岡山医学会雑誌

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There is increasing interest in the intrinsic activity of the resting brain, especially the activity slower than 0.1Hz (i.e., low-frequency oscillations, or LFOs). To investigate the origin of LFOs observed in functional near-infrared spectroscopy (fNIRS), we recorded multichannel fNIRS and electroencephalography (EEG) from the frontal cortex of 11 healthy young volunteers in the resting state. Electrocardiography (ECG), electro-oculography and respiration were also measured. Synchronous oscillations of oxy-hemoglobin (oxy-Hb) around 1.0Hz were detected in all fNIRS channels, and their frequency was consistent with a peak frequency of ECG, suggesting the changes of cerebral blood flow due to heart beats. In addition, oxy-Hb oscillations around 0.1Hz (i.e., LFOs) appeared in the fNIRS. The channels where LFOs appeared differed among the subjects, and the LFOs appeared or disappeared even in the same fNIRS channels. The appearance of LFOs in fNIRS channels was significantly higher when the LFOs appeared on the EEG in the adjacent EEG electrodes compared to when LFOs did not appear on EEG. The amplitude and coherence (synchronicity) of the LFOs were increased by changing the subjects' position from dorsal to the sitting position in both fNIRS and EEG, and the coherence in particular was increased in the homologous fNIRS channels on the bilateral hemispheres. These results suggest that LFOs of oxy-Hb couple with resting-state EEG activity.

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The definite diagnosis of persimmon phytobezoar (i.e., diospyrobezoar) is often accomplished by a component analysis using infrared spectroscopy. However, no studies have been conducted to investigate which substance is the best as a standard for the component analysis. Here we analyzed tannic acid, Japanese persimmon (kaki), fermented persimmon extract (kaki-shibu), conventional dried persimmon, and dried persimmon smoked in sulfur (ampo-kaki) by infrared spectroscopy to determine which would be optimal as a component analysis standard. The spectrum between 1,600 to 600cm^－1 of a persimmon phytobezoar was quite similar to the spectrum of kaki-shibu rather than that of tannic acid. Consequently, we conclude that kaki-shibu should be used as a standard for infrared spectroscopy analyses of persimmon phytobezoars.

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A 58-year-old man with cervical esophageal cancer and a history of epilepsy was treated with chemoradiotherapy from May of 2013. When tube feeding was initiated due to aspiration pneumonitis, the patient showed a degree of irritability that affected routine staff work and treatment compliance. We attempted to perform supportive care for maladjustment by the notice, the fast, and the tube feeding, but there was no improvement. After we added carbamazepine, primidone, and propericiazine (which had been canceled at the initiation of the tube feeding) to the patient's intravenous phenytoin, the symptoms and treatment compliance improved significantly. We concluded that the causes of the patient's irritability were maladjustment and his epilepsy.

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We encountered a patient with an adult Bochdalek hernia discovered asymptomatically. A 77-year-old Japanese woman visited a local clinic with chief complaints of melena and difficulty in defecation. Based on the results of the detailed examination in our hospital, she was diagnosed with a rectal gastrointestinal stromal tumor (GIST) with a concurrent asymptomatic adult right-sided Bochdalek hernia. Because the tumor was large, laparoscopic abdominoperineal rectal amputation was performed after systemic imatinib therapy. During the surgery, we found a right diaphragmatic defect more than 13cm in long dia., through which the right hepatic lobe, colon, and greater omentum had prolapsed into the right thoracic cavity. No visceral adhesions were noted. No hernia sac was observed. Adult Bochdalek hernia is a relatively rare condition, and only three (incidentally discovered) cases of asymptomatic Bochdalek hernia, including the present case, have been reported in Japan. Here we provide a case report for the patient, who was followed-up without hernia surgery, plus a review of the literature.

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