2024-03-29T00:39:39Zhttp://ginmu.naramed-u.ac.jp/dspace-oai/request
oai:ginmu.naramed-u.ac.jp:10564/27572017-05-29T06:08:33Zhdl_10564_2756Internet survey of the influence of environmental factors on human health: environmental epidemiologic investigation using the web-based daily questionnaire for health.環境因子が健康に与える影響について インターネット調査;WDQH(Web-based Daily Questionnaire for Health)を利用した環境疫学調査Sano, TomomiAkahane, ManabuSugiura, HiroakiOhkusa, YasushiOkabe, NobuhikoImamura, Tomoakiweb-based surveyenvironmental factorminimum temperaturegeneral populationWith increasing Internet coverage, the use of a web-based survey for epidemiological study is a possibility. We performed an investigation in Japan in winter 2008 using the web-based daily questionnaire for health (WDQH). The WDQH is a web-based questionnaire survey formulated to obtain information about the daily physical condition of the general public on a real-time basis, in order to study correlations between changes in physical health and changes in environmental factors. Respondents were asked whether they felt ill and had specific symptoms including fever. We analysed the environmental factors along with the health conditions obtained from the WDQH. Four factors were found to influence health: minimum temperature, hours of sunlight, median humidity and weekday or holiday. The WDQH allowed a daily health survey in the general population in real time via the Internet.博士(医学)・甲第593号・平成24年11月27日© 2013 Taylor & Francis GroupTaylor and Francis2014-12-18T06:33:52Z2014-12-18T06:33:52Z2013ThesisThesis or DissertationInternational journal of environmental health research Vol.23 No.3 p.247-25709603123http://hdl.handle.net/10564/275709603123AA10856375International journal of environmental health research233247257enghttp://www.ncbi.nlm.nih.gov/pubmed/22946467http://dx.doi.org/10.1080/09603123.2012.717916none
oai:ginmu.naramed-u.ac.jp:10564/27582017-05-29T06:08:34Zhdl_10564_2756Diffuse vascular injury: convergent-type hemorrhage in the supratentorial white matter on susceptibility-weighted image in cases of severe traumatic brain damage.びまん性血管損傷 磁化率強調画像を用いた重症頭部外傷での収束性出血Iwamura, AsamiTaoka, ToshiakiFukusumi, AkioSakamoto, MasahikoMiyasaka, ToshiteruOchi, TomokoAkashi, ToshiakiOkuchi, KazuoKichikawa, KimihikoSusceptibility-weighted imageApparent diffusion coefficientDiffuse axonal injuryDiffuse vascular injuryGlasgow Coma ScaleINTRODUCTION:Susceptibility-weighted image (SWI) is one of the most sensitive methods for detect microbleeding and useful for evaluation of traumatic brain damage. The purpose of this study is to delineate the characteristics and importance of supratentorial deep white matter hemorrhages detected by SWI in cases of traumatic brain damage.
METHODS:Twenty-one consecutive cases with severe traumatic head injury were included in the current study. MRI examinations were made within 1 month after injury. We evaluated the degree and distribution of the supratentorial hemorrhages on SWI retrospectively. We classified the degree of bleeding into four grades: "small hemorrhage," "single bead-like hemorrhage," "convergent-type hemorrhage," and "massive hemorrhage." We then correlated the degree and distribution of the hemorrhage to clinical outcomes. We also evaluated the apparent diffusion coefficient (ADC) image of lobes with "convergent-type hemorrhage."
RESULTS:Existence of "massive hemorrhage" correlated with a poor outcome, that is, worse than "severely disabled" on the Glasgow Outcome Scale. The number of lobes affected by "convergent-type hemorrhage" also correlated with poor outcome. There were 45 lobes with "convergent-type hemorrhage" and 27 of them showed increased diffusivity on ADC images.
CONCLUSION:Supratentorial massive hemorrhages and supratentorial convergent-type multiple hemorrhages were associated with poor prognosis after traumatic brain injury. The increased diffusivity in lobes with convergent-type hemorrhages may indicate that congestion of the proximal medullary vein may play some role for these hemorrhages.博士(医学)・甲第594号・平成25年3月15日© Springer International Publishing AG,2012Springer-Verlag2014-12-18T06:55:08Z2014-12-18T06:55:08Z2012-04ThesisThesis or DissertationNeuroradiology Vol.54 No.4 p.335-34300283940http://hdl.handle.net/10564/275800283940AA00754889Neuroradiology544335343enghttp://www.ncbi.nlm.nih.gov/pubmed/21611726http://dx.doi.org/10.1007/s00234-011-0892-9none
oai:ginmu.naramed-u.ac.jp:10564/27592017-05-29T06:08:35Zhdl_10564_2756Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia.多飲水統合失調症男性患者における脳構造変化と神経心理学的障害Nagashima, TomohisaInoue, MakotoKitamura, SoichiroKiuchi, KuniakiKosaka, JunOkada, KojiKishimoto, NaokoTaoka, ToshiakiKichikawa, KimihikoKishimoto, ToshifumiSchizophreniaPolydipsiaVolumetryMRINeuropsychological impairmentBrief assessment of cognition in schizophreniaBACKGROUND:Polydipsia frequently occurs in schizophrenia patients. The excessive water loading in polydipsia occasionally induces a hyponatremic state and leads to water intoxication. Whether polydipsia in schizophrenic patients correlates with neuropsychological impairments or structural brain changes is not clear and remains controversial.
METHODS:Eight polydipsic schizophrenia patients, eight nonpolydipsic schizophrenia patients, and eight healthy controls were recruited. All subjects underwent magnetic resonance imaging (MRI) and neuropsychological testing. Structural abnormalities were analyzed using a voxel-based morphometry (VBM) approach, and patients' neuropsychological function was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J).
RESULTS:No significant differences were found between the two patient groups with respect to the clinical characteristics. Compared with healthy controls, polydipsic patients showed widespread brain volume reduction and neuropsychological impairment. Furthermore, the left insula was significantly reduced in polydipsic patients compared with nonpolydipsic patients. These nonpolydipsic patients performed intermediate to the other two groups in the neuropsychological function test.
CONCLUSIONS:It is possible that polydipsia or the secondary hyponatremia might induce left insula volume reduction. Furthermore, this structural brain change may indirectly induce more severe neuropsychological impairments in polydipsic patients. Thus, we suggest that insula abnormalities might contribute to the pathophysiology of polydipsic patients.博士(医学)・甲第595号・平成25年3月15日© 2012 BioMed Central LtdBioMed Central2014-12-19T06:48:51Z2014-12-19T06:48:51Z2012-11ThesisThesis or DissertationBMC Psychiatry Vol.12 p.2101471244Xhttp://hdl.handle.net/10564/27591471244XAA12072671BMC Psychiatry12210210enghttp://www.ncbi.nlm.nih.gov/pubmed/23181904http://dx.doi.org/10.1186/1471-244X-12-210none
oai:ginmu.naramed-u.ac.jp:10564/27602017-05-29T06:08:35Zhdl_10564_2756Efficacy of FDG-PET for defining gross tumor volume of head and neck cancer.頭頸部癌の肉眼的腫療体積の境界限定におけるFDG-PET の有用性Kajitani, ChikaeAsakawa, IsaoUto, FumiakiKatayama, EmikoInoue, KazuyaTamamoto, TetsuroShirone, NorihisaOkamoto, HideyukiKirita, TadaakiHasegawa, MasatoshiFDG-PETgross tumor volumetarget delineationhead and neck cancerWe analyzed the data for 53 patients with histologically proven primary squamous cell carcinoma of the head and neck treated with radiotherapy between February 2006 and August 2009. All patients underwent contrast-enhanced (CE)-CT and 18F-fluorodeoxyglucose (FDG)-PET before radiation therapy planning (RTP) to define the gross tumor volume (GTV). The PET-based GTV (PET-GTV) for RTP was defined using both CE-CT images and FDG-PET images. The CE-CT tumor volume corresponding to a FDG-PET image was regarded as the PET-GTV. The CE-CT-based GTV (CT-GTV) for RTP was defined using CE-CT images alone. Additionally, CT-GTV delineation and PET-GTV delineation were performed by four radiation oncologists independently in 19 cases. All four oncologists did both methods. Of these, PET-GTV delineation was successfully performed in all 19 cases, but CT-GTV delineation was not performed in 4 cases. In the other 15 cases, the mean CT-GTV was larger than the PET-GTV in 10 cases, and the standard deviation of the CT-GTV was larger than that of the PET-GTV in 10 cases. Sensitivity of PET-GTV for identifying the primary tumor was 96%, but that of CT-GTV was 81% (P < 0.01). In patients with oropharyngeal cancer and tongue cancer, the sensitivity of CT-GTV was 63% and 71%, respectively. When both the primary lesions and the lymph nodes were evaluated for RTP, PET-GTV differed from CT-GTV in 19 cases (36%). These results suggested that FDG-PET is effective for defining GTV in RTP for squamous cell carcinoma of the head and neck, and PET-GTV evaluated by both CE-CT and FDG-PET images is preferable to CT-GTV by CE-CT alone.博士(医学)・甲第596号・平成25年3月15日Copyright © 2013 Japan Radiation Research Society and Japanese Society for Radiation OncologyOxford University Press / Japan Radiation Research Society2014-12-25T04:25:34Z2014-12-25T04:25:34Z2013-07ThesisThesis or DissertationJournal of radiation research Vol.54 No.4 p.671-67804493060http://hdl.handle.net/10564/276004493060AA00705792Journal of radiation research544671678enghttp://www.ncbi.nlm.nih.gov/pubmed/23287772http://dx.doi.org/10.1093/jrr/rrs131none
oai:ginmu.naramed-u.ac.jp:10564/27612017-05-29T06:08:27Zhdl_10564_2756Identification of thymus and activation-regulated chemokine (TARC/CCL17) as a potential marker for early indication of disease and prediction of disease activity in drug-induced hypersensitivity syndrome (DIHS)/drug rash with eosinophilia and systemic symptoms (DRESS).血清TARC/CCL17値は薬剤性過敏症症候群(DIHS) の早期診断および病勢の指標となりうる。Ogawa, KoheiMorito, HironoriHasegawa, AyakoDaikoku, NatsukoMiyagawa, FumiOkazaki, AikoFukumoto, TakayaKobayashi, NobuhikoKasai, TakahikoWatanabe, HideakiSueki, HirohikoIijima, MasafumiTohyama, MikikoHashimoto, KojiAsada, HideoDIHSDRESSTARCDendritic cellsTh2BACKGROUND:Drug-induced hypersensitivity syndrome (DIHS)/drug rash with eosinophilia and systemic symptoms (DRESS) is a serious acute drug reaction with fever, cutaneous eruption, lymphadenopathy, and several visceral dysfunctions. Eosinophilia is a common hematological abnormality in DIHS/DRESS suggesting that the Th2-type immune response is involved. Thymus and activation-regulated chemokine (TARC/CCL17) is a family of CC chemokines known to play an important role in Th2-mediated immune-inflammatory processes.
OBJECTIVE:We investigated the pathogenic role of TARC in patients with DIHS.
METHODS:Sera were obtained from 8 patients with DIHS, 7 patients with Stevens-Johnson syndrome/Toxic epidermal necrolysis (SJS/TEN), and 14 patients with drug-induced maculopapular exanthema (MPE). Serum TARC levels were measured by ELISA. TARC levels were then compared with clinical symptoms and various hematological parameters. In addition, a biopsy was taken from the lesional skin of patients with DIHS and stained with anti-TARC Ab and anti-CD11c Ab.
RESULTS:Serum TARC levels in patients with DIHS were significantly higher than those in patients with SJS/TEN and MPE during the acute phase. Serum TARC levels in DIHS patients correlated with skin eruptions, serum sIL-2R levels, eosinophil counts, and serum IL-5 levels. Immunohistochemical staining revealed that TARC was mainly expressed on CD11c+ dermal dendritic cells in patients with DIHS.
CONCLUSION:Serum TARC levels may be associated with the initial presentation of DIHS as well as disease activity during the course. Thus, they could be useful as an indicator for early diagnosis and assessment of disease activity in DIHS. CD11c+ dendritic cells may be the main source of TARC in patients with DIHS.博士(医学)・甲第597号・平成25年3月15日Copyright © 2012 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.Elsevier Science2014-12-25T05:34:01Z2014-12-25T05:34:01Z2013-01ThesisThesis or DissertationJournal of dermatological science Vol.69 No.1 p.38-4309231811http://hdl.handle.net/10564/276109231811AA1075636XJournal of dermatological science6913843enghttp://www.ncbi.nlm.nih.gov/pubmed/23141052http://dx.doi.org/10.1016/j.jdermsci.2012.10.002none
oai:ginmu.naramed-u.ac.jp:10564/27622017-05-29T06:08:26Zhdl_10564_2756Depression of p53-independent Akt survival signals in human oral cancer cells bearing mutated p53 gene after exposure to high-LET radiation.p53 変異型ヒト口腔がん細胞における高LET 放射線によるp53 非依存Akt 生存シグナルの抑制Nakagawa, YosukeTakahashi, AkihisaKajihara, AtsuhisaYamakawa, NobuhiroImai, YuichiroOta, IchiroOkamoto, NoritomoMori, EiichiroNoda, TaichiFurusawa, YoshiyaKirita, TadaakiOhnishi, TakeoHigh LETAktCaspaseApoptosisCell cycleAlthough mutations and deletions in the p53 tumor suppressor gene lead to resistance to low linear energy transfer (LET) radiation, high-LET radiation efficiently induces cell lethality and apoptosis regardless of the p53 gene status in cancer cells. Recently, it has been suggested that the induction of p53-independent apoptosis takes place through the activation of Caspase-9 which results in the cleavage of Caspase-3 and poly (ADP-ribose) polymerase (PARP). This study was designed to examine if high-LET radiation depresses serine/threonine protein kinase B (PKB, also known as Akt) and Akt-related proteins. Human gingival cancer cells (Ca9-22 cells) harboring a mutated p53 (mp53) gene were irradiated with 2 Gy of X-rays or Fe-ion beams. The cellular contents of Akt-related proteins participating in cell survival signaling were analyzed with Western Blotting 1, 2, 3 and 6h after irradiation. Cell cycle distributions after irradiation were assayed with flow cytometric analysis. Akt-related protein levels decreased when cells were irradiated with high-LET radiation. High-LET radiation increased G(2)/M phase arrests and suppressed the progression of the cell cycle much more efficiently when compared to low-LET radiation. These results suggest that high-LET radiation enhances apoptosis through the activation of Caspase-3 and Caspase-9, and suppresses cell growth by suppressing Akt-related signaling, even in mp53 bearing cancer cells.博士(医学)・甲第598号・平成25年3月15日Copyright © 2012 Elsevier Inc. All rights reservedElsevier / Academic Press2014-12-25T06:03:40Z2014-12-25T06:03:40Z2012-07-13ThesisThesis or DissertationBiochemical and biophysical research communications Vol.423 No.4 p.654-6600006291Xhttp://hdl.handle.net/10564/27620006291XAA00564395Biochemical and biophysical research communications4234654660enghttp://www.ncbi.nlm.nih.gov/pubmed/22695120http://dx.doi.org/10.1016/j.bbrc.2012.06.004none
oai:ginmu.naramed-u.ac.jp:10564/27632017-05-29T06:08:29Zhdl_10564_2756就労女性の妊娠判明後の退職行動規定要因に関する疫学研究Epidemiological Study of Factors Associated with Quitting a Job among Pregnant Working Women.大原, 賢了佐伯, 圭吾鴻池, 義純岡本, 希冨岡, 公子西岡, 久之車谷, 典男Maternity protectionNon-regular employeePregnant workerQuitting a job就労女性の妊娠判明後の退職行動規定要因に関する疫学研究:大原賢了ほか.奈良県立医科大学地域健康医学講座―目的:女性の社会進出が進む中,就労女性の妊娠判明後の退職割合が,日本は他の先進国より未だ高いことを踏まえ,退職割合減少のため介入すべき要因を明らかにする.対象と方法:2004年11月から12月に,奈良県内の7産科医療機関を健診や出産目的で受診入院した全妊産婦にアンケート調査を実施し,この内,妊娠判明時に就労中であった603人を研究対象とした.退職をイベントの発生,調査時に就労中の者を打ち切り例(censored case)として,妊娠経過に伴う退職割合の推移をKaplan-Meier法により求めた.また,対象者の年齢や就労先の従業員規模や雇用形態のほか,職場の母性保護制度の有無などの職場要因,本人や夫の就業継続に関する考え方などの個人要因と,退職との関係について,Coxの比例ハザードモデルを用いて検討を行った.結果:出産までの退職割合は63.1%であり,第1子妊娠に限ると69.8%であった.妊娠経過の健康診査などを受けるための時間保障の制度がある(HR=0.59, 95%CI(0.41–0.83)),育児休業制度がある(0.37(0.22–0.63)),産休・育休からの復職後の支援体制が比較的整っている職場である(0.60(0.42–0.87)),結婚や子供の誕生があると勤めにくい雰囲気のある職場でない(0.59(0.43–0.81)),子どもができても,ずっと仕事を続けるのがよいと本人(0.63(0.43–0.93))または夫(0.50(0.30–0.86))が思っているが,妊娠判明後の退職行動に有意につながりにくい独立した要因であった.一方,非正規雇用者(1.93(1.46–2.56))であること,低年齢(1.74(1.10–2.75))であることが退職につながりやすい要因であった.結論:妊娠判明後も就労を継続させる条件づくりとしては,従来からの母性保護制度に加え,職場環境の工夫や,本人と夫の就労意思形成の働きかけが重要である.また,非正規雇用者全てが対象となっていない育児休業制度の全面適用が望まれる.博士(医学)・乙第1291号・平成24年5月28日Copyright © 2012 公益社団法人 日本産業衛生学会日本産業衛生学会2014-12-25T22:43:59Z2014-12-25T22:43:59Z2012-03ThesisThesis or Dissertation産業衛生学雑誌 54巻2号 p.61-7013410725http://hdl.handle.net/10564/276313410725AN10467364産業衛生学雑誌5426170jpnhttp://www.ncbi.nlm.nih.gov/pubmed/22277289http://dx.doi.org/10.1539/sangyoeisei.B11017none
oai:ginmu.naramed-u.ac.jp:10564/27642017-05-29T06:08:28Zhdl_10564_2756Work-related aggression and violence committed by patients and its psychological influence on doctors.医師が患者から受ける暴力被害とその心理的影響Saeki, KeigoOkamoto, NozomiTomioka, KimikoObayashi, KenjiNishioka, HisayukiOhara, KenryoKurumatani, NorioAggression and violenceDoctorsIncidence ratePeriod prevalencePost-traumatic stress disorderRisk factorsObjectives: To determine the incidence rate of work-related aggression and violence (WRAV) against doctors and investigate risk factors and psychological influences of WRAV doctors. Methods: We sent a self-administered questionnaire on WRAV committed by patients and their associates to 1,148 doctors in Nara Prefecture, Japan. We calculated the incidence rate of WRAV using the number of incidents encountered during the previous 12 mo and the doctor's average weekly working hours. Risk factors for the incidence WRAV were analyzed by Poisson regression, and the influence of WRAV on the symptoms of post-traumatic stress disorder (PTSD) was evaluated by multiple logistic regression analysis. Results: A total of 758 (66.0%) doctors returned the questionnaire. The incidence rate of WRAV was 0.20 [95% CI: 0.17-0.24]×10-3 per practice hour. Adjusted incidence rate ratios of WRAV were significantly increased among doctors 1) with a shorter career (11.0; 95% CI: 5.0-24.2), 2) working in a region with the lowest average taxable income (1.6; 1.1-2.4), and 3) whose specialties were dermatology (3.8; 2.3-6.3), psychiatry (2.7; 1.3-5.6) and ophthalmology (1.9; 1.2-3.2). Of 289 subjects who had encountered WRAV at least once during their career, 26 doctors (8.2%) had symptoms suggestive of PTSD due to the most severe incident. Conclusions: Doctors encountered WRAV at an incidence rate of 0.20×10-3 per practice hour, and some of them might develop PTSD. Countermeasures are required to maintain sound health and safe workplaces for doctors.博士(医学)・乙第1292号・平成24年5月28日Copyright © 2011 by the Japan Society for Occupational Health日本産業衛生学会2014-12-25T23:12:00Z2014-12-25T23:12:00Z2011ThesisThesis or DissertationJournal of occupational health Vol.53 No.5 p.356-36413419145http://hdl.handle.net/10564/276413419145AA11090645Journal of occupational health535356364enghttp://www.ncbi.nlm.nih.gov/pubmed/21828959http://dx.doi.org/10.1539/joh.11-0108-OAnone
oai:ginmu.naramed-u.ac.jp:10564/27652017-05-29T06:08:29Zhdl_10564_2756Decreased renal α-Klotho expression in early diabetic nephropathy in humans and mice and its possible role in urinary calcium excretion.早期糖尿病性腎症での腎臓におけるα-Klotho 発現の低下とその尿中カルシウム排世に対する役割についての検討Asai, OsamuNakatani, KimihikoTanaka, TomohiroSakan, HirokazuImura, AkihiroYoshimoto, ShuheiSamejima, Ken-ichiYamaguchi, YukinariMatsui, MasaruAkai, YasuhiroKonishi, NoboruIwano, MasayukiNabeshima, YoichiSaito, Yoshihikodiabetic nephropathyhypercalciuriahypoxiaHypercalciuria is one of the early manifestations of diabetic nephropathy. We explored here the role of α-Klotho, a protein expressed predominantly in distal convoluted tubules that has a role in calcium reabsorption. We studied 31 patients with early diabetic nephropathy and compared them with 31 patients with IgA nephropathy and 7 with minimal change disease. Renal α-Klotho expression was significantly lower and urinary calcium excretion (UCa/UCr) significantly higher in diabetic nephropathy than in IgA nephropathy or minimal change disease. Multiple regression analyses indicated that α-Klotho mRNA was inversely correlated with calcium excretion. We next measured these parameters in a mouse model of streptozotocin (STZ)-induced diabetic nephropathy, characterized by glomerular hyperfiltration, as seen in early diabetic nephropathy. We also confirmed a reduction of renal α-Klotho mRNA down to almost 50% and enhanced calcium excretion in mice with STZ-induced diabetic nephropathy in comparison with nondiabetic mice. Hypercalciuria was exacerbated in heterozygous α-Klotho knockout mice in comparison with wild-type mice, each with STZ-induced diabetic nephropathy. Thus, α-Klotho expression was decreased in distal convoluted tubules in diabetic nephropathy in humans and mice. Renal loss of α-Klotho may affect urinary calcium excretion in early diabetic nephropathy.博士(医学)・乙第1293号・平成24年5月28日© 2012 International Society of NephrologyNature Publishing Group2014-12-26T03:42:10Z2014-12-26T03:42:10Z2012-03ThesisThesis or DissertationKidney international Vol.81 No.6 p.539-54700852538http://hdl.handle.net/10564/276500852538AA00710996Kidney international816539547enghttp://www.ncbi.nlm.nih.gov/pubmed/22217880http://dx.doi.org/10.1038/ki.2011.423none
oai:ginmu.naramed-u.ac.jp:10564/27662017-05-29T06:08:35Zhdl_10564_2756Reduced larger von Willebrand factor multimers at dawn in OSA plasmas reflect severity of apnoeic episodes.閉塞型睡眠時無呼吸症候群患者における早朝の高分子量フォンウィルブランド因子減少は無呼吸の重症度を反映するKoyama, NorikoMatsumoto, MasanoriTamaki, ShinjiYoshikawa, MasanoriFujimura, YoshihiroKimura, HiroshiADAMTS13obstructive sleep apnoeavon Willebrand factorPlasma von Willebrand factor (VWF), produced in and released from vascular endothelial cells by various stimuli including hypoxia, induces platelet aggregation under high shear stress and plays dual pivotal roles in haemostasis and thrombosis within arterioles, which are regulated by the size of vWF multimers (VWFMs). Patients with obstructive sleep apnoea (OSA) have increased risk of thrombotic cardiovascular events, but the pathogenesis is unclear. We examined the relationship between VWF and OSA by measuring VWF antigen (VWF:Ag), VWFMs, VWF collagen binding activity (VWF:CB) and a disintegrin-like, metalloproteinase, and thrombospiondin type 1 motifs 13. A total of 58 OSA patients were enrolled. Blood samples were collected before sleep, after sleep, and after one night of nasal continuous positive airway pressure therapy. Based on VWFM analysis, OSA patients were classified into three groups; consistently normal VWFMs (group 1, n=29), increased high molecular weight (HMW)-VWFMs at 06:00 h (group 2, n=18), and decreased or absent HMW-VWFMs at 06:00 h (group 3, n=11). Patients in group 3 had significantly worse apnoea/hypopnoea index; VWF:CB followed a similar pattern. We observed a significant decrease in platelet count between 21:00 h and 06:00 h in OSA patients, potentially associated with reduced larger VWFMs together with decreased VWF:Ag levels. Severe OSA may contribute to an arterial pro-thrombotic state.博士(医学)・乙第1294号・平成24年5月28日Copyright © 2012 by the European Respiratory SocietyEuropean Respiratory Society2014-12-26T05:23:34Z2014-12-26T05:23:34Z2012-09ThesisThesis or DissertationThe European respiratory journal Vol.40 No.3 p.657-66409031936http://hdl.handle.net/10564/276609031936AA10688995The European respiratory journal403657664enghttp://www.ncbi.nlm.nih.gov/pubmed/22362856http://dx.doi.org/10.1183/09031936.00186210none
oai:ginmu.naramed-u.ac.jp:10564/27672017-05-29T06:08:27Zhdl_10564_2756Predictors of distal radioulnar joint instability in distal radius fractures.不安定型橈骨遠位端骨折に合併する橈尺靭帯損傷の予測因子Fujitani, RyotaroOmokawa, ShoheiAkahane, ManabuIida, AkioOno, HiroshiTanaka, YasuhitoRadioulnarligamentdistal radiusfracturePURPOSE:A tear of the triangular fibrocartilage complex (TFCC) is the most frequent soft tissue injury associated with fractures of the distal radius, and repair of the deep ligamentous portion of the TFCC is considered when the tear contributes to instability of the distal radioulnar joint (DRUJ). The purpose of this prospective cohort study was to identify predictors of DRUJ instability accompanying unstable distal radius fractures.
METHODS:Between 2002 and 2007, we prospectively treated 163 consecutive patients with unstable distal radius fractures with the volar locking plating system. Complete radioulnar ligament tears representing DRUJ instability were present in 11 of 163 distal radius fractures. We tested univariate associations between DRUJ instability and potential predictors and conducted multivariate analysis to establish independent predictors of instability. We applied receiver operating characteristics curves within the significant risk factors to determine threshold values.
RESULTS:In univariate analyses, only the radial and sagittal translation ratios of the fracture site were significant predictors of DRUJ instability. Multivariate logistic regression analysis confirmed that the radial translation ratio, which corresponds to a normalized DRUJ gap, was a significant risk factor. According to the receiver operating characteristics curve for the radial translation ratio, the area under the curve was 0.89. A cutoff value of 15% for the radial translation ratio showed the highest diagnostic accuracy rate.
CONCLUSIONS:A radiographic finding of a normalized DRUJ gap on posteroanterior views was the most important predictor to identify DRUJ instability accompanying unstable distal radius fractures. The relative risk of instability increases by 50% when the ratio of DRUJ widening increases by 1%.博士(医学)・乙第1295号・平成24年5月28日Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reservedAmerican Society for Surgery of the Hand / Elsevier2014-12-26T06:08:45Z2014-12-26T06:08:45Z2011-11ThesisThesis or DissertationThe Journal of hand surgery Vol.36 No.12 p.1919-192503635023http://hdl.handle.net/10564/276703635023AA10522529The Journal of hand surgery361219191925enghttp://www.ncbi.nlm.nih.gov/pubmed/22036131http://dx.doi.org/10.1016/j.jhsa.2011.09.004none
oai:ginmu.naramed-u.ac.jp:10564/27682017-05-29T06:08:30Zhdl_10564_2756Low concentrations of alendronate increase the local invasive potential of osteoblastic sarcoma cell lines via connexin 43 activation.低濃度アレンドロネートはコネキシン43 活性を介して造骨系肉腫細胞株の局所浸潤能を増加させるYoshitani, KazuhiroKido, AkiraHonoki, KanyaAkahane, ManabuFujii, HiromasaTanaka, YasuhitoLow-concentrationAlendronateOsteoblastic sarcomaConnexin 43OleamideBisphosphonates (BPs) are agents used for treating disorders of excessive bone resorption. In addition, due to their cell-killing activity, BPs were potent candidates for adjuvant cancer therapy. On the other hand, low-concentrations of BPs have been reported to increase cellular viability in several types of tumor cells. Therefore, we focused on the effect of BPs on cellular aggressiveness of malignant bone tumors at low concentrations. MTS assay was performed using osteosarcoma cell lines MG63 and HOS, fibrosarcoma cell line HT1080, and prostate cancer cell line PC3. All the cell lines showed toxicity at high concentrations. On the other hand, at lower concentrations, the cellular viabilities of HOS and MG63 were rather higher than those of untreated controls. Since this tendency was most evident, HOS was used for further assays, including cellular motility, bone resorption activity, and cathepsin K activity. The low-concentration of alendronate enhanced cellular viability and motility, which correlated with the expression of connexin 43 at the mRNA and protein levels. Interestingly, oleamide, a potent connexin 43 inhibitor, had an inhibitory effect on the enhanced proliferation. Our data suggest that alendronate may enhance the proliferation of osteoblastic cell line through connexin 43 activation.博士(医学)・乙第1296号・平成24年5月28日Copyright © 2011 Elsevier GmbH. All rights reserved.Elsevier2015-01-09T05:07:44Z2015-01-09T05:07:44Z2011-07-15ThesisThesis or DissertationPathology, research and practice Vol.207 No.7 p.417-42203440338http://hdl.handle.net/10564/276803440338AA00769966Pathology, research and practice2077417422enghttp://www.ncbi.nlm.nih.gov/pubmed/21665377http://dx.doi.org/10.1016/j.prp.2011.04.007none
oai:ginmu.naramed-u.ac.jp:10564/27692017-05-29T06:08:35Zhdl_10564_2756The factor VIIIa C2 domain (residues 2228-2240) interacts with the factor IXa Gla domain in the factor Xase complex.活性化第VIII 因子のC2 ドメイン(残基2228-2240) はFactor Xase 複合体における活性化第IX 因子のGla ドメインと相互作用するSoeda, TetsuhiroNogami, KeijiNishiya, KatsumiTakeyama, MasahiroOgiwara, KenichiSakata, YoichiYoshioka, AkiraShima, MidoriFactor VIIIa functions as a cofactor for factor IXa in the phospholipid surface-dependent activation of factor X. Both the C2 domain of factor VIIIa and the Gla domain of factor IXa are involved in phospholipid binding and are required for the activation of factor X. In this study, we have examined the close relationship between these domains in the factor Xase complex. Enzyme-linked immunosorbent assay-based and surface plasmon resonance-based assays in the absence of phospholipid showed that Glu-Gly-Arg active site-modified factor IXa bound to immobilized recombinant C2 domain (rC2) dose-dependently (Kd = 108 nm). This binding ability was optimal under physiological conditions. A monoclonal antibody against the Gla domain of factor IXa inhibited binding by approximately 95%, and Gla domainless factor IXa failed to bind to rC2. The addition of monoclonal antibody or rC2 with factor VIIIa inhibited factor IXa-catalyzed factor X activation in the absence of phospholipid. Inhibition was not evident, however, in similar experiments in the absence of factor VIIIa, indicating that the C2 domain interacted with the Gla domain of factor IXa. A fragment designated C2-(2182-2259), derived from V8 protease-cleaved rC2, bound to Glu-Gly-Arg active site-modified factor IXa. Competitive assays, using overlapping synthetic peptides encompassing residues 2182-2259, demonstrated that peptide 2228-2240 significantly inhibited both this binding and factor Xa generation, independently of phospholipid. Our results indicated that residues 2228-2240 in the factor VIIIa C2 domain constitutes an interactive site for the Gla domain of factor IXa. The findings provide the first evidence for an essential role for this interaction in factor Xase assembly.博士(医学)・乙第1297号・平成24年5月28日Copyright © 2009 American Society for Biochemistry and Molecular BiologyAmerican Society for Biochemistry and Molecular Biology2015-01-09T05:49:15Z2015-01-09T05:49:15Z2009-02-06ThesisThesis or DissertationThe Journal of biological chemistry Vol.284 No.6 p.3379-338800219258http://hdl.handle.net/10564/276900219258AA00251083The Journal of biological chemistry284633793388enghttp://www.ncbi.nlm.nih.gov/pubmed/19047063http://dx.doi.org/10.1074/jbc.M804955200none
oai:ginmu.naramed-u.ac.jp:10564/27702017-05-29T06:08:35Zhdl_10564_2756A putative inhibitory mechanism in the tenase complex responsible for loss of coagulation function in acquired haemophilia A patients with anti-C2 autoantibodies.後天性血友病A (抗C2 自己抗体)の凝固機能低下におけるFX 複合体阻害様式の解明Matsumoto, TomokoNogami, KeijiOgiwara, KenichiShima, Midorithrombin generationtenase complexAcquired haemophilia Aanti-C2 autoantibodyFXa generationAcquired haemophilia A (AHA) is caused by the development of factor (F)VIII autoantibodies, demonstrating type 1 or type 2 inhibitory behaviour, and results in more serious haemorrhagic symptoms than in congenital severe HA. The reason(s) for this remains unknown, however. The global coagulation assays, thrombin generation tests and clot waveform analysis, demonstrated that coagulation parameters in patients with AHA-type 2 inhibitor were more significantly depressed than those in patients with moderate HA with similar FVIII activities. Thrombin and intrinsic FXa generation tests were significantly depressed in AHA-type 1 and AHA-type 2 compared to severe HA, and more defective in AHA-type 1 than in AHA-type 2. To investigate these inhibitory mechanism(s), anti-FVIII autoantibodies were purified from AHA plasmas. AHA-type 1 autoantibodies, containing an anti-C2 ESH4-epitope, blocked FVIII(a)-phospholipid binding, whilst AHA-type 2, containing an anti-C2 ESH8-epitope, inhibited thrombin-catalysed FVIII activation. The coagulation function in a reconstituted AHA-model containing exogenous ESH4 or ESH8 was more abnormal than in severe HA. The addition of anti-FIX antibody to FVIII-deficient plasma resulted in lower coagulation function than its absence. These results support the concept that global coagulation might be more suppressed in AHA than in severe HA due to the inhibition of FIXa-dependent FX activation by steric hindrance in the presence of FVIII-anti-C2 autoantibodies. Additionally, AHA-type 1 inhibitors prevented FVIIIa-phospholipid binding, essential for the tenase complex, whilst AHA-type 2 antibodies decreased FXa generation by inhibiting thrombin-catalysed FVIII activation. These two distinct mechanisms might, in part, contribute to and exacerbate the serious haemorrhagic symptoms in AHA.博士(医学)・乙第1298号・平成24年5月28日© Schattauer Publishers, Stuttgart, 2012Schattauer2015-01-09T06:44:15Z2015-01-09T06:44:15Z2012-02ThesisThesis or DissertationThrombosis and haemostasis Vol.107 No.2 p.288-30103406245http://hdl.handle.net/10564/277003406245AA00863137Thrombosis and haemostasis1072288301enghttp://www.ncbi.nlm.nih.gov/pubmed/22234708http://dx.doi.org/10.1160/TH11-05-0331none
oai:ginmu.naramed-u.ac.jp:10564/27712021-05-25T01:52:01Zhdl_10564_2756A comparison of epidermal growth factor receptor expression in malignant peritoneal and pleural mesothelioma.腹膜および胸膜悪性中皮腫におけるEGFR発現の比較Enomoto, YasunoriKasai, TakahikoTakeda, MaikoTakano, MasatoMorita, KouheiKadota, EijiIizuka, NorishigeMaruyama, HiroshiHaratake, JojiKojima, YuIkeda, NaoyaNonomura, Akitakaepidermal growth factor receptorFISHgene copy number gainimmunohistochemistrymalignant mesotheliomaAn evaluation of epidermal growth factor receptor (EGFR) phenotypic expression in malignant pleural and peritoneal mesothelioma was undertaken, using immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) analysis. Thirty-eight malignant mesothelioma (MM) specimens were subjected to IHC staining and FISH to evaluate the expression of EGFR protein and gene status. Overall positive IHC reaction was detected in 20/38 (53%) cases, in 11/22 (50%) pleural MM, and in 9/16 (56%) peritoneal MM. Our study confirmed that EGFR membranous expression is a common feature in MM, but not in benign mesothelial lesion. Thirty-seven cases did not show a gene copy number gain. Only one case showed a copy number gain. The protein overexpression of EGFR was not related to a gene copy number gain.博士(医学)・乙第1299号・平成24年5月28日© 2012 The Authors. Pathology International© 2012 Japanese Society of Pathology and Blackwell Publishing Asia Pty Ltd.Blackwell Scientific Pub. for the Japanese Society of Pathology2015-01-13T00:20:36Z2015-01-13T00:20:36Z2012-04ThesisThesis or DissertationPathology international Vol.62 No.4 p.226-23113205463http://hdl.handle.net/10564/277113205463AA10984364Pathology international624226231enghttp://www.ncbi.nlm.nih.gov/pubmed/22449226http://dx.doi.org/10.1111/j.1440-1827.2011.02778.xnone
oai:ginmu.naramed-u.ac.jp:10564/27722017-05-29T06:08:24Zhdl_10564_2756Prognostic importance of tumour-infiltrating memory T cells in oesophageal squamous cell carcinoma.食道扁平上皮癌における腫瘍浸潤メモリーT細胞の予後因子としての重要性についてEnomoto, KojiSho, MasayukiWakatsuki, KoheiTakayama, TomoyoshiMatsumoto, SoheiNakamura, ShinjiAkahori, TakahiroTanaka, TetsuyaMigita, KazuhiroIto, MasahiroNakajima, YoshiyukiCD45ROmemory cellsoesophagusprognosissurgeryMemory T cells survive for many months and years and are critically important for host defence in humans. In tumour immunity, they have been also suggested to play a significant role in tumour progression and metastasis. However, the role of memory T cells in actual human cancer remains largely unknown. In this study, the clinical importance of tumour-infiltrating CD45RO(+) memory T cells was investigated in human oesophageal squamous cell carcinoma (OSCC). CD45RO(+) T cells were evaluated by immunohistochemistry in primary OSCC tumours from 105 patients. Patients were classified into two groups as CD45RO(+hi) or CD45RO(+lo) based on the number of cells stained positively for CD45RO. No significant difference was observed between CD45RO status and several clinicopathological prognostic factors. However, the postoperative overall and disease-free survival for CD45RO(+hi) patients was significantly better than for CD45RO(+lo) patients. Furthermore, there were significant correlations of CD45RO status in the primary tumour with postoperative lymph node and pulmonary recurrence, suggesting that memory T cells may control postoperative metastatic recurrence. Most importantly, CD45RO(+) memory T cell status has a significant prognostic value for OSCC independently of conventional tumour-node-metastasis (TNM) classification. Our study may provide a rationale for developing a novel immunotherapy in intentional induction of memory T cells for the treatment of oesophageal cancer.博士(医学)・乙第1300号・平成24年7月26日© 2012 The Authors;Clinical and Experimental Immunology© 2012 British Society for ImmunologyBlackwell Scientific Publications / British Society for Immunology2015-01-13T01:00:43Z2015-01-13T01:00:43Z2012-05ThesisThesis or DissertationClinical and experimental immunology Vol.168 No.2 p.186-19100099104http://hdl.handle.net/10564/277200099104AA00607716Clinical and experimental immunology1682186191enghttp://www.ncbi.nlm.nih.gov/pubmed/22471279http://dx.doi.org/10.1111/j.1365-2249.2012.04565.xnone
oai:ginmu.naramed-u.ac.jp:10564/27802017-05-29T06:08:34Zhdl_10564_2756Significance of hyperglobulinemia in severe chronic liver diseases--with special reference to the correlation between serum globulin/IgG level and ICG clearance.重症慢性肝疾患における高γク口ブリン血症の意義 : とくに血清グ口プリン/IgG とICG除去能との相聞に関連してTanaka, ShinobuOkamoto, YasuyukiYamazaki, MasaharuMitani, NoriakiNakajima, YoshiyukiFukui, HiroshiHyperglobuiinemiaICGlg6Liver cirrhosisGlycosylationBACKGROUND/AIMS:Although hyperglobulinemia is frequently detected in severe chronic liver diseases (CLD) such as liver cirrhosis (LC), the mechanism for this is still uncertain. Hyperglobulinemia may represent a functional aspect of the liver.METHODOLOGY:
The correlation between serum globulin (GLB) level and each of various liver function tests including the indocyanine green (ICG) retention rate at 15 min (ICGR15) was studied using 146 patients with liver dysfunction. The correlations among GLB, IgG and ICGR15 were also studied in other 32 patients with LC, in whom the glycosylation pattern of IgG was determined by enzyme-linked immunosorbent assay to detect terminal galactose (Gal) and neuraminic acid (NA) using biotinylated lectins.RESULTS:GLB level was predominantly correlated with ICGR15 (r = 0.449) among various liver function tests in 146 patients with liver dysfunction. In the 32 patients with LC, strong positive correlations between GLB and IgG (r = 0.875), between GLB and ICGR15 (r = 0.435), and between IgG and ICGR15 (r = 0.557) were evident. The glycosylation pattern of IgG showed that the proportions of both Gal and NA were inversely correlated with serum IgG levels (r = -0.516 and -0.390, respectively) in these patients. Significant decreases of the proportions were found in patients with IgG elevation (> 20 g/L, n = 13).CONCLUSIONS:The correlation between GLB and ICGR15 suggested that hyperglobulinemia is related to a common dysfunction estimated by ICG clearance, which represents mainly the liver's blood flow and removal capacity. The removal of immunoglobulins by the liver may be impaired in patients with severe liver dysfunction because the liver is a major catabolic site for immunoglobulins. The glycation pattern suggested that the proportions of asialo IgG and agalactosyl IgG were increased in the LC patients with IgG elevation possibly by deficient receptor-mediated removal in the liver. Although further investigations will be needed, hyperglobulinemia could be predictive for a certain impaired hepatic function estimated by ICG clearance in severe CLD such as LC.博士(医学)・乙第1301号・平成24年7月26日Hepato Gastroenterology © 2007H.G.E. Update Medical Publishing2015-01-21T04:35:46Z2015-01-21T04:35:46Z2007-12ThesisThesis or DissertationHepato-gastroenterology Vol.54 No.80 p.2301-230501726390http://hdl.handle.net/10564/278001726390AA00213244Hepato-gastroenterology548023012305enghttp://www.ncbi.nlm.nih.gov/pubmed/18265652none
oai:ginmu.naramed-u.ac.jp:10564/27812017-05-29T06:08:34Zhdl_10564_2756Determination of advanced glycation end-products on IgG in liver cirrhosis.肝硬変におけるIgGの終末糖化産物量測定Tanaka, ShinobuYamazaki, MasaharuOkamoto, YasuyukiHyperglobulinemiaHepatic removal functionHalf-lifeNεε-(carboxymethyl) lysine (CML)BACKGROUND/AIMS:Our previous report showed that IgG levels are strongly correlated with the indocyanine green (ICG) retention rate in patients with liver cirrhosis (LC). This correlation suggests that hyperglobulinemia in LC could be explained by impairment of hepatic removal function. To estimate IgG turnover in LC, in the present paper was determined the advanced glycation end-products (AGE) on IgG as a marker of half-life.METHODOLOGY:Serum samples were obtained from patients with LC, rheumatoid arthritis (RA), and Sjögren syndrome (SjS), and from age-matched control patients. IgG was purified from serum by the protein G-based affinity method, concentrated by filtration, and used for assay of Nepsilon-(carboxymethyl) lysine (CML), a predominant AGE, by ELISA.RESULTS:CML on IgG was significantly lower in patients with LC than in control patients, whereas there was no significant difference in total serum CML levels among patients with LC, RA, and SjS, and control patients. CML levels on IgG were negatively correlated with serum IgG levels in patients with LC, RA, and Sjögren syndrome SjS.CONCLUSIONS:Based on these findings, it is suggested that IgG turnover is not likely to be prolonged but rather may be shortened in LC It may be concluded that, hyperglobulinemia is primarily caused by enhanced synthesis followed by up-regulation of catabolism of immunoglobulins.博士(医学)・乙第1301号・平成24年7月26日Hepato Gastroenterology © 2009H.G.E. Update Medical Publishing2015-01-21T05:10:54Z2015-01-21T05:10:54Z2009-12ThesisThesis or DissertationHepato-gastroenterology Vol.56 No.96 p.1735-173701726390http://hdl.handle.net/10564/278101726390AA00213244Hepato-gastroenterology569617351737enghttp://www.ncbi.nlm.nih.gov/pubmed/20214227none
oai:ginmu.naramed-u.ac.jp:10564/27822020-09-30T04:26:39Zhdl_10564_2756Carnitine-induced senescence in glioblastoma cells.神経膠芽腫細胞におけるカルニチンによるセネッセンスの誘導Yamada, ShuichiMatsuda, RyosukeNishimura, FumihikoNakagawa, IchiroMotoyama, YasushiPark, Young-SuNakamura, MitsutoshiNakase, HiroyukiOuji, YukiteruYoshikawa, MasahidecarnitineglioblastomasenescenceCarnitine is essential for lipid metabolism in cells and is known to possess antioxidant properties. Previous reports have suggested that antioxidants are able to induce senescence in glioblastoma cells, consequently, in the present study, we investigated the effect of carnitine on glioblastoma cells. Under conditions of hyponutrition (undernutrition), the proliferation of glioblastoma cells was attenuated and the level of intracellular carnitine was increased. Glioblastoma cell proliferation was also attenuated in cultures that were supplemented with exogenous carnitine, where the induction of senescence was detected by senescence-associated β-gal (SA-β-gal) staining. However, there was no evidence of the induction of apoptosis. These effects were not detected when cells were cultured with carnitine plus an inhibitor of p38 mitogen-activated protein kinase (MAPK). It, therefore, appears that carnitine has antioxidant actions in normal cells but induces senescence, which may be regarded as an opposite phenomenon, in glioblastoma cells. Senescence has been reported in cells exposed to temozolomide, which is a standard drug used for the treatment of glioblastoma. Carnitine could, therefore, represent an attractive alternative therapy for glioblastoma.博士(医学)・乙第1302号・平成24年11月27日Copyright © Spandidos Publications 2012Spandidos Publications2015-01-21T05:41:42Z2015-01-21T05:41:42Z2012-07ThesisThesis or DissertationExperimental and therapeutic medicine Vol.4 No.1 p.21-2517920981http://hdl.handle.net/10564/278217920981AA12610820Experimental and therapeutic medicine412125enghttp://www.ncbi.nlm.nih.gov/pubmed/23060917http://dx.doi.org/10.3892/etm.2012.556none
oai:ginmu.naramed-u.ac.jp:10564/27832017-05-29T06:08:34Zhdl_10564_2756Early Fixation of Cobalt-Chromium Based Alloy Surgical Implants to Bone Using a Tissue-engineering Approach.再生骨組み込みコバルトクロム製インプラントと骨との早期固着性についての基礎的研究Ogawa, MunehiroTohma, YasuakiOhgushi, HajimeTakakura, YoshinoriTanaka, Yasuhitocobalt chromium alloyimplant-bone interfacemarrow mesenchymal cellosteogenesistissue engineeringTo establish the methods of demonstrating early fixation of metal implants to bone, one side of a Cobalt-Chromium (CoCr) based alloy implant surface was seeded with rabbit marrow mesenchymal cells and the other side was left unseeded. The mesenchymal cells were further cultured in the presence of ascorbic acid, β-glycerophosphate and dexamethasone, resulting in the appearance of osteoblasts and bone matrix on the implant surface. Thus, we succeeded in generating tissue-engineered bone on one side of the CoCr implant. The CoCr implants were then implanted in rabbit bone defects. Three weeks after the implantation, evaluations of mechanical test, undecalcified histological section and electron microscope analysis were performed. Histological and electron microscope images of the tissue engineered surface exhibited abundant new bone formation. However, newly formed bone tissue was difficult to detect on the side without cell seeding. In the mechanical test, the mean values of pull-out forces were 77.15 N and 44.94 N for the tissue-engineered and non-cell-seeded surfaces, respectively. These findings indicate early bone fixation of the tissue-engineered CoCr surface just three weeks after implantation.博士(医学)・乙第1303号・平成24年11月27日© 2012 MDPI AGMDPI : Multidisciplinary Digital Publishing Institute2015-01-21T06:06:44Z2015-01-21T06:06:44Z2012-05ThesisThesis or DissertationInternational journal of molecular sciences Vo.13 No.5 p.5528-554114220067http://hdl.handle.net/10564/278314220067AA12038549International journal of molecular sciences Vo. No. p.13555285541enghttp://www.ncbi.nlm.nih.gov/pubmed/22754313http://dx.doi.org/10.3390/ijms13055528none
oai:ginmu.naramed-u.ac.jp:10564/27842017-05-29T06:08:34Zhdl_10564_2756Validity and reliability of the Japanese Orthopaedic Association score for osteoarthritic knees.変形性膝関節症患者に対するJOA スコアの妥当性と信頼性の検討Okuda, MasayoshiOmokawa, ShoheiOkahashi, KohjiroAkahane, ManabuTanaka, YasuhitoBACKGROUND:A variety of outcome measures are available to evaluate physical impairment and disability in patients with knee osteoarthritis, and most physician-rated measures are not validated. The objective of this study was to assess the validity and reliability of an observer-based knee scoring system of the Japanese Orthopaedic Association (the JOA) commonly used in Japanese clinical practice, and to determine demographic variables affecting the score. METHODS:A consecutive series of 85 patients with primary knee osteoarthritis completed the JOA (four domains pain on walking, pain on ascending or descending stairs, range of motion, and joint effusion), two validated patient-rated measures including the generic instrument of the Medical Outcomes Study 36-Item Short-Form (the SF-36) Health Survey, and the disease-specific scale of the Japanese Knee Osteoarthritis Measure (the JKOM), and a performance based timed-up-and-go test (TUG). Concurrent validity was determined by examining correlations of the JOA with the SF-36 and the JKOM. Construct validity was verified by correlating each domain of the JOA with objective measurements of TUG using Spearman's rank correlation coefficient. Intra- and interobserver reliability and internal consistency of the JOA were evaluated with another cohort of 32 patients who had a knee disorder at baseline and again at a mean of 18 days later. RESULTS:The JOA was significantly correlated with validated patient-rated outcome measures (the JKOM, the SF-36), indicating concurrent validity of the JOA. Domains of the JOA had significant correlations with the TUG, showing adequate construct validity. Intra- and interobserver reliability for the JOA showed a moderate to almost perfect agreement, and internal consistency of Cronbach's α indicated that the JOA score was a highly reliable instrument to assess knee osteoarthritis. As a demographic variable, age was highly correlated with the JOA. CONCLUSIONS:The JOA, generally used as an observer-derived knee scoring system, is a valid and reliable tool for evaluating functional status in patients with knee osteoarthritis.博士(医学)・乙第1304号・平成24年11月27日© Springer International Publishing AG,2012© The Japanese Orthopaedic Association 2012Springer Japan / Japanese Orthopaedic Association2015-01-21T06:34:37Z2015-01-21T06:34:37Z2012-11ThesisThesis or DissertationJournal of orthopaedic science Vol.17 No.6 p.750-75609492658http://hdl.handle.net/10564/278409492658AA11052566Journal of orthopaedic science176750756enghttp://www.ncbi.nlm.nih.gov/pubmed/22868702http://dx.doi.org/10.1007/s00776-012-0274-0none
oai:ginmu.naramed-u.ac.jp:10564/27852017-05-29T06:08:33Zhdl_10564_2756Branching pattern of lenticulostriate arteries observed by MR angiography at 3.0 T.3.OT MRA で観察される外側線条体動脈の分枝形態Akashi, ToshiakiTaoka, ToshiakiOchi, TomokoMiyasaka, ToshiteruWada, TakeshiSakamoto, MasahikoTakewa, MegumiKichikawa, KimihikoMRA3.0 TLenticulostriate arteryInfarctionLacunarPURPOSE:We hypothesized that the pattern of branching of the lenticulostriate arteries (LSAs) is involved in the variation of the distribution of the infarction within the LSA region. Our purpose was to evaluate the visibility of LSAs in 3D time-of-flight (TOF) MR angiography (MRA) with a 3.0 T scanner and to investigate the branching patterns of LSAs.MATERIALS AND METHODS:We performed 3D TOF MRA at 3.0 T for 100 healthy subjects. We assessed the number of LSAs and the number of branches arising from each LSA by evaluating MRA source images.RESULTS:In 200 hemispheres, 330 LSAs were visualized (mean = 1.65/hemisphere). In 3.5% of all hemispheres, no LSA was depicted; one LSA was depicted in 39%, two in 46.5%, and three in 11%. The maximum number of depicted LSA branches was five in 2% of all subjects, four in 7%, three in 26%, and two in 49% (mean = 2.3/subject). A large LSA trunk with three or more branches was found in 35% of subjects.CONCLUSION:
Visualization of LSAs was possible in 96.5% of subjects by use of 3.0 T MRA. LSA branching patterns were variable, and a large LSA trunk with three or more branches was common.博士(医学)・乙第1305号・平成24年11月27日© Springer International Publishing AG,2012Copyright © 2012 Japan Radiological SocietySpringer Japan / Japan Radiological Society2015-01-22T03:28:16Z2015-01-22T03:28:16Z2012-05ThesisThesis or DissertationJapanese journal of radiology Vol.30 No.4 p.331-33518671071http://hdl.handle.net/10564/278518671071AA12375935Japanese journal of radiology Vol. No. p.304331335enghttp://www.ncbi.nlm.nih.gov/pubmed/22350636http://dx.doi.org/10.1007/s11604-012-0058-7none
oai:ginmu.naramed-u.ac.jp:10564/27862017-05-29T06:08:33Zhdl_10564_2756Influence of mouth guards on autonomic nervous system activities: A quantitative study of pupillary flash responses.マウスガードの自律神経活動への影響 : 瞳孔フラッシュ応答による定量的評価Ishida, Jun-ichiWada, YoshiroImai, YuichiroHirata, YutakaYamashita, MasayukiKirita, TadaakiMouth guardsAutonomic nervous systemPupillary flash responsesUnpleasant sensationsSports injuriesBackground:Recently, it has been reported that mouth guards (MGs), which reduce the incidence and severity of traumatic oral injuries in contact sports, may actually affect sports performance. We have observed that a majority of subjects showed improved dynamic visual acuity during head rotation when using a MG, but subjects who were unwilling to use a MG showed the opposite effect. Thus, we hypothesized that unpleasant sensations due to MGs may decrease sports performance.Methods:In this study, we measured autonomic nervous system activity to evaluate unpleasant sensations objectively and quantitatively by measuring the pupillary flash response (PFR) and heart rate variability (HRV), before, during, and after wearing 3- and 5-mm-thick custom-made MGs in 10 healthy subjects.Results:It was found that the 5-mm MG had a higher incidence of unpleasant sensations (50% of subjects) than did the 3-mm MG (10%). PFR (not HRV) analysis showed that both sympathetic and parasympathetic nervous system activities increased in subjects with unpleasant sensations.Conclusions:We suggest that the unpleasant sensation induced this unusual autonomic nervous system response, which could not be detected by traditional methods such as HRV analysis. By using PFR analysis, it is possible to make MGs without unpleasant sensations for better sports performance.博士(医学)・乙第1306号・平成24年11月27日Copyright © 2012 Japanese Stomatological Society. Published by Elsevier Japan KKJapanese Stomatological Society / Elsevier2015-01-22T05:03:24Z2015-01-22T05:03:24Z2012-11ThesisThesis or DissertationOral Science International Vol.9 No.2 p.38-4213488643http://hdl.handle.net/10564/278613488643AA1196972XOral Science International923842enghttp://dx.doi.org/10.1016/S1348-8643(12)00026-2none
oai:ginmu.naramed-u.ac.jp:10564/27872017-05-29T06:08:34Zhdl_10564_2756Advanced glycation end products (AGE) induce the receptor for AGE in the colonic mucosa of azoxymethane-injected Fischer 344 rats fed with a high-linoleic acid and high-glucose diet.終末糖化産物(AGE) は高リノール酸および高グルコース摂取下のアゾキシメタン投与F344 ラットの大腸粘膜においてAGE 受容体(RAGE) を発現誘導するShimomoto, TakasumiLuo, YiOhmori, HitoshiChihara, YoshitomoFujii, KiyomuSasahira, TomonoriDenda, AyumiKuniyasu, HirokiColon carcinogenesisLinoleic acidSugarAGEBACKGROUND:Advanced glycation end products (AGE) and the receptor for advanced glycation end products (RAGE) are closely associated with colorectal cancer progression. The association between RAGE and AGE in colon carcinogenesis needs to be clarified.METHODS:Levels of RAGE and AGE were examined in azoxymethane (AOM)-injected Fischer 344 rats fed a control diet (Group C), a 15 % linoleic acid (LA) diet (Group L), a control diet with 10 % glucose drink (Group G), and a 15 % LA diet with 10 % glucose drink (Group L + G). Group L + G showed the most pronounced increase of body weight, blood sugar, and serum insulin.RESULTS:The rats in Group L + G showed the most pronounced multiplicity of aberrant crypt foci (ACF) and carcinomas with increased mucosal RAGE and AGE. IEC6 rat intestinal epithelial cells treated with AGE showed increased RAGE expression, which was inhibited by treatment with metformin or losartan. In the AOM-injected rat colon cancer model, the levels of RAGE and AGE, and the multiplicity of ACF and carcinomas, in Group L + G rats were suppressed by treatment with metformin or losartan.CONCLUSIONS:These results suggest that AGE-RAGE induced by high-LA and high-glucose diets substantially enhances colon cancer development; thus, suppression of AGE-RAGE could be a potential target for colon cancer chemoprevention.博士(医学)・乙第1307号・平成25年3月15日© Springer International Publishing AG,2012© Japanese Society of Gastroenterology 2012Springer / Japanese Society of Gastroenterology2015-01-22T06:12:16Z2015-01-22T06:12:16Z2012-10ThesisThesis or DissertationJournal of gastroenterology Vol.47 No.10 p.1073-108309441174http://hdl.handle.net/10564/278709441174AA10988015Journal of gastroenterology471010731083enghttp://www.ncbi.nlm.nih.gov/pubmed/22467055http://dx.doi.org/10.1007/s00535-012-0572-5none
oai:ginmu.naramed-u.ac.jp:10564/27882017-05-29T06:08:33Zhdl_10564_2756Positive effect of daylight exposure on nocturnal urinary melatonin excretion in the elderly: a cross-sectional analysis of the HEIJO-KYO study.高齢者における日中光曝露が夜間尿中メラトニン分泌への与える影響 : 平城京スタディ横断解析Obayashi, KenjiSaeki, KeigoIwamoto, JunkoOkamoto, NozomiTomioka, KimikoNezu, SatokoIkada, YoshitoKurumatani, NorioCONTEXT:Melatonin is involved in a variety of diseases, including cancer, insomnia, depression, dementia, hypertension, and diabetes; its secretion is influenced by environmental light. Although daylight exposure increases nocturnal melatonin secretion in a controlled laboratory setting, whether it increases nocturnal melatonin secretion in an uncontrolled daily life setting remains unclear.OBJECTIVE:We aimed to determine the association between daylight exposure in an uncontrolled daily life setting and urinary 6-sulfatoxymelatonin excretion.DESIGN AND PARTICIPANTS:A cross-sectional study was conducted in 192 elderly individuals (mean age, 69.9 yr).MEASURES:We measured ambulatory daylight exposure using a wrist light meter in two 48-h sessions; furthermore, we measured overnight urinary 6-sulfatoxymelatonin excretion, an index of melatonin secretion, on the second night of each session.RESULTS:The median duration of daylight exposure of at least 1000 lux was 72 min (interquartile range, 37-124). Univariate linear regression analysis showed marginal to significant associations between log-transformed urinary 6-sulfatoxymelatonin excretion and age, current smoking status, benzodiazepine use, day length, log-transformed duration of daylight exposure of at least 1000 lux, and daytime physical activity. In a multivariate model, log-transformed duration of daylight exposure of at least 1000 lux was significantly associated with log-transformed urinary 6-sulfatoxymelatonin excretion (regression coefficient, 0.101; 95% confidence interval, 0.003-0.199; P = 0.043). Furthermore, an increase in the duration of daylight exposure of at least 1000 lux from 37 to 124 min (25th to 75th percentiles) was associated with a 13.0% increase in urinary 6-sulfatoxymelatonin excretion (6.8 to 7.7 μg).CONCLUSIONS:Daylight exposure in an uncontrolled daily life setting is positively associated with urinary 6-sulfatoxymelatonin excretion in the elderly.博士(医学)・乙第1308号・平成25年3月15日Copyright © 2012 by The Endocrine SocietyEndocrine Society2015-01-22T06:36:51Z2015-01-22T06:36:51Z2012-11ThesisThesis or DissertationThe Journal of clinical endocrinology and metabolism Vol.97 No.11 p.4166-41730021972Xhttp://hdl.handle.net/10564/27880021972XAA00695484The Journal of clinical endocrinology and metabolism971141664173enghttp://www.ncbi.nlm.nih.gov/pubmed/22948764http://dx.doi.org/10.1210/jc.2012-2561none
oai:ginmu.naramed-u.ac.jp:10564/27892017-05-29T06:08:36Zhdl_10564_2756The dichotomy in the histogenesis of endometriosis-associated ovarian cancer: clear cell-type versus endometrioid-type adenocarcinoma.子宮内膜症と関連する卵巣癌 : 明細胞腺癌と類内膜腺癌の発癌機序における相違点Kajihara, HirotakaYamada, YoshihikoShigetomi, HiroshiHigashiura, YumiKobayashi, HiroshiEndometriosisOvarian cancerEndometrioidClear cellImmunohistochemistryThe histogenesis of endometriosis and endometriosis-associated ovarian cancer is one of the most mysterious aspects of pathology. To better understand the histogenesis of endometriosis and endometriosis-associated ovarian cancer, we analyzed the possibility of a link of endometrium, ovarian surface epithelium, and a cortical inclusion cyst to ovarian endometriosis and endometriosis-associated ovarian cancer by immunohistochemistry using the epithelial membrane antigen (an epithelial marker), calretinin (a mesothelial marker), and hepatocyte nuclear factor (HNF)-1β (a clear cell carcinoma-specific transcription factor). During ovarian surface epithelium invagination, cortical inclusion cyst epithelial cells may, in some cases, undergo mesothelial–epithelial transition and subsequently differentiate into endometriosis. This case of endometriosis that has undergone Müllerian metaplasia arises from the HNF-1β-negative cells. The remaining endometriosis may develop from the late secretory and menstrual endometria, with HNF-1β-positive staining, by retrograde menstruation. Endometrioid adenocarcinoma and clear cell carcinoma arise from the HNF-1β-negative and HNF-1β-positive epithelial cells of endometriosis, respectively. It has been proposed that clear cell and endometrioid-type adenocarcinomas arise from distinct types of endometriosis with different cells of origin.博士(医学)・乙第1309号・平成25年3月15日©2012 International Society of Gynecological PathologistsLippincott Williams & Wilkins / International Society of Gynecological Pathologists2015-01-26T04:06:24Z2015-01-26T04:06:24Z2012-06ThesisThesis or DissertationInternational journal of gynecological pathology Vol.31 No.4 p.304-31202771691http://hdl.handle.net/10564/278902771691AA1063069XInternational journal of gynecological pathology314304312enghttp://www.ncbi.nlm.nih.gov/pubmed/22653342http://dx.doi.org/10.1097/PGP.0b013e318243a97bnone
oai:ginmu.naramed-u.ac.jp:10564/27902017-05-29T06:08:35Zhdl_10564_2756ADAMTS13 gene deletion enhances plasma high-mobility group box1 elevation and neuroinflammation in brain ischemia-reperfusion injury.ADAMTS13 遺伝子欠損は脳虚血再灌流傷害における血漿high mobility group box1 の上昇を促進し神経炎症を悪化させる。Fujioka, MasayukiNakano, TakafumiHayakawa, KazuhideIrie, KeiichiAkitake, YoshiharuSakamoto, YuyaMishima, KenichiMuroi, CarlYonekawa, YasuhiroBanno, FumiakiKokame, KoichiMiyata, ToshiyukiNishio, KenjiOkuchi, KazuoIwasaki, KatsunoriFujiwara, MichihiroSiesjö, Bo K.Brain ischemia–reperfusionHigh-mobility group box1ADAMTS13InflammationVon Willebrand factorThrombotic thrombocytopenic purpuraHighly adhesive glycoprotein von Willebrand factor (VWF) multimer induces platelet aggregation and leukocyte tethering or extravasation on the injured vascular wall, contributing to microvascular plugging and inflammation in brain ischemia–reperfusion. A disintegrin and metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS13) cleaves the VWF multimer strand and reduces its prothrombotic and proinflammatory functions. Although ADAMTS13 deficiency is known to amplify post-ischemic cerebral hypoperfusion, there is no report available on the effect of ADAMTS13 on inflammation after brain ischemia. We investigated if ADAMTS13 deficiency intensifies the increase of extracellular HMGB1, a hallmark of post-stroke inflammation, and exacerbates brain injury after ischemia–reperfusion. ADAMTS13 gene knockout (KO) and wild-type (WT) mice were subjected to 30-min middle cerebral artery occlusion (MCAO) and 23.5-h reperfusion under continuous monitoring of regional cerebral blood flow (rCBF). The infarct volume, plasma high-mobility group box1 (HMGB1) level, and immunoreactivity of the ischemic cerebral cortical tissue (double immunofluorescent labeling) against HMGB1/NeuN (neuron-specific nuclear protein) or HMGB1/MPO (myeloperoxidase) were estimated 24 h after MCAO. ADAMTS13KO mice had larger brain infarcts compared with WT 24 h after MCAO (p < 0.05). The rCBF during reperfusion decreased more in ADAMTS13KO mice. The plasma HMGB1 increased more in ADAMTS13KO mice than in WT after ischemia–reperfusion (p < 0.05). Brain ischemia induced more prominent activation of inflammatory cells co-expressing HMGB1 and MPO and more marked neuronal death in the cortical ischemic penumbra of ADAMTS13KO mice. ADAMTS13 deficiency may enhance systemic and brain inflammation associated with HMGB1 neurotoxicity, and aggravate brain damage in mice after brief focal ischemia. We hypothesize that ADAMTS13 protects brain from ischemia–reperfusion injury by regulating VWF-dependent inflammation as well as microvascular plugging.博士(医学)・乙第1310号・平成25年3月15日© Springer International Publishing AG,2012Springer / Società italiana di neurologia2015-01-26T04:42:40Z2015-01-26T04:42:40Z2012-10ThesisThesis or DissertationNeurological sciences Vol.33 No.5 p.1107-111515901874http://hdl.handle.net/10564/279015901874AA11469873Neurological sciences33511071115enghttp://www.ncbi.nlm.nih.gov/pubmed/22212812http://dx.doi.org/10.1007/s10072-011-0913-9none