著者

Nobue Takaiso Haruki Nishizawa Sachie Nishiyama Tomio Sawada Eriko Hosoba Tamae Ohye Tsutomu Sato Hidehito Inagaki Hiroki Kurahashi

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

vol.2, no.3, pp.59-61, 2016 (Released:2016-08-31)

参考文献数

13

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The genetic etiology of female infertility is almost completely unknown. Recently, the egg membrane protein JUNO was identified as a receptor of the sperm-specific protein IZUMO1 and their interaction functions in sperm-egg fusion in fertilization. In the present study, we examined 103 women with infertility of unknown etiology. We analyzed the JUNO gene in these cases by PCR and Sanger sequencing. We identified seven variants in total: four common, two synonymous, and a previously unidentified intronic mutation. However, it is not clear from these variants that JUNO has a major role, if any, in infertility. Many factors affect sterility and a larger cohort of patients will need to be screened in the future because the cause of female infertility is highly heterogeneous.

著者

Yuka Kawada Akira Yamada Shinji Jinno Chihiro Nakashima Naoki Hoshino Sayano Ueda Meiko Hoshino Sayuri Yamabe Kayoko Takada Kunihiko Sugimoto Hideo Izawa

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-038, (Released:2023-08-28)

参考文献数

22

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Objectives: We aimed to identify which resting echocardiographic parameters can detect asymptomatic or mildly symptomatic patients with primary mitral regurgitation (MR) who require exercise stress echocardiography (ESE) to determine their suitability for surgery.Methods: We examined 56 consecutive patients with primary moderate/severe MR who underwent ergometer-based ESE. Patients who met the surgical indications at rest were excluded. Eligible patients were divided into Group I (pulmonary artery systolic pressure [PASP] during exercise >60 mmHg; n=11) and Group II (PASP during exercise ≤60 mmHg; n=30).Results: Forty-one patients were included. Group I was significantly older (65±12 vs. 54±14 years, P=0.042) and had significantly higher serum N-terminal pro-B-type natriuretic peptide concentrations than Group II (351±278 vs. 125±163 pg/mL, P=0.002). The univariate analysis demonstrated that peak E wave velocity (Group I vs. Group II: 125±45 vs. 101±24 cm/sec, P=0.050), left ventricular (LV) end-diastolic diameter index (32±4 vs. 30±3 mm/m2, P=0.035), and left atrial volume index (LAVI; 45±14 vs. 30±11 mL/m2, P=0.008) were predictors of increased PASP during exercise. In the multivariate analysis, resting LAVI best predicted exercise-induced pulmonary hypertension (hazard ratio 1.081 [95% confidence interval 1.009–1.158], P=0.028), with a cutoff value of 37 mL/m2.Conclusions: In asymptomatic or mildly symptomatic patients with primary moderate/severe MR, increased resting LAVI indicates the requirement for ESE, even without LV dilatation.

著者

Kazuhiro Nishii Naoki Aizu Kouji Yamada

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-020, (Released:2022-12-27)

参考文献数

75

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Exercise reduces the risk of obesity-based, lifestyle-related diseases, such as metabolic abnormalities and cardiovascular diseases. The present review covers the health-promoting effects of exercise from the point of view of the physiologically active factor myokine, which is secreted by skeletal muscle, and focuses on the skeletal muscle as a new endocrine organ. Myokines have various effects, such as preventing metabolic syndrome by breaking down fat, preventing diabetes by improving glucose metabolism, and preventing progression of arteriosclerosis, dementia, and osteoporosis by enhancing bone metabolism. These substances also stabilize blood pressure, prevent cancer, increase immunity against infections, and prevent the development of age-associated diseases. Myokines are secreted by skeletal muscle into blood vessels, allowing them to exert systemic endocrine effects in organs throughout the body. Myokines are involved in bodily homeostasis and adaptation to the environment, and function by a mechanism similar to that of the skeletal muscle mass regulatory mechanism. Determining the relationships between multiple organs and their biological significance is important for exercise and health research. Progress in this field is expected to result in the identification of pathological mechanisms of action, development of new drugs, evaluation of the effectiveness of biomarkers over a wide range, and future improvement in healthcare.

著者

Asuka Kato Yuki Hirakawa Wakako Hiraoka

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

vol.5, no.4, pp.98-103, 2019 (Released:2019-11-01)

参考文献数

36

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Objectives: The objective of this study was to identify the role of reactive oxygen species (ROS) generated by nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, in inositol hexaphosphate (IP6)-induced metabolic disruption in human leukemia PLB-985 cells.Methods: PLB-985 and X chromosome linked gp91-phox gene knockout (X-CGD) cells were treated with 5, 10, or 20 mM IP6 for 24 to 72 h. Cell growth was assayed using a highly water-soluble tetrazolium salt. The rate of apoptotic and necrotic cell death was determined with an Annexin V-fluorescein isothiocyanate/propidium iodide kit. The expression of CD11b as a marker of monocytic property and of LC3 as an autophagy marker was tested, using flow cytometry combined with fluorescent antibodies.Results: Treatment with 5 and 10 mM IP6 for 24 h was found to suppress the growth of both cell lines, though the effect was more dramatic in PLB-985 cells. After 6-h treatment with 20 mM IP6, the necrosis rate of PLB-985 cells was significantly greater than that of X-CGD cells. Further, after 72-h treatment with 10 mM IP6, CD11b expression was observed in PLB-985 cells but inhibited in X-CGD cells. Autophagy monitoring after 6-h treatment with 10 mM IP6 revealed that LC3 expression was suppressed in PLB-985 cells, whereas it was somewhat increased in X-CGD cells.Conclusions: Our results suggest that NADPH oxidase activation mediates IP6-induced metabolic disruption associated with necrosis, differentiation, cell growth, and autophagy in PLB-985 cells.

著者

Yoshitaka Wada Seiko Shibata Ayato Shinohara Koji Mizutani Masahiko Mukaino Yohei Otaka

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2023-015, (Released:2023-11-29)

参考文献数

29

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Objectives: To examine the functional outcomes of patients with coronavirus disease 2019 (COVID-19) who underwent a new protocol-based rehabilitation program.Methods: In this retrospective cohort study, we enrolled patients who were hospitalised in a university hospital in Japan because of COVID-19 from 1st September, 2020–5th July, 2021. The primary outcome was the Functional Independence Measure (FIM) subtotal score for motor items at discharge. The secondary outcomes included the FIM cognitive subtotal score, length of hospital stay, rehabilitation period, total rehabilitation time, final rehabilitation protocol level, and discharge destination.Results: Of the 78 enrolled patients (49 men; mean age [standard deviation], 70.3 [13.9] years), 24 died (30.8%) during hospitalisation. Disease severity was classified as mild, moderate I, moderate II, and severe in 1, 6, 41, and 30 patients, respectively. The FIM motor subtotal score differed significantly among groups for all participants (p=0.027). Post hoc analysis revealed that the FIM motor subtotal score in the severe group was significantly lower than that in the moderate II group (p=0.030).Conclusions: Disease severity significantly affected patients’ functional outcome for COVID-19 at discharge. Our protocol-based program provides a benchmark for COVID-19 rehabilitation in an acute care setting.

著者

Johannes M. Dijkstra Toshiharu Nagatsu

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2023-014, (Released:2023-11-29)

参考文献数

42

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Distinguished Professor Emeritus Tsuneko Okazaki is a hero of science. Together with her late husband, Professor Reiji Okazaki, she discovered that DNA replication involves the discontinuous synthesis of the DNA lagging strand by intermediates of, what is now called, “Okazaki fragments.” She has been a pioneer for women in science and, in 1983, became the first female full Professor at Nagoya University. From 1997 to 2012, she was a full Professor and later a Visiting Professor at Fujita Health University, and this review zooms in on that period. Besides a summary of her career, this article also includes personal memories of researchers who worked with Professor Okazaki.

著者

Makoto Hasegawa Yasuhiro Osugi Yoshifumi Moriwaki Yohei Doi

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2023-012, (Released:2023-11-29)

参考文献数

23

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Objectives: Multidrug-resistant (MDR) bacterial infections are highly prevalent among long-term care facility (LTCF) residents, and are thus important targets for antimicrobial stewardship. Diagnoses of urinary tract infections (UTIs), which are associated with antimicrobial use in these facilities, are not always made by physicians. Past epidemiologic studies have included asymptomatic bacteriuria together with UTIs. The National Healthcare Safety Network has initiated a surveillance program to identify the causative organisms of UTIs in LTCF residents. In Japan, medical care for these residents is provided through in-person physician visits; however, limited related data are available. Therefore, we investigated the organisms causing UTIs and their drug susceptibility among LTCF residents in central Japan, and examined the prevalence of multidrug resistance, its risk factors, and correlations with clinical outcomes.Methods: We retrospectively evaluated clinical and urine culture data of LTCF residents with physician-diagnosed UTIs between April 1, 2019, and April 30, 2022.Results: The detection rate of multidrug-resistant organisms was high, with Escherichia coli being the most prevalent. Ceftriaxone was frequently used for initial therapy. The initial antimicrobial agents were significantly less active against MDR pathogens than non-MDR pathogens. Most residents continued to receive the initial agents regardless of culture results. Nonetheless, differences in the therapy duration, relapse and hospitalization rates, and death rate within 28 days between the multidrug-resistant and non–multidrug-resistant groups were not significant.Conclusions: Antimicrobial stewardship is essential for reducing antimicrobial use and selective pressure in LTCFs in Japan; however, more specific data are needed for its effective implementation.

著者

Yuji Matsuwaki Takashi Muramatsu Yukio Ozaki Takashi Uwatoko Takuo Toriya Hidemaro Takatsu Yu Yoshiki Masataka Yoshinaga Masato Ishikawa Masaya Ohota Hideaki Ota Hideo Izawa

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2023-006, (Released:2023-11-29)

参考文献数

25

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Objective: To examine the clinical outcomes of optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) in patients presenting with ST-segment elevation myocardial infarction (STEMI).Methods: We retrospectively investigated 533 consecutive patients who underwent primary PCI for STEMI between June 2016 and December 2020. The primary endpoint was a target lesion failure (TLF; defined as a composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization). Propensity score (PS) matching was performed to allow direct comparison of OCT-guided and intravascular ultrasound (IVUS)-guided PCI.Results: Patients in the OCT group (n=166) were younger than those in the IVUS group (n=367) and had a significantly higher left ventricular ejection fraction and estimated glomerular filtration rate. Killip class IV and left main stem disease were more common in the IVUS group. The median peak creatine kinase level was comparable between the two groups (1953 U/L vs 1603 U/L). A significantly larger amount of contrast was used in the OCT group (200 mL vs 165 mL; p<0.001). The cumulative incidence of TLF during a median follow-up of 2.2 years did not differ significantly between OCT and IVUS groups (9.6% vs 13.6%; p=0.221) but cardiac mortality was significantly higher in the IVUS group (8.7% vs 3.6%; p=0.047). After PS matching (n=161 in each group), there was no significant between-group difference in TLF or any other clinical outcome measures.Conclusions: OCT-guided PCI demonstrated clinical outcomes in patients with STEMI that were comparable to those of IVUS-guided PCI despite considerable differences in background characteristics.

著者

Koichi Furuhashi

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2023-003, (Released:2023-08-28)

参考文献数

14

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Background: The novel coronavirus disease (COVID-19) pandemic has no end in sight. Currently, the emphasis is on policies aimed at easing movement restrictions and maintaining socio-economic activities. However, infection control in psychiatric hospitals has been challenging. There have been reports on the impact on mental health and outpatient/inpatient treatment environments in the field of child psychiatry. An outbreak of COVID-19 was experienced in a child and adolescent psychiatric ward, and considering that there have been few similar reports, it was deemed meaningful to accumulate such experiences.Case presentation: Three COVID-19-positive cases, all 14-year-old girls, were confirmed in a cluster among seven hospitalized patients in a child and adolescent psychiatric ward. Two patients presented symptoms of upper respiratory inflammation and one was asymptomatic. The main psychiatric diagnoses were post-traumatic stress disorder in one patient and autism spectrum disorder in the other two patients. The entire hospital ward was designated as a red zone (contaminated area), and infection control measures were adopted, such as halting group activities, wearing masks, and maintaining distance between patients. Additionally, it was necessary to use the infection control ward as it was difficult to ensure patient compliance.Conclusion: Infection control in COVID-19 clusters at child and adolescent psychiatric wards is difficult due to patient characteristics and symptoms. Restricted activities and care also result in psychobehavioral consequences, regardless of infection status. To achieve both infection control and a better treatment environment, it is necessary to make careful preparations while learning from these experiences.

著者

Daijiro Suzuki Takanori Suzuki Masayuki Fujino Yumiko Asai Arisa Kojima Hidetoshi Uchida Kazuyoshi Saito Hirofumi Kusuki Yuanying Li Hiroshi Yatsuya Tsuneaki Sadanaga Tadayoshi Hata Tetsushi Yoshikawa

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2023-001, (Released:2023-08-28)

参考文献数

26

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Objectives: The Gunma score is used to predict the severity of Kawasaki disease (KD), including coronary artery aneurysm (CAA) as a cardiac complication, in Japan. Additionally, the characteristic ratio of ventricular repolarization (T-peak to T-end interval to QT interval [Tp-e/QT]) on a surface electrocardiogram reflects myocardial inflammation. This study aimed to determine whether the Tp-e/QT can be used to predict CAA in children with KD.Methods: We analyzed chest surface electrocardiograms of 112 children with KD before receiving intravenous immunoglobulin therapy using available software (QTD; Fukuda Denshi, Tokyo, Japan).Results: The Tp-e/QT (lead V5) was positively correlated with the Gunma score (r=0.352, p<0.001). The Tp-e/QT was larger in patients with CAA (residual CAA at 1 month after onset) than in those without CAA (0.314±0.026 versus 0.253±0.044, p=0.003). A receiver operating characteristic curve analysis was performed to assess whether the Gunma score and Tp-e/QT could predict subsequent CAA. The area under the curve of the Gunma score was 0.719 with the cutoff set at 5 points. The area under the curve of the Tp-e/QT was 0.892 with a cutoff value of 0.299. The fit of the prediction models to the observed probability was tested by the Hosmer–Lemeshow test with calibration plots using Locally weighted scatterplot smoothing (LOESS) fit. The Gunma score (p=0.95) and Tp-e/QT (p=0.95) showed a good fit.Conclusions: The Tp-e/QT is a useful biomarker in predicting coronary aneurysm complications in KD.

著者

Tetsuro Watari Kei Ohtsuka Yukari Suzuki Fumihiro Matsuda Soichiro Koyama Naoki Aizu Yoshikiyo Kanada Hiroaki Sakurai

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-032, (Released:2023-08-28)

参考文献数

31

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Objectives: This study investigates how online frame-of-reference (FOR) training of raters of the objective structured clinical examination (OSCE) for physical therapy students affects assessment accuracy.Methods: The research was conducted in a 1-month-long randomized controlled trial.Participants: The participants were 36 physical therapists without experience assessing clinical skills using the OSCE. The training group completed the FOR training online, which was conducted once a week in two 90-minute sessions. The control group self-studied the rubric rating chart used in the assessment. As a measure of accuracy, weighted kappa coefficients were used to check the agreement between correct score and those assessment by the participant in the OSCE.Results: The scores of the training group were higher than those of the control group in both post- and follow-up assessments, showing significant differences. No significant difference was found based on the assessment time and group for the high-agreement groups. Furthermore, scores of the low-accuracy training group were higher in the post- and follow-up assessments than those in the pre-assessment, showing significant differences.Conclusions: Online FOR training of the raters of the OSCE for physical therapists improved the assessment accuracy of the raters who had low accuracy in the pre-assessment; this improvement was maintained.

著者

Yoshiki Niimi Sayuri Shima Yasuaki Mizutani Akihiro Ueda Shinji Ito Tatsuro Mutoh

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

vol.5, no.2, pp.45-48, 2019 (Released:2019-05-08)

参考文献数

19

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Background: Although fatigue is an important nonmotor symptom in Parkinson’s Disease (PD) patients, little is known about the pathophysiological details of fatigue in PD, and it is still unknown whether fatigue correlates with PD prognosis. In this study, we investigated whether fatigue in PD correlates with clinical manifestations, treatment, or patient prognosis.Methods: We recruited 75 idiopathic PD patients and used the Parkinson Fatigue Scale (PFS-16) to investigate fatigue. We compared PFS-16 scores with clinical details such as age, disease duration, daily levodopa equivalent dosage, and Hoehn & Yahr (H&Y) disease stage in the 56 patients who fully completed the questionnaire.Results: In total, 62% of subjects suffered from fatigue, as defined by a mean PFS-16 score above 3.3. There was no correlation between PFS-16 scores and disease duration or levodopa equivalent daily dose. However, there was a significant correlation between mean PFS-16 scores and a worsening grade of H&Y staging. The comparison between patients who showed stable H&Y grades (n=26) and patients with severely aggravated H&Y grades (n=7) revealed that the most significant differences were in questions 14 and 16 in the PFS-16 (p<0.001).Conclusion: Fatigue is common in PD patients, as demonstrated in the present study. The PFS-16 questionnaire may be helpful to predict disease prognosis.

著者

Kurenai Hachiya Soya Kawabata Takehiro Michikawa Sota Nagai Hiroki Takeda Daiki Ikeda Shinjiro Kaneko Nobuyuki Fujita

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-035, (Released:2023-05-09)

参考文献数

21

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Objectives: Although cervical spondylotic myelopathy (CSM) has a marked impact on locomotive function, few studies have evaluated this relationship in terms of locomotive syndrome. Thus, we assessed (i) the stages of locomotive syndrome in preoperative CSM patients using the 25-question geriatric locomotive function scale (GLFS-25), (ii) the correlation between GLFS-25 scores and the Japanese orthopaedic association (JOA) scores or the JOA cervical myelopathy evaluation questionnaire (JOACMEQ) scores, and (iii) the factors associated with stage 3 locomotive syndrome in preoperative CSM patients.Methods: We used clinical data from 107 patients scheduled for cervical spinal surgery for CSM. Data were collected prior to surgery, and included age, gender, body mass index, medical history, JOA score, and JOACMEQ and GLFS-25 scores.Results: Of the included CSM patients, 93.5% were diagnosed with locomotive syndrome, of whom 77.6% were stage 3 according to GLFS-25 evaluation. For the correlation between GLFS-25 and JOA or JOACMEQ, the upper and lower extremity function scores of JOACMEQ and the JOA were strongly inversely correlated with the GLFS-25 score. Finally, multivariate analysis suggested that severe lower extremity status in the JOACMEQ was significantly associated with stage 3 locomotive syndrome in preoperative CSM patients.Conclusions: Using the GLFS-25, we found that lower extremity status had the strongest association with stage 3 locomotive syndrome in preoperative CSM patients. These findings are useful for preventing CSM patients from requiring future nursing care.

著者

Chiho Sumitomo Yohei Iwata Masaru Arima Kazumitsu Sugiura

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-030, (Released:2023-05-09)

参考文献数

11

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Objectives: Extramammary Paget’s disease (EMPD) is a neoplastic skin disease of unknown etiology. EMPD is frequently associated with forkhead box A1 (FOXA1) expression, which correlates with the expression of estrogen receptor alpha (ER). FOXA1 regulates the transcriptional activity of ER and may function cooperatively in the tumorigenesis of breast cancer.Methods: We performed immunohistochemical staining for FOXA1 and ER using tissue samples from 16 patients with EMPD.Results: The nuclei of Paget cells isolated from each of the 16 patients with EMPD (100%) were strongly FOXA1-positive, and the FOXA1 staining intensity was similar across all samples. ER staining was detected in the nuclei of Paget cells originating from seven patients with EMPD (44%), and the ER staining intensity varied between these patients.Conclusions: In the present study, we confirmed that EMPD was frequently associated with FOXA1 expression. However, ER expression varied between patients and did not always coincide with FOXA1 expression. No clear relationship was observed between ER expression, the intensity of ER staining, or EMPD metastasis and prognosis. However, the results indicate that hormone-dependent cancer therapy may be effective in patients with ER-positive EMPD.

著者

Akiko Hasebe Ichiro Nakahara Shoji Matsumoto Jun Morioka Jun Tanabe Sadayoshi Watanabe Kenichiro Suyama Takuma Ishihara Yuichi Hirose

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-033, (Released:2023-05-09)

参考文献数

16

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Objective: This retrospective study aimed to investigate factors associated with inhibition of early aneurysm obliteration after flow diverter (FD) treatment. We also created the early obliteration inhibition (EOI) score for pre-operative evaluation.Methods: We examined 110 cerebral aneurysms in 104 patients who underwent FD treatment. The following parameters were investigated: age, sex, symptoms, aneurysm location and type, maximum aneurysm diameter, parent vessel diameter, neck diameter, and dome–neck ratio. We also noted aneurysm location relative to the curvature of the parent artery and any branches arising from the aneurysm dome. Procedural factors such as FD diameter and length, number of FDs placed, type of FD, and use of adjunctive coiling were also investigated. Aneurysm obliteration was evaluated using digital subtraction angiography 3 months after the procedure. Adequate obliteration was defined as grade C or D on the O’Kelly–Marotta scale.Results: The following factors inhibited early obliteration: 1) extradural location, 2) saccular aneurysm, 3) aneurysm neck located at the outer convexity of the parent artery, and 4) arterial branch arising from the aneurysm dome. Odds ratios were used to create an EOI score. Receiver operating characteristic curve analysis showed that the optimal cut-off EOI score for adequate obliteration was 1.5 (area under the curve, 0.81; 95% confidence interval, 0.73–0.9; sensitivity, 0.9; specificity, 0.57).Conclusion: The EOI score, which is based on factors that inhibit early obliteration, may predict early treatment outcomes of FD placement.

著者

Yoshihiro Sato Masahiro Kumada Hideki Kawai Sadako Motoyama Masayoshi Sarai Tsutomu Nakagawa Hideo Izawa

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-028, (Released:2022-12-27)

参考文献数

27

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Objectives: Malnutrition is associated with an increased risk of hospital readmission for heart failure in patients with acute decompensated heart failure (ADHF). Therefore, evaluation of the nutritional status in patients with ADHF may be important. The geriatric nutritional risk index (GNRI), the controlling nutritional status (CONUT) score, and the prognostic nutritional index (PNI) are widely used objective indexes for evaluation of the nutritional status. The present study was performed to determine the best nutritional index for predicting the prognosis in older adults with ADHF.Methods: We retrospectively studied 167 older adults (>65 years of age) who were admitted with ADHF from January 2012 to December 2015 and discharged alive. The objective nutritional status was evaluated using the GNRI, CONUT score, and PNI at admission. The endpoint of this study was unplanned hospitalization for worsening heart failure (WHF) within 1 year after discharge.Results: During the follow-up period, 58 patients were readmitted for WHF. In the multivariate Cox analysis, only the GNRI (p<0.0001) was independently associated with readmission for WHF among the three nutritional indexes. Kaplan–Meier analysis revealed that patients in the low-GNRI group (<90 as determined by receiver operating characteristic curve analysis) had a significantly greater risk of 1-year hospital readmission for WHF (p<0.0001; hazard ratio, 6.1; 95% confidence interval, 3.5–10.5).Conclusion: Among the objective nutritional indexes, the GNRI is the best predictor of readmission for WHF within 1 year after discharge in older adults with ADHF.

著者

Taro Okui Yoshikazu Kobayashi Madoka Isomura Masakazu Tsujimoto Koji Satoh Hiroshi Toyama

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-025, (Released:2022-12-27)

参考文献数

30

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Objectives: This study investigated the relationships between quantitative values calculated from bone single photon emission computed tomography/computed tomography (SPECT/CT) images and histopathological findings observed in surgical specimens from patients with antiresorptive agent-related osteonecrosis of the jaw (ARONJ); it sought to clarify histopathological factors that cause accumulation in bone SPECT/CT images of patients with ARONJ.Methods: This study included 81 pathological specimens of 21 lesions obtained from 18 patients with ARONJ who underwent SPECT/CT and jaw resection. The maximum standardized uptake value (SUVmax) of each volume of interest of the specimens was calculated using RAVAT® software. The ratio of the SUVmax to the mean value of SUVmax in temporal bone was termed rSUVmax. The rSUVmax and pathological findings (sequestration, degree of fibrosis, degree of trabecular bone destruction, degree of inflammatory cell infiltration, and vascularity) were compared using the Mann–Whitney U test and the Kruskal–Wallis test.Results: In univariate analysis with rSUVmax as the dependent variable, the pathological findings of sequestration (P=0.058), degree of fibrosis (P=0.810), degree of trabecular bone destruction (P=0.237), degree of inflammatory cell infiltration (P=0.120), and vascularity (P=0.111) showed no significant difference among the groups for each variable.Conclusions: We found no association between quantitative values in bone SPECT/CT and histological changes in ARONJ, probably because bone SPECT/CT has limited spatial resolution. Limitations of this study may include the imaging findings of a decrease in tracer accumulation because of an involucrum of necrosed bone, various histopathological findings in ARONJ, and failure to consider the effect of preoperative anti-inflammatory treatment.

著者

Chika Fujisawa-Tanaka Izumi Hiratsuka Megumi Shibata Kei Kurihara Naohiro Aida Takeshi Takayanagi Yusuke Seino Taihei Ito Takashi Kenmochi Atsushi Suzuki

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-019, (Released:2022-12-27)

参考文献数

28

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Objectives: Type 1 diabetes mellitus (T1DM) patients with diabetic kidney disease-induced kidney failure have a significantly impaired quality of life (QOL), resulting in a high level of physical, mental, and social anxiety. In this study, we evaluated the QOL of T1DM patients on the list for pancreas transplantation (PTx) at their registration, and determined whether PTx improved their QOL.Methods: There were 58 patients (men/women, 22/36; mean age, 42.8±8.0 years) with T1DM and who were registered on the waiting list for PTx. Quantitative QOL assessment was performed using the Medical Health Survey Short Form (SF-36) version 2. Changes in the QOL before and after PTx were also examined in 24 of these patients.Results: The mean value of each endpoint and the summary score of the SF-36 physical (PCS), mental (MCS), and role (RCS) components were all below the national normal level at PTx registration. No significant difference in QOL scores was observed in the intergroup comparison of 35 patients on dialysis, 13 patients without dialysis, and ten patients after kidney transplantation. The 24 patients who underwent PTx showed improvement in PCS, MCS, and most SF-36 scores.Conclusion: T1DM patients waiting for PTx had a decreased QOL, regardless of dialysis, and PTx improved their QOL.

著者

Atsushi Ogasawara Hiroki Doi Taei Matsui Etsuko Tokunaga Masao Amakawa Hidehiko Akiyama

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-021, (Released:2022-10-28)

参考文献数

20

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Objectives: Agaritine (AGT) is a hydrazine-containing compound derived from the mushroom Agaricus blazei Murill. We previously reported the antitumor effect of AGT on hematological tumor cell lines and suggested that AGT induces apoptosis in U937 cells via caspase activation. However, the antitumor mechanism of AGT has not been fully understood.Methods: Four hematological tumor cell lines (K562, HL60, THP-1, H929) were used in this study. The cells were incubated in the presence of 50 μM AGT for 24 h and analyzed for cell viability, annexin V positivity, caspase-3/7 activity, mitochondrial membrane depolarization, cell cycle, DNA fragmentation, and the expression of mitochondrial membrane-associated proteins (Bax and cytochrome c).Results: In HL60, K562, and H929 cells, AGT reduced cell viability and increased annexin V- and dead cell-positive rates; however, it did not affect THP-1 cells. In K562 and HL60 cells, caspase-3/7 activity, mitochondrial membrane depolarization, and expression of mitochondrial membrane proteins, Bax and cytochrome c, were all increased by AGT. Cell cycle analysis showed that only K562 exhibited an increase in the proportion of cells in G2/M phase after the addition of AGT. DNA fragmentation was also observed after the addition of AGT.Conclusions: These results indicate that AGT induces apoptosis in K562 and HL60 cells, like U937 reported previously, but showed no effect on THP-1 cells. It was suggested that AGT-induced apoptosis involves the expression of Bax and cytochrome c via mitochondrial membrane depolarization.

著者

Satoshi Yamamoto Kazuo Inui Yoshiaki Katano Hironao Miyoshi Takashi Kobayashi Yoshihiko Tachi

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2022-011, (Released:2022-10-28)

参考文献数

22

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Objectives: We aimed to determine when a coexisting pseudocyst was likely to complicate the nonsurgical treatment of pancreatolithiasis.Methods: We treated 165 patients with pancreatolithiasis nonsurgically between 1992 and 2020, including 21 with pseudocysts. Twelve patients had a single pseudocyst less than 60 mm in diameter. Pseudocysts in the other nine patients had diameters of at least 60 mm or were multiple. The locations of pseudocysts along the length of the pancreas varied from the area with stone involvement to the pancreatic tail. We compared the outcomes in these groups.Results: We found no significant differences in pain relief, stone clearance, stone recurrence, or the likelihood of adverse events between pseudocyst groups or between patients with vs without pseudocysts. However, 4 of 9 patients with large or multiple pseudocysts required transition to surgical treatment (44%) compared with 13 of 144 patients with pancreatolithiasis and no pseudocyst (9.0%) (P=0.006).Conclusions: Patients with smaller pseudocysts typically underwent nonsurgical stone clearance successfully with few adverse events, similar to findings in patients with pancreatolithiasis and no pseudocysts. Pancreatolithiasis complicated by large or multiple pseudocysts did not cause more adverse events but was more likely to require transition to surgery compared with pancreatolithiasis without pseudocysts. In patients with large or multiple pseudocysts, early transition to surgery should be considered when nonsurgical treatment is ineffective.