巻号一覧
238 巻 (2016)
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238 巻, 4 号
April
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Case
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Yukihisa Suzuki, Motohiro Kiyosawa, Keiichi Oda, Kiich Ishiwata, Kenji ...原稿種別: Case
2016 年 238 巻 4 号 p. 267-271
発行日: 2016年
公開日: 2016/03/31
ジャーナル フリー HTMLDamage to the visual cortex or the geniculostriatal pathways could cause homonymous visual field (VF) defects at the contralateral side of the lesion. In clinical practice, it is known that the VF defects are gradually recovered over months on the cases. We report a case with recovered homonymous hemianopia following an infarction in the visual cortex by positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) and 11C-flumazenil (FMZ). A 58-year-old man experienced defect of left VF, and magnetic resonance imaging (MRI) revealed a localized infarction in the right occipital lobe. Goldmann VF perimetry revealed left homonymous hemianopia, but central VF was intact. Three months after the onset of infarction, we measured cerebral glucose metabolism with FDG and FMZ binding using PET. FMZ binding reflects the density of surviving neurons. Moreover, eight months after the onset, FDG-PET scan was performed. Goldmann VF perimetry was also performed at the same times of PET examinations. Decrease of cerebral glucose metabolism in the right anterior striate cortex was observed at three months after onset, while FMZ binding in the same area did not decrease in the patient. At eight months after onset, we observed recovery of VF and improvement of cerebral glucose metabolism in the anterior striate cortex. We presented change of cerebral glucose metabolism using PET accompanying improvement of VF. Evaluation of cerebral glucose metabolism and FMZ binding in the striate cortex is useful for estimating the prognosis of hemianopia caused by organic brain damage.抄録全体を表示PDF形式でダウンロード (922K) HTML形式で全画面表示 -
Takahiro Kitahara, Yoshihito Tsuji, Tomoyuki Shirase, Hiroyuki Yukawa, ...原稿種別: Case
2016 年 238 巻 4 号 p. 273-278
発行日: 2016年
公開日: 2016/03/31
ジャーナル フリー HTMLImmature teratoma (IMT) is the most frequent histological subtype of infantile intracranial teratoma, the most common congenital brain tumor. IMT contains incompletely differentiated components resembling fetal tissues. Infantile intracranial IMT has a dismal prognosis, because it is often inoperable due to its massive size and high vascularity. Neoadjuvant chemotherapy has been shown to be effective in decreasing tumor volume and vascularity to facilitate surgical resection in other types of infantile brain tumors. However, only one recent case report described the effectiveness of neoadjuvant chemotherapy for infantile intracranial IMT in the literature, even though it is common entity with a poor prognosis in infants. Here, we describe the case of a 2-month-old male infant with a very large intracranial IMT. Maximal surgical resection was first attempted but was unsuccessful because of severe intraoperative hemorrhage. Neoadjuvant carboplatin and etoposide (CARE) chemotherapy was then administered with the aim of shrinking and devascularizing the tumor. After neoadjuvant chemotherapy, tumor size did not decrease, but intraoperative blood loss significantly decreased and near-total resection was achieved by the second and third surgery. The patient underwent adjuvant CARE chemotherapy and has been alive for 3 years after surgery without tumor regrowth. Even when neoadjuvant chemotherapy does not decrease tumor volume of infantile intracranial IMT, surgical resection should be tried because chemotherapy can facilitate surgical resection and improve clinical outcome by reducing tumor vascularity.抄録全体を表示PDF形式でダウンロード (669K) HTML形式で全画面表示
Regular Contribution
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WenJun Tang, Li Xue, QiXing Yan, ShaoXi Cai, YuJie Bai, Li Lin, BiLin ...原稿種別: Regular Contribution
2016 年 238 巻 4 号 p. 279-286
発行日: 2016年
公開日: 2016/04/08
ジャーナル フリー HTMLApoptosis plays a critical role in tumorigenesis. TP63 inhibits the pro-apoptosis function of TP53, and CD40 increases expression of anti-apoptotic proteins. Two single nucleotide polymorphisms (SNPs), rs6790167 (g243059A>G) in intron 9 of TP63 and rs1535045 (g6194C>T) in intron 1 of CD40 respectively, may affect the susceptibility of lung cancer. To evaluate the association of these SNPs with lung cancer, we performed a case-control study with 258 patients, including 149 adenocarcinoma and 47 small cell lung cancer, and 270 controls. Genotyping was conducted using allele-specific polymerase chain reaction and pyrosequencing. We found that rs6790167 and rs1535045 are associated with the risk of lung adenocarcinoma (P = 0.048) and small cell lung cancer (P = 0.019), respectively. Non-smoking males carrying the GG genotype of rs6790167 had higher risk for lung adenocarcinoma than individuals carrying the AA genotype (OR = 7.58, 95% CI: 2.43-23.65). Compared to the TT genotype of rs1535045, non-smoking women with the CC genotype had higher risk for lung adenocarcinoma (OR = 4.20, 95% CI: 1.34-13.12). After stratified analysis based on clinical characteristics, the frequency of the CC genotype of rs1535045 was higher in patients at I-II stages (P = 0.013) or patients whose tumor markers were negative (P = 0.003). Individuals carrying both the GG genotype of rs6790167 and the CC genotype of rs1535045 were associated with significantly higher risk for lung adenocarcinoma. Thus, the polymorphisms in the TP63 and CD40 genes are associated with lung cancer in a Chinese Han population.抄録全体を表示PDF形式でダウンロード (470K) HTML形式で全画面表示
Review
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Toshio Hattori, Haorile Chagan-Yasutan, Beata Shiratori, Shinichi Egaw ...原稿種別: Review
2016 年 238 巻 4 号 p. 287-293
発行日: 2016年
公開日: 2016/03/26
ジャーナル フリー HTMLAfter disaster, the victims lose their safe lives and are even exposed to nature where they could suffer from animal bites and vectors followed by suffering from zoonosis or vector-born diseases. Because of the urgent need for rapid and cheap diagnosis for infectious diseases after disaster, anonymous questionnaire clarified that leptospirosis, dengue, diarrhea, and cholera were recognized as common disaster-related infections in the Philippines, while diarrhea and pneumonia were more common in Indonesia. It should also be noted that infectious disease itself such as tuberculosis associated with acquired immune deficiency syndrome in South Africa is a disaster. Thus, the possible occurrence of similar situation in Asia should be prevented. We have conducted an international collaborative research in the Philippines and Indonesia on dengue virus, leptospira and mycobacterium tuberculosis (MTB) infectious diseases. Development of point-of-care testing for molecular diagnosis and disease severity was the principal purpose of the research. Loop-mediated isothermal amplification assay, which does not require a source of electricity, was developed for leptospirosis, dengue and MTB and has been proved to be useful where resource is limited. The plasma levels of matricellular proteins, including galectin-9 and osteopontin, were found to reflect the disease severities in dengue virus and MTB infection, probably because matricellular proteins are one of the most functional extracellular proteins that are associated with inflammatory edema. The study on disaster-related infectious disease facilitates the international cooperation for development of point-of-care testing for tropical infectious diseases.抄録全体を表示PDF形式でダウンロード (1255K) HTML形式で全画面表示
Regular Contribution
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Yuanqiao He, Qianxing Zou, Houyang Chen, Shiqi Weng, Tao Luo, Xuhui Ze ...原稿種別: Regular Contribution
2016 年 238 巻 4 号 p. 295-303
発行日: 2016年
公開日: 2016/04/08
ジャーナル フリー HTMLIt is well known that there has been a worldwide decrease in human male fertility in recent years. One of the main factors affecting this is environmental pollution. Lead is one of the major heavy metal contaminants that threaten the health of animals and human beings in China. It preferentially accumulates in male reproductive organs and can be up to 10 µM in human seminal plasma. Lead impairs mammalian spermatogenesis and sperm quality in vivo. It also inhibits sperm functions in vitro but the underlying mechanisms remain unclear. Therefore, we aimed to investigate the in vitro toxicity of lead on human sperm functions and to elucidate the underlying mechanisms. Semen samples were collected from 20 healthy volunteers with different careers and backgrounds living in Nanchang, Jiangxi. Human sperm suspensions were treated with different concentrations of lead acetate (0, 0.5, 2.5, 10, 50, and 100 µM) and the viability, motility, capacitation and progesterone-induced acrosome reaction were examined. Treatment with 10-100 µM lead acetate dose-dependently inhibited total and progressive motility measures, capacitation and progesterone-induced acrosome reaction. It also dose-dependently decreased the intracellular concentrations of cyclic adenosine monophosphate (cAMP) and calcium ([Ca2+]i), and reduced the tyrosine phosphorylation of sperm proteins, all of which are thought to be key factors in the regulation of sperm function. Our findings suggest that lead inhibits human sperm functions by reducing the levels of sperm intracellular cAMP, [Ca2+]i and tyrosine phosphorylation of sperm proteins in vitro.抄録全体を表示PDF形式でダウンロード (1729K) HTML形式で全画面表示
Case
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Ruixue Sun, Chun Wang, Xushu Zhong, Yu Wu原稿種別: Case
2016 年 238 巻 4 号 p. 305-310
発行日: 2016年
公開日: 2016/04/13
ジャーナル フリー HTMLMyelodysplastic syndrome (MDS) is a group of clonal hematopoietic diseases characterized by cytopenia, dysplasia and increased risk of development to acute myeloid leukemia (AML). Unfavorable cytogenetic changes such as complex karyotypes or chromosome 7 anomalies are predictive of the progression to AML and poor prognosis. Central diabetes insipidus (CDI) is the result of a deficiency of arginine vasopressin, and its major causes are idiopathic, primary or secondary tumors, neurosurgery and trauma. Importantly, CDI is a rare complication of MDS. To date, only 5 cases of MDS co-occurring with CDI have been reported; 3 of 5 had cytogenetic abnormalities uncovered by metaphase cytogenetics and 3 of 5 evolved to AML. Here, we describe a 74-year-old woman who presented with CDI as her initial symptom of MDS and eventually progressed to AML. The metaphase cytogenetics, combined with the single-nucleotide polymorphism array (SNP-A)-based karyotyping, with superiority in resolution and detecting copy number variation, revealed a complex karyotype that included monosomy of chromosome 7, deletion of 20q, and absence of heterogeneity (AOH) in more than one chromosome. To the best of our knowledge, this is the first case report of MDS co-occurring with CDI with numerous cytogenetic abnormalities revealed by the SNP-A-based karyotyping. Our case supports that the cytogenetic abnormalities may be associated with the clinical features and the prognosis of MDS co-occurring with CDI. The SNP-A-based karyotyping is helpful in revealing more subtle cytogenetic abnormalities and unveiling their roles in the pathogenesis of MDS.抄録全体を表示PDF形式でダウンロード (545K) HTML形式で全画面表示
Regular Contribution
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Takaaki Murakami, Yuya Shinoto, Shin Yonemitsu, Seiji Muro, Shogo Oki, ...原稿種別: Regular Contribution
2016 年 238 巻 4 号 p. 311-316
発行日: 2016年
公開日: 2016/04/09
ジャーナル フリー HTMLApproximately 80% of patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) carry the A3243G mutation in the mitochondrial tRNALeu (UUR) gene. Conversely, this mutation has also been identified as one of the most prevalent genetic abnormalities in patients with diabetes mellitus. Mitochondrial diabetes mellitus complicated with MELAS is relatively common, and 12.5% of patients with the A3243G mutation develop MELAS after being diagnosed with diabetes mellitus. However, the clinical impact of diabetes mellitus in MELAS patients remains unclear. Therefore, we retrospectively studied 14 Japanese MELAS patients with the A3243G mutation: three men and eleven women, with the mean age of 48.0 (± 15.4) years. Eight patients had been diagnosed with diabetes mellitus prior to the diagnosis of mitochondrial disease, and all of them were treated with insulin. The other six included four patients with concurrent diagnosis of diabetes and mitochondrial disease, one patient diagnosed with diabetes after the diagnosis of mitochondrial disease, and one patient without developing diabetes currently. We thus compared the patients’ characteristics between those with and without early onset of diabetes mellitus. Cognitive decline (75.0% vs. 0%; p = 0.03) and poor glycemic control with severe hypoglycemic events (75.0% vs. 16.7%; p = 0.05) were more common in MELAS patients with a prior diagnosis of diabetes than in those without the prior diagnosis of diabetes. Our data suggest that the latent progress of cognitive decline is accelerated because of early onset of diabetes mellitus in MELAS patients.抄録全体を表示PDF形式でダウンロード (279K) HTML形式で全画面表示 -
Chunyan Xie, Duo Chen, Chunlin Jin, Lixia Du, Changying Wang, Hongyun ...原稿種別: Regular Contribution
2016 年 238 巻 4 号 p. 317-324
発行日: 2016年
公開日: 2016/04/14
ジャーナル フリー HTMLDementia has been increasingly paid attention by policymakers in China. However, the majority of the public has an indistinct concept of dementia and its diagnostic criteria. Therefore, many abnormal characteristics and actions of older people are labeled as having dementia while diagnosed without dementia. We examined a multi-stage cluster sample of 11,223 participants aged 60 years and above who have been clinically confirmed by general practitioners as not having dementia in 2013, and 7,861 participants were willing to participate the following study and were followed-up in 2014. To assess the differences of status of older people who were mistakenly labeled as having dementia or not, we asked main caregivers ‘Do you think this older person suffers from dementia?’, and found out that 244 participants had been mistakenly labeled as having dementia since 2013. Related effects were measured using international generic scales as well, and the results showed that participants with better physical status deteriorated more rapidly if they were mistakenly labeled as having dementia. Additionally, the mental health of these 244 participants also deteriorated more quickly. Older adults that were not labeled as having dementia were more willing to participate in social activities relative to their labeled counterparts. In conclusion, being mistakenly labeled as having dementia without a medical diagnosis impaired older adults’ physical functioning and mental health. Moreover, the reduction of social activities of labeled older people leads to separation and social exclusion.抄録全体を表示PDF形式でダウンロード (366K) HTML形式で全画面表示 -
Tsuguo Nishijima, Kazuki Tajima, Yoshihiro Yamashiro, Keisuke Hosokawa ...原稿種別: Regular Contribution
2016 年 238 巻 4 号 p. 325-338
発行日: 2016年
公開日: 2016/04/16
ジャーナル フリー HTML(Pro)renin receptor ((P)RR), a receptor for renin and prorenin, is implicated in the pathophysiology of diabetes mellitus, hypertension and their complications. Soluble (P)RR (s(P)RR) is composed of extracellular domain of (P)RR and thus exists in blood. We have reported that plasma concentrations of s(P)RR were elevated in male patients with obstructive sleep apnea syndrome (OSAS). The aim of the present study was to clarify the difference in plasma s(P)RR concentrations between male and female OSAS patients. Plasma s(P)RR concentrations were studied in 289 subjects (206 males and 83 females) consisting of 259 OSAS patients and 30 non-OSAS control subjects. The 259 OSAS patients were classified into mild (5 ≤ apnea hypopnea index (AHI) < 15 events/h), moderate (15 ≤ AHI < 30), and severe OSAS (AHI ≥ 30). Plasma s(P)RR levels were significantly elevated in all three OSAS groups compared to non-OSAS control subjects (AHI < 5) in the entire cohort and male subjects, whereas in female subjects, the significant elevation was found only in severe OSAS. Plasma s(P)RR levels were significantly correlated with AHI in both sexes, with a higher r value found in male subjects (male r = 0.413, p < 0.0001; female r = 0.263, p < 0.05). Importantly, when OSAS patients (26 males and 15 females) with AHI ≥ 20 underwent continuous positive airway pressure treatment, plasma s(P)RR levels were significantly decreased. In conclusion, plasma s(P)RR levels are elevated in both male and female OSAS patients in parallel with the disease severity.抄録全体を表示PDF形式でダウンロード (795K) HTML形式で全画面表示 -
Yojiro Ishikawa, Tatsuya Nakamura, Takahiro Kato, Noriyuki Kadoya, Mot ...原稿種別: Regular Contribution
2016 年 238 巻 4 号 p. 339-345
発行日: 2016年
公開日: 2016/04/15
ジャーナル フリー HTMLProton beam therapy (PBT) is the preferred modality for early-stage lung cancer. Compared with X-ray therapy, PBT offers good dose concentration as revealed by the characteristics of the Bragg peak. Rib fractures (RFs) after PBT lead to decreased quality of life for patients. However, the incidence of and the risk factors for RFs after PBT have not yet been clarified. We therefore explored the relationship between irradiated rib volume and RFs after PBT for early-stage lung cancer. The purpose of this study was to investigate the incidence and the risk factors for RFs following PBT for early-stage lung cancer. We investigated 52 early-stage lung cancer patients and analyzed a total of 215 irradiated ribs after PBT. Grade 2 RFs occurred in 12 patients (20 ribs); these RFs were symptomatic without displacement. No patient experienced more severe RFs. The median time to grade 2 RFs development was 17 months (range: 9-29 months). The three-year incidence of grade 2 RFs was 30.2%. According to the analysis comparing radiation dose and rib volume using receiver operating characteristic curves, we demonstrated that the volume of ribs receiving more than 120 Gy3 (relative biological effectiveness (RBE)) was more than 3.7 cm3 at an area under the curve of 0.81, which increased the incidence of RFs after PBT (P < 0.001). In this study, RFs were frequently observed following PBT for early-stage lung cancer. We demonstrated that the volume of ribs receiving more than 120 Gy3 (RBE) was the most significant parameter for predicting RFs.抄録全体を表示PDF形式でダウンロード (1004K) HTML形式で全画面表示
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