巻号一覧
210 巻 (2006)
- 4 号 p. 279-
- 3 号 p. 175-
- 2 号 p. 91-
- 1 号 p. 1-
210 巻, 1 号
September
選択された号の論文の11件中1～11を表示しています
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Invited Review
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Hideo Harigae2006 年 210 巻 1 号 p. 1-9
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーThe development of mature blood cells from hematopoietic stem cells is regulated by transcription factors that control and coordinate the expression of lineage-specific genes. The GATA family consists of six transcription factors that function in hematopoietic and endodermal development. Among them, GATA-1 is expressed in erythroid, megakaryocytic, eosinophil and mast cell lineages, and GATA-2 is expressed in stem and progenitor cells, at more immature stage compared with GATA-1. Based on the characteristic phenotypes of GATA-1 and GATA-2 mutant mice, it has been suggested that mutations of these GATA genes in humans may result in the onset of certain clinical diseases. To date, mutations of GATA-1 gene have been found in inherited anemia and thrombocytopenia, and Down syndrome-related acute leukemia, which exhibits megakaryocytic phenotypes and frequently occurs in patients with Down syndrome. In contrast, no mutation of GATA-2 gene has been identified in hematological diseases; however, we found the expression level of GATA-2 is significantly decreased in CD34 positive cells in patients with aplastic anemia. Since GATA-2 functions in the proliferation of hematopoietic stem cells, the reduction of GATA-2 expression in CD34 positive cells may result in the decreased number of hematopoietic stem cells, which is the characteristic feature of aplastic anemia. Based on these lines of evidence, some types of hematological diseases may be defined as transcription factor diseases.抄録全体を表示PDF形式でダウンロード (667K)
Regular Contributions
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Mitsuo Kanagae, Yasuyo Abe, Sumihisa Honda, Noboru Takamura, Yosuke Ku ...2006 年 210 巻 1 号 p. 11-19
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーIn developed countries, the elderly population is growing rapidly. Self-rated health is an important indicator of health and has been the focus of a number of aging studies. However, little is known about the possible differences in determinants of self-rated health according to age. Self-rated health and its possible determinants were examined in 542 community-dwelling Japanese women aged 40 to 91 years. The proportion of women with poor self-rated health increased with age. Approximately half of the women had poor self-rated health among women aged 80 years and over. We used multiple logistic regression analysis to examine the association with poor self-rated health in women aged 40 to 64 years (n = 248) and 65 years and over (n = 294). Lower physical activity and a greater number of comorbidities were associated with poor self-rated health for ages 40 to 64 and 65 years and over. Furthermore, the risk of poor self-rated health increased by 1.5-fold with every increase in the number of painful joints in the lower extremities for the 40- to 64-year-old age group, and increased by 2-fold with back pain for those 65 years and over. The determinants of self-rated health were similar in both middle-aged and elderly Japanese women. Our results could contribute to effective interventions to improve quality of life among Japanese women.抄録全体を表示PDF形式でダウンロード (362K) -
Reiko Saito, Danjuan Li, Chieko Shimomura, Hironori Masaki, Mai Q. Le, ...2006 年 210 巻 1 号 p. 21-27
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーAn off-season community influenza outbreak with high prevalence of amantadine-resistant influenza A/H3N2 occurred during September-October 2005 in Nagasaki Prefecture, Japan, prior to standard influenza circulation. A total of 48 patients with influenza-like-illness (ILI) visited a clinic during the outbreak and 27 (69.2%) of 39 ILI patients were positive for influenza A with rapid antigen testing (Quick Vue Rapid SP Influ). Nine patients were not tested because their symptoms were compatible for influenza without examination. Nasopharyngeal swabs were obtained from 4 of 27 rapid test positive patients, and influenza H3N2 strain was isolated from one out of four. The 4 nasopharyngeal samples were positive for influenza A M2 gene in polymerase chain reaction, and sequencing results all showed identical mutation at position 31, serine to asparagine (S31N) in the gene, conferring amantadine resistance. The phylogenetic tree analysis demonstrated that the hemagglutinin (HA) gene sequences of the 4 samples formed a distinct cluster (named clade N) from recent circulating H3N2 strains, characterized by dual mutations at position 193, serine to phenylalanine (S193F), and at position 225, asparatic acid to asparagine (D225N). Our findings suggested that an off-season community influenza outbreak in Nagasaki was caused by a distinct clade in H3N2 (named clade N), which possessed characteristics of amantadine resistance.抄録全体を表示PDF形式でダウンロード (358K) -
Futoshi Nagasaki, Yoshiyuki Ueno, Takeshi Yamamoto, Yu Nakagomi, Osamu ...2006 年 210 巻 1 号 p. 29-36
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーHepatitis B virus (HBV) infection, which causes liver cirrhosis and hepatocellular carcinoma, remains a major health problem in Asian countries. Recent development of vaccine for prevention is reported to be successful in reducing the size of chronically infected carriers, although the standard medical therapies have not been established up to now. In this report, we encountered a patient with decompensated HBV-related cirrhosis who exhibited the dramatic improvements after antiviral therapy. The patient was a 50-year-old woman. Previous conventional medical treatments were not effective for this patient, thus this patient had been referred to our hospital. However, the administration of lamivudine, a reverse transcriptase inhibitor, for 23 months dramatically improved her liver severity. During this period, no drug resistant mutant HBV emerged, and the serum HBV-DNA level was continuously suppressed. These virological responses were also maintained even after the antiviral therapy was discontinued. Moreover, both hepatitis B surface antigen and e antigen were observed to have disappeared in this patient. The administration of lamivudine to patients with HBV-related cirrhosis, like our present case, should be considered as an initial medical therapeutic option, especially in countries where liver transplantation is not reliably available.抄録全体を表示PDF形式でダウンロード (1946K) -
Yasuhiko Asai, Kazuhiko Kotani, Youichi Kurozawa2006 年 210 巻 1 号 p. 37-40
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーThe Internet has provided open access to health- and disease-related information for people with chronic diseases. Atopic dermatitis (AD) is mostly chronic, and the treatment of AD often requests some self-management such as skin care. For this situation, adult AD patients may have a motive of obtaining information on AD from various sources such as the Internet. Although the status of Internet access among AD patients has not been thoroughly investigated, knowledge about this status may be useful to understand AD patients in primary care. We studied the actual status among 62 adult Japanese outpatients with AD (male:female = 29:33; mean age [± S.D.]: 27.8 ± 7.9 years). All 62 patients owned cellular phones, while 51 subjects (82.3%) owned personal computers (PCs). Internet web-site information on both general health and AD was more commonly accessed via PCs rather than cellular phones, but the access rates via PCs were only 35.3% among all users of PCs. When AD patients assessed the extent of credibility of web site information on AD on a scale of 0 to 100 points, it was at best 52.4 ± 19.8 points. Moreover, both the duration and severity of AD had a positive influence on the credibility of information on AD. These results suggest that Internet access is not common and the information is not necessarily credible among adult AD patients in Japan, and that more consideration is needed for the Internet to become a powerful and vital source to support health care for AD.抄録全体を表示PDF形式でダウンロード (227K) -
Takahiro Shinozaki, Eiji Sakamoto, Shunji Shiiba, Futoshi Ichikawa, Yu ...2006 年 210 巻 1 号 p. 41-47
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーHeadache associated with cervical lesions is called cervicogenic headache and involves the occiput but not the orofacial region. However, patients occasionally present with orofacial pain accompanied by neck symptoms. This study investigates whether orofacial pain can originate from the neck and whether cervical plexus block can help in diagnosis. We enrolled eight patients suffering from chronic orofacial pain that had not been relieved by dental treatment. Radiographic and magnetic resonance imaging revealed abnormal findings in the neck in seven of them. To identify the origin of the orofacial pain, we firstly blocked peripheral sensory input from the oral cavity and surrounding tissues, followed by that from deep cervical structures. We injected local anesthetics around the painful orofacial region, then to the tender points in the masticatory and superficial cervical muscles (trigger point injection), and consequently around the cervical plexus. Pain was assessed using a pain relief score compared with pre-treatment control values. Local anesthesia in the painful oral region provided insufficient relief whereas trigger point injection significantly relieved pain. The amount of pain relief generated by the deep cervical plexus block was more significant than that produced by any other procedures. We conclude that certain types of orofacial pain originate from cervical structures and that a deep cervical plexus block can be helpful in differentially diagnosing such pain.抄録全体を表示PDF形式でダウンロード (355K) -
Huseyin Bakkaloglu, Ahmet Dinccag, Hakan Yanar, Fatih Tunca, Oner Doga ...2006 年 210 巻 1 号 p. 49-55
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーIdiopathic thrombocytopenic purpura (ITP) is an isolated thrombocyte disease that has no correlation with other causes of clinical thrombocytopenia in adults. About 70% of patients with ITP were successfully treated by medical care and splenectomy, but nearly 30% of ITP patients do not respond to these treatments. The aim of this study is to evaluate the predictive factors that affect the success of treatment in 26 patients with ITP. Thirteen patients with ITP responded to splenectomy (responsive group), whereas 13 other patients were resistant to medical treatment and splenectomy (resistant group). The control group consisted of 13 patients who had undergone posttraumatic splenectomy. Age, sex, spleen weight, the number of follicles per mm2, and the length of time between diagnosis and splenectomy were retrospectively analyzed. No significant difference was found between the groups with respect to these variables. Mean maximum follicle diameter (MMaFD), mean minimum follicle diameter (MMiFD), and the number and distribution of CD56 (+) cells were evaluated for each spleen specimen. There was no statistical difference in the distribution of CD56 (+) cells between the ITP patients and the control group, but the number of CD56 (+) cells was significantly higher in the control group than in patients with ITP. While MMiFD showed no statistical difference between the groups of ITP patients, a MMaFD of 350 μm and above was significantly more likely in the resistant group than in the other groups. In conclusion, this study has shown that the MMaFD is a significant predictor of the response to splenectomy.抄録全体を表示PDF形式でダウンロード (2549K) -
Zeynep Tartan, Huseyin Uyarel, Hulya Kasikcioglu, Ahmet Taha Alper, Ba ...2006 年 210 巻 1 号 p. 57-66
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーMetabolic syndrome (MS) and non-dipping hypertension both increase cardiovascular mortality. Although both clinical modalities share common pathophysiologic factors in their etiologies, previous studies did not find any association between them. We aimed to investigate the association between MS and non-dipping blood pressure by comparing different definitions of MS. One-hundred-thirty-two consecutive patients (58 men) who underwent 24-hour ambulatory blood pressure monitoring were analyzed. MS was evaluated according to the currently used Adult Treatment Panel (ATP) III definition criteria, named MS-ATP III. In order to reveal the weights of risk contributing to MS, a new diagnostic scoring method (MS-Score) was used in comparison with MS-ATP III. Nocturnal non-dipping refers to a reduction in average systolic and/or diastolic blood pressure at night (≤ 10%) compared with daytime average values. Non-dipping pattern was found in 61.4% of patients. The frequency of MS according to MS-Score, but not MS ATP III, was significantly higher in patients with non-dipping pattern than those without it (p = 0.009). Although more prominent in the nighttime, MS-Score showed positive correlation with all systolic blood pressure results (r = 0.27, p = 0.002). Adjusted for baseline characteristics, high (≥ 27.5) MS-Score remained as an independent predictor of non-dipping pattern (OR 2.64, p = 0.038). Finally, high MS-Score, but not MS-ATP III, is a predictor of non-dipping pattern. Nighttime systolic blood pressure is higher in patients with high MS-Score. Therefore, patients with high MS-Score may be more prone to cardiovascular events than those with low MS-Score.抄録全体を表示PDF形式でダウンロード (751K) -
Thaweesak Chieochansin, Salin Chutinimitkul, Sunchai Payungporn, Apira ...2006 年 210 巻 1 号 p. 67-78
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーHepatitis B virus (HBV) is one of the major causes of liver disease worldwide, and chronic HBV infection may progress to cirrhosis and hepatocellular carcinoma. Mutations at the active site of DNA polymerase of HBV, tyrosine-methionine-aspartate-aspartate (YMDD) motif, render infected patients resistant to antiviral drug (Lamivudine) therapy. Hence, sensitive and specific methods aimed at detecting the mutants are essential. The purpose of this study was to develop methods for detecting the mutations at YMDD by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and real-time PCR using locked nucleic acid (LNA)-mediated TaqMan probes. The results obtained by these methods were compared with those examined by conventional direct sequencing on serum samples of 77 patients treated with lamivudine. Our results show that both PCR-RFLP and real-time PCR could detect wild type, YMDD, and its mutants, tyrosine-isoleucine-aspartate-aspartate and tyrosine-valine-aspartate-aspartate. In addition, the mixtures of the wild-type virus and its mutants in the serum sample were detected. Importantly, real-time PCR is less time-consuming, and more sensitive for the detection of mixed populations than PCR-RFLP. The real-time PCR with LNA-mediated TaqMan probes is a sensitive, specific and rapid detection method for mutations at the YMDD motif, which will be essential for monitoring patients undergoing lamivudine antiviral therapy.抄録全体を表示PDF形式でダウンロード (2899K)
Case Reports
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Fatih Dede, Elvin Dogan, Mehmet Demir, Didem Sener, Mehmet Kös, M ...2006 年 210 巻 1 号 p. 79-82
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーTuberculosis is an important health problem in developing countries, with varying clinical presentations depending on the organs/systems involved. Tuberculosis is mostly seen in immuno-compromised individuals, such as those with acquired immune deficiency syndrome or malignancies. Here we report a case of a spleen tuberculoma in a 29-year-old male patient with no known immune deficiency. He first presented with abdominal pain, and subsequent ultrosonographic examination revealed a splenic lesion of 10 cm in diameter. A computerized tomography scan of the abdomen confirmed the presence of a solitary, hypodense, septated cystic lesion. Lack of evidence supporting the presence of a splenic infection or a primary/metastatic malignancy prompted explorative surgery where a septated abscess formation was discovered and splenectomy was performed. Histopathological examination revealed granulomatous inflammatory changes with Langerhans-type giant cells, which are consistent with tuberculosis. For a period of two months, antituberculosis therapy with four drugs, isoniazid, rifampicin, pyrazinamide, and ethambutol, was carried out. Pyrazinamide and ethambutol were quitted at the end of two months. Theraphy with isoniazid and rifampicin was planned for an additional 10 months. We would like to call attention to yet another atypical presentation of extrapulmonary tuberculosis.抄録全体を表示PDF形式でダウンロード (820K) -
Yoichi Shimada, Yuji Kasukawa, Naohisa Miyakoshi, Michio Hongo, Shiger ...2006 年 210 巻 1 号 p. 83-89
発行日: 2006年
公開日: 2006/09/06
ジャーナル フリーWe present a case of a chronic spinal subdural hematoma combined with a ligamentum flavum hematoma in the lumbar spine treated surgically. An 83-year-old woman receiving antiplatelet medicine due to an angina suffered from pain in her lower extremity and gait disturbance after a backward fall. Radiological findings including magnetic resonance imaging (MRI) revealed hematoma in the ligamentum flavum at the level of L2 - L3 and a chronic subdural hematoma at the level from L3 to L5. Laminectomy through L2 to L5 was performed and a hematoma existing in the ligamentum flavum and cystic mass was removed. A chronic subdural hematoma was spontaneously evacuated after splitting of the dura mater and an intact arachnoid membrane was observed with no leakage of cerebrospinal fluid. Her clinical symptoms completely disappeared after surgery. To the best of our knowledge, this is the first case of combination of chronic subdural hematoma and ligamentum flavum hematoma in the lumbar spine treated by surgery. Chronic spinal subdural hematoma and hematoma in the ligamentum flavum should be considered as a cause of progressive nerve root compression in patients with anticoagulant theraphy, and an appropriate pre-operative diagnosis would be needed to achieve complete decompression of subdural and epidural hematoma.抄録全体を表示PDF形式でダウンロード (3527K)
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