A-PPK was higher than that using P-PPK. Moreover, the optimal cutoff value of age was determined to be 6 years.
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  • Noriko Takiyoshi, Hajime Nakano, Daisuke Sawamura
    2013 Volume 64 Issue 1 Pages 65-70
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
        Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder characterized by palmoplantar keratoderma (PPK) and early-onset periodontitis. PLS is caused by mutations in the gene coding for cathepsin C (CTSC) known as dipeptidyl peptidase I (DPPI). CTSC is a lysosomal cysteine proteinase that activates many serine proteinases in immune/inflammatory cells.
        We conducted functional analyses of a single nucleotide polymorphism (SNP); c.1357 A>G (p.I453V) in CTSC. Compared to controls homozygous for c.1357A, the CTSC activity was 50% in individuals heterozygous for c.1357G, while that was only 10% in those homozygous for c.1357G. Furthermore, we also determined the CTSC activity of the five proband's of PLS, the average of activity was less than 1% of controls homozygous for c.1357A. All the homozygotes for the SNP examined had no symptoms of PPK and periodontitis compatible with PLS. These findings strongly suggest that the disease expression of PLS requires nearly total loss of the CTSC activity.
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  • Mitsuhiro Tanaka, Takashi Umeda, Ippei Takahashi, Ritsuko Kasai, Motok ...
    2013 Volume 64 Issue 1 Pages 71-83
    Published: 2013
    Released: July 06, 2021
    JOURNAL FREE ACCESS
        We evaluated the effect of blood glucose level before transient physical exercise on an athlete's physical condition and neutrophil functions. The changes and associations between blood glucose level immediately before training and neutrophil function at rest were investigated in female long-distance runners. Seventeen females in a university track team were divided into 2 groups by medial blood glucose levels: 9 subjects were in the high blood glucose group (HBG group) and 8 subjects in the low blood glucose group (LBG group). Myogenic enzymes, immunoglobulines, complements and neutrophil function such as reactive oxygen species (ROS) production capability were measured. The post-practice rate of change in ALT and C3 levels were significantly higher in the LBG group compared to the HBG group. At pre-practice, total ROS production capability was significantly lower in the HBG group compared to LBG group. Total ROS production capability increased significantly post-practice (“normal pattern”) in the HBG group, though it tended to decrease (“abnormal pattern”) in the LBG group. In conclusion, an adequate blood glucose level in athletes prior to exercise is suggested to be effective not only to supply energy to the body, but also to maintain normal immune function which is potentially suppressed during exercise.
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