著者
Ryutaro Arita Rie Ono Natsumi Saito Satoko Suzuki Akiko Kikuchi Minoru Ohsawa Yasunori Tadano Tetsuya Akaishi Takeshi Kanno Michiaki Abe Ko Onodera Shin Takayama Tadashi Ishii
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.257, no.3, pp.241-249, 2022 (Released:2022-07-02)
参考文献数
49
被引用文献数
2

Coronavirus disease 2019 (COVID-19) causes a variety of pain symptoms in the acute phase. Severe chest pain suddenly occurs even without abnormalities on examination and is sometimes refractory to analgesics. Such pain is a clinical concern in care facilities with limited resources, and this is the first report on the use of saikanto for its treatment. In Miyagi Prefecture, Japan, COVID-19 patients with mild symptoms were admitted to a hotel that operated as an isolation facility, and their symptoms were observed. In this article, we report four cases in which chest pain comorbid with mild to moderate COVID-19 was successfully treated with saikanto, a traditional Japanese (Kampo) medicine. The patients presented with chest pain and underwent medical examination at the facility. Two patients had severe chest pain refractory to acetaminophen. Critical cardiopulmonary diseases were ruled out in all the patients, and three patients had features of pneumonia on chest radiograph. Medications, including saikanto, were administered to the patients. The patients’ chest pain and other symptoms improved 1-4 days after the administration of saikanto, and they left the care facility without hospitalization. The cause of the chest pain experienced by these patients is unclear, but we speculate that it could be minimal pleural inflammation or neuropathy. Previous pharmacological studies have suggested anti-inflammatory and analgesic properties of the crude drugs that constitute saikanto. This case report suggests that saikanto could be a treatment option for chest pain refractory to analgesics in patients with mild to moderate COVID-19.
著者
Osamu Matsuno Toshiyuki Okubo Shigeo Hiroshige Rhyuichi Takenaka Emiko Ono Takuya Ueno Shinichi Nureki Masaru Ando Eishi Miyazaki Toshihide Kumamoto
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.212, no.1, pp.49-53, 2007 (Released:2007-04-27)
参考文献数
9
被引用文献数
25 27

Diagnosis of drug-induced pneumonia, which represents pulmonary toxicity caused by certain drugs, is difficult, as a large number of different drugs can elicit various immune-mediated diseases with distinct pathomechanisms. The drug-induced lymphocyte stimulation test (DLST) is widely used for diagnosing drug-induced pneumonia in Japan. Recent reports, however, indicate that DLST is not reliable for diagnosis of drug-induced pneumonia. To diagnose drug-induced pneumonia, a provocation test with the suspected drug is the most reliable method of assessing the relationship between the drug and pneumonia. We examined the correlation between the DLST and the provocation test in 6 cases of suspected drug-induced pneumonia. DLST was performed in all of the patients. The causes of pneumonia in all patients were confirmed by a provocation test. The DLST was positive in 3 of 6 cases of suspected drug-induced pneumonia, but the suspected drugs were ruled out by the provocation test. If we had relied solely on the DLST, these 3 cases would have been labeled as false allergy. The results of the DLST did not coincide with the results of the provocation test in any of the cases. Our results suggest that the DLST is not useful for the diagnosis of drug-induced pneumonia. Following provocation with the causative drug, reappearance of pulmonary infiltration was not observed in any of the cases. These findings indicate that a carefully performed provocation test is the safe and most reliable method.
著者
Michiko Kano Lukas Van Oudenhove Patrick Dupont Tor D. Wager Shin Fukudo
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.250, no.3, pp.137-152, 2020 (Released:2020-03-03)
参考文献数
124
被引用文献数
3 8

When patients present with persistent bodily complaints that cannot be explained by a symptom-linked organic pathology (medically unexplained symptoms), they are diagnosed with ‘functional’ somatic syndromes (FSS). Despite their prevalence, the management of FSS is notoriously challenging in clinical practice. This may be because FSS are heterogeneous disorders in terms of etiopathogenesis. They include patients with primarily peripheral dysfunction, primarily centrally driven somatic symptoms, and a mix of both. Brain-imaging studies, particularly data-driven pattern recognition methods using machine learning algorithms, could provide brain-based biomarkers for these clinical conditions. In this review, we provide an overview of our brain imaging data on brain-body interactions in one of the most well-known FSS, irritable bowel syndrome (IBS), and discuss the possible development of a brain-based biomarker for FSS. Anticipation of unpredictable pain, which commonly elicits fear in FSS patients, induced increased activity in brain areas associated with hypervigilance during rectal distention and non-distention conditions in IBS. This was coupled with dysfunctional inhibitory influence of the medial prefrontal cortex (mPFC) and pregenual anterior cingulate cortex (pACC) on stress regulation systems, resulting in the activated autonomic nervous system (ANS) and neuroendocrine system stimulated by corticotropin-releasing hormone (CRH). IBS subjects with higher alexithymia, a risk factor for FSS, showed stronger activity in the insula during rectal distention but reduced subjective sensitivity. Reduced top-down regulation of the ANS and CRH system by mPFC and pACC, discordance between the insula response to stimulation and subjective sensation of pain, and stronger threat responses in hypervigilance-related areas may be a candidate brain-based biomarker.
著者
Hisashi Masugata Shoichi Senda Michio Inukai Takashi Himoto Koji Murao Naohisa Hosomi Yasuyoshi Iwado Takahisa Noma Masakazu Kohno Fuminori Goda
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.2, pp.137-142, 2011 (Released:2011-05-27)
参考文献数
17
被引用文献数
17 24

Seasonal variations in blood pressures should be kept in mind when controlling blood pressure in hypertensive patients. Seasonal variations in glomerular filtration rate (GFR) also may have a clinical significance. However, it is time-consuming to measure GFR directly. We therefore examined the seasonal variation in estimated glomerular filtration rate (eGFR) based on serum creatinine levels in hypertensive patients without CKD (eGFR ≥ 60 mL/min/1.73 m2) and those with chronic kidney disease (CKD) (eGFR < 60 mL/min/1.73 m2). This study included 47 hypertensive patients without CKD (69 ± 11 yrs) and 55 hypertensive patients with CKD (76 ± 8 yrs). The eGFR was determined from the equation: eGFR = 194 × age−0.287 × (serum creatinine)−1.094 (× 0.739 if female). Overall, both groups of hypertensive patients demonstrated similar seasonal variations in eGFR. Importantly, hypertensive patients without CKD and those with CKD showed the lower eGFR in summer (June-August) (71.8 ± 13.2 and 37.2 ± 13.0 mL/min/1.73 m2, respectively) compared with the eGFR in spring (March-May) (77.9 ± 13.0 and 43.0 ± 14.0 mL/min/1.73 m2, respectively) (p < 0.05). The decrease in eGFR from spring to summer was similar for both types of hypertensive patients (without CKD, −6.1 ± 7.0; with CKD, −5.8 ± 5.2 mL/min/1.73 m2). However, the percent change in eGFR from spring to summer was greater in hypertensive patients with CKD (−13.8 ± 9.4 %) than in those without CKD (−7.7 ± 8.3 %) (p = 0.001). In conclusion, careful observation regarding renal function is needed for hypertensive patients with CKD during summer.
著者
Yasuhiro Miki Kiyoshi Ito
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.256, no.3, pp.187-195, 2022 (Released:2022-03-19)
参考文献数
64
被引用文献数
4

In situations of a disaster, it has been observed that the damage suffered by women and men is not equal. The vulnerability of women during disasters has been the focus of several studies and disaster management guidelines. Records show that there were more women victims than men victims in both the Great Hanshin-Awaji Earthquake in 1995 and the Great East Japan Earthquake (GEJE) in 2011. Biologically speaking, women are physically less fit than men are; hence, they are more susceptible to physical disabilities induced by disasters and may be disadvantaged in evacuation situations. However, vulnerability of women during disasters is a complex problem that involves physical fitness, as well as other various factors. In the Sendai Framework for Disaster Risk Reduction 2015-2030 (SFDRR) adopted in 2015, prioritized actions such as “Build Back Better” were defined based on the GEJE experiences. In the SFDRR, in addition to vulnerability of women during disasters, medical services including maternal, newborn, and child health and sexual and reproductive health are considered the key factors for disaster risk reduction. This has been discussed in all phases of disaster risk reduction planning and post-disaster response. These findings suggest that the role of obstetrics and gynecology is comprehensive and important as a part of disaster medicine at the local and national levels, as recommended in the SFDRR. In this review, we summarized the management of women’s health and gynecological responses during disasters and considered the importance of women as stakeholders in disaster risk reduction.
著者
Tsukasa Ohuchi Xueting Guan Masato Funayama
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.255, no.4, pp.275-281, 2021 (Released:2021-12-09)
参考文献数
9

Although the Great East Japan Earthquake occurred on March 11, 2011, identification of victims is still ongoing. Typically, mitochondrial DNA (mtDNA) is performed when it is difficult to identify an individual using nuclear DNA. In Japan, samples from criminal investigations are subjected to nuclear DNA testing at the Scientific Research Institute belonging to each prefectural police headquarters, while all mtDNA tests were originally conducted at the National Research Institute of Police Science. However, the appraisal work using mtDNA became more time-consuming as the number of target samples increased. Because our department is capable of performing mtDNA testing, the Miyagi Prefectural Police requested that our department perform mtDNA testing. Specifically, we focused on 16 individuals as putative candidates for 11 unidentified human remains; efforts to identify these remains were performed using samples from 20 relatives. These efforts positively identified six victims. This included confirmation that one corpse had originally been identified incorrectly. Although disasters of a similar scale can strike Japan again, there are limited facilities that can consistently perform mtDNA testing. Expensive sequencing machines and properly trained operators are essential for mtDNA testing, but they cannot be established at the forensic departments of all medical schools. There is thus an urgent need to establish core facilities at appropriate sites, such as Tohoku University in the Tohoku Region, to build a mtDNA testing system suitable for the aftermath of any disaster.
著者
Saira Baloch Mohsin Ali Baloch Tianli Zheng Xiaofang Pei
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.250, no.4, pp.271-278, 2020 (Released:2020-04-23)
参考文献数
19
被引用文献数
73 230

The present study provides an overview of the coronavirus disease 2019 (COVID-19) outbreak which has rapidly extended globally within a short period. COVID-19 is a highly infectious respiratory disease caused by a new coronavirus known as SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2). SARS-CoV-2 is different from usual coronaviruses responsible for mild sickness such as common cold among human beings. It is crucial to understand the impact and outcome of this pandemic. We therefore overview the changes in the curves of COVID-19 confirmed cases and fatality rate in China and outside of China from 31st of December 2019 to 25th of March 2020. We also aimed to assess the temporal developments and death rate of COVID-19 in China and worldwide. More than 414,179 confirmed cases of COVID-19 have been reported in 197 countries, including 81,848 cases in China and 332,331 outside of China. Furthermore, 18,440 infected patients died from COVID-19 infection; 3,287 cases were from China and 15,153 fatalities were reported worldwide. Among the worldwide infected cases, 113,802 patients have been recovered and discharged from different hospitals. Effective prevention and control measures should be taken to control the disease. The presented Chinese model (protocol) of disease prevention and control could be utilized in order to curb the pandemic situation.
著者
Nobue Saito Toshimi Sairenchi Fujiko Irie Hiroyasu Iso Kyoko Iimura Hiroshi Watanabe Takashi Muto Hitoshi Ota
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.229, no.3, pp.203-211, 2013 (Released:2013-02-27)
参考文献数
25
被引用文献数
13 18

Liver cancer a global public health concern and well known for poor prognosis. The association between low total cholesterol level and liver cancer has been reported. However, the association between low low-density lipoprotein (LDL) cholesterol levels and liver cancer is still unclear. The aim of this study was to examine the relationship between LDL cholesterol level and liver cancer mortality. A total of 16,217 persons (5,551 men and 10,666 women) aged 40-79 years in 1993 were followed until 2008. LDL cholesterol levels were divided into four categories (< 80 mg/dl, 80-99 mg/dl, 100-119 mg/dl, and ≥ 120 mg/dl). Hazard ratio of LDL cholesterol level for liver cancer mortality was calculated using a multivariable Cox proportional hazards model. Covariates were age, sex, alanine transaminase, body mass index, alcohol intake and smoking status, all of which were correlated with LDL cholesterol levels. There were 51 deaths (32 men and 19 women) from liver cancer. Multivariable hazard ratios of liver cancer deaths for LDL cholesterol levels of < 80 mg/dl was 4.33 (95% confident interval [CI]: 1.94, 9.68), for LDL cholesterol levels of 80-99 mg/dl was 1.03 (95% CI: 0.42, 2.53), and for LDL cholesterol levels of ≥ 120 mg/dl was 0.43 (95% CI: 0.20, 0.92) compared with LDL cholesterol levels of 100-199 mg/dl (p for trend < 0.01). Therefore, low LDL cholesterol levels are associated with elevated risk of liver cancer mortality. Low LDL cholesterol may be a predictive marker for death due to liver cancer.
著者
Haneul Lee Jerrold S. Petrofsky JongEun Yim
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.237, no.1, pp.51-56, 2015 (Released:2015-09-03)
参考文献数
29
被引用文献数
8 13

Hormones such as estradiol have an effect on human connective tissue, making women more susceptible to knee injuries. Indeed, women have a greater risk for non-contact injuries of anterior cruciate ligament (ACL) compared to men when participating in the same sports. The purpose of the present study was to examine the difference in ACL laxity after an eccentric exercise in the lower limbs in young healthy women between oral contraceptive pill (OCP) users and non-OCP users to see the effect of OCP on ACL laxity. Forty young healthy women participated in the experiments (25 with normal menstrual cycle and 15 with taking OCP). ACL laxity and a visual analog pain scale were measured before and after a bout of squat. OCP users had more pain than non-OCP users after heavy exercise (p < 0.001). Both groups showed a significant reduction in ACL laxity on the 2nd day after exercise (p < 0.05). While ACL laxity was always less in the OCP group, when expressed as a percent change from baseline, the ACL laxity change was similar in both groups (p > 0.05). We found that there was no statistically significant difference in ACL laxity recovery over time in response to the delayed onset muscle soreness after a bout of squat between two groups. However, health professionals working with young female adults should recognize that OCP users with less ACL laxity are at higher risk for having knee injuries because of ACL stiffness when doing exercise.
著者
Mitsutoshi Munakata Kaori Kobayashi Junko Niisato-Nezu Souichiro Tanaka Yosuke Kakisaka Takae Ebihara Satoru Ebihara Kazuhiro Haginoya Shigeru Tsuchiya Akira Onuma
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.214, no.4, pp.327-332, 2008 (Released:2008-04-26)
参考文献数
15
被引用文献数
18 24

Patients with severe neurological disorders often require enteral nutrition (EN). Since long-term EN can cause multiple complications, reinstating the oral intake of food is beneficial. Olfactory stimulation using black pepper oil (BPO), a strong appetite stimulant, was reported to facilitate swallowing in older people. Therefore, the effects of olfactory stimulation with BPO were investigated in pediatric patients receiving long-term EN due to neurological disorders. The effects of scenting with BPO for 1 min immediately before every meal were evaluated in ten patients: 4 boys and 6 girls, aged 19-97 months (51 ± 26 months). The neurological disorders included periventricular leukomalacia (3 patients), hypoxic ischemic encephalopathy (3), Costello syndrome (1), Russell-Silver syndrome (1), Miller-Dieker syndrome (1), and cerebral palsy of unknown etiology (1). In eight of these patients, BPO intervention was continued for 3 months. Five of these eight patients showed increases in the amount of oral intake with desirable effects including facilitated swallowing movement, although complete elimination of the need for EN was not achieved. In the other three patients, BPO intervention was not effective; severe cerebral tissue loss, profound malformation or intractable seizures seemed to reduce the efficacy of BPO. In two cases, BPO intervention was discontinued due to cough or because the odor of BPO was unbearable to the family. In conclusion, olfactory stimulation with BPO facilitated oral intake in a subset of patients on long-term EN. BPO stimulation may be useful for facilitating oral intake when used in combination with conventional methods.
著者
Yusaku Maeda Keita Fukushima Satomi Kyoutani James P. Butler Masahiko Fujii Hidetada Sasaki
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.252, no.3, pp.263-267, 2020 (Released:2020-11-10)
参考文献数
22
被引用文献数
4

Behavioral and psychological symptoms of dementia (BPSD) challenge caregivers, leading to caregiver burden and subsequent nursing home or inpatient placement in a psychiatric hospital for dementia. Favorable positive emotions should be an important goal for the treatment of negative emotions of BPSD. Arts are one of the most profound areas to stimulate favorable emotions. We have asked a professional actor, who was not involved in the daily care and regular rehabilitations, to give a dramatic performance by reading selected stories as if the patients with BPSD felt to be in the audiences of a theater. We wondered whether a dramatic performance by the actor might be a way to respond to the complex needs of inpatients with BPSD, especially focused on favorable emotions. New inpatients (Alzheimer’s disease, vascular dementia, or dementia with Lewy bodies) were randomly assigned to a control group (n = 20) and a dramatic performance group (n = 14) in Sendai Tomizawa Hospital, a psychiatric hospital for dementia, in Japan. Dramatic performances were performed for one and half hours once per week for 3 months. Neuropsychiatric Inventory for BPSD decreased in both groups and delightful emotional index (DEI) for favorable emotions increased in the intervention group but not in the control group after 3 months. At 3 months, there was an increase of DEI in intervention group compared with control group. We conclude that dramatic performance may be one of the appropriate interventions in patients with BPSD, as it appears to help in their favorable emotional state.
著者
Tomomi Suda Aya Murakami Yayoi Nakamura Hiroyuki Sasaki Ichiro Tsuji Yumi Sugawara Kazuaki Hatsugai Masafumi Nishizawa Shinichi Egawa
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.248, no.2, pp.73-86, 2019 (Released:2019-06-08)
参考文献数
38
被引用文献数
2 11

The medical records of service in disaster provided at a place other than a medical facility are defined as disaster medical records (DMRs). In this epidemiological study, to clarify medical need characteristics and trends after disaster, we analyzed the all anonymized DMRs of Minamisanriku Town that lost medical facilities in 2011 Great East Japan Earthquake and its consequent tsunami. After screening of duplicated or irrelevant documents, there were 10,464 DMRs with 18,532 diagnoses from March 11 through May 13. From 34 diagnostic groups according to International Classification of Diseases (ICD)-10, we integrated diagnostic groups into five modules that might require treatment concepts of different types: non-communicable disease (NCD), infectious disease, mental health issue, trauma, and maternal and child health (MCH). Age and sex distributions of the patients were similar to those of population before the disaster. The largest diagnostic module was NCD (68%), followed by infectious disease (21%), mental health issues (6%), trauma (4%), and MCH (0.2%). The age-specific rate of NCD exhibited a similar or suppressed level from that of nationwide survey, with higher rate of pollinosis among young population. Infectious disease increased in most age groups but there was no apparent outbreak because of early interventions. Sleep deprivation was twice as frequent in middle-aged women, compared with men. Trauma and MCH were less frequent, but each exhibited a unique time trend. Trauma onset was continuously recorded, while MCH visits were concentrated on a specific day. The medical need after disaster dynamically changes, and appropriate anticipatory countermeasures are necessary.
著者
Haruhisa Ibayashi Yoshihisa Fujino Truong-Minh Pham Shinya Matsuda
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.215, no.3, pp.237-245, 2008 (Released:2008-07-19)
参考文献数
38
被引用文献数
33 45

In Japan, one of the duties of the long-term care insurance system is the prevention of oral function degradation. Although various exercise programs for oral function have been developed and practiced in Japan, to date, no study has reported their effects. In the present study, we examined the effects of an exercise program on oral functions in healthy elderly people. Healthy elderly people participated in the study and were randomly divided into intervention and control groups (39 subjects/group). The exercise program consisted of four exercises: exercise for expression muscles, tongue, salivary glands, and swallowing. Before and after a six-month intervention period, we evaluated changes in oral functions, namely bite force, swallowing ability, and salivary flow rate. Fifty-four subjects completed the study protocol: 26 and 28 subjects from intervention and control groups, respectively. A significant improvement in all oral functions, including bite force, swallowing ability, as well as unstimulated and stimulated salivary flow rate, was observed in the intervention group after six months, whereas no improvement was observed in the control group. Further, among the intervention group, a significant improvement in oral functions was observed in 17 subjects with 20 or more remaining teeth, whereas no improvement was observed in the other nine with less than 20 teeth. Our results suggest that oral functions significantly improve after conducting a six-month exercise program for oral function. Further, this improvement appears to be influenced by the number of remaining teeth.
著者
Mi Yang Jeon HyeonCheol Jeong SeungWon Lee Wonjae Choi Jun Hyuck Park Sa Jin Tak Dae Ho Choi Jongeun Yim
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.233, no.3, pp.183-188, 2014 (Released:2014-07-09)
参考文献数
25
被引用文献数
8 20

Because sleep comprises one-third of a person’s life, using an optimal pillow for appropriate neck support to maintain cervical curve may contribute to improve quality of sleep. Design of orthopedic pillow conforms to orthopedic guidelines to ensure the right support of the cervical curve. The aim of this study was to investigate effect of different pillow shape and content on cervical curve, pillow temperature, and pillow comfort. A feather pillow is regarded as a standard pillow, and a memory foam pillow is one of the most popular pillows among pillow users. We, therefore, compared these two pillows with an orthopedic pillow. Twenty healthy subjects (10 men and 10 women; age range, 21-30 years) participated in the study. Each subject was asked to assume the supine position with 3 different pillows for 30 minute in each trial and then cervical curve, pillow temperature, and pillow comfort were measured. When comparing the cervical curve of the 3 different pillows, that of the orthopedic pillow was significantly higher than that of the other 2 pillows (p < 0.001). The degree of temperature increase was significantly lower for the orthopedic pillow than for the memory foam and feather pillows (p < 0.001). The visual analog scale (VAS) score of pillow comfort was significantly higher in orthopedic pillow than the other 2 pillows. This study shows that pillow shape and content plays a crucial role in cervical curve, pillow temperature, and pillow comfort and orthopedic pillow may be an optimal pillow for sleep quality.
著者
Mari Yamasue Shin-ichi Nureki Hiroyuki Matsumoto Takamasa Kan Takehiro Hashimoto Ryoichi Ushijima Yuko Usagawa Jun-ichi Kadota
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.3, pp.223-230, 2016 (Released:2016-07-09)
参考文献数
28
被引用文献数
4 9

Relapsing polychondritis (RP) is a rare systemic disorder characterized by recurrent, widespread chondritis of the auricular, nasal, and tracheal cartilages. IgG4-related disease (IgG4-RD) is a systemic immune-mediated disease characterized by the infiltration of IgG4-bearing plasma cells into systemic organs. Although 25% to 35% of patients with RP have a concurrent autoimmune disease, coexistence of RP and IgG4-RD is rare. We herein report a case of RP complicated by IgG4-RD. A 63-year-old man developed recurrent bilateral ear pain and swelling, recurrent blurred and decreased vision, and migratory multiple joint pain, sequentially within one year. Fourteen months after the first symptom, he experienced dry cough and dyspnea with exertion. A computed tomography (CT) scan detected interstitial pneumonia, swelling of bilateral submandibular glands, bilateral hilar and mediastinal lymphadenopathy, and several nodules in bilateral kidneys. His serum levels of IgG and IgG4 were elevated. The biopsy specimen of auricular cartilage showed infiltrations of inflammatory cells and fibrosis consistent with RP. The IgG4-positive cells were not observed in auricular cartilage. The patient met the diagnostic criteria of RP, including bilateral auricular chondritis, conjunctivitis, iritis and polyarthritis. The biopsy specimens of lung and kidney revealed the significant infiltrations of IgG4-positive plasma cells and fibrosis. We also diagnosed him as having IgG4-RD, affecting bilateral submandibular glands, hilar and mediastinal lymph nodes, lungs, and kidneys. Thus, RP preceded the onset of IgG4-RD. Corticosteroid therapy improved the symptoms and CT scan findings. In conclusion, RP and IgG4-RD do coexist; however, the pathogenesis of their coexistence is unknown.
著者
山田 勝義
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.54, no.2, pp.163-174, 1951-06-25 (Released:2008-11-28)
参考文献数
12
被引用文献数
7 11

The sensory terminations in clitoris in adult show remarkable develop-ment, compared with those in the embryo of 10th month, but with a exception of the intraepithelial fibres which exist no more even in the common epithelium remained in the radix clitoridis. Such a special corpusclar termination as having a swelling inner bulb in the embryo seems to beloiig to a Pacinian corpuscle, because it show in adult in its periphery the formation of some of lamellae. The corpusclar terminations except the Pacinian corpuscles in the external genitals in adult have long included Krause's end bulbs, Krause's genital bodies and Meissner's tactile bodies. But there is no essential difference between both of the formers. And the existence of the latters is denied too. The morphological difference of these bodies consists in the conditions of the arrangement of the sensory nerve fibres and special nuclei in the inner bulb. These terminal bodies are divided into 3 types. But, as they have morphologically more or less similarities, they should be called collectively the genital nerve bodies. Each termination of the type 1 and 2 has remarkable inner bulb, which is showed as a synchytium consisting of fine granular substance and special nuclei and considered to be of peripheral glia and of endocrine nature. The terminal bodies of the type 1 are characteristic with the glornerular arrangement of the nerve fibres extending widely in the whole territorium of the inner bulb, while the type 2 with the nerve distribution mainly in the center part of the inner bulb. The terminations of the type 3, which have no formation of the inner bulb and could be called the special ramified terminations too, are seen in general in the strong connective tissue, for example in the tunica albuginea of corpora cavernosa clitoridis. The thick medullated fibre loses its myelin just before the terminal formation and divides into many branches, which terminate with the. arrangement as seen in the type 2.
著者
Akio Hoshi Hiromi Watanabe Masatoshi Kobayashi Momoko Chiba Yutaka Inaba Naoto Kimura Takashi Ito
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.195, no.3, pp.163-169, 2001 (Released:2004-12-22)
参考文献数
31
被引用文献数
9 16

Trace elements in sweat during sauna bathing were assessed. Sweat collected by the whole body method was compared with that collected by the arm bag method. The sweat samples were collected from ten healthy male adults aged 22-26 years, by heat exposure in dry sauna bathing (60°C, 30 minutes). Concentrations of major (Na, Cl, K, Ca, P and Mg) and trace (Zn, Cu, Fe, Ni, Cr and Mn) elements in sweat tended to be lower in the arm bag method than in the whole body method. It was found that Ca, Mg, Fe and Mn concentrations in the arm bag method were significantly lower than those in the whole body method. The amount of trace elements in sweat measured by the arm bag method was less than that by the whole body method; significant differences were observed in Fe and Mn amounts. These observations suggest that excretion of trace elements by sweating induces trace element decrease. Therefore, athletes and workers who work in a hot environment and sweat much habitually should ingest adequate amounts of trace elements.