Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
48 巻, 15 号
選択された号の論文の18件中1~18を表示しています
REVIEW ARTICLE
  • Tetsuo Hayakawa, Chun Xiang Jin, Shigeru B. H. KO, Motoji Kitagawa, Hi ...
    2009 年 48 巻 15 号 p. 1251-1254
    発行日: 2009年
    公開日: 2009/08/03
    ジャーナル オープンアクセス
    Lactoferrin, a major whey protein, is a red iron-binding protein present mainly in external secretions such as breast milk and in polymorphonuclear neutrophils. The presence of lactoferrin in body fluids is proportional to the flux of neutrophils and its assessment can provide a reliable biomarker for inflammation. In gastrointestinal diseases increased fecal lactoferrin is a sensitive and specific surrogate marker for inflammatory bowel diseases in patients with chronic diarrhea and pain, and ascites lactoferrin can also provide a promising and reliable biomarker for bacterial peritonitis. Lactoferrin in pancreatic juice and stone could provide pathophysiological information of protein plug and stone formation in the pancreatic duct. Serum anti-lactoferrin autoantibody might contribute to the clarification of the pathogenetic mechanisms of autoimmune pancreatitis and liver diseases, although its diagnostic and prognostic value appears to be limited. Further studies will be necessary to elucidate the exact details.
ORIGINAL ARTICLES
  • Shinji Tamaki, Motoo Yamauchi, Atsuhiko Fukuoka, Kiyoshi Makinodan, No ...
    2009 年 48 巻 15 号 p. 1255-1262
    発行日: 2009年
    公開日: 2009/08/03
    ジャーナル オープンアクセス
    Background Obstructive sleep apnea syndrome (OSAS) is known to be a risk factor of cardiovascular events. However, the precise mechanism linking the two has not been fully elucidated.
    Objective The aim of this study was to investigate the effect of hypoxic stress on the production of tumor necrosis factor (TNF)-α, monocyte chemoattractant protein-1 (MCP-1), and matrix metalloproteinase-9 (MMP-9) by monocytes.
    Methods Thirty-three OSAS patients and 13 healthy control subjects were enrolled. The OSAS patients were classified as mild-to-moderate (13) and severe (20). Venous blood samples were collected before and after sleep as well as after long-term nasal continuous positive airway pressure (CPAP) treatment for the purpose of isolation of monocytes. Peripheral blood monocytes were isolated using standard methods. Monocytes were cultured under lipopolysaccharide stimulation for 24 hours, and TNF-α, MCP-1, and MMP-9 in the culture supernatants were determined by ELISA.
    Results In severe patients, the TNF-α production by monocytes was significantly elevated as compared to that before sleep (p<0.01). In all OSAS patients, the TNF-α production after sleep was significantly correlated with AHI (p<0.01), ODI (p<0.01) and % time in SpO2<90% (p<0.05), and inversely correlated with the lowest SpO2 (p<0.01). The production of MCP-1 and MMP-9 by monocytes was significantly elevated compared to that before sleep in severe patients (p<0.05). The production of these mediators by monocytes was significantly decreased after long-term nasal CPAP treatment (p<0.05).
    Conclusion These results indicate that OSAS-induced hypoxic stress activates the production of inflammatory mediators by monocytes.
  • Sachie Tanno, Masumi Ohhira, Yoshihiro Tsuchiya, Toshiharu Takeuchi, S ...
    2009 年 48 巻 15 号 p. 1263-1266
    発行日: 2009年
    公開日: 2009/08/03
    ジャーナル オープンアクセス
    Objective In the present study, we tried to clarify the prevalence of selective serotonin reuptake inhibitor (SSRI) prescription and early discontinuation of SSRI in a outpatient unit where primary care physicians are working in Japan.
    Materials and Methods Consecutive outpatients who newly visited the Department of General Medicine, Asahikawa Medical College Hospital, Asahikawa, Japan between April 2004 and March 2008 were analyzed. Each parameter such as age, sex, diagnosis, period of continuation of SSRI or reason why they discontinued SSRI was investigated.
    Results Among 4670 patients, 126 patients (2.7%) had been prescribed SSRI because of depressive state (n=117) or panic disorder (n=9). Female patients with depression received SSRI (84/2714 = 3.10%) more frequently than male patients (33/1956 = 1.69%). Out of 117 patients with depression who had been prescribed SSRI, 28 (23.9%) patients discontinued SSRI within 4 weeks. Male patients (30.5%) discontinued SSRI within 4 weeks due to patient's decision more frequently than female patients (11.1%). The rate of patients who discontinued SSRI within 4 weeks due to patient's decision was particularly high (6/9; 67%) in male patients aged 20 to 29 years.
    Conclusion These results suggest for the first time that there is a high prevalence of early discontinuation of SSRI in young male patients in Japan.
CASE REPORTS
PICTURES IN CLINICAL MEDICINES
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