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Volume 57, Issue 3
Displaying 1-7 of 7 articles from this issue
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OriginalContribution
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NORIYUKI ANDO, KIMIAKI SATO, MAMORU MITSUKAWA, KEI YAMADA, TORU WAKIOK ...2010 Volume 57 Issue 3 Pages 43-49
Published: June 30, 2010
Released on J-STAGE: December 21, 2010
JOURNAL FREE ACCESSForty patients (24 male and 16 female; age 13-87 years, mean 66 years) with pyogenic spondylitis were treated by percutaneous suction aspiration and drainage between January 1997 and September 2007 at Kurume University Hospital. The surgical procedure and transpedicular approach were similar to those used for percutaneous discectomy in the treatment of intervertebral disc herniation. The average postoperative follow-up period was 22.6 months. Two patients had died by the time of the survey, and two had undergone multiple operations. The clinical outcomes were excellent in 12 patients, good in 17 patients, fair in 5 patients, and poor in 6 patients. The response rate (cases with “excellent” or “good” outcomes) was 72.5% (29 patients). Identification of the organism was possible in 26 patients (65%). The most frequently identified organism was methicillin-resistant Staphylococcus aureus (MRSA; 11 cases), followed by methicillin-sensitive Staphylococcus aureus (MSSA; 5 cases) and Escherichia coli (3 cases). Percutaneous suction aspiration and drainage has been demonstrated as an effective means of treating early spondylitis. This procedure is minimally invasive and enables pathogen identification, histopathological diagnosis and even simultaneous treatment. This is the only means of treatment available for patients who cannot tolerate open surgery. This therapy also promises medico-economic advantages by shortening treatment periods and eliminating open surgery.View full abstractDownload PDF (650K) -
YASUHIRO OKAMOTO, KIICHIRO MORITA, ATSUSHI YAMAMOTO, YOUHEI ISHII, NOR ...2010 Volume 57 Issue 3 Pages 51-58
Published: June 30, 2010
Released on J-STAGE: December 21, 2010
JOURNAL FREE ACCESSUsing optical topography (near-infrared spectroscopy: NIRS), relative changes in oxidized hemoglobin (oxy-Hb) were measured before and after the introduction of Role lettering. Tasks performed during measurements included antegrade (from the subject to other persons) and retrograde (from other persons to the subject) mental imaging and writing tasks. All subjects were junior high school students. Relative changes in oxy-Hb were measured before and 3, 6, and 12 months after the start of Role lettering. The region of interest (ROI) was determined based upon the motor cortex region of hand movement and upon relative oxy-Hb changes noted before any Role lettering. For antegrade mental tasks, oxy-Hb increased significantly in right-sided ROI after 3 months; this increase persisted at 1 year. For retrograde mental tasks, oxy-Hb significantly increased bilaterally at 3 months, an effect that also persisted at 1 year. With the antegrade writing task, no significant difference was observed throughout the study; with the retrograde writing task, oxy-Hb level decreased significantly in right lateral ROI after 6 months; the decrease persisted at 1 year. The number of words produced after Role lettering increased significantly in both antegrade and retrograde writing tasks at 1 year, compared with the number before Role lettering. Role lettering thus altered mental activity, particularly in the right hemisphere. Retrograde writing tasks, similar to those employed in the actual practice of Role lettering, reduced right hemispheric function; continuation of the task enhanced performance. Role lettering studies using NIRS may provide useful psychophysiologic indices.View full abstractDownload PDF (829K) -
KAORI NAGATOMI, TATSUYA ISHITAKE, KUNIO HARA, AKIRA SHIGEMOTO, MICHIKO ...2010 Volume 57 Issue 3 Pages 59-66
Published: June 30, 2010
Released on J-STAGE: December 21, 2010
JOURNAL FREE ACCESSThe study aimed to examine the effects of long-term unemployment and the transition from unemployment to re-employment after abrupt bankruptcy on the mental health of unemployed Japanese. The cases of 96 men and 54 women who were laid off by a large shoemaking company because of sudden bankruptcy in 1998, were examined for one year. The mental health of these individuals was evaluated using a ‘self-rating questionnaire for depression (SRQ-D)’. The respondents were categorized by employment transition status into four groups: (1) still employed full-time, (2) unemployment to full-time employment, (3) unemployment to part-time employment, and (4) still unemployed. The prevalence rate of depressive symptoms in the ‘still unemployed’ group was significantly higher (adjusted odds ratio (OR) = 4.33) than in the still employed group. Moreover, high levels of depressive symptoms were observed in the individuals in the ‘unemployment to part-time employment’ group (adjusted OR = 4.93). There was no significant risk of depressive tendency among individuals in the ‘unemployment to full-time employment’ group. The results suggest that the negative effect of re-employment to part-time employment on depressive symptoms is similar to that in long-term unemployment.View full abstractDownload PDF (563K) -
NAOKO MASAKI, KOJI TOYOMASU2010 Volume 57 Issue 3 Pages 67-72
Published: June 30, 2010
Released on J-STAGE: December 21, 2010
JOURNAL FREE ACCESSWe studied 199 inpatients and outpatients at a public psychiatric hospital to clarify the factors related to outcome following psychiatric care for substance-related disorder (SRD), and we discuss approaches for more effective community care in the future. The percentage of patients who discontinued treatment was 33.7%, suggesting that creation of a follow-up system for continuing outpatient care is an urgent task. Women were 35% more likely higher to discontinue treatment than men. Those with solvent dependence were 12% and 7.32 times more likely, respectively, to discontinue treatment than those with alcohol dependence. Those without complications were 2.24 times more likely than those with complications to discontinue treatment. Divorced patients were 18% and 6.35 times more likely, respectively, to discontinue treatment than married patients. There is insufficient support for patients with solvent dependence, and we observed that patients tended to have little motivation to stop using drugs or alcohol until physical complications occurred. Among the many divorced patients, desire for treatment was weak following breakdown of the family. The present findings suggest the importance of comprehensive efforts to treat substance use disorder at specialist medical institutions.View full abstractDownload PDF (550K) -
JIRO MIYAJIMA, TOKUMASA HAYASHI, KOUJIRO SAITO, SHIZUKA IIDA, KEI MATS ...2010 Volume 57 Issue 3 Pages 73-80
Published: June 30, 2010
Released on J-STAGE: December 21, 2010
JOURNAL FREE ACCESSIt is well known that the incidence of urinary stones is higher in men than women. Although it is believed that the lower incidence of urinary stones in women is due to a protective effect of estrogen, the mechanisms remain unclear. To clarify the relation between female sex hormones and stone matrix protein, we examined the interaction of estrogen receptor-α (ERα), estrogen receptor-related receptor-α (ERRα), and stone matrix protein osteopontin (OPN) in a rat hyperoxaluric model and in primary cultured rat kidney cells. Adult female Wistar rats were divided into 6 groups. Groups 1 and 4 consisted of normal females, Groups 2 and 5 consisted of ovariectomized females, and Groups 3 and 6 consisted of ovariectomized females receiving female sex hormone supplements. Groups 1-3 were administered distilled water, while groups 4-6 were administered 0.5% ethyleneglycol (EG). Moreover, rat kidney primary cultured cells were examined after treatment with female sex hormones under various conditions. The expressions of ERα, ERRα and OPN-mRNA in whole kidney and primary cultured cells were examined using Real-Time PCR. The expressions of OPN and ERRα-mRNA were suppressed by ovariectomy. Supplementation with female sex hormones increased the expression of OPN and ERRα-mRNA. In contrast, the expression of ERα-mRNA was increased by ovariectomy and suppressed by supplementation with female sex hormones. The results of the mRNA expression in primary cultured cells matched those in the hyperoxaluric model rats. Although the reason for the difference in expression between ERα and ERRα-mRNA is unclear, estrogen may regulates OPN expression through ERα and/or ERRα, either independently or in combination. Moreover, the decrease of OPN induced by removal of estrogen may increase urinary stones in postmenopausal women.View full abstractDownload PDF (685K)
Case report
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TAMAKI NAGATA, YASUNORI MISHIMA, TAKAHIKO ITO, MAIKO SAWADA, TERUYUKI ...2010 Volume 57 Issue 3 Pages 81-84
Published: June 30, 2010
Released on J-STAGE: December 21, 2010
JOURNAL FREE ACCESSA 73-year-old woman suffering from an abdominal aortic aneurysm (AAA), unstable angina, and low cardiac function (32% of ejection fraction) was scheduled for abdominal aortic replacement and coronary artery bypass grafting. However, before the scheduled operation the patient fell into cardiopulmonary arrest with ventricular fibrillation due to rupture of the AAA. Immediate cardiopulmonary resuscitation (CPR) using epinephrine and electrical defibrillation restored the spontaneous circulation. Following CPR, a continuous high-dose dopamine infusion (15 μg/kg/min) was initiated and emergent abdominal aortic replacement was performed. On arrival at the operating room, the patient showed serious hypotension, atrial fibrillation with multifocal ventricular premature contractions, and metabolic acidosis. Transesophageal echocardiography (TEE) suggested that the circulatory collapse might have resulted from diastolic dysfunction and deteriorated compliance of the left ventricular (LV) wall, possibly due to myocardial stunning induced by myocardial ischemia, and tachycardia induced by hypovolemia, both of which are influenced by high doses of catecholamine. We accordingly transfused adequate amounts of blood products and gradually decreased the infusion rate of dopamine to 4 μg/kg/min, while carefully monitoring blood pressure, central venous pressure, and TEE. By the end of surgery hemodynamic parameters had recovered to near normal levels. In post-resuscitated and hypovolemic patients, caution should be taken when administering high levels of exogenous catecholamines, which can induce myocardial stunning and circulatory collapse.View full abstractDownload PDF (579K) -
AVNI KAYA, MEHMET ACIKGOZ, LOKMAN USTYOL, SERHAT AVCU, ERTAN SAL, MESU ...2010 Volume 57 Issue 3 Pages 85-89
Published: June 30, 2010
Released on J-STAGE: December 21, 2010
JOURNAL FREE ACCESSAcute disseminated encephalomyelitis (ADEM) is a monophasic, immune-mediated demyelinating disorder that can follow immunizations or more often infections including rubeola, rubella, varicella, herpes zoster, mumps, Mycoplasma pneumoniae, or, more commonly, other nonspecific upper respiratory tract infections. Documentation of a preceding illness is not required to make this diagnosis. This report examines the case of a 9-month-old male patient presenting with the features of an acute leukodystrophy following innoculation with the mixed vaccine Pentaxim (Sanofi Pasteur, Lyon- France) while suffering from a lower respiratory tract infection, and who was eventually diagnosed as ADEM. The case is presented as a reminder that ADEM can sometimes be linked to lower respiratory tract infection and vaccination, and that the features in such cases can be confused with leukodystrophy.View full abstractDownload PDF (815K)
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