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Volume 210 (2006)
- Issue 4 Pages 279-
- Issue 3 Pages 175-
- Issue 2 Pages 91-
- Issue 1 Pages 1-
Volume 210, Issue 3
November
Displaying 1-12 of 12 articles from this issue
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Review
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Yuka Ozawa, Takashi Murakami, Yukihiro Terada, Nobuo Yaegashi, Kunihir ...2006 Volume 210 Issue 3 Pages 175-188
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSEndometriosis is a condition characterized by ectopic endometrial tissues located outside of the uterus, most commonly found on the pelvic peritoneum or ovary. Endometriosis, which occurs in 7-10% of women in the general population and 71-87% of women with chronic pelvic pain, is associated with dysmenorrhea, chronic pelvic pain, and infertility. There is considerable debate about the effectiveness of various interventions for endometriosis. This review discusses the benefits and drawbacks of pharmacologic and surgical treatments for the pain associated with endometriosis. Laparoscopic surgery has been demonstrated to relieve the pain associated with endometriosis. Hormonal therapies, such as gonadotropin-releasing hormone (GnRH) analogues or the weak androgen danazol, have also been effective at relieving the pain associated with endometriosis. Oral contraceptives appear to be as effective as GnRH analogues for pain relief. Although both surgical and pharmacologic treatments have been effective for relief of the pain associated with endometriosis, the recurrence rate remains significant. The management of pain associated with endometriosis has thus not been satisfied. Larger unified clinical trials are needed to evaluate the effectiveness of new treatments in managing the pain associated with endometriosis.View full abstractDownload PDF (508K)
Regular Contributions
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Masato Ishizuka, Masahito Hatori, Osamu Dohi, Takashi Suzuki, Yasuhiro ...2006 Volume 210 Issue 3 Pages 189-198
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSDesmoid tumors are benign fibrous neoplasms which arise from the fibrous tissue of intra- and extra- abdominal sites, but their clinical management is sometimes difficult because of extensive infiltration into the surrounding tissues. Desmoid tumors commonly occur in women, especially after childbirth. Recently, both clinical and experimental findings indicate the possible roles of sex steroids in the development and progression of desmoid tumors but detailed information is still ambiguous. In this study, we first examined immunoreactivity of sex steroid receptors in desmoid tumors (27 cases) by immunohistochemistry and compared the findings with those in reactive self-limiting lesions associated with fibrosis (8 cases). Estrogen receptor (ER) α and ERβ immunoreactivities were detected in 7.4% (2/27) and 7.4% (2/27) of desmoid tumors, respectively. One desmoid tumor expressed both ERα and ERβ. Progesterone receptor (PR)-A and PR-B were detected in 25.9% (7/27) and 33.3% (9/27), respectively, and androgen receptor (AR) in 52.9% (14/27). In reactive lesions with fibrosis, only AR was detected in 37.5% (3/8). Sex steroid receptor mRNAs was further examined by reverse transcription and polymerase chain reaction (RT-PCR) analysis using fresh frozen tissues, demonstrating the expression of PR (PR-A and/or PR-B) and AR mRNAs in eight desmoid tumors examined and all cases of reactive fibrosis. These results indicate that sex steroid hormones might play an important role in the pathogenesis of desmoid tumors and could lead to the introduction of novel hormone therapeutic approaches in managing patients with recurrent desmoid tumors.View full abstractDownload PDF (1494K) -
Toshimi Aizawa, Tetsuro Sato, Yasuhisa Tanaka, Hiroshi Ozawa, Takeshi ...2006 Volume 210 Issue 3 Pages 199-208
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSThoracic myelopathy is defined as spinal cord compression in the thoracic region, leading to sensory and motor dysfunctions in the trunk and lower extremities, and can be caused by various degenerative processes of the spine. Thoracic myelopathy is rare, and there are many unsolved problems including its epidemiological and clinical features. We have established a registration system of spinal surgeries, which covered almost all surgeries in Miyagi Prefecture, and enrolled the data of 265 patients with thoracic myelopathy from 1988 to 2002. The annual rate of surgery gradually increased and averaged 0.9 per 100,000 inhabitants, which was less than 1/10 of that for cervical myelopathy. About 20 patients with thoracic myelopathy are operated on in Miyagi Prefecture each year. It frequently develops in middle-aged males. About half of the cases were caused by ossification of the ligamentum flavum, followed by ossification of the posterior longitudinal ligament, intervertebral disc herniation and posterior spur. Patients usually noticed numbness or pain in the legs and the preoperative duration was long, averaging 2 years. Its symptomatic similarities to lumbar disorders might cause difficulty in making a correct diagnosis. Since thoracic myelopathy can markedly restrict the activities of daily life, even general physicians should recognize this entity.View full abstractDownload PDF (532K) -
Mitsutoshi Munakata, Akira Onuma, Kazuhiro Haginoya, Yasuko Kobayashi, ...2006 Volume 210 Issue 3 Pages 209-212
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSThe exposure to mercury (Hg) of various groups of people with different dietary backgrounds has been assessed because of its hazardous effects, but little is known about that in patients receiving enteral nutrition. Therefore, we studied the Hg exposure in 25 patients with severe motor disabilities, who received liquid enteral feedings for more than one year, by determining total mercury (T-Hg) in their hair samples with inductively coupled plasma-mass spectrometry. The geometric mean of the T-Hg level in hair from the patients was 88 ng/g hair (± 1 geometric standard deviation [GSD], 34 - 228 ng/g), whereas that for the control group on a normal diet was 1,900 ng/g (± 1 GSD, 1,022 - 3,531 ng/g). The T-Hg levels in the patients' hair were far lower than those in the controls (p < 0.001). The T-Hg levels in the enteral feedings used were below the detection limit of cold-vapor atomic absorption spectrophotometry (< 10 ng/g). The present study has shown that Hg exposure is low in patients receiving enteral nutrition, indicating that food is a primary source of Hg exposure.View full abstractDownload PDF (207K) -
Kazumasa Suzuki, Shuichi Awata, Takehisa Takano, Yukio Ebina, Kosei Ta ...2006 Volume 210 Issue 3 Pages 213-220
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSSchizophrenia is a serious psychiatric disorder that develops mainly in young adults. Electroconvulsive therapy (ECT) is known to be effective and safe in patients with schizophrenia with acute psychotic exacerbation. Because of the shortage of systematic studies, we conducted a prospective naturalistic study to examine the short-term effects of acute ECT and its safety in young adults with medically intractable first-episode schizophrenia. Subjects were seven consecutive patients, 15-35 years of age, with first-episode schizophrenia or schizophreniform disorder (Diagnostic and Statistical Manual of Mental Disorders, 4th edition; DSM-IV), who had failed to respond to neuroleptics. The seven patients were treated with a first course of ECT, and their clinical symptoms were evaluated on the basis of the Brief Psychiatric Rating Scale (BPRS) (18 items, rated 0-6) and Global Assessment of Functioning (GAF) Scale. The GAF Scale is presented in DSM-IV as a means of assessing global functioning of a psychiatric patient. Scores range from 1-100; the higher GAF score indicates the higher global functioning. Adverse effects resulting from acute ECT were also evaluated. The total BPRS score 1 week after the final session improved significantly compared to the total pre-ECT BPRS score. The GAF score also improved significantly compared to the pre-ECT GAF score. There were no adverse effects during the acute ECT course, except for mild delirium. We conclude that ECT may be an effective and safe treatment option for young adults with intractable first-episode schizophrenia.View full abstractDownload PDF (323K) -
Masahito Hatori, Hideyuki Doi, Mika Watanabe, Hironobu Sasano, Masami ...2006 Volume 210 Issue 3 Pages 221-230
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSEwing's sarcoma, a small round cell sarcoma arising in soft tissue as well as the bone, is one of the most malignant tumors in children and young adults. Few established cell lines of extraskeletal Ewing's sarcoma (EES) have been reported, which made it difficult to examine the biological features of EES. Therefore, we have established a new clonal cell line of EES. We report its morphological characters, results of chromosomal and immunohistochemical analysis. A piece of tumor obtained from the 18-year-old female patient with EES was xenografted in a nude mouse. In vitro subcultured cells were then obtained from this xenograft. A clonal cell line was subsequently established by limiting dilution and designated EES1. EES1 cells had a doubling time of 24 hours. In the xenografted tumor, the cells expressed vimentin, CD99 (MIC2), neuron specific enolase (NSE) and cytokeratin. The original tumor cells also expressed vimentin, CD 99, and NSE, but was negative for cytokeratin. The morphological and immunohistochemical features of this cell line established, except for cytokeratin expression, were consistent with those of the primary tumor. Cytogenetic analysis of EES1 revealed chromosomal translocation of t(11; 12)(q24;ql2). The chimeric fusion of the Ewing's sarcoma gene in band 22q12 with the Friend leukemia virus integration-1 gene in band 11q24 was also demonstrated. Fluorescence in situ hybridization further confirmed the presence of translocation involving the Ewing's sarcoma gene in both the primary tumor and EES1 cells. In conclusion, we have established a human EES cell line EES1, which will provide a useful model for studying various aspects of human EES.View full abstractDownload PDF (1620K) -
Halil Ibrahim Durak, Sila Elif Törün, Abdullah Sayiner, G&uu ...2006 Volume 210 Issue 3 Pages 231-237
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSThe purpose of this study is to share educational structure and evaluation results of an innovative course on effective learning and study skills for the first year medical students. In Turkey, undergraduate medical education takes six years and each year nearly 5,000 high school graduates start medical schools. However, many students experience frustration and failure because of their lack in the learning and studying strategies. At the Ege University Faculty of Medicine, preclinical curriculum consists of the body function systems-based teaching blocks. Year one has three blocks. We implemented an effective learning and study skills course at the first and third blocks of the 2003-2004 curriculum. We evaluated the course by students' feedbacks derived from block questionnaires and students' homework performance analysis. At the first block questionnaire, out of 297, 163 students (54.8%) clearly stated that the course positively influenced their learning process. Structured analysis of the first block's students' homework showed that an average of 206 students (69.3%) can sufficiently describe their learning and studying approach, while 218 (73.4%) can identify the strengths and weaknesses of the curriculum. The average student scores were 74 ± 10 and 68 ± 11 out of 100 for first and third blocks, respectively. We interpreted these results as students enjoyed the course and learned the content. In conclusion, a course on effective learning and study skills is likely to assist first year medical students in improving their learning and adaptation to the school.View full abstractDownload PDF (300K) -
Aydin Sanli, Ahmet Onen, Sulen Sarioglu, Banu Sis, Ensari Guneli, Banu ...2006 Volume 210 Issue 3 Pages 239-245
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSBeneficial effects of glutamine on wound healing are well known. Parenchymal injuries in the lung cause air leakage that resolves with wound healing. We aimed to determine the effect of glutamine on the healing of lung injuries. Wistar albino female rats were randomized in three groups. One group (control, n = 7) received intraperitoneal injection of 0.9% sodium chloride (1.5 ml /day), while other group (GLN, n = 7) received glutamine (1.5 g/kg/day), beginning two days prior to the operation for total four days. After thoracotomy, a lung parenchymal lesion was made with a scalpel in the right upper lobe. Only thoracotomy was performed to sham group (n = 4). Air leakage was observed in the isolated lungs of control group, but not GLN and sham groups, at 5 cm H2O of positive airway pressure (p < 0.001). The threshold of positive airway pressure for air leakage was 4.85 ± 0.37 and 19.42 ± 4.54 cm H2O for control and GLN groups, respectively (p < 0.001). For measurement of collagen content in the healing parenchyma, digital images were processed to calculate the stained area percentage (SAP). SAP for immature collagen, a marker for wound healing, was 0.36 ± 0.18% and 1.48 ± 0.83% (p = 0.02) in control and GLN groups, respectively, but no significant difference was noted in SAP for mature collagen. The grade of inflammation was not significantly different between control and GLN groups. We conclude that glutamine enhances lung parenchymal healing by increasing immature collagen secretion.View full abstractDownload PDF (439K) -
Vjeran Nikolic-Heitzler, Filip Rabuzin, Franz Tatzber, Nada Vrkic, Nik ...2006 Volume 210 Issue 3 Pages 247-255
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSAcute myocardial infarction causing cardiac ischemia is responsible for the majority of cardiac related deaths. Medical interventions that ensure rapid reperfusion, such as percutaneous coronary intervention, are aimed to allow myocardial re-oxygenation. However, this generates reactive oxygen species, resembling ischemia-reperfusion type of injury based on oxidative stress. In the present study we monitored dynamic changes of total serum peroxides, total antioxidant capacity and soluble intercellular adhesion molecule-1 as well as the titer of antibodies against oxidized low-density lipoproteins in the blood during the convalescence period of 32 patients with acute myocardial infarction treated by percutaneous coronary intervention. Samples were taken at admittance and at two hours, four hours, three days and seven days following percutaneous coronary intervention. Total antioxidant capacity dropped to 82% (p < 0.05). The titer of antibodies against oxidized low-density lipoproteins transiently decreased within the first three days, and increased afterwards. The values of serum peroxides and soluble intercellular adhesion molecule-1 increased continuously in respect to the initial levels reaching the maximum at the time of release from hospital. These findings indicate a persistent oxidative stress that might be associated with intravascular inflammation in patients during convalescence and release from hospital.View full abstractDownload PDF (639K)
Case Reports
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Aysegul Ozakyol, Mahmut Kebapci2006 Volume 210 Issue 3 Pages 257-261
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSLiver hemangiomatosis is defined as extensive hemangioma in the liver. Although hemangioma is the most common hepatic tumor, diffuse hepatic hemangiomatosis is very rare. Most cases of hepatic hemangiomatosis are seen in infancy, but it is extremely rare in adults. This is the first report, showing the enhanced growth of diffuse hepatic hemangiomatosis after hormone replacement therapy. We report herein two unrelated women, 47 and 42 year-old, from different regions of Turkey, who admitted to hospital because of right abdominal pain with diffuse hepatic hemangiomatosis, developed after hormone replacement therapy for menopause. The patients were healthy, except for hemangiomatosis, and their physical examination, routine laboratory tests, and tumor marker levels were within normal limits. It should be noted that their abdominal ultrasonography was normal before hormone therapy, but ultrasonography on admission revealed numerous, ill defined, diffusely located liver nodules in both patients. Dynamic magnetic resonance imaging and scintigraphy have revealed that these lesions are compatible with hemangiomatosis. These results suggest that hepatic hemangiomatosis was induced by estrogen therapy. Consequently, hormone replacement therapy was discontinued, and the patients were followed up for 3 years. Their physical examination and blood chemistry, including liver enzymes, remained within normal range, and the follow-up examination with ultrasonography showed no changes in size of lesions. Because of the possible association of hemangioma with estrogen administration, decisions should be made carefully about estrogen therapy for patients who already have hemangioma, and the periodic ultrasonograpy examination should be planned to detect possible new growth of liver hemangiomatosis.View full abstractDownload PDF (532K) -
Tomayoshi Hayashi, Tsutomu Tagawa, Kazuto Ashizawa, Kuniko Abe, Naoe K ...2006 Volume 210 Issue 3 Pages 263-267
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSAn abnormal opacity was found incidentally on chest radiography in a 19-year-old Japanese man with lumbago. Chest computed tomography (CT) revealed a 55 × 40 mm well-defined mass with smooth margins in the lower lobe of the right lung (S6). Contrast-enhanced dynamic CT showed that the lesion was not enhanced, suggesting a cystic lesion, such as a bronchogenic cyst. However, contrast-enhanced dynamic magnetic resonance imaging (MRI) revealed enhancement of the lesion, which had a clear margin and homogenous consistency, suggesting a benign pulmonary solid tumor. Video-assisted thoracoscopic surgery, S6 segmentectomy, was performed, disclosing the lesion to be solid. Histopathologically, the tumor consists of spindle cells with ample eosinophilic cytoplasm arranged in an interlacing pattern. Immunohistochemical staining revealed positive desmin reactivity but was negative for α smooth muscle actin and HHF-35 (muscle specific actin), indicating atypical phenotypic differentiation. The lesion was accordingly diagnosed as leiomyosarcoma with low grade malignancy, and right lower lobectomy was performed. The patient has remained free from recurrence for 18 months without any additional chemotherapy or radiation therapy. Contrast-enhanced dynamic MRI should be carried out to facilitate accurate preoperative diagnosis and selection of the correct surgical plan.View full abstractDownload PDF (854K) -
Mitsuyoshi Mineta, Masahito Hatori, Hirotaka Sano, Masami Hosaka, Shoi ...2006 Volume 210 Issue 3 Pages 269-277
Published: 2006
Released on J-STAGE: November 01, 2006
JOURNAL FREE ACCESSCrow-Fukase syndrome (CFS) is a rare multi-system disorder, characterized by polyneuropathy, organomegaly, endocrinopathy, M-proteins, skin changes and anasarca, with or without myeloma. The pathophysiology, diagnosis, and treatment of CFS are controversial. CFS may be associated with the overproduction of vascular endothelial growth factor (VEGF). However, there have been no reports of monitoring the serum VEGF level after recurrence, to the best of our knowledge. We report a 54-year-old man with CFS presenting with a 3-year history of ascites, anasarca, weakness of the lower extremities, and plasmacytoma in the scapula. At the initial examination, the VEGF level was 1,590 pg/ml (the VEGF level of a healthy control, 78.4 ± 75.2 pg/ml). After initial treatment with chemotherapy and irradiation of the affected shoulder, the VEGF level decreased to 154 pg/ml and the symptoms disappeared. Twenty one months later, gate disturbance and anasarca recurred, and the VEGF level was over 2,000 pg/dl. After total scaplectomy, the VEGF level decreased to 730 pg/dl and the symptoms disappeared. The serum level of VEGF well correlated to the clinical course of the patient. In conclusion, measurement of the VEGF level is useful for diagnosing CFS and for monitoring its clinical course.View full abstractDownload PDF (710K)
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