The Tohoku Journal of Experimental Medicine
Online ISSN : 1349-3329
Print ISSN : 0040-8727
ISSN-L : 0040-8727
Volume 225, Issue 2
October
Displaying 1-10 of 10 articles from this issue
Perspectives
  • Kayo Sakamoto, Yoshitaka Minamidate, Takayuki Nagai
    2011 Volume 225 Issue 2 Pages 77-80
    Published: 2011
    Released on J-STAGE: September 08, 2011
    JOURNAL FREE ACCESS
    On March 11, 2011 at 14:46 (Friday), a massive magnitude-9.0 earthquake attacked large areas of northeastern Japan, including Sendai City. The huge earthquake generated catastrophic tsunamis, leading to unprecedented disasters in the seacoast areas of the Tohoku region (about 20,000 dead and missing persons). Upon this earthquake, in Tohoku University Medical Library, a 3-storey earthquake-resistant building, most of books fell down from bookshelves on the second and third floors, but the bookshelves remained steady because of the effective fixation. Many piles of fallen books blocked up the walkways and the narrow passages between the bookshelves; namely, books are easily transformed to dangerous weapons in a shaking building. Fortunately, all library staffs and users evacuated outside the building without even a scratch. Importantly, we were able to open the first floor of the Medical Library on March 14 (Monday), because the first floor has been used for the Learning Commons, with open space for group meetings. We thus provided students, medical staffs, and faculty members with the comfortable place during the early stage of the disasters. In fact, medical staffs and faculty members worked hard over weekend to deal with many patients and clear the post-quake confusions. Moreover, electricity, gas, or water supply was not yet restored in most areas of Sendai City. In the earthquake-prone zones, the Medical Library should function as a facility that not only enhances information gathering but also provides the place like an oasis of relaxation for students and medical staffs upon great earthquakes.
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Regular Contributions
  • Yoshitomo Morinaga, Katsunori Yanagihara, Nobuko Araki, Yosuke Harada, ...
    2011 Volume 225 Issue 2 Pages 81-84
    Published: 2011
    Released on J-STAGE: September 03, 2011
    JOURNAL FREE ACCESS
    The genus Aeromonas comprises flagellated gram-negative rods widely distributed in freshwater, estuarine and marine environments. Aeromonas species may cause a variety of illnesses in humans, such as enterocolitis and septicemia, especially in warmer tropical or subtropical environments. To recognize the characteristics of Aeromonas septicemia in Japan, we reviewed laboratory data and medical records in our hospital. During 11 years (from 2000 to 2010), Aeromonas septicemia was observed in seven patients involving six female subjects. Six patients were observed in summer or fall. The incidence of Aeromonas septicemia was about 0.07 per 1000 admissions, and two out of the seven patients died. All patients had underlying diseases such as malignancy (six patients) and choledocholithiasis (one patient). Two patients developed septicemia within two days after ingesting raw seafood. Five patients developed Aeromonas septicemia > 48 h after admission. Fever was present in all patients, and four out of the seven patients developed septic shock. All patients developed monomicrobial septicemia. A. hydrophila was isolated from five patients, and A. caviae and A. veronii biovar sobria were isolated from one patient each. Most antimicrobial agents had high activity against the isolated strains. However, a carbapenem-resistant strain appeared in one patient during treatment and led to death. Aeromonas septicemia is uncommon in temperate areas but can occur particularly in warm seasons. Immunocompromised conditions and recent ingestion of raw fish or shellfish are important characteristics of developing Aeromonas septicemia.
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  • Tetsuo Ono, Daisuke Katsura, Shunichiro Tsuji, Hiroko Yomo, Akiko Ishi ...
    2011 Volume 225 Issue 2 Pages 85-87
    Published: 2011
    Released on J-STAGE: September 03, 2011
    JOURNAL FREE ACCESS
    Sirenomelia is a rare congenital syndrome that is characterized by the anomalous development of the caudal region of the body. The anomalies include bilateral renal agenesis or dysgenesis and the absence of the sacrum and other vertebral defects. Sirenomelia is also known as “mermaid syndrome,” because of the one lower extremity. It is usually associated with severe oligohydramnios, and its prognosis is very poor due to pulmonary hypoplasia that is caused by severe oligohydramnios. The patient referred to our hospital at the gestational age of 27 weeks with fetal growth restriction and oligohydramnios. The estimated fetal body weight was 970 g (−4.9 S.D.). We could identify only one-side extremities, and could not identify kidneys by ultrasound examination. Because a single lower extremity and severe oligohydramnios are characteristics of the sirenomelia, we suspected sirenomelia. However, it could not be confirmed by ultrasound examination because of oligohydramnios. Therefore, we performed three-dimensional helical computed tomography (3D-CT), which is more accurate than ultrasound examinations for prenatal diagnosis of skeletal abnormalities. 3D-CT revealed an only one lower extremity. At 36 weeks and 5 days of gestation, the woman went into spontaneous labor and delivered an infant weighing 870 g. The infant has a single upper extremity and a single lower extremity. We provided supportive care for the neonate, who however died 1 hour 36 minutes after birth from severe respiratory distress. In summary, we report the correct diagnosis of sirenomelia with 3D-CT in the late second trimester.
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  • Naoaki Sato, Tetsuro Hoshiai, Takuya Ito, Kazunari Owada, Hiroshi Chis ...
    2011 Volume 225 Issue 2 Pages 89-94
    Published: 2011
    Released on J-STAGE: September 09, 2011
    JOURNAL FREE ACCESS
    Accurate assessment of fetal well-being is one of the most important tasks for obstetricians. It is still difficult to measure fetal electrocardiogram (ECG) during fetal movements. Recently, a new method, blind source separation with reference signals, was proposed for stable measurements. This method distinguishes weak signals from noisy mixed signals with little information about the sources. The aim of this study is to estimate the ability of this method for fetal ECG monitoring and to establish standard fetal ECG electrocardiogram values of normal singletons including during fetal movement. The subjects enrolled were 167 pregnant women with normal single pregnancy from 18- to 41-week gestation, who regularly visited Tohoku University Hospital, and 12 pregnant women with fetal abnormality. Fetal signals were successfully separated in 163 of 179 subjects at 91.1% success rate regardless of fetal movements. Time intervals of ECG (P, PR and QRS intervals and QTc) were measured. The standard curves of each interval through the gestational period were obtained. The data in active phase were compared to that in rest phase and the data obtained from normal and abnormal fetuses were investigated. PR intervals in the rest phase were prolonged compared to those in the active phase. Fetal ECG showed anomalous values such as PR interval or QTc prolongation in the abnormal fetuses. The fetal ECG was measured by the new method with or without fetal movements, and the standard fetal ECG values have been established. This study provides a foundation for further detailed clinical studies.
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  • Fangchun Shao, Ruifeng Zhang, Liangliang Don, Kejing Ying
    2011 Volume 225 Issue 2 Pages 95-101
    Published: 2011
    Released on J-STAGE: September 09, 2011
    JOURNAL FREE ACCESS
    Gelsolin-like actin-capping protein (CapG), a ubiquitous actin-binding protein, has been shown to play a critical role in regulating the migration ability of cells. In this study, we investigated CapG expression in lung cancer cell lines under hypoxia and evaluated the effect of CapG on the migration ability of these cells. We also analyzed the expression of CapG in a total of 75 patients with lung adenocarcinoma by immunohistochemistry. Our results showed that hypoxia increased the expression of CapG in the human lung cancer cell lines, A549 and H358. Knockdown of CapG expression with small interfering RNA led to a decrease in the migration ability of these cell lines. These results indicate that CapG expression is upregulated in lung cancer cell lines under hypoxia and that CapG may contribute to the migration ability of lung cancer cells. Moreover, the excised lung adenocarcinoma tissues showed significantly increased immunoreactivity for CapG, compared to the adjacent tumor-free tissues. Importantly, overexpression of CapG is significantly associated with male sex (χ2 = 5.195, p = 0.033) and lymph node metastasis (χ2 = 5.58, p = 0.021). Likewise, CapG overexpression was observed with advanced tumor stages (III and IV, 16/31), compared with early tumor stages (I and II, 14/44), but the difference was not statistically significant. These results suggest that overexpression of CapG may be associated with progression of lung adenocarcinoma. In conclusion, CapG may be a promising target for therapy and a potential biomarker for predicting the prognosis of lung adenocarcinoma.
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  • Mehmet Ali Kaygin, Özgür Dag, Mustafa Günes, Mutlu Seno ...
    2011 Volume 225 Issue 2 Pages 103-108
    Published: 2011
    Released on J-STAGE: September 10, 2011
    JOURNAL FREE ACCESS
    Artrial fibrillation is the most common arrhythmia that occurs after coronary bypass grafting operation with the rate of 30%. Atrial fibrillation is associated with hemodynamic instability, strokes, and prolonged hospital stay. Pericardial effusion is a risk factor for atrial fibrillation after cardiac surgery, and it occurs commonly in the posterior area during the post-operative period. The aim of this prospective study was to demonstrate the effectiveness of posterior pericardiotomy in reducing the incidence of atrial fibrillation. This prospective randomized study was carried out on 425 patients undergoing a coronary artery bypass grafting in our clinic between August 2009 and February 2011. There were 276 male patients and 149 female patients. These patients were randomly divided into two groups; posterior pericardial incision was performed in 213 patients (pericardiotomy group), while any pericardial incision was not performed in 212 patients (control group). Atrial fibrillation occurred more frequently in control group (62 patients, 14.6%), compared to the pericardiotomy group (14 patients, 3.1%; p < 0.0001). The incidences of early pericardial effusion, late pericardial effusion, and tamponade were also significantly higher in control group. Moreover, posterior pericardiotomy was associated with the decreases in the duration of stay in hospital and intensive care unit. In fact, the total hospital costs were lower in the pericardiotomy group. In conclusion, posterior pericardiotomy is an effective and safe technique that reduces early pericardial effusion, atrial fibrillation, length of stay in hospital, and hospital costs after the coronary artery bypasses grafting.
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  • Kuo-Cheng Lu, Hsin-Yi Yang, Yuh-Feng Lin, Sen-Yeong Kao, Ching-Huang L ...
    2011 Volume 225 Issue 2 Pages 109-116
    Published: 2011
    Released on J-STAGE: September 10, 2011
    JOURNAL FREE ACCESS
    Chronic kidney disease (CKD) is increasingly recognized as a global public health problem. As inflammatory processes and genetic factors are involved in the pathogenesis of CKD, we have investigated the potential genetic contribution of Toll-like receptor (TLR) gene polymorphisms in CKD. In a case-control association study, 149 CKD patients and 429 healthy controls were genotyped by real-time polymerase chain reaction. CKD patients were defined as kidney damage (albuminuria, proteinuria or hematuria) or glomerular filtration rate < 60 ml/min/1.73 m2 for 3 months or more. Single nucleotide polymorphisms (SNPs) at TLR-2 G2408A, TLR-4 A12874G and C13174T, and TLR-9 T-1237C, T-1486C, and G1635A were assessed, and linkage disequilibrium calculations and haplotype association analysis were undertaken. The functions of TLR-9 have been documented to recognize the viral and bacterial CpG DNA sequences, whereas detects microbe-derived peptidoglycan and lipopeptides and TLR-4 binds lipopolysaccharides. SNPs within the TLR genes may influence promoter activity, mRNA conformation and subcellular localization, and/or protein structure and function. Our results show that only the TLR-9 T-1237C and G1635A gene polymorphisms demonstrate an association with CKD (p = 0.002 and p = 0.04, respectively). The TLR-9 TCA haplotype at T-1237C, T-1486C, and G1635A was associated with a lower risk of CKD, whereas the TTA haplotype was associated with a higher risk of CKD. In the Han Chinese population, those who carry the C and A alleles at SNPs T-1237C and G1635A in the TLR-9 gene appear to be more susceptible to the development of CKD.
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  • Shojiro Watanabe, Tomomi Aizawa-Yashiro, Kazushi Tsuruga, Toru Takahas ...
    2011 Volume 225 Issue 2 Pages 117-121
    Published: 2011
    Released on J-STAGE: September 13, 2011
    JOURNAL FREE ACCESS
    Churg-Strauss syndrome (CSS), which is characterized by systemic small-vessel vasculitis of unknown etiology, is associated with a history of asthma. Although reports of CSS occurring in children are limited, effective treatment of pediatric patients with severe CSS remains challenging. A 10-year-old Japanese boy with a 6-month history of asthma treated with a leukotriene modifier, pranlukast, developed high fever, pleural infiltration, and pericarditis that were associated with marked hypereosinophilia (10,350 eosinophils/μl). Owing to his persistent high fever, mononeuritis multiplex, and severe abdominal pain that was refractory to prednisolone, his general condition progressively deteriorated thereafter. Although intravenous high-dose immunoglobulin administration was transiently effective for mononeuritis multiplex, the recurrent high fever and severe abdominal pain remained refractory. An endoscopic study revealed ulcerative lesions of the total colon. In this context, we treated the patient with an aggressive multidrug immunosuppressive regimen consisting of a high-dose methylprednisolone pulse plus short-course intravenous cyclophosphamide pulse therapy, followed by oral tacrolimus combined with prednisolone. After the rescue multidrug treatment, his severe clinical signs dramatically subsided within a short time, and the concomitantly administered prednisolone was successfully tapered without flare. At present, 12 months after the presentation, he is free from CSS signs or therapy-related toxicity except for an occasional mild asthma attack. Although further close observation should be needed to draw a long-term outcome in this patient, we believe that aggressive multidrug immunosuppressive treatment should be considered as an alternative rescue treatment in selected patients with severe CSS, even with pediatric-onset disease, that is refractory to prednisolone.
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  • Gunilla Wieslander, Nina Fabjan, Maja Vogrincic, Ivan Kreft, Christer ...
    2011 Volume 225 Issue 2 Pages 123-130
    Published: 2011
    Released on J-STAGE: September 17, 2011
    JOURNAL FREE ACCESS
    Buckwheat food is a good source of antioxidants, e.g. rutin, and other beneficial substances. Here we investigated the effects of the intake of common buckwheat (low rutin content) and tartary buckwheat cookies (high rutin content) on selected clinical markers. A double blind crossover study was performed among female day-care centre staffs (N = 62) from five day-care centres. Participants were randomly divided into two groups. The first group initially consumed four common buckwheat cookies per day (16.5 mg rutin equivalents/day) for two weeks, while the second group consumed four tartary buckwheat cookies per day (359.7 mg rutin equivalents/day). Then the groups switched their type of cookies and consumed them for another two weeks. We monitored selected clinical markers related to cardiovascular disease and lower airway inflammation, lung function, and subjective breathing difficulties in the staffs. Intake of tartary buckwheat cookies reduced the serum level of myeloperoxidase (MPO) by a factor 0.84 (p = 0.02). When grouping the two types of buckwheat cookies together, there was a reduction of total serum cholesterol (p < 0.001) and HDL-cholesterol (p < 0.001) during the study period, with improved lung vital capacity (p < 0.001). The degree of reduction in total and HDL cholesterol levels was similar in staffs with low and high body mass index (cut off 25). In conclusion, intake of tartary buckwheat cookies with high level of the antioxidant rutin may reduce levels of MPO, an indicator of inflammation. Moreover, intake of both types of buckwheat cookies may lower cholesterol levels.
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  • Wanting Wang, Yutaka Kagaya, Yasuhide Asaumi, Shigefumi Fukui, Morihik ...
    2011 Volume 225 Issue 2 Pages 131-143
    Published: 2011
    Released on J-STAGE: September 21, 2011
    JOURNAL FREE ACCESS
    Chronic left ventricular (LV) pressure overload induced by hypertension is one of the most common causes of heart failure. Earlier reports have shown the cardioprotective effects of erythropoietin (EPO). In the present study, we tested the hypothesis that recombinant human EPO exerts a protective effect against pressure-overload induced LV remodeling. Mice subjected to transverse aortic constriction (TAC) (n = 70) were randomly assigned to the treatment with phosphate buffer solution (PBS) (TAC-PBS) or EPO (2,000 U/kg twice a week) (TAC-EPO). At 8 weeks after TAC, LV weight was comparably increased in both TAC groups compared with sham-operated mice (Sham) (both P < 0.001). The treatment with EPO improved the survival of TAC mice as compared with treatment with PBS (80 vs. 47%, P < 0.01), which was associated with reductions in the extent of myocardial fibrosis and the number of TUNEL positive cardiomyocytes (both P < 0.05). Echocardiography revealed that TAC increased LV chamber diameter and decreased LV fractional shortening compared with Sham (P < 0.05), which was ameliorated by the treatment with EPO (P < 0.05). In TAC-EPO as compared to TAC-PBS, phosphorylation of STAT3, Akt and eNOS was all increased, while phosphorylation of p38 was decreased (all P < 0.05). Importantly, the expression level of VEGF and the capillary density in LV myocardium were similar among the 3 groups. These results suggest that recombinant human EPO ameliorates the cardiac remodeling and the premature death associated with chronic LV pressure overload through the mechanisms independent of angiogenesis.
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