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Volume 59 (2012)
- Issue 3.4 Pages 39-
- Issue 1.2 Pages 1-
Volume 59, Issue 3.4
Displaying 1-6 of 6 articles from this issue
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Original Contribution
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KOICHIRO KUHARA, TATSUYA IDE, NAOHISA UCHIMURA, RYUKICHI KUMASHIRO, TE ...2012 Volume 59 Issue 3.4 Pages 39-44
Published: December 31, 2012
Released on J-STAGE: July 03, 2013
JOURNAL FREE ACCESSSome patients receiving pegylated interferon and ribavirin treatment for chronic hepatitis C are forced to discontinue the treatment due to psychiatric disorders. We performed a retrospective study to evaluate whether pre-treatment psychiatric examinations could increase successful completion rates for this treatment. Methods: A total of 535 patients who started pegylated interferon-α-2b and ribavirin treatment at 6 hospitals affiliated with our hospital were included in this study. The patients were divided into two groups. Those who had visited a psychiatric clinic before treatment were Group A (N=223), and those who did not visit a psychiatric clinic before treatment were Group B (N=312). We analyzed the rate of discontinuation due to psychiatric disorders in the two groups. Results: The rate of discontinuation due to psychiatric disorders in Group A was found to be significantly lower than that of Group B (1.8% (4⁄223) vs. 6.1% (19⁄312), P=0.035). In Group A, 6.1% (4⁄65) discontinued the treatment due to psychiatric disorders, while the comparable rate in Group B was 27% (19⁄68) (P=0.0004). Among patients who presented with psychiatric symptoms during treatment, the rate of treatment completion was significantly higher in Group A than in Group B (69.2% (18⁄26) vs. 5.0% (1⁄20), P=0.0067). In patients with a history of psychiatric symptoms, no discontinuation due to psychiatric disorder was observed in Group A. Conclusions: A psychiatric examination before pegylated interferon and ribavirin treatment was found to positively contribute to the successful completion of the treatment.View full abstractDownload PDF (658K) -
GEN AKASU, RYUICHI KAWAHARA, MAKIKO YASUMOTO, TAKENORI SAKAI, YUICHI G ...2012 Volume 59 Issue 3.4 Pages 45-52
Published: December 31, 2012
Released on J-STAGE: July 03, 2013
JOURNAL FREE ACCESSThe contrast harmonic imaging technique allows visualization of micro bubbles and has facilitated the detection of blood flow on contrast-enhanced ultrasonography (CE-US). In hypovascular tumors such as pancreatic cancer a hypoxic nutrition-deficient environment increases tumor malignancy. In this study, we investigated the relation between CE-US findings, intratumoral microvessel density (MVD), and pathological analysis in pancreatic cancer, and we also investigated the clinicopathological significance of CE-US.
The subjects were 16 pancreatic cancer patients who underwent CE-US before surgery. A time-signal intensity curve (TIC) was prepared based on the region of interest (ROI) in the tumor on CE-US, and the signal intensity (SI) was defined as an increase from the value before contrast imaging to the maximum value. Regarding MVD, histological sections were stained with anti-CD34 and α-smooth muscle actin (α-SMA) antibodies, and double stained micro-blood vessels were counted. The correlation between SI and MVD was investigated. In addition, disease-free survival (DFS) was compared between the hypo (≤mean SI) and hyper (>mean SI) SI groups.
SI in cancerous lesions was 54.6±42.9 dB (mean±SD), and MVD in cancerous lesions was 12.5±5.02 (mean±SD). A positive correlation was noted between the SI and MVD (r2=0.408, p=0.008). The median DFS were 212 and 606 days in the hypo and hyper SI groups, respectively, showing a significantly shorter DFS in the hypo SI group (P=0.003). No patient died of the primary disease during the follow-up period in the hyper SI group, and a maximum 47-month follow-up was possible.
A positive correlation was noted between SI and MVD, indicating that MVD of pancreatic cancer could be evaluated using CE-US. We suggested that CE-US is a useful predictor of patient prognosis after pancreatic cancer surgery.View full abstractDownload PDF (2174K) -
RYO FUJIKI, KIICHIRO MORITA, MASAYUKI INOUE, YOSHIHISA SHOJI, KEIICHIR ...2012 Volume 59 Issue 3.4 Pages 53-60
Published: December 31, 2012
Released on J-STAGE: July 03, 2013
JOURNAL FREE ACCESSVarious functional imaging studies have demonstrated reduced lateralization of cortical activation during neurocognitive tasks in schizophrenia. —A well-known card game, “concentration” , reflects working memory (WM). We compared characteristics of hemodynamic changes in the prefrontal to temporo-parietal areas of the brain during this card game between 24 outpatients with schizophrenia and 24 age- and gender-matched healthy control subjects. Using multi-channel near-infrared spectroscopy, we measured relative changes in oxygenated hemoglobin concentration (oxy-Hb changes), which reflects brain activity during this task. Patients showed reduced lateralization in the midfrontal area, which is involved in executive functions, and in the inferior parietal area, involved in WM subcomponents. We also found a significant negative correlation between left midfrontal region oxy-Hb changes and severity of negative symptoms of schizophrenia. Our results characterized disease-related features, suggesting the usefulness of oxy-Hb change measurement during this card game for assessing functional outcome in schizophrenic patients.View full abstractDownload PDF (2796K) -
TARO ISOBE, KOUSUKE HASHIMOTO, JUNYA KIZAKI, MOTOSHI MIYAGI, KEISHIRO ...2012 Volume 59 Issue 3.4 Pages 61-70
Published: December 31, 2012
Released on J-STAGE: July 03, 2013
JOURNAL FREE ACCESSMany elderly individuals suffer from reduced functioning of major organs with cardiovascular and respiratory system comorbidity. Consequently, surgical stress and postoperative complications can be fatal. We investigated whether gastrectomy can safely improve the prognosis in very elderly (>85 years) patients with gastric cancer. We compared the clinical and pathological features of patients 85 years and older (Group A) with those 80- to 84-year-old (Group B) who underwent gastrectomy. We also compared the survival rates of Group A and Group B, and investigated the prognostic factors. Group A had a high incidence of patients with 3 or more comorbidities, but these did not influence postoperative complications or survival rate. Patients at stage I or II had a significantly higher survival rate than those who did not undergo surgery. However, there was no statistical difference in survival rate at stage III or IV. Our study results revealed that in the early stages (I and II) of well-differentiated gastric cancer with low risk of lymph node metastasis, surgery should consist of minimal lymphadenectomy and be minimally invasive. Further, treatments other than gastrectomy should be considered for patients in whom complete resection via reduction surgery is not possible.View full abstractDownload PDF (682K)
Case Report
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TETSUYA MIZOKAMI, YOUHEI ITOH, YUICHI SATO, KIYOHIDE NUNOI, KEN OKAMUR ...2012 Volume 59 Issue 3.4 Pages 71-77
Published: December 31, 2012
Released on J-STAGE: July 03, 2013
JOURNAL FREE ACCESSA 53-year-old Japanese man was admitted with a 3-month history of transient headache followed by general fatigue and weight loss. He had a history of ocular myasthenia gravis which had been in remission following thymectomy 30 years ago. He had a small diffuse goiter without tenderness, and was diagnosed as having painless thyroiditis with mild thyrotoxicosis on admission. Endocrinological studies showed he had isolated adrenocorticotropin deficiency. Magnetic resonance imaging of the pituitary gland revealed no abnormalities. His symptoms improved soon after replacement of glucocorticoid. After an episode of hypothyroidism, he spontaneously became euthyroid. It is likely that thyrotoxicosis uncovered adrenal insufficiency that had developed insidiously, and hypoadrenocorticism-induced immunological changes may have triggered the development of painless thyroiditis. Moreover, thymectomy might have facilitated the development of pituitary and thyroid autoimmunity.View full abstractDownload PDF (601K) -
KOTARO MATSUDA, MASAFUMI GOTOH, YASUHIRO MITSUI, EIICHIRO YOSHIKAWA, S ...2012 Volume 59 Issue 3.4 Pages 79-82
Published: December 31, 2012
Released on J-STAGE: July 03, 2013
JOURNAL FREE ACCESSWe report the case of a patient with rheumatoid arthritis (RA) who showed a reduction in disease severity (from class IV to class II) after multi-joint surgery. The patient was a 61-year-old man with a history of RA, type-2 diabetes, chronic obstructive pulmonary disease, and nephrotic syndrome. He had been undergoing treatment for RA for the past 10 years, but his condition could not be appropriately controlled. In addition to generalized edema, marked destruction of the left elbow joint and knees was observed, and he was unable to move in bed (Steinbrocker classification: stage IV, class IV).
In March 2009, he developed suppurative arthritis of the left elbow (methicillin-sensitive Staphylococcus aureus [MSSA] infection) and was referred to our institution, where the infection subsided after cleaning of the wound and administration of antibiotics. In March 2010, he underwent artificial joint replacement arthroplasty of the left elbow, followed by replacement arthroplasty of the right knee in July that year and of the left knee in November. As of December 2011, the patient showed no signs of inflammatory reactions and was able to walk using crutches (Steinbrocker classification: stage IV, class II). Recent advancements in pharmacotherapy have made it possible to control the advancement of joint destruction in RA. However, in this patient, because of the advanced stage of joint destruction, surgical methods were required to aid the patient in recovering his ability to walk.View full abstractDownload PDF (3455K)
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