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Volume 209 (2006)
- Issue 4 Pages 277-
- Issue 3 Pages 169-
- Issue 2 Pages 75-
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Volume 209, Issue 1
May
Displaying 1-10 of 10 articles from this issue
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Regular Contributions
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Yoichi Shimada, Naohisa Miyakoshi, Yuji Kasukawa, Michio Hongo, Shiger ...2006 Volume 209 Issue 1 Pages 1-6
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSIn this study, we evaluated the clinical features of cauda equina tumors requiring surgical treatment. Medical records of 28 patients with cauda equina tumors (13 men and 15 women) undergoing surgical treatment were retrospectively reviewed. The majority of histological diagnoses indicated schwannoma (23 cases, 82%), and the remaining 5 indicated ependymoma, neurofibroma, meningioma, and ganglioneuroblastoma. In 86% of the cases, the initial symptom was pain in the lower back and/or lower extremities. Preoperatively, half of the patients had symmetrical pain in the lower back or lower extremities, severe pain in the supine position, or pain that was increased by coughing. One third of the patients needed morphine to control nocturnal pain. Tumor size, as determined by magnetic resonance imaging (MRI), correlated with preoperative symptom duration (r = 0.66, p < 0.001). These findings indicate that symmetrical lower back pain and/or pain that radiates to both lower extremities and increases in the supine position are characteristic of cauda equina tumors. The correlation between symptom duration and tumor size indicates that earlier diagnosis of this tumor is necessary. Earlier diagnosis based on these characteristic symptoms should make use of further examinations such as MRI.View full abstractDownload PDF (282K) -
Hiroshi Osawa, Norio Nakamura, Kenichi Shirato, Masayuki Nakamura, Mic ...2006 Volume 209 Issue 1 Pages 7-13
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSChronic renal disease with elevated level of serum creatinine (Cr) often progresses to end-stage renal disease. Although blockade of the renin-angiotensin system has been shown to slow the progression of chronic renal disease, it remains uncertain whether one could expect such a renoprotective effect even when the treatment is initiated late in the course of renal disease. The purpose of the present study was to examine the effect of losartan, an angiotensin-II receptor antagonist, on the progression of advanced renal insufficiency. We retrospectively analyzed eight hypertensive patients, whose baseline Cr levels exceeded 2.0 mg/dl (2.2-5.5); the subjects included 6 non-diabetic glomerular diseases, 1 diabetic nephropathy and 1 polycystic kidney disease. Losartan was given at the dosage of 25-50 mg/day. Changes in mean blood pressure (MBP) and serum levels of Cr, potassium (K) and uric acid were evaluated after treatment for 24 weeks. Slopes of reciprocal of serum Cr plotted against time (1/sCr slope), which indicate the rate of renal function loss before and after the treatment period, were compared. There was a significant reduction of 1/sCr slope after losartan (−0.004 ± 0.002 dl/mg/week before and −0.001 ± 0.002 dl/mg/week after the treatment, p < 0.05). MBP and serum levels of Cr, K and uric acid were not changed significantly by losartan treatment. However, improvement of 1/sCr slope was correlated to the degree of MBP changes. Based on the available data from 4 patients, proteinuria was decreased in 3 patients. These results suggest that losartan may retard the progression of advanced renal insufficiency.View full abstractDownload PDF (309K) -
Hongjian Liu, Yoshifumi Saijo, Xiumin Zhang, Yasuyuki Shiraishi, Yun L ...2006 Volume 209 Issue 1 Pages 15-21
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSPulse wave velocity (PWV) is the velocity of a pulse wave traveling a given distance between 2 sites in the arterial system, and is a well-known indicator of arteriosclerosis. Brachial-ankle PWV (baPWV) is a parameter more simple to obtain, compared with the conventional PWV, and is an easy and effective means of evaluating arteriosclerosis. BaPWV can be obtained by only wrapping the four extremities with blood pressure cuffs, and it can be easily used to screen a large number of subjects. Type A behavior has been confirmed as an independent risk factor for the development of coronary heart disease. To examine the relationship between Type A behavior and arteriosclerosis, 307 normal Japanese subjects were classified into either a Type A group (n = 90) or a non-Type A group (n = 217) by using Maeda's Type A Scale. BaPWV was evaluated using a PWV diagnosis device. The baPWV in the Type A group was significantly higher than that obtained in the non-Type A group. The baPWV showed a positive correlation with age both in the Type A group and in the non-Type A group; however, the straight-line regression slope of baPWV versus age in the Type A group was significantly larger than that in the non-Type A group. Therefore, our results suggest that arteriosclerosis might be promoted earlier in subjects expressing the Type A behavior pattern. Type A behavior pattern is confirmed as a risk factor for arteriosclerosis, and may increase the risk of the cardiovascular disease related to arteriosclerosis.View full abstractDownload PDF (293K) -
Hideyuki Nakama, Keiko Ohsugi, Taisuke Otsuki, Isao Date, Motomichi Ko ...2006 Volume 209 Issue 1 Pages 23-32
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSMucopolysaccharidosis type VII (MPSVII) is a lysosomal storage disease resulted from a deficiency of the enzyme β-glucuronidase (GUSB), which is necessary for degradation of glycosaminoglycans (GAGs). The deficiency of GUSB causes progressive accumulation of GAGs and subsequent lysosomal distension in multiple tissues, including the central nervous system (CNS). In murine experiments, bone marrow transplant, enzyme replacement, viral vectors, and genetically modified cells were successfully used for correction of the visceral accumulation of GAGs, but little improvement was seen in the brain, because these therapeutic agents cannot cross the blood-brain barrier (BBB). Although direct intracerebral injection of GUSB-encoding viral vectors has been developed to bypass the BBB, the possibility of tumor formation and the toxicity of over-expressed GUSB have been reported. In this study, we generated immortalized human amniotic epithelial (IHAE) cells to maintain the effect of implantation, and encapsulated these cells to prevent harmful immunological response and tumor formation and to regulate the level of GUSB expression within the host. Moreover, we generated IHAE cells that over-express and secrete human GUSB following transduction with an adenoviral vector encoding human GUSB. Therapeutic efficacy for MPSVII was evaluated in and ex vivo experiments using these encapsulated genetically engineered GUSB-encoding IHAE cells. We confirmed that encapsulated genetically engineered IHAE cells could secrete significant amounts of GUSB outside the capsule in vitro and into the cerebral parenchyma of C3H mice seven days after the capsule implantation. Thus, encapsulation cell therapy using genetically engineered IHAE cells is an effective armamentarium for the treatment of MPSVII.View full abstractDownload PDF (387K) -
Toshihiro Iwasaki, Naoto Shiba, Hiroo Matsuse, Takeshi Nago, Yuichi Um ...2006 Volume 209 Issue 1 Pages 33-40
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSWeight training (WT) is the most common method of maintaining and increasing muscle strength. WT, however, is not always useful as it requires the external resistance and stabilization. We have developed a “hybrid training” (HYB) approach that avoids these problems by using electrically stimulated muscles to provide resistance to the motion of a muscle undergoing training. Here we report the efficacy of HYB compared with conventional WT for increasing the muscle strength around the knee at both slow and fast joint speeds (at 30 and 180°/sec). Two matched groups, each of 8 healthy men aged 22 years, exercised 3 times/week for six weeks. Both groups showed significantly increased strength in concentric torque at 30°/sec (HYB +28%, WT +33%) and at 180°/sec (HYB +33%, WT +38%), and also in eccentric torque at 30°/sec (HYB +25%, WT +24%) and at 180°/sec (HYB +19%, WT +30%) (p < 0.001). HYB is comparable with WT exercising with the exception of high-speed contractions, while HYB has a clear advantage in not needing external resistance equipment or stabilization. HYB is therefore considered a useful approach for strengthening muscles when a person is restricted to bed rest or during space flight.View full abstractDownload PDF (303K) -
Fatma Yigit, Alpay Turan Sezgin, Senol Demircan, Goknur Tekin, Tansel ...2006 Volume 209 Issue 1 Pages 41-48
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSSlow coronary flow (SCF) in a normal coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear. Carotid intima-media thickness (CIMT) is a noninvasive marker of atherosclerosis. The aim of this study was to investigate the CIMT and diameter of carotid and coronary artery in relation to SCF. Twenty-four patients with angiographically diagnosed SCF (51 ± 7 years), and 26 age-matched subjects with normal coronary flow (NCF) (52 ± 8 years) in the coronary angiography were enrolled. Coronary flow rates were documented by thrombolysis in myocardial infarction (TIMI) frame count (TFC), a simple method for evaluating coronary blood flow. Carotid and coronary artery diameters and CIMT were measured. Mean TFC was significantly higher in patients with SCF than in patients with NCF (p < 0.001). There were no significant differences regarding maximum (p = 0.84) and mean CIMT (p = 0.61). On the other hand, carotid lumen (p = 0.03) and coronary artery diameters (p = 0.001) were significantly greater in patients with SCF than in subjects with NCF. There was a significant relation between mean coronary artery diameter and TFC (p = 0.004, 95% CI for OR: 1.61-11.87). In conclusion, these findings suggest that CIMT is not altered in patients with SCF as compared with those with NCF. However, carotid and coronary artery diameters are increased in patients with SCF as compared to those with NCF. Because the common carotid artery can be assessed in nearly every patient, carotid artery dilatation may be used as an early indicator for SCF.View full abstractDownload PDF (533K)
Case Reports
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Ikuyo Ohguro, Hiroshi Ohguro, Takuya Ohta, Mitsuru Nakazawa2006 Volume 209 Issue 1 Pages 49-52
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSOpen angle glaucoma, a slowly progressive optic atrophy, is clinically characterized by visual field defects corresponding to excavation of the optic disc, called glaucomatous cupping. Open angle glaucoma is further divided into primary open angle glaucoma caused by elevated intraocular pressure (higher than the normal limit of 21 mmHg), and normal tension glaucoma, in which intraocular pressure is in the normal range. Here we report a case of normal tension glaucoma associated with Buerger's disease, also known as thromboangiitis obliterans, which causes systemic blood flow disturbance. A 66-year-old man suffering from Buerger's disease for 10 years was diagnosed as having branch retinal artery occlusion in his left eye. He was referred to our clinic due to progressive visual field disturbance in that eye. Ophthalmologic examinations revealed occlusion in the infero-temporal retinal artery in the left eye, and glaucomatous cupping, normal intraocular pressure, retinal vessel tortuosity and retinal arteriosclerosis in both eyes. Visual field examination revealed decreased retinal sensitivities in the areas within the visual field arches above and below fixation from the blind spot to the median raphe, corresponding to the arcuate retinal nerve fibers comprising the Bjerrum areas and the area corresponding to the retinal artery occlusion. Buerger's disease is characterized by the development of segmental thrombotic occlusions and vasospasm of the medium and small arteries. Our case suggests that the blood flow disturbance due to arteriosclerosis, thrombotic occlusions and vasospasm associated with Buerger's disease might affect the ophthalmic circulation system, thereby contributing to the etiology of normal tension glaucoma.View full abstractDownload PDF (536K) -
Masahito Hatori, Mika Watanabe, Masami Hosaka, Hironobu Sasano, Masaha ...2006 Volume 209 Issue 1 Pages 53-59
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSAdamantinoma is known as a low-grade malignant biphasic tumor. Classic adamantinoma is in general characterized by admixture of both epithelial and osteofibrous components that are associated with various proportions and differentiation patterns. Osteofibrous dysplasia (OFD) is a self-limited benign fibro-osseous lesion of bone during infancy and childhood. OFD-like adamantinoma is characterized by predominance of osteofibrous tissues, in which small groups of epithelial cells are only detected by careful search or immunohistochemistry. There have been controversies as to the potential correlation among OFD, OFD-like adamantinoma and classic adamantinoma. We report an unusual case of adamantinoma arising in the tibia, with an extensive review of the literature. The present findings suggest a direct correlation between OFD-like adamantinoma and classic adamantinoma. At the age of 12 years, the tibial biopsy lesion was diagnosed as OFD. At the age of 23, the lesion became larger and more destructive on x-ray films. The biopsy lesion was diagnosed as classic adamantinoma. Wide excision was performed. The primary lesion was retrospectively diagnosed as OFD-like adamantinoma because of presence of keratin-positive epithelial cells within the stroma. At five years after surgery, the patient was free from recurrence or metastasis. The retrospective histological findings of OFD-like adamantinoma in the original biopsy and of a classic adamantinoma in all sections of the later resection specimen raised the possibility of an unusual progression of OFD-like adamantinoma to a classic adamantinoma. The present case and the literature review suggest that an OFD-like adamantinoma may be a precursor lesion of classic adamantinoma. Therefore, the possibility of progression of OFD-like adamantinoma to a classic adamantinoma should be kept in mind, particularly when the destructive changes are seen radiologically.View full abstractDownload PDF (3361K) -
Atsushi Komatsuda, Yoshinari Kawabata, Takahito Horiuchi, Mutsuhito Mo ...2006 Volume 209 Issue 1 Pages 61-67
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSA 19-year-old man with systemic sclerosis (SSc) was hospitalized for autologous peripheral blood stem cell transplantation (auto-PBSCT) due to progressive scleroderma and cardiac involvement despite conventional treatment. During the administration of cyclophosphamide (60 mg/kg/day for 2 days) for mobilization and collection of CD34+ selected peripheral blood stem cells, he developed congestive heart failure. Echocardiogram showed hypokinetic asynergy from the septum to posterior wall, which might indicate underlying cardiac damage. We were also concerned about the risk of high-dose cyclophosphamide-induced cardiotoxicity. Since the dose-limiting toxicity of thiotepa, an alkylating agent, is myelosuppression, and cardiac toxicity due to thiotepa is less common, we used a conditioning regimen consisting of thiotepa (10 mg/kg/day, day −5) and low-dose cyclophosphamide (50 mg/kg/day, days −3 and −2), instead of the conventional high-dose cyclophosphamide (50 mg/kg/day × 4 days/course). The post-transplant course was uneventful, and the modified Rodnan skin thickness score improved from 32 to 15. The present case report demonstrates that thiotepa can be employed as a conditioning regimen for auto-PBSCT in SSc patients with cardiac involvement in order to reduce cyclophosphamide-induced cardiotoxicity.View full abstractDownload PDF (276K) -
Ikuko Takahashi, Tsutomu Takahashi, Satoko Tsuchida, Tamaki Mikami, Hi ...2006 Volume 209 Issue 1 Pages 69-73
Published: 2006
Released on J-STAGE: April 25, 2006
JOURNAL FREE ACCESSAdenovirus pneumonia is uncommon but its severe infection has a mortality as high as 10%, and survivors may have residual airway damages, manifested by bronchiectasis, bronchiolitis obliterans, or pulmonary fibrosis. We report a case of adenovirus pneumonia demonstrating fatal respiratory distress. Adenovirus was isolated from pharyngeal specimens using cell culture and typed as serotype 3 by a combination of polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis. The patient characteristically showed hypercytokinemia, characterized by increased levels of lactate dehydrogenase, ferritin, and several cytokines including interferon-γ and interleukin-6. We treated the patient with pulse methylprednisolne therapy (25 mg/kg/day, for 3 days), resulting in the rapid amelioration of respiratory distress. This is the first report describing the treatment of pulse methylprednisolone therapy in fatal adenovirus pneumonia. During the clinical course, serum Krebs von den Lungen-6 (KL-6), which is a marker for the activity of diffuse interstitial lung disease, was elevated, suggesting that serum KL-6 could be available as a marker of pulmonary prognosis in viral pneumonia.View full abstractDownload PDF (734K)
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