Kobe Journal of Medical Sciences最新文献

{"title":"A Case of a Highly Obese Covid-19 Patient with Severe Hypoxemia and Subcutaneous Mediastinal Emphysema Who Was Rescued by Early Introduction of ECMO.","authors":"Shuhei Takahashi,&nbsp;Norihiko Obata,&nbsp;Shohei Makino,&nbsp;Nana Furushima,&nbsp;Taichi Nishimura,&nbsp;Satoshi Mizobuchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We conducted the treatment of a highly obese patient with severe Covid-19 pneumonia who had a history of asthma. When she arrived at the hospital, she was already intubated and had mediastinal emphysema and severe hypoxemia. Because the patient's condition did not improve with mechanical ventilation, we introduced extracorporeal membrane oxygenation (ECMO) immediately after admission. The patient improved with early induction of ECMO and prone positioning. In the management of patients with severe Covid-19 pneumonia, early introduction of ECMO should be considered if oxygenation does not improve with mechanical ventilation, and prone positioning can also be effective.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 2","pages":"E49-E51"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501758/pdf/kobej-69-e49.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10607795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aquaporin 4 Expression Level Is Decreased in Skeletal Muscles with Aging.","authors":"Minenori Ishido,&nbsp;Yung-Li Hung,&nbsp;Shuichi Machida","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Skeletal muscle is a tissue that contains abundant water. However, by aging a decrease in muscle water content is induced in skeletal muscles, which is one of major age-related alterations in skeletal muscles as common as muscle atrophy. Selective water channel aquaporin 4 (AQP4) is one of major water transport networks in the skeletal muscles. However, the effects of aging on water transport via AQP4 in skeletal muscles remain unclear. Thus, the current study investigated the change of the expression level of AQP4 in the aged skeletal muscles. Eight-week-old (the young group) and 2-year-old (the old group) female Fischer 344 rats were used in this study (n = 6/group). In skeletal muscles of each group, the expression levels of some target proteins were quantified by Western blot analysis. As a result, the relative muscle weight in the old group was significantly decreased, compared with that in the young group (p < 0.05). The decline in the muscle water content was accompanied by the decrease in expression of AQP4 in the aged skeletal muscles (p < 0.05, respectively). Moreover, the expression of transient receptor potential vanilloid 4, which synergistically regulates the osmolality together with AQP4, was significantly reduced in the aged skeletal muscles (p < 0.05). Therefore, the current study suggested that water transport abilities via AQP4 may decrease in the aged skeletal muscles, and thereby may be involved in age-related loss of muscle water content.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 2","pages":"E40-E48"},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501756/pdf/kobej-69-e40.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10257873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influences of Orogastric and Nasogastric Tubes on Sucking Pressure during Bottle Feeding in Immature Infants.","authors":"Takeshi Komatsu,&nbsp;Tatsuya Furukawa,&nbsp;Daisuke Kobayashi,&nbsp;Sota Iwatani,&nbsp;Seiji Yoshimoto,&nbsp;Toshihiko Yamashita,&nbsp;Yumi Endo,&nbsp;Sayaka Katsunuma,&nbsp;Masahide Otsu,&nbsp;Ken-Ichi Nibu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Orogastric (OG) and nasogastric (NG) tubes have been reported to delay breastfeeding initiation and affect respiratory function. However, the effects of feeding tubes on sucking pressure have not been well studied. Fourteen preterm infants were enrolled in this study, and their sucking pressures during bottle feeding with an OG tube, NG tube, and without any tube were measured. Sucking pressure significantly increased after changing the OG tube to an NG tube (p = 0.044). However, sucking pressure showed no significant differences after changing the feeding method from an NG tube to oral intake. Thus, NG tubes are superior to OG tubes in terms of sucking pressure.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 1","pages":"E25-E32"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306263/pdf/kobej-69-e25.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9740380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital Mortality among Patients with High-flow Nasal Cannulas in the General Ward.","authors":"Jun Yamada,&nbsp;Naoko Katsurada,&nbsp;Masatsugu Yamamoto,&nbsp;Hiroki Sato,&nbsp;Chihiro Mimura,&nbsp;Junya Yoshioka,&nbsp;Masako Yumura,&nbsp;Daisuke Hazama,&nbsp;Tatsuya Nagano,&nbsp;Motoko Tachihara,&nbsp;Yoshihiro Nishimura,&nbsp;Kazuyuki Kobayashi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>High-flow nasal cannulas (HFNCs) have become common devices for patients with respiratory failure who are treated in general wards. Few reports have been published on in-hospital mortality associated with the ratio of oxygen saturation (ROX) index, measured by pulse oximetry/fraction of inspired oxygen to respiratory rate, in patients treated with HFNCs. We aimed to examine in-hospital mortality and associated factors in patients who initiated HFNC use in a general ward. Sixty patients who initiated HFNC use in general wards at Kobe University Hospital between December 2016 and October 2020 were retrospectively enrolled. We assessed in-hospital mortality, comorbidities, and ROX index. The in-hospital mortality was 48.3%, and ROX index values were significantly lower in patients who died than in those who did not (at HFNC oxygen therapy initiation; 6.93 [2.73-18.5] vs. 9.01 [4.62-18.1], p = 0.00861). Although the difference was not statistically significant, the change in ROX index values between HFNC initiation and 12 hours after initiation tended to be greater in the patients who died in the hospital (0.732 [-2.84-3.5] vs. -0.35[-4.3-2.6], p = 0.0536). Lower ROX index values may be associated with the in-hospital death of patients who are treated with HFNCs in general wards.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 1","pages":"E33-E39"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306262/pdf/kobej-69-e33.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9740382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Low-Dose Oral Food Challenges for Hen's Eggs, Cow's Milk, and Wheat: Report from a General Hospital without Allergy Specialists in Japan.","authors":"Keita Nakanishi, Ikuo Okafuji, Takashi Kihara, Yukino Kawanami, Ayaka Shimizu, Shinpei Kotani, Yoshiaki Kamoi, Takahiro Okutani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An oral food challenge (OFC) is useful for managing food allergies. However, because OFCs have the risk of severe allergic reactions, including anaphylaxis, conducting OFCs under this situation without allergy specialists is difficult. To investigate the safety of a low-dose OFC for eggs, milk, and wheat in a general hospital without allergy specialists. We retrospectively analyzed the medical records of children who were hospitalized in a general hospital without allergy specialists for a low-dose OFC of egg, milk, or wheat between April 2018 and March 2021. The records of 108 patients were evaluated. The median age was 15.8 months (range: 7.5-69.3 months). Challenged foods were eggs (n = 81), milk (n = 23), and wheat (n = 4). Fifty-three (49.0%) patients showed positive allergic reactions. Thirty-five (66.0%) patients showed grade 1 (mild), 18 (34.0%) showed grade 2 (moderate), and none showed grade 3 (severe) reactions. The interventions comprised antihistamines (n = 18), prednisolone (n = 3), inhaled Β2-agonist (n = 2). No patients required adrenaline and no deaths occurred. Low-dose OFCs may be safe in a general hospital without allergy specialists. Conducting a low-dose OFC may be essential in food allergy practice.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 1","pages":"E16-E24"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306261/pdf/kobej-69-e16.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9705736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Bisphosphonate and Active Vitamin D Analog on Glucocorticoid-induced Osteoporosis in Patients with IgA Nephropathy: A Retrospective Observational Study.","authors":"Rie Takiguchi,&nbsp;Shinichi Nishi,&nbsp;Shunsuke Goto,&nbsp;Hideki Fujii","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Few studies on glucocorticoid (GC)-induced osteoporosis exist in IgA nephropathy (IgAN). Here we aimed to compare the effects of bisphosphonate (Bis) and active vitamin D analog (Vit. D) in maintaining bone mineral density (BMD) in patients with IgAN. This study is a retrospective observational one. Between April 2007 and December 2014, a total of 127 patients with IgAN received GC treatment at Kobe University Hospital. Among them, we measured the BMD of 48 patients with a mean age of approximately 30 years, before and after GC treatment. The %ΔBMD of the lumber spine increased in the Bis group (1.6% ± 2.3%), but decreased in the Vit. D group (-3.3% ± 3.6%). The %ΔBMD of the two groups differed significantly (p < 0.05). Although the %ΔBMD of the femoral neck showed the same tendency, the difference between two groups was not significant. Bis was significantly superior to Vit. D in maintaining the BMD of lumbar spine bones. Even in young patients with IgAN, Bis is recommended to prevent the reduction of BMD during GC treatment.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 1","pages":"E9-E15"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128593/pdf/kobej-69-e9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9478339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chlorogenic Acid and Caffeine in Coffee Restore Insulin Signaling in Pancreatic Beta Cells.","authors":"Yuka Ihara,&nbsp;Shun-Ichiro Asahara,&nbsp;Hiroyuki Inoue,&nbsp;Masako Seike,&nbsp;Misaki Ando,&nbsp;Hiroki Kabutoya,&nbsp;Maki Kimura-Koyanagi,&nbsp;Yoshiaki Kido","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The incidence of type 2 diabetes is reported to be lower in frequent coffee drinkers than in non-coffee drinkers. To elucidate the mechanism by which coffee prevents the onset of type 2 diabetes, we analyzed how caffeine and chlorogenic acid, which are components of coffee, alter insulin signaling in MIN6 cells, a mouse pancreatic Β cell line. The results showed that caffeine improved insulin signaling under endoplasmic reticulum stress, and chlorogenic acid protected pancreatic Β cells by enhancing the expression of insulin receptor substrate 2 via cAMP response element-binding protein and promoting insulin signaling downstream of insulin receptor substrate 2. In addition, chlorogenic acid was a potent antioxidant for the protection of pancreatic Β cells. Furthermore, in vivo and in vitro analyses revealed that the pancreatic Β cell-protective effect of chlorogenic acid was mediated by the alleviation of endoplasmic reticulum stress. The results suggest that these components of coffee have the potential to reduce the pathogenesis of type 2 diabetes and improve pancreatic Β cell insufficiency.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 1","pages":"E1-E8"},"PeriodicalIF":0.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128592/pdf/kobej-69-e1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Management of Refractory Autoimmune Hemolytic Anemia with Cold Agglutinin Disease with Splenectomy: A Case Report with Review of Literature.","authors":"Shuji Okamoto,&nbsp;Takeshi Urade,&nbsp;Kimikazu Yakushijin,&nbsp;Masahiro Kido,&nbsp;Kaori Kuramitsu,&nbsp;Shohei Komatsu,&nbsp;Hidetoshi Gon,&nbsp;Hironori Yamashita,&nbsp;Sachiyo Shirakawa,&nbsp;Daisuke Tsugawa,&nbsp;Sachio Terai,&nbsp;Hiroaki Yanagimoto,&nbsp;Hirochika Toyama,&nbsp;Takumi Fukumoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia characterized by agglutination of red blood cells at temperatures below the normal core body temperature. In patients with CAD, splenectomy is not indicated because of its low therapeutic effect on hemolytic anemia induced by extravascular hemolysis. Herein, we report a case of refractory hemolytic anemia with CAD successfully managed with splenectomy.</p><p><strong>Clinical case: </strong>A 60-year-old man visited a municipal hospital with the chief complaint of fatigue. He was found to have hemolytic anemia and icterus with increased cold agglutination and was diagnosed with CAD. Malignant lymphoma was suspected as the underlying disease; however, no clear underlying disease was identified. Hemolytic anemia progressed during the subsequent winter seasons, and he was treated with temperature control, warming, and weekly blood transfusions. However, despite the blood transfusions, his hemoglobin level did not improve during the summer 2 years after diagnosis, and his previously observed splenomegaly had progressed. He was referred to our department, and a splenectomy was performed to diagnose any occult malignant lymphoma and improve the refractory hemolytic anemia. Because histopathological examination revealed no evidence of malignant lymphoma, a diagnosis of primary CAD was made. The hemolytic anemia improved, and no blood transfusion was required after splenectomy.</p><p><strong>Conclusions: </strong>Splenectomy significantly improved the patient's refractory hemolytic anemia due to primary CAD. Thus, it may be an effective treatment option in such cases, although further cases and studies are required to evaluate the effects of splenectomy.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"68 1","pages":"E30-E34"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10117625/pdf/kobej-68-e30.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9688417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase in the Number and Duration of Sleep Episodes During Class After Reopening of Schools Following Closure due to COVID-19.","authors":"Shigemi Kimura,&nbsp;Yutaka Takaoka,&nbsp;Aki Sugano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sleep is important for the well-being of school-aged children. Almost all schools in Hyogo prefecture in Japan were closed from April 7 to May 31, 2020, owing to the coronavirus disease 2019 pandemic. The pandemic restrictions resulted in the disruption of the sleep routines of children. The number of children who experienced sleepiness in class after school closure increased. The number of children who visited our hospital 1 year before and after the closure was 208 (11.73 ± 3.24 years of age) and 155 (11.45 ± 3.30 years), respectively. The number of chief complaints of sleep-related symptoms at the first visits showed no significant difference between the two time periods. The percentage of patients who slept during class increased (but not significantly) after the school closure. However, the mean number and duration of sleep episodes during class significantly increased from 0.31 ± 0.76 to 1.04 ± 1.14 episodes/day and from 15.8 ± 38.6 to 45.7 ± 46.9 min/day (each P < 0.001) before and after school closure, respectively. The total number of patients in our hospital with the primary central disorders of hypersomnolence, i.e., narcolepsy, idiopathic hypersomnia, and Kleine-Levin syndrome, and the number of patients with insufficient sleep syndrome after the school closure significantly increased compared with those before closure (P = 0.034 and 0.048, respectively). School closure was associated with an increased incidence of sleeping during class; therefore, maintaining a stable daily routine for children with sleep disorders could have an alleviating effect.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"68 1","pages":"E23-E29"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10117627/pdf/kobej-68-e23.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Changes and Features of Sleep Patterns of Mothers with Preterm Infants during the Early Postpartum Period.","authors":"Madoka Toda Miyano,&nbsp;Hisafumi Yasuda,&nbsp;Satoshi Takada","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study comprised 13 mothers of preterm infants and 21 mothers of term infants. Sleep assessment was conducted using an actigraph for three consecutive days. The participants were asked to record their sleep behaviors and activities over these 3 days, and complete two questionnaires (Edinburgh Postnatal Depression Scale [EPDS] and Pittsburgh Sleep Quality Index [PSQI]). As compared to the mothers of term infants, the sleep efficiency in the preterm mothers was significantly lower than that in the term mothers. The total sleep time was shorter and nighttime awakenings were more frequent in the preterm mothers at 2 weeks after childbirth, but without a significant difference. We analyzed the changes in the sleep data of the mothers of preterm infants longitudinally, including sleep behaviors and the EPDS and PSQI scores. The total sleep time at 1 month postpartum was shorter than that at other periods, and significantly shorter than that at 2 weeks and 6 months postpartum. Our results suggested that sleep problems tended to last longer in mothers of preterm infants than in mothers of term infants, as the problems occurred twice, immediately after childbirth and immediately after discharge.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"68 1","pages":"E11-E22"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10117626/pdf/kobej-68-e11.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}