著者

Miyako Kishimoto Hisako Endo Shotaro Hagiwara Akiyoshi Miwa Mitsuhiko Noda

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.57, no.3,4, pp.345-349, 2010 (Released:2010-09-14)

参考文献数

11

被引用文献数

10 17

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Excessive iron storage sometimes causes diabetes in patients with hemochromatosis, a disease caused by iron overloading. We performed an immunohistochemical analysis to study an autopsy case of aplastic anemia and diabetic hemochromatosis caused by frequent blood transfusions, and extensive hemosiderin deposition was observed in the liver and pancreas. The pancreatic islets of the patient and a control subject were stained to detect glucagon, insulin, and proinsulin. Significantly lower levels of immunoreactivity with both insulin antibodies and proinsulin antibodies, but not with glucagon antibodies, was observed in the islet cells in the patient’s tissue than in the islet cells of the control. Hemosiderin deposition in the islets is known to be exclusively distributed in the β-cells, thus, selective iron-induced damage to the β-cells may have affected insulin synthesis and secretion and led to glucose intolerance in the patient. J. Med. Invest. 57: 345-349, August, 2010

著者

Yurika Numata‐Uematsu Hiroyuki Yokoyama Hiroki Sato Wakaba Endo Mitsugu Uematsu Chieko Nara Shigeo Kure

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.65, no.3.4, pp.280-282, 2018 (Released:2018-10-04)

参考文献数

10

被引用文献数

16 17

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Many studies have reported many adverse effects of children's use of media. These effects include reduced cognitive development and hyperactivity and attention disorders. Although it has been recommended that child be kept away from the media during the early developmental period, many modern parents use the media as a way to calm their children. Consequently, these children lack the opportunity to form selective attachments by reduced social engagement. These children's symptoms occasionally mimic autism spectrum disorder (ASD). However, few studies have examined the symptoms children develop with early media exposure. Here, we present a boy exposed to the media during his early development who was diagnosed with attachment disorder. He was unable to make eye contact and was hyperactive and had delayed language development, like children with ASD. His symptoms improved dramatically after he was prevented from using all media and encouraged to play in other ways. After this treatment, he would make eye contact, and talked about playing with their parents. Simply avoiding the media and playing with others can change the behavior of a child with ASD‐like symptoms. It is important to understand the symptoms caused by attachment disorder and early media exposure. J. Med. Invest. 65:280‐282, August, 2018

著者

Naoto Suzue Tetsuya Matsuura Toshiyuki Iwame Kosaku Higashino Toshinori Sakai Daisuke Hamada Tomohiro Goto Yoichiro Takata Toshihiko Nishisho Yuichiro Goda Takahiko Tsutsui Ichiro Tonogai Ryo Miyagi Mitsunobu Abe Masatoshi Morimoto Kazuaki Mineta Tetsuya Kimura Akihiro Nitta Tadahiro Higuchi Shingo Hama Subash C. Jha Rui Takahashi Shoji Fukuta Koichi Sairyo

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.62, no.3.4, pp.109-113, 2015 (Released:2015-09-18)

参考文献数

39

被引用文献数

2 14

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Athletes sometimes experience overuse injuries. To diagnose these injuries, ultrasonography is often more useful than plain radiography, computed tomography (CT), or magnetic resonance imaging (MRI). Ultrasonography can show both bone and soft tissue from various angles as needed, providing great detail in many cases. In conditions such as osteochondrosis or enthesopathies such as Osgood-Schlatter disease, Sinding-Larsen-Johansson disease, bipartite patella, osteochondritis dissecans of the knee, painful accessory navicular,and jumper's knee, ultrasonography can reveal certain types of bony irregularities or neovascularization of the surrounding tissue. In patients of enthesopathy, ultrasonography can show the degenerative changes at the insertion of the tendon. Given its usefulness in treatment, ultrasonography is expected to become essential in the management of overuse injuries affecting the lower limb in athletes. J. Med. Invest. 62: 109-113, August, 2015

著者

Nobuto Nakanishi Takuya Takashima Jun Oto

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.67, no.1.2, pp.1-10, 2020 (Released:2020-05-02)

参考文献数

114

被引用文献数

19

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Critically ill patients exhibit prominent muscle atrophy, which occurs rapidly after ICU admission and leads to poor clinical outcomes. The extent of atrophy differs among muscles as follows: upper limb: 0.7%–2.4% per day, lower limb: 1.2%–3.0% per day, and diaphragm 1.1%–10.9% per day. This atrophy is caused by numerous risk factors such as inflammation, immobilization, nutrition, hyperglycemia, medication, and mechanical ventilation. Muscle atrophy should be monitored noninvasively by ultrasound at the bedside. Ultrasound can assess muscle mass in most patients, although physical assessment is limited to almost half of all critically ill patients due to impaired consciousness. Important strategies to prevent muscle atrophy are physical therapy and electrical muscular stimulation. Electrical muscular stimulation is especially effective for patients with limited physical therapy. Regarding diaphragm atrophy, mechanical ventilation should be adjusted to maintain spontaneous breathing and titrate inspiratory pressure. However, the sufficient timing and amount of nutritional intervention remain unclear. Further investigation is necessary to prevent muscle atrophy and improve long-term outcomes. J. Med. Invest. 67 : 1-10, February, 2020

著者

Ryo Momosaki Shoji Kinoshita Wataru Kakuda Naoki Yamada Masahiro Abo

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.63, no.3.4, pp.153-158, 2016 (Released:2016-09-17)

参考文献数

26

被引用文献数

8

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The purpose of this study was to review the best available evidence of noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) for dysphagia after acquired brain injury. We searched randomized controlled trials that compared noninvasive brain stimulation with control used to improve dysphagia after acquired brain injury. We assessed dysphagia severity rating scales and penetration-aspiration scale as outcomes immediately after intervention. We calculated the pooled estimate of the standardized mean difference (SMD) to combine individual results. We included 8 published studies. Two heterogenous trials of 48 patients showed that rTMS was associated with a significant improvement in the dysphagia severity rating scale score (SMD 2.95). Three homogeneous trials of 88 patients showed a significant effect of rTMS on the penetration-aspiration scale score (SMD 0.77). Two homogeneous trials of 34 patients showed that tDCS was associated with a significant improvement in the dysphagia severity rating scale score (SMD 1.20). The review provided low-quality evidence for the effectiveness of noninvasive brain stimulation in improving dysphagia after acquired brain injury. Further trials of larger sample sizes are needed to determine the most appropriate noninvasive brain stimulation protocol. J. Med. Invest. 63: 153-158, August, 2016

著者

Mikio Sugano Homare Yoshida Hirotsugu Kurobe Hiroki Arase Hajime Kinoshita Takashi Kitaichi Noriko Sugasawa Soichiro Nakayama Kazuhisa Maeda Minoru Irahara Tetsuya Kitagawa

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.64, no.1.2, pp.43-49, 2017 (Released:2017-03-29)

参考文献数

27

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Objectives: To investigate the effects of human umbilical cord blood-derived mononuclear cell (hUCB-MNC) transplantation on pulmonary hypertension (PH) induced by monocrotaline (MCT) in immunodeficient mice and their distribution. Methods: MCT was administered to BALB/c Slc-nu/nu mice, and PH was induced in mice 4 weeks later. Fresh hUCB-MNCs harvested from a human donor after her delivery were injected intravenously into those PH mice. The medial thickness of pulmonary arterioles, ratio of right ventricular to septum plus left ventricular weight (RV/S+LV), and ratio of acceleration time to ejection time of pulmonary blood flow waveform (AT/ET) were determined 4 weeks after hUCB-MNC transplantation. To reveal the incorporation into the lung, CMTMR-labeled hUCB-MNCs were observed in the lung by fluorescent microscopy. DiR-labeled hUCB-MNCs were detected in the lung and other organs by bioluminescence images. Results: Medial thickness, RV/S+LV and AT/ET were significantly improved 4 weeks after hUCB-MNC transplantation compared with those in mice without hUCB-MNC transplantation. CMTMR-positive hUCB-MNCs were observed in the lung 3 hours after transplantation. Bioluminescence signals were detected more strongly in the lung than in other organs for 24 hours after transplantation. Conclusions: The results indicate that hUCB-MNCs are incorporated into the lung early after hUCB-MNC transplantation and improve MCT-induced PH. J. Med. Invest. 64: 43-49, February, 2017

著者

Kiyotaka Hasebe Yu Okubo Koji Kaneoka Kohei Takada Daisuke Suzuki Koichi Sairyo

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.63, no.1.2, pp.85-90, 2016 (Released:2016-04-01)

参考文献数

26

被引用文献数

20

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Objectives: To ascertain the dynamic stretch effects of flexibility of the hamstrings on lumbar spine and pelvic kinematics. Background: Tight hamstrings are positively correlated with low back pain. However, it is unclear how flexibility of the hamstrings affects spino-pelvic rhythm. Methods: Twelve healthy men participated in the study. The straight leg raising (SLR) angle, finger floor distance (FFD), and spino-pelvic rhythm was measured before and after the 6-week stretching protocol. The forward bending task was divided into 4 phases. The paired t-test was used to determine significant differences before and after the FFD, SLR angle, lumbar motion, and pelvic motion, and spino-pelvic rhythm in each phase (p<0.05). Results: After 6 weeks of stretching, significant improvements were seen in the FFD with maximum forward bending and in the SLR angle. Total pelvic rotation was also significantly increased in contrast to total lumbar flexion. A decreased spino-pelvic ratio was seen in the final phase. Conclusion: Dynamic stretching could change the spino-pelvic rhythm to a pelvis-dominant motion, indicating that flexible hamstrings are important for preventing low back pain. J. Med. Invest. 63: 85-90, February, 2016

著者

Toshiyuki Iwame Tetsuya Matsuura Naoto Suzue Shinji Kashiwaguchi Takenobu Iwase Shoji Fukuta Daisuke Hamada Tomohiro Goto Takahiko Tsutsui Keizo Wada Hiroshi Egawa Akihiro Nagamachi Koichi Sairyo

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.63, no.3.4, pp.171-174, 2016 (Released:2016-09-17)

参考文献数

11

被引用文献数

10

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Purpose: Our aim was to examine the outcome of an elbow check-up system for youth baseball players. In particular, we investigated the nature of elbow injuries in youth baseball players with elbow pain and ultrasonographic findings of the capitellum. Materials and Methods: A total of 1605 players participating in the regional summer championship in July 2013 underwent a questionnaire survey, physical examination, ultrasound imaging, and radiographic examination. Results: A total of 499 (31.1%) players reported episodes of elbow pain, of whom 320 (64.1%) had abnormal findings on physical examination, and 115 (35.9%) agreed to undergo radiography. Among them, 98 (85.2%) exhibited radiographic abnormalities. On the initial ultrasonography screening, 60 (3.7%) players had an abnormal finding and 55 (91.7%) agreed to undergo radiography. Among them, 26 (47.3%) were found to have osteochondritis dissecans (OCD) of the capitellum on radiographs. Conclusions: About 30% of youth baseball players had episodes of elbow pain, and 64.1% of players with elbow pain had abnormal findings on physical examination. Furthermore, 85.2% of subjects who underwent radiographic examination exhibited radiographic abnormalities. About 4% of young baseball players had an abnormal finding on initial ultrasonography screening, and nearly 50% of them had OCD of the capitellum on radiographs. J. Med. Invest. 63: 171-174, August, 2016

著者

Yasuhiro Funakoshi Masafumi Harada Hideki Otsuka Kenji Mori Hiromichi Ito Takashi Iwanaga

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.63, no.3.4, pp.204-208, 2016 (Released:2016-09-17)

参考文献数

21

被引用文献数

19

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Purpose: The purpose of this study was to investigate changes in the functional connectivity of the default mode network (DMN) in normal aging and in children with autistic spectrum disorder (ASD) by using resting-state functional magnetic resonance imaging (rsfMRI) and independent component analysis. Methods: Thirty-one healthy controls (HC) in four age groups (1-3, 4-8, 20-29, and 50-59 years) and 14 childhood ASD cases (1-8 years of age) were examined by rsfMRI echo-planar imaging on a clinical 3-T MRI scanner. Imaging of all children (1-8 years) was conducted under sedation, while adults were scanned in the awake state with eyes closed. Results: The regions of DMN functional connectivity in the bilateral inferior parietal lobule and posterior cingulate cortex were smaller in HC children than in HC adults, and smaller in the ASD group than in the HC children. Conclusion: It is possible to observe developmental and pathological changes in the DMN by rsfMRI. Reduced DMN functional connectivity in children may be a useful biomarker for ASD diagnosis. J. Med. Invest. 63: 204-208, August, 2016

著者

Bei Zhou Hisami Yamanaka-Okumura Sayaka Seki Hiroshi Tatano Chisaki Adachi Eiji Takeda

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.61, no.1.2, pp.118-125, 2014 (Released:2014-04-04)

参考文献数

25

被引用文献数

1 4

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In general, vegetables are abundantly consumed in a calorie-restricted diet to achieve sufficient satiety through fresh food or various cooking methods. In this study, we examined the effects of different cooking methods on appetite and specific perceptions of the food after consumption; eating approaches were also analyzed by meal duration. A total of 153 individuals aged 20-59 years were assigned to 2 groups: raw vegetable or boiled vegetable meals, including packed meals that were served as test meals with the same energy and vegetable amount. Subjective levels of sensory properties and meal duration were assessed over time using visual analog scales, including questionnaires. Results showed that meal duration was significantly longer for raw vegetable meals than boiled vegetable meals, and there were significantly stronger correlations between meal duration and fullness. A higher degree of fullness was provided by a raw vegetable meal than a boiled vegetable meal, especially in men. However, an excess of raw vegetables led to overall insufficient satisfaction. Taken together, these findings suggest that cooking methods should be altered for different situations with an adequate amount of vegetables, and the meal duration should be recommended to be given as much attention as cooking methods. J. Med. Invest. 61: 118-125, February, 2014

著者

Yoshitoyo Ueno Koji Sato Kazuki Momota Hiroki Sato Yuki Nakano Yusuke Akimoto Toshiyuki Nunomura Natsuki Tane Taiga Itagaki Jun Oto

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.69, no.3.4, pp.266-272, 2022 (Released:2022-10-17)

参考文献数

35

被引用文献数

1

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Purpose : High-flow nasal cannula oxygen therapy (HFNC) is a new type of non-invasive respiratory support for acute respiratory failure patients. However, patients receiving HFNC often develop sleep disturbances. We therefore examined whether dexmedetomidine could preserve the sleep characteristics in patients who underwent HFNC. Patients and Methods : This was a pilot, randomized controlled study. We assigned critically ill patients treated with HFNC to receive dexmedetomidine (0.2 to 0.7 µg / kg / h, DEX group) or not (non-DEX group) at night (9:00 p.m. to 6:00 a.m.). Polysomnograms were monitored during the study period. The primary outcomes were total sleep time (TST), sleep efficiency and duration of stage 2 non-rapid eye movement (stage N2) sleep. Results : Of the 28 patients who underwent randomization, 24 were included in the final analysis (12 patients per group). Dexmedetomidine increased the TST (369 min vs. 119 min, p = 0.024) and sleep efficiency (68% vs. 22%, P = 0.024). The duration of stage N2 was increased in the DEX group compared with the non-DEX group, but this finding did not reach statistical significance. The incidences of respiratory depression and hemodynamic instability were similar between the two groups. Conclusions : In critically ill patients who underwent HFNC, dexmedetomidine may optimize the sleep quantity without any adverse events. J. Med. Invest. 69 : 266-272, August, 2022

著者

Ryo Miyachi Ayaka Sano Nana Tanaka Misaki Tamai Junya Miyazaki

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.69, no.1.2, pp.38-44, 2022 (Released:2022-04-22)

参考文献数

25

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Purpose:The purpose of this study was to clarify the differences in lumbar spine and hip joint motor control ability (MCA) in prone hip extension (PHE) between individuals with and without low back pain (LBP). It also aimed to determine the relationship between lumbar spine and hip joint MCA and lumbar perceptual awareness in individuals with LBP. Methods:In total, 78 university students (20 with LBP and 58 without) were included in the study. The MCA of the lumbar spine and hip joint in PHE and perceptual awareness were evaluated. The MCA of the lumbar spine and hip joint was measured using a wearable sensor. Subsequently, a comparison of the MCA of the lumbar spine and hip joints of the participants and the relationship between MCA and lumbar perceptual awareness were examined. Results:The MCA of the LBP group was higher than that of the non-LBP group in motion on the sagittal plane. In addition, perceptual awareness was negatively correlated with MCA in the sagittal plane in the lumbar spine. Conclusion:People with LBP had higher lumbar spine and hip joint MCA than those without LBP. Perceptual awareness was associated with lumbar spine and hip joint MCA in people with LBP. J. Med. Invest. 69 : 38-44, February, 2022

著者

Rie Hashimoto Atsuko Sakai Masumi Murayama Arisa Ochi Tomoki Abe Katsuya Hirasaka Ayako Ohno Shigetada Teshima-Kondo Hiroaki Yanagawa Natsuo Yasui Mikiko Inatsugi Daisuke Doi Masanori Takeda Rie Mukai Junji Terao Takeshi Nikawa

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.62, no.3.4, pp.177-183, 2015 (Released:2015-09-18)

参考文献数

20

被引用文献数

9 22

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Background: In recent years, the number of bedridden people is rapidly increasing due to aging or lack of exercise in Japan. This problem is becoming more serious, since there is no countermeasure against it. In the present study, we designed to investigate whether dietary proteins, especially soy, had beneficial effects on skeletal muscle in 59 volunteers with various physical activities. Methods: We subjected 59 volunteers with various physical activities to meal intervention examination. Persons with low and high physical activities were divided into two dietary groups, the casein diet group and the soy diet group. They ate daily meals supplemented with 7.8 g of powdered casein or soy protein isolate every day for 30 days. Bedridden patients in hospitals were further divided into three dietary groups: the no supplementation diet group, the casein diet group and the soy diet group. They were also subjected to a blood test, a urinalysis, magnetic resonance imaging analysis and muscle strength test of the knee before and after the meal intervention study. Results: Thirty-day soy protein supplementation significantly increased skeletal muscle volume in participants with low physical activity, compared with 30-day casein protein supplementation. Both casein and soy protein supplementation increased the volume of quadriceps femoris muscle in bedridden patients. Consistently, soy protein significantly increased their extension power of the knee, compared with casein protein. Although casein protein increased skeletal muscle volume more than soy protein in bedridden patients, their muscle strength changes by soy protein supplementation were bigger than those by casein protein supplementation. Conclusions: The supplementation of soy protein would be one of the effective foods which prevent the skeletal muscle atrophy caused by immobilization or unloading. J. Med. Invest. 62: 177-183, August, 2015

著者

Yasuko Okamoto Takanori Sakaguchi Yoshito Ikematsu Toshikazu Kanai Kazuhisa Hirayama Hiroaki Tamura Tadataka Hayashi Yoshiro Nishiwaki Hiroyuki Konno Katsunori Aoki

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.70, no.3.4, pp.325-333, 2023 (Released:2023-11-09)

参考文献数

37

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The effects of early enteral arginine-rich nutrition (EAN) were analyzed among patients undergoing curative-intent total gastrectomy for gastric cancer. There were 19 patients in this prospective study, all randomly assigned to either a parenteral nutrition (PN) group or an EAN group for the first seven days after surgery. The EAN group received 1.8-fold greater arginine (10.1 g/day) compared with the PN group, which was administered through an enteral tube inserted into the jejunal loop. Both groups were provided almost identical amounts of total amino acids (54 g/day), and the total energy was set at 65% of the total requirement (25 kcal/kg/day). No significant differences were observed between the two groups in postoperative complications, length of hospital stay, oral intake, nutritional status, or body weight. The serum arginine profile was similar in the two groups, as it decreased significantly on postoperative day (POD) 1, and gradually returned to preoperative levels by POD 7. The nitrogen balance remained negative until POD 7 in the PN group, but turned neutral at POD 7 in the EAN group. While we could not confirm body weight loss improvement, these results suggested that early arginine-rich enteral nutrition could improve the nitrogen balance after total gastrectomy. J. Med. Invest. 70 : 325-333, August, 2023

著者

Makoto Tachibana

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.62, no.1.2, pp.19-23, 2015 (Released:2015-03-27)

参考文献数

47

被引用文献数

12 14

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Epigenetics is the study of changes in gene function that cannot be explained by changes in DNA sequence. A mammalian body contains more than two-hundred different types of cells, all derived from a single fertilized egg. Epigenetic gene regulation mechanisms essentially contribute to various processes of mammalian development. The essence of epigenetic regulation is the modulation of gene activity through changes in chromatin structure. DNA methylation and histone modifications are the major epigenetic mechanisms. Sex determination is the process of establishing a gender. Sry, the sex-determining gene in therian mammals, initiates testis differentiation. Recent studies have provided evidence that epigenetic mechanisms contribute to Sry regulation. J. Med. Invest. 62: 19-23, February, 2015

著者

Asuka Ito Hideyuki Nushida Hiromitsu Kurata Hitomi Umemoto Hirofumi Iseki Itsuo Tokunaga Akiyoshi Nishimura

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.70, no.1.2, pp.290-293, 2023 (Released:2023-05-11)

参考文献数

29

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Complete decapitation due to suicide by hanging is rare. We report the case of a decapitated man who was found in the sea near an estuary. A polyethylene rope was tied to the handrail of the bridge across a strait near the site of the body. The rope was 12 mm in diameter and 19 m in length from the handrail. It ended with a slip knot noose, and skin and mustache-like hair fragments were attached to it. The decapitated head was not found. The deceased weighed 82 kg and was 152 cm long without the head. The autopsy revealed coarse abrasions and intramuscular hemorrhage around the severed edge. The third cervical spine was not fractured. We reviewed the literature and suggested the conditions of body weight, fall height, rope diameter, and number of rolls in cases of decapitation by hanging. We calculated the hanging decapitation index (HDI) as the fall height (m) multiplied by the body weight (kg), divided by the rope diameter (mm), divided by the number of rolls ; and discussed the differences between complete and incomplete decapitation cases. J. Med. Invest. 70 : 290-293, February, 2023

著者

Shigeru Aomura Hiromichi Nakadate Yuelin Zhang Takahiro Ueno Akiyoshi Nishimura

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.70, no.1.2, pp.213-220, 2023 (Released:2023-05-11)

参考文献数

21

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In this paper the effectiveness of the support system which predicts the risk of the repetitive brain concussion is studied biomechanically. In the risk prediction system, the accident that caused the concussion is reconstructed by analyzing the game video via multibody dynamics and the resulting brain injury is calculated in detail by the finite element method. In order to calculate the aggravation of the brain injury by the repeated brain concussion, the following two methods are examined. In the first method, the material properties of the part of the brain damaged by the1st impact are changed in the simulation of the 2nd impact. In the second method, each brain damage caused by the repeated impacts is accumulated. The system was applied to the real-life accidents that occurred during Judo and American football games. As a result of the simulations, the aggravation of the brain damage due to repetitive concussion was determined numerically in terms of the maximum strain of the brain and the brain damage rate of the whole brain. The biomechanical process of the collision accidents and the resulting brain damage were reconstructed based on the video and the results are effective to prevent the future repeated concussion accidents. J. Med. Invest. 70 : 213-220, February, 2023

著者

Taiga Itagaki

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.69, no.3.4, pp.165-172, 2022 (Released:2022-10-17)

参考文献数

71

被引用文献数

1

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Mechanical ventilation injures not only the lungs but also the diaphragm, resulting in dysfunction associated with poor outcomes. The chief mechanisms of ventilator-induced diaphragm dysfunction are : disuse atrophy due to insufficient contraction and excessive ventilatory support ; concentric load-induced injury due to excessive contraction and insufficient ventilatory support ; eccentric load-induced injury due to contraction during the expiratory phase ; and longitudinal atrophy caused by high positive end-expiratory pressure. To protect the diaphragm during mechanical ventilation, maintaining proper levels of diaphragm contraction is paramount ; thus, monitoring of respiratory effort and finely tuned ventilator settings are necessary. Furthermore, maintaining of synchronization between the patient and the ventilator is also important. As diaphragm dysfunction is more likely to occur in critically ill patients, diaphragm-protective mechanical ventilation strategies are essential to reduce the mortality rate of intensive care unit patients. This review outlines clinical evidence of ventilator-induced diaphragm dysfunction and its underlying mechanisms, and strategies to facilitate diaphragm-protective mechanical ventilation. J. Med. Invest. 69 : 165-172, August, 2022

著者

Tsuneo Ninomiya Hiroko Hashimoto Hiroe Tani Kenji Mori

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.64, no.1.2, pp.153-159, 2017 (Released:2017-03-29)

参考文献数

12

被引用文献数

1 6

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Objective: To improve primary prevention of child maltreatment, the association between at-risk parents identified by maternity hospitals and local health centers and intervention outcomes was investigated. Methods: A screening program for primary prevention of child maltreatment has been implemented for parents with children aged<3 years in A Prefecture. At-risk parents are identified at maternity hospitals and local health centers. Public health nurses provide intervention to promote positive parenting through home visits, and referred to child protective centers when they suspect child maltreatment. Results: Between 2009 and 2014, a total of 2,252 new at-risk parents were identified, 956 from maternity hospitals and 1,296 from local health centers. Among these at-risk parents, 356 (15.8%) were referred to child protective centers for possible child maltreatment, 88 of which came from maternity hospitals and 268 from local health centers. The rate of referral from maternity hospitals was significantly lower than that from local health centers (9.2% vs. 20.7%, p<0.001). Conclusions: Identification of at-risk parents during pregnancy and early intervention resulted in a decrease in the rate of referrals to child protective centers. The specific risk factors of “perceived lack of social support”, “mental illness” and “teen pregnancy” may be mitigated by early intervention. J. Med. Invest. 64: 153-159, February, 2017

著者

Michiko Sato Teruhiro Morishita Takafumi Katayama Shigeko Satomura Hiroko Okuno Nami Sumida Masae Sakuma Hidekazu Arai Shinsuke Katoh Koichi Sairyo Akihiko Kawaura Eiji Takeda

出版者

The University of Tokushima Faculty of Medicine

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.67, no.1.2, pp.151-157, 2020 (Released:2020-05-02)

参考文献数

53

被引用文献数

8

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A clearer understanding of skeletal muscle mass (SMM) in middle-aged and elderly individuals is important for maintaining functionality. In the present study, age-related changes in SMM, the threshold of SMM with walking difficulty, intestinal nutrient absorption rate, and various serum factors were examined in Japanese populations of different ages. We used 24-h creatinine excretion as a measure of total body SMM. Age-related decreases in SMM, intestinal nutrient absorption rates, and serum 25-hydroxyvitamin D [25(OH)D] concentrations were significantly higher in women than in men. The cut-off values for SMM (kg), its percentage of total body weight (BW), the SMM index [SMMI] (Kg / m2), and creatinine height index (CHI) (%) in elderly individuals with walking difficulty were approximately 8-10 kg, 17-20% of BW, 3.9-4.6 kg / m2, and 44%, respectively. Serum 25(OH)D concentrations were closely associated with SMM (kg, % of BW, kg / m2) and CHI (%) as well as the intestinal absorption rates of nitrogen (%) and phosphorus (%) in women, but not in men. The present results demonstrate that vitamin D is an important metabolic factor in skeletal muscle, and contributes to the optimal management of skeletal muscle and the prevention of sarcopenia. J. Med. Invest. 67 : 151-157, February, 2020