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Volume 233 (2014)
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- Issue 3 Pages 155-
- Issue 2 Pages 73-
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Volume 233, Issue 3
July
Displaying 1-9 of 9 articles from this issue
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Regular Contribution
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Konosuke Sasaki, Ryoko MaruyamaArticle type: Regular Contribution
2014 Volume 233 Issue 3 Pages 155-163
Published: 2014
Released on J-STAGE: June 26, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLHeart rate variability (HRV), the beat-to-beat alterations in heart rate, comprises sympathetic and parasympathetic nerve activities of the heart. HRV analysis is used to quantify cardiac autonomic regulation. Since respiration could be a confounding factor in HRV evaluation, some studies recommend consciously controlled breathing to standardize the method. However, it remains unclear whether controlled breathing affects HRV measurement. We compared the effects of controlled breathing on HRV with those of spontaneous breathing. In 20 healthy volunteers, we measured respiratory frequency (f), tidal volume, and blood pressure (BP) and recorded electrocardiograms during spontaneous breathing (14.8 ± 0.7 breaths/min) and controlled breathing at 15 (0.25 Hz) and 6 (0.10 Hz) breaths/min. Compared to spontaneous breathing, controlled breathing at 0.25 Hz showed a higher heart rate and a lower high-frequency (HF) component, an index of parasympathetic nerve activity, although the f was the same. During controlled breathing at 0.10 Hz, the ratio of the low frequency (LF) to HF components (LF/HF), an index of sympathetic nerve activity, increased greatly and HF decreased, while heart rate and BP remained almost unchanged. Thus, controlled breathing at 0.25 Hz, which requires mental concentration, might inhibit parasympathetic nerve activity. During controlled breathing at 0.10 Hz, LF/HF increases because some HF subcomponents are synchronized with f and probably move into the LF band. This increment leads to misinterpretation of the true autonomic nervous regulation. We recommend that the respiratory pattern of participants should be evaluated before spectral HRV analysis to correctly understand changes in autonomic nervous regulation.View full abstractDownload PDF (604K) Full view HTML
Case
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Tetsuo Shimoyama, Yasuhiro Yamamoto, Makoto Kuroda, Yasunari Takakuwa, ...Article type: Case
2014 Volume 233 Issue 3 Pages 165-169
Published: 2014
Released on J-STAGE: June 26, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLParosteal osteosarcoma (POS) is a low-grade well-differentiated variant of osteosarcoma that affects the metaphyseal surface of a long bone. Although Grade-1 POS sometimes involve the medullary canal, such patients are not at a greater risk of local recurrence or metastases. In this report, we describe a rare case of POS in the right distal femur with an intramedullary sclerotic lesion mimicking medullary involvement caused by secondary remodeling of the underlying cortex of the tumor. A 34-year-old woman complained of having a painful hard mass in her right knee for six months. Imaging studies revealed a broad-based sclerotic mass attached to the cortex of the distal and lateral aspect of the femur, along with an intramedullary lesion. Histopathological examination of a biopsy specimen revealed Grade-1 POS. We diagnosed a medullary involvement and we performed a wide resection, including the intramedullary lesion. Histopathological examination of the resected specimen revealed that the intramedullary lesion only exhibited remodeling of the underlying tumor cortex without tumor cell invasion. To the best of our knowledge, this is the first report of such imaging features and pathological findings in a patient with POS. Our experience with the present patient indicates that good local control and overall prognosis of patients with medullary involvement in Grade-1 POS may be due to the remodeling of the underlying cortex mimicking “medullary involvement.” This feature will add to the range of diagnostic difficulty experienced during the preoperative staging of POS.View full abstractDownload PDF (1090K) Full view HTML -
Kazuhiro Nomura, Yohei Honkura, Daiki Ozawa, Yuri Okumura, Hiroshi Hid ...Article type: Case
2014 Volume 233 Issue 3 Pages 171-174
Published: 2014
Released on J-STAGE: June 26, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLAcute rhinosinusitis is frequently associated with secondary orbital infection, most commonly subperiosteal abscess. Although orbital subperiosteal abscess is a deadly disease that might lead to blind and cavernous sinus thrombosis, recent review of literature showed that immediate surgical intervention might not always be necessary for subperiosteal abscess. Orbital inflammation secondary to sinusitis is common in children, whereas orbital subperiosteal hematoma secondary to sinusitis is extremely rare, with only 11 reported cases, including one case in children. All the cases were treated with surgical intervention. Here we present a 12-year-old girl with rhinosinusitis and proptosis. Emergent endoscopic sinus surgery with partial removal of the lamina papyracea revealed dark brown fluid in the subperiosteal space. The patient was symptom-free 2 weeks after surgery. The present case was treated exclusively via an endonasal approach, whereas all 11 previous cases of subperiosteal hematoma were treated with external incision. The endonasal approach is favorable, especially for young female patients. Our review of literature shows that sudden onset, afebrile, and few signs of inflammation on blood test in patients with subperiosteal lesion may indicate subperiosteal hematoma. Surgery rather than antibiotic administration should be considered for the treatment of suspected subperiosteal hematoma. Treatment through only the endonasal approach is possible even if the hematoma is located in the roof of the orbit.View full abstractDownload PDF (677K) Full view HTML
Regular Contribution
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Xinyi Li, Yanfu Wang, Chao Han, Pai Li, Hua ZhangArticle type: Regular Contribution
2014 Volume 233 Issue 3 Pages 175-182
Published: 2014
Released on J-STAGE: July 02, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLColorectal cancer is a significant worldwide health problem, and an altered immunoresponse plays an important role in colorectal tumorigenesis and cancer progression. T helper 17 (Th17) lymphocytes (a subgroup of CD4+ T cells), together with the related cytokines, such as interleukin (IL)-6 and IL-17A, participate in cancer-related immunity. In this study, we measured the percentage of Th17 cells in peripheral blood mononuclear cells (PBMCs) and the levels of IL-17A and IL-6 in serum samples or tumor tissues, prepared from 40 colorectal cancer patients (a median age of 75 years), 32 age-matched healthy controls (a median age of 74 years), and 30 young healthy controls (a median age of 26 years). The percentage of Th17 cells in PBMCs and the serum IL-6 levels were higher in cancer patients than those in elderly controls, and they were associated with tumor progression. Moreover, the percentage of Th17 cells and the serum IL-6 levels were higher in elderly healthy controls than those in young healthy controls. In contrast, serum IL-17A levels were similar in the cancer patients and the elderly controls, although its serum levels were higher than those in young controls. Importantly, Th17 cells were accumulated in the intratumor and peritumor regions. In conclusion, the percentage of Th17 cells and the serum IL-6 level are significantly increased with aging, and their higher levels are correlated with colorectal cancer progression. The percentage of Th17 cells in PBMCs and the serum IL-6 level are potential biomarkers for predicting disease progression.View full abstractDownload PDF (1074K) Full view HTML -
Mi Yang Jeon, HyeonCheol Jeong, SeungWon Lee, Wonjae Choi, Jun Hyuck P ...Article type: Regular Contribution
2014 Volume 233 Issue 3 Pages 183-188
Published: 2014
Released on J-STAGE: July 09, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLBecause sleep comprises one-third of a person’s life, using an optimal pillow for appropriate neck support to maintain cervical curve may contribute to improve quality of sleep. Design of orthopedic pillow conforms to orthopedic guidelines to ensure the right support of the cervical curve. The aim of this study was to investigate effect of different pillow shape and content on cervical curve, pillow temperature, and pillow comfort. A feather pillow is regarded as a standard pillow, and a memory foam pillow is one of the most popular pillows among pillow users. We, therefore, compared these two pillows with an orthopedic pillow. Twenty healthy subjects (10 men and 10 women; age range, 21-30 years) participated in the study. Each subject was asked to assume the supine position with 3 different pillows for 30 minute in each trial and then cervical curve, pillow temperature, and pillow comfort were measured. When comparing the cervical curve of the 3 different pillows, that of the orthopedic pillow was significantly higher than that of the other 2 pillows (p < 0.001). The degree of temperature increase was significantly lower for the orthopedic pillow than for the memory foam and feather pillows (p < 0.001). The visual analog scale (VAS) score of pillow comfort was significantly higher in orthopedic pillow than the other 2 pillows. This study shows that pillow shape and content plays a crucial role in cervical curve, pillow temperature, and pillow comfort and orthopedic pillow may be an optimal pillow for sleep quality.View full abstractDownload PDF (543K) Full view HTML -
Junichi Kameoka, Tomoya Okubo, Emi Koguma, Fumie Takahashi, Seiichi Is ...Article type: Regular Contribution
2014 Volume 233 Issue 3 Pages 189-195
Published: 2014
Released on J-STAGE: July 10, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLIn addition to input evaluation (education delivered at school) and output evaluation (students’ capability at graduation), the methods for outcome evaluation (performance after graduation) of medical education need to be established. One approach is a review of medical records, which, however, has been met with difficulties because of poor inter-rater reliability. Here, we attempted to develop a peer review system of medical records with high inter-rater reliability. We randomly selected 112 patients (and finally selected 110 after removing two ineligible patients) who visited (and were hospitalized in) one of the four general hospitals in the Tohoku region of Japan between 2008 and 2012. Four reviewers, who were well-trained general internists from outside the Tohoku region, visited the hospitals independently and evaluated outpatient medical records based on an evaluation sheet that consisted of 14 items (3-point scale) for record keeping and 15 items (5-point scale) for quality of care. The mean total score was 84.1 ± 7.7. Cronbach’s alpha for these items was 0.798. Single measure and average measure intraclass correlations for the reviewers were 0.733 (95% confidence interval: 0.720-0.745) and 0.917 (95% confidence interval: 0.912-0.921), respectively. An exploratory factor analysis revealed six factors: history taking, physical examination, clinical reasoning, management and outcome, rhetoric, and patient relationship. In conclusion, we have developed a peer review system of medical records with high inter-rater reliability, which may enable us, with further validity analysis, to measure quality of patient care as an outcome evaluation of medical education in the future.View full abstractDownload PDF (365K) Full view HTML -
Kenji Nemoto, Shuji Oh-ishi, Masayuki Itoh, Takefumi Saito, Toshio Ich ...Article type: Regular Contribution
2014 Volume 233 Issue 3 Pages 197-204
Published: 2014
Released on J-STAGE: July 12, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLChronic obstructive pulmonary disease (COPD) is the most common chronic lung disease and is an important cause of morbidity worldwide. The aim of this study was to evaluate whether pulmonary rehabilitation (PR) improves the oxidant/antioxidant imbalance, exercise capacity and health-related quality of life (HRQL) in patients with different stages of COPD. Eighteen stable COPD patients participated in 8-week PR; the exercise intensity was set at 70% of the VO2 peak. Subjects were divided into 2 groups: moderate to severe (stages II/III: n = 12) and very severe COPD with FEV1 < 30% predicted (stage IV: n = 6). In patients at stages II/III, PR improved exercise capacity (6-minute walking test: 431.2 ± 26.6 vs. 489.1 ± 26.5 m, P < 0.01 and shuttle walking test: 329.2 ± 41.4 vs. 378.2 ± 41.5 m, P < 0.01) and HRQL, whereas no significant change was observed in erythrocyte lipid peroxidation and urinary 8-hydroxydeoxyguanosine, a marker for DNA damage. In contrast, PR for stage IV patients did not improve exercise capacity and HRQL, but significantly increased urinary 8-hydroxydeoxyguanosine (14.5 ± 1.7 vs. 24.3 ± 2.6 ng/mg Cr, P < 0.05). In both groups, erythrocyte antioxidants (superoxide dismutase, glutathione peroxidase, and catalase) did not change significantly after PR. Thus, urinary 8-hydroxydeoxyguanosine is a useful indicator for the PR-induced oxidative stress in COPD patients. In conclusion, appropriate exercise program in COPD patients can improve exercise capacity and HRQL without further increase of oxidative stress. However, PR for very severe COPD patients enhanced exercise-induced oxidative stress.View full abstractDownload PDF (440K) Full view HTML -
Othoniel Hugo Aragon-Martinez, Othir Galicia, Mario Alberto Isiordia-E ...Article type: Regular Contribution
2014 Volume 233 Issue 3 Pages 205-214
Published: 2014
Released on J-STAGE: July 19, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLThe ATP-related compounds in whole blood or red blood cells have been used to evaluate the energy status of erythrocytes and the degradation level of the phosphorylated compounds under various conditions, such as chronic renal failure, drug monitoring, cancer, exposure to environmental toxics, and organ preservation. The complete interpretation of the energetic homeostasis of erythrocytes is only performed using the compounds involved in the degradation pathway for adenine nucleotides alongside the uric acid value. For the first time, we report a liquid chromatographic method using a diode array detector that measures all of these compounds in a small human whole blood sample (125 μL) within an acceptable time of 20 min. The stability was evaluated for all of the compounds and ranged from 96.3 to 105.1% versus the day zero values. The measurement had an adequate sensitivity for the ATP-related compounds (detection limits from 0.001 to 0.097 μmol/L and quantification limits from 0.004 to 0.294 μmol/L). This method is particularly useful for measuring inosine monophosphate, inosine, hypoxanthine, and uric acid. Moreover, this assay had acceptable linearity (r > 0.990), precision (coefficients of variation ranged from 0.1 to 2.0%), specificity (similar retention times and spectra in all samples) and recoveries (ranged from 89.2 to 104.9%). The newly developed method is invaluable for assessing the energetic homeostasis of red blood cells under diverse conditions, such as in vitro experiments and clinical settings.View full abstractDownload PDF (1853K) Full view HTML -
Kaoru Tounaka, Kenya Yuki, Keisuke Kouyama, Takayuki Abe, Kazuo Tsubot ...Article type: Regular Contribution
2014 Volume 233 Issue 3 Pages 215-220
Published: 2014
Released on J-STAGE: July 23, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLDry eye disease (DED) is defined as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear-film instability, with potential damage to the ocular surface. It is thought to be associated with reduced quality of life (QOL). The aim of the present study was to investigate the effects of DED on health-related QOL in Japanese university sedentary office workers who are daily users of visual display terminal. In this study, 163 university staff (99 male and 64 female), aged 23-69 years, served as study subjects. Subjects were asked to answer the following three questions. (1) How often do your eyes feel dry? (2) How often do your eyes feel irritated? (3) Have you ever been diagnosed by a clinician as having dry eye syndrome? Sixty-eight subjects who answered “constantly,” “often”, or “sometimes” to both questions 1 and 2 were classified as the DED Group, and the remaining 95 were defined as the Non-DED Group. QOL was assessed by the SF-36 questionnaire, which consisted of 36 items to produce three summary scores, namely, mental, physical, and role/social component summary scores. For males, the DED Group had significantly lower scores than the Non-DED Group for mental component summary (MCS) (P = 0.005). In multiple regression analysis, MCS scores were adversely related to DED in males (P = 0.015). DED was associated with worsened QOL. DED should be regarded as a factor that can lead to deterioration of mental health.View full abstractDownload PDF (392K) Full view HTML
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