The Tohoku Journal of Experimental Medicine
Online ISSN : 1349-3329
Print ISSN : 0040-8727
ISSN-L : 0040-8727
219 巻, 3 号
November
選択された号の論文の11件中1~11を表示しています
Invited Review for the 90th Anniversary
  • Leonard P Rybak, Debashree Mukherjea, Sarvesh Jajoo, Vickram Ramkumar
    2009 年 219 巻 3 号 p. 177-186
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Cisplatin is a chemotherapeutic agent that is widely used to treat a variety of malignant tumors. Serious dose-limiting side effects like ototoxicity, nephrotoxicity and neurotoxicity occur with the use of this agent. This review summarizes recent important clinical and experimental investigations of cisplatin ototoxicity. It also discusses the utility of protective agents employed in patients and in experimental animals. The future strategies for limiting cisplatin ototoxicity will need to avoid interference with the therapeutic effect of cisplatin in order to enhance the quality of life of patients receiving this important anti-tumor agent.
Regular Contributions
  • Emre Tascilar, Mehmet Yokusoglu, Rusen Dundaroz, Oben Baysan, Sami Ozt ...
    2009 年 219 巻 3 号 p. 187-191
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    The involvement of autonomic imbalance has been reported in the pathogenesis of hypersensitivity reactions. Allergic diseases are more frequent in children and some of predisposing factors may be changed according to the increasing age, but the involvement of autonomic imbalance has not been investigated in pediatric population. In this cross-sectional, case-control study, we evaluated the autonomic system by measuring heart rate variability (HRV) in pediatric patients with allergic rhinitis. Thirty-five pediatric patients with allergic rhinitis and 36 healthy children (mean age 11 ± 2.7, and 12 ± 3 years, respectively) were enrolled in the study. Age and gender were not different between the groups. The diagnosis of allergic rhinitis was based on the history, symptoms, and skin prick tests. Participants with acute infection, nasal polyposis, bronchial asthma, and any other medical problems, assessed by history, physical examination and routine laboratory tests, were excluded. Twenty-four hour ambulatory electrocardiographic recordings were obtained, and the time domain and frequency domain indices of HRV were analyzed. We found significant increase in calculated HRV variables in children with allergic rhinitis compared to controls, which reflect parasympathetic tones, such as number of R-R intervals exceeding 50 ms, root mean square of successive differences between normal sinus R-R intervals, the percentage of difference between adjacent normal R-R intervals, and high frequency. These results indicate that HRV is increased, which implies sympathetic withdrawal and parasympathetic predominance. We propose that autonomic imbalance may be involved in the pathophysiology of allergic rhinitis in pediatric patients.
  • Marios-Konstantinos Tasoulis, Olga Livaditi, Michalis Stamatakos, Char ...
    2009 年 219 巻 3 号 p. 193-199
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Increased levels of cytokines or reactive oxygen species (ROS) in the bronchoalveolar lavage (BAL) fluid are associated with acute lung injury after ischemia/reperfusion. We investigated the correlation of these markers with the degree of lung injury in a rabbit model of hemorrhagic shock. Rabbits, maintained by mechanical ventilation, were left untreated (control) or subjected to hemorrhagic shock by withdrawing blood (n = 12 for each group). Shock animals were re-infused their shed blood for resuscitation. At the end of the experiment, BAL fluid was recovered, in which parameters of oxidative stress and cytokines were measured. Macrophages and malondialdehyde levels were increased (p = 0.043 and p = 0.003, respectively), and total antioxidant capacity (TAC) was decreased in the shock animals compared with control (p = 0.009). Production of ROS was significantly enhanced in shock animals compared with controls (p < 0.001). BAL fluid levels of tumor necrosis factor-α, interleukin (IL)-1β and IL-6 were higher in shock rabbits by more than twofold (p < 0.001 for each). Shock animals also showed higher histopathological scores that represent severe tissue damage than controls (p = 0.022). Numbers of macrophages and levels of ROS and TAC were correlated with the degree of lung injury (p = 0.006, p = 0.02, and p = 0.04, respectively), but not cytokines. Therefore, resuscitation from hemorrhagic shock results in acute lung injury, with enhanced pulmonary oxidative and inflammatory responses. In conclusion, ROS in the BAL fluid are good markers that predict lung injury following hemorrhagic shock and resuscitation.
  • Vedat Davutoglu, Suat Zengin, Ibrahim Sari, Cuma Yildirim, Behcet Al, ...
    2009 年 219 巻 3 号 p. 201-206
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Being the most common cause of death from poisoning worldwide, cardiovascular manifestations of acute carbon monoxide (CO) poisoning have been subject of various studies but current evidence about effects of chronic CO exposure on atherosclerosis is limited which is very common. We aimed to investigate association of chronic CO exposure with atherosclerosis by measuring carotid intima-media thickness (CIMT) and high-sensitivity C-reactive protein (hs-CRP). Forty healthy male non-smoker indoor barbecue workers (mean age; 33.0 ± 9.0 years) working in different restaurants for at least three years and 48 age-matched healthy men (mean age; 34.3 ± 6.6 years) enrolled in the study. Clinical characteristics of indoor barbecue workers and control group were comparable in terms of body mass index, blood pressure, and lipid profile. However, carboxyhemoglobin (COHb) (6.4 ± 1.5% vs. 2.0 ± 1.1%), hs-CRP (2.7 ± 2.0 mg/L vs. 1.1 ± 0.8 mg/L) and CIMT (1.1 ± 0.3 mm vs. 0.9 ± 0.1 mm) were higher in indoor barbecue workers (p < 0.001 for each). In Pearson correlation analysis, CIMT was correlated with COHb concentration (r = 0.635, p < 0.001) and hs-CRP level (r = 0.466, p < 0.001). Among indoor barbecue workers, the years worked (years exposed to CO) are correlated with COHb, hs-CRP and CIMT. In multivariate analysis, COHb concentration is the only independent predictor of CIMT (β = 0.571, p < 0.001). The increased CIMT and hs-CRP in indoor barbecue workers suggest that chronic CO exposure may increase the risk of atherosclerotic cardiovascular events.
  • Shu-Hui Liu, Tzung-Han Li, Yun-Lian Lin, Yu-Jen Shiao, Shiao-Chi Wu, C ...
    2009 年 219 巻 3 号 p. 207-214
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Healthy physicians are critical to the quality of care for patients. There is a common trend in Chinese societies seeking for medical treatments from Chinese medicine physicians. However, there are limited studies that investigated the health status for the Chinese medicine physicians. In this report, we used National Health Insurance Research database of Taiwan between 1998 and 2002 to compare the morbidities between Chinese medicine physicians and general population. The number of Chinese medicine physicians in this study is 6,143 (5,036 males with the mean age of 40.47 years and 1,107 females with the mean age of 36.24 years), and the number of the referent subjects is 24,576, randomly selected from the database matching by sex and age. We found that the Chinese medicine physicians have lower all-causes morbidity (86% vs. 95%, p < 0.001), except that female Chinese medicine physicians had significantly higher rates of complications of pregnancy, childbirth, and puerperium than female population. Such an exception might reflect a consequence of maternal age effect. The odds ratio between all causes and two comparison groups was 0.36 (95% CI: 0.33, 0.40), indicating that the Chinese medicine physicians have much lower disease risk. Higher education, better socioeconomic status, and good knowledge in medicine (possible self-treatment) may explain the observed differences. Among the Chinese medicine physicians, the morbidity rate of male subjects is lower than the female subjects (85.9% vs. 91.4%, p < 0.001). This study will provide the helpful information in guiding future investigations about health hazards to the practice of Chinese medicine.
  • Junji Nishiyama, Masaaki Ueki, Takehiko Asaga, Kousuke Chujo, Nobuhiro ...
    2009 年 219 巻 3 号 p. 215-222
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Hyperglycemia amplifies the inflammatory state after ischemia/reperfusion (I/R), and activated neutrophils have been implicated in the development of I/R-induced renal injuries. D-ribose is a naturally occurring monosaccharide found in all living cells. In this study, we examined whether D-ribose attenuates I/R-induced renal injury by reducing neutrophil activation in rats with transient hyperglycemia. Male Wistar rats were divided into sham (n = 24), control (n = 64), and D-ribose (n = 32) groups. Rats received intraperitoneal injection of glucose (3 g/kg) 30 min before induction of ischemia to induce transient hyperglycemia. Anesthetized rats underwent right nephrectomy and subsequent occlusion of the left renal artery and vein for 45 min. D-ribose (400 mg/kg) was intravenously administered 30 min before induction of ischemia. D-ribose significantly reduced the degree of the I/R-induced increases in renal concentrations of cytokine-induced neutrophil chemoattractant-1 (a chemotactic factor for the activation of neutrophils and chemotaxis to the site of injury) and myeloperoxidase (an indicator of neutrophils infiltration). D-ribose also reduced the I/R-induced increases in serum levels of blood urea nitrogen and creatinine, and improved histological changes, including acute tubular necrosis in the corticomedullary junction fields. These results indicate that D-ribose reduces the I/R-induced acute renal injury in rats with transient hyperglycemia, probably by reducing neutrophil activation. D-ribose might thus be useful for surgical procedures, such as renal transplant surgery, under hyperglycemia.
  • Young Dae Kwon, Chang Hoon You, Eun-Hwan Oh, Sungwook Kang
    2009 年 219 巻 3 号 p. 223-230
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Periodic health examinations (PHEs) are prevalent in Korea. While some people frequently use public PHEs, others use private PHEs with high fees. This study examined the determinants of the use of public and private PHEs using a multinomial logit model. We used the data from the Korean Longitudinal Study of Aging (KLoSA) Wave I conducted in 2006. The KLoSA was a national longitudinal study of a representative sample of individuals (n = 10,253) aged 45 years or older. The mean age of the sample was 61.6 years; 77.8% of subjects were married and 37.5% had at least a high school education. The most frequent type of PHE usage was public PHEs only (38.9%), followed by private PHEs only (7.3%) and both public and private PHEs (6.5%). This study found that subjects who lived in rural areas or who were employed were significantly more likely to use public PHEs because of many public health facilities in rural area and mandatory public PHEs for employees. Those who used private PHEs only were educated, wealthy, or unhealthy, because private PHEs required out-of-pocket payments and provided higher quality services. Those who used both types of PHE had a high socio-economic status or a bad health status. The authors suggest that policy makers pay attention to the use of public PHEs among populations with lower socio-economic status. As for the group of subjects who use both types of PHE, their overutilization of PHEs must be reduced through cooperation between the public and private PHEs.
  • Yasushi Kudo, Mitsushi Okada, Masashi Tsunoda, Toshihiko Satoh, Yoshih ...
    2009 年 219 巻 3 号 p. 231-241
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Japanese law stipulates that workers undergo worksite health checkups. If workers do not use their results of those checkups in their daily health management, the merit of this law will not be realized. Therefore, it is important to identify the predictors to improve their motivation to use the results of health checkups. We investigated those predictors by using a questionnaire survey. Multiple linear regression analysis was conducted for 1,791 subjects (1,530 males and 261 females) at a Japanese manufacturing plant. The average age of enrolled subjects was 42.0 years (standard deviation [S.D.], 13.4 years). The average age of male subjects was 42.3 (S.D., 13.8) years and that of the female subjects was 39.9 (S.D., 10.4) years. The results revealed that as workers advanced in age, they maintained their motivation more to use those results. Women maintained their motivation more than men. Workers who believe that their health depends on the influence from physicians and healthcare providers in hospitals felt motivated. Workers who realized the effectiveness of those checkups to maintain good health, who knew how to adopt an appropriate lifestyle, and who were given consultations with physicians when they received their health checkups, felt motivated. Regarding the healthcare organizations' and occupational health staffs' responsibilities, only detecting illness early is not sufficient. Those healthcare providers must value more primary prevention. Our findings can be applied to various occupational health activities, including health consultations, health education seminars, and providing appropriate instruction on how to interpret the results of the worksite health checkups.
  • Shi-Min Yuan, Hai-Wei Wu, Hua Jing
    2009 年 219 巻 3 号 p. 243-250
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Patients with combined carotid and coronary arterial diseases pose a high risk of cerebrovascular events, and the treatment of choice with either a simultaneous or a staged surgical procedure remains controversial. The literature of combined carotid and coronary arterial diseases of a recent decade in English was retrieved. Totally 41,901 patients undergoing simultaneous or staged carotid and coronary procedures from 53 reports were included. As a result, carotid endarterectomy plus coronary artery bypass remained the most commonly used procedure for the intervention of combined carotid artery stenosis and coronary artery disease, and was associated with higher incidences of perioperative transient ischemic attack, stroke and hospital mortality, but with less perioperative myocardial infarction comparing with the staged procedures. Patients with a simultaneous carotid endarterectomy and coronary artery bypass were generally related more to an advanced atherosclerotic coronary artery disease, so that a pure comparison between the two strategies was not always possible. To compare the efficacy of different surgical methods for combined carotid and coronary arterial diseases is of pronounced importance. The new hybrid approach consisting of the simultaneous carotid artery stenting and subsequent on-pump coronary artery bypass can be a safe approach, with the aim to reduce the surgical trauma as compared to surgical procedures, and to reduce the risk of myocardial infarction in the interval period required for the staged operations. Thus, for patients with combined carotid artery stenosis and coronary artery disease, the simultaneous surgical procedure, rather than the staged procedure, is recommended.
  • Yasushi Kotani, Mitsuru Shiota, Masahiko Umemoto, Hidekatsu Nakai, Tak ...
    2009 年 219 巻 3 号 p. 251-255
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    Acute eosinophilic pneumonia is a disease of unknown etiology characterized by peripheral blood eosinophilia and pulmonary infiltrative shadows on radiography. Acute eosinophilic pneumonia follows an acute course within 1 week and the symptoms include fever, dyspnea, and cough. Acute eosinophilic pneumonia has a good prognosis and responds promptly to steroid treatments. Here we present a critical case of acute eosinophilic pneumonia during pregnancy, which led to emergency cesarean section because of fetal distress. The patient was a 24-year-old gravida at 34 + 6 weeks gestation, with fever, and an elevated CRP; thus antibiotics were started. At 35 + 1 weeks gestation, cardiotocography (CTG) revealed late decelerations, fetal distress was diagnosed, and an emergency cesarean section was performed. The pre-operative maternal blood gas analysis showed a low PaO2 of 55.7 mmHg and a chest X-ray revealed ground-glass opacities and pleural effusions in the middle lower lung fields bilaterally. A male of 2,336 g in weight was delivered with Apgar scores of 8 and 8 at 1 and 5 min, respectively. Due to the clinical progress and the elevated eosinophil count (532/μl) in the peripheral blood differential leukocyte count, the diagnosis of acute eosinophilic pneumonia was made. With the administration of oxygen and steroid treatment, the patient's general condition recovered. Both the mother and the baby were discharged on the 10th post-operative day and the patient has been leading a normal life with no recurrence for > 3 years since delivery.
  • Isamu Sugawara, Tadashi Udagawa, Toshiaki Aoki, Satoru Mizuno
    2009 年 219 巻 3 号 p. 257-262
    発行日: 2009年
    公開日: 2009/10/23
    ジャーナル フリー
    There exists latent tuberculosis, in which small numbers of tubercle bacilli remain viable in the host without visible granulomatous lesions. As few data exist on the mechanisms of latent tuberculosis, it is important to examine latent tuberculosis in terms of pathogenesis and efficacy of chemotherapy. As a first step, we used green fluorescent protein (GFP)-introduced H37Rv Mycobacterium tuberculosis to establish latent tuberculosis in the guinea pig that provides one of the best animal models of tuberculosis. We inoculated the guinea pigs subcutaneously with 100 or 1,000 colony-forming unit (CFU) of tubercle bacilli. During the 300-day follow-up period after infection, there were no clinical signs of disease, suggesting a lack of visible granulomatous lesions. In fact, upon necropsy, no macroscopic tuberculous lesions were recognized, but histopathological examination of the lung, spleen and liver revealed microgranulomas consisting of epithelioid macrophages and lymphocytes without central necrosis. Importantly, photon imaging visualized granulomatous lesions corresponding to these histologically apparent microgranulomas. Tuberculin skin testing of infected guinea pigs showed strong positivity (≥ 10 mm induration) until the end of the experiments. Real-time PCR analysis showed a significant increase in the expression levels of interferon-γ, tumor necrosis factor-α, interleukin-12, and inducible nitric oxide synthase mRNAs in infected lung tissues after 300 days (P < 0.01). As human samples are hardly available to study latent tuberculosis, our guinea pig model would be useful for examining the pathogenesis and molecular mechanisms of latent tuberculosis as well as for monitoring the results of chemotherapy with green fluorescence emission of tubercle bacilli.
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