巻号一覧
234 巻 (2014)
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234 巻, 3 号
November
選択された号の論文の10件中1～10を表示しています
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Regular Contribution
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Kentaro Tamaki, Nobumitsu Tamaki, Shigeharu Terukina, Yoshihiko Kamada ...原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 169-174
発行日: 2014年
公開日: 2014/10/03
ジャーナル フリー HTMLDietary changes resulting from the post-World War II occupation of Okinawa by the US military have been largely deleterious, resulting in a marked increase of obesity among Okinawan residents. In this study, we examined the association between BMI and the risk of developing breast cancer according to the menstruation status and age, and the correlation between BMI and expression of estrogen receptor (ER). Breast cancer cases were 3,431 females without any personal or family history of breast cancer. Control subjects were 5,575 women drawn from the clinical files of Nahanishi Clinic. We found that women, who were overweight or obese, regardless of menopausal stage, had a higher risk of breast cancer compared to women with normal weight and this difference was statistically significant (p < 0.001, respectively). This risk was especially apparent in older (> 40 years) overweight or obese women. The women who were overweight or obese during postmenopausal ages were at higher risk of ER-positive breast cancer compared to women with normal weight. Results of our present study clearly indicate that increased BMI was associated with increased risk of developing breast cancer in Okinawan women, regardless of menopausal status. In addition, there was statistically significant correlation between BMI and ER expression in the postmenopausal period. Given the obesity epidemic associated with the extreme sociological and dietary changes brought about by the post-war occupation of Okinawa, the present study provides essential guidelines on the management, treatment and future breast cancer risk in Okinawa.抄録全体を表示PDF形式でダウンロード (389K) HTML形式で全画面表示 -
Akira Arai, Tomohiro Kaneta, Nobuyuki Okamura, Manabu Tashiro, Ren Iwa ...原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 175-181
発行日: 2014年
公開日: 2014/10/11
ジャーナル フリー HTMLTwo methods are commonly used in brain image voxel-based analyses widely used for dementia work-ups: 3-dimensional stereotactic surface projections (3D-SSP) and statistical parametric mapping (SPM). The methods calculate the Z-scores of the cortical voxels that represent the significance of differences compared to a database of brain images with normal findings, and visualize them as surface brain maps. The methods are considered useful in amyloid positron emission tomography (PET) analyses to detect small amounts of amyloid-β deposits in early-stage Alzheimer’s disease (AD), but are not fully validated. We analyzed the 11C-labeled 2-(2-[2-dimethylaminothiazol-5-yl]ethenyl)-6-(2-[fluoro]ethoxy)benzoxazole (BF-227) amyloid PET imaging of 56 subjects (20 individuals with mild cognitive impairment [MCI], 19 AD patients, and 17 non-demented [ND] volunteers) with 3D-SSP and the easy Z-score imaging system (eZIS) that is an SPM-based method. To clarify these methods’ limitations, we visually compared Z-score maps output from the two methods and investigated the causes of discrepancies between them. Discrepancies were found in 27 subjects (9 MCI, 13 AD, and 5 ND). Relatively high white matter uptake was considered to cause higher Z-scores on 3D-SSP in 4 subjects (1 MCI and 3 ND). Meanwhile, in 17 subjects (6 MCI, 9 AD, and 2 ND), Z-score overestimation on eZIS corresponded with high skull uptake and disappeared after removing the skull uptake (“scalping”). Our results suggest that non-specific uptakes in the white matter and skull account for errors in voxel-based amyloid PET analyses. Thus, diagnoses based on 3D-SSP data require checking white matter uptake, and “scalping” is recommended before eZIS analysis.抄録全体を表示PDF形式でダウンロード (1716K) HTML形式で全画面表示 -
Jiro Takeuchi, Masashi Goto, Takashi Kawamura, Atsushi Hiraide原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 183-187
発行日: 2014年
公開日: 2014/10/16
ジャーナル フリー HTMLJapan experienced measles outbreaks in both 2006 and 2007 mainly among university students. Improvement of vaccine coverage against vaccine-preventable viral infections is the prime task for preventing outbreaks of viral infections. To elucidate the promoting factors for complete vaccination against measles, rubella, mumps, and varicella-zoster viruses, we conducted a case-control study among single university students in Japan. Information on vaccinations and clinico-demographical factors were collected using a self-administered questionnaire and a photocopy of the Maternal and Child Health Handbook. Logistic regression analysis was performed to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) for two-time vaccination against measles and rubella viruses as mandatory vaccinations and at least one-time vaccination against mumps and varicella-zoster viruses as optional vaccinations. A total of 1,370 (744 medical, 508 paramedical, and 118 pharmaceutical) students were invited to participate, 960 (70.1%) of whom were enrolled in the study. Students aged < 20 years had a greater propensity for measles and rubella vaccinations (OR 7.8 [95% CI, 5.1-11.8] and OR 6.1 [95% CI, 3.7-10.0], respectively) compared with those aged ≥ 20 years. Students with a history of living over-seas for 1 month or longer were more likely to complete vaccination for measles (OR 4.4 [95% CI, 1.4-13.5] compared with those without such history. This significantly high vaccination coverage was attributed to the measles-rubella catch-up campaign by the Japanese government and the immunization regulations by foreign countries. These findings suggest that social regulations would predispose people to complete vaccination.抄録全体を表示PDF形式でダウンロード (763K) HTML形式で全画面表示 -
Sea-Hyun Bae, Gi-Do Kim, Kyung-Yoon Kim原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 189-195
発行日: 2014年
公開日: 2014/10/21
ジャーナル フリー HTMLPain that occurs after a stroke lowers the quality of life. Such post-stroke pain is caused in part by the brain lesion itself, called central post-stroke pain. We investigated the analgesic effects of transcranial direct current stimulation (tDCS) in stroke patients through quantitative sensory testing. Fourteen participants with central post-stroke pain (7 female and 7 male subjects) were recruited and were allocated to either tDCS (n = 7) or sham-tDCS (n = 7) group. Their ages ranged from 45 to 55 years. tDCS was administered for 20 min at a 2-mA current intensity, with anodal stimulations were performed at primary motor cortex. The sham-tDCS group was stimulated 30-second current carrying time. Both group interventions were given for 3 days per week, for a period of 3 weeks. Subjective pain was measured using the visual analogue scale (VAS) of 0 to 10. Sensations of cold and warmth, and pain from cold and heat were quantified to examine analgesic effects. The sham-tDCS group showed no statistically significant differences in time. In contrast, tDCS group showed decreased VAS scores and skin temperature (p < 0.05). The threshold temperatures for the sense of cold and pain from cold increased (p < 0.05), and those for the sense of warmth and pain from heat decreased (p < 0.05). Our findings indicate that tDCS improved sensory identification and exerted analgesic effects in the stroke patients with central post-stroke pain.抄録全体を表示PDF形式でダウンロード (931K) HTML形式で全画面表示 -
Megumi Tsubota-Utsugi, Michihiro Satoh, Miki Hosaka, Ryusuke Inoue, Ke ...原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 197-207
発行日: 2014年
公開日: 2014/10/23
ジャーナル フリー HTMLNumerous factors that affect functional decline have been identified, and personality traits are considered to be an important factor in functional decline risk. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG) was developed to measure three higher-level functional capacities, instrumental activities of daily living, intellectual activity, and social roles, in Japanese elderly, which were previously not assessed adequately with existing scales of functional decline. The objective of this study was to explore the effect of personality traits as predictors of higher-level functional decline over a 7-year follow-up in a rural Japanese community. Data on 676 participants (mean 67.1 years) who were free of functional decline and had completed questionnaires at baseline and 7 years later, were analyzed. Demographic characteristics, lifestyle and personality characteristics were obtained from a self-administered questionnaire at baseline. Higher-level functional decline was examined using the subscales of the TMIG at baseline and at a 7-year follow-up examination. Over the 7-year study period, 21.7% of eligible participants reported decline in higher-level functional capacity. After adjustment for putative confounding factors, the traits that were significant predictors of decline in higher-level functional capacity at the 7-year follow-up had higher psychoticism scores [odds ratio (95% confidence interval) 2.12 (1.23-3.66)] and lower extraversion scores [1.89 (1.01-3.56)]. The personality traits of higher psychoticism and lower extraversion were significantly associated with a risk of future functional decline. A better understanding of these personality traits may help identify of at-risk individuals and could help reduce functional decline in older adults.抄録全体を表示PDF形式でダウンロード (798K) HTML形式で全画面表示 -
Ting-Ting Pan, Wei-Dong Jia, Qi-Yang Yao, Qi-Kai Sun, Wei-Hua Ren, Mei ...原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 209-219
発行日: 2014年
公開日: 2014/10/24
ジャーナル フリー HTMLHOXA13 is a member of homeobox genes that encode transcription factors regulating embryonic development and cell fate. Abnormal HOXA13 expression was reported in hepatocellular carcinoma (HCC), but its correlation with tumor angiogenesis and prognosis still remain unclear. This study was aimed to uncover the expression, diagnostic and prognostic significance of HOXA13 in HCC. Immunohistochemistry was performed to detect HOXA13 expression in HCC and corresponding paracarcinomatous tissues from 90 patients. Enzyme-linked immunosorbent assay was used to detect serum HOXA13 in 90 HCC patients and 20 healthy volunteers. Receiver operating characteristics was analyzed to calculate diagnostic accuracy of serum HOXA13, alpha-fetoprotein (AFP) and their combination. Immunoreactivity of HOXA13 was detected in 72.2% of HCC, and 12.2% of adjacent non-cancerous samples. HOXA13 expression was significantly associated with tumor size, microvascular invasion, pathological grade, tumor capsula status, AFP level, tumor-node-metastasis stage and positively correlated with VEGF (p < 0.001) and microvessel density (p < 0.001). The combination of serum HOXA13 and AFP had a markedly higher area under the curve than HOXA13 alone. HOXA13 expression was associated with unfavorable overall survival (OS) (p < 0.001) and disease-free survival (DFS) (p < 0.001). Multivariate analysis indicated that patients with HOXA13-expressing tumors had a significantly shorter OS (p = 0.030) and DFS (p = 0.005) than those with HOXA13-negative tumors. Thus, HOXA13 expression possibly plays an important role in tumor angiogenesis, progression and prognosis of HCC. Moreover, we demonstrate that serum HOXA13 may serve as a biomarker for early HCC diagnosing and predicting outcome.抄録全体を表示PDF形式でダウンロード (2302K) HTML形式で全画面表示 -
Kae Okoshi, Kyoko Nomura, Kayo Fukami, Yasuko Tomizawa, Katsutoshi Kob ...原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 221-227
発行日: 2014年
公開日: 2014/10/28
ジャーナル フリー HTMLDuring the past three decades, the participation of women in medicine has increased from 10.6% (1986) to 19.7% (2012) in Japan. However, women continue to be underrepresented in the top tiers of academic medicine. We highlight gender inequality and discuss the difficulties faced by female surgeons in Japanese academic surgery. Using anonymous and aggregate employment data of medical doctors at Kyoto University Hospital from 2009 and 2013, and a commercially-published faculty roster in 2012-2013, we compared gender balance stratified by a professional and an academic rank. The numbers of total and female doctors who worked at Kyoto University Hospital were 656 and 132 (20.1%) in 2009 and 655 and 132 (20.2%) in 2013, respectively. Approximately half the men (n = 281) were in temporary track and the rest (n = 242) were in tenure track, but only one fifth of women (n = 24) were in tenure track compared to 108 women in temporary track (p < 0.0001) in 2013. There were three female associate professors in basic medicine (8.1%), two female professors in clinical non-surgical medicine (3.9%) and one female lecturer in clinical surgical medicine (2.3%) in 2012. Fewer female doctors were at senior positions and at tenure positions than male doctors at Kyoto University Hospital. There were no female associate and full professors in surgery. The status of faculty members indicates the gender differences in leadership opportunities in Japanese academic surgery.抄録全体を表示PDF形式でダウンロード (831K) HTML形式で全画面表示 -
Yun Mi Lee, Chan-Sik Kim, Eunjin Sohn, Kyuhyung Jo, Hye Ryeng Lim, Sun ...原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 229-236
発行日: 2014年
公開日: 2014/11/01
ジャーナル フリー HTMLRetinal neovascularization is a common pathology in age-related macular degeneration, retinopathy of prematurity and proliferative diabetic retinopathy. Platelet derived growth factor (PDGF) is a vasoactive factor and has been implicated in proliferative retinopathies. Oxygen-induced retinopathy in the mouse is the standard experimental model of proliferative retinopathies. Sipjeondaebo-tang (SDT) is the most widely used traditional herbal formula in East Asia, also known as Shi-Quan-Da-Bu-Tang in Chinese and Juzen-taiho-to in Japanese. SDT has been known to exert anti-angiogenic activities in several tumor models, but the role of SDT in proliferative retinopathies remains unclear. Thus, the object of the present study is to examine the mechanism of action and efficacy of SDT on retinal neovascularization in oxygen-induced ischemic retinopathy (OIR) mice. Neonatal mice at postnatal day 7 (P7) were exposed to 75% concentration of oxygen for 5 days (P7-P12), and then returned to room air from P12 to P17 to induce retinal neovascularization. SDT were administered once per day for 5 consecutive days (P12-P16) by intraperitoneal injection. Retinal neovascularization was measured at P17. We used a protein array to evaluate the expression levels of angiogenic factors. Inhibitory activity of SDT on PDGF-BB/PDGFRβ interaction was evaluated in vitro. Retinal neovascularization in the OIR mice was significantly decreased by SDT. SDT decreased the expression levels of PDGF-BB protein and VEGF mRNA. Moreover, SDT dose-dependently inhibited PDGF-BB/PDGFRβ interaction (IC50 = 388.82 ± 7.31 µg/ml). In conclusion, SDT is a potent inhibitor of retinal neovascularization through inhibiting the pro-angiogenic effect of PDGF-BB.抄録全体を表示PDF形式でダウンロード (1496K) HTML形式で全画面表示 -
Shuhei Mayanagi, Maiko Kishino, Yuko Kitagawa, Makoto Sunamura原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 237-240
発行日: 2014年
公開日: 2014/11/07
ジャーナル フリー HTMLFunctional dyspepsia (FD) is a gastroduodenal disorder that presents as postprandial fullness, early satiation, or epigastric burning despite no evidence of a structural disease. Proton pump inhibitors (PPIs) are often the first choice for treating FD. However, some patients need additional medication because of residual symptoms despite a certain level of benefit from the PPI. For these patients, a combination of PPI and other agents has a possibly more beneficial effect than changing their medication. This study aimed to evaluate the efficacy of an initial PPI followed by combination therapy with PPI and acotiamide in FD patients with residual symptoms after an initial PPI. We enrolled 105 patients who started an initial PPI (20 mg of esomeprazole once a day). Twenty-three patients with residual symptoms received 100 mg of acotiamide, a cholinesterase inhibitor, three times a day with esomeprazole as a combination therapy for 2 weeks. The symptoms were evaluated using the modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (mFSSG). Eighteen of 23 patients (78%) achieved an overall improvement in symptoms. Almost all FD-related symptoms statistically improved after the combination therapy, with an improvement in the mFSSG score relevant to the postprandial distress syndrome and epigastric pain syndrome. The symptoms improved regardless of age, sex, and the pre-combination therapy score of the mFSSG. Our findings suggest that the combination therapy of acotiamide and PPI may be effective in selected FD patients with insufficient improvement with an initial PPI. However, well-designed trials are required to confirm the efficacy.抄録全体を表示PDF形式でダウンロード (845K) HTML形式で全画面表示 -
Shihoko Koyama, Jun Aida, Ichiro Kawachi, Naoki Kondo, S V Subramanian ...原稿種別: Regular Contribution
2014 年 234 巻 3 号 p. 241-247
発行日: 2014年
公開日: 2014/11/08
ジャーナル フリー HTMLThe victims of the Great East Japan Earthquake and Tsunami have been forced to live in temporary housing, mainly by two different methods of resettlement: group allocation that preserved pre-existing local social ties and lottery allocation. We examined the effects of various factors, including the resettlement methods and social support, on mental health. From February to March 2012, we completed a cross-sectional survey of 281 refugees aged 40 years or older, who had lost their homes in the tsunami and were living in temporary housing in Iwanuma city. Psychological distress of the victims was assessed using the Kessler Psychological Distress Scale (K6) that consists of six self-reported items. Participants were also asked whether they had provided or received social support during this time. Participants were categorized as “providing social support” if they listened to someone else’s concerns and complaints, or “receiving social support” if they have someone who listened to their concerns and complaints. After adjusting for age and sex, multiple log-binomial regression analysis showed that participants without social support had a higher risk of psychological distress. Group allocation victims were more likely to receive social support than those who underwent lottery allocation. However, the resettlement approach did not significantly correlate with distress. Other factors associated with a higher risk of psychological distress were a younger age (55 or younger), living with either 3 people or 6 or more people, and having a lower income. The present results suggest that social support promotes the mental health of disaster victims.抄録全体を表示PDF形式でダウンロード (813K) HTML形式で全画面表示
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