Nagoya Journal of Medical Science最新文献

{"title":"Associations among smoking, sleep quality, and decline in Mini-Mental State Examination scores based on health check-up data in Japan: a case-control study.","authors":"Masahiro Nakatochi, Kei Yoshida, Masaya Fujitani, Yuki Ohashi, Fumie Kinoshita, Yumiko Kobayashi, Hiroyuki Sato, Yoshiko Takahashi, Koichi Murashita, Akihiro Hirakawa","doi":"10.18999/nagjms.87.1.105","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.105","url":null,"abstract":"<p><p>The number of individuals with age-related mild cognitive impairment and subsequent dementia has inevitably increased with the rise in population aging. It is important to maintain cognitive function or decelerate declines in cognitive function. However, the evidence on lifestyle-based factors associated with this decline is lacking. Here, we investigated modifiable lifestyle-based factors associated with chronological cognitive decline in cognitively healthy adults aged ≥60 years (Mini-Mental State Examination [MMSE] score ≥27). This case-control study enrolled 363 participants who were divided into two groups based on annual declines in MMSE score: 40 cases with an MMSE score decline of ≥0.5 points/year and 323 controls with maintained MMSE scores. Smoking, lower social functioning scores on the 36-Item Short Form Health Survey version 2, higher Pittsburgh Sleep Quality Index (PSQI) global scores, and sleep disorders were significantly associated with a decline in MMSE scores. Multivariate logistic regression analysis revealed higher age, current smoking status, and either higher PSQI global scores or sleep disorders to be independently associated with MMSE score decline. In conclusion, the present study identified aging, smoking, and sleep quality as factors associated with a greater decline in MMSE scores in cognitively healthy individuals. Our findings highlight the potential importance of lifestyle factors in preventing cognitive decline.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"105-121"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of atrial fibrillation ablation in patients aged ≥80 years: a retrospective study.","authors":"Yusuke Sakamoto, Hiroyuki Osanai, Yuki Tanaka","doi":"10.18999/nagjms.87.1.37","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.37","url":null,"abstract":"<p><p>Catheter ablation is the first-line treatment for atrial fibrillation. Although the efficacy and safety of this procedure have been reported in older patients, they might diminish with age. Therefore, this study aimed to determine the safety and effectiveness of atrial fibrillation ablation in patients aged ≥80 years. We retrospectively analyzed the features of the catheter ablation and the subsequent clinical course and outcomes of 100 patients with atrial fibrillation aged ≥80 years who underwent ablation between July 2019 and December 2021 at Tosei General Hospital, Seto, Aichi, Japan. The average duration of atrial fibrillation was 6.0 ± 9.5 months, and 83% of the patients were symptomatic. Approximately 30% of patients developed heart failure, with 15% requiring hospitalization within one year before ablation. After ablation, 93% of patients were atrial fibrillation-free, and none required postoperative hospitalization due to heart failure. However, several complications have been observed, including cardiac tamponade, hematoma at the access site, and postoperative bradycardia. Notably, an enlarged left atrial diameter before ablation is a predictor of complications. In patients aged ≥80 years, atrial fibrillation ablation therapy demonstrated a high non-recurrence rate and may alter the progression of heart failure. Although the incidence of complications was relatively low, caution should be exercised when older patients with enlarged left atrial diameters undergo atrial fibrillation ablation.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"37-50"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifampicin-induced type 1 Kounis syndrome: a rare case.","authors":"Sidar Şiyar Aydın, Onur Furkan Akgün, Taha Karabacak, Ali Bilal Ulaş, Yavuzer Koza","doi":"10.18999/nagjms.87.1.163","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.163","url":null,"abstract":"<p><p>Kounis syndrome (KS) manifests as an acute coronary syndrome triggered by allergy, hypersensitivity, or anaphylaxis. It is believed that mast cells and histamine can potentially induce acute cardiac events by activating various inflammatory pathways. Here, we present a case of KS triggered by rifampicin administered during empyema drainage in a young male patient with no history of coronary artery disease. To the best of our knowledge, our case is the first report of rifampicin-induced KS documented in the literature. The wide range of etiological factors complicates the diagnosis of KS. Healthcare professionals should consider KS as a potential diagnosis in patients experiencing angina or similar pain alongside suspected allergic reactions.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"163-167"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of SARS-CoV-2 antecedent infection in patients with Kawasaki disease.","authors":"Kiyotaka Go, Yoshihiko Kawano, Noriko Nagai, Daisuke Omori, Yoshihito Morimoto, Hidenori Yamamoto, Yoshie Fukasawa, Yoshinori Ito, Yoshiyuki Takahashi, Taichi Kato","doi":"10.18999/nagjms.87.1.76","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.76","url":null,"abstract":"<p><p>Since the COVID-19 pandemic, it has been found that SARS-CoV-2 antecedent infection can cause multisystem inflammatory syndrome in children. However, the frequency of SARS-CoV-2 antecedent infection in Kawasaki disease (KD) is unknown. The purpose of this study was to investigate the frequency of SARS-CoV-2 infection that preceded the onset of KD. This study is a multi-center observational study. The subjects were patients who were diagnosed with KD at 4 hospitals from April 1, 2020 to August 31, 2022. Serum SARS-CoV-2 IgM and total antibody including IgG levels were measured by the chemiluminescence immunoassay method before and after treatment for KD. A total of 55 patients participated in the study. The first antibody measurement before the initial treatment was performed on a median of 4th days of illness and the second antibody measurement was performed after the initial treatment on a median of 12th days of illness. No patient had a significant increase in SARS-CoV-2 IgM levels in two measurements. Only one patient (1.8%) had elevated total antibodies including IgG, and the patient had a history of COVID-19 6 months before the onset of KD. SARS-CoV-2 antecedent infection before the onset of KD was not observed in this study, and strong association between development of KD and SARS-CoV-2 infection was not suggested.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"76-83"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Added value of diffusion-weighted magnetic resonance imaging in the diagnosis of recurrent cholangiocarcinoma.","authors":"Keiichiro Yamada, Yasuo Takehara, Satoko Ishigaki, Hiroshi Ogawa, Ayumi Nishida, Keita Kato, Tomoki Ebata, Takashi Mizuno, Shinji Naganawa","doi":"10.18999/nagjms.87.1.22","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.22","url":null,"abstract":"<p><p>Distinguishing recurrent cholangiocarcinoma lesions from postoperative fibrosis or biliojejunostomy lesions using contrast-enhanced computed tomography (CECT) alone is challenging. This study examined the value of adding diffusion-weighted magnetic resonance imaging (DWI) to CECT for the detection of cholangiocarcinoma recurrence. This single-institution retrospective analysis included 33 patients who underwent cholangiocarcinoma resection between January 2016 and December 2020. Of the patients, 20 were in the recurrence group and 13 were in the non-recurrence group. Two observers independently reviewed the CECT images and subsequently reviewed the combined CECT and DWI images (b-value, 1000 s/mm²), with each image reviewed twice. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. Kappa statistics were used to evaluate agreement. The diagnostic performance (area under the ROC curve [AUC]) of both observers improved after the addition of DWI; the AUC improved from 0.614 to 0.918 (<i>P</i> = 0.003) in the first session and from 0.820 to 0.928 (<i>P</i> = 0.20) in the second session for Observer A, whereas it improved from 0.566 to 0.858 (<i>P</i> < 0.001) in the first session and from 0.753 to 0.930 (<i>P</i> = 0.02) in the second session for Observer B. The intraobserver and interobserver agreements improved after the addition of DWI; the kappa value improved from 0.586 to 0.656 for Observer A, from 0.371 to 0.838 for Observer B, from 0.308 to 0.766 in the first session, and from 0.464 to 0.620 in the second session. Adding DWI to CECT improves the detection of cholangiocarcinoma recurrence compared to CECT alone.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"22-36"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of an ectopic Pacinian corpuscle in the pancreas mimicking pancreatic metastasis of renal cell carcinoma.","authors":"Hiroshi Ogawa, Yasuo Takehara, Marina Higashi, Hidenori Mizumoto, Daichi Ito, Shinji Naganawa, Hideki Takami, Masato Nakaguro","doi":"10.18999/nagjms.87.1.178","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.178","url":null,"abstract":"","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"178-181"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of severe immune-related adverse events, myocarditis with myositis, and myasthenia gravis overlap syndrome following adjuvant nivolumab administration for muscle-invasive bladder cancer.","authors":"Hiroki Kamikawa, Yoshihisa Matsukawa, Hisae Nishii, Yushi Naito, Kazuki Obara, Kentaro Sahashi, Ryota Morimoto, Kazuna Matsuo, Shohei Ishida, Satoshi Inoue, Shohei Miyagi, Ayako Sakakibara, Masahisa Katsuno, Kennosuke Karube, Shusuke Akamatsu","doi":"10.18999/nagjms.87.1.156","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.156","url":null,"abstract":"<p><p>Herein, we present a case of severe immune-related adverse events (irAEs), myocarditis with myositis, and myasthenia gravis overlap syndrome (IM3OS) in a patient receiving an immune checkpoint inhibitor (ICI), as adjuvant therapy after surgery for muscle-invasive bladder cancer. An 80-year-old woman who had undergone a total cystectomy for bladder cancer presented with ptosis, diplopia, and paralysis 18 days after receiving nivolumab, an anti-programmed cell death-1 (PD-1) monoclonal antibody, as adjuvant therapy for the first time. Initial testing revealed positive findings on the ice pack test; elevated troponin, creatine kinase, and aldolase levels; and an abnormal electrocardiogram, suggesting that the patient had developed ICI-related myocarditis, myositis, and myasthenia gravis. Despite treatment with intravenous immunoglobulin (IVIG) and high-dose corticosteroids, her condition worsened, leading to a complete atrioventricular block. After cardiac pacemaker insertion and intensive treatment with repeated high-dose corticosteroids, IVIG, plasma exchange, and tacrolimus, left ventricular function and myositis symptoms improved. However, the patient developed a respiratory infection and renal failure, leading to death on day 99. Although ICIs are considered relatively safe with few side effects, they can cause serious complications and lead to death. In particular, when severe irAEs occur in multiple organs, such as IM3OS, the prognosis is poor. Although IM3OS has no specific diagnostic biomarker, making early detection difficult, clinicians should always pay attention to patient symptoms when using ICI and evaluate other pathologies with IM3OS when conditions such as myositis or myocarditis are suspected. Further research is needed to elucidate the pathophysiology and risk factors of IM3OS.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"156-162"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ulnar nerve snagged on Kirschner wire following surgery for supracondylar fracture of humerus.","authors":"Tetsuhiro Hagino, Michitomo Sakuma, Takahiro Jubashi, Masanori Wako, Tetsuo Hagino, Hirotaka Haro","doi":"10.18999/nagjms.87.1.150","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.150","url":null,"abstract":"<p><p>A 9-year-old boy fell off his skateboard, resulting in a supracondylar fracture of his left humerus. The fracture was surgically repaired on the same day using two Kirschner wires inserted from the medial and lateral sides. Following surgery, the patient developed ulnar nerve palsy, prompting reoperation. It was discovered that the ulnar nerve was located anterior to the medial epicondyle and was snagged on the Kirschner wire, causing compression. Despite clear confirmation of the wire entry site, the presence of an unstable ulnar nerve anterior to the medial epicondyle necessitates caution to prevent ulnar nerve injury.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"150-155"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An appendiceal mucocele associated with inverted epithelium and submucosal hyperplasia at the appendiceal root: a rare case report.","authors":"Shuhei Asai, Hideo Miyake, Asayo Kato, Norihiro Yuasa, Rio Takada, Masahiko Fujino","doi":"10.18999/nagjms.86.4.703","DOIUrl":"https://doi.org/10.18999/nagjms.86.4.703","url":null,"abstract":"<p><p>A 54-year-old woman was referred to our hospital because of abnormal colonoscopic findings, including a submucosal protuberance at the appendiceal root. A biopsy showed no malignant findings. Computed tomography revealed a 20-mm cystic lesion with thick walls at the appendiceal root, suggestive of an appendiceal mucocele. Laparoscopic ileocecal resection was performed based on the preoperative diagnosis of a suspected mucinous appendiceal neoplasm. The resected specimen showed a closed appendiceal orifice surrounded by a mucus-containing submucosal tumor. Histopathologically, the appendiceal epithelium was circumferentially inverted in the appendiceal root, with hyperplasia of the submucosal connective tissue. No atypical epithelium was observed. We hypothesized that repeated partial invagination of the appendiceal root caused submucosal hyperplasia and drainage disturbance of the appendiceal content, leading to the development of a mucocele.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 4","pages":"703-710"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and antimicrobial susceptibility of <i>Eggerthella lenta</i> infection over a 5-year trend at a university hospital in Japan.","authors":"Nobuaki Mori, Akiko Nakamura, Jun Hirai, Nobuhiro Asai, Yuichi Shibata, Mina Takayama, Yuzuka Kawamoto, Narimi Miyazaki, Daisuke Sakanashi, Tomoko Ohno, Atsuko Yamada, Hiroyuki Suematsu, Isao Koita, Sumie Chida, Toshiaki Ohta, Hiroshige Mikamo","doi":"10.18999/nagjms.86.4.683","DOIUrl":"https://doi.org/10.18999/nagjms.86.4.683","url":null,"abstract":"<p><p><i>Eggerthella lenta</i> (<i>E. lenta</i>) is known to cause intra-abdominal and anaerobic bloodstream infections. However, clinical insights and information on antimicrobial susceptibility in <i>E. lenta</i> infections are limited. This study aimed to elucidate the clinical characteristics and antimicrobial susceptibility of <i>E. lenta</i> infections. Patients with <i>E. lenta</i> isolated from various specimens who presented at Aichi Medical University Hospital between January 2018 and December 2022 were included. Patient information was retrospectively collected from electronic medical records. Logistic regression analysis was conducted to identify risk factors for bloodstream infections. The antimicrobial susceptibility of various antimicrobial agents against isolated strains was investigated. During the study period, seventy cases were classified as infection cases. The median age of patients was 69 years (range: 15-100 years), and 48 (68.6%) were males. The most common site of infection was the lower digestive tract (54.3%). In 70.4% of cases, polymicrobial infections occurred. Community-acquired infection was a significant risk factor for bloodstream infection, with an odds ratio of 4.94 (95% confidence interval: 1.02-23.9). The 30-day mortality rate was 10.0%. Univariate analysis showed lower mortality in patients who underwent surgical intervention than in those who did not (42.9% vs 57.1%, <i>p</i> = 0.02). The proportion of minimal inhibitory concentrations (MICs) of ≥ 32 μg/mL for piperacillin-tazobactam was 6.3%. Additionally, the proportions of MICs of ≥ 8 μg/mL for imipenem and meropenem were 1.4% and 0%, respectively. <i>E. lenta</i> should be considered when blood cultures yield gram-positive rods in community-acquired intra-abdominal infections. Effective treatment involves both antimicrobial agents and surgical interventions.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 4","pages":"683-692"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}