Osaka city medical journal最新文献

{"title":"Anxiety in children with high-functioning pervasive developmental disorder.","authors":"Yuta Nakai,&nbsp;Dai Miyawaki,&nbsp;Hiroto Kusaka,&nbsp;Hiroaki Okamoto,&nbsp;Eri Futoo,&nbsp;Ayako Goto,&nbsp;Yu Okada,&nbsp;Nobuo Kiriike,&nbsp;Koki Inoue","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Anxiety symptoms in children with pervasive developmental disorder (PDD) often appear to be not as severe as those in children with anxiety disorders or often appear to be the core features of PDD, and therefore, they do not meet the diagnostic criteria for anxiety disorders. In this study, we assessed anxiety broadly in line with dimensions of anxiety and not with an operational categorical diagnosis. The objective of this study was to reveal that children with high-functioning PDD have more anxiety than children in the general population.</p><p><strong>Methods: </strong>Forty-six children with high-functioning PDD (6-15 years old) were assessed for total anxiety and six subcategories of anxiety, including separation anxiety, generalized anxiety, social phobia, panic/agoraphobia, physical injury fears, and obsessive-compulsiveness. Anxiety in children with high-functioning PDD was compared to that in children of the general population and to that in children with anxiety disorders in a previous study.</p><p><strong>Results: </strong>Children with high-functioning PDD had significantly more symptoms of total anxiety and all subcategories of anxiety except for social phobias than children in the general population, and had significantly fewer symptoms of total anxiety, separation anxiety, generalized anxiety, and social phobias than children with anxiety disorders.</p><p><strong>Conclusions: </strong>As anxiety in children with high-functioning PDD does not always meet diagnostic criteria for an anxiety disorder, psychiatrists must pay much attention to anxiety and not only depend on diagnostic criteria in order to not miss the chance of treating these children.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"59 1","pages":"23-34"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31626150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skeletal-related events in advanced lung adenocarcinoma patients evaluated EGFR mutations.","authors":"Misato Nagata,&nbsp;Shinzoh Kudoh,&nbsp;Shigeki Mitsuoka,&nbsp;Tomohiro Suzumura,&nbsp;Kanako Umekawa,&nbsp;Hidenori Tanaka,&nbsp;Kuniomi Matsuura,&nbsp;Tatsuo Kimura,&nbsp;Naruo Yoshimura,&nbsp;Kazuto Hirata","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The rate of lung cancer metastasis to the bone is high and skeletal-related events (SREs) decrease the quality of life in many patients. Recently, it was found that a subgroup of patients with non-small cell lung cancer (NSCLC) have specific mutations in the EGFR (epidermal growth factor receptor) gene. We assessed the SREs in advanced lung adenocarcinoma patients that evaluated EGFR mutations in whom bone metastasis was present.</p><p><strong>Methods: </strong>We retrospectively investigated the clinical records of 377 patients with advanced NSCLC. Patients were evaluated for the presence of EGFR mutations, bone metastases, the incidence of SREs, and treatment history before the first SRE.</p><p><strong>Results: </strong>A total of 78 patients who were evaluated for EGFR mutations had bone metastasis from lung adenocarcinoma. The most frequent site of bone metastasis was the spine (36.2%). SREs occurred in 37 patients (47.4%), the most common of which was bone radiotherapy (41.0%). Significant differences were not observed in the sites of bone metastases or the patterns of SREs between patients with and without EGFR mutations. The median time from bone metastasis to the first SRE was 5.8 months in all of the subjects, history of EGFR-tyrosine kinase inhibitor (TKI) treatment was significantly associated with longer median time to first SRE (14.2 months vs 1.3 months, p < 0.0001), and the median time to first SRE of patients with PS 0-1 was longer (8.5 months vs 0.9 months, p = 0.0023).</p><p><strong>Conclusions: </strong>We found that SRE patterns have no difference between EGFR mutation positive and negative, and that the time from bone metastasis to the first SRE was longer in advanced lung adenocarcinoma patients with good PS and history of EGFR-TKI treatment.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"59 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31626152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological significance of combined analysis of cytokeratin19 expression and preoperative serum CYFRA21-1 levels in human lung squamous cell carcinoma.","authors":"Shoji Hanada,&nbsp;Noritoshi Nishiyama,&nbsp;Shinjiro Mizuguchi,&nbsp;Shotaro Yamano,&nbsp;Anna Kakehashi,&nbsp;Min Wei,&nbsp;Hidetoshi Inoue,&nbsp;Hiroaki Komatsu,&nbsp;Kyukwang Chung,&nbsp;Shigefumi Suehiro,&nbsp;Hideki Wanibuchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>To identify a useful biomarker for human lung squamous cell carcinoma (SCC), the expression of cytokeratin19 (CK19) in human SCC tissue was investigated. In addition, we examined the significance of CK19 expression levels by immunostaining and CYFRA21-1 levels in preoperative serum, and their correlation with the clinicopathologic features of human lung SCC.</p><p><strong>Methods: </strong>To identify proteins in cancerous and non-cancerous tissues for the diagnosis and prognosis of SCC, QSTAR Elite LC-MS/MS was used. Immunostaining for CK19 was classified as either \"CK19-strong\" or \"CK19-weak\". Correlations between prognosis and both CK19 expression in tumor tissues and serum concentrations of CYFRA 21-1 were analyzed in 107 cases of lung SCC.</p><p><strong>Results: </strong>The upregulation of CK19 in human squamous cell carcinoma tissues was observed by LCMS/MS. The weak expression of CK19, as determined by immunostaining intensity, was a significant predictor of poorer disease-specific survival (p = 0.032). The prognosis was significantly poorer for patients with weak CK19 immunostaining in tumor tissues and a high serum concentration of CYFRA21-1 compared with the other groups (p = 0.003).</p><p><strong>Conclusions: </strong>The combination of weak CK19 expression and high serum CYFRA21-1 levels is a predictor of poorer prognosis for patients with human lung SCC.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"59 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31626151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaction of plasma adiponectin level in non-small cell lung cancer patients treated with EGFR-TKIs.","authors":"Kanako Umekawa,&nbsp;Tatsuo Kimura,&nbsp;Shinzoh Kudoh,&nbsp;Tomohiro Suzumura,&nbsp;Misato Nagata,&nbsp;Shigeki Mitsuoka,&nbsp;Kuniomi Matsuura,&nbsp;Takako Oka,&nbsp;Naruo Yoshimura,&nbsp;Yukimi Kira,&nbsp;Kazuto Hirata","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are routinely used to treat advanced non-small cell lung cancer (NSCLC) patients with activated EGFR mutations, and are associated with excellent response and improvement of performance status. Adipose tissue produces and releases substances called adipokines, which include adiponectin, leptin, resistin, and hepatocyte growth factor (HGF), etc. Previously, we reported that high levels of plasma HGF at diagnosis indicated intrinsic resistance to EGFR-TKIs. EGFR-TKIs have been hypothesized to affect these adipokines.</p><p><strong>Methods: </strong>This prospective study, to evaluate the correlation between plasma adiponectin and insulin levels and non-hematological adverse effects in advanced NSCLC following EGFR-TKIs administration, was conducted at the Osaka City University Hospital. Plasma adiponectin and insulin levels were determined at diagnosis and on treatment day 30.</p><p><strong>Results: </strong>Overall 33 patients were enrolled. We obtained plasma samples for analyses from all patients at diagnosis and from 26 patients on day 30. Increased adiponectin (13.69 to 14.42 microg/mL, p = 0.0092), and decreased insulin (404.0 to 351.2 pg/mL, p = 0.022) were observed after EGFR-TKI treatments. High levels of adiponectin at diagnosis were associated with severities of skin rash (p = 0.035).</p><p><strong>Conclusions: </strong>The adiponectin was affected by EGFR-TKI treatments for NSCLC. Besides, the adverse events by EGFR-TKIs were influenced by the plasma adipokines at diagnosis. Our study may provide useful information regarding patient outcomes to EGFR-TKI treatments. A prospective large clinical trial is warranted to clarify these results.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"59 1","pages":"53-60"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31626153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of postoperative intraabdominal abscess in laparoscopic versus open appendectomy.","authors":"Shogo Tanaka,&nbsp;Kanji Ishihara,&nbsp;Takahiro Uenishi,&nbsp;Ryoya Hashiba,&nbsp;Yukiko Kurashima,&nbsp;Kohichi Ohno,&nbsp;Sayaka Tanaka,&nbsp;Masahiko Ohsawa,&nbsp;Takatsugu Yamamoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Complicated appendicitis (gangrenous or perforated appendicitis) is a risk for postoperative intraabdominal abscess, but management of intraabdominal abscess may differ between laparoscopic and open appendectomy.</p><p><strong>Methods: </strong>We reviewed 67 patients who underwent appendectomy for complicated appendicitis, including 26 who received laparoscopic appendectomy (LA group) and 41 who underwent open appendectomy (OA group). The operation was performed under general anesthesia in all 26 patients in the LA group and in 10 (24%) in the OA group. Patient characteristics, operative factors, and postoperative complications (especially postoperative intraabdominal abscess) were compared between the two groups. Management of postoperative intraabdominal abscess was also investigated.</p><p><strong>Results: </strong>Postoperative intraabdominal abscess occurred in 3 patients (12%) in the LA group and in 10 (24%) in the OA group (p = 0.23). All 3 patients in the LA group were treated conservatively. Of the 10 patients in the OA group, 6 were treated conservatively, but 4 needed a reoperation, including 3 who had undergone right pararectal skin incision under spinal analgesia and in whom sufficient irrigation was not possible because anesthesia had worn off.</p><p><strong>Conclusions: </strong>Our results suggest that insertion of abdominal drainage may be appropriate treatment for intraabdominal abscess after laparoscopic appendectomy. Light anesthesia may induce residual abscess in open appendectomy performed under spinal analgesia.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"59 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31626823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dye laser photodynamic therapy for Bowen's disease in a patient with epidermodysplasia verruciformis.","authors":"Mari Sunohara,&nbsp;Toshiyuki Ozawa,&nbsp;Kuniyuki Morimoto,&nbsp;Teruichi Harada,&nbsp;Masamitsu Ishii,&nbsp;Kazuyoshi Fukai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Epidermodysplasia verruciformis (EV) is a rare heritable skin disease that results in unusual susceptibility to infection with specific types of human papillomavirus (HPV). Here we report a 53-year-old man with EV who developed Bowen's disease on his lower eyelid and the chest. Mutation analysis of EVER1 gene revealed homozygous splice acceptor site mutation (IVS8-2, A > T). In this patient, HPV3, HPV14, and HPV38 had been identified from the skin lesions. The Bowen's skin lesion on the left lower eye-lid was treated by photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) and pulsed dye laser (PDL). After two rounds of the PDT treatment, the skin lesion disappeared and a skin biopsy confirmed the efficacy of the treatment. This method was simple, less invasive than other treatments, and achieved a satisfactory cosmetic result.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"58 2","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31471041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intense pulsed light therapy for aberrant Mongolian spots.","authors":"Makiko Shirakawa,&nbsp;Toshiyuki Ozawa,&nbsp;Chiharu Tateishi,&nbsp;Naho Fujii,&nbsp;Daisuke Sakahara,&nbsp;Masamitsu Ishii","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Aberrant Mongolian spots (AMS) distal to the lumbosacral region are thought to be more likely to persist than typical sacral Mongolian spots. So far, Q-switched ruby laser (QSRL) has been the treatment of choice for AMS. Intense pulsed light (IPL) is obtained from flashlamp devices that emit wavelengths between 515 and 1200 nm. IPL has documented efficacy for the treatment of irregular pigmentation, telangiectasia, rough skin texture, rhytids, hair removal, and vascular lesions, with several filters being available that can be used to block shorter wavelengths from the skin. As far as we could determine, there have been no clinical and histological studies on the treatment of AMS with IPL. Accordingly, the aim of this study was to assess the clinical and histological efficacy of IPL for AMS.</p><p><strong>Methods: </strong>Seven patients (4 males and 3 females) presenting from September 2008 to July 2009 were assessed. Their mean age was 2.0 years, ranging from 0 to 7 years. The IPL device used in this study was a Natulight (Lumenis Ltd., Tokyo, Japan). Photographs were taken of all patients with a high-resolution digital camera at baseline and 6 months after treatment. Skin biopsy specimens were taken from 1 patient (case 4) before, immediately after, and 6 months after treatment.</p><p><strong>Results: </strong>According to the 7 family members of the patients, the outcome of IPL was graded as follows: excellent improvement in 1 (14%), good improvement in 4 (57%), and slight improvement in 2 (29%). All families would have liked to continue IPL treatment. Evaluation of the effect of treatment by a physician was less favorable, with excellent improvement in 1 (14%), good improvement in 2 (29%), and slight improvement in 4 (57%). Histopathologic examination of the pigmented region revealed the typical features of a Mongolian spot in the hematoxylin-eosin stained section. Immediately after IPL, there were no changes in the dermis. At 6 months after treatment, however, the number of melanocytes in the middle and upper dermis was obviously decreased.</p><p><strong>Conclusions: </strong>IPL is an effective method for the treatment of AMS.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"58 2","pages":"59-65"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31471039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asystole developed during total gastrectomy under general anesthesia combined with thoracic epidural anesthesia.","authors":"Hiroai Okutani,&nbsp;Ryu Okutani,&nbsp;Taketo Nakamura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a 73-year-old woman who developed sudden bradycardia and asystole due to vagal reflex during transabdominal total gastrectomy under general anesthesia with thoracic epidural analgesia. General anesthesia was induced with propofol, fentanyl and maintained with sevoflurane and epidural infusion of lidocaine. Severe bradycardia, followed by asystole was detected on electrocardiography 10 minutes after starting surgery, triggered by the retraction of the abdominal wall and intestines. Blood pressure and heart rate recovered in response to atropine, ephedrine and chest compressions in 10 seconds. Surgery was completed uneventfully and the patient was discharged without complications. For preventing life-threatening bradycardia and asystole by vagal reflex, we suggest the use of atropine prior to the operations in patients undergoing abdominal or ophthalmic surgery, where vagal reflex may occur.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"58 2","pages":"83-6"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31471042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very rare survival case of elective surgery for a ruptured thoracic aortic aneurysm.","authors":"Yasuhiko Kubota,&nbsp;Dairoku Nishikawa,&nbsp;Noriyuki Kashiyama,&nbsp;Hironori Izutani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a very rare case of survival after a ruptured thoracic aortic aneurysm (TAA). An 84-year-old man was transferred to a local hospital because of unconsciousness. Computed tomography showed a ruptured TAA and he was referred to our hospital for management. Although emergency surgery was recommended, the patient rejected it and remained hospitalized for conservative management. One week later, the patient decided to proceed with the surgery and graft replacement was successfully performed. His recovery was uneventful.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"58 2","pages":"87-90"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31471043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between peak VO2 and subcutaneous fat thickness of the thigh measured by ultrasonography.","authors":"Shigehiro Tanaka,&nbsp;Kana Goto,&nbsp;Saho Yamamoto,&nbsp;Aya Arai","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Measured physical activity and percent body fat obtained by bioelectrical impedance analysis have been used as indicators of cardiorespiratory fitness in middle-aged women and children. However, the relationship between subcutaneous fat thickness in various regions of the thigh determined by ultrasonography and cardiorespiratory fitness has not been previously reported.</p><p><strong>Methods: </strong>We measured subcutaneous fat thickness in the frontal, lateral, and medial regions of both thighs using ultrasonography, and also determined peak VO2 and percent body fat in 13 healthy and generally well female college students.</p><p><strong>Results: </strong>There were significant negative correlations found between peak VO2 and the 3 frontal portions of the thigh, as well as the vastus lateralis (both sides), while correlations were not seen with the right and left medial regions 15 cm above the medial epicondyle.</p><p><strong>Conclusions: </strong>Our results suggest that increases in peak VO2 are reflected by decreases in subcutaneous fat thickness in the frontal and lateral regions of the thigh, but not in decreases in that in both sides of the medial region of the thigh. In addition, subcutaneous fat thickness may indicate partial or segmental activation of the frontal and lateral regions of the legs, such as that obtained by cycling. We concluded that measurement of subcutaneous fat thickness in the region above the muscle mass of the thigh such as the rectus femoris or lateral vastus using ultrasonography may reasonably represent physical activity. Further study is needed to be done with larger groups of subjects and to evaluate the effects of training on activation of regions of the thigh.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"58 2","pages":"51-8"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31471038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}