Kurume Medical Journal最新文献

{"title":"Cell Type-Specific Relationships Among Immune Cells in Human Aortic Dissection Tissue.","authors":"Shinya Negoto, Hiroki Aoki, Koichi Ohshima, Eiji Nakamura, Takahiro Shojima, Kazuyoshi Takagi, Hiroyuki Otsuka, Tohru Takaseya, Shinichi Hiromatsu, Eiki Tayama","doi":"10.2739/kurumemedj.MS7034007","DOIUrl":"10.2739/kurumemedj.MS7034007","url":null,"abstract":"<p><strong>Background: </strong>Although recent studies have revealed the importance of inflammation in the pathogenesis of aortic dissection (AD), little is known about the relationships among inflammatory cells in human AD tissue.</p><p><strong>Methods and results: </strong>We assessed the relationships among various immune cell types, including neutrophils, macrophages (M1 and M2), B cells, and helper T cells (Th1, Th2, Th17, Treg and Tfh ) in human AD tissue. AD tissues displayed abundant infiltration of immune cells. Correlation analysis revealed two groups of highly correlated cell types: a group of neutrophils and M1 and M2 macrophages, and another group consisting of B cells and helper T cells. In one particular case of AD, we were able to analyze the correlations between neutrophils and M1 and M2 macrophages in the entry, border, and intact zones of the AD lesions. Neutrophils showed significant correlations with M1 and M2 macrophages in the border zones. The entry and border zones showed M1-dominant polarization, whereas the intact zone showed M2-dominant polarization.</p><p><strong>Conclusions: </strong>These findings indicate the existence of cell type-specific and site-specific interactions among immune cell types in human AD tissues.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"145-155"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113114","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 Evaluation of Postpancreaticoduonenectomy Hemorrhage with Endovascular Treatment.","authors":"Tomoko Kugiyama, Masamichi Koganemaru, Akiko Sumi, Shuichi Tanoue, Asako Kuhara, Masaaki Nonoshita, Ryoji Iwamoto, Masashi Kusumoto, Masakazu Nabeta, Miyuki Sawano, Norimitsu Tanaka, Kiminori Fujimoto, Jun Akiba, Toshi Abe","doi":"10.2739/kurumemedj.MS7034001","DOIUrl":"10.2739/kurumemedj.MS7034001","url":null,"abstract":"<p><strong>Introduction: </strong>Postpancreaticoduodenectomy hemorrhage (PPH) is a serious complication. Fatty or nonfibrous pancreas, or both, is a risk factor for pancreatic fistula. This study assessed various prognostic factors for interventional procedures for PPH, also focusing on the degree of pancreatic fatty infiltration/fibrosis evaluated histopathologically.</p><p><strong>Material and methods: </strong>The participants were 29 patients with PPH who underwent endovascular treatment from September 2001 to March 2020. Univariate analysis was performed to determine whether the histopathological degree of pancreatic fatty infiltration/fibrosis and other factors were associated with complications and mortality after endovascular treatment for PPH.</p><p><strong>Results: </strong>Of 39 treatment sessions overall, 38 (97%) achieved technical success and 34 (87%) had clinical success. In-hospital mortality occurred in five patients (17%). No association was found between the pancreatic fistula and the histopathological degree of pancreatic fatty infiltration/fibrosis. Fourteen patients with hemorrhagic shock before endovascular treatment included all five patients with in-hospital mortality, while the 15 patients without hemorrhagic shock survived (P = 0.017). A bleeding tendency was associated with complications after endovascular treatment for PPH (P = 0.033).</p><p><strong>Conclusions: </strong>Although our results revealed no significant relation between the histopathological degree of pancreatic fatty infiltration/fibrosis and clinical success, including prognosis, endovascular treatment may be effective for PPH.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"97-104"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890345","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":"Comparison of Anorectal Function and Quality of Life Measures in Patients Following Intersphincteric Resection and Lower Anterior Resection.","authors":"Susumu Shimomura, Tomoya Sudo, Kenta Murotani, Kenji Fujiyoshi, Takefumi Yoshida, Kenichi Koushi, Fumihiko Fujita, Yoshito Akagi","doi":"10.2739/kurumemedj.MS7034002","DOIUrl":"10.2739/kurumemedj.MS7034002","url":null,"abstract":"<p><p>This study explored postoperative outcomes for patients with lower rectal cancer who underwent low anterior resection (LAR) or intersphincteric resection (ISR). A total of 49 patients (33 LAR, 16 ISR) were followed using anorectal manometry and quality of life (QOL) questionnaires over a year, pre- and post surgery. The primary aim of this study is to clarify differences in anal manometry, sphincter function, fecal incontinence, and QOL between the two surgical arms. The secondary aim was to identify indicators suitable for assessing relationships between anorectal manometry measurements, fecal incontinence, and QOL. Anorectal manometry elements (AMEs), such as atmospheric maximum mean squeeze pressure (aMSP), maximum tolerable volume (MTV), and incremental maximum mean squeeze pressure (iMSP), showed no significant differences during the observation period. However, maximum resting pressure (MRP), high-pressure zone length (HPZ), and threshold volume (TV) were significantly worse in the ISR group. Fecal incontinence, measured by Wexner and Kirwan scores, was significantly better in the LAR group. We observed no differences in SF36 between the two groups. Multi-correlation analysis revealed positive and negative correlations among these factors, with inverse correlations between anorectal manometry measurements and incontinence assessments decreasing post-surgery. We found no correlation between SF36 and anorectal manometry at any time. The findings indicate that surgical technique affects postoperative anal function, fecal incontinence, and SF36. However, combined assessment methods should be used with caution when deriving relationships between anal function and SF36.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890346","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":"Pilot Study on Reading and Writing Characteristics in Children with Attention-Deficit Hyperactivity Disorder.","authors":"Shota Tsuji","doi":"10.2739/kurumemedj.MS7034011","DOIUrl":"10.2739/kurumemedj.MS7034011","url":null,"abstract":"<p><p>This study surveys the factors regarding reading and writing difficulties in children with attentiondeficit hyperactivity disorder (ADHD) and uses these results to provide support. We conducted surveys on 16 elementary school children from 3rd to 6th grades who were diagnosed with ADHD by a physician based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We conducted a Hiragana reading test, a Kanji reading and writing test, and a visual perception test on the subject children. We requested that the parents of the children complete a reading and writing symptom checklist, the Developmental Coordination Disorder Questionnaire (DCDQ), the Strength and Difficulties Questionnaire (SDQ), the ADHD-Rating Scale (ADHD-RS), and the Autism-Spectrum Quotient (AQ). We conducted a multiple regression analysis using the Kanji reading and writing test as the dependent variable. Results revealed that the positional task score in the visual perception test was a factor that influences Kanji writing. Meanwhile, gender, reading-related items on the reading and writing symptom checklist, and performance such as misreading of hiragana were factors that influenced Kanji reading. Based on the results, we suggested that when teaching Kanji writing, children's visual cognition ability should be assessed, and ways to incorporate learning methods that supplement visual perception, such as color masses and electronic learning materials, should be devised. When teaching reading, we suggest using teaching materials that present not only text but also audio as needed, and support the awareness of parents.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"157-164"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113115","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":"Morphometry of the Foramen Ovale in Adult Human Skulls from a Clinical Perspective.","authors":"Anupama Kodialbail, Radhika Paramesh Mudaliar, Jyothi Krishnarajanagar Chandrachari, Shailaja Shetty","doi":"10.2739/kurumemedj.MS7034010","DOIUrl":"10.2739/kurumemedj.MS7034010","url":null,"abstract":"<p><strong>Introduction: </strong>The foramen ovale (FO) is present in the posterior part of the greater wing of sphenoid. A trauma or space-occupying lesion in this area would result in clinical manifestations due to compression of the structures passing through it. This study was undertaken because of the clinical significance of the FO in radiological and neurological procedures. The aim is to study the morphometry of the FO and its bilateral variations.</p><p><strong>Material and methods: </strong>Fifty adult dry human skulls of unknown age and sex were studied. The shape of the FO, presence of accessory foramina or abnormal bony outgrowths, if any, were noted. Maximum length and width of FO were measured.</p><p><strong>Results: </strong>The FO was present bilaterally in all 50 skulls. Accessory foramen was present in 17 (34%) and 13 (26%) skulls on the right and left side, respectively. Bony out growths were present in 9 (18%) and 15 (30%) skulls on the right and the left side, respectively.</p><p><strong>Conclusion: </strong>Understanding the exact topography, morphometry and variations of the FO is required to enable the clinician to correctly interpret radiographs and help in planning the surgical procedures. The findings presented here should be taken into account when neurological procedures of the middle cranial fossa are performed.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"91-95"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297703","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":"Development and Psychometric Verification of a Self-Administered Scale for Family Needs in Japanese Critical Care Settings.","authors":"Sayaka Fujimaru, Hiroki Inutsuka, Tatsuyuki Kakuma, Kimiko Morimoto, Mitsuyoshi Ayabe","doi":"10.2739/kurumemedj.MS7034008","DOIUrl":"10.2739/kurumemedj.MS7034008","url":null,"abstract":"<p><strong>Aim: </strong>We developed and evaluated the statistical reliability and validity of a family needs scale directly answerable by families in critical care settings.</p><p><strong>Methods: </strong>In this qualitative study, 39 questions were drafted to capture family needs. These questions were then administered to the families of patients in emergency care settings. Exploratory factor analyses identified several needs factors and factor structures of the questions with oblique rotation. A confirmatory factor analysis examined internal consistency and criterion-related and construct validity.</p><p><strong>Results: </strong>Three factors comprising 32 items were extracted from the exploratory factor analysis: \"Needs for fulfilling family roles,\" \"Needs for appropriate treatment and care,\" and \"Needs for respecting family ties.\" Cronbach's α was 0.949 for the total score and 0.927, 0.914, and 0.896 for factors A-C, respectively, with cumulative variance of 50.0%. The three factors' confirmatory factor analysis revealed a relatively good model fit. A significant correlation was found between this scale and the assessment scale for the needs of families of patients in the intensive care unit.</p><p><strong>Conclusions: </strong>A new scale assessing family needs was developed, and its reliability and validity were confirmed. The scale has acceptable psychometric properties and can be used to measure family needs in critical care settings, particularly in Japanese cultural contexts.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"131-144"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297702","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":"Papillary Fibroelastoma of the Aortic Valve:Acute Coronary Syndrome Due to Dynamic Obstruction of the Right Coronary Artery Ostium.","authors":"Hiroyuki Saisho, Satoru Tobinaga, Shigeaki Aoyagi, Yusuke Shintani, Hiroshi Yasunaga","doi":"10.2739/kurumemedj.MS7034004","DOIUrl":"10.2739/kurumemedj.MS7034004","url":null,"abstract":"<p><p>A 59-year-old woman, who had a history of acute coronary syndrome (ACS) but without obstructive coronary lesions 2 years previously, presented with vertigo. MRI revealed a left cerebellar embolism. TEE detected a mobile aortic valve tumor, suggesting a papillary fibroelastoma (PFE). Reviewing previous echocardiograms, it was discovered that the tumor was present at the time of the ACS event. At surgery, the PFE was present on the right coronary cusp. When the aortic valve was opened, it was found that the tumor was obstructing the right coronary artery (RCA) ostium. ACS was probably caused by PFE's dynamic obstruction of the RCA ostium.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"165-168"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890350","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":"Hybrid Training System Consisting of Synchronized Neuromuscular Electrical Stimulation for Voluntary Exercise Using an Articular Motion Sensor.","authors":"Hiroo Matsuse, Hiroshi Tajima, Eriko Baba, Sohei Iwanaga, Masayuki Omoto, Ryuki Hashida, Takeshi Nago, Naoto Shiba","doi":"10.2739/kurumemedj.MS7034006","DOIUrl":"10.2739/kurumemedj.MS7034006","url":null,"abstract":"<p><p>Neuromuscular electrical stimulation (NMES) is widely used for improving muscle strength, preventing muscle atrophy, and decreasing pain. Recently, NMES has become a substitute for exercise therapy for metabolism improvement and functional capacity improvement. However, NMES has several disadvantages. First, slow-twitch muscle contractions are insufficient because the recruitment pattern of NMES does not obey Henneman's size principle. Second, when using surface electrodes, it is difficult to contract deep skeletal muscles at the application site. Third, electrical stimulation causes discomfort. Therefore, we devised a simultaneous combination of NMES and voluntary muscle contractions to overcome the weak points of NMES. A hybrid training system (HTS) that resists the motion of a volitionally contracting agonist muscle with force generated by its electrically stimulated antagonist was developed as a technique to combine the application of NMES and volitional contractions. This motion sensor makes it possible to simultaneously combine voluntary movements with NMES. Our HTS synchronizes with voluntary movements, enhancing safety and reducing discomfort. This HTS enhances the exercise effect of even simple exercise. So far, our HTS has been reported to be effective for muscle strength enhancement, prevention of muscle atrophy, improvement of physical function, pain relief, enhancement of physical fitness, and improvement of metabolic function. HTS are expected to be useful methods in environments where sufficient exercise load is not available or for individuals with low exercise tolerance.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890349","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":"Extrahepatic Portal Venous Gas Is the Strongest Predictor of Mortality in Patients with Portal Venous Gas and Pneumatosis Intestinalis.","authors":"Naohiro Yoshida, Yoshihiko Sadakari, Hiroyuki Nakane, Munehiro Yoshitomi, Kazuhito Tamehiro, Gentaro Hirokata, Takeshi Aoyagi, Toshiro Ogata, Masahiko Taniguchi","doi":"10.2739/kurumemedj.MS7034005","DOIUrl":"10.2739/kurumemedj.MS7034005","url":null,"abstract":"<p><strong>Background: </strong>Very few studies have examined the association between contrast-enhanced computed tomography (CT) findings observed in portal venous gas (PVG) and pneumatosis intestinalis (PI) and the underlying diseases in these conditions.</p><p><strong>Objectives: </strong>In this study, we analyzed this association and report the findings for predicting mortality.</p><p><strong>Materials and methods: </strong>Overall, 50 patients diagnosed with PVG or PI, observed on contrast-enhanced CT, underwent treatment at our hospital. Based on the underlying disease, we divided the patients into three groups, those with ischemic disease, infectious disease, or gastrointestinal dilatation. Furthermore, cases that underwent surgical treatment or needed surgery but were inoperable were assigned to the high risk group (n=16) and patients who received conservative treatment were assigned to the low risk group (n=34). We reviewed the patients' medical charts, laboratory data, and CT images retrospectively, and analyzed the relationship between CT findings, underlying disease, and association with the high risk or low risk group in each case.</p><p><strong>Results: </strong>Poor enhancement of the intestinal wall, mesenteric fat stranding, extrahepatic PVG, advanced age, and renal disease were significantly associated with ischemic disease (p=0.02, p=0.02, p=0.005, p=0.008 and p=0.049, respectively). PI alone was strongly associated with gastrointestinal dilatation (p=0.009). Patients in the low risk group had more favorable outcomes with conservative treatment. In multivariate analysis, extrahepatic PVG was the only factor associated with the high risk group (p=0.002).</p><p><strong>Conclusion: </strong>Extrahepatic PVG associated with ischemic disease was the strongest predictive factor of mortality. Other CT findings, though useful in diagnosing the underlying disease, were not significant predictive factors.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"121-130"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890348","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":"Right Parasternal Approach for Aortic Valve Replacement After Presternal Gastropexy.","authors":"Hiroyuki Otsuka, Hiroyuki Saisho, Tohru Takaseya, Hiromasa Fujita, Hiroyuki Tanaka, Eiki Tayama","doi":"10.2739/kurumemedj.MS7034009","DOIUrl":"10.2739/kurumemedj.MS7034009","url":null,"abstract":"<p><p>Due to bicuspid aortic valve aortic stenosis, a 78-year-old man with a history of esophagectomy and presternal gastric tube reconstruction required aortic valve replacement (AVR). AVR with a bioprosthetic valve was performed through a right parasternal thoracotomy. Despite the unfavorable conditions for conventional median sternotomy, AVR was successfully performed through an alternate approach. The right parasternal approach was excellent for AVR in patients with presternal gastric tube reconstruction for esophageal cancer (EC).</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156232","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}