The Tohoku Journal of Experimental Medicine
Online ISSN : 1349-3329
Print ISSN : 0040-8727
ISSN-L : 0040-8727
232 巻, 3 号
March
選択された号の論文の10件中1~10を表示しています
Regular Contribution
  • Grazyna Iwanowicz-Palus, Ewa Rzonca, Agnieszka Bien, Anna Wloszczak-Sz ...
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 155-162
    発行日: 2014年
    公開日: 2014/03/04
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    The loss of a baby is a traumatic event, irrespective of the duration of pregnancy. In the present study, we attempted to recognize the opinions of women after miscarriage that needed assistance and support from the medical staff during hospitalization. The study was conducted during the period from January to June 2012 and included 303 women who miscarried and used medical care in the Lublin Region (Poland). The method of a diagnostic survey was applied using a questionnaire technique. The majority of the respondents reported that information obtained from physicians after the diagnosis of miscarriage were rather understandable (44.22%) and sufficient (41.91%). According to more than a half of respondents, after miscarriage, midwives demonstrated adequate skills (57.43%) and provided necessary informative support (52.81%). The study showed that during hospital stay the women who had experienced miscarriage evaluated in relatively high terms the physicians and midwives providing them with care. The evaluations of the attitudes of doctors and midwives increased with the women’s growing needs during hospitalization. The results of the study allow the presumption that the medical staff providing care of women after miscarriage possess a relatively high level of knowledge and skills in the area of diagnostics and treatment of pregnancy terminated with miscarriage. However, it should be remembered that the constant training of doctors and midwives in the provision of emotional and psychological support is necessary.
Case
  • Keisuke Sugimoto, Hitomi Nishi, Tomoki Miyazawa, Shinsuke Fujita, Mits ...
    原稿種別: Case
    2014 年 232 巻 3 号 p. 163-166
    発行日: 2014年
    公開日: 2014/03/07
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    Oculocerebrorenal syndrome of Lowe (OCRL, OMIM 309000), also known as Lowe syndrome, is a rare X-linked multisystem disorder characterized by congenital cataracts, mental retardation, and Fanconi syndrome of the kidney proximal tubules. Lowe syndrome is caused by mutations in the gene encoding a member of the inositol polyphosphate-5-phosphatase protein family (OCRL1) on chromosome Xq26.1. OCRL1 contains 24 exons and encodes a 105-kDa phosphatidylinositol (4,5) bisphosphate 5-phosphatase. An OCRL1 isoform generated by alternative splicing is predominantly expressed in brain, and localizes to the trans-Golgi network, lysosomes, and endosomes. Impaired inositol polyphosphate-5-phosphatase activity elevates phosphatidylinositol (4,5) bisphosphate levels that are required for vesicle trafficking within the Golgi apparatus, actin cytoskeleton remodeling closely associated with Golgi, and endosomal membrane trafficking. Accordingly, abnormalities in the actin cytoskeleton may influence the function of renal epithelial cells in patients with Lowe syndrome. OCRL1 mutations exist in about 95% of patients with Lowe syndrome, and new mutations occur in 32% affected males. We here describe a Japanese male with the mild phenotype of Lowe syndrome. Physical examination revealed mild congenital bilateral cataracts, mild mental disability, and short stature. Proteinuria was also mild with a high β2-microglobulinuria level. Nucleotide sequence analysis identified a hemizygous mutation (T-to-C transition) at nucleotide 2039 in exon 18 that substitutes Ser (TCT) for Phe (TTT) at amino acid position 680. This missense mutation is located outside the known catalytic domain that is encoded by exons 4 through 15. The present patient carries a novel OCRL1 mutation that is helpful for genetic counseling.
Regular Contribution
  • Ting Yu, Qin Lu, Xilong Ou, Dazhong Cao, Qian Yu
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 167-176
    発行日: 2014年
    公開日: 2014/03/12
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    There is an association between sedentary behavior and the risk of colorectal cancer (CRC), but the underlying mechanism is unclear. CRC is characterized by the changes in the expression levels of biomarkers, including voltage-gated proton channel Hv1, matrix-remodeling associated 5 (MXRA5), DEK (inducing positive supercoils into circular DNA) and protein inhibitor of activated signal transducer and activators of transcription 3 (PIAS3). Thus, sedentary behavior may affect the expression levels of these biomarkers in the colorectal tissue. Here, we recruited 228 CRC patients (128 males, 57.8 ± 7.8 years; 100 females, 57.7 ± 7.5 years) and 80 healthy subjects (48 males, 57.5 ± 6.8 years; 32 females, 56.9 ± 6.5 years) from March 7th, 2010 to May 6th, 2012. All the subjects were unrelated Han Chinese with the similar cultural and economic background. All the subjects were interviewed concerning sedentary time (sitting time categories: less than 1, 1-3, 4-6, and more than 6 h/day). The daily sedentary time of most CRC patients was more than 4 h/day, while the sedentary time of most healthy subjects was less than 3 h/day. The expression levels of Hv1, MXRA5 and DEK mRNAs and proteins were higher in CRC tissues and the levels of PIAS3 mRNA and protein were lower when the daily sedentary time was longer in CRC patients (p < 0.05). The daily sedentary time was correlated with the protein levels of CRC biomarkers. Furthermore, the sedentary time was positively related with body mass index but not daily calorie intake.
  • Seung Seok Han, Shin Young Ahn, Jiwon Ryu, Seon Ha Baek, Kwang-il Kim, ...
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 177-185
    発行日: 2014年
    公開日: 2014/03/13
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    Low or high counts of white blood cells (WBCs) and WBC subtypes can be a predictor of morbidity and mortality in several clinical settings. However, the correlations of WBC and its subtypes with acute kidney injury (AKI) and mortality remain unresolved in critically ill patients. The counts of WBC and subtypes, such as neutrophil, lymphocyte, monocyte, and eosinophil, were measured in 2,079 patients admitted to the intensive care unit (ICU) from June 2004 through June 2010. The non-linear relationship between WBC counts and AKI risk was initially explored by a restricted cubic spline analysis. The odds ratios (ORs) for AKI and 1-year mortality were calculated after adjustment for multiple covariates. The relationship between WBC counts and AKI risk was U-shaped. Accordingly, we divided patients into quintiles according to the counts of WBC or subtypes. The 1st and 5th quintiles of WBC counts had greater ORs for AKI (1.42 and 2.05, respectively) and mortality (1.40 and 1.36, respectively) compared with the 3rd quintile. After stratification by WBC subtype, the 5th quintile of neutrophil counts and the 1st quintiles of lymphocyte and monocyte counts tended to have higher ORs for AKI (1.69, 1.40, and 1.77, respectively). For mortality, the 1st quintiles of neutrophil, lymphocyte, and eosinophil counts were associated with higher mortality compared with the 3rd quintile (the ORs were 1.48, 1.57, and 1.42, respectively). Both leukopenia and leukocytosis are associated with AKI and mortality risk in critically ill patients. This result may be attributable to the change in the subtype counts.
  • Yang Yang, Yu-Chen Fan, Shuai Gao, Cheng-Yun Dou, Jian-Jun Zhang, Feng ...
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 187-194
    発行日: 2014年
    公開日: 2014/03/18
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    Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality worldwide. Epigenetic analysis has attracted increasing attention in the molecular diagnosis of HCC. Cysteine dioxygenase 1 (CDO1) is a key enzyme in the taurine biosynthetic pathway and converts cysteine to cysteine sulfinate. The CDO1 gene is a tumor suppressor gene and is usually silenced by the methylation of its promoter in carcinogenesis. In this study, we evaluated whether the methylation status of CDO1 gene promoter is of diagnostic value for hepatitis B virus (HBV)-related HCC. The CDO1 promoter methylation status was determined in serum samples using methylation-specific polymerase chain reaction (MSP) in a cohort of 123 patients with HBV-related HCC, 28 with liver cirrhosis (LC), 29 with chronic hepatitis B (CHB) and 20 healthy controls. The frequency of the CDO1 promoter methylation in HBV-related HCC (42.3%) was significantly higher than that in LC (14.3%), CHB (6.9%) and healthy controls (0%) (P = 0.006; P < 0.0001; P < 0.0001; respectively). Furthermore, in HCC patients, the frequency of CDO1 promoter methylation was higher in advanced stages (III-IV) (53%) than the early stages (I-II) (20%) (P = 0.001). Evaluation of the CDO1 promoter methylation status in serum, in combination with AFP (> 20 ng/ml), significantly improved the diagnostic value, with sensitivity and specificity of 82.9% and 75.4%, respectively in distinguishing HCC from LC and CHB. In conclusion, methylation status of serum CDO1 gene promoter may be helpful in the diagnosis of HCC and the estimation of the HCC stages.
  • Kyoungsim Jung, Young Kim, Yijung Chung, Sujin Hwang
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 195-199
    発行日: 2014年
    公開日: 2014/03/19
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    Trunk instability is one of main problems in survivors following stroke. We investigated the effects of weight-shift training (WST) on an unstable surface in sitting position on trunk control, proprioception, and balance in individuals with chronic hemiparetic stroke. Eighteen participants with chronic hemiparetic stroke were recruited and were allocated to either WST or control group. The WST group received a weight-shift training program for 30 min and then received a conventional exercise program for 30 min, while the control group received conventional exercise program for 60 min, five times a week for four weeks for both groups. In this randomized control study, we used three outcome measures: trunk reposition error (TRE), Trunk Impairment Scale (TIS), and Timed Up and Go (TUG) test. TRE was measured by each participant’s reposition error to the target angle during his/her active trunk movement. TIS and TUG were examined for trunk control abilities and dynamic balance abilities, respectively. After training, TRE showed significantly greater improvement in the WST group (mean change, 1.67 ± 1.45˚) than the control group (mean change, 0.08 ± 1.05˚). The TIS score was significantly higher in the WST group (mean change, 2.33 ± 1.50) than the control group (mean change, 0.13 ± 0.83). The TUG test also showed a significant improvement in the WST group (mean change, 5.03 ± 1.88 sec) than the control group (mean change, 2.59 ± 1.86 sec). Our findings indicate that weight-shift training is beneficial for improving trunk control and proprioception in patients with chronic hemiparetic stroke.
  • Hidetoshi Oshima, Kazuhiro Nomura, Mitsuru Sugawara, Kazuya Arakawa, T ...
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 201-206
    発行日: 2014年
    公開日: 2014/03/19
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    Fungus is one of the causes of chronic rhinosinusitis. If the fungus occupies the sinus but does not invade the sinonasal mucosa, this is called sinus fungus ball. Any association between anatomical variations and fungus ball remains unclear. Sinus fungus ball is defined as non-invasive chronic fungal rhinosinusitis occurring in immunocompetent patients, and the maxillary sinus is the most commonly affected. The etiology of maxillary sinus fungus ball remains unclear. This study assessed the potential contribution of anatomical variations, such as deviated nasal septum, concha bullosa, and Haller cell to the development of fungus ball in the maxillary sinus. Concha bullosa and Haller cell are structural variations that narrow the nasal airflow passage and contribute to chronic rhinosinusitis. The involvement of these variations has been investigated in chronic sinusitis but not in sinus fungus ball. Preoperative computed tomography findings of 103 patients with maxillary sinus fungus ball were evaluated retrospectively. Septal deviation and Haller cell were not correlated with the side of maxillary sinus fungus ball. Concha bullosa was more common on the unaffected side (p = 0.099). When we analyzed males and females separately, maxillary sinus fungus ball was more common on the concave side of the deviated septum in only male patients (p = 0.006). The high incidence of maxillary fungus ball in the concave side may reflect the consequences of the traumatic effects caused by wall shear stress of the high-velocity airflow and the increased chance of inhaling fungus spores.
  • Hwi-young Cho, Hye Rim Suh, Hee Chul Han
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 207-214
    発行日: 2014年
    公開日: 2014/03/20
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    Neuropathic pain is a devastating chronic condition and is often induced in the upper limb following nerve injury or damage. Various drugs or surgical methods have been used to manage neuropathic pain; however, these are frequently accompanied by undesirable side effects. Transcutaneous electrical nerve stimulation (TENS) is a safe and non-invasive intervention that has been used to alleviate different types of pain in the clinic, but it is unclear whether TENS can improve chronic neuropathic pain in the upper limb. Thus, the aim of this study was to investigate the effects of a single trial of TENS on chronic neuropathic pain following median nerve injury. Male rats weighing 200-250 g received median nerve-ligation of the right forearm, while the control group received only skin-incision without nerve-ligation. Neuropathic pain-behaviors, including mechanical, cold, and thermal allodynia, were measured for 4 weeks. After the development of chronic neuropathic pain, TENS (100 Hz, 200 µs, sub-motor threshold) or placebo-TENS (sham stimulation) was applied for 20 min to the ipsilateral or contralateral side. Neuropathic pain behavior was assessed before and after intervention. Median nerve-ligation significantly induced and maintained neuropathic pain in the ipsilateral side. TENS application to the ipsilateral side effectively attenuated the three forms of chronic neuropathic pain in the ipsilateral side compared to sham-treated rats (peripheral and central effects), while TENS application to contralateral side only reduced mechanical allodynia in the ipsilateral side (central effect). Our findings demonstrate that TENS can alleviate chronic neuropathic pain following median nerve injury.
  • Kotaro Yoshinaka, Noriaki Shoji, Takashi Nishioka, Yumiko Sugawara, To ...
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 215-222
    発行日: 2014年
    公開日: 2014/03/20
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    Periodontal disease is a chronic inflammatory disease that results in the breakdown of the tooth-supporting tissues, and can ultimately lead to resorption of the alveolar bone. Recently, several studies have shown a close relationship between increased interleukin-18 (IL-18) levels and the pathogenesis of chronic periodontitis, a major cause of tooth loss. However, it has yet to be shown whether chronic periodontitis results from or causes an increase in IL-18 after bacterial infection. In the present study, we investigated how IL-18 overexpression relates to periodontal disease using IL-18 transgenic (Tg) mice. IL-18Tg and wild-type mice were inoculated intraorally with Porphyromonas (P.) gingivalis, which has been implicated in the etiology of chronic periodontitis. Seventy days after P. gingivalis infection, alveolar bone loss and gingival cytokine levels were assessed using histo-morphological analysis and enzyme-linked immuno-absorbent assay, respectively. Periodontal bone loss was evoked in IL-18Tg mice, but not in wild-type mice. Interestingly, levels of bone-resorptive cytokines, including IL-1α, IL-1β, tumor necrosis factor-α, and IL-6, were unchanged in the gingival tissues of IL-18Tg mice infected with P. gingivalis, although levels of interferon γ (a proinflammatory T-helper 1 cytokine) decreased. RT-PCR analysis showed elevated expression of mRNAs for receptor activator of nuclear factor kappa-B ligand (a key stimulator of osteoclast development and activation) and CD40 ligand (a marker of T cell activation) in the gingiva of IL-18Tg mice infected with P. gingivalis. We conclude that increased IL-18 in the gingival tissues evokes chronic periodontitis after bacterial infection, presumably via a T cell-mediated pathway.
  • Yasutomo Oda, Hirotaka Onishi, Takanobu Sakemi
    原稿種別: Regular Contribution
    2014 年 232 巻 3 号 p. 223-227
    発行日: 2014年
    公開日: 2014/03/20
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    Problem-based learning (PBL) is a teaching and learning method designed to develop clinical reasoning skills. Tutor performance in PBL affects both the process and outcome of student learning. In this study, we investigated the factors that influence the evaluation by undergraduate students on the performance of tutors in medical education. From April 2009 to February 2010, 49 PBL sessions were conducted for 191 3rd- and 4th-year medical students at Saga Medical School in Japan. Twenty-nine 6th-year students and 205 faculty members tutored these sessions. After each session, students evaluated their tutor by a Likert scale. This evaluation score was dichotomized and used as the dependent variable. A multivariate logistic regression analysis was used to assess the contribution of student’s gender and year level (3rd or 4th), the tutor’s gender and background, and the quality of the case scenario to evaluation ratings. A total of 4,469 responses were analyzed. Male student and tutor background were associated with excellent tutor evaluation. Concerning the tutor background, compared with basic scientists, the 6th-year students and content-expert clinicians were positively associated with excellent tutor evaluations (ORs of 1.77 [95% CI: 1.15-2.72] and 1.47 [95% CI: 1.11-1.97]), while non-content-expert clinicians received negative evaluations (OR of 0.72 [95% CI: 0.55-0.95]). The quality of the case scenario was also associated with excellent tutor evaluation (odds ratio [OR] of 12.43 [95% CI: 10.28-15.03]). In conclusion, excellence of case scenarios, 6th-year student tutors, and content-expert clinicians show positive impact on tutor evaluation in a PBL curriculum.
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