著者
Kae Okoshi Kyoko Nomura Kayo Fukami Yasuko Tomizawa Katsutoshi Kobayashi Koichi Kinoshita Yoshiharu Sakai
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.234, no.3, pp.221-227, 2014 (Released:2014-10-28)
参考文献数
45
被引用文献数
4 9

During 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.
著者
Haneul Lee Jerrold Petrofsky Nirali Shah Abdulaziz Awali Karan Shah Mohammed Alotaibi JongEun Yim
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.234, no.2, pp.117-122, 2014 (Released:2014-09-17)
参考文献数
25
被引用文献数
2 6

Evaporation 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.
著者
Di Wu Fuminori Kimura Akiko Takashima Yoshihiko Shimizu Akie Takebayashi Nobuyuki Kita GuangMei Zhang Takashi Murakami
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.230, no.1, pp.17-23, 2013 (Released:2013-05-11)
参考文献数
38
被引用文献数
4 5

Polycystic ovary syndrome (PCOS) is one of major causes of irregular menstruation. It is defined as a condition involving the combination of hyperandrogenism and chronic oligomenorrhea or anovulation, and is thought to have a variety of etiologies. Insulin resistance (impaired insulin sensitivity) has been suggested to be one of the etiologies of PCOS. PCOS patients often need to take medication to treat anovulation and infertility. Therefore, it would be beneficial to patients if simple non-pharmacological treatments can be developed. Recently the efficacy of vinegar to improve insulin resistance has been reported. To study the effect of vinegar on metabolic and hormonal indices and ovulatory function in PCOS, seven patients seeking a non-pharmacological treatment for PCOS took a beverage containing 15 g of apple vinegar daily for 90 to 110 days. Ovulation, the menstrual interval, fasting serum glucose level, fasting serum insulin level, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testosterone were compared before and after intake of the vinegar beverage. Intake of the vinegar beverage resulted in a decrease of the homeostasis model assessment insulin resistance index (HOMA-R) in six patients, as well as a decrease of the LH/FSH ratio in five of seven patients. Ovulatory menstruation was observed within 40 day in four of seven patients. These findings suggest the possibility of vinegar to restore ovulatory function through improving insulin sensitivity in PCOS patients, thus, avoiding pharmacological treatment. Intake of vinegar might reduce medical cost and treatment time for insulin resistance, anovulation, and infertility in patients with PCOS.
著者
Jin Qi Yaoqi Yang Ping Hao Jianqiang Xu
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.242, no.4, pp.335-335, 2017 (Released:2017-09-06)

We reported “Transcription Factor SOX9 Promotes Osteosarcoma Cell Growth by Repressing Claudin-8 Expression” in Tohoku J. Exp. Med., 2017, 241 (1), 55-63; doi: 10.1620/tjem.241.55. After publication of the paper, we have become aware of the ethical violation in collecting the samples from some patients. We therefore wish to retract the paper and apologize for any inconvenience caused by the retraction.
著者
Yusuke Matsuyama Toru Tsuboya Shun-ichiro Bessho Jun Aida Ken Osaka
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.244, no.2, pp.163-173, 2018 (Released:2018-03-01)
参考文献数
29

Healthcare utilization after natural disasters remains understudied. In general, people in Japan pay 10%-30% of total amount of costs, according to their health insurance plan. A policy exempting survivors from copayments was introduced after the Great East Japan Earthquake in March 2011, which had a magnitude of 9.0 on the Richter scale and followed by devastating tsunamis. Among the disaster-affected areas, Miyagi prefecture experienced the largest number of deaths and the greatest extent of damage. However, the exemption was suspended in Miyagi prefecture from April, 2013, because of the huge governmental financial burden due to the immensity of damage from the disaster. Subsequently, in April 2014, the exemption was re-introduced, with smaller coverage. We, therefore, evaluated the influence of this policy change on monthly healthcare utilization in Miyagi prefecture between April 2008 and June 2015. We also evaluated the association between the proportion of people exempted from copayment in each municipality and the difference in healthcare utilization before and after the suspension using multivariable linear regression. Healthcare utilization in Miyagi increased immediately after the institution of the exemption policy and it peaked after one year. In March 2013, just before the suspension, a rapid increment in healthcare utilization was observed, suggesting that the copayment may be a barrier for people in the disaster-affected area to access to healthcare. The exemption policy did help the survivors to use healthcare utilization in Miyagi. After devastating natural disasters, policymakers should guarantee that all survivors can utilize healthcare services on demand.
著者
Jerrold Petrofsky Haneul Lee
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.237, no.3, pp.219-226, 2015 (Released:2015-11-03)
参考文献数
61
被引用文献数
1 5

One of the sexual hormones, estrogen, increases elasticity of human connective tissue such as the anterior cruciate ligament during the menstrual cycle in women. In the present investigation, the plantar fascia was investigated to see if there is a difference in elasticity with the menstrual cycle. Fifteen young healthy females in the age range of 18-35 years old with a regular menstrual cycle were tested twice throughout one full menstrual cycle; once during the early follicular phases and once at ovulation. Foot length, while standing on both feet and one foot were used to assess plantar fascia elasticity, ultrasound measured plantar fascia thickness while lying and standing, and posture sway and tremor using a balance platform during 8 different balance tests were assessed to see the impact of elasticity changes. Foot length increased significantly at ovulation compared to menstruation when standing on two feet (p = 0.03) and standing on one foot (p < 0.001). There was also a significant increase in plantar fascia in thinning per kilogram weight applied to the foot at ovulation compared to menstruation (p = 0.014). Associated with this increase in elasticity at ovulation, there was a reduction in balance in the most difficult balance tasks and an increase in tremor during ovulation (p < 0.05). Plantar fascia elasticity change during the menstrual cycle might have effects on posture sway and tremor, which could have a potential risk of falling. Therefore, healthy professionals working with young female adults should recognize these physiological effects.
著者
Hisanori Fukunaga Akinari Yokoya Yasuyuki Taki Kevin M. Prise
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.242, no.1, pp.77-81, 2017 (Released:2017-05-27)
参考文献数
32
被引用文献数
3

On March 11, 2011, a devastating earthquake and subsequent tsunami caused serious damage to areas of the Pacific coast in Fukushima prefecture and prompted fears among the residents about a possible meltdown of the Fukushima Daiichi Nuclear Power Plant reactors. As of 2017, over six years have passed since the Fukushima nuclear crisis and yet the full ramifications of the biological exposures to this accidental release of radioactive substances remain unclear. Furthermore, although several genetic studies have determined that the variation in radiation sensitivity among different individuals is wider than expected, personalized medical approaches for Fukushima victims have seemed to be insufficient. In this commentary, we discuss radiobiological issues arising from low-dose radiation exposure, from the cell-based to the population level. We also introduce the scientific utility of the Integrative Japanese Genome Variation Database (iJGVD), an online database released by the Tohoku Medical Megabank Organization, Tohoku University that covered the whole genome sequences of 2,049 healthy individuals in the northeastern part of Japan in 2016. Here we propose a personalized radiation risk assessment and medical approach, which considers the genetic variation of radiation sensitivity among individuals, for next-step developments in radiological protection.
著者
Yeongcheol Eum Jongeun Yim
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.235, no.1, pp.17-23, 2015 (Released:2014-12-26)
参考文献数
65
被引用文献数
6

Stroke is one of the leading causes of morbidity and long-term disability worldwide, and post-stroke depression (PSD) is a common and serious psychiatric complication of stroke. PSD makes patients have more severe deficits in activities of daily living, a worse functional outcome, more severe cognitive deficits and increased mortality as compared to stroke patients without depression. Therefore, to reduce or prevent mental problems of stroke patients, psychological treatment should be recommended. Literature and art therapy are highly effective psychological treatment for stroke patients. Literature therapy divided into poetry and story therapy is an assistive tool that treats neurosis as well as emotional or behavioral disorders. Poetry can add impression to the lethargic life of a patient with PSD, thereby acting as a natural treatment. Story therapy can change the gloomy psychological state of patients into a bright and healthy story, and therefore can help stroke patients to overcome their emotional disabilities. Art therapy is one form of psychological therapy that can treat depression and anxiety in stroke patients. Stroke patients can express their internal conflicts, emotions, and psychological status through art works or processes and it would be a healing process of mental problems. Music therapy can relieve the suppressed emotions of patients and add vitality to the body, while giving them the energy to share their feelings with others. In conclusion, literature and art therapy can identify the emotional status of patients and serve as a useful auxiliary tool to help stroke patients in their rehabilitation process.
著者
Ferda Kaleagasioglu Ercan Olcay
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.226, no.4, pp.251-258, 2012 (Released:2012-03-28)
参考文献数
66
被引用文献数
6 13

Tendinopathy is a serious health problem and its etiology is not fully elucidated. Among intrinsic and extrinsic predisposing factors of tendinopathy, the impact of therapeutic agents, especially fluoroquinolone (FQ) group antibiotics, is recently being recognized. FQs are potent bactericidal agents widely used in various infectious diseases, including community acquired pneumonia and bronchitis, chronic osteomyelitis, traveler's diarrhea, typhoid fever, shigellosis, chronic bacterial prostatitis, uncomplicated cervical and urethral gonorrhea and prophylaxis of anthrax. FQs have an acceptable tolerability range. However, many lines of evidence for developing tendinitis and tendon rupture during FQ use have resulted in the addition of a warning in patient information leaflets. FQ-induced tendinopathy presents a challenge for the clinician because healing response is poor due to low metabolic rate in mature tendon tissue and tendinopathy is more likely to develop in patients who are already at high risk, such as elderly, solid organ transplant recipients and concomitant corticosteroid users. FQs become photo-activated under exposure to ultraviolet light, and this process results in formation and accumulation of intracellular reactive oxygen species (ROS). The subsequent FQ-related oxidative stress disturbs mitochondrial functions, leading to apoptosis. ROS overproduction also has direct cytotoxic effects on extracellular matrix components. Understanding the mechanisms of the FQ-associated tendinopathy may enable designing safer therapeutic strategies, hence optimization of clinical response. In this review, we evaluate multi-factorial etiology of the FQ-induced tendinopathy and discuss proposed preventive measures such as antioxidant use and protection from natural sunlight and artificial ultraviolet exposure.
著者
Junichiro Hashimoto
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.233, no.1, pp.1-8, 2014 (Released:2014-04-12)
参考文献数
73
被引用文献数
3 9

Recent advances in technology have enabled the noninvasive evaluation of pulsatile hemodynamics in the central aorta; namely, central pressure and flow measurements. The central blood pressure represents the true load imposed on the heart, kidney and brain, and the central blood flow influences the local flow into these vital organs. An elevation of the central blood pressure has a direct, adverse impact on the target organ and, thus, the cardiovascular prognosis in patients with hypertension. A decrease in the central blood flow can cause organ dysfunction and failure. The central pressure and flow dynamics were conventionally regarded as unidirectional from the heart to the periphery. However, current evidence suggests that it should be recognized as a bidirectional interplay between the central and peripheral arteries. Specifically, the pressure pulse wave is not only transmitted forward to the periphery but also reflected backward to the central aorta. The flow pulse wave is also composed of the forward and reverse components. Aortic stiffening and arteriolar remodeling due to hypertension not only augment the central pressure by increasing the wave reflection but also may alter the central bidirectional flow, inducing hemodynamic damage/dysfunction in susceptible organs. Therefore, central hemodynamic monitoring has the potential to provide a diagnostic and therapeutic basis for preventing systemic target organ damage and for offering personalized therapy suitable for the arterial properties in each patient with hypertension. This brief review will summarize hypothetical mechanisms for the association between the central hemodynamics and hypertensive organ damage in the heart, kidney and brain.
著者
Hisanori Fukunaga Hiromi Kumakawa
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.237, no.1, pp.41-43, 2015 (Released:2015-09-01)
参考文献数
6
被引用文献数
1 6

The great earthquake of 11 March 2011 and resulting tsunami caused serious damage to various areas of the Pacific coast in northeast Fukushima, and all the residents faced fears of meltdown of the reactors at the Fukushima Daiichi Nuclear Power Plant. One of the most seriously affected areas was the district of Soso, located in the northeast part of Fukushima prefecture, with 12 municipalities (Soma City, Minamisoma City, Shinchi Town, Namie Town, Futaba Town, Ōkuma Town, Tomioka Town, Naraha Town, Hirono Town, Iitate Village, Katsurao Village and Kawauchi Village). The district of Soso is home to approximately 200,000 residents, many of whom were seriously affected by the threefold disaster. During the subsequent four years, the population of Soso decreased by nearly 10%. In March 2011 before the disaster, five hospitals and two clinics for psychiatric patients, along with 712 inpatients, were operating in the district of Soso. However, as of March 2015, there were only one hospital and three clinics, along with approximately 50 inpatients, although a new mental health clinic in Soma City was opened in 2012 for supporting victims suffering from the disaster. We hereby suggest that the patients and residents of northeast Fukushima may be undergoing mental health crisis. In fact, disaster-related psychological stress could have induced several physical and mental disorders. The mid- and long-term supports are urgently needed not only for psychiatric patients but also for all residents in the district of Soso.
著者
SEIICHI AONUMA FUMIO ARIJI KOTARO OIZUMI KIYOSHI KONNO
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.152, no.2, pp.119-128, 1987 (Released:2006-08-31)
参考文献数
9
被引用文献数
2 2

AONUMA, S., ARIJI, F., OIZUMI, K. and KONNO, K. Electron Microscopy of Pseudomonas aeruginosa Treated with Sulbenicillin and Dibekacin. Tohoku J. exp. Med., 1987, 152 (2), 119-128 - A possible mechanism responsible for the combined effects of sulbenicillin and dibekacin on Pseudomonas aeruginosa TAM 1007 was investigated. The bactericidal activity of the above two drugs in combination was very strong. The regrowth of test strains after removal of the drugs was suppressed markedly, even when they were exposed to sulbenicillin plus dibekacin at a subinhibitory concentration of individual drugs. Sulbenicillin caused elongation of the bacterial cells. At the early stage of elongation, no demonstrable changes of ultrastructure of the cell wall were observed. At the late stage, lysis of the peptidoglycan layer occurred and spheroplast was formed. However, most of the outer membrane of the cell wall remained intact. Sulbenicillin acts upon the peptidoglycan layer, but not on the outer membrane. Thus it is difficult for sulbenicillin alone to cause cell lysis. On the other hand, dibekacin caused destruction of ribosomes and lysis of the outer membrane of the cell wall. Both sulbenicillin and dibekacin act on the cell wall, the former on the peptidoglycan layer (the inner membrane) and the latter on the outer membrane. The combined use of sulbenicillin and dibekacin caused elongation of bacilli and severe destruction of the inner and outer membranes of the cell wall. These morphological changes occurred even when the concentration of the individual drug was lower than its minimum inhibitory concentration (MIC). Furthermore, the cells elongated by sulbenicillin were ruptured easily when treated with dibekacin subsequently. The bacilli treated with dibekacin at a concentration lower than MIC and then treated with sulbenicillin at a concentration lower than MIC showed a marked elongation of the cells, which indicated that the effects of sulbenicillin was enhanced by dibekacin. These findings suggested strongly that sulbenicillin and dibekacin act on cell wall constituents and that their effects were complementary and synergistic.
著者
Hiroyuki Tsuchie Naohisa Miyakoshi Yuji Kasukawa Tomio Nishi Hidekazu Abe Masaaki Takeshima Yoichi Shimada
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.230, no.2, pp.83-86, 2013 (Released:2013-06-12)
参考文献数
13
被引用文献数
2 3

Low back pain (LBP) is one of the most common symptoms in outpatient clinics, and abdominal aortic aneurysm (AAA) is one of the causes of LBP. In the present study, we examined the prevalence of chronic LBP in patients with aortic aneurysm. The study included 23 patients with AAA and 23 patients with thoracic aortic aneurysm (TAA); all of them visited a regional center hospital in Akita, Japan. A total of 207 hypertension patients were also enrolled as a control. Chronic LBP was defined in patients who visited the orthopedic outpatient clinic for the LBP treatment for more than three months. The prevalence of chronic LBP in the AAA group (52.2%) was significantly higher than that in the TAA (17.4%, P < 0.05) or hypertension patients (11.6%, P < 0.01). The rate of a trigger point (TP) injection was significantly higher in the AAA group or the TAA group than that in hypertension patients (P < 0.01, P < 0.05), but there was no significant difference between the AAA and TAA groups. The TP injection represents an injection of local anesthesia to the low back muscles. We also evaluated the involvement of various factors in LBP caused by AAA, such as age, gender, blood pressure, the existence of dissection, and the maximum diameter of AAA, but none of them showed significant relationship to LBP. The prevalence of LBP is high in AAA patients, and doctors who treat chronic LBP should be aware of AAA as a potential cause of LBP.
著者
James P. Butler Masahiko Fujii Hidetada Sasaki
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.227, no.3, pp.203-210, 2012 (Released:2012-06-27)
参考文献数
96
被引用文献数
12 16

Our new lessons of nurturing life to make happiness and well-being of geriatric patients suggest comprise several important steps. First, geriatric patient care should not be delegated to specialists who focus on individual organ system. Instead, we should respond to the patient's condition based on comprehensive assessment to identify the single pathogenesis. Second, we should appreciate that the behavioral and psychological symptoms of dementia (BPSD) often reflect the behavioral and psychological symptoms of the caregiver (BPSC), and in particular the caregiver's attitude. Third, pleasant stimulations to the limbic system should receive more emphasis than attempting brain training in atrophied portions of the neocortex. Fourth, we should aim not for “successful aging,” but for “balanced aging.” Fifth, we should rely less on drug-based therapy and utilize more non-pharmacologic approaches to appropriate therapy. Geriatric patients should be cared for based on our new lessons of nurturing life rather than the heavily medicalized treatment modalities that are in wide use today.
著者
Susumu Ogawa Takaaki Abe Kazuhiro Nako Masashi Okamura Miho Senda Takuya Sakamoto Sadayoshi Ito the DIMS study group
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.231, no.1, pp.63-74, 2013 (Released:2013-09-25)
参考文献数
37
被引用文献数
4 9

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are ω3-polyunsaturated fatty acids mainly contained in the blue-backed fish oil, and are effective in decreasing the lipids disorder and the cardiovascular incidence among diabetic patients. Moreover, it has been suggested that EPA and DHA may improve the insulin resistance and glucose metabolism. However, the clinical effects of EPA and DHA on glucose metabolism remain unclear. We aimed to clarify the effects of EPA/DHA treatment on glycemic control in type 2 diabetes mellitus. This study was a multicenter prospective randomized controlled trial involving 30 elderly type 2 diabetic patients on a liquid diet. Their exercises were almost zero and the content of their meals was strictly managed and understood well. Therefore, the difference by the individual's life was a minimum. The subjects were divided into two groups: those receiving EPA/DHA-rich liquid diet [EPA/DHA (+)] or liquid diet lacking EPA/DHA [EPA/DHA (−)]. Changes in factors related to glucose and lipid metabolism were assessed after the three-month study. Serum concentrations of EPA rose in EPA/DHA (+), although the levels of DHA and fasting C-peptide remained unchanged in EPA/DHA (+). In addition, there was a significant decline in the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), fasting remnant-like particles and apolipoprotein (apo) B in EPA/DHA (+), compared with the values in EPA/DHA (−). EPA/DHA-rich diet might improve glucose metabolism in elderly type 2 diabetic patients on a liquid diet. This phenomenon may be due to the improved insulin resistance mediated by the rise in serum EPA concentrations.
著者
Chayanin Angthong Wirana Angthong Thos Harnroongroj Thossart Harnroongroj
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.226, no.2, pp.129-135, 2012 (Released:2012-01-26)
参考文献数
26
被引用文献数
1 1

Little is known about the effect of a subsequent osteoporotic vertebral compression fracture on the survival rate of patients with a previous hip fracture. In this study, we aimed to compare the survival rates of hip fracture patients with and without subsequent osteoporotic vertebral compression fractures and determine the risk factors associated with subsequent fracture. During 2000-2008, 933 initial hip fracture patients were reviewed and divided into two groups: subsequent fracture group (160 patients) and single hip fracture group (i.e., no subsequent fracture; 773 patients). All information pertaining to their most recent fracture event(s), including mortality causes/rates, were recorded. Differences in mortality rates and hazard ratios (HRs) between the two groups were also analyzed. The 1-year and 1-to-5-year mortality rates were 1.3% and 1.9%, respectively, in the subsequent fracture group, and 4.7% and 1.4%, respectively, in the single hip fracture group, with no significant differences observed. Interestingly, the HR for mortality was significantly higher in the single hip fracture group than in the subsequent fracture group (p < 0.05). The significant risk factors for subsequent fractures were identified as knee osteoarthritis, neurological disease, and an initial hip fracture with intertrochanteric involvement. Our findings indicate that the occurrence of a vertebral compression fracture after an initial hip fracture does not greatly impact patient survival. Conversely, patients presenting with a single hip fracture have a significantly higher mortality-HR, indicating that single hip fracture patients without subsequent fracture should be provided with the same standard of care as patients with subsequent fractures.
著者
Yuka Miyoshi Osamu Ogawa Yu Oyama
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.239, no.2, pp.155-158, 2016 (Released:2016-06-09)
参考文献数
14
被引用文献数
37 38

Programmed cell death-1 (PD-1), an immunoreceptor, is located on T cells and pro-B cells and interacts with its ligands to inhibit T cell activation and proliferation, thereby promoting immunological self-tolerance. Nivolumab, an anti-PD1 antibody, blocks PD-1 and can restore anticancer immune responses by abrogating PD-1 pathway-mediated T-cell inhibition. Autoimmune adverse events are expected with PD-1 therapy. Fulminant type 1 diabetes is the subtype of type 1 diabetes. The clinical feature is the extremely rapid progression of hyperglycemia and ketoacidosis. Here we describe a 66-year-old woman with advanced melanoma who was treated with nivolumab. After 4 months and six doses of the medicine, the patient was admitted to the hospital with complaints of nausea and vomiting. The laboratory data showed ketonuria, hyperglycemia (531 mg/dl), high anion gap metabolic acidosis, HbA1c (7.3%), and absence of insulin-secreting capacity. These data are compatible with the criteria of fulminant type 1 diabetes. The patient was diagnosed with diabetic ketoacidosis because of fulminant type 1 diabetes. The findings of this case indicated that nivolumab can cause fulminant type 1 diabetes. Diabetic ketoacidosis due to fulminant type 1 diabetes is potentially fatal condition. Thus, diabetic ketoacidosis due to fulminant type 1 diabetes should be considered in the differential diagnosis when patients treated with nivolumab complain of gastrointestinal symptoms.
著者
Makoto Shoji Kouki Katayama Kunio Sano
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.224, no.4, pp.251-256, 2011 (Released:2011-06-25)
参考文献数
10
被引用文献数
18

Influenza epidemics occur periodically during the winter season in temperate areas. Characteristic features of winter include low temperature and low humidity. Humidity is expressed in two different ways: absolute humidity (AH) defined as absolute amount of water in the air, and relative humidity (RH) defined as the relative proportion of water in the air in comparison to the maximum water vapor. There have been many arguments for RH as a determinant factor for influenza epidemics. On the other hand, we have been putting emphasis on AH on the basis of our epidemiological observations. In this context, a recent experimental and theoretical study by other investigators has shown that AH correlates with influenza survival, transmission, and seasonality. Accordingly, we collected meteorological and influenza epidemiological data from 46 prefectures in temperate Japan for 1991-1995 and 1999-2009, and analyzed 2,392 sets of weekly compiled data for each season year by using multiple linear regression analysis, in which the numbers of influenza cases were regarded as a function of AH and RH. We found that the standardized partial regression coefficient for AH was consistently stronger than that for RH with statistical significance. In addition, AH increased and decreased significantly at the time of the epidemic onset and subsidence in seven and twelve out of fourteen influenza seasons, respectively, whereas RH did so in none and two out of fourteen influenza seasons. Thus, we have substantiated our quarter-century-old assertion that AH strongly correlates with the onset and subsidence of influenza epidemics.
著者
Kento Morozumi Keiko Ainoya Jun Takemoto Kiyohide Sakai
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.245, no.3, pp.187-191, 2018 (Released:2018-07-14)
参考文献数
11

Campomelic dysplasia (CD) is a skeletal dysplasia characterized by shortened and bowed long bones, airway instability, the potential for disorders of sexual differentiation (DSD), and Pierre Robin Sequence (PRS) with cleft palate, midface hypoplasia and laryngotrachemomalacia. CD is caused by alterations in the Sex-determining region of the Y chromosome (SRY)-related-box 9 (SOX9), which has important roles in tissue and sexual differentiation. The SOX9 gene and the enhancer regions of SOX9 are located at chromosome 17q24.3. We report a 6-year-old phenotypically female referred to our department because of precocious puberty. The patient was born with Tetralogy of Fallot (TOF) and PRS. Skeletal X-ray examination showed only 11 pairs of ribs and bilateral bowed radiuses. Endocrine evaluations showed that increased levels of serum testosterone, and chromosomal analysis revealed a 46, XY, t(2;17)(p15;q24.2) karyotype. The patient was diagnosed with peripheral precocious puberty caused by over-secretion of testosterone by gonadoblastoma originating from dysgenetic gonads with Y-chromosome-related DSD. Multiple somatic abnormalities and DSD indicated that the patient might have CD. Laparoscopy revealed bilateral dysgenetic gonads, and these were removed in the successive operation to prevent malignant transformation and virilization, caused by dysgenetic gonads with Y chromosomal materials. It is highly suggestive that the chromosomal translocation of 17q 24.2 may cause DSD and multiple somatic abnormalities, including CD, although the identified 17q breakpoint was located outside of known SOX9 enhancer regions. Thus, a hitherto unknown enhancer may be present at 17q24.2. This is the first reported case of CD with a translocation breakpoint at 17q24.2.