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Volume 234 (2014)
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- Issue 3 Pages 169-
- Issue 2 Pages 89-
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Volume 234, Issue 2
October
Displaying 1-10 of 10 articles from this issue
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Regular Contribution
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Sung Woo Lee, Myounghee Kim, Ho Kim, Seung Seok Han, Hajeong Lee, Jung ...Article type: Regular Contribution
2014 Volume 234 Issue 2 Pages 89-97
Published: 2014
Released on J-STAGE: September 04, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLThe inverse relationship between 25-hydroxyvitamin D [25(OH)D] status and insulin resistance (IR) has been reported, but many interventional studies failed to reduce IR with 25(OH)D supplementation. In addition, there has been a paucity of literature on the interaction between 25(OH)D status and IR according to the degree of obesity in Asian subjects. We therefore evaluated the association between 25(OH)D status and IR according to the degree of obesity. Data from the Korea National Health and Nutrition Examination Survey in 2008-2010 were analyzed. The study subjects comprised 10,629 participants aged ≥ 20 years with fasting glucose < 100 mg/dL. IR was estimated by the homeostasis model assessment (HOMA). We found an inverse linear association between 25(OH)D and loge(HOMA-IR) in multiple linear regression analysis; namely, 10 ng/mL increase of 25(OH)D was associated with 0.018 decrease of loge(HOMA-IR) (p < 0.0001). In the subgroup analysis, we identified a distinct trend that the inverse linear association between 25(OH)D and loge(HOMA-IR) became more prominent with the progression of body mass index, waist circumference, or fat mass quartile (Q): −0.009, −0.004, −0.029 and −0.037 in Q1-Q4 of body mass index, −0.004, −0.014, −0.02 and −0.038 in Q1-Q4 of waist circumference, and −0.002, −0.001, −0.017 and −0.025 in Q1-Q4 of fat mass. Thus, the IR-lowering effect of 25(OH)D became more evident with the progression of obesity in an adult Korean population without increased fasting glucose levels. We suggest that proper supplementation of vitamin D might be beneficial in obese Korean adults.View full abstractDownload PDF (1647K) Full view HTML -
Qingwu Qin, Juntao Feng, Chengping Hu, Xi Chen, Ling Qin, Yuanyuan LiArticle type: Regular Contribution
2014 Volume 234 Issue 2 Pages 99-110
Published: 2014
Released on J-STAGE: September 09, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLExercise is one of the most common triggers of bronchoconstriction in patients with asthma. The low levels of circulating epinephrine produced by the adrenal medullary chromaffin cells (AMCCs) are associated with exercise-induced bronchoconstriction (EIB) in asthmatics. In the present study, we tested the hypothesis that low-intensity aerobic exercise may ameliorate EIB using a rat model of asthma. Male Sprague-Dawley rats at 7 weeks of age, sensitized with ovalbumin or treated with saline, were subjected to low or moderate exercise training (50 or 75% of maximum velocity) for one hour in a treadmill 30 min after ovalbumin or saline inhalation. The exercise capacity, airway responsiveness, lung morphology, the morphological changes and endocrine function of AMCCs were measured in both groups of rats after exercise training for 6 weeks. Either low-intensity or moderate-intensity exercise mitigated EIB and increased exercise capacity in ovalbumin-sensitized (asthmatic) rats. Low-intensity aerobic exercise reduced the vacuolar degeneration degrees, lipid contents, neuronal peripherin and neurofilament-68 expression, demolished neurites, but increased the chromaffin granule density, endocrine chromogranin A and phenylethanolamine N-methyltransferase expression in the adrenal medullary tissues, accompanied by increased levels of circulating epinephrine and corticosterone, but decreased nerve growth factor in asthmatic rats. Finally, low-intensity aerobic exercise significantly reduced the relative levels of phosphorylated extracellular signal-regulated kinase and phosphorylated cAMP responsive element-binding protein and the relative mRNA expression levels of downstream molecules, including c-FOS and c-JUN in the adrenal medullary of asthmatic rats. We suggest that low-intensity aerobic exercise improves the endocrine dysfunction of AMCCs and mitigates EIB.View full abstractDownload PDF (14158K) Full view HTML -
Hajime Kanamori, Koichi Tokuda, Shinobu Ikeda, Shiro Endo, Chiyuki Ish ...Article type: Regular Contribution
2014 Volume 234 Issue 2 Pages 111-116
Published: 2014
Released on J-STAGE: September 13, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLSusceptible healthcare personnel (HCP) are at high risk for acquiring and transmitting measles, mumps, rubella, and varicella (MMRV). Presumptive evidence of immunity to MMRV is recommended for HCP. The aim of this investigation was to examine the seroprevalence of MMRV in Japanese HCP and the association with history or vaccination in terms of occupational safety. To improve infection control at our hospital, we also assessed their immune status by implementing prevaccination antibody screening and an immunization program with postvaccination serological testing. We implemented seroprevalence surveys on MMRV antibodies among 243 newly and 2,664 previously hired HCP in a Japanese tertiary care hospital. Self-administered questionnaires about history of MMRV and vaccination with or without written documentation were completed for newly hired HCP. Prevaccination and postvaccination serological tests were performed using virus-specific IgG enzyme-linked immunosorbent assays. Indeed, only a few HCP accurately remembered or had written records of their disease or vaccination history. After our immunization program was implemented, the seropositivity rate reached levels as high as ~98% for measles, rubella, and varicella, and increased to ~80% for mumps. Our program was cost-effective, and no severe adverse reactions were reported. The prevaccination antibody screening for HCP would be helpful, given the lack of written vaccination records or documented disease history, and is also useful for the prevention of adverse reactions associated with unnecessary vaccination. It is important for infection control practitioners to comprehend the immune status of HCP against MMRV, and then provide an appropriate immunization program for susceptible HCP.View full abstractDownload PDF (363K) Full view HTML -
Haneul Lee, Jerrold Petrofsky, Nirali Shah, Abdulaziz Awali, Karan Sha ...Article type: Regular Contribution
2014 Volume 234 Issue 2 Pages 117-122
Published: 2014
Released on J-STAGE: September 17, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLEvaporation by sweating is the most effective way to remove heat from the body. Sweat rates increase under both local and whole-body heat stress. Men and women differ in how they respond to heat, because sexual steroids alter resting body core temperature and the threshold for sweating and skin blood flow (SBF) during heating. The purpose of the present study was to compare local sweat rates and cutaneous vasodilatation during heat exposure in women with a regular menstrual cycle. The cutaneous vasodilatation was judged by measuring the SBF. Eight female and nine male subjects participated in this study, and their age range was 24-29 years. Female subjects were tested twice throughout one full menstrual cycle: once during the middle follicular phases and once during the luteal phase. Subjects remained in a temperature-regulated room at 41°C and 21% of relative humidity for 40 minutes. Sweat rate was recorded from the forehead, forearm, and thigh, and skin temperature and SBF were measured on the thigh and forehead. We found that the sweating rate and SBF were greater in the luteal phase compared to follicular phase (p < 0.05). Since both SBF and sweating were controlled by the sympathetic nerve system, the sympathetic outflow was greater during whole body heat exposure in the luteal phase. In contrast, for men, there was no significant difference in sweating and SBF over the same calendar period (p > 0.05). We propose the enhanced sympathetic activity in the luteal phase with a regular menstrual cycle.View full abstractDownload PDF (1865K) Full view HTML
Case
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Mariko Yanagihara, Masaki Nakamura, Akira Usui, Shingo Nishida, Eiki I ...Article type: Case
2014 Volume 234 Issue 2 Pages 123-128
Published: 2014
Released on J-STAGE: September 23, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLAlong with urbanization of the living environment, the number of patients with circadian rhythm sleep disorder (CRSD) has been increasing. There are several treatment candidates for CRSD, such as light therapy, drugs (melatonin and vitamin B12), and sleep hygiene education. However, successful treatment method has not been established. In free-running type (FRT) CRSD, the endogenous circadian rhythm cannot be entrained to the 24-h light-dark cycle, resulting in free running on a cycle 0.5-2.5 h longer than the 24-h period. This condition is relatively common in blind individuals and is unusual in sighted individuals. Here we report two sighted patients with FRT, successfully treated with a melatonin receptor agonist, ramelteon. Patient 1 (36-year-old female) had suffered from FRT for nearly 4 months after resigning her job. She was given sleep hygiene education together with ramelteon at first and the free-running cycle stopped after treatment day 15. Triazolam was added from the day 25 to promote earlier sleep onset. And the sleep-wake schedule was normalized by the day 34. Patient 2 (33-year-old male) had suffered from FRT for nearly 8 months after starting to take a leave of absence from his job. He was given sleep hygiene education and was treated with ramelteon and methylcobalamin. His sleep-wake schedule was normalized from the first treatment day. By the combined treatment with ramelteon, both patients have maintained favorable sleep-wake schedules. The agonist action of ramelteon at the melatonin 2 receptor may have primarily contributed to the cessation of the free-running cycle in these patients.View full abstractDownload PDF (659K) Full view HTML -
Zenei Arihara, Kanako Sakurai, Rika Yamashita, Satsuki Niitsuma, Takay ...Article type: Case
2014 Volume 234 Issue 2 Pages 129-135
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLBromocriptine, a potent D2-dopamine agonist, suppresses growth hormone (GH) secretion in most patients with acromegaly and has been approved for the treatment of acromegaly. Here we report a patient with acromegaly who showed increased GH secretion after administration of bromocriptine. A 70-year-old man with acromegalic manifestation was admitted to our hospital because of a pituitary tumor invading to the right cavernous sinus detected by brain magnetic resonance imaging. Serum GH and insulin-like growth factor-I (IGF-I) levels were elevated in several occasions (GH: 15.0-51.7 ng/mL, reference range: < 2.47 ng/mL; and IGF-I: 776-856 ng/mL, reference range: 57-175 ng/mL). Effect of bromocriptine on serum GH levels was then studied because pre-operative treatment with a D2-dopamine agonist was planned in order to reduce the tumor size and serum GH levels before surgery. After oral administration of 2.5 mg of bromocriptine, serum GH levels were unexpectedly increased from 30.7 ng/mL to 189 ng/mL, despite the fact that the levels of prolactin (PRL) were decreased from 4.2 ng/mL to 0.6 ng/mL. By contrast, serum GH levels were decreased by a somatostatin analogue, octreotide. Transsphenoidal surgery of the pituitary tumor was performed after treatment of octreotide. Histological analysis and immunohistochemistry revealed a GH-producing pituitary adenoma positive for D2-dopamine receptor. This case of acromegaly suggests that the preliminary test with a single administration of a short-acting D2-dopamine agonist, bromocriptine, is mandatory before the long-term therapy with a D2-dopamine agonist in patients with GH-secreting pituitary tumors.View full abstractDownload PDF (1297K) Full view HTML -
Yuji Ishimatsu, Hanako Koyama, Masaomi Tomonaga, Tatsuhiko Harada, Sho ...Article type: Case
2014 Volume 234 Issue 2 Pages 137-141
Published: 2014
Released on J-STAGE: September 30, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLSarcoidosis is a granulomatous disorder of unknown etiology, with several clinical manifestations. Löfgren’s syndrome is an acute type of sarcoidosis, characterized by the triad of arthritis, erythema nodosum, and bilateral hilar lymphadenopathy (BHL), which spontaneously resolve within about 2 years. Löfgren’s syndrome is common among young white women from Nordic countries and Ireland, but it is very rare in Japan. Because the incidence of Löfgren’s syndrome varies according to race, most studies on Löfgren’s syndrome, including HLA typing, have been reported in Western countries. Indeed, HLA-DR3 has been reported to be associated with Löfgren’s syndrome in Western countries, although the association between HLA typing and Japanese Löfgren’s syndrome remains unclear. Here we present a Japanese patient with Löfgren’s syndrome. A 34-year-old female patient was hospitalized with arthritis and erythema nodosum. Chest computed tomography revealed mediastinal and BHL. Endobronchial ultrasound-guided transbronchial needle aspiration showed non-caseating epithelioid cell granulomas. Löfgren’s syndrome was thus diagnosed. Her ankle arthralgia and bilateral ankle swelling recovered without steroid treatment within two months, and the BHL almost completely diminished one year after admission. Her HLA genotype contains DR12. We also reviewed the literature on 11 Japanese patients with Löfgren’s syndrome, showing that HLA-DR12 is present in five out of nine patients (55.6%). The relevant data were unavailable in the remaining three patients. Importantly, only 5.4% of registered donors in the Japan Marrow Donor Program are positive for this allele. We suggest the potential link between HLA-DR12 and the pathogenesis of Löfgren’s syndrome in Japanese patients.View full abstractDownload PDF (653K) Full view HTML
Review
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Feng Xu, Yaning Sun, Rui Shang, Minghua Li, Lianqun Cui, Zhaoqiang Cui ...Article type: Review
2014 Volume 234 Issue 2 Pages 143-150
Published: 2014
Released on J-STAGE: September 27, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLCoronary artery disease (CAD) is a leading cause of death, and its genetic mechanism has been always a major research concern. Recently, increasing evidence has indicated that the aldehyde dehydrogenase 2 (ALDH2) polymorphism, known as Glu504Lys (rs671), may contribute to CAD development. ALDH2 has been well known as a key enzyme in alcohol metabolism, and subjects with *504Lys allele exist in 30-50% of the East Asian population (6% of the world’s population). However, recent studies have indicated that the *504Lys allele of the ALDH2 gene may be associated with the pathogenesis of CAD in a given number of Chinese, Japanese, and Korean people. This discovery has been further confirmed by a genome-wide association study in 2012 that identified the link of ALDH2 Glu504Lys polymorphism to CAD susceptibility. ALDH2 may therefore serve as an important target for CAD intervention. Several studies have suggested that ALDH2 polymorphism plays an important role in the progress of CAD through multiple mechanisms, including the regulation of alcohol consumption, inflammation, endothelial progenitor cells, oxidative stress, asymmetric dimethylarginine, endothelial nitric oxide synthase, and other CAD-promoting factors. Furthermore, the ALDH2 Glu504Lys polymorphism has been shown to be associated with certain traditional cardiovascular risk factors, such as dyslipidemia, hypertension, and diabetes mellitus or hyperglycemia. In this review, we update the current research on the association of the Glu504Lys polymorphism with the susceptibility to CAD. We also highlight and discuss the underlying mechanisms, by which the ALDH2 Glu504Lys polymorphism may be targeted for the prevention and treatment of CAD.View full abstractDownload PDF (805K) Full view HTML
Regular Contribution
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Tsuyoshi Nishinakagawa, Hideaki Senjyu, Takako Tanaka, Masaharu Asai, ...Article type: Regular Contribution
2014 Volume 234 Issue 2 Pages 151-160
Published: 2014
Released on J-STAGE: October 02, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLAir pollution due to industrial waste and tobacco smoke is detrimental to pulmonary function. However, the combined effects of air pollution and smoking on pulmonary function have not been investigated. We examined the combined effect of air pollution of 40 years ago and concurrent smoking on the pulmonary function of officially acknowledged female victims in Japan, because females are more susceptible to the adverse effects of both irritants than males. The subjects comprised 655 female victims living in one of two areas with air pollution of 40 years ago and 572 females living in an area without air pollution. All victims have been prescribed standard respiratory medications. Pulmonary function was measured in 2000 for air-pollution groups (130 smokers and 525 non-smokers; mean age, 68.4 years) and during the period of 2004 to 2013 for non-air-pollution groups (113 smokers and 459 non-smokers; mean age, 69.0 years). The smokers included both current smokers and ex-smokers. The victims with a history of smoking had significantly lower forced expiratory volume in 1 second (FEV1 % predicted) (mean, 74%) and significantly lower FEV1/forced vital capacity (FVC) (mean, 70%) than the other groups (P < 0.001). Thus, smoking aggravates the pulmonary function in officially acknowledged female victims, despite the improved air pollution and the continuous medical care provided by the government. In conclusion, exposure to air pollution of 40 years ago and cigarette smoking are associated with reduced pulmonary function. These results highlight the importance of measures aimed at smoking cessation and limiting air pollution.View full abstractDownload PDF (671K) Full view HTML -
Toshimi NakanishiArticle type: Regular Contribution
2014 Volume 234 Issue 2 Pages 161-168
Published: 2014
Released on J-STAGE: October 03, 2014
JOURNAL FREE ACCESS FULL-TEXT HTMLThe process of medical mediation involves the reconstruction of doctor-patient relationships through sharing mutual truthful information and encouraging dialogue between doctors and their patients. This study was designed to examine the effects of disclosing the avoidable as well as unavoidable causes of doctors’ behavior following malpractice or perceived inconsiderate behavior on patients’ feelings in medical mediation. An avoidable cause was defined as doctor’s behavior that was incautious or showed insufficient empathy. An unavoidable one, however, was defined as any cause other than doctors’ behavior. A questionnaire was administered to 385 Japanese hospital outpatients, in which participants were presented a range of scenarios with the above two causes for doctor’s behavior or an adverse event. Participants’ feelings toward the doctor in each scenario were measured on a seven-point scale following disclosure of each cause. The five scenarios provoking negative feelings toward doctors involved “(the patient) being ignored,” “refusal of a request,” “dominating behavior,” “a minor incident,” and “an adverse event.” The valid response rate was 62.9% (242/385). Negative feelings were evoked in all five scenarios. After disclosure of avoidable causes, scores for negative feelings significantly increased between 3% and 33%. In contrast, after disclosure of unavoidable causes, scores for negative feelings significantly decreased between 11% and 43%. These findings imply that disclosure of causal information in medical mediation will provide the opportunity to reevaluate unexpected doctors’ behavior and change patients’ negative feelings. Therefore, disclosures should be made in the case of not only unavoidable causes but also avoidable ones.View full abstractDownload PDF (503K) Full view HTML
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