Nagoya Journal of Medical Science最新文献

{"title":"Head and neck free flap reconstruction under the COVID-19 pandemic.","authors":"Shinichi Higuchi, Kazunobu Hashikawa, Katsumi Ebisawa, Miki Kambe, Yuzuru Kamei","doi":"10.18999/nagjms.86.3.472","DOIUrl":"10.18999/nagjms.86.3.472","url":null,"abstract":"<p><p>High perioperative mortality and complication rates during the coronavirus disease 2019 (COVID-19) pandemic have been reported. In head and neck reconstruction, not only is patient safety important, but the prevention of infection introduced by the surgical team is also important because the procedure is performed in close proximity to the upper respiratory tract. In addition, recent studies have reported an increased risk for thrombus formation after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 vaccination, which is problematic for microsurgical reconstruction procedures. At the authors' institution, patients undergoing head and neck reconstruction are requested to stay home for 2 weeks and undergo screening tests for COVID-19 before admission. Surgeons use standard personal protective equipment during surgery. There was no significant difference in the rate of total flap necrosis between the COVID-19 and non-pandemic periods or large difference of perioperative complication rates between vaccinated and non-vaccinated patients. No surgery-related infections among the surgical staff were also found.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"472-478"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362365","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":"Nature of storage iron turnover.","authors":"Hiroshi Saito","doi":"10.18999/nagjms.86.3.361","DOIUrl":"10.18999/nagjms.86.3.361","url":null,"abstract":"<p><p>Despite recent advance in the study of the nature of storage iron turnover, a comprehensive analysis remains lacking. This study aimed to clarify the nature of storage iron turnover. Ferritin-hemosiderin iron transformation rate and the standard normal storage iron turnover rate were utilized in this study to describe the mechanism of iron absorption in relation to ferritin and hemosiderin iron turnover. The synchronization of radioiron uptake peaks by bone marrow and liver indicates that the distribution of radioiron is proportional to the pre-existing iron levels in organs at 24 h after radioiron injection. Moreover, the synchronization indicates the independence of iron mass from red cell precursors in acquiring plasma iron. Thus, the erythron does not dominate the radioiron uptake process. The inverse correlation between transformation rate and the amount of pre-existing iron storage implies that the intra-storage iron turnover is active in iron deficiency, but inactive in iron overload. The decreased ferritin/hemosiderin iron ratio in chronic hepatitis C (CHC) with normal iron storage suggests a trend of iron transformation from ferritin into hemosiderin. The correlation between the pretreatment iron storage and the speed of rebound in CHC implies that the vacant iron-storing rooms in iron-removed cells have a potential to increase iron absorption. This study presents new insights into the turnover of stored iron to enhance our understanding of iron metabolism in various hematologic disorders.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"361-369"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362370","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 usefulness of endothelial progenitor cells in predicting the efficacy of riociguat in chronic thromboembolic pulmonary hypertension.","authors":"Ryo Imai, Shiro Adachi, Masahiro Yoshida, Shigetake Shimokata, Yoshihisa Nakano, Naoki Okumura, Toyoaki Murohara, Takahisa Kondo","doi":"10.18999/nagjms.86.2.292","DOIUrl":"10.18999/nagjms.86.2.292","url":null,"abstract":"<p><p>Endothelial dysfunction is important in the pathology of pulmonary hypertension, and circulating endothelial progenitor cells (EPCs) have been studied to evaluate endothelial dysfunction. In patients with chronic thromboembolic pulmonary hypertension (CTEPH), riociguat reportedly increases the number of circulating EPCs. However, the relationship between EPC numbers at baseline and changes in clinical parameters after riociguat administration has not been fully elucidated. Here, we evaluated 27 treatment-naïve patients with CTEPH and analyzed the relationships between EPC number at diagnosis and clinical variables (age, hemodynamics, atrial blood gas parameters, brain natriuretic peptide, and exercise tolerance) before and after riociguat initiation. EPCs were defined as CD45^dim CD34⁺ CD133⁺ cells and measured by flow cytometry. A low number of circulating EPCs at diagnosis was significantly correlated with increased reductions in mean pulmonary arterial pressure (mPAP) (correlation coefficient = 0.535, <i>P</i> = 0.004) and right atrial pressure (correlation coefficient = 0.618, <i>P</i> = 0.001) upon riociguat treatment. We then divided the study population into two groups according to the mPAP change: a weak-response group (a decrease in mPAP of 4 mmHg or less) and a strong-response group (a decrease in mPAP of more than 4 mmHg). The number of EPCs at diagnosis was significantly lower in the strong-response group than in the weak-response group (<i>P</i> = 0.022), but there were no significant differences in other clinical variables or in medication profiles. In conclusion, circulating EPC numbers could be a potential predictor of the therapeutic effect of riociguat in CTEPH patients.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"292-303"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499408","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":"Evaluation of demographic/clinical features and hemorrhagic complications in patients with ischemic stroke who underwent reperfusion therapy.","authors":"Hatice Ferhan Kömürcü, Eren Gözke, Işıl Kalyoncu Aslan, Pelin Doğan Ak, Irmak Salt","doi":"10.18999/nagjms.86.2.237","DOIUrl":"10.18999/nagjms.86.2.237","url":null,"abstract":"<p><p>The relationship between demographic/clinical characteristics, clinical outcomes and the development of hemorrhagic complications in patients with ischemic stroke who underwent reperfusion therapy has not been studied sufficiently. We have aimed to compare genders and age groups in terms of clinical features and outcome; and types of reperfusion treatments and clinical features regarding the development of hemorrhagic complications in patients with ischemic stroke who underwent recombinant tissue plasminogen activator (rtPA) and/or thrombectomy. Patients with acute ischemic stroke undergoing rtPA and/or thrombectomy were divided into six age groups. Parameters including hemorrhagic complications, anticoagulant and antiaggregant use, hyperlipidemia, smoking status, biochemical parameters, and comorbidities were documented. National Institutes of Health Stroke Scale (NIHSS) scores, modified Rankin Score (mRS) and Glasgow Coma Scale scores were recorded. Etiological classification of stroke was done. These parameters were compared in terms of age groups, genders, and hemorrhagic complications. Significant differences were found between age groups concerning hypertension, coronary artery disease, smoking status, and antiaggregant use. Rate of hemorrhagic complications in rtPA group was significantly lower when compared with other treatment groups. Hemorrhagic complications developed mostly in the rtPA+thrombectomy group. Among the patients who developed hemorrhagic complications, NIHSS scores on admission were found to be significantly lower in men than women. Admission, discharge, and 3^rd month mRS values in men were significantly lower than those of women. Knowing demographic and clinical features of patients that may have an impact on the clinical course of ischemic stroke managed with reperfusion therapy will be useful in predicting the hemorrhagic complications and clinical outcomes.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"237-251"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499412","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":"Tissue characteristics of residual lesion in patients with acute coronary syndrome caused by plaque rupture versus plaque erosion: a single-center, retrospective, observational study.","authors":"Wataru Suzuki, Hirofumi Ohashi, Hirohiko Ando, Yusuke Nakano, Hiroaki Takashima, Masanobu Fujimoto, Hiroaki Sawada, Reiji Goto, Akihiro Suzuki, Shinichiro Sakurai, Tetsuya Amano","doi":"10.18999/nagjms.86.2.189","DOIUrl":"10.18999/nagjms.86.2.189","url":null,"abstract":"<p><p>Patients with acute coronary syndrome (ACS), frequently caused by plaque rupture (PR), often have vulnerable plaques in residual lesions as well as in culprit lesions. However, whether this occurs in patients with plaque erosion (PE) as well is unknown. We retrospectively analyzed the data of 88 patients with ACS who underwent both optimal coherence tomography (OCT) and intravascular ultrasound (IVUS). Based on plaque morphology of the culprit lesions identified using OCT, patients were classified into PE (n=23) and PR (n=35) groups. The tissue characteristics of residual lesions evaluated using integrated backscatter IVUS were compared between both groups after percutaneous coronary intervention. The PE group had a significantly lower percent lipid volume and a higher percent fibrous volume than the PR group (35.0±17.8% vs 49.2±13.4%, p<0.001; 63.2±17.1% vs 50.3±13.1%, p=0.002, respectively). Receiver operating characteristic curve analysis revealed that percent lipid volume in the residual lesions was a significant discriminant factor in estimating the plaque morphology of the culprit lesion (optimal cut-off value, <43.5%; sensitivity and specificity values were 73.9% and 68.6%, respectively). In conclusion, patients with PE had a significantly lower percent lipid volume and a significantly higher percent fibrous volume in the residual lesions than those with PR, suggesting that the nature of coronary plaques in patients with PE is different from that of those with PR.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"189-200"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499437","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":"Pregnancy co-treated with oral gonadotropin-releasing hormone antagonist in a woman with premature ovarian insufficiency: a case report.","authors":"Daichi Inoue, Manami Kondo, Rie Mizuno, Shinichi Shibuya, Yoshiki Hashiba, Yoshimasa Asada","doi":"10.18999/nagjms.86.2.333","DOIUrl":"10.18999/nagjms.86.2.333","url":null,"abstract":"<p><p>To the best of our knowledge, this is the first case of pregnancy with a healthy baby after treatment with an oral gonadotropin-releasing hormone (GnRH) antagonist in women with premature ovarian insufficiency. A 36-year-old female presented at our hospital after being diagnosed with premature ovarian insufficiency by a previous doctor. We administered clomiphene, human menopausal gonadotropin (hMG), and GnRH antagonist (injection) together with estrogen replacement for 11 cycles (27 months), but no follicular development was observed. When the oral GnRH antagonist (relugolix), which has recently become available, was used in the 12^th cycle, follicular growth of 13 mm was confirmed on the 14^th day of stimulation. After stimulation, the use of hMG and GnRH antagonist (injection) was continued, and a maturation trigger, human chorionic gonadotropin 10000 IU, was administered. Oocyte retrieval was performed successfully, intracytoplasmic sperm injection and frozen embryo transfer were performed, and fetal heartbeat was confirmed. The patient was admitted to the perinatal management facility. She delivered a healthy baby of 3,732 g via cesarean section at 41 weeks +2. This case shows the possibility of using an oral GnRH antagonist as an option for infertility treatment.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"333-340"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499432","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":"Protective effect of <i>Sasa veitchii</i> extract against all-trans-retinoic acid-induced inhibition of proliferation of cultured human palate cells.","authors":"Yosuke Tsukiboshi, Yurie Mikami, Hanane Horita, Aya Ogata, Azumi Noguchi, Satoshi Yokota, Kenichi Ogata, Hiroki Yoshioka","doi":"10.18999/nagjms.86.2.223","DOIUrl":"10.18999/nagjms.86.2.223","url":null,"abstract":"<p><p>Cleft palate is the most common facial birth defect worldwide. It is caused by environmental factors or genetic mutations. Environmental factors such as pharmaceutical exposure in women are known to induce cleft palate. The aim of the present study was to investigate the protective effect of <i>Sasa veitchii</i> extract against medicine-induced inhibition of proliferation of human embryonic palatal mesenchymal cells. We demonstrated that <i>all-trans</i>-retinoic acid inhibited human embryonic palatal mesenchymal cell proliferation in a dose-dependent manner, whereas dexamethasone treatment had no effect on cell proliferation. Cotreatment with <i>Sasa veitchii</i> extract repressed <i>all-trans</i>-retinoic acid-induced toxicity in human embryonic palatal mesenchymal cells. We found that cotreatment with <i>Sasa veitchii</i> extract protected <i>all-trans</i>-retinoic acid-induced cyclin D1 downregulation in human embryonic palatal mesenchymal cells. Furthermore, <i>Sasa veitchii</i> extract suppressed <i>all-trans</i>-retinoic acid<i>-</i>induced <i>miR-4680-3p</i> expression. Additionally, the expression levels of the genes that function downstream of the target genes <i>(</i> <i>ERBB2</i> and <i>JADE1</i> <i>)</i> of <i>miR-4680-3p</i> in signaling pathways were enhanced by cotreatment with <i>Sasa veitchii</i> extract and <i>all-trans</i>-retinoic acid compared to <i>all-trans</i>-retinoic acid treatment. These results suggest that <i>Sasa veitchii</i> extract suppresses <i>all-trans</i>-retinoic acid-induced inhibition of cell proliferation via modulation of <i>miR-4680-3p</i> expression.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"223-236"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499433","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 recurrent erythema induratum of Bazin in a patient with myelodysplastic syndrome.","authors":"Kei Noro, Chiaki Murase, Ryo Fukaura, Naoki Watanabe, Keisuke Sunohara, Norihisa Ishii, Masashi Yamazaki, Masashi Akiyama","doi":"10.18999/nagjms.86.2.341","DOIUrl":"10.18999/nagjms.86.2.341","url":null,"abstract":"<p><p>We describe a case of erythema induratum of Bazin (EIB) that presented recurrently on the extremities during treatment with anti-tuberculosis medications. The anti-tuberculosis medications were effective, so they were continued despite the occurrence of the EIB lesions, and those lesions disappeared 5 months after first appearing. EIB is currently considered a multifactorial disorder with many different causes, with tuberculosis being an example, and it is thought to be a hypersensitive immune response to <i>Mycobacterium tuberculosis</i>. The clinical manifestations may fluctuate depending on the immune response of the host. Our patient was affected with myelodysplastic syndrome, and we believe that this was a major factor that interfered with a normal immune response. This case illustrates the importance of providing intensive anti-tuberculosis treatment from the start, and in cases where EIB co-presents, to continue this treatment until the end, in order to prevent relapse.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"341-344"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499407","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":"Comparison of the influenza vaccination coverage among high-risk people between the online registration system and walk-in service system in Bangkok, Thailand.","authors":"Ranai Sairuk, Kimihiro Nishino, Souphalak Inthaphatha, Nobuyuki Hamajima, Eiko Yamamoto","doi":"10.18999/nagjms.86.2.252","DOIUrl":"10.18999/nagjms.86.2.252","url":null,"abstract":"<p><p>Until recently, the Thai national program of seasonal influenza vaccination for high-risk people has been using a walk-in service system. However, in 2020, an online registration system was introduced in Bangkok to improve vaccine coverage. This study aimed to compare the coverage of influenza vaccination between the walk-in service and online registration systems. The study participants included 374,710 Thai individuals who obtained an influenza vaccination from the national program in the Bangkok health region in 2018 (n = 162,214) and in 2020 (n = 212,496). The registration systems that were examined were the walk-in service system in 2018 and the online registration system in 2020. The characteristics of vaccine recipients and the vaccine coverage in each risk group and health facility level were compared between the two systems. Coverage comparison in Bangkok between the years 2018 and 2020 showed an increase in coverage, particularly among individuals who had an influenza vaccination at health facilities of the primary level and in the elderly and obesity groups. The coverage among children was lowest among all high-risk groups. To improve coverage in Thailand, the online registration system should be introduced in all regions. Additionally, information about influenza vaccination for children should be disseminated to parents using handbooks or by word-of-mouth from healthcare workers.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"252-261"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499410","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":"Development and validation of the chronic obstructive pulmonary disease self-care assessment scale: a concise and comprehensive instrument to assess self-management, decision-making, and coping.","authors":"Sanae Iwaya, Kazuki Sato","doi":"10.18999/nagjms.86.2.201","DOIUrl":"10.18999/nagjms.86.2.201","url":null,"abstract":"<p><p>The purpose of this study was to develop and test the reliability and validity of a brief and comprehensive instrument to assess self-management, decision-making, and coping by chronic obstructive pulmonary disease (COPD) patients. A web-based questionnaire was administered to 300 COPD patients and a retest was administered to 100 COPD patients. Cronbach's alpha was used to assess internal consistency, and an intraclass correlation coefficient was calculated to test the reliability of the retest. The convergent and discriminant validities were also examined. Valid responses were obtained from 279 participants in the first survey and 70 participants in the retest. From our analysis, a COPD self-care assessment scale (CSCS) was developed, consisting of seven subscales and 14 items. Cronbach's alpha for the total CSCS score, intraclass correlation coefficient, and scale success rate were 0.80, 0.79, and 100%, respectively. A multivariate analysis showed that CSCS was associated with current smoking (standardized partial regression coefficient [std β] = -0.30; p < 0.001), long-term oxygen therapy (std β = 0.23; p < 0.001), and social support (std β = 0.24; p < 0.001), but not psychological symptoms or quality of life. The CSCS is also useful in assessing self-management, decision-making, and coping in Japanese COPD patients, and the scale has high reliability and validity.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 2","pages":"201-215"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499411","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}