2024-03-28T14:26:03Zhttp://ginmu.naramed-u.ac.jp/dspace-oai/request
oai:ginmu.naramed-u.ac.jp:10564/32542017-06-11T23:20:26Zhdl_10564_3215Hedgehog Signaling Components Are Expressed in Choroidal Neovascularization in Laser-induced Retinal Lesion.網膜へのレーザー凝固により惹起される脈絡膜新生血管はヘッジホッグシグナル系因子を発現する。Nochioka, KatsunoriOkuda, HiroakiTatsumi, KoukoMorita, ShokoOgata, NahokoWanaka, Akiosonic hedgehogretinamousechoroidal neovascularizationChoroidal neovascularization is one of the major pathological changes in age-related macular degeneration, which causes devastating blindness in the elderly population. The molecular mechanism of choroidal neovascularization has been under extensive investigation, but is still an open question. We focused on sonic hedgehog signaling, which is implicated in angiogenesis in various organs. Laser-induced injuries to the mouse retina were made to cause choroidal neovascularization. We examined gene expression of sonic hedgehog, its receptors (patched1, smoothened, cell adhesion molecule down-regulated by oncogenes (Cdon) and biregional Cdon-binding protein (Boc)) and downstream transcription factors (Gli1-3) using real-time RT-PCR. At seven days after injury, mRNAs for Patched1 and Gli1 were upregulated in response to injury, but displayed no upregulation in control retinas. Immunohistochemistry revealed that Patched1 and Gli1 proteins were localized to CD31-positive endothelial cells that cluster between the wounded retina and the pigment epithelium layer. Treatment with the hedgehog signaling inhibitor cyclopamine did not significantly decrease the size of the neovascularization areas, but the hedgehog agonist purmorphamine made the areas significantly larger than those in untreated retina. These results suggest that the hedgehog-signaling cascade may be a therapeutic target for age-related macular degeneration.博士(医学)・甲第653号・平成28年7月8日Copyright © 2016 The Japan Society of Histochemistry and Cytochemistry(日本組織細胞化学会)J-STAGEへのリンク:http://doi.org/10.1267/ahc.15036日本組織細胞化学会ThesisThesis or DissertationActa histochemica et cytochemica Vol.49 No.2 p.67-74(2016 Apr)00445991http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3254Acta histochemica et cytochemica, 49(2): 67-74http://hdl.handle.net/10564/3254http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3254/1/01_%e7%94%b2653%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3254/2/02_%e7%94%b2653%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3254/3/03_%e7%94%b2653%e6%9c%ac%e6%96%87.pdf00445991AA00508022Acta histochemica et cytochemica49267742016-04-28jpnhttp://www.ncbi.nlm.nih.gov/pubmed/27239075http://doi.org/10.1267/ahc.15036ETD24601A6532016-07-08博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32552017-07-25T16:30:10Zhdl_10564_3215Lymphocyte Count at 4 Days Postoperatively and CRP Level at 7 Days Postoperatively: Reliable and Useful Markers for Surgical Site Infection Following Instrumented Spinal Fusion.術後4日目リンパ球数と7日目CRP値は信頼度の高い有用な手術部位感染の指標である : 脊椎後方インストゥルメンテーション手術における検討Iwata, EiichiroShigematsu, HidekiKoizumi, MunehisaNakajima, HiroshiOkuda, AkinoriMorimoto, YasuhikoMasuda, KeisukeYamamoto, YusukeTanaka, Yasuhito岩田, 栄一朗重松, 英樹小泉, 宗久中島, 弘司奥田, 哲教森本, 安彦増田, 佳亮山本, 雄介田中, 康仁C-reactive proteindiagnosisinstrumentationlaboratory datalaboratory markerlymphocyteneutrophilscreening testsensitivityspecificitysurgical site infectionwhite blood cellwhite blood cell differentialSTUDY DESIGN: A case-control study. OBJECTIVE: The objective of this study is to identify biochemical markers for surgical site infection (SSI) in posterior instrumented spinal fusion that are not affected by operative circumstances and to determine diagnostic cutoffs for these markers. SUMMARY OF BACKGROUND DATA: Numerous biochemical markers may be used for early detection of SSI; however, these markers may be affected by operative factors. METHODS: We reviewed data on C-reactive protein level and total white blood cell count and differential count before instrumented spinal fusion and at 1, 4, and 7 days postoperatively. The 141 patients in our sample were divided into an SSI group (patients who developed deep SSI) and a no-SSI group. We determined which markers differed significantly between groups and identified those not affected by operative circumstances (operating time, intraoperative blood loss, number of fusion segments) in the no-SSI group. Then, we determined diagnostic cutoffs for these unaffected markers by using receiver-operating characteristic curves. RESULTS: Three markers were selected: lymphocyte count at 4 days postoperatively (cutoff 1180/μL, sensitivity 90.9%, specificity 65.4%, area under the curve [AUC] 0.80), lymphocyte count of at 7 days postoperatively (cutoff <1090/μL, sensitivity 63.6%, specificity 78.5%, AUC 0.77), and C-reactive protein level at 7 days postoperatively (cutoff >4.4 mg/dL, sensitivity 90.9%, specificity 89.2%, AUC 0.95). CONCLUSION: Lymphocyte count at 4 and 7 days postoperatively and C-reactive protein level at 7 days postoperatively are reliable markers for SSI following instrumented spinal fusion. Lymphocyte count at 4 days should be useful for screening because of its high sensitivity and because it can be measured early. C-reactive protein level at 7 days should be useful for definitive diagnosis given its high sensitivity and specificity and large AUC.博士(医学)・甲第654号・平成28年7月8日Copyright © 2016 Wolters Kluwer Health, Inc. All rights reservedThis is a non-final version of an article published in final form in "http://dx.doi.org/10.1097/BRS.0000000000001501"Lippincott Williams & WilkinsThesisThesis or DissertationSpine Vol.41 No.14 p.1173-1178 (2016 Jul)03622436http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3255Spine, 41(14): 1173-1178http://hdl.handle.net/10564/3255http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3255/1/01_%e7%94%b2654%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3255/2/02_%e7%94%b2654%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3255/10/03_%e7%94%b2654%e6%9c%ac%e6%96%87.pdf03622436AA0084801XSpine4114117311782016-07-15enghttp://www.ncbi.nlm.nih.gov/pubmed/26890955http://dx.doi.org/10.1097/BRS.0000000000001501none24601A6542016-07-08博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32562017-06-11T23:20:26Zhdl_10564_3215Predictors of Proximal Interphalangeal Joint Flexion Contracture After Homodigital Island Flap.指尖部切断に対する動脈島状皮弁をもちいた再建術後のPIP関節屈曲拘縮の予見因子の検討Nakanishi, AkitoOmokawa, ShoheiIida, AkioKaji, DaisukeTanaka, YasuhitoHomodigital island flapadvancement flapflexion contractureproximal interphalangeal jointpredictorPURPOSE: To identify independent predictors of postoperative proximal interphalangeal (PIP) joint contracture after direct-flow homodigital island flap transfer. METHODS: Forty-four fingertip amputations in 39 patients treated with oblique triangular flaps were evaluated at a minimum of 1 year after surgery. Five variables were examined: patient age, injured finger, mechanism of injury, flap advancement distance, and time required for wound healing. Univariate and multivariate linear regression analyses were performed to identify the extent to which these variables affected the flexion contracture of the PIP joint. RESULTS: The average reduction in the passive extension angle of the PIP joint was 16° at final follow-up. Univariate analysis indicated significant correlations of PIP joint flexion contracture with age, injured finger, and time for wound healing, but no significant correlation with the distance the flap was advanced. Multivariate analysis indicated that the age and duration of wound healing were independent predictors of the flexion contracture of the PIP joint. CONCLUSIONS: Elderly people and cases with delayed wound healing are at risk for postoperative PIP joint contracture after homodigital flap transfer. Intervention with early hand therapy and orthotics may be useful in elderly patients with delayed wound healing.博士(医学)・乙第1377号・平成28年7月8日Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.ElsevierThesisThesis or DissertationThe Journal of hand surgery Vol.40 No.11 p.2155-2159 (2015 Nov)03635023http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3256The Journal of hand surgery, 40(11): 2155-2159http://hdl.handle.net/10564/3256http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3256/1/01_%e4%b9%991377%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3256/2/02_%e4%b9%991377%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3256/3/03_%e4%b9%991377%e6%9c%ac%e6%96%87.pdf03635023AA10522529The Journal of hand surgery4011215521592015-11enghttp://www.ncbi.nlm.nih.gov/pubmed/26409583http://dx.doi.org/10.1016/j.jhsa.2015.08.008ETD24601B13772016-07-08博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32572017-06-11T23:20:26Zhdl_10564_3215Analysis of trabecular bone microstructure in osteoporotic femoral heads in human patients: in vivo study using multidetector row computed tomography.骨粗鬆患者大腿頭における海綿微細構造解析 : MDCTを用いたin vivo研究Munemoto, MitsuruKido, AkiraSakamoto, YoshihiroInoue, KazuyaYokoi, KazuyukiShinohara, YasushiTanaka, YasuhitoTrabecular structureMicrostructureFemoral headOsteoporosisBACKGROUND: Lag screw position is very important in the treatment of intertrochanteric femoral fracture to prevent complications such as screw cut-out. Current studies recommend central or inferior placement of the lag screw on the anteroposterior radiograph, and central placement on the lateral radiographs. These reports are based on radiographic evaluation, but few studies have investigated the importance of bone quality at the site of lag screw placement. In this study, we used multidetector row computed tomography (MDCT) to perform in vivo evaluation of the bone microstructure of the femoral head in patients with intertrochanteric femoral fractures. METHODS: This study was approved by the Ethics Committee of Okanami General Hospital. MDCT images were obtained in our hospital from ten patients who had sustained intertrochanteric femoral fracture. Patients who needed computed tomography to confirm fracture morphology were included. We defined six areas as regions of interest (ROI): ROI 1-3 were defined as the femoral head apex area, and ROI 4-6 were defined as the femoral neck area. Trabecular microstructure parameters, including mean bone volume to total volume (BV/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), and structure model index (SMI), were evaluated with bone analysis software (TRI/3D-BON). Statistical analyses were performed using EZR software; each parameter among the ROIs was statistically evaluated by analysis of variance (ANOVA) and Tukey's test. Statistical significance was established at p < 0.05. RESULTS: In the apical area, all parameters indicated that ROI 1 (superior) had the highest bone quality and ROI 2 (central) was higher in bone quality than ROI 3 (inferior). In the femoral neck, all parameters indicated that bone quality was significantly greater in ROI 6 (inferior) than ROI 5 (central). DISCUSSION AND CONCLUSIONS: We could evaluate bone quality with clinical MDCT in vivo. Bone quality in the central area of the femoral head apical was greater than in the inferior area, and bone quality in the inferior area of the femoral neck was greater than in the central area. Recognizing which area of femoral head has greater bone quality may lead to a better clinical result in treating intertrochanteric femoral fracture.博士(医学)・乙第1378号・平成28年7月8日© Munemoto et al. 2016 Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BioMed CentralArticleThesis or DissertationBMC musculoskeletal disorders Vol.17 Article No.13 (2016 Jan)14712474http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3257BMC musculoskeletal disorders, 17: Article No.13http://hdl.handle.net/10564/3257http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3257/1/01_%e4%b9%991378%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3257/2/02_%e4%b9%991378%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3257/3/03_%e4%b9%991378%e6%9c%ac%e6%96%87.pdf14712474AA12035278BMC musculoskeletal disorders17Article No.132016-01enghttp://www.ncbi.nlm.nih.gov/pubmed/26758746http://dx.doi.org/10.1186/s12891-015-0848-zETD24601B13782016-07-08博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32582017-06-11T23:20:26Zhdl_10564_3215Preliminary experience with superparamagnetic iron oxide-enhanced dynamic magnetic resonance imaging and comparison with contrast-enhanced computed tomography in endoleak detection after endovascular aneurysm repair.超常磁性体酸化鉄造影MRIを用いた大動脈ステントグラフ治療後のエドリークの検出 : 造影CTとの比較検討Ichihashi, ShigeoMarugami, NagaakiTanaka, ToshihiroIwakoshi, ShinichiKurumatani, NorioKitano, SatoruNogi, AkihiroKichikawa, KimihikoOBJECTIVE: Contrast-enhanced computed tomography (CE-CT) has been commonly used for follow-up imaging after endovascular aneurysm repair (EVAR), but it is difficult to use on patients with renal insufficiency. Superparamagnetic iron oxide (SPIO) particles, contrast medium for magnetic resonance imaging (MRI) that has been widely used for detection of the liver tumor, rarely affects renal function. The present study examined SPIO-enhanced dynamic MRI as a potential alternative to CE-CT for detection of endoleaks after EVAR. METHODS: Institutional review board approval was obtained for this prospective study. Twenty-three consecutive patients with normal renal function were evaluated using both CE-CT and SPIO-enhanced MRI within 2 weeks after EVAR. The median interval between the two modalities was 2 days. SPIO-enhanced MRI was performed at 1.5 T with T1-weighted, SPIO-enhanced dynamic, and postcontrast T1-weighted gradient echo sequences. The CE-CT protocol consisted of triple scans. Two experienced, blinded observers evaluated all images. Consensus reading of CE-CT and SPIO-MRI was defined as the reference standard. Interobserver, intraobserver, and intermodality agreement for endoleak detection was assessed by κ statistics. RESULTS: A total of 11 type II endoleaks originating from either the lumbar or inferior mesenteric artery were detected. Eight were able to be detected by CE-CT (8/11:73%) and 10 (10/11:91%) by SPIO-enhanced MRI. Interobserver (κ = 0.91; 95% CI, 0.74-1.00) and intraobserver agreement for MRI (κ = 1.00) were excellent. Intermodality agreement for endoleak detection was moderate (κ = 0.63; 95% CI, 0.32-0.94; and κ = 0.62; 95% CI, 0.29-0.95 for observers A and B, respectively). CONCLUSIONS: SPIO-enhanced MRI could represent a useful alternative to CE-CT, as it offers excellent interobserver, intraobserver agreement, and could detect more endoleaks than CE-CT.博士(医学)・乙第1379号・平成28年7月8日Copyright © 2013 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.ElsevierThesisThesis or DissertationJournal of vascular surgery Vol.58 No.1 p.66-72 (2013 Jul)07415214http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3258Journal of vascular surgery, 58(1): 66-72http://hdl.handle.net/10564/3258http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3258/1/01_%e4%b9%991379%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3258/2/02_%e4%b9%991379%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3258/3/03_%e4%b9%991379%e6%9c%ac%e6%96%87.pdf07415214AA10630634Journal of vascular surgery58166722013-07enghttp://www.ncbi.nlm.nih.gov/pubmed/23561434http://dx.doi.org/10.1016/j.jvs.2012.12.061ETD24601B13792016-07-08博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32592017-06-23T08:28:17Zhdl_10564_3215Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System.膵癌術後予防肝動注におけるリザーバー留置術の検討 : 従来法とcoaxialシステムの比較Hashimoto, AyaTanaka, ToshihiroSho, MasayukiNishiofuku, HideyukiMasada, TetsuyaSato, TakeshiMarugami, NagaakiAnai, HiroshiSakaguchi, HiroshiKanno, MasatoshiTamamoto, TetsuroHasegawa, MasatoshiNakajima, YoshiyukiKichikawa, KimihikoArterial infusion chemotherapyPancreatic cancerLiver metastasesPURPOSE: Previous reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer. MATERIALS AND METHODS: 93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used. RESULTS: The overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312). CONCLUSIONS: The coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.博士(医学)・乙第1380号・平成28年7月8日© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016The final publication is available at Springer via http://dx.doi.org/10.1007/s00270-016-1292-7Springer VerlagThesisThesis or DissertationCardiovascular and interventional radiology Vol. 39 No.6 p.831-839 (2016 Jun)01741551http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3259Cardiovascular and interventional radiology, 39(6): 831-839http://hdl.handle.net/10564/3259http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3259/1/01_%e4%b9%991380%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3259/2/02_%e4%b9%991380%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3259/10/03%20%e4%b9%991380%e6%9c%ac%e6%96%87.pdf01741551AA00141846Cardiovascular and interventional radiology3968318392016-06enghttp://www.ncbi.nlm.nih.gov/pubmed/26762632http://dx.doi.org/10.1007/s00270-016-1292-7ETD24601B13802016-07-08博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32702022-08-23T06:32:36Zhdl_10564_3215Development and Application of an Alert System to Detect Cases of Food Poisoning in Japan.日本で発生する食中毒を検出するための警告システムの開発と応用Maeyashiki, AkieAkahane, ManabuSugiura, HiroakiOhkusa, YasushiOkabe, NobuhikoImamura, TomoakiRecent public health concerns regarding commercial food products have increased the need to develop an automated method to detect food product-related health events. We developed and verified a method for the early detection of potentially harmful events caused by commercial food products. We collected data from daily internet-based questionnaires examining the presence or absence of symptoms and information about food purchased by the respondents. Using these data, we developed a method to detect possible health concerns regarding commercialized food products. To achieve this, we combined the signal detection method used in the reporting system of adverse effects of pharmaceutical products and the Early Aberration Reporting System (EARS) used by the United States Centers for Disease Control. Whiteleg shrimp (Litopenaeus vannamei), which had odds ratio and Odds(−) of 8.99 and 4.13, respectively, was identified as a possible causative food product for diarrhea and vomiting. In conclusion, this study demonstrated that food distributors can implement post-marketing monitoring of the safety of food products purchased via the internet.博士(医学)・甲第655号・平成28年9月28日Copyright: © 2016 Maeyashiki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Public Library of ScienceThesisThesis or DissertationPloS one Vol.11 No.5 Article No.e0156395 (2016 May)19326203http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3270PloS one, 11(5): Article No.e0156395http://hdl.handle.net/10564/3270http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3270/1/01_%e7%94%b2655%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3270/5/02_%e7%94%b2655%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3270/3/03_%e7%94%b2655%e6%9c%ac%e6%96%87.pdf19326203PloS one115Article No.e01563952016-05-27enghttp://www.ncbi.nlm.nih.gov/pubmed/27231884http://dx.doi.org/10.1371/journal.pone.0156395ETD24601A6552016-09-28博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32712017-12-28T16:30:09Zhdl_10564_3215Bodily pain, social support, depression symptoms and stroke history are independently associated with sleep disturbance among the elderly: a cross-sectional analysis of the Fujiwara-kyo study.体の痛み、社会的支援、抑うつ状態、脳血管疾患は独立して高齢者の睡眠障害と関連する : 藤原京スタディ横断解析Kishimoto, YukoOkamoto, NozomiSaeki, KeigoTomioka, KimikoObayashi, KenjiKomatsu, MasayoKurumatani, NorioBodily painElderly peoplePSQISleep disturbanceSocial supportOBJECTIVE: To investigate independent effects of various factors associated with sleep disturbance among community-dwelling elderly individuals. METHODS: We analyzed data obtained from 3732 individuals aged ≥65 years who responded to a self-administered questionnaire and participated in a structured interview which assessed the Pittsburgh Sleep Quality Index (PSQI), subjective bodily pain, the Jichi Medical School Social Support Scale, the Geriatric Depression Scale (GDS-15), health status, and demographic characteristics. Sleep disturbance was defined as a global PSQI score >5.5, which was used as a dependent variable in multiple logistic regression analysis to determine adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) of related factors. RESULTS: We identified a significant increase in the adjusted ORs for female (OR 1.56, 95 % CI 1.34-1.83), age ≥80 years (1.31, 1.01-1.69), history of stroke (1.44, 1.08-1.92), and a GDS-15 score ≥6 as compared to 0-2 (2.29, 1.86-2.81), with regard to sleep disturbance. Participants with severe or very severe bodily pain had the highest adjusted OR (3.00, 2.15-4.19), and those with very mild bodily pain also had a relatively high OR (1.30, 1.06-1.60), relative to those without subjective bodily pain. In addition, compared with participants with strong social support from spouse or family, those with weak social support had significantly increased adjusted ORs (1.21, 1.01-1.44, 1.44, 1.23-1.70, respectively). CONCLUSIONS: The present study indicates that sleeping disturbances among the elderly are closely associated with social support from a spouse and family. They are also associated with pain, even at stages in which subjective bodily pain is very mild.博士(医学)・乙第1381号・平成28年9月28日© The Japanese Society for Hygiene 2016The final publication is available at Springer via http://dx.doi.org/10.1007/s12199-016-0529-zSpringer JapanThesisThesis or DissertationEnvironmental health and preventive medicine Vol.21 No.5 p.295-303(2016 Sep)1342078Xhttp://ginmu.naramed-u.ac.jp/dspace/handle/10564/3271Environmental health and preventive medicine, 21(5): 295-303http://hdl.handle.net/10564/3271http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3271/1/01_%e4%b9%991381%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3271/2/02_%e4%b9%991381%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3271/10/03%20%e4%b9%991381%e6%9c%ac%e6%96%87.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3271/11/04%20%e4%b9%991381Figure.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3271/12/05%20%e4%b9%991381Tables.pdf1342078XAA1108348XEnvironmental health and preventive medicine2152953032016-09enghttp://www.ncbi.nlm.nih.gov/pubmed/27072924http://dx.doi.org/10.1007/s12199-016-0529-zETD24601B13812016-09-28博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32722017-06-11T23:20:26Zhdl_10564_3215ADAM23 is downregulated in side population and suppresses lung metastasis of lung carcinoma cells.Side populationにおいて発現抑制されているADAM23は肺癌の転移を抑制しているOta, MasahideMochizuki, SatsukiShimoda, MasayukiAbe, HitoshiMiyamae, YukaIshii, KenKimura, HiroshiOkada, YasunoriADAM23colony formation; metastasisnon-small cell lung carcinoma cellsside populationCancer cells contain a small population of cancer stem cells or cancer initiating cells, which can be enriched in the side population (SP) after fluorescence activated cell sorting. To examine the members of the ADAM, ADAMTS and MMP gene families related to phenotypes of the SP and the main population (MP), we screened the expression of all the members in the propagated SP and MP of A549 lung adenocarcinoma cells, and found that the relative expression ratio of ADAM23 in the MP to the SP is most highly increased, but none of them are increased in the SP. A similar result on the ADAM23 expression was obtained with another cell line, Calu-3 cells. Overexpression of ADAM23 inhibited colony formation, cell adhesion and migration, and knockdown of ADAM23 by shRNA showed the reverse effects. ADAM23-mediated suppression of colony formation, cell adhesion and migration was greatly reduced by treatment with neutralizing anti-ADAM23 antibody, anti-αvβ3 integrin antibody and/or ADAM23 disintegrin peptide. Expression of cancer stem cell-related genes, including AKRC1/2, TM4SF1 and NR0B1, was increased by knockdown of ADAM23. In addition, lung metastasis of A549 transfectants with different levels of ADAM23 expression was negatively regulated by the ADAM23 expression levels. Our data provide evidence that ADAM23 plays a role in suppression of cancer cell progression through interaction with αvβ3 integrin, and suggest that downregulation of ADAM23 in SP cells may contribute toward providing a cancer stem cell phenotype by facilitating the activity of integrin αvβ3.博士(医学)・乙第1382号・平成28年9月28日© 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd
on behalf of Japanese Cancer Association.This is an open access article under the terms of the Creative Commons
Attribution-NonCommercial-NoDerivs License(https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution
in any medium, provided the original work is properly cited, the use is noncommercial
and no modifications or adaptations are made.Wiley PublishingThesisThesis or DissertationCancer science Vol.107 No.4 p.433-443 (2016 Apr)13479032http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3272Cancer science, 107(4): 433-443http://hdl.handle.net/10564/3272http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3272/1/01_%e4%b9%991382%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3272/2/02_%e4%b9%991382%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3272/3/03_%e4%b9%991382%e6%9c%ac%e6%96%87.pdf13479032AA11808050Cancer science10744334432016-04enghttps://www.ncbi.nlm.nih.gov/pubmed/26800504http://dx.doi.org/10.1111/cas.12895ETD24601B13822016-09-28博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32732017-06-11T23:20:26Zhdl_10564_3215Vaginal fluid pH and buffer capacity for predicting false preterm labor in Japanese women.日本人女性における切迫早産予測のための腟分泌物pHと腟分泌物緩衝能に関する研究Noguchi, TaketoshiSado, ToshiyukiNaruse, KatsuhikoKobayashi, HiroshiBuffering capacityPredictionPreterm deliveryPreterm laborThreatened preterm laborVaginal pHOBJECTIVE: To determine the relationship between preterm labor and delivery, and the pH and buffer capacity of vaginal secretions. METHODS: Between January 1, 2009 and March 31, 2012, two cohorts of patients at 22-36weeks of pregnancy were enrolled in a prospective cohort study at Nara Medical University Hospital, Japan. Patients experiencing preterm contractions and a control group of patients experiencing normal pregnancies were included. The pH and buffer capacity of vaginal secretions were measured and compared. RESULTS: Of the 237 patients enrolled, 48 (20.3%) were experiencing symptoms of preterm labor and 189 (79.7%) were included in the control group. The pH was higher (P<0.001) and the buffer capacity was lower (P=0.0135) in the vaginal secretions of the patients experiencing preterm contractions compared with the control group. There was no difference in the pH and buffer capacity of the vaginal secretions of symptomatic patients who would experience preterm delivery and those who would not. Receiver operating characteristic curve analyses demonstrated that vaginal-secretion pH and buffer capacity could differentiate between patients experiencing preterm contractions and those not, but could not differentiate between patients who would experience preterm delivery and those who would not. CONCLUSION: Vaginal-secretion pH and buffer capacity could be useful in diagnosing preterm labor; further studies are needed to determine potential practical diagnostic criteria.博士(医学)・乙第1383号・平成28年9月28日Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.ElsevierThesisThesis or DissertationInternational journal of gynaecology and obstetrics Vol.134 No.1 p.69-74 (2016 Jul)00207292http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3273International journal of gynaecology and obstetrics, 134(1): 69-74http://hdl.handle.net/10564/3273http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3273/1/01_%e4%b9%991383%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3273/2/02_%e4%b9%991383%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3273/3/03_%e4%b9%991383%e6%9c%ac%e6%96%87.pdf00207292AA00680363International journal of gynaecology and obstetrics134169742016-07enghttps://www.ncbi.nlm.nih.gov/pubmed/27039048http://dx.doi.org/10.1016/j.ijgo.2015.11.018ETD24601B13832016-09-28博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32822020-12-15T01:17:22Zhdl_10564_3215Bone marrow stromal cell sheets may promote axonal regeneration and functional recovery with suppression of glial scar formation after spinal cord transection injury in rats.骨髄間葉系細胞シートはラット脊髄離断損傷後にグリア瘢痕形成を抑制し、軸索再生と後肢運動機能改善を促進する。Okuda, AkinoriHorii-Hayashi, NorikoSasagawa, TakayoShimizu, TakamasaShigematsu, HidekiIwata, EiichiroMorimoto, YasuhikoMasuda, KeisukeKoizumi, MunehisaAkahane, ManabuNishi, MayumiTanaka, Yasuhitobone marrow stromal cellcell sheetaxonal regenerationspinal cord injuryascorbic acidglial scarOBJECTIVE Transplantation of bone marrow stromal cells (BMSCs) is a theoretical potential as a therapeutic strategy in the treatment of spinal cord injury (SCI). Although a scaffold is sometimes used for retaining transplanted cells in damaged tissue, it is also known to induce redundant immunoreactions during the degradation processes. In this study, the authors prepared cell sheets made of BMSCs, which are transplantable without a scaffold, and investigated their effects on axonal regeneration, glial scar formation, and functional recovery in a completely transected SCI model in rats. METHODS BMSC sheets were prepared from the bone marrow of female Fischer 344 rats using ascorbic acid and were cryopreserved until the day of transplantation. A gelatin sponge (GS), as a control, or BMSC sheet was transplanted into a 2-mm-sized defect of the spinal cord at the T-8 level. Axonal regeneration and glial scar formation were assessed 2 and 8 weeks after transplantation by immunohistochemical analyses using anti-Tuj1 and glial fibrillary acidic protein (GFAP) antibodies, respectively. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan scale. RESULTS The BMSC sheets promoted axonal regeneration at 2 weeks after transplantation, but there was no significant difference in the number of Tuj1-positive axons between the sheet- and GS-transplanted groups. At 8 weeks after transplantation, Tuj1-positive axons elongated across the sheet, and their numbers were significantly greater in the sheet group than in the GS group. The areas of GFAP-positive glial scars in the sheet group were significantly reduced compared with those of the GS group at both time points. Finally, hindlimb locomotor function was ameliorated in the sheet group at 4 and 8 weeks after transplantation. CONCLUSIONS The results of the present study indicate that an ascorbic acid-induced BMSC sheet is effective in the treatment of SCI and enables autologous transplantation without requiring a scaffold.博士(医学)・甲第656号・平成28年11月24日© Copyright 2016 American Association of Neurological SurgeonsThe definitive version is available at " http://dx.doi.org/10.3171/2016.8.SPINE16250 "American Association of Neurological SurgeonsThesisThesis or DissertationJournal of neurosurgery. Spine Vol.26 No.3 p.388-395 (2017 Mar)15475654http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3282Journal of neurosurgery. Spine, 26(3): 388-395http://hdl.handle.net/10564/3282http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3282/1/01_%e7%94%b2656%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3282/2/02_%e7%94%b2656%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3282/10/03%20%e7%94%b2656%e6%9c%ac%e6%96%87.pdf15475654AA11357949Journal of neurosurgery. Spine2633883952016-11-25enghttp://www.ncbi.nlm.nih.gov/pubmed/27885959http://dx.doi.org/10.3171/2016.8.SPINE16250ETD24601A6562016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32832017-06-11T23:20:26Zhdl_10564_3215Relationship Between Displacement and Degenerative Changes of the Sesamoids in Hallux Valgus.外反母祉における種子骨の偏位と関節症変化の関係Ryuhei KatsuiNorihiro SamotoAkira TaniguchiManabu AkahaneShinji IsomotoKazuya SugimotoYasuhito Tanakasesamoidhallux valguscomputed tomographyBACKGROUND: Although the tangential sesamoid view is used to visualize the sesamoid position relative to the first metatarsal head, correctly evaluating patients with severe varus of the first metatarsal is difficult. Computed tomography (CT) can be helpful due to its cross-sectional images in any plane. The purposes of this study were to evaluate the alignment of the tibial sesamoid and investigate the relationship between malalignment and degenerative change in the sesamoid metatarsal joint (SMJ) using simulated weight-bearing CT imaging in patients with hallux valgus. METHODS: In total, 269 feet from 142 patients with hallux valgus were included. The mean age was 63.7 years (range, 33-87 years). An anteroposterior weight-bearing radiograph was assessed for sesamoid position into 3 grades: grade 1, the tibial sesamoid was medial to the axis of the first metatarsal; grade 2, the tibial sesamoid was located below the first metatarsal axis; and grade 3, the tibial sesamoid was lateral to the first metatarsal axis. The hallux valgus and intermetatarsal angles (HVA and IMA, respectively) were measured. The lateral shift of the tibial sesamoid relative to the first metatarsal was classified into 3 grades on simulated weight-bearing CT classification: grade 1, tibial sesamoid was entirely medial to the intersesamoid ridge; grade 2, tibial sesamoid was subluxated laterally but located below the intersesamoid ridge; and grade 3, tibial sesamoid was located entirely lateral to the intersesamoid ridge. The differences of HVA and IMA in each grade were confirmed by using 1-way analysis of variance with Bonferroni post hoc corrections. Furthermore, multiple linear regression analysis was used to predict the degenerative change in the SMJ for age, sex, sesamoid position determined by CT or plain radiography, HVA, and IMA. The χ2 test was used for descriptive statistics to analyze the agreement between radiography or CT classifications of sesamoid position against degenerative change in the SMJ. RESULTS: Based on the radiographic classification of the tibial sesamoid position, 7 feet were classified as grade 1, 72 were grade 2, and 190 were grade 3, respectively. Based on the CT classification, 34 feet were classified as grade 1, 116 were grade 2, and 119 were grade 3. Degenerative change in SMJ progressed according to the sesamoid shift relative to the first metatarsal using either radiography or CT. In radiography, statistically significant differences were found except for the difference in HVA between grades 1 and 2. In addition, statistically significant differences were found between HVA and IMA, along with the grades in CT.In multiple linear regression, degenerative change was correlated with age and sesamoid position in CT and radiographic classifications. CONCLUSION: Our study showed that lateral shift of the tibial sesamoid increased in association with progression of the hallux valgus deformity. Furthermore, increasing lateral shift of the tibial sesamoid was associated with worsening degenerative change within the SMJ. LEVEL OF EVIDENCE: Level III, retrospective comparative study.博士(医学)・甲第657号・平成28年11月24日© Copyright 2016 American Orthopaedic Foot & Ankle SocietyThe definitive version is available at " http://dx.doi.org/10.1177/1071100716661827 "Sage PublicationsThesisThesis or DissertationFoot & ankle international Vol.37 No.12 p.1303-1309(2016 Dec)10711007http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3283Foot & ankle international, 37(12): 1303-1309http://hdl.handle.net/10564/3283http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3283/1/01_%e7%94%b2657%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3283/2/02_%e7%94%b2657%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3283/3/03_%e7%94%b2657%e6%9c%ac%e6%96%87.pdf10711007AA10988467Foot & ankle international3712130313092016-12enghttp://www.ncbi.nlm.nih.gov/pubmed/27530982http://dx.doi.org/10.1177/1071100716661827ETD24601A6572016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32842017-06-11T23:20:26Zhdl_10564_3215Effectiveness of Bone Marrow Stromal Cell Sheets in Maintaining Random-Pattern Skin Flaps in an Experimental Animal Model.動物モデルにおける骨髄間質細胞シートの乱軸型皮弁の延長効果Kira, TsutomuOmokawa, ShoheiAkahane, ManabuShimizu, TakamasaNakano, KenichiNakanishi, YasuakiOnishi, TadanobuKido, AkiraInagaki, YusukeTanaka, YasuhitoBACKGROUND: Bone marrow stromal cells can be applied therapeutically to enhance angiogenesis; however, the use of bone marrow stromal cell suspensions reduces efficiency because of low-level attachment. The authors hypothesized that bone marrow stromal cell sheets would facilitate cell fixation, thus enhancing angiogenesis. The authors investigated flap survival area and enhancement of angiogenic factors in a rat random-pattern skin flap model after application of bone marrow stromal cell sheets. METHODS: Bone marrow stromal cell sheets (prepared from 7-week-old rat femurs) were cultured under four different hypoxic conditions. Sheets with the highest angiogenic potential, determined by an in vitro pilot study, were injected into subcutaneous layers of the rat dorsum (bone marrow stromal cell sheet group). A control group (phosphate-buffered saline only) was included. On day 2 after injection, caudally based random-pattern skin flaps (12 × 3 cm) were elevated. On day 7 after elevation, surviving skin flap areas were measured. Skin samples were harvested from each flap and gene expression levels of vascular endothelial growth factor and basic fibroblast growth factor were measured by quantitative real-time polymerase chain reaction. RESULTS: Skin flap survival area (71.6 ± 2.3 percent versus 51.5 ± 3.3 percent) and levels of vascular endothelial growth factor and basic fibroblast growth factor were significantly higher in the bone marrow stromal cell sheet group than in the control group (p < 0.05). CONCLUSIONS: Implantation of bone marrow stromal cell sheets increased the survival area of random-pattern skin flaps. Expression of angiogenic factors may have contributed to the increased flap survival.博士(医学)・甲第658号・平成28年11月24日Copyright © 2015 American Society of Plastic SurgeonsThe definitive version is available at " http://dx.doi.org/10.1097/PRS.0000000000001679 "Lippincott Williams & WilkinsThesisThesis or DissertationPlastic and reconstructive surgery Vol.136 No.5 p.624e-632e(2015 Nov)00321052http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3284Plastic and reconstructive surgery, 136(5): 624e-632ehttp://hdl.handle.net/10564/3284http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3284/1/01_%e7%94%b2658%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3284/2/02_%e7%94%b2658%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3284/3/03_%e7%94%b2658%e6%9c%ac%e6%96%87.pdf00321052AA00775696Plastic and reconstructive surgery1365624e632e2015-11enghttp://www.ncbi.nlm.nih.gov/pubmed/26505719http://dx.doi.org/10.1097/PRS.0000000000001679ETD24601A6582016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32872022-08-23T07:01:27Zhdl_10564_3215Ultrasound-guided Selective Sensory Nerve Block for Wide-awake Forearm Tendon Reconstruction.超音波ガイド下選択的知覚神経ブロックによる、前腕健機能再建のためのwide-awake surgeryNakanishi, YasuakiOmokawa, ShoheiKobata, YasunoriShimizu, TakamasaKira, TsutomuOnishi, TadanobuHayami, NaokiTanaka, YasuhitoBACKGROUND: Wide-awake hand surgery is useful for tendon reconstruction because surgeons can observe the actual movement of the reconstructed tendons during the surgery. We hypothesized that accurate ultrasound-guided injection of local anesthetics into the sensory nerves contributes to reliable analgesia with a relatively small amount of anesthetic. METHODS: We enrolled 8 patients who underwent forearm tendon transfer. Three patients underwent reconstruction of flexor tendon ruptures in zones 4 and 5, 3 underwent opponensplasty, and 2 underwent multiple tendon transfers according to Brand's procedure. All patients underwent ultrasound-guided injection of ropivacaine to each sensory nerve branch of the upper arm and forearm and into the subfascial layer of the forearm. The mean amount of total ropivacaine was 193 mg. RESULTS:
In 7 of the 8 patients, we confirmed adequate active contraction of the flexor or extensor muscles during surgery. The expected active motion of the flexor pollicis longus was not found in 1 patient during surgery because the effect of the anesthetic had spread too widely, involving the motor branch of the median nerve. Two patients required additional infiltration of 2-3 mL of local anesthetic because of local wound pain. All patients gained satisfactory function of the transferred tendons after the surgery, and no remarkable perioperative complications related to local anesthetic systemic toxicity occurred. CONCLUSIONS: Selective administration of an anesthetic to the sensory nerve branches and subfascial layer enables the performance of wide-awake forearm tendon surgery. The ultrasound-guided injection technique provides safe and effective regional anesthesia for wide-awake surgery.博士(医学)・甲第659号・平成28年11月24日Copyright © 2015 The Authors. Published by Wolters Kluwer
Health, Inc. on behalf of The American Society of Plastic Surgeons.
All rights reserved. This is an open-access article distributed under
the terms of the Creative Commons Attribution-NonCommercial NoDerivatives 3.0 License(https://creativecommons.org/licenses/by-nc-nd/3.0/), where it is permissible to download
and share the work provided it is properly cited. The work cannot
be changed in any way or used commercially.Wolters Kluwer Health/Lippincott Williams & WilkinsThesisThesis or DissertationPlastic and reconstructive surgery. Global open Vol.3 No.5 Article No.e392 (2015 Jun)21697574http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3287Plastic and reconstructive surgery. Global open, 3(5): Article No.e392http://hdl.handle.net/10564/3287http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3287/1/01_%e7%94%b2659%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3287/2/02_%e7%94%b2659%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3287/14/03_%e7%94%b2659%e6%9c%ac%e6%96%87.pdf21697574Plastic and reconstructive surgery. Global open35Article No.e3922015-06-05http://www.ncbi.nlm.nih.gov/pubmed/26090282http://dx.doi.org/10.1097/GOX.0000000000000365ETD24601A6592016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32882022-08-24T01:41:52Zhdl_10564_3215Pathogenesis of Fifth Metatarsal Fractures in College Soccer Players.大学サッカー選手における第5中足骨疲労骨折の発生因子Fujitaka, KoheiTaniguchi, AkiraIsomoto, ShinjiKumai, TsukasaOtuki, ShingoOkubo, MamoruTanaka, Yasuhitofifth metatarsal bonestress fracturesoccermedical checkupBACKGROUND: The pathogenesis of fifth metatarsal stress fractures remains uncertain. HYPOTHESIS: Physical characteristics and environmental factors, which have received limited attention in the literature thus far, might be involved in the development of fifth metatarsal stress fractures. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: To test the study hypothesis, a medical examination and survey of the living environment of collegiate soccer players was conducted and correlated with the existence of fifth metatarsal stress fractures. The survey and measurements were conducted in 273 male athletes from the same college soccer team between 2005 and 2013. A medical examination comprising assessment of stature, body weight, body mass index, foot-arch height ratio, toe-grip strength, quadriceps angle, leg-heel angle, functional reach test, single-leg standing time with eyes closed, straight-leg raise angle, finger-floor distance, heel-buttock distance, ankle joint range of motion, and a general joint laxity test were performed once a year, along with a questionnaire survey. The survey was also repeated when a fifth metatarsal stress fracture was diagnosed. The study participants were separated into a fifth metatarsal stress fracture injury group and a noninjury group. The measurement items and survey items were compared, and the association between the factors and the presence or absence of injuries was analyzed. RESULTS: Toe-grip strength was significantly weaker in the injury group compared with the noninjury group, suggesting that weak toe-grip is associated with fifth metatarsal stress fracture (P < .05). In addition, fifth metatarsal stress fractures were more common in the nondominant leg (P < .05). Between-group comparisons of the other items showed no statistically significant differences. CONCLUSION: The association between weak toe-grip strength and fifth metatarsal fracture suggests that weak toe-grip may lead to an increase in the load applied onto the lateral side of the foot, resulting in stress fracture. The finding of stress fracture being more common in the nondominant leg needs further study.博士(医学)・甲第660号・平成28年11月24日© The Author(s) 2015 : This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/
licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are
credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site
at http://www.sagepub.com/journalsPermissions.nav.Sage on behalf of: The American Orthopaedic Society for Sports MedicineThesisThesis or DissertationOrthopaedic journal of sports medicine Vol.3 No.9 Article No.2325967115603654 (2015 Sep 18)23259671http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3288Orthopaedic journal of sports medicine, 3(9): Article No.2325967115603654http://hdl.handle.net/10564/3288http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3288/1/01_%e7%94%b2660%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3288/2/02_%e7%94%b2660%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3288/3/03_%e7%94%b2660%e6%9c%ac%e6%96%87.pdf23259671Orthopaedic journal of sports medicine39Article No.23259671156036542015-09-18enghttp://www.ncbi.nlm.nih.gov/pubmed/26535399http://dx.doi.org/10.1177/2325967115603654ETD24601A6602016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32892017-06-23T08:29:42Zhdl_10564_3215Suppressed Production of Soluble Fms-Like Tyrosine Kinase-1 Contributes to Myocardial Remodeling and Heart Failure.可溶性Flt-1産生低下は、心筋リモデリングおよび心不全増悪に寄与するSeno, AyakoTakeda, YukijiMatsui, MasaruOkuda, AyaNakano, TomoyaNakada, YasukiKumazawa, TakuyaNakagawa, HitoshiNishida, TakuOnoue, KenjiSomekawa, SatoshiWatanabe, MakotoKawata, HiroyukiKawakami, RikaOkura, HiroyukiUemura, ShiroSaito, Yoshihikochronic kidney diseaseheart failurehypertrophy/remodelingmonocyte chemoattractant protein-1placental growth factorSoluble fms-like tyrosine kinase-1 (sFlt-1), an endogenous inhibitor of vascular endothelial growth factor and placental growth factor, is involved in the pathogenesis of cardiovascular disease. However, the significance of sFlt-1 in heart failure has not been fully elucidated. We found that sFlt-1 is decreased in renal failure and serves as a key molecule in atherosclerosis. In this study, we aimed to investigate the role of the decreased sFlt-1 production in heart failure, using sFlt-1 knockout mice. sFlt-1 knockout mice and wild-type mice were subjected to transverse aortic constriction and evaluated after 7 days. The sFlt-1 knockout mice had significantly higher mortality (52% versus 15%; P=0.0002) attributable to heart failure and showed greater cardiac hypertrophy (heart weight to body weight ratio, 8.95±0.45 mg/g in sFlt-1 knockout mice versus 6.60±0.32 mg/g in wild-type mice; P<0.0001) and cardiac dysfunction, which was accompanied by a significant increase in macrophage infiltration and cardiac fibrosis, than wild-type mice after transverse aortic constriction. An anti–placental growth factor–neutralizing antibody prevented pressure overload–induced cardiac hypertrophy, fibrosis, and cardiac dysfunction. Moreover, monocyte chemoattractant protein-1 expression was significantly increased in the hypertrophied hearts of sFlt-1 knockout mice compared with wild-type mice. Monocyte chemoattractant protein-1 inhibition with neutralizing antibody ameliorated maladaptive cardiac remodeling in sFlt-1 knockout mice after transverse aortic constriction. In conclusion, decreased sFlt-1 production plays a key role in the aggravation of cardiac hypertrophy and heart failure through upregulation of monocyte chemoattractant protein-1 expression in pressure-overloaded heart.博士(医学)・乙第1384号・平成28年11月24日© 2016 American Heart Association, Inc.The definitive version is available at " https://doi.org/10.1161/HYPERTENSIONAHA.116.07371 "American Heart Association / Lippincott, Williams & WilkinsThesisThesis or DissertationHypertension Vol.68 No.3 p.678-687 (2016 Sep)0194911Xhttp://ginmu.naramed-u.ac.jp/dspace/handle/10564/3289Hypertension, 68(3): 678-687http://hdl.handle.net/10564/3289http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3289/1/01_%e4%b9%991384%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3289/2/02_%e4%b9%991384%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3289/10/03%20%e4%b9%991384%e6%9c%ac%e6%96%87.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3289/11/04%20%e4%b9%991384Figure1-5.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3289/12/05%20%e4%b9%991384Supplementary%20data.pdf0194911XHypertension6836786872016-09enghttp://www.ncbi.nlm.nih.gov/pubmed/27480835https://doi.org/10.1161/HYPERTENSIONAHA.116.07371ETD24601B13842016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32902017-06-11T23:20:26Zhdl_10564_3215Vascularized Bone Grafts from the Dorsal Wrist for the Treatment of Kienböck Disease.キーンベック病に対する手関節背側からの血管柄付骨移植術Nakagawa, MakotoOmokawa, ShoheiKira, TsutomuKawamura, KenjiTanaka, Yasuhitovascularized bonegraftinglunateosteonecrosisKienböckPurpose The objective of this article is to evaluate functional and radiological outcomes of vascularized bone grafts for stage 2 and 3 Kienböck disease. The outcomes of three different donor sites via dorsal approach of the wrist were compared. Pearls and pitfalls in surgical technique were discussed. Methods There were 28 patients who underwent vascularized bone grafts, including the extensor fourth and fifth compartmental artery graft of distal radius in 8 patients, the first and second supraretinacular intercompartmental artery graft of distal radius in 12 patients, and the second dorsal metacarpal neck graft in 8 patients. Average age was 32 years, and radiological grading according to Lichtman classification was stage 2 in 8 patients, stage 3A in 10 patients, and stage 3B in 10 patients. Temporary pinning fixing the midcarpal joint was conducted for 10 weeks postoperatively. Results Follow-up periods averaged 70 months. Pain reduced in 27 patients, and visual analog scale for pain of pre- and postoperative level averaged 59 and 18. Range of wrist flexion and extension motion improved from 87 to 117 degrees, and average grip strength improved from 21 kg preoperatively to 33 kg postoperatively. Carpal height ratio had almost no change from 0.52 to 0.53. Fragmentation of necrotic bone healed in 7 of the 14 cases. Comparative analyses of functional and radiological outcomes between three donor sites found no significant difference. Conclusion Three different vascularized bone grafts from the dorsal wrist and hand area demonstrated favorable and comparable functional outcomes. It was technically important to elevate vascular bundle with surrounding retinaculum or fascia, to include sufficient periosteum, and to insert the vascularized bone as the cortex aligned longitudinally.博士(医学)・乙第1385号・平成28年11月24日最終稿掲載不可のため本文の掲載無し(国立国会図書館には送付済み)Thieme PublishersThesisOthersJournal of wrist surgery Vol.5 No.2 p.98-104 (2016 May)21633916http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3290Journal of wrist surgery, 5(2): 98-104http://hdl.handle.net/10564/3290http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3290/1/01_%e4%b9%991385%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3290/2/02_%e4%b9%991385%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf21633916Journal of wrist surgery52981042016-05enghttp://www.ncbi.nlm.nih.gov/pubmed/27104073http://dx.doi.org/10.1055/s-0036-1582427none24601B13852016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32912017-06-11T23:20:26Zhdl_10564_3215Distinctive Rorschach profiles of young adults with schizophrenia and autism spectrum disorder.青年期の統合失調症と自閉スペクトラム症のロールシャッハ・テスト反応の相違Kishimoto, NaokoYamamuro, KazuhikoIida, JunzoOta, ToyosakuTanaka, ShoheiKyo, MasanoriKimoto, SoheiKishimoto, Toshifumiautism spectrum disorderperceptionpsychopathologyRorschach testschizophreniaOBJECTIVE: The differential diagnosis of schizophrenia (SZ) versus autism spectrum disorder (ASD) can be clinically challenging because accumulating evidence suggests both clinical and biological overlaps between them. The aim of this study was to compare Rorschach profiles between young adults with SZ and those with ASD. METHODS: We evaluated quantitative tendencies on the Rorschach test among 20 patients diagnosed with SZ and 20 diagnosed with ASD. Both groups were matched for age, sex, and intelligence quotient. RESULTS: We found significant differences in six response variables on the Rorschach comprehensive system. Those with SZ had significantly higher scores on D score, adjusted D score (Adj D), developmental quality code reflecting ordinary response (DQo), and form quality minus (FQ -) than those with ASD. In contrast, those with SZ had significantly lower scores on the active and developmental quality code reflecting synthesized response (DQ+) subscales than those with ASD. CONCLUSION: The present findings reveal that individuals with SZ might have more stress tolerance, stronger perception distortions, and simpler and poorer recognition than those with ASD. We suggest that the Rorschach test might be a useful tool for differentiating between SZ and ASD.博士(医学)・乙第1386号・平成28年11月24日© 2016 Kishimoto et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).The definitive version is available at " https://doi.org/10.2147/NDT.S116223 "Dove PressThesisThesis or DissertationNeuropsychiatric disease and treatment Vol.12 p.2403-2410 (2016 Sep)11766328http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3291Neuropsychiatric disease and treatment, 12: 2403-2410http://hdl.handle.net/10564/3291http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3291/1/01_%e4%b9%991386%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3291/2/02_%e4%b9%991386%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3291/3/03_%e4%b9%991386%e6%9c%ac%e6%96%87.pdf11766328AA12157821Neuropsychiatric disease and treatment12240324102016-09-21enghttp://www.ncbi.nlm.nih.gov/pubmed/27703357https://doi.org/10.2147/NDT.S116223ETD24601B13862016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32922017-06-11T23:20:26Zhdl_10564_3215Two-year prognosis after residential treatment for patients with alcohol dependence: three chief guidelines for sobriety in Japan.アルコール依存症で入院加療二年予後調査 : 日本の伝統的断酒3本柱についてCho, TetsujiNegoro, HidekiSaka, YasuhiroMorikawa, MasayukiKishimoto, Toshifumialcohol dependencethree chief guidelines for sobriety (3CGS)disulfiramself-help grouprecoveryBACKGROUND: In Japan, the three chief traditional guidelines for sobriety (3CGS) are regular medical checkups, participation in self-help groups, and pharmacotherapy with antidipsotropics. However, the official record of the origins of 3CGS is not clear. The aim of this current study was to assess 3CGS by an examination of the prognosis of patients with alcohol dependence 2 years after their discharge from a residential treatment program. SUBJECTS AND METHODS: The association between subjects' abstinence from alcohol and their regular medical checkups, participation in self-help groups, and treatment with antidipsotropics were prospectively examined. Two years after discharge, the relationship between the 3CGS compliance and abstinence rates was investigated as the primary outcome. In addition, the following were examined as secondary outcomes: the time taken till the first drink after discharge, whether the participants were readmitted to residential treatment, the number of days to readmission, the number of heavy drinking days, and recovery. RESULTS: A total of 98 patients participated. The perfect and partial abstinence rates for patients who followed all the principles of 3CGS were significantly higher than those for patients who followed no guidelines (P<0.05 and P<0.01, respectively). The perfect abstinence rates for patients who had continued attending checkup sessions (P<0.001) and who were taking antidipsotropics (P<0.05) were significantly higher than those for patients who did not follow these components of 3CGS. However, the perfect abstinence rates were not higher for patients who had continued to participate in self-help groups. In addition, the perfect abstinence rate was statistically associated with regular medical checkups (adjusted odds ratio =5.33, 95% confidence interval =1.35-21.0) and participation in self-help groups (adjusted odds ratio =3.79, 95% confidence interval =1.17-12.3). CONCLUSION: This study, reports the effectiveness of 3CGS for the first time. The recovery rate of alcoholics 2 years after discharge from residential treatment was examined. However, due to the chronic nature of alcoholism, further studies are required to investigate the efficacy of 3CGS beyond 2 years.博士(医学)・乙第1387号・平成28年11月24日© 2016 Cho et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).The definitive version is available at " http://dx.doi.org/10.2147/NDT.S111230 "Dove PressThesisThesis or DissertationNeuropsychiatric disease and treatment Vol.12 p.1983-1991 (2016 Aug)11766328http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3292Neuropsychiatric disease and treatment, 12: 1983-1991http://hdl.handle.net/10564/3292http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3292/1/01_%e4%b9%991387%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3292/2/02_%e4%b9%991387%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3292/3/03_%e4%b9%991387%e6%9c%ac%e6%96%87.pdf11766328AA12157821Neuropsychiatric disease and treatment12198319912016-08-05enghttp://www.ncbi.nlm.nih.gov/pubmed/27540295http://dx.doi.org/10.2147/NDT.S111230ETD24601B13872016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32932017-06-23T08:34:21Zhdl_10564_3215Functional characterization of tissue factor in von Willebrand factor-dependent thrombus formation under whole blood flow conditions.全血流動下でのフォンビルブランド因子依存性血栓形成における組織因子の機能特性Matsunari, YasunoriSugimoto, MitsuhikoDoi, MasaakiMatsui, HidetoKawaguchi, MasahikoBlood flowFibrinThrombus formationTissue factorVon Willebrand factorVon Willebrand factor (VWF) plays an important role in mediating platelet adhesion and aggregation under high shear rate conditions. Such platelet aggregates are strengthened by fibrin-network formation triggered by tissue factor (TF). However, little is known about the role of TF in VWF-dependent thrombus formation under blood flow conditions. We evaluated TF in thrombus formation on immobilized VWF under whole blood flow conditions in an in vitro perfusion chamber system. Surface-immobilized TF amplified intra-thrombus fibrin generation significantly under both low and high shear flow conditions, while TF in sample blood showed no appreciable effects. Furthermore, immobilized TF enhanced VWF-dependent platelet adhesion and aggregation significantly under high shear rates. Neutrophil cathepsin G and elastase increased significantly intra-thrombus fibrin deposition on immobilized VWF–TF complex, suggesting the involvement of leukocyte inflammatory responses in VWF/TF-dependent mural thrombogenesis under these flow conditions. These results reveal a functional link between VWF and TF under whole blood flow conditions, in which surface-immobilized TF and VWF mutually contribute to mural thrombus formation, which is essential for normal hemostasis. By contrast, TF circulating in blood may be involved in systemic hypercoagulability, as seen in sepsis caused by severe microbial infection, in which neutrophil inflammatory responses may be active.博士(医学)・乙第1388号・平成28年11月24日© The Japanese Society of Hematology 2016The original publication is available at www.springerlink.comThe final publication is available at Springer via http://dx.doi.org/10.1007/s12185-016-2086-zSpringer NatureThesisThesis or DissertationInternational journal of hematology Vol.104 No.6 p.661-668 (2016 Dec)09255710http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3293International journal of hematology, 104(6): 661-668http://hdl.handle.net/10564/3293http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3293/1/01_%e4%b9%991388%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3293/2/02_%e4%b9%991388%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3293/4/03_%e4%b9%991388%e6%9c%ac%e6%96%87.pdf09255710AA10797094International journal of hematology10466616682016-12enghttp://www.ncbi.nlm.nih.gov/pubmed/27562418http://dx.doi.org/10.1007/s12185-016-2086-zETD24601B13882016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/32942021-05-25T01:52:23Zhdl_10564_3215The unique luminal staining pattern of cytokeratin 5/6 in adenoid cystic carcinoma of the breast may aid in differentiating it from its mimickers.乳腺腺様嚢胞癌においてサイトケラチン5/6の腺腔形成細胞の染色性は類似病変との鑑別に有用であるNakai, TokikoIchihara, ShuKada, AkikoIto, NorikoMoritani, SuzukoKawasaki, TomonoriUchiyama, TomokoItami, HiroeMorita, KouheiTakano, MasatoTakeda, MaikoHatakeyama, KintaOhbayashi, ChihoAdenoid cystic carcinomaCollagenous spherulosisCytokeratin 5/6Myoepithelial cellsVimentinAdenoid cystic carcinoma (AdCC) of the breast is an uncommon but distinct neoplasm composed of a dual cell population polarized around true glandular (luminal) spaces and pseudolumina. The aim of this study was to clarify whether various immunohistochemical markers (CK7, EMA, CD117, p63, calponin, CD10, S100, CK5/6, CK14, vimentin, and type IV collagen) can distinguish between the two cell types in classical AdCC (n = 14) and in collagenous spherulosis (n = 5). The sensitivity and specificity of these 11 markers to distinguish luminal from abluminal cells were evaluated using a curve created by plotting the true-positive rate (sensitivity) against the false-positive rate (1 - specificity) at threshold settings of 0, 10, 50, and 70 %. The most sensitive and specific markers for luminal cells in AdCC were CK7 and EMA; those for abluminal cells were type IV collagen, p63, and vimentin. CD10 and S100 did not act as abluminal markers in AdCC. CK5/6, one of the basal/myoepithelial markers, was expressed more frequently in luminal than in abluminal cells of AdCC. Thus, CK5/6 immunostaining resulted in a reverse expression pattern, analogous to what we recently documented in clear cells in mammary adenomyoepithelioma. In conclusion, compared with myoepithelial/abluminal cells of normal breast or collagenous spherulosis, the neoplastic abluminal cells of classical AdCC are characterized by enhanced vimentin and attenuated CD10 and S100. Furthermore, the luminal cells of AdCC show a unique aberrant staining pattern for CK5/6 that may aid in the differential diagnosis.博士(医学)・乙第1389号・平成28年11月24日© Springer-Verlag Berlin Heidelberg 2016The final publication is available at Springer via http://dx.doi.org/10.1007/s00428-016-1963-4Springer NatureThesisThesis or DissertationVirchows Archiv Vol.469 No.2 p.213-222 (2016 Aug)09456317http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3294Virchows Archiv, 469(2): 213-222http://hdl.handle.net/10564/3294http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3294/1/01_%e4%b9%991389%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3294/2/02_%e4%b9%991389%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3294/10/03%20%e4%b9%991389%e6%9c%ac%e6%96%87.pdf09456317AA10992872Virchows Archiv46922132222016-08enghttp://www.ncbi.nlm.nih.gov/pubmed/27240462http://dx.doi.org/10.1007/s00428-016-1963-4none24601B13892016-11-24博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33112022-08-24T01:47:56Zhdl_10564_3215Frontal lobe function in elderly patients with Alzheimer's disease and caregiver burden.アルツハイマー型認知症患者における前頭葉機能と介護負担の関係Hashimoto, AkikoMatsuoka, KiwamuYasuno, FumihikoTakahashi, MasatoIida, JunzoJikumaru, KiyokoKishimoto, ToshifumiAlzheimer's diseasecaregiver burdendementiafrontal lobe functionAIM: Understanding of the relationship between caregiver burden and the degree of behavioural deficits in patients with Alzheimer's disease (AD) is relatively limited. Therefore, it is worthwhile to examine the correlations between the various relevant factors to improve the efficacy of care for patients with AD. The aim of this study was to investigate the specific contributions of frontal lobe dysfunction in AD patients to caregiver burden, while controlling for other predictor variables. METHODS: Participants included 30 pairs of caregivers and patients with AD. The Zarit Burden Interview and Frontal Assessment Battery were used to measure the caregiver burden and patients' frontal lobe function, respectively. To investigate the effects of frontal lobe dysfunction on caregiver burden, hierarchical regression equations with steps incorporating additional predictor variables were fitted. We also performed a correlation analysis between the individual subdomains of the Zarit Burden Interview and the predictor variables. RESULTS: Our study suggests that the degree of frontal lobe dysfunction in AD patients predicts their caregiver burden, when other factors of daily functional limitations and neuropsychiatric symptoms are controlled. Daily functional limitations and neuropsychiatric symptoms affected caregivers' psychosocial burden, whereas frontal lobe dysfunction affected caregivers' burden due to the increase in the dependency of the patients. CONCLUSION: Our findings indicate that to ameliorate the disabilities of patients and reduce caregiver burden, there is a need for interventions that focus on psychosocial burdens, as shown in previous studies, as well as on excessive dependency due to frontal lobe dysfunction.博士(医学)・甲第661号・平成29年3月15日© 2017 Japanese Psychogeriatric SocietyThis is the pre-peer reviewed version of the following article: http://dx.doi.org/10.1111/psyg.12231, which has been published in final form at http://dx.doi.org/10.1111/psyg.12231. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.John Wiley & Sons, IncThesisThesis or DissertationPsychogeriatrics Vol.17 No.4 p.267-272 (2017 Jul)13463500http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3311Psychogeriatrics, 17(4): 267-272http://hdl.handle.net/10564/3311http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3311/1/01_%e7%94%b2661%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3311/10/02%20%e7%94%b2661%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3311/11/03%e7%94%b2661%e6%9c%ac%e6%96%87.pdf13463500AA11919302Psychogeriatrics1742672722017enghttp://www.ncbi.nlm.nih.gov/pubmed/28130804http://dx.doi.org/10.1111/psyg.12231ETD24601A6612017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33132017-06-11T23:20:26Zhdl_10564_3215Microstructural Differences in the Corpus Callosum in Patients With Bipolar Disorder and Major Depressive Disorder.気分状態に依存しない双極性障害と大うつ病性障害における脳梁の白質微細構造の差異Matsuoka, KiwamuYasuno, FumihikoKishimoto, ToshifumiYamamoto, AkihideKiuchi, KuniakiKosaka, JunNagatsuka, KazuyukiIida, HidehiroKudo, TakashiOBJECTIVE: It is difficult to distinguish between bipolar disorder and major depressive disorder (MDD) in patients lacking a clear history of mania. There is an urgent need for an objective biomarker for differential diagnosis. Using diffusion tensor imaging, this study investigated the differences in the brain white matter microstructure between patients with bipolar disorder and MDD. METHODS: Participants included 16 patients with bipolar disorder and 23 patients with MDD having depressed or euthymic states based on DSM-IV-TR criteria and 23 healthy volunteers. Whole-brain voxel-based morphometric analysis was used to detect any significant differences in fractional anisotropy between patients with bipolar disorder and MDD. The study was conducted between August 2011 and July 2015. RESULTS: We found a significant decrease in fractional anisotropy values in the anterior part of the corpus callosum in patients with bipolar disorder compared with MDD (P < .001), which did not depend on the patients' affective state. This decrease was associated with increased radial diffusivity values (P < .05), which was also found in patients with bipolar disorder when compared with healthy volunteers (P < .05). We predicted bipolar disorder and MDD in all patients using the fractional anisotropy values, with a correct classification rate of 76.9%. CONCLUSIONS: The present study revealed that patients with bipolar disorder have microstructural abnormalities in the corpus callosum during depressed or euthymic states, which may deteriorate the exchange of emotional information between the cerebral hemispheres, resulting in emotional dysregulation. Our results indicate the possible use of diffusion tensor imaging as a differential diagnostic tool.博士(医学)・甲第662号・平成29年3月15日© Copyright 2017 Physicians Postgraduate Press, Inc.発行元の規定により、本文の登録不可。本文は以下のURLを参照 "http://dx.doi.org/10.4088/JCP.15m09851" (※全文閲覧は学内限定)Physicians Postgraduate PressThesisThesis or DissertationJournal of clinical psychiatry Vol.78 No.1 p.99-104 (2017 Jan)01606689http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3313Journal of clinical psychiatry, 78(1): 99-104http://hdl.handle.net/10564/3313http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3313/1/01_%e7%94%b2662%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3313/2/02_%e7%94%b2662%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf01606689AA00695611Journal of clinical psychiatry781991042017-01enghttp://www.ncbi.nlm.nih.gov/pubmed/27574839http://dx.doi.org/10.4088/JCP.15m09851none24601A6622017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33142017-07-20T06:36:30Zhdl_10564_3215Feasibility and efficacy of definitive radiotherapy with 66 GY and concurrent carboplatin-paclitaxel chemotherapy for stage Ⅲ non-small cell lung cancer.Ⅲ期非小細胞肺癌に対するカルボプラチン・パクリタキセル同時併用66Gy放射線治療の安全性と有効性についてInoue, KazuyaHontsu, ShigetoMiura, SachikoAsakawa, IsaoTamamoto, TetsuroYoshimine, TadashiKimura, HiroshiHasegawa, MasatoshiNon-small cell lung cancerConcurrent chemoradiotherapy66GyCarboplatin-paclitaxel chemotherapyPurpose/Objectives: This study was conducted to assess the feasibility and efficacy of definitive radiotherapy (RT) with a total dose of 66Gy and concurrent carboplatin-paclitaxel chemotherapy for patients (pts) with stage Ⅲ non-small cell lung cancer. Materials/Methods: Between April 2007 and December 2013, 99 pts with non-small cell lung cancer were treated by RT with concurrent carboplatin-paclitaxel chemotherapy in our hospital. Sixty-eight of them received RT with a total dose of 66Gy. We analyzed 46 Stage Ⅲ pts who had been treated with RT using three-dimensional radiotherapy treatment planning. The prophylactic mediastinal lymph nodes were included in the clinical target volume of RT. The survival rate after the beginning of RT was estimated using the Kaplan-Meier method. We estimated the cumulative local failure and distant metastasis rates with the Fine-Gray method. Adverse events were evaluated according to the CTCAE (v.4.0). Results: The median age of the pts was 70.9 (52.8-78.7) years old (y.o.). The performance status (PS) of each pt was fairly good (ECOG PS 0: 25, PS 1: 20, PS3:1), and clinical stages (UICC 7th) consisted of twenty-nine ⅢA and seventeen ⅢB. Diagnoses were pathologically confirmed in 32 pts. The median follow-up period was 35.7 (2.0-82.2) months among all pts, and 55.9 (40.1-82.2) months among survivors. The 3- and 5-year Kaplan-Meier overall survival rates were 52.2 and 34.0%, respectively, and the median survival time was 36.6 months. The 3- and 5-year Kaplan-Meier progression-free survival rates were 29.1 and 21.9%, respectively, and the median progression-free survival time was 9.9 months. The 5-year local failure rate was 37.6%, and the 5-year distant metastasis rate was 49.7%. Sixteen (34.8%) pts required steroid administration because of radiation pneumonitis (CTCAE Grade 2 or higher) and two of them died (Grade 5). No other severe non-hematologic toxicity (Grade 3 or higher) was observed. Conclusion: These results suggest that definitive RT with a total dose of 66Gy and concurrent carboplatin-paclitaxel chemotherapy is feasible and may be promising for pts with Stage Ⅲ non-small cell lung cancer.博士(医学)・甲第663号・平成29年3月15日奈良医学会奈良県立医科大学ThesisThesis or DissertationJournal of Nara Medical Association Vol.68 No.1,2,3 p.1-6 (2017.06)13450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3314Journal of Nara Medical Association, 68(1-2)http://hdl.handle.net/10564/3314http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3314/1/01_%e7%94%b2663%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3314/2/02_%e7%94%b2663%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3314/14/03_%e7%94%b2663%e6%9c%ac%e6%96%87.pdf13450069AA11252383Journal of Nara Medical Association681-22017-04engETD24601A6632017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33172017-06-11T23:20:26Zhdl_10564_3215Alkalemic conditions result in blood clotting in the circuit soon after initiating cardiopulmonary bypass.体外循環開始後早期にアルカレミア環境で出現する回路内の血液凝集塊形成Soyama, TomonoriTakahashi, YukihiroYoshida, HidetoSakoda, TohruNiitsuma, TomokazuNishikubo, Toshiyaalkalemic conditionsblood clottingechinocyteDonnan equilibrium ratioalbuminPurpose : This study investigated the relationship between blood clotting in the circuit soon after initiating cardiopulmonary bypass (CPB) and echinocytes that appear with alkalemia, using a recirculation circuit filled with heparinized bovine blood. Methods : Alkalemic conditions in the recirculation circuit were prepared by adding various concentrations of NaHCO3 to the priming fluid. Albumin was also added to confirm its inhibitory effect on blood clotting. Blood pH, hold-up, the pressure gradient, and red blood cell (RBC) reduction rate were monitored. Blood clots were examined microscopically. Results : Although blood pH was elevated under all experimental conditions, clotting in the circuit increased with increased concentrations of HCO3-. Albumin inhibited the clotting under the same alkalemic conditions. Microscopic findings revealed echinocytes in the blood clots. Conclusions : The shape of echinocytes was transformed by a reduction in the Donnan equilibrium ratio because of changes in pH inside and outside the RBC membrane. Blood clotting in the circuit soon after initiating CPB may be caused by echinocytes that appear under alkalemic conditions. This was inhibited by albumin, suggesting that the addition of albumin to the priming fluid may prevent such clotting in the circuit after initiating CPB.博士(医学)・甲第664号・平成29年3月15日Copyright © 2016 Japanese Journal of Extra-Corporeal Technology(日本体外循環技術医学会)This is a non-final version of an article published in final form in "http://doi.org/10.7130/jject.43.339"日本体外循環技術医学会ThesisThesis or Dissertation体外循環技術 43巻4号 p.339-345 (2016.12)09122664http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3317体外循環技術, 43(4): 339-345http://hdl.handle.net/10564/3317http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3317/1/01_%e7%94%b2664%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3317/2/02_%e7%94%b2664%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3317/3/03_%e7%94%b2664%e6%9c%ac%e6%96%87.pdf09122664AN1020635X体外循環技術4343393452016-12http://doi.org/10.7130/jject.43.339ETD24601A6642017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33182018-01-11T16:30:09Zhdl_10564_3215Ipragliflozin, a sodium-glucose cotransporter 2 inhibitor, ameliorates the development of liver fibrosis in diabetic Otsuka Long-Evans Tokushima fatty rats.SGLT2阻害薬であるイプラグリフロジンは2型糖尿病自然発症モデルであるOLETFラットにおいて肝線維化進展を抑制する。Nishimura, NorihisaKitade, MitsuteruNoguchi, RyuichiNamisaki, TadashiMoriya, KeiTakeda, KosukeOkura, YasushiAihara, YosukeDouhara, AkitoshiKawaratani, HidetoAsada, KiyoshiYoshiji, HitoshiSGLT2 inhibitorLiver fibrosisInsulin resistanceBACKGROUND: It is widely understood that insulin resistance (IR) critically correlates with the development of liver fibrosis in several types of chronic liver injuries. Several experiments have proved that anti-IR treatment can alleviate liver fibrosis. Sodium-glucose cotransporter 2 (SGLT2) inhibitors comprise a new class of antidiabetic agents that inhibit glucose reabsorption in the renal proximal tubules, improving IR. The aim of this study was to elucidate the effect of an SGLT2 inhibitor on the development of liver fibrosis using obese diabetic Otsuka Long-Evans Tokushima fatty (OLETF) rats and their littermate nondiabetic Long-Evans Tokushima Otsuka (LETO) rats. METHODS: Male OLETF and LETO rats were intraperitoneally injected with porcine serum twice a week for 12 weeks to augment liver fibrogenesis. Different concentrations of ipragliflozin (3 and 6 mg/kg) were orally administered during the experimental period. Serological and histological data were examined at the end of the experimental period. The direct effect of ipragliflozin on the proliferation of a human hepatic stellate cell (HSC) line, LX-2, was also evaluated in vitro. RESULTS: OLETF rats, but not LETO rats, received 12 weeks of porcine serum injection to induce severe fibrosis. Treatment with ipragliflozin markedly attenuated the development of liver fibrosis and expression of hepatic fibrosis markers, such as alpha smooth muscle actin, collagen 1A1, and transforming growth factor beta (TGF-β), and improved IR in a dose-dependent manner in OLETF rats. In contrast, the proliferation of LX-2 in vitro was not affected, suggesting that ipragliflozin had no significant direct effect on the proliferation of HSCs. CONCLUSION: In conclusion, our dataset suggests that an SGLT2 inhibitor could alleviate the development of liver fibrosis by improving IR in naturally diabetic rats. This may provide the basis for creating new therapeutic strategies for chronic liver injuries with IR.博士(医学)・甲第665号・平成29年3月15日© Japanese Society of Gastroenterology 2016The final publication is available at Springer via http://dx.doi.org/10.1007/s00535-016-1200-6.SpringerThesisThesis or DissertationJournal of gastroenterology Vol.51 No.12 p.1141-1149 (2016 Dec)09441174http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3318Journal of gastroenterology, 51(12): 1141-1149http://hdl.handle.net/10564/3318http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3318/1/01_%e7%94%b2664%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3318/2/02_%e7%94%b2665%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3318/10/03%e7%94%b2665%e6%9c%ac%e6%96%87.pdf09441174AA10988015Journal of gastroenterology5112114111492016-12enghttp://www.ncbi.nlm.nih.gov/pubmed/27025708http://dx.doi.org/10.1007/s00535-016-1200-6none24601A6652017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33192017-06-23T08:26:07Zhdl_10564_3215Higher Cognitive Function in Elderly Individuals with Previous Cataract Surgery: Cross-Sectional Association Independent of Visual Acuity in the HEIJO-KYO Cohort.白内障手術既往のある高齢者は視力と独立して高い認知機能を維持する : 平城京コホート研究横断解析Miyata, KimieObayashi, KenjiSaeki, KeigoTone, NobuhiroTanaka, KunihikoNishi, TomoMorikawa, MasayukiKurumatani, NorioOgata, NahokoCataract surgery improves visual acuity and drastically increases the capacity for light reception to the retina. Although previous studies suggested that both light exposure and visual acuity were associated with cognitive function, the relationships between cataract surgery, visual acuity, and cognitive function have not been evaluated in large populations. In this cross-sectional study, we measured cognitive function using the Mini-Mental State Examination and best-corrected visual acuity in pseudophakic (previous cataract surgery) and phakic (no previous cataract surgery) elderly individuals. Of 945 participants (mean age 71.7 years), 166 (17.6%) had pseudophakia and 317 (33.5%) had impaired cognitive function (score ≤26). The pseudophakic group showed significantly better visual acuity than the phakic group (p = 0.003) and lower age-adjusted odds ratio (ORs) for cognitive impairment (OR 0.66; p = 0.038). Consistently, in multivariate logistic regression models, after adjusting for confounding factors, including visual acuity and socioeconomic status, ORs for cognitive impairment were significantly lower in the pseudophakic group than in the phakic group (OR 0.64; 95% confidence interval 0.43-0.96; p = 0.031). This association remained significant in sensitivity analysis, excluding participants with low cognitive score ≤23 (n = 36). In conclusion, in a general elderly population, prevalence of cognitive impairment was significantly lower in pseudophakic individuals independently of visual acuity. The association was also independent of several major causes of cognitive impairment such as aging, gender, obesity, socioeconomic status, hypertension, diabetes, sleep disturbances, depressive symptoms, and physical inactivity.博士(医学)・甲第666号・平成29年3月15日© Mary Ann Liebert, Inc.This is a non-final version of an article published in final form in "http://dx.doi.org/10.1089/rej.2015.1718"Mary Ann Liebert Inc.ThesisThesis or DissertationRejuvenation research Vol.19 No.3 p.239-243 (2016 Jun)15491684http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3319Rejuvenation research, 19(3): 239-243http://hdl.handle.net/10564/3319http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3319/1/01_%e7%94%b2666%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3319/2/02_%e7%94%b2666%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3319/10/03%20%e7%94%b2666%e6%9c%ac%e6%96%87.pdf15491684AA11965693Rejuvenation research1932392432016-06enghttp://www.ncbi.nlm.nih.gov/pubmed/26414122http://dx.doi.org/10.1089/rej.2015.1718ETD24601A6662017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33202018-02-28T16:30:09Zhdl_10564_3215Tumor-inhibition effect of levetiracetam in combination with temozolomide in glioblastoma cells.膠芽腫細胞株におけるテモゾロミド併用によるレベチラセタムの抗腫瘍効果Marutani, AkikoNakamura, MitsutoshiNishimura, FumihikoNakazawa, TsutomuMatsuda, RyosukeHironaka, YasuoNakagawa, IchiroTamura, KentaroTakeshima, YasuhiroMotoyama, YasushiBoku, EishuOuji, YukiteruYoshikawa, MasahideNakase, Hiroyukitemozolomidelevetiracetampremature senescenceglioblastomaGlioblastoma (GBM) is a malignant brain tumor with a poor prognosis. The standard postoperative chemotherapy is temozolomide (TMZ), which does not greatly improve survival. The DNA repair gene O-6-methylguanine-DNA methyltransferase (MGMT) contributes to the response of TMZ-induced DNA damage. The commonly prescribed antiepileptic drug levetiracetam (LEV) has been shown to enhance TMZ’s antitumor effect via inhibition of histone deacetylases (HDACs), but the therapeutic advantages of the LEV and TMZ combination remain poorly understood. Mechanisms of response to chemotherapy include apoptosis and mitotic catastrophe, and recent studies have suggested that premature senescence may also be invoked when cancer cells are exposed to therapeutic agents. In our study, we evaluated cell proliferation and premature senescence after single and combined treatments of TMZ and LEV in two GBM cell lines that differ in TMZ sensitivity caused by the absence (A172) or presence (T98) of the MGMT protein. Both LEV and TMZ reduced cell proliferation in a dose-dependent manner in A172 cells. A senescent-like phenotype, as determined by β-galactosidase activity, was induced by both TMZ and LEV. Overall, there was a greater effect following combined treatment compared to the monotherapy groups. Thus, LEV appears to have a tumor-suppressive effect and induces cellular senescence, and combined treatment of LEV and TMZ enhanced these effects. because LEV treatment results in few adverse effects, its use in GBM treatment may allow for reduction of the TMZ dose to enhance the clinical efficacy of TMZ chemotherapy and improve quality of life.博士(医学)・甲第667号・平成29年3月15日© Pleiades Publishing, Ltd. 2017The final publication is available at Springer via http://dx.doi.org/10.1134/S1819712416040073SpringerThesisThesis or DissertationNeurochemical Journal Vol.11 No.1 p.43-49 (2017 Jan)18197124http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3320Neurochemical Journal, 11(1): 43-49http://hdl.handle.net/10564/3320http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3320/1/01_%e7%94%b2667%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3320/2/02_%e7%94%b2667%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3320/10/03%20%e7%94%b2667%e6%9c%ac%e6%96%87.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3320/11/04%20%e7%94%b2667Figures01-03.pdf18197124Neurochemical Journal11143492017-01enghttp://dx.doi.org/10.1134/S1819712416040073ETD24601A6672017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33212017-06-11T23:20:26Zhdl_10564_3215Maxillofacial bone regeneration with osteogenic matrix cell sheets: An experimental study in rats.骨形成シートによる顎顔面の再生 : ラットにおける実験研究Ueyama, YoshihiroYagyuu, TakahiroMaeda, MasahikoImada, MitsuhikoAkahane, ManabuKawate, KenjiTanaka, YasuhitoKirita, TadaakiBone regenerationMandibular defectBone marrow-derived stromal cellsCell sheetOBJECTIVE: Regeneration of maxillofacial bone defects, characterized by relatively small but complicated shapes, poses a significant clinical challenge. Osteogenic matrix cell sheets (OMCSs) have osteogenic ability and good shaping properties and may be ideal graft materials. Here, we assessed whether implantation of OMCSs could be used to repair maxillofacial bone defects. DESIGN: We adopted a rat mandibular symphysis model. The rat mandible is formed by a paired bone and the central portion consisting of fibrous tissue. There is no bone tissue at the site; accordingly, this site was interpreted as a physiological bone gap and was used for evaluation. Rat bone marrow cells were cultured in medium containing dexamethasone and ascorbic acid phosphate to create OMCSs. The OMCSs were implanted into the rat mandibular symphysis without a scaffold. Microcomputed tomography and histological analyses were conducted after 2, 4, and 8 weeks. RESULTS: Two weeks after implantation, microcomputed tomography images and histological sections showed some sparse granular calcification tissue within the bone gap at the mandibular symphysis. At 4 weeks, the calcification tissue spread, and the gap of the mandibles were continued. At 8 weeks, this continuous new bone tissue was matured. The experimental group showed abundant new bone tissue in the group with OMCS implantation, but not in the group with sham implantation. CONCLUSIONS: Our present results indicated that use of OMCSs may be an optimal approach towards achieving maxillofacial regeneration.博士(医学)・甲第668号・平成29年3月15日Copyright © 2016 Elsevier Ltd. All rights reserved.ElsevierThesisThesis or DissertationArchives of oral biology Vol.72 p.138-145 (2016 Dec)00039969http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3321Archives of oral biology Vol. p., 72: 138-145http://hdl.handle.net/10564/3321http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3321/1/01_%e7%94%b2668%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3321/2/02_%e7%94%b2668%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3321/3/03_%e7%94%b2668%e6%9c%ac%e6%96%87.pdf00039969AA00548457Archives of oral biology Vol. p.721381452016-12enghttp://www.ncbi.nlm.nih.gov/pubmed/27597533http://dx.doi.org/10.1016/j.archoralbio.2016.08.017ETD24601A6682017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33222017-06-11T23:20:26Zhdl_10564_3215Linkage of Lower Urinary Tract Symptoms to Sleep Quality in Elderly Men with Nocturia: A Community Based Study Using Home Measured Electroencephalogram Data.高齢者における睡眠の質と夜間頻尿関連 : 在宅脳波データを用いた地域密着研究Matsushita, ChieTorimoto, KazumasaGoto, DaisukeMorizawa, YosukeKiba, KeisukeShinohara, MasatakeHirayama, AkihideKurumatani, NorioFujimoto, Kiyohidesleepnocturialower urinary tract symptomsPURPOSE: We objectively investigated the relationship between sleep quality/efficiency and factors associated with micturition using at-home electroencephalogram assessment. MATERIALS AND METHODS: Participants were recruited from among those enrolled in the Fujiwara-kyo Study, a community based longitudinal evaluation that began in Nara Prefecture, Japan, in 2007. Included participants were men at least 65 years old who woke up in the middle of the night/early morning at least 3 times per week with the urge to void. We evaluated lower urinary tract symptoms using the I-PSS and subjective sleep quality using the Pittsburgh Sleep Quality Index. Uroflowmetry and 3-day frequency volume charting measurements were also obtained. Electroencephalogram recordings were obtained during sleep to evaluate objective sleep quality. RESULTS: Final analysis included data from 47 participants. I-PSS-quality of life score and slow wave sleep time were independent predictors of good subjective sleep quality as determined by Pittsburgh Sleep Quality Index scores. Nocturnal urinary volume was an independent predictor of greater sleep efficiency. Maximum flow rate was an independent predictor of longer slow wave sleep time. CONCLUSIONS: In elderly men with nocturia, sleep quality is associated with lower urinary tract function. Higher subjective sleep quality is associated with longer slow wave sleep time and less severe lower urinary tract symptoms. Higher objective sleep quality is further associated with a higher urinary flow rate and lower nocturnal urinary volume.博士(医学)・甲第669号・平成29年3月15日Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.ElsevierThesisThesis or DissertationThe Journal of urology Vol.197 No.1 p.204-209 (2017 Jan)00225347http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3322The Journal of urology, 197(1): 204-209http://hdl.handle.net/10564/3322http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3322/1/01_%e7%94%b2669%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3322/2/02_%e7%94%b2669%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3322/3/03_%e7%94%b2669%e6%9c%ac%e6%96%87.pdf00225347AA00708666The Journal of urology19712042092017-01enghttp://www.ncbi.nlm.nih.gov/pubmed/27506695http://dx.doi.org/10.1016/j.juro.2016.07.088ETD24601A6692017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33232022-08-24T01:51:51Zhdl_10564_3215Japanese Consumer Perceptions of Genetically Modified Food: Findings From an International Comparative Study.遺伝子組み換え食品に関する日本の消費者意識に関する国際比較Komoto, KeikoOkamoto, SawakoHamada, MikiObana, NaoyaSamori, MamiImamura, Tomoakigenetically modified foodJapanperceptionhealthriskBACKGROUND: Reports of food-related incidents, such as cows infected with bovine spongiform encephalopathy (2001) and the Fukushima nuclear accident (2011), engendered significant fear among Japanese consumers and led to multiple farmer suicides, even when no actual health damage occurred. The growing availability of genetically modified (GM) food is occurring against this backdrop of concern about food safety. Consumers need information to assess risk and make informed purchasing decisions. However, we lack a clear picture of Japanese consumer perceptions of GM food. OBJECTIVE: This study aims to understand Japanese consumer perceptions of GM food for risk communication. Consumer perceptions of GM food were compared among 4 nations. METHODS: A Web-based survey was conducted in Japan, the United States, the United Kingdom, and France. Participants were asked about demographics, fear of health hazards, resistance to GM and breeding-improved products, perception of GM technology and products, and willingness to pay. Multiple linear regression analyses were conducted, as were t tests on dichotomous variables, and 1-way analysis of variance and post hoc tests. RESULTS: Of 1812 individuals who agreed to participate, 1705 (94%) responded: 457 from Japan and 416 each from France, the United States, and the United Kingdom. The male/female and age group ratios were all about even. Some resistance to GM food was seen in all countries in this study. France showed the strongest resistance (P<.001), followed by Japan, which had stronger resistance than the United States and the United Kingdom (P<.001). Overall, females, people in their 60s and older, and those without higher education showed the greatest resistance to GM food. Japan showed stronger fear of food hazards than other nations (P<.001, odds ratio=2.408, CI: 1.614-3.594); Japanese and French respondents showed the strongest fear of hazards from GM food (P<.001). Regarding perceptions of GM technology and products, consumers in nations other than Japan would accept GM food if it were appropriately explained, they were provided with scientific data supporting its safety, and they understood that all food carries some risk. However, Japanese consumers tended to accept GM technology but rejected its application to food (P<.001). Of those willing to purchase GM food, consumers in Japan required a discount of 30% compared with about 20% in other nations. CONCLUSION: All consumers in our study showed resistance to GM food. Although no health hazards are known, respondents in Japan and France strongly recognized GM food as a health risk. Price discounts of 30% and GM technology may be communication cues to start discussions about GM food among Japanese consumers. Although education-only risk communication generally is not effective, such an approach may work in Japan to help consumers better understand GM technology and, eventually, GM food. The gap between accepting GM technology and rejecting its application to food should be explored further.博士(医学)・乙第1390号・平成29年3月15日Copyright © Keiko Komoto, Sawako Okamoto, Miki Hamada, Naoya Obana, Mami Samori, Tomoaki Imamura. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 29.08.2016. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Interactive Journal of Medical Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.i-jmr.org/, as well as this copyright and license information must be included.JMIR PublicationsThesisThesis or DissertationInteractive journal of medical research Vol.5 No.3 Article No.e23 (2016 Jul-Sep)1929073Xhttp://ginmu.naramed-u.ac.jp/dspace/handle/10564/3323Interactive journal of medical research, 5(3): Article No.e23http://hdl.handle.net/10564/3323http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3323/1/01_%e4%b9%991390%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3323/2/02_%e4%b9%991390%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3323/3/03_%e4%b9%991390%e6%9c%ac%e6%96%87.pdf1929073XInteractive journal of medical research53Article No.e232016-08enghttp://www.ncbi.nlm.nih.gov/pubmed/27573588http://dx.doi.org/10.2196/ijmr.5850ETD24601B13902017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33242018-03-07T16:30:10Zhdl_10564_3215Variability of breathing during wakefulness while using CPAP predicts adherence.CPAPアドヒランスの予測因子としてのCPAP装着下覚醒時の呼吸不規則性Fujita, YukioYamauchi, MotooUyama, HirokiKumamoto, MakikoKoyama, NorikoYoshikawa, MasanoriStrohl, Kingman P.Kimura, Hiroshibreathing regularitycontinuous positive airway pressure adherenceobstructive sleep apnoea syndromepredictive markerrespiratory physiologyBACKGROUND AND OBJECTIVE: The standard therapy for obstructive sleep apnoea (OSA) is continuous positive airway pressure (CPAP) therapy. However, long-term adherence remains at ~50% despite improvements in behavioural and educational interventions. Based on prior work, we explored whether regularity of breathing during wakefulness might be a physiologic predictor of CPAP adherence. METHODS: Of the 117 consecutive patients who were diagnosed with OSA and prescribed CPAP, 79 CPAP naïve patients were enrolled in this prospective study. During CPAP initiation, respiratory signals were collected using respiratory inductance plethysmography while wearing CPAP during wakefulness in a seated position. Breathing regularity was assessed by the coefficient of variation (CV) for breath-by-breath estimated tidal volume (VT ) and total duration of respiratory cycle (Ttot). In a derivation group (n = 36), we determined the cut-off CV value which predicted poor CPAP adherence at the first month of therapy, and verified the validity of this predetermined cut-off value in the remaining participants (validation group; n = 43). RESULTS: In the derivation group, the CV for estimated VT was significantly higher in patients with poor adherence than with good adherence (median (interquartile range): 44.2 (33.4-57.4) vs 26.0 (20.4-33.2), P < 0.001). The CV cut-off value for estimated VT for poor CPAP adherence was 34.0, according to a receiver-operating characteristic (ROC) curve. In the validation group, the CV value for estimated VT >34.0 confirmed to be predicting poor CPAP adherence (sensitivity, 0.78; specificity, 0.83). CONCLUSION: At the initiation of therapy, breathing regularity during wakefulness while wearing CPAP is an objective predictor of short-term CPAP adherence.博士(医学)・乙第1391号・平成29年3月15日© 2016 Asian Pacific Society of RespirologyThis is the peer reviewed version of the following article: Respirology Vol.22 No.2 p.386-393 (2017 Feb), which has been published in final form at http://dx.doi.org/10.1111/resp.12900. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.John Wiley & Sons, Inc.ThesisThesis or DissertationRespirology Vol.22 No.2 p.386-393 (2017 Feb)13237799http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3324Respirology, 22(2): 386-393http://hdl.handle.net/10564/3324http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3324/1/01_%e4%b9%991391%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3324/2/02_%e4%b9%991391%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3324/10/03%20%e4%b9%991391%e6%9c%ac%e6%96%87.pdf13237799AA11097269Respirology2223863932017-02-22enghttp://www.ncbi.nlm.nih.gov/pubmed/27623518http://dx.doi.org/10.1111/resp.12900ETD24601B13912017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33252022-08-24T01:57:32Zhdl_10564_3215Characteristics of Risk-Factor Profiles Associated with Stroke in Patients with Myotonic Dystrophy Type 1.筋強直性ジストロフィー1型における脳卒中に関する危険因子の臨床的特徴Sugie, MihoSugie, KazumaEura, NobuyukiIwasa, NaokiShiota, TomoNanaura, HitokiIzumi, TessekiUeno, SatoshiMyotonic dystrophyMuscular dystrophyMyopathyStrokeArrhythmiasAtrial fibrillationDyslipidemiaObjective: Myotonic dystrophy type 1 (DM1) is a rare autosomal dominant disorder with highly variable phenotypic expression. Some patients have diabetes mellitus, dyslipidemia, and/or arrhythmias, which are risk factors for stroke. However, the mechanism of stroke is poorly understood in patients with DM1. We studied the characteristics of risk-factor profiles for stroke associated with DM1. Patients and methods: We studied 77 patients with DM1 (45 men and 32 women) on the basis of the patients’ clinical histories and laboratory and genetic examination results. Results: The analysis showed that 26 patients (34%) had dyslipidemia, and 16 (21%) had diabetes. Arrhythmias were diagnosed in 46 patients (61%), including 11 (14%) with atrial fibrillation and 9 (12%) with conduction defects. Echocardiographic abnormalities were found in 28 patients (37%). Eight patients (11%) met the criteria for metabolic syndrome. We identified 2 patients (2.6%) with ischemic stroke caused by cardiogenic embolism among 77 patients with DM1. One had paroxysmal atrial fibrillation and sick sinus syndrome, and the other had cardiac dysfunction with an ejection-fraction of 35% and dyslipidemia. Both patients had highly expanded numbers of CTG repeats (1000 and 1500). Conclusion: To our knowledge, this is the first study to report a comprehensive analysis of risk-factor profiles for stroke in patients with DM1. Stroke is a relatively rare, but severe complication of DM1. Our results indicate that it is important to manage risk factors for stroke, especially cardiac involvement and arrhythmias.博士(医学)・乙第1392号・平成29年3月15日Copyright: © 2016 Sugie M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.iMed Pub.ThesisThesis or DissertationJournal of Rare Disorders : Diagnosis & Therapy Vol.2 No.4 Article No.19 (2016)23807245http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3325Journal of Rare Disorders : Diagnosis & Therapy, 2(4): Article No.19http://hdl.handle.net/10564/3325http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3325/1/01_%e4%b9%991392%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3325/2/02_%e4%b9%991392%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3325/3/03_%e4%b9%991392%e6%9c%ac%e6%96%87.pdf23807245Journal of Rare Disorders : Diagnosis & Therapy24Article No.192016enghttp://dx.doi.org/10.21767/2380-7245.100048ETD24601B13922017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33262017-06-11T23:20:26Zhdl_10564_3215Impact of Smoking on Pancreatic Cancer Patients Receiving Current Chemotherapy.化学療法を施行した膵癌患者に対する喫煙の影響Kawaguchi, ChihiroSho, MasayukiTanaka, ToshihiroAkahori, TakahiroKinoshita, ShoichiNagai, MinakoYasuda, SatoshiNishiwada, SatoshiNishiofuku, HideyukiKichikawa, KimihikoNakajima, Yoshiyukichemotherapypancreatic cancerprognosissmokingsurgeryOBJECTIVE: Smoking may affect pharmacokinetics of chemotherapeutic agents and hemodynamics of the smokers, thereby influencing adverse events and efficacy of chemotherapy in patients with pancreatic cancer (PC). The aim of this study was to clarify how smoking totally affected patients with PC receiving current chemotherapy. METHODS: We evaluated the impact of smoking status on the performance of chemotherapy and survival in 262 patients with PC including 158 resectable and 104 unresectable PC. RESULTS: There were more male and younger patients in current smokers than in nonsmokers. In unresectable PC, current smokers had more metastatic tumors than locally advanced tumors compared with nonsmokers. In current smokers receiving chemotherapy, the baseline white blood cell count, neutrophil count, and hemoglobin concentration were significantly higher in current smokers than in nonsmokers. Furthermore, grades 3 to 4 neutropenia was observed more often in nonsmokers than smokers. On the other hand, the performance and efficacy of the planned adjuvant chemotherapy were similar between smokers and nonsmokers. More importantly, there was no significant difference in overall prognosis between smokers and nonsmokers receiving chemotherapy. CONCLUSIONS: Smoking status has no significant impact on the efficacy of current chemotherapy for both resectable and unresectable PC.博士(医学)・乙第1393号・平成29年3月15日Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.This is a non-final version of an article published in final form in "http://dx.doi.org/10.1097/MPA.0000000000000395"Wolters Kluwer Health, Inc.ThesisThesis or DissertationPancreas Vol.44 No.7 p.1155-1160 (2015 Oct)08853177http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3326Pancreas, 44(7): 1155-1160http://hdl.handle.net/10564/3326http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3326/1/01_%e4%b9%991393%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3326/2/02_%e4%b9%991393%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3326/3/03_%e4%b9%991393%e6%9c%ac%e6%96%87.pdf08853177AA10674276Pancreas447115511602015-10enghttp://www.ncbi.nlm.nih.gov/pubmed/26355552http://dx.doi.org/10.1097/MPA.0000000000000395ETD24601B13932017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33272017-06-11T23:20:26Zhdl_10564_3215Impact of preoperative asymptomatic renal dysfunction on clinical course after pancreatoduodenectomy.無症候性腎機能障害が膵頭十二指腸切除術後臨床経過に及ぼす影響Nagai, MinakoSho, MasayukiAkahori, TakahiroTanaka, ToshihiroKinoshita, ShoichiNishiofuku, HideyukiNishiwada, SatoshiOhbayashi, ChihoKichikawa, KimihikoNakajima, YoshiyukiPancreatoduodenectomyPostoperative complicationPrognosisRenal dysfunctionSurgeryBACKGROUND: Although recent large-scale clinical studies have shown that preoperative renal insufficiency is associated with increased risk of postoperative complications after pancreatoduodenectomy (PD), it is unknown whether asymptomatic renal dysfunction has an impact on postoperative course after PD. METHODS: Two hundred and fifty-four patients who underwent PD between 2007 and 2013 were enrolled. Renal function was evaluated by the preoperative estimated glomerular filtration rate (eGFR). Patients were divided into two groups according to the cutoff value of 55 of eGFR. RESULTS: Thirty-five patients were classified as the low eGFR group, while 219 were classified as the normal group. There were differences between groups in age, comorbidity and pancreatic texture. The incidence of overall postoperative complication, grade B/C pancreatic fistula and severe complication in the low eGFR group was significantly higher than that in the normal group. Multivariate analysis identified low eGFR as an independent risk factor for severe postoperative complications and grade B/C pancreatic fistula after PD. However, there were no differences in mortality and survival between the low and normal eGFR groups. CONCLUSIONS: We have demonstrated for the first time that preoperative asymptomatic renal dysfunction may be a significant risk factor for severe morbidity and clinically relevant pancreatic fistula after PD.博士(医学)・乙第1394号・平成29年3月15日© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.This is the peer reviewed version of the following article: http://dx.doi.org/10.1002/jhbp.286, which has been published in final form at http://dx.doi.org/10.1002/jhbp.286. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.John Wiley & Sons, Inc.ThesisThesis or DissertationJournal of hepato-biliary-pancreatic sciences Vol.22 No.11 p.810-818 (2015 Nov)18686974http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3327Journal of hepato-biliary-pancreatic sciences, 22(11): 810-818http://hdl.handle.net/10564/3327http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3327/1/01_%e4%b9%991394%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3327/2/02_%e4%b9%991394%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3327/3/03_%e4%b9%991394%e6%9c%ac%e6%96%87.pdf18686974AA12507209Journal of hepato-biliary-pancreatic sciences22118108182015-11enghttp://www.ncbi.nlm.nih.gov/pubmed/26333519http://dx.doi.org/10.1002/jhbp.286ETD24601B13942017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33282017-06-11T23:20:26Zhdl_10564_3215Rapid Restoration of Thrombus Formation and High-Molecular-Weight von Willebrand Factor Multimers in Patients with Severe Aortic Stenosis After Valve Replacement.重度大動脈弁狭窄症患者の大動脈弁置換術後における血小板機能および高分子量 von Willebrand 因子多量体の急速な回復Yamashita, KeigoYagi, HideoHayakawa, MasakiAbe, TakehisaHayata, YoshihiroYamaguchi, NaokoSugimoto, MitsuhikoFujimura, YoshihiroMatsumoto, MasanoriTaniguchi, ShigekiAortic valve stenosisAcquired von Willebrand syndromeThrombus formationADAMTS13AIM: Patients with severe aortic stenosis (AS) may have bleeding episodes due to the loss of high-molecular-weight (HMW) von Willebrand factor multimers (VWFMs). The absence of HMW-VWFMs and bleeding tendency are usually corrected after aortic valve replacement (AVR). To investigate the process of VWFM recovery and symptoms in patients with severe AS, we analyzed changes in VWF antigen (VWF:Ag), ADAMTS13 activity (ADAMTS13:AC), and platelet thrombus formation under high shear stress conditions. METHODS: Nine patients with severe AS undergoing AVR were analyzed. RESULTS: Evident deficiency of HMW-VWFMs was observed in six patients before surgery, which was rapidly restored within 8 days after AVR. Median levels of VWF:Ag before surgery, on postoperative days (PODs) 1, 8, 15, and 22, and one year after AVR were 78.1%, 130%, 224%, 155%, 134%, and 142%, respectively. In contrast, ADAMTS13:AC was 50.5%, 35.5%, 25.5%, 25.1%, 30.3%, and 84.6%, respectively. Preoperative thrombus formation but not surface coverage was significantly lower than that on POD 22, which was considered as normal level in each patient. Compared with preoperative levels, thrombus volume was significantly lower on POD 1, but rapidly increased by POD 8. CONCLUSION: Bleeding tendency and loss of HMW-VWFMs observed in patients with severe AS before surgery was rapidly corrected after AVR. Instead, patients were in a VWF-predominant state between POD 8 and 22.博士(医学)・乙第1395号・平成29年3月15日Copyright © 2016 Japan Atherosclerosis Society本論文の著作権は日本動脈硬化学会が保持しています。This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.日本動脈硬化学会ThesisThesis or DissertationJournal of atherosclerosis and thrombosis Vol.23 No.10 p.1150-1158 (2016 Oct)13403478http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3328Journal of atherosclerosis and thrombosis, 23(10): 1150-1158http://hdl.handle.net/10564/3328http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3328/1/01_%e4%b9%991395%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3328/2/02_%e4%b9%991395%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3328/3/03_%e4%b9%991395%e6%9c%ac%e6%96%87.pdf13403478AA11018976Journal of atherosclerosis and thrombosis2310115011582016-10-01enghttp://www.ncbi.nlm.nih.gov/pubmed/27052664http://doi.org/10.5551/jat.34421ETD24601B13952017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33292017-06-11T23:20:26Zhdl_10564_3215Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study.高齢者における視機能と認知機能障害の関連 : 藤原京アイスタディよりMine, MasashiMiyata, KimieMorikawa, MasayukiNishi, TomoOkamoto, NozomiKawasaki, RyoYamashita, HidetoshiKurumatani, NorioOgata, NahokoagingneuroscienceregenerationBoth visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA) >0.2 logarithm of the minimum angle of resolution (logMAR) units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE) score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation). The mean BCVA of the better eye was -0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = -0.10, p < 0.0001). Subjects with mild visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5-3.8, p < 0.001) after adjusting for age, sex, and length of education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment.博士(医学)・乙第1396号・平成29年3月15日© Masashi Mine et al. 2016; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly credited.Mary Ann Liebert, Inc.ThesisThesis or DissertationBioResearch open access Vol.5 No.1 p.228-234 (2016 Aug)21647860http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3329BioResearch open access, 5(1): 228-234http://hdl.handle.net/10564/3329http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3329/1/01_%e4%b9%991396%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3329/2/02_%e4%b9%991396%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3329/3/03_%e4%b9%991396%e6%9c%ac%e6%96%87.pdf21647860BioResearch open access512282342016-08-01enghttp://www.ncbi.nlm.nih.gov/pubmed/27610269http://dx.doi.org/10.1089/biores.2016.0023ETD24601B13962017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33302018-03-07T16:30:09Zhdl_10564_3215Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial.肺外科手術における術後早期の高次脳機能および術中脳酸素需給バランスに対する麻酔薬の効果 : ランダム化比較試験Egawa, JunjiInoue, SatokiNishiwada, TadashiTojo, TakashiKimura, MichitakaKawaguchi, TakeshiTaniguchi, ShigekiFuruya, HitoshiKawaguchi, MasahikoPURPOSE: One-lung ventilation (OLV) may impair cerebral oxygen balance and induce postoperative cognitive dysfunction (POCD). It is unclear whether the type of anesthetic influences the incidence of POCD in patients undergoing OLV. This prospective study compared the incidence of POCD and intraoperative cerebral oxygen desaturation in OLV patients anesthetized with propofol vs sevoflurane during lung surgery. METHODS: There were 148 participants enrolled in this study and randomized equally to either the propofol or the sevoflurane group. Anesthesia was maintained with either propofol or sevoflurane combined in both groups with fentanyl and epidural anesthesia. Regional cerebral oxygen saturation (rSO2), jugular bulb venous oxygen saturation (SjO2), and the incidence of cerebral oxygen desaturation (rSO2 or SjO2 < 50% or rSO2 < 80% of baseline) were measured during anesthesia. Cognitive function was assessed using seven neurocognitive tests two days preoperatively, five days postoperatively (primary outcome), and three months postoperatively. Bivariable and multivariable regression analyses were conducted to identify factors associated with POCD. RESULTS: Rates of POCD did not differ statistically between groups five days postoperatively (propofol, 16/72 patients; sevoflurane, 24/72 patients; RR, 0.67; 95% CI, 0.39 to 1.15; P = 0.14) or three months postoperatively (propofol, 9/60 patients; sevoflurane, 12/58 patients; RR, 0.73; 95% CI, 0.33 to 1.59; P = 0.42). Only three subjects per group showed intraoperative cerebral oxygen desaturation. Multivariable regression analysis revealed older age as an independent predictor of POCD. CONCLUSIONS: No statistically significant difference in the incidence of POCD could be detected between the sevoflurane and propofol anesthesia groups. Postoperative cognitive dysfunction was relatively frequent following OLV in both groups. (REGISTRATION NUMBER: UMIN 000002826).博士(医学)・乙第1397号・平成29年3月15日© Canadian Anesthesiologists' Society 2016This is a post-peer-review, pre-copyedit version of an article published in Canadian journal of anaesthesia. The final authenticated version is available online at: http://dx.doi.org/10.1007/s12630-016-0700-4.SpringerThesisThesis or DissertationCanadian journal of anaesthesia Vol.63 p.10 p.1161-1169 (2016 Oct)0832610Xhttp://ginmu.naramed-u.ac.jp/dspace/handle/10564/3330Canadian journal of anaesthesia, 63(10): 1161-1169http://hdl.handle.net/10564/3330http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3330/1/01_%e4%b9%991397%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3330/2/02_%e4%b9%991397%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3330/10/03%20%e4%b9%991397%e6%9c%ac%e6%96%87.pdf0832610XAA1066866XCanadian journal of anaesthesia6310116111692016-10enghttp://www.ncbi.nlm.nih.gov/pubmed/27412465http://dx.doi.org/10.1007/s12630-016-0700-4ETD24601B13972017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33312022-08-24T02:08:02Zhdl_10564_3215Biomechanical analysis of immediately loaded implants according to the "All-on-Four" concept.“All-on-Four”コンセプトに基づいて即時荷重を適用したインプラントの力学解析Horita, SatoshiSugiura, TsutomuYamamoto, KazuhikoMurakami, KazuhiroImai, YuichiroKirita, TadaakiAll-on-Four conceptFinite element analysisImmediate loadingCantilever loadingFramework materialPURPOSE: The purpose of this study was to investigate the biomechanical behavior of immediately loaded implants in an edentulous mandible according to the "All-on-Four" concept. METHODS: A 3D-finite element model of an edentulous mandible was constructed. Four implants were placed between the bilateral mental foramen according to "All-on-Four" concept. A framework made of titanium or acrylic resin between the bilateral first molars was modeled. Immediate loading and a delayed loading protocol were simulated. A vertical load of 200N was applied at the cantilever or on the abutments region of the distal implants, simulating the absence of a cantilever. RESULTS: The peak principal compressive strains in the immediate loading models resulted in 24.0-35.8% and 26.4-39.0% increases compared with the delayed loading models under non-cantilever loading and cantilever loading, respectively. The loading position greatly affected the principal compressive and tensile strain values. The peak principal compressive strains in non-cantilever loading resulted in a 45.3-52.6% reduction compared with those in cantilever loading. The framework material did not influence the peak compressive and tensile strain. The maximum micromotion at the bone-implant interface in the immediate loading models was 7.5-14.4μm. CONCLUSIONS: Mandibular fixed full-arch prostheses without cantilevers may result in a favorable reduction of the peri-implant bone strain during the healing period, compared with cantilevers. The maximum micromotion was within the acceptable limits for uneventful implant osseointegration in the immediate loading models. Framework material did not play an important role in reducing the peri-implant bone strain and micromotion at the bone-implant interface.博士(医学)・乙第1398号・平成29年3月15日Copyright © 2017 The Authors. Published by Elsevier Ltd on behalf of Japan Prosthodontic Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).ElsevierThesisThesis or DissertationJournal of prosthodontic research Vol.61 No.2 p.123-132 (2017 Apr)18831958http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3331Journal of prosthodontic research, 61(2): 123-132http://hdl.handle.net/10564/3331http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3331/1/01_%e4%b9%991398%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3331/2/02_%e4%b9%991398%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3331/13/03_%e4%b9%991398%e6%9c%ac%e6%96%87.pdf18831958AA12395171Journal of prosthodontic research6121231322016-09-05enghttp://www.ncbi.nlm.nih.gov/pubmed/27615425http://dx.doi.org/10.1016/j.jpor.2016.08.002ETD24601B13982017-03-15博士(医学)奈良県立医科大学
oai:ginmu.naramed-u.ac.jp:10564/33322021-05-25T01:48:57Zhdl_10564_3215Keratin 19 as a key molecule in progression of human hepatocellular carcinomas through invasion and angiogenesis.浸潤および血管新生を通しての人肝細胞癌の進行におけるケラチン19分子の役割Takano, MasatoShimada, KeijiFujii, TomomiMorita, KoheiTakeda, MaikoNakajima, YoshiyukiNonomura, AkitakaKonishi, NoboruObayashi, ChihoKeratin 19Hepatocellular carcinomaSenescenceApoptosisAngiogenesisBACKGROUND: Keratin (K) 19-positive hepatocellular carcinoma (HCC) is well known to have a higher malignant potential than K19-negative HCC: However, the molecular mechanisms involved in K19-mediated progression of HCC remain unclear. We attempted to clarify whether K19 directly affects cell survival and invasiveness in association with cellular senescence or epithelial-mesenchymal transition (EMT) in K19-positive HCC. METHODS: K19 expression was analysed in 136 HCC surgical specimens. The relationship of K19 with clinicopathological factors and survival was analysed. Further, the effect of K19 on cell proliferation, invasion, and angiogenesis was examined by silencing K19 in the human HCC cell lines, HepG2, HuH-7, and PLC/PRF/5. Finally, we investigated HCC invasion, proliferation, and angiogenesis using K19-positive HCC specimens. RESULTS: Analysis of HCC surgical specimens revealed that K19-positive HCC exhibited higher invasiveness, metastatic potential, and poorer prognosis. In vitro experiments using the human HCC cell lines revealed that K19 silencing suppressed cell growth by inducting apoptosis or upregulating p16 and p27, resulting in cellular senescence. In addition, transfection with K19 siRNA upregulated E-cadherin gene expression, significantly inhibited the invasive capacity of the cells, downregulated angiogenesis-related molecules such as vasohibin-1 (VASH1) and fibroblast growth factor 1 (FGFR1), and upregulated vasohibin-2 (VASH2). K19-positive HCC specimens exhibited a high MIB-1 labelling index, decreased E-cadherin expression, and high microvessel density around cancer foci. CONCLUSION: K19 directly promotes cancer cell survival, invasion, and angiogenesis, resulting in HCC progression and poor clinical outcome. K19 may therefore be a novel drug target for the treatment of K19-positive HCC.博士(医学)・乙第1399号・平成29年3月15日© The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BioMed CentralThesisThesis or DissertationBMC cancer Vol.16 No.1 Article No.903 (2016 Nov)14712407http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3332BMC cancer, 16(1): Article No.903http://hdl.handle.net/10564/3332http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3332/1/01_%e4%b9%991399%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3332/2/02_%e4%b9%991399%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdfhttp://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3332/3/03_%e4%b9%991399%e6%9c%ac%e6%96%87.pdf14712407AA12034763BMC cancer161Article No.9032016-11-18enghttp://www.ncbi.nlm.nih.gov/pubmed/27863477http://dx.doi.org/10.1186/s12885-016-2949-yETD24601B13992017-03-15博士(医学)奈良県立医科大学