The Tohoku Journal of Experimental Medicine
Online ISSN : 1349-3329
Print ISSN : 0040-8727
ISSN-L : 0040-8727
257 巻, 2 号
June
選択された号の論文の10件中1~10を表示しています
Editorial: Review Series in Disaster Medicine
  • Yasuto Kunii, Hitomi Usukura, Yusuke Utsumi, Moe Seto, Yumiko Hamaie, ...
    原稿種別: Editorial: Review Series in Disaster Medicine
    2022 年 257 巻 2 号 p. 85-95
    発行日: 2022年
    公開日: 2022/06/04
    [早期公開] 公開日: 2022/05/13
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    After the Great East Japan Earthquake, Tohoku University began to provide mental health services during the acute phase of the disaster in cooperation with Shichigahama Town, one of the municipalities located in the coastal area of the Miyagi Prefecture that was severely damaged by the earthquake and tsunami; it continued to be providing long-term mental health activities, incorporating annual surveys for affected residents in the town for 10 years. Ten years of combination of surveys and outreach activities first depicted detailed longitudinal alterations in the mental health conditions of communities affected by a catastrophe. While posttraumatic stress reaction had recovered year by year after the year following the Great East Japan Earthquake, recovery from psychological distress retreated between 2014 and 2017, probably due to the relocation from temporal to eternal housing conditions. The annual cycles of assessment and provision of mental health support and promotion activities continued for 10 years can be an initial model for evidence-based, long-term post-disaster mental health and psychosocial support for the affected communities. Data regarding subsequent disasters should be collected in comparable ways, in order to improve the accuracy and usefulness of the accumulated data for planning and providing evidence-based post-disaster mental health and psychosocial support.

Regular Contribution
  • Akiko Kikuchi, Ryutaro Arita, Rie Ono, Yasunori Tadano, Natsumi Saito, ...
    原稿種別: Regular Contribution
    2022 年 257 巻 2 号 p. 97-106
    発行日: 2022年
    公開日: 2022/06/04
    [早期公開] 公開日: 2022/04/07
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    The fifth wave of the coronavirus disease 2019 (COVID-19) pandemic caused by delta variant infection depleted medical resources, and the Japanese government announced glucocorticoid use for outpatients. An appropriate outpatient-glucocorticoid treatment for COVID-19 has not been established; therefore, we created treatment manuals with indications for glucocorticoid administration in a care facility adequately equipped to manage patients with mild to moderate COVID-19. Thirty-eight patients (24 males, 14 females; mean age 40.5 ± 11.8 years) were treated with glucocorticoids from August 1 to October 1, 2021 [COVID-19 staging, mild (n = 1), moderate I (n = 19), and moderate II (n = 18)]. Patients were treated with 6.6 mg/day d.i.v. or 6 mg/day p.o. dexamethasone, or 20-30 mg/day p.o. prednisolone. The median (25th-75th percentile) number of days from the date of onset to glucocorticoid administration was 8.0 days (7.0-11.25 days). While 24 patients were hospitalized, the condition of 14 improved without hospitalization. The median number of days from glucocorticoid administration to hospitalization was 1.0 day (range, 1.0-1.0 day). In the non-hospitalized patients, the median number of days of glucocorticoid administration was 5.0 days (5.0-5.25 days). The mean number of days from glucocorticoid administration to discharge from the care facility for non-hospitalized patients was 8.4 ± 3.3 days. The adverse reactions among non-hospitalized patients included insomnia (n = 1) and mild liver dysfunction (n = 3). The present method of glucocorticoid administration can be safely used for patients with COVID-19 in care facilities.

  • Yoshihiro Hagiwara, Yutaka Yabe, Takuya Sekiguchi, Yumi Sugawara, Masa ...
    原稿種別: Regular Contribution
    2022 年 257 巻 2 号 p. 107-115
    発行日: 2022年
    公開日: 2022/06/07
    [早期公開] 公開日: 2022/04/14
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    Shoulder pain is more common among survivors of natural disasters than the general population. This study aimed to examine the occurrence of shoulder pain, especially the association between prior and later shoulder pain episodes, in survivors living in coastal areas severely damaged by the Great East Japan Earthquake (GEJE) (n = 1,821) over a period of 5 years. The presence of shoulder pain was assessed at 2 (first period), 4 (second period), and 7 (third period) years after the disaster. Multiple logistic regression analyses were performed to assess the association between shoulder pain during the first and second periods and shoulder pain during the third period. Shoulder pain in the first period was significantly associated with shoulder pain in the third period [adjusted odds ratio (OR) 5.93; 95% confidence interval (CI) 4.06-8.66]. Furthermore, shoulder pain in the first and second periods was significantly associated with shoulder pain in the third period. With the absence of shoulder pain in both the first and second periods used as the reference, adjusted ORs for the presence of shoulder pain during each period and both periods were 4.58 (95% CI 3.17-6.62) and 15.54 (95% CI 8.38-28.84), respectively (P for trend < 0.001). Thus, prior shoulder pain was significantly associated with shoulder pain after 5 years among GEJE survivors, and the association was stronger as the number of prior shoulder pain episodes increased. This expertise should be shared with other expert teams to address the affected people and prepare for future disasters.

  • Alena Zakharova, Keiko Kabasawa, Yumi Ito, Junta Tanaka, Aya Hinata, K ...
    原稿種別: Regular Contribution
    2022 年 257 巻 2 号 p. 117-125
    発行日: 2022年
    公開日: 2022/06/07
    [早期公開] 公開日: 2022/04/14
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    Several studies have reported an association between sarcopenia and depression. Their results, however, are inconsistent, partly due to small sample sizes and lack of consideration of important confounders. The present study aimed to cross-sectionally examine this association in community-dwelling people in Japan. This study used baseline data from the Yuzawa cohort study (age ≥ 40 years), with the final analysis population comprising 2,466 participants. A self-administered questionnaire was used to elicit information related to sarcopenia, depressive symptoms, demographic characteristics, anthropometrics, disease history, and lifestyles. Sarcopenia was diagnosed using SARC-F, a validated questionnaire including components of Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls. Depressive symptoms were assessed using the 11-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). For depressive symptoms, prevalence ratios (PRs) were calculated, and odds ratio (ORs) were obtained using simple and multiple logistic regression analyses. Mean age of participants was 61.7 years (standard deviation = 11.8), and 10.5% and 34.7% had sarcopenia and depressive symptoms, respectively. Sarcopenic individuals had a significantly higher PR (2.00), unadjusted OR (3.67), and adjusted OR (4.96) compared to non-sarcopenic individuals, with an estimated adjusted PR of 2.7. There was a significant dose-dependent association between SARC-F scores and depressive symptoms in sarcopenic individuals (adjusted P for trend = 0.0028). In conclusion, sarcopenia and depressive symptoms were robustly associated in community-dwelling, middle-aged and older people in Japan. However, the direction of this association is unclear, and a future cohort study will be needed to determine causality.

Case
  • Daigo Chiba, Yoshihide Kawasaki, Atsushi Miyagi, Yuki Katsumata, Yohei ...
    原稿種別: Case
    2022 年 257 巻 2 号 p. 127-133
    発行日: 2022年
    公開日: 2022/06/08
    [早期公開] 公開日: 2022/04/14
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    The present case study was conducted on a 74-year-old man who visited our department due to a left renal and retroperitoneal tumor on computed tomography (CT). The patient was diagnosed with left renal cancer lymph node metastasis and was hospitalized a few weeks prior to surgery due to fever, malaise, and severe appetite loss. Biochemical laboratory findings at admission showed markedly high levels of inflammation. The cause of high inflammatory response was paraneoplastic syndrome. Tumor resection was considered necessary, and left nephrectomy and lymphadenectomy were performed; however, it did not improve the inflammatory response. After operation, positron emission tomography-CT revealed hyperaccumulation of 18F-fluorodeoxyglucose in the bone marrow throughout the body. Pathological examination of the resected specimen and bone marrow aspiration revealed the coexistence of idiopathic multicentric Castleman disease (CD) and renal cancer. Prednisolone and tocilizumab were administered for idiopathic multicentric CD and a tyrosine kinase inhibitor for renal cancer; however, they had poor therapeutic effect, and the patient died. CD is characterized by systemic symptoms due to the overproduction of interleukin-6. Treatment for idiopathic multicentric CD involves steroid and anti-interleukin-6 therapy. The diagnostic criteria for CD require the exclusion of malignant tumors although there are some cases in which CD and malignant tumors coexist. The prognosis for CD is relatively good; however, as in this case, the prognosis of CD coexisting with uncontrollable renal cancer is insufficient due to poor improvement in the inflammatory response.

Regular Contribution
  • Qingchao Sun, Haiping Zhang, Liang Zong, Ainiwaer Julaiti, Xiaoliang J ...
    原稿種別: Regular Contribution
    2022 年 257 巻 2 号 p. 135-145
    発行日: 2022年
    公開日: 2022/06/08
    [早期公開] 公開日: 2022/03/24
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    Dysregulated expression of ubiquitin-specific protease 43 (USP43) has been recently discovered in malignancies. This study aimed to investigate the expression pattern of USP43 protein in lung squamous cell carcinoma (LUSC) and to explore its correlation with patients’ clinicopathological characteristics as well as clinical outcomes. Expression of USP43 protein was determined by immunohistochemistry staining in a retrospective cohort containing 157 LUSC cases who underwent curative surgery in our hospital. Accordingly, USP43 protein was positively correlated with tumor size, depth of invasion, and lymph node metastasis. Patients with increased USP43 expression or positive lymph nodes exhibited a poorer overall survival. In addition, cellular assays elucidated that USP43 can promote LUSC growth and invasion. Taken together, our study demonstrated that USP43 may act as a proto-oncogene, which could be a promising biomarker and therapeutic target in the survival prediction and treatment of LUSC.

  • Yusuf Taha Güllü, Ebru Kulucan, Nazmiye Tibel Tuna, Nurhan Köksal, Niz ...
    原稿種別: Regular Contribution
    2022 年 257 巻 2 号 p. 147-151
    発行日: 2022年
    公開日: 2022/06/08
    [早期公開] 公開日: 2022/04/21
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    The number of cases of coronavirus disease-2019 (COVID-19) globally is over 225 million, and disease-related deaths are over 4 million. The type, prevalence, and antibody susceptibility of the virus variants of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and the vaccination rate and coverage are considered critical factors in the progress of COVID-19. We aimed to compare the clinical and laboratory parameters of the patients hospitalized due to COVID-19 in pre-vaccination and post-vaccination periods. We conducted this retrospective cross-sectional study in a tertiary clinic in Turkey. The files of the patients over the age of 18, whose real-time polymerase chain reaction (RT-PCR) tests were positive and who were hospitalized before (November-December 2020, Group 1) and after (March-April 2021, Group 2) COVID-19 vaccination were scanned. Patients’ demographical data, clinical severity, laboratory parameters, thorax computed tomography involvement, and mortalities were recorded. The obtained data were compared among the groups. 601 patients (344 male, 57% and 257 female, 43%) were included in the study. It was observed that the patients in the Group 2 were younger (60.71 ± 14.06 vs. 66.95 ± 14.57, p < 0.001), and a significant decrease in mortality [83 (28.6%) vs.139 (44.6%), p = 0.001] were observed in Group 2. The number of patients who needed ventilatory support and the rate of pulmonary involvement was lesser in Group 2, but the difference was non-significant. C-reactive protein, D-dimer, procalcitonin levels were significantly lower in Group 2 patients. Our study shows that the age and mortality of hospitalized COVID-19 patients decreased significantly after vaccination. An increase in the number of booster doses in individuals with advanced age (age > 75) and comorbidity (especially malignancy) may contribute to the control of the disease and immunity in this population.

Case
  • Yuji Fujita, Keiichi Tominaga, Takanao Tanaka, Kazuyuki Ishida, Shigem ...
    原稿種別: Case
    2022 年 257 巻 2 号 p. 153-156
    発行日: 2022年
    公開日: 2022/06/08
    [早期公開] 公開日: 2022/04/21
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    Eosinophilic gastrointestinal disorders (EGIDs) cause various gastrointestinal symptoms due to infiltration of eosinophils into the gastrointestinal tract. Helicobacter pylori (H. pylori) is a microorganism that is associated with various diseases such as autoimmune diseases. In recent years, H. pylori is considered protective in inflammatory bowel diseases and gastrointestinal autoimmune disorders but is not known to be protective in EGIDs. A 14-year-old boy presented with epigastric pain and nausea, without diarrhea. His symptoms were not associated with meals. Blood examination showed an eosinophil count of 1,666 cells/µL (17.0%) and an interleukin-5 (IL-5) level of less than 3.9 pg/mL. Esophagogastroduodenoscopy showed chronic gastritis and duodenal ulcers. Capsule endoscopy and colonoscopy showed no abnormal findings. The patient was diagnosed with chronic gastritis due to H. pylori infection and eosinophilic duodenal ulcers. H. pylori eradication was performed. However, the abdominal pain worsened with elevated peripheral eosinophil count [2,314/µL (26%)] and serum IL-5 level (8.0 pg/mL). Montelukast administration improved the symptoms and laboratory findings [peripheral eosinophil count, 330/µL (5.9%); IL-5, < 3.9 pg/mL]. EGIDs should be considered as a cause of duodenal ulcers. H. pylori may be protective in EGIDs. Montelukast monotherapy may be considered as a first line treatment for eosinophilic duodenal lesions.

  • Tímea Éltes, Boglárka Hajnal, Anita Kamondi
    原稿種別: Case
    2022 年 257 巻 2 号 p. 157-161
    発行日: 2022年
    公開日: 2022/06/08
    [早期公開] 公開日: 2022/04/14
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    Neurological emergencies, such as acute stroke, are especially challenging during the current Coronavirus disease-2019 (COVID-19) pandemic. Symptoms as aphasia or dysarthria are severely impacting cooperation and communication with patients. During physical examination, both the patient and the medical team are fitted routinely with surgical masks to minimize potential exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, such a practice can lead to concealment of particularly relevant physical signs. We report a case series of four acute stroke patients who were transferred for endovascular mechanical thrombectomy to our institute after intravenous thrombolysis was initiated at primary stroke centers. Upon arrival, after removing their masks, we observed oral angioedema, as a reaction to thrombolytic agent alteplase. Symptoms remained obscured by face masks through patient care at the referring stroke unit and during transportation, nevertheless they resolved after treatment. Most probably, there are a number of similar cases encountered at emergency departments and acute stroke units. To improve patient safety, a compromise between ensuring protection against the novel coronavirus and facilitating detection of potentially life-threatening physical signs must be found.

Regular Contribution
  • Rosa María Márquez-González, Anilú Margarita Saucedo-Sariñana, Patrici ...
    原稿種別: Regular Contribution
    2022 年 257 巻 2 号 p. 163-169
    発行日: 2022年
    公開日: 2022/06/08
    [早期公開] 公開日: 2022/04/21
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    Colorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide. Down-regulation of the cysteine-rich reversion-inducing protein with Kazal motifs (RECK) has been confirmed in numerous human cancers and is clinically associated with metastasis. This study aims to explore, for the first time, the possible association of the RECK variants rs11788747 and rs10972727 with CRC susceptibility and clinicopathological features. DNA from 130 CRC patients and 130 healthy blood donors was analyzed. Identification of genetic variants was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology. Association was calculated using the odds ratio (OR) test and P values were adjusted using the Bonferroni test. Individuals carrying the G/G genotype for the rs11788747 variant showed a lower risk of colorectal cancer (OR 0.33; 95% CI 0.16-0.70; P = 0.006). Patients older than 50 years who carry the G/G genotype have a lower risk of CRC (OR 0.26; 95% CI 0.09-0.73; P = 0.019) and of developing advanced tumor-nodule-metastasis (TNM) stages (OR 0.23; 95% CI 0.09-0.54; P = 0.001). Individuals carrying the A/A genotype of the rs10972727 variant also showed decreased risk of CRC (OR 0.38; 95% CI 0.19-0.77; P = 0.011), and were associated with age (over 50 years), sex, advanced TNM stages, and tumor location in the colon. Our results suggest that the RECK variants studied here (rs11788747 and rs10972727) are associated with decreased CRC risk, TNM stages and tumor location.

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