The Kurume Medical Journal (Kurume Med J)

Publisher: Kurume Daigaku. Igakubu

Journal description

Journal of the Kurume University School of Medicine.

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Website Kurume Medical Journal, The website
Other titles Kurume medical journal (Online)
ISSN 0023-5679
OCLC 77079261
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Ebstein’s anomaly (EA) is a rare congenital heart disease of the tricuspid valve, and less than 5% of patients with EA survive beyond the age of 50. We report two unoperated cases of EA in adult patients aged over 50 years. Two patients, a 70-year-old Japanese woman and a 59-year-old Chinese woman, were referred to us for tachyarrhythmias. Transthoracic echocardiography demonstrated apical displacement (>8 mm⁄m2 body surface area) of the septal leaflet of the tricuspid valve from the atrioventricular ring with tricuspid regurgitation in both patients. The former suddenly expired 20 months later after suffering from repetitive supraventricular tachyarrhythmias and/or heart failure, and the latter is alive with minimal signs of heart failure 12 months after the diagnosis of EA. Although the natural history of EA is extremely variable, these two patients are exceptional in that they tolerated EA well for over 50 years without any surgical intervention.
    The Kurume Medical Journal 01/2014; 60(3.4):115-117. DOI:10.2739/kurumemedj.MS63007
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    ABSTRACT: To reduce chemotherapy induced gonadotoxicity, co-treatment with gonadotropin releasing hormone against analogue (GnRHa) was tested using rat model. Leuprorelin acetate (Leuplin) with or without cisplatin (CDDP) was given subcutaneously at a dose of 9.4 microg/ml to Wistar strain female rats. The total number of follicles was counted and the maturation of follicles was evaluated at the largest section of the ovary on the 5th and 10th day after administration. Leuplin led the ovary to a resting phase in which primordial follicle occupied 80% of all follicles in only 5 days after administration. The serum E2 level was also down by the 5th day and maintained a low level to the 10th day. In co-treatment with GnRHa and CDDP rats, the primordial follicle occupied 90% of all follicles and the total number of follicles was higher than in CDDP alone rats. This rat model verified that GnRHa co-treatment well minimized CDDP induced gonadotoxocity by desensitization of the ovary. These results were promising for the clinical application introducing GnRHa co-treatment as ovarian protection in cancer chemotherapy in young women.
    The Kurume Medical Journal 02/2007; 54(1-2):25-9. DOI:10.2739/kurumemedj.54.25
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    ABSTRACT: Of the patients who underwent resection of hilar cholangiocarcinoma, those who received palliative surgery, or could not be followed up clinicopathologically, were excluded from this study. In the remaining 37 patients, the cumulative postoperative survival rate (simply referred to as the cumulative survival rate below) was analyzed according to gross types, histopathological parameters, final stages, and final curability. These patients showed a 5-year survival rate of 17.7% and a 50% survival of 2.2 years. By gross type, patients with a localized papillary or nodular expansion type tended to have a better survival rate than those with an invasive papillary or nodular expansion type. A greater histological depth of invasion tended to be associated with a poorer prognosis: the s(-) group, that is, a group of patients without serosal exposure of cancer (invasion depths of m, fm, and ss) had a significantly better prognosis than the s(+) group, a group of patients with serosal exposure of cancer (invasion depths of se and si). Other histopathological parameters, such as ly, pn, pHinf, pHM, and pEM, were associated with significant prognostic differences. By final stage, the stage I/II group and stage III or higher group showed a particularly significant difference in prognosis. By final curability, the curability A/B group had a significantly better prognosis than the curability C group. Taken together, surgery providing curability A and B promises a good long-term prognosis. Therefore, it is important that efforts are made to detect cancer early, adequately evaluate the degree of cancer extension, and determine the extent of resection and the surgical technique.
    The Kurume Medical Journal 02/2007; 54(1-2):41-9. DOI:10.2739/kurumemedj.54.41
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    ABSTRACT: We used an embryological approach to investigate development and microvasculature of lingual papillae, and expression of vascular endothelial growth factor (VEGF) in the rat tongue. Temporal changes in the rat tongue at each developmental stage from embryonic day 13 (E13) to postnatal day 7 (P7) were observed by intravascular injection of India ink and immunohistochemistry using a VEGF antibody. At E13, the primordium of circumvallate papilla was observed among various lingual papillae. VEGF was widely expressed at E16 on the proliferated epithelium and the connective tissue core of circumvallate papilla. Invasion by capillary sprouts forming the lingual papillae was observed at E17. The primordium of fungiform papillae was observed at E14. VEGF was strongly expressed around the basal cells of proliferated epithelial tissues of fungiform papillae at E17. At E18, blind-ended capillary sprouts invaded into connective tissue cores from subepithelial sinusoidal capillaries by sprout angiogenesis. At P1, the invading capillary sprouts formed loops by vascular remodeling. The primordium of foliate papillae was observed at E16. VEGF was slightly expressed, but uniformly at E17 on the epithelium, muscle cells, and fibroblasts of foliate papillae. At E18, vascular density was increased by angiogenesis. The primordium of filiform papillae was observed at E17. It was the last to develop among the lingual papillae. VEGF was expressed in the cytoplasm of grown epithelial cells of filiform papillae at E19, and in blind-ended capillary sprouts formed by angiogenesis in the connective tissue cores at E20. The capillary sprouts formed loops by vascular remodeling at P1. Consequently, VEGF was expressed on the papillary epithelium and connective tissue cores of papillae during development of the papillary epithelium, and invasion by capillary sprouts into each papillae was observed thereafter. These results suggest a close relationship between expression of VEGF and angiogenesis of lingual papillae in the rat.
    The Kurume Medical Journal 02/2007; 54(1-2):9-24. DOI:10.2739/kurumemedj.54.9
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    ABSTRACT: The present study aimed to investigate the potential use of the transtheoretical model (TTM) by clarifying the program's effects on workers at a small-scale company. Subjects were 22 male workers at a communication system company. They were divided into two physical activity improvement program groups, the TTM-based assistance group (TTM group, n=12) and the control group (n=10). During the study period each subject was asked to wear a calorie counter and to record daily exercise. Changes in number of steps per day and body weight were measured before, immediately after, and 1 month after the intervention ended. Stage of exercise behavior, health protective behavior, and self-efficacy were also examined by means of self-administered questionnaires. In the control group, the number of steps per day tended to increase immediately after the intervention and then decreased at 1 month after the program ended. In both groups, physical activity peaked during commuting and lunch hours. This peak persisted for 1 month after the intervention in the TTM group, but not in the control group. Moreover, the stage of exercise behavior tended to progress in the TTM group, whereas regression in the stage of exercise behavior was observed in the control group. In the control group, although the exercise self-efficacy score after intervention was higher than that before intervention, the health protective behavior score decreased at 1 month after the program ended. This study suggested that physical activity improvement programs based on TTM may be useful for workers at small-scale companies. However, further study of larger numbers of workers will be needed to confirm the validity and usefulness of these results.
    The Kurume Medical Journal 02/2007; 54(1-2):1-8. DOI:10.2739/kurumemedj.54.1
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    ABSTRACT: Muscle training exercises are needed for muscular endurance during spaceflight. This study was designed to investigate effects of volitional contraction against applied electrical stimulation on the muscular endurance of the proximal upper extremity. Thirteen healthy sedentary men were allocated into two groups. One group participated in a hybrid (HYB) exercise regimen in which the biceps brachii was stimulated as he volitionally extended his elbow, and the triceps brachii was stimulated as the volitionally flexed his elbow. The second group underwent a similar regimen in which the electrical stimulation (ELS) was alternatively delivered to the biceps brachii and then to the triceps brachii with the limb fixed. Forty-second surface electromyography (EMG) recordings at 50% maximum voluntary contraction (MVC) were made as baseline data at just before starting the training regimen, and again conclusion. The median frequency (MF) and mean power frequency (MPF) slopes with time were determined using power spectrum analysis. There were statistical significance only for the triceps in which the MF and MPF slopes in the HYB Group became less negative over the period of study (from -45.7+/-14.7 and -47.0+/-8.6%/min at baseline to -36.9+/-10.7 and -36.8+/-7.0%/min at the end of training, respectively). The corresponding values for these slopes in the ELS Group showed opposite tends with less marked changes of borderline significance for MF and of statistical significance for MPF. These results suggested that the HYB exercise regimen was capable of producing an improvement in triceps but not biceps brachii.
    The Kurume Medical Journal 02/2007; 54(1-2):35-40. DOI:10.2739/kurumemedj.54.35
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    ABSTRACT: Little is known about the influence of simple limbectomy on the growth of the acetabulum. An experimental study was carried out in ten monkeys divided into two groups: limbectomy only (Group A) and limbectomy with concomitant cartilage resection (Group B). After three years and four months postoperatively, monkeys were sacrificed. Excised joints were examined macro-and microscopically. Degenerative changes in the cartilage and hypertrophy in the joint capsule were noted in all five monkeys of Group B, and in none of Group A. The diameter of the acetabulum was significantly enlarged in Group B (longitudinal diameter: p<0.05, transverse diameter: p<0.01, Mann-Whitney's U test), compared with Group A and the contralateral hips as controls. There was no other significant difference in other soft tissue or osseous components, between two groups. Histologically, the injured limbus was healed with irregular and sparse fibrous tissue in both groups. Fibrillation in the superficial layer of the cartilage and cluster formation was frequently noted in group B, while normal appearance was noted in Group A. This study demonstrated that simple limbectomy dose not affect the growth of the acetabulum, but may cause degenerative changes if the adjacent acetabular cartilage was simultaneously injured.
    The Kurume Medical Journal 02/2007; 54(1-2):31-4. DOI:10.2739/kurumemedj.54.31
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    ABSTRACT: The present study reports the effects of systemic deep hypothermia (SDH) and subarachnoid block (SAB) on the longitudinally conducting evoked spinal cord potential (conducting ESCP) in man. Before induction of anesthesia, a pair of bipolar catheter electrodes was introduced to the epidural space: one at the level of the cervical enlargement and the other at the lumbosacral enlargement. The conducting ESCP was produced by electrical stimulation through the upper electrode and recorded through the lower electrode, and vice versa. SDH Study: Subjects were 6 patients who underwent replacement surgery of an aortic aneurysm with deep hypothermia anesthesia. The peak latency of the ESCP was gradually prolonged and the duration was widened with cooling via extracorporeal circulation. The amplitude of ESCP showed a biphasic change over the course of cooling with a turning point of around 30 degrees C in esophageal temperature. The ESCP was well observed until blood temperatures as low as near 10 degrees C. The result shows that ESCP is available as an intra-operative monitoring parameter of the spinal function even under SDH. SAB Study: Subjects were 7 patients, 6 of whom had SAB and the remaining 1 intravenous application of a local anesthetic. The conducting ESCP was markedly depressed or disappeared completely even after SAB with clinical doses of various local anesthetics, while it was hardly affected by the intravenous application. The result implies that SAB causes, at least partially, the conduction block within the spinal cord.
    The Kurume Medical Journal 02/2006; 53(1-2):13-22. DOI:10.2739/kurumemedj.53.13
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    ABSTRACT: Loss of appetite is frequently seen and is a main factor affecting quality of life (QOL) in patients with advanced cancer. The etiology for loss of appetite in patients with cancer is multifactorial. The sensory properties of food are factors regulating appetite. Changes in taste, smell and texture of foods influence food intake. The appearance of the food is also a notable factor in sensory-specific satiety. We described a 46-year-old Japanese woman with multiple metastatic liver tumors. Although there was no obvious factor for loss of appetite, she suffered from a loss of appetite and subsequent malnutrition. In order to improve the appearance of food, we reduced the diet to 1,000 kcal/day from 1,500 kcal/day. On the new diet, the patient's appetite significantly increased and patient's nutritional status was improved. Eating whole diet was an important achievement and increased in mental aspects of QOL. Arrangement for the appearance of food may be a simple and nontoxic therapeutic strategy for patients with cancer suffering a loss of appetite.
    The Kurume Medical Journal 02/2006; 53(1-2):41-6. DOI:10.2739/kurumemedj.53.41
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    ABSTRACT: Multiple round opacities suggestive of metastatic lung tumors were incidentally found on a chest x-ray film in a 43-year-old woman. The patient underwent hysterectomy for "myoma uteri" three years previously. Extensive examinations could not specify the primary neoplastic lesions. Morphological characteristics of the thracoscopically resected lung tumors suggested low-grade endometrial stromal sarcoma (ESS), and immunostaining revealed that the tumor cells were positive for progesterone and estrogen receptors, CD10 and vimentin, confirming a diagnosis of ESS. ESS is an uncommon uterine neoplasm, however, may be mistaken as benign tumors such as epithelioid leiomyoma, and occasionally metastasizes to remote organs such as lungs even after long disease-free period, posing diagnostic challenge.
    The Kurume Medical Journal 02/2006; 53(3-4):95-7. DOI:10.2739/kurumemedj.53.95
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    ABSTRACT: The water-soluble vitamin (included vitamin B1, B6, B12 and C) preparations are not always replenished when peripheral parenteral nutrition (PPN) is used in Japan. We evaluated the need for administration of vitamins preparation during PPN, and involved analysis of the blood levels of water-soluble vitamins in patients receiving perioperative PPN before and after gastrectomy. Patients were examined as two set of groups as follows; 18 patients who did not receive water-soluble vitamin preparations during PPN, the Unsupplemented Group, and 22 patients who received such preparations during PPN, the Supplemented Group. Consequently, in the Unsupplemented Group, the blood vitamin B1 level during the early postoperative period was significantly lower than the preoperative level, but in the Supplemented Group, it was significantly higher than the preoperative level. In the Supplemented Group, the blood vitamin B12 level during the early postoperative period was markedly higher than the preoperative level. And in both groups, the blood vitamin C level remained below the lower limit of the criterion range throughout the perioperative period. These results suggested that administration of water-soluble vitamins during PPN was needed to avoid potential vitamin deficiencies after surgery and to prevent a potential onset of severe metabolic complications from any deficiencies.
    The Kurume Medical Journal 02/2006; 53(3-4):79-87. DOI:10.2739/kurumemedj.53.79
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    ABSTRACT: The patient was a 45-year-old man with a history of heavy drinking. A pseudocyst about 30 mm in diameter was found in the head of his pancreas. About four weeks later an upper abdominal mass, abdominal pain and obstructive jaundice were confirmed. Abdominal CT revealed that the cyst had increased in size to about 60 mm, compressing the lower common bile duct and the surrounding digestive tract. Therefore endoscopic ultrasonography-guided cystogastrostomy following percutaneous transhepatic biliary drainage (PTBD) was performed. Postoperatively, the cyst quickly decreased in size and jaundice improved. Because of persistent common bile duct stenosis, an endoscopic retrograde biliary stent was implanted. There has been no recurrence at ten months after the endoscopic therapy. While invasive surgery is generally employed in the treatment of pancreatic pseudocyst complicated by obstructive jaundice, EUS-guided cystogastrostomy appears to be a useful procedure, particularly when considering the relatively minor degree of surgical invasion.
    The Kurume Medical Journal 02/2006; 53(3-4):89-94. DOI:10.2739/kurumemedj.53.89
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    ABSTRACT: The purpose of this study was to investigate the cross-sectional and longitudinal effects of endurance training on the relationships of body composition, blood lipid profiles and sex hormones in adolescent female distance-runners. We cross-sectionally compared body composition, blood lipid profiles and blood sex hormones of non-athletes (n=7) and distance-runners (n=8), with the similar lower level of BMI (17.1 kg/m(2) vs. 18.7 kg/m(2), respectively). After the cross sectional comparison on the influence of endurance training, body composition, blood lipid profiles and blood sex hormones were examined at pre- and post-one year endurance training in the distance-runners (n=6) to determine longitudinal effects. %Fat in distance-runners revealed a tendency to be lower than that in non-athletes (23.8+/-3.5 vs 27.3+/-2.5%). Both groups showed good blood lipid profiles, such as high levels of high density lipoprotein-cholesterol (HDL-c), HDL-2c, and apolipoprotein A-I (ApoA-I). However, the estrogen (E(2)) level of distance-runners was less than one third of that in non-athletes (30.5+/-11.3 vs 112.9+/-66.2 pg/ml, p<0.01). In addition, the blood E(2) levels (pg/ml) were significantly associated with the internal fat mass (IF, kg) in all subjects (r=-0.613, p<0.05, n=15). On the other hand, the overall body composition and good blood lipid profiles in the longitudinal comparison were maintained to a constant level for one year endurance training, except for significant elevations in the two enzyme activities and E(2) level (LPL activity: from 145.3+/-40.8 to 362.2+/-65.8 ng/ml, HTGL activity: from 0.054+/-0.020 to 0.173+/-0.080 micromole/ml/min, E(2): from 30.7+/-13.2 to 65.6+/-24.2 pg/ml, p<0.05). These results suggest that the lipid profiles such as HDL-c and Apo A-I in adolescent female distance-runners could be rather affected by endurance training, despite the low level of E(2) for a long term.
    The Kurume Medical Journal 02/2006; 53(1-2):29-35. DOI:10.2739/kurumemedj.53.29
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    ABSTRACT: We describe a technique of double-door laminoplasty for the management of cervical myelopathy using the autologous spinous process instead of an artificial spacer. The aims in the present study were to determine the fusion rate and the incidence rate of breakage in the autologous spinous process, and to assess its efficacy for cervical laminoplasty. Twenty-three patients of cervical myelopathy were treated with double-door laminoplasty followed by implantation of the autologous spinous process. The spinous process from C3 to C7 was resected, at 8 mm from the basal part of the spinous process. The autologous spinous process was made from the removed spinous process, and was implanted between each expanded laminae. Post-operative CT scanning determined the fusion rate between the expanded laminae and the autologous spinous process as 70.4% at 3 months, and 93.5% at 6 months, after the operation. There was no dissociation and no breakage in the autologous spinous process during the follow-up observation period. There were certain advantages to our technique including the high fusion rate and good stability in the autologous spinous process. In addition, this technique was less expensive than other techniques using an artificial spacer. These findings indicated that this technique was a reliable procedure for effectively treating of cervical myelopathy which are caused by multisegmental cervical canal stenosis.
    The Kurume Medical Journal 02/2006; 53(1-2):7-12. DOI:10.2739/kurumemedj.53.7
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    ABSTRACT: We investigated 115 patients with salivary gland epithelial tumors who had undergone preoperative fine needle aspiration cytology (FNAC) of salivary glands and had been diagnosed by postoperative histopathological examination. We compared the findings of preoperative FNAC with their histopathological types in salivary gland tumors, and discuss the results and problems. The diagnostic accuracy, sensitivity, and specificity of preoperative FNAC of salivary glands were 98.2%, 88.2%, and 100%, respectively. The percentage of inadequate specimens was 6.1%. The rates of agreement in the diagnosis of pleomorphic adenoma, Warthin tumor, and basal cell adenoma were 96%, 92.9%, and 55.5%, respectively. The rate of agreement of histopathological types in the malignant tumors was 30%. We realized again not only that the diagnostic accuracy of preoperative FNAC for salivary gland tumors was high, but also that it was a safe, easy-to-perform, clinically very useful diagnostic procedure. However, this study exposed several problems which are the inadequate sampling rate and the difficulty in diagnosing malignant tumors. We have been making efforts to take appropriate specimens by writing comments on the cytological report indicating a re-examination, or by the presence of the clinical laboratory technician at the FNAC procedure. We consider it necessary to adequately re-aspirate the solid portion after cyst fluid aspiration, or to re-perform FNAC at a later date, and to improve the diagnostic accuracy by further experience with more patients.
    The Kurume Medical Journal 02/2006; 53(1-2):23-7. DOI:10.2739/kurumemedj.53.23
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    ABSTRACT: One of the longstanding challenges in the treatment of pancreatic cancer, the fifth most common cancer worldwide, is to establish a simple and reliable diagnostic marker for the disease. This study examined whether or not the simultaneous measurement of plasma levels of IgG antibodies (IgGs) reactive to peptides recognized by cytotoxic T lymphocytes was useful for screening of pancreatic cancer. Sixty-three kinds of peptides were tested for their reactivity to plasma IgGs of pancreatic cancer patients with Luminex system followed by discriminatory analysis of the results using the Statistical Discovery Software. Under these circumstances, 83% of subjects with pancreatic cancer and 12% of healthy donors were diagnosed as having pancreatic cancer, respectively. These results suggest that the simultaneous measurement of IgGs reactive to these peptides could potentially be useful as a new diagnostic tool to screen for pancreatic cancer.
    The Kurume Medical Journal 02/2006; 53(3-4):63-70. DOI:10.2739/kurumemedj.53.63
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    ABSTRACT: A 25-year-old male who had no significant medical history presented abrupt onset of high-grade fever and chills without noticeable trigger. The patient sought for medical attention for subsequently developed dyspnea and chest pain. Radiological examinations revealed bilateral lung peripheral multiple opacities, some of which were cavitating, suggesting of septic pulmonary emboli (SPE). Isolation of Staphylococcus aureus in blood and sputum culture confirmed the diagnosis. Extensive examinations disclosed neither underlying immunocompromising conditions nor infectious foci, which are usually notable in patients with SPE. The present patient illustrates that there are patients with SPE in whom underlying conditions or infectious foci are difficult to determine, and that suspicion of the disease based on characteristic radiological findings is critical for appropriate management in those patients.
    The Kurume Medical Journal 02/2006; 53(3-4):99-101. DOI:10.2739/kurumemedj.53.99