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Volume 230 (2013)
- Issue 4 Pages 191-
- Issue 3 Pages 129-
- Issue 2 Pages 67-
- Issue 1 Pages 1-
Volume 230, Issue 3
July
Displaying 1-8 of 8 articles from this issue
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Case
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Soutoku Someya, Chikashi Shibata, Naoki Tanaka, Katsuyoshi Kudoh, Take ...Article type: Case
2013 Volume 230 Issue 3 Pages 129-132
Published: 2013
Released on J-STAGE: June 27, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLReflux gastroesophagitis is a common postgastrectomy complication after proximal gastrectomy, and conservative treatments including protease inhibitors and proton pump inhibitors are effective in most patients. Here we report a patient with severe reflux gastroesophagitis after proximal gastrectomy, in whom surgical treatment of duodenal switch was effective. An 80-year-old man complained of intractable heartburn, anorexia, and body weight loss after having undergone proximal gastrectomy, with reconstruction by esophagogastrostomy with valvuloplasty and pyloroplasty, for early gastric cancer 14 months before referral to our department. Oral administration of protease inhibitors and proton pump inhibitors was ineffective. Laboratory evaluation showed poor nutritional status. On endoscopic examination, we noted the redness, bleeding, and multiple erosions in the esophagus and the gastric remnant. He was diagnosed to have severe gastroesophagitis due to reflux of duodenal juice into the gastric remnant and esophagus. We performed duodenal switch to divert duodenal juice from the gastric remnant and esophagus; the duodenum was transected 2 cm distal to the pylorus, the duodenal distal end was closed, and a 50-cm Roux limb from the proximal jejunum was anastomosed to the proximal end of the duodenum. The heartburn disappeared postoperatively, and endoscopic examination revealed marked improvement of the reflux gastroesophagitis. One year postoperatively, the patient is free from symptoms including heartburn. His body weight increased, and laboratory data showed improvement in nutritional status. In conclusion, the duodenal switch may be surgical treatment of choice for intractable reflux gastroesophagitis after proximal gastrectomy.View full abstractDownload PDF (682K) Full view HTML
Regular Contributions
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Jia Yin, Tian-Ming Lü, Guang Qiu, Rui-Yu Huang, Min Fang, Yuan-Yuan Wa ...Article type: Regular Contributions
2013 Volume 230 Issue 3 Pages 133-139
Published: 2013
Released on J-STAGE: June 28, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLIntracerebral hemorrhage (ICH) is a devastating disorder associated with high morbidity and mortality. ICH results in the formation of hematoma that affects not only the primary site of injury but also the remote regions. In fact, hematoma can extend via perivascular spaces (also called Virchow–Robin spaces, VRS) and perineurium in an animal model of ICH. In the present study, we used magnetic resonance imaging (MRI) with susceptibility-weighted imaging (SWI) to investigate the characteristics of the perivascular and perineural extensions of hematomas in patients with ICH. A total of 20 ICH patients without secondary subarachnoid and secondary intraventricular hemorrhages were recruited. Brain MRI scans, including SWI, T1, and T2-weighted images, were performed between 17 h to 7 days after the onset of ICH. MRI with SWI revealed that paramagnetic substances spread along the VRS or the perineurium. Such distribution could cause the formation of cerebral microbleeds (CMBs). However, the distribution of remote hemorrhagic lesions varied, depending on the size and location of the original hematoma. The unenhanced CT scans of the 20 patients did not show any hyperdensity around the blood vessels and nerve tracts outside the hematoma. These results indicate the perivascular and perineural extensions of hematomas in patients with ICH, which is formed by the leakage of the original hematoma via the VRS or perineurium. We also provide a new explanation for the series of pathological processes involved in ICH, including the remote effects of hematoma and the formation of CMBs in patients with ICH.View full abstractDownload PDF (942K) Full view HTML -
Tomomi Kiyama, Satoru Okada, Yukinori Tanaka, Siyoung Kim, Kanan Bando ...Article type: Regular Contributions
2013 Volume 230 Issue 3 Pages 141-149
Published: 2013
Released on J-STAGE: July 02, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLDiseases involving enhanced bone-resorption (e.g., osteoporosis) are widely treated with bisphosphonates (BPs). BPs are of two types: the nitrogen-containing BPs (N-BPs) and the non-nitrogen-containing BPs (non-N-BPs). N-BPs have much stronger anti-bone-resorptive effects than non-N-BPs, and N-BPs can exert inflammatory and necrotic effects, including osteonecrosis of jawbones. Minodronate, an N-BP, was approved in 2009 in Japan for osteoporosis. Its anti-bone-resorptive effect is comparable to that of zoledronate, the N-BP with the strongest anti- bone-resorptive effect and the highest risk of side effects yet reported. Unlike other N-BPs, minodronate has an analgesic effect, and no serious side effects have been documented. Here, to examine whether minodronate lacks inflammatory and/or necrotic effects, we used mice (since the N-BPs tested so far induce such effects in mice with potencies that parallel those reported in humans). To facilitate comparison with previous studies, we gave a single systemic (intraperitoneal) or local (ear pinna) injection of minodronate (or another N-BP). We measured the systemic responses (weight of thoracic exudate, number of inflammatory cells in the peritoneal cavity, and spleen weight) or local responses (area of inflamed skin and incidence of necrosis). Anti-bone-resorptive effects were evaluated by X-ray analysis of tibias following intraperitoneal injection. Minodronate's anti-bone-resorptive effect and its inflammatory and necrotic effects were as great as, or greater than those of zoledronate. Moreover, in cultured human periodontal ligament cells, the cytotoxicity of minodronate was significantly greater than that of zoledronate. These results suggest that caution may be needed with minodronate in clinical use, as with other N-BPs.View full abstractDownload PDF (514K) Full view HTML -
Takashi Takeda, Mari Tadakawa, Shoko Koga, Satoru Nagase, Nobuo Yaegas ...Article type: Regular Contributions
2013 Volume 230 Issue 3 Pages 151-154
Published: 2013
Released on J-STAGE: July 09, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLOn March 11, 2011, the Great East-Japan Earthquake occurred and a massive tsunami hit the northeastern coast of Japan. Catastrophic disasters such as earthquakes and war cause tremendous damage, not only physically but also mentally. Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs in the aftermath of a traumatic event. Premenstrual syndrome (PMS) is a cluster of psychological and somatic symptoms that are limited to the late luteal phase of the menstrual cycle. Premenstrual dysphoric disorder (PMDD) is considered a severe form of PMS. To determine the relationship between premenstrual symptoms and natural disaster-induced PTSD among Japanese adolescent girls, we conducted a cross-sectional study. Overall, 1489 high school students who belong to two high schools in Sendai, the largest city in northeastern Japan, were assessed 9 months after the earthquake. These schools are located inland, far from the seashore, and were not damaged by the tsunami. Premenstrual symptoms were assessed using the Premenstrual Symptoms Questionnaire, and PTSD symptoms were assessed using the Japanese-language version of Impact of Event Scale-Revised, which is a widely used self-assessment questionnaire about PTSD symptoms. We analyzed the data of 1,180 girls who completed the questionnaires and 118 girls (10.0%) were classified as having PTSD. The prevalence rates of PMDD and moderate to severe PMS increased according to the comorbidity of PTSD (p < 0.001), showing a correlation between the severity of PMS/PMDD and natural disaster-induced PTSD. The comorbidity of PMS/PMDD and PTSD may complicate the follow-up of both conditions.View full abstractDownload PDF (452K) Full view HTML
Review
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Hiroshi Fukuda, Kazuo Kubota, Taiju MatsuzawaArticle type: Review
2013 Volume 230 Issue 3 Pages 155-169
Published: 2013
Released on J-STAGE: July 24, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLPositron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG), a glucose analog, is widely used throughout the world as an indispensable imaging modality for the management of cancer treatment. This article reviews the pioneering achievements of PET in oncology with a focus on the development of PET that occurred from 1980 through the early-1990s. 18F-FDG was first applied for imaging of animal tumors in 1980 and for brain tumor imaging clinically in 1982. 18F-FDG enabled to visualize liver metastasis as clear positive image that could not be obtained by conventional nuclear imaging. Subsequently, 18F-FDG was used for imaging various cancers, such as lung, pancreas, colorectal and hepatoma. 11C-L-methionine (11C-MET) that reflects amino acid transport of cancers has an advantage that its uptake is lower in the brain and inflammatory tissue compared to 18F-FDG, and was first applied for imaging lung cancer and brain tumor. 18F-FDG and 11C-MET were proved to be sensitive tracers that can be used to objectively evaluate the effectiveness of cancer treatment. The diagnostic accuracy of PET, which is critical in clinical practice, was evaluated for the differential diagnosis of malignant and benign lung nodules using 18F-FDG or 11C-MET. In addition to 18F-FDG and 11C-MET, many radiopharmaceuticals were developed, such as 18F-labled thymidine analogs for evaluating proliferative activity, 18F-fluoromisonidazole for imaging of hypoxia, and 18F-fluorodeoxygalactose for evaluating liver-specific galactose metabolism and for imaging of hepatoma that retains galactose metabolic activity. These early efforts and achievements have greatly contributed to the development and clinical application of 18F-FDG PET in oncology.View full abstractDownload PDF (1057K) Full view HTML
Regular Contributions
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Cagri Sakalar, Esra Gurbuz, Nihat Kalay, Mehmet Gungor KayaArticle type: Regular Contributions
2013 Volume 230 Issue 3 Pages 171-176
Published: 2013
Released on J-STAGE: July 13, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLSingle Nucleotide Polymorphisms (SNPs) can genetically predispose individuals for certain diseases and therefore are of clinical significance. Myocardial infarction (MI) was investigated in large genetic association studies revealing novel SNPs associated with MI. rs4977574 is a non-protein coding SNP (A>G) that is located in proximity of cyclin-dependent kinase inhibitor 2A and B genes on chromosome 9p21.3. rs4977574 has been recently found to be associated with the early-onset of MI, and rs4977574 is characterized by a guanine nucleotide (G) instead of an adenine nucleotide (A). rs4977574 has been reported to increase the risk for MI by 28%. In this study, we developed a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for detecting rs4977574 in Turkish population that consisted of 28 controls without previous MI record and 44 patients with MI. An intergenic genomic region containing the target SNP was amplified by PCR using patient’s genomic DNA. Amplified DNA fragments were digested with a restriction enzyme, HhaI that cuts the amplified sequence if only the sequence has GCGC that carries rs4977574. After digestion with HhaI, DNA fragments were visualized in order to detect genotypes. PCR-RFLP revealed that the frequency of rs4977574, the MI-associated allele (G), was 56.8% (25/44) in patients with MI and 33.9% (9.5/28) in controls; the frequency of rs4977574 in patients with MI was significantly higher compared to controls (P = 0.027). Importantly, for the first time in this study, we have developed a novel PCR-RFLP method to detect the presence of rs4977574.View full abstractDownload PDF (512K) Full view HTML -
Yorihide Yanagita, Hideaki Senjyu, Masaharu Asai, Takako Tanaka, Yudai ...Article type: Regular Contributions
2013 Volume 230 Issue 3 Pages 177-184
Published: 2013
Released on J-STAGE: July 18, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLLung function is one of the strongest determinants of cardiopulmonary health and longevity. Long-term exposure to air pollution has been associated with decreased lung function. We undertook a retrospective study to compare the long-term consequences of air pollution in two areas of Japan: Mizushima, Okayama Prefecture and Kitakyushu, Fukuoka Prefecture. Industrialization began in Mizushima in the 1940s, whereas it began in Kitakyushu in the early 1900s. In Kitakyushu, levels of nitrogen dioxide have been higher compared to the Mizushima area. The subjects comprised 623 officially acknowledged victims of pollution-related illness (489 from Mizushima and 134 from Kitakyushu). All subjects were lifetime non-smokers and aged 65 years or older at the time of their last medical examination in 2009. Demographic data including diagnosed lung diseases and lung function at the time of certification assessment performed between 1973 and 1988 were obtained. The subjects from Kitakyushu were significantly younger (47.1 vs. 51.0 years, p < 0.001) and a higher percentage had asthma (91.2 vs. 36.8%, p < 0.001) compared to those from Mizushima. Furthermore, all measures of lung function were significantly lower in Kitakyushu group at the time of the certification assessment (p < 0.001) and at the follow-up (p < 0.001). However, no significant differences were observed in the annual mean decline in lung function between the two groups, despite the overall decrease in air pollution. In conclusion, the normal lung function is not restored even after improvement of air pollution. It is essential for every city to prevent air pollution.View full abstractDownload PDF (580K) Full view HTML -
Hiroko Aikawa, Michiru NoroArticle type: Regular Contributions
2013 Volume 230 Issue 3 Pages 185-190
Published: 2013
Released on J-STAGE: July 24, 2013
JOURNAL FREE ACCESS FULL-TEXT HTMLImprovement in neonatal care has led to increased survival rates of very premature infants. Accordingly, there are now more extremely preterm infants who are at risk of developing retinopathy of prematurity (ROP). ROP is a disorder of low birth-weight preterm infants and may lead to blindness. However, the prevalence of ROP varies globally, depending on different neonatal and ophthalmic care. Therefore, we studied the incidence and progression of ROP in extremely preterm infants in Japan. In addition, we investigated the characteristics and the clinical courses of the infants who progressed to sight-threatening ROP. A total of 3,154 infants were born at the Japanese Red Cross Sendai Hospital between 2009 and 2011, including 53 live-born infants born before 28 weeks’ gestation. Two extremely preterm infants died before the first ROP examination. Among the survived 51 infants (the birth-weight ranged from 309 to 1,354 g, mean 779 g), 36 infants (70.6%) developed ROP: 18 infants with mild ROP and 18 infants with severe ROP. Eight out of the 51 infants (15.7%) underwent laser treatment. None of the infants born at older than 27 weeks 0 day of gestation required any treatment for ROP. In conclusion, most of extremely preterm infants develop some degree of ROP. However, in the majority of these infants the ROP never progressed beyond mild disease and resolved spontaneously without treatment. Sight-threatening ROP was rare. The present study clarifies the natural history of ROP in extremely preterm infants with active perinatal care.View full abstractDownload PDF (345K) Full view HTML
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