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Article type: Cover
2005 Volume 36 Issue 4 Pages
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Published: December 30, 2005
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Article type: Cover
2005 Volume 36 Issue 4 Pages
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Toshiyuki TAKAGI, Takehiko IIJIMA
Article type: Article
2005 Volume 36 Issue 4 Pages
313-319
Published: December 30, 2005
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Pulse spectrophotometry is a noninvasive photometrical technology used to detect the concentration of given substance in the bloodstream. This technology was applied to detection of hemoglobin concentrations. The optical probe, which incorporated photodiodes detecting 3 or 4 wavelengths, was applied to the finger in 41 surgical patients. Sampled blood was also assayed in a CO-oximeter to validate the value obtained from pulse spectrophotometry. The mean bias was 0.9±1.35g/dl (3 wavelengths) and 0.2±1.30g/dl (4 wavelengths). A concentration-dependent bias was found in the 3-wavelength measurement. The specificity and sensitivity in detecting more or less than a hemoglobin concentration of 10g/dl were respectively 0.08 and 0.95 with 3-wavelength and 0.69 and 0.93 with 4-wavelength pulse spectrophotometry Multiple logistic regression analysis demonstrated that MCHC significantly contributes to bias of the hemoglobin value. In conclusion, 4-wavelength pulse spectrophotometry can be clinically feasible in monitoring hemoglobin concentrations continuously and noninvasively.
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Masayuki WATANABE
Article type: Article
2005 Volume 36 Issue 4 Pages
320-328
Published: December 30, 2005
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The causes of bone atrophy around the stem after cementless total hip arthroplasty (THA) observed by imaging techniques are unclear and few studies have analyzed the pathology of bone atrophy from the standpoint of bone metabolism. This study examined whether changes in bone metabolic markers could be used to predict bone atrophy. To define bone atrophy, the femoral index was used for the femoral shaft and bone mineral density was used for the trochanter. Fifty patients who had received cementless THA 18 months to 3 years (mean, 2 years and a month) prior to the study and 20 patients who had not been surgically treated were the subjects of the study. The surgical patients were divided into two groups: 37 patients with bone atrophy (Group a) and 13 patients without bone atrophy (Group b). The non-operative patients were Group c. Bone atrophy developed most frequently at 24 to 48 weeks postoperatively in the bone shaft and 12 to 48 weeks postoperatively in the trochanter. Deoxypyridinoline (DPD) and pyridinoline (PYD) levels were significantly elevated in both Groups a and b at 4 weeks postoperatively. Levels increased until 8 weeks postoperatively in Group a but decreased in Group b and a significant difference was observed between the groups at eight weeks. All of the patients in Group a with increases in DPD and PYD levels of 20% or greater from four to eight weeks postoperatively experienced bone atrophy. This indicates the importance of analysis of bone resorption markers during this period and measures based on these results. The use of bone resorption markers may allow early quantification of small changes in bone metabolism that cannot be detected with radiography or bone mineral density analysis. Thus, these markers may be useful for predicting femoral bone atrophy after THA and taking measures to control it.
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Shoji Maruyama
Article type: Article
2005 Volume 36 Issue 4 Pages
329-339
Published: December 30, 2005
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Although inflammatory bowel disease (IBD) is clinically important, its etiology is not yet fully understood. To investigate the role of suppressor T cells in IBD, lymphocytes were collected from the spleen and large intestine after treatment with dextran sulfate sodium (DSS) and Yersinia enterocolitica heat-shock protein 60 (Ye-hsp60), respectively. From mice with DSS-induced colitis (a frequently used model of colitis) and mice with colitis induced by intraperitoneal administrations of Ye-hsp60 after feeding with a high linoleic acid diet (our own model of colitis), we collected splenic lymphocytes and intraepithelial lymphocytes (IEL) of the large intestine for subsequent flow-cytometric analysis of CD25^+ CD4^+ cells. While the CD25^+ CD4^+ cells among intestinal IEL increased significantly in DSS mice without macroscopic melena, the count in DSS mice with macroscopic melena did not change significantly. CD25^+ CD4^+ CD69^+ cells decreased in intestinal IEL from mice with Ye-hsp60 colitis. CD25^+ CD4^+ cells among spleen decreased in DSS mice without macroscopic melena. The CD25^+ CD4^+ cell pattern differed between splenic lymphocytes and intestinal IEL. These findings suggest that analysis of suppressor T cells in IEL from animal models of Ye-hsp60 colitis and DSS colitis will be useful for clarifying the pathogenesis of IBD.
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Kunihiko TONARI
Article type: Article
2005 Volume 36 Issue 4 Pages
340-347
Published: December 30, 2005
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Background: The mechanism by which onset of postoperative pulmonary hypertensive crisis occurs in congenital heart disease patients accompanying pulmonary hypertension is still unclear, and in many cases may greatly complicate treatment. The purpose of this study was to examine on the pharmacological effects of adenosine on pulmonary hypertension. Methods: Twelve pigs with an experimental pulmonary hypertension (age, about 2 months. mean weight, 10.9kg) were studied under general anesthesia. An experimental pulmonary hypertension was induced by giving hypoxic inhalation with FiO_2=0.1. Data was collected for mean systemic artery pressure (MAP), mean pulmonary artery pressure (MPAP), central venous pressure (CVP), left atrial pressure (LAP), and cardiac output. And cardiac index, MAP, MPAP, CVP, LAP, pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), PVR/SVR ratio, and MPAP/MAP ratio were determined before, during, and after central venous infusion of adenosine (20 to 80μg・kg^<-1>・min^<-1>) for 30 minutes. Statistical analysis was performed using ANOVA and Tukey's post hoc analysis, and statistical significance was defined as a P-value of less than 0.05. Results: Effective adenosine concentration was 40μg・kg^<-1>・min^<-1> (11 out of 12 cases). Concerning the effects of adenosine on experimental acute PH in pigs, MPAP was significantly decreased from 26.9mmHg to 17.3mmHg (p<0.01), and PVR was significantly decreased from 4.2 Wood units (W.u.) to 1.9±1.1 W.u. (p<0.01). No change in systemic circulation during adenosine infusion occurred. Conclusion: This study showed that adenosine selectively decreased PAP and PVR without decreasing systemic blood pressure and SVR. The results of this study suggest that adenosine may be available clinically for the treatment of perioperative and postoperative pulmonary hypertension for infants and young children.
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Fumitaka KUDO
Article type: Article
2005 Volume 36 Issue 4 Pages
348-357
Published: December 30, 2005
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SNARE (soluble N-ethylmaleimide-sensitive factor attachment protein receptor) proteins, which play a central role in vesicle and plasma membrane transport processes, are localized at the growth cone and are considered to have an important role in neurite formation and regeneration. In order to evaluate chronological changes of protein expression in the rat spinal cord after transection of the rat sciatic nerve, we investigated the changes in the amount of expressed SNARE proteins such as HPC-1/syntaxin1A, SNAP25, and synaptotagmin-1 during peripheral nerve regeneration. Western blotting experiments showed that SNARE protein expression in the lumbar spinal cord decreased significantly 30 minutes after transection, while no change in the expression of this protein was observed in the thoracic spinal cord. Immunohistochemical studies showed that HPC-1/syntaxin 1A protein expression on the transected side of the lumbar spinal cord 30 minutes after transection was significantly lower than that before transection. SNAP25 protein expression was slightly but not significantly lower. c-Fos expression increased significantly in the ventral and dorsal horns 30 minutes after transection, and gradually recovered in three days. Taken that changes in the expression of SNARE proteins are thought to cause the sprouting and extension of axons, the results of the present study suggest that nerve regeneration begins quite soon after transection of the sciatic nerve.
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Yukio NAKAMURA, Hisaaki OKAMIYA, Shigeo OOSHIMA, Hiroaki KOSUGE, Mai M ...
Article type: Article
2005 Volume 36 Issue 4 Pages
358-363
Published: December 30, 2005
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The efficacy of UAE for uterine leiomyomas is reported. A total of 140 patients underwent UAE at Kugayama Hospital between September 2002 and November 2005. Follow-up clinical data were available for 127 patients at three month or more after UAE. The relative uterine and leiomyoma volumes were 53.6±3.7% and 38.6±6.5%, respectively, at one year follow-up, 53.1±2.4% and 37.7±4.1%, respectively, at 2-year follow-up. The symptoms of hypermenorrhea and dysmenorrhea were improved after UAE. In twelve patients, transcervical leiomyoma expulsion occured. Two patients with infection of degenerated leiomyomas required a simple dilatation and curettage. In one patient, leiomyoma regrowth occurred. She underwent hysterectomy and leiomyosarcoma was denied. The catheterization failure was occured on one side in the three patients. In one case of them, UAE were ineffective. The patients with bulky leiomyomas resolved their symtoms satisfactory. The postprocedural pain was densely controlled with epidural anesthesia. UAE is effective and safe for treatment of uterine leiomyomas. This minimally invasive procedure will become accepted as an alternative to hysterectomy.
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Kengo SAKAKURA, Shoichi ICHIMURA, Kazuyuki HATTORI, Jun OGAWA, Kazuhik ...
Article type: Article
2005 Volume 36 Issue 4 Pages
364-368
Published: December 30, 2005
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A 3-year-old girl with left thoracic scoliosis of 29°measured using Cobb's method was diagnosed as the Arnold-Chiari malformation with syrinx extending from C2 to the conus medullaris by MRI. She had no neurological abnormalities and underwent (surgical) foramen magnum decompression. Three years after surgery, MRI showed improvement in syrinx size, scoliosis slightly decrease to 23°and no neurological deficits were observed. Scoliosis is a common complication of Arnold-Chiari malformation and syringomyelia. Early diagnosis and treatment is paramount as scoliosis associated with Arnold-Chiari malformation is often progressive and neurological deficits often develop. Children with scoliosis onset as early as this case require a thorough physical examination with careful attention to the neurologic system. MRI study is recommended to evaluate the spinal cord abnormalities.
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Article type: Appendix
2005 Volume 36 Issue 4 Pages
369-
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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2005 Volume 36 Issue 4 Pages
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