The Kurume Medical Journal (Kurume Med J)

Publications in this journal

• Article: A case of central nervous system lymphoma manifesting as multiple patchy white matter lesions with a past history of tonsil lymphoma.

  Susumu Kobayashi, Keita Sakurai, Motoki Tanikawa, Yusuke Nishikawa, Noriyuki Matsukawa, Kenji Okita, Yukio Fujiyoshi, Yuta Shibamoto
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  ABSTRACT: Lymphoma of the central nervous system (CNS) parenchyma is known to present as a well-demarcated mass with strong and homogenous gadolinium enhancement in the periventricular and/or superficial region. We report a case of central nervous system lymphoma (CNSL) manifesting as multiple white matter lesions with non-tumorous patchy or ring-like enhancement and partial spontaneous resolution on magnetic resonance imaging (MRI). Such findings are unusual and could lead to misdiagnosis without pathological evaluation.
  The Kurume Medical Journal 01/2012; 59(1-2):33-8.
• Article: Relationship between Masseter Muscle Form and Occlusal Supports of Remaining Teeth.

  Makoto Tetsuka, Tsuyoshi Saga, Moriyoshi Nakamura, Yoko Tabira, Jingo Kusukawa, Koh-Ichi Yamaki
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  ABSTRACT: To chew, it is necessary to maintain harmony between the masseter muscle and other organs. Various studies have been conducted on the masseter muscle, but none has examined the relationships among masseter muscle form, occlusal support of remaining teeth, and maxillofacial morphology. Thus, we conducted the present study using cadavers donated to anatomy practice. After the masseter muscle was extracted, its length, width, thickness, and volume were measured; histological observations were conducted; and the muscle fiber cross-sectional area and muscle density were calculated. In addition, denture use and non-use were examined. The results showed that when regional support loss occurs, muscle fiber thickness and density decrease. This in turn causes masseter muscle thickness and volume to decrease, resulting in muscle atrophy. Furthermore, excluding Eichner class A cases (all regions intact), the thickness of the masseter muscle is greatest when the premolar support region remains. The premolar support region was shown to have the most impact on masseter muscle morphology. These results suggest that atrophy of the masseter muscle can be arrested or improved with the use of dentures in the case of tooth loss.
  The Kurume Medical Journal 01/2012; 59(1-2):5-15.
• Article: Psychoeducation may Reduce Self-Stigma of People with Schizophrenia and Schizoaffective Disorder.

  Toshiro Uchino, Masaharu Maeda, Naohisa Uchimura
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  ABSTRACT: Previous studies suggest that self-stigma is related to social isolation and discrimination. Although it is known that stigma has cultural and social impacts, only a few studies in Japan have explored self-stigma in people with schizophrenia. The present study was conducted to investigate self-stigma in people with schizophrenia and schizoaffective disorder in Japan under a typical clinical setting, and to examine the effect of psychoeducation on self-stigma. Fifty-six participants (44 men and 12 women) who met the DSM-IV criteria for schizophrenia and schizoaffective disorder were recruited. All participants completed several questionnaires including social distance scale. Collected data were classified into an experiential or non-experiential group according to hospital records. The experiential group received psychoeducation which focused on reducing self-stigma by correcting inaccurate ideas about schizophrenia, and the relation between schizophrenia and criminal activity or violence, by watching videotapes and analyzing data from a report published by the National Police Agency. After the intervention, participants completed the Japanese version of the Social Distance Scale (SDS-J), the Knowledge of Illness and Drugs Inventory (KIDI) questionnaire, the Drug Attitude Inventory 10 (DAI-10), and the Birchwood's Psychosis Insight Scale (BPIS). In addition Global Assessment of Functioning Scale (GAF) scores were calculated for each participant. Significant differences between the 2 groups were observed for the SDS-J, KIDI, and BPIS (P<0.01 for each). However, no significant differences were observed for the DAI-10, GAF, age, and duration of treatment. The results of a path analysis showed that increasing knowledge about schizophrenia and its treatment might play an important role in reducing the self-stigma associated with this disease. When performing psychoeducation for people with schizophrenia and schizoaffective disorder, we need to discuss the pervasive effects of stigma and discrimination.
  The Kurume Medical Journal 01/2012; 59(1-2):25-31.
• Article: Risk of adverse maternal and peri-natal outcome in subjects with placenta previa with previous cesarean section.

  Aqueela Ayaz, Mian Usman Farooq
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  ABSTRACT: The aim of this study was to compare maternal and perinatal adverse outcomes between groups of placenta previa (PP) with and without previous cesarean section (CS). A prospective study was carried out from March 2008 to August 2009 at the department of Obstetrics and Gynecology, Hera General Hospital, Makkah, Saudi Arabia. Diagnosed cases of PP with singleton pregnancy presenting with ante-partum hemorrhage (APH) in the 3rd trimester undergoing either emergency or elective CS were included. Subjects were divided into two groups, 30 with previous CS (group A) and 27 without previous CS (group B), and the risks of adverse maternal and perinatal outcomes were compared. Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL, USA).One mother in group A died due to disseminated intravascular coagulation. The risk of post partum hemorrhage (PPH), blood transfusion and coagulopathy was higher in group A, (OR 4.8, 95% CI 1.5-15; p=0.008; OR 4.8, 95% CI 1.5-15; p=0.008; OR 9.5, 95% CI 1.2-81.6; p=0.03, respectively). Mean length of hospital stay (days±SD) in group A was significantly longer than that in group B (5.3±3.2 vs. 3.2±1.5, 95% CI 0.8-3.2; p=0.002). A higher risk of perinatal adverse outcome was found in group A, but the difference was not significant.Risk of maternal morbidity was higher than that of perinatal morbidity in Group A.
  The Kurume Medical Journal 01/2012; 59(1-2):1-4.
• Article: Left Eye Scanning Deficit in Schizophrenia Patients under Emotional Loading Task: Comparison with Healthy Controls.

  Youhei Ishii, Kiichiro Morita, Yoshihisa Shoji, Chizuko Kawabe, Ryo Fujikia, Masayuki Inoue, Naohisa Uchimura
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  ABSTRACT: The aim of the present study was to evaluate and characterize visual cognitive function and the effect of emotion in patients with schizophrenia.We recorded exploratory eye movements as biologic markers in 40 schizophrenic patients and 40 age-matched healthy controls. Total eye scanning length (TESL), total number of gaze points (TNGP), and TNGP in right (right TNGP) and left (left TNGP) visual fields on screen were calculated as subjects viewed affectively charged pictures (smiling and crying babies) with fitting sounds.TESL of patients was shorter than that of controls when viewing pictures of smiling babies while recalling pleasurable events, and significantly decreased under negative emotional loading when viewing crying babies while recalling sad events. TESL recovered to the original values after loading positive emotion again in the controls. However, TESL did not recover to the original values in schizophrenic patients. TNGP showed similar alterations in the emotional loading task. When TNGP was evaluated in left and right fields, in patients, the non-recovery of TNGP was only observed in the left side. TESL and left TNGP were negatively correlated with negative symptom scores on PANSS.Schizophrenic patients'eye movements in the left visual field screen during the emotional loading task were different from those of controls, which suggests that visual cognitive function is impaired in the right brain in schizophrenic patients. Exploratory eye movements are a useful marker of visual cognitive function, and are a useful tool to evaluate the influence of emotion in schizophrenic patients.
  The Kurume Medical Journal 01/2012; 59(1-2):17-24.
• Article: Retropenitoneal dedifferentiated liposarcoma: A case report

  Taro Isobe, Teruo Sasatomi, Shinji Uchida, Hidetsugu Murakami, Rin Yamaguchi, Kazuo Shirouzu, Yutaka Ogata
  The Kurume Medical Journal 02/2011;
• Article: "Hybrid exercise" prevents muscle atrophy in association with a distinct gene expression pattern.

  Toru Matsugaki, Naoto Shiba, Shohei Kohno, Takeshi Nikawa, Katsuya Hirasaka, Yuushi Okumura, Kazumi Ishidoh, Takashi Soejima, Kazuhiro Yoshimitsu, Kensei Nagata
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  ABSTRACT: "Hybrid exercise" utilizing combined electrical stimulation and voluntary muscle contraction has been developed as a muscle exercise method. Although our previous studies have confirmed the effectiveness of the procedure, the mechanisms of its efficacy still remain unclear. In the present study, we identified genes that are specifically expressed in disused muscles, using the semitendinosus muscle from patients who underwent anterior cruciate ligament (ACL) reconstruction. Preoperative exercise was performed by four ACL-injured patients, who were subjected either to hybrid exercise (n=2), electrical stimulation (n=1), or no electrical stimulation (n=1), in addition to standard weight training for 4 weeks. Cross-sectional area (CSA) of the semitendinosus muscle was measured before and after the exercise by magnetic resonance imaging (MRI). A piece of the semitendinosus muscle was isolated during the surgery, and comprehensive analysis of the gene expression in this sample was performed using DNA microarray analysis. CSA increased in size by 4.2 and 14.7%, respectively, after hybrid exercise, and by 1.4% after electrical stimulation. However it shrunk by 7.7% without electrical stimulation. DNA microarray analysis revealed that hybrid exercise was more effective at stimulating the expression of signal transduction-, transcription- and cytoskeleton-related genes in semitendinosus muscles than electrical stimulation alone. In particular, gene ontology analysis revealed that hybrid exercise induced significantly higher expression of eukaryotic translation initiation factor 5A (EIFSA), peroxisomal biogenesis factor 6 (PEX6) and histone cluster 1 H4 (HIST1H4), compared with electrical stimulation alone. The expression of signal transduction-, transcription- and cytoskeleton-related genes may play an important role in muscle bulk increasing mechanisms in hybrid exercise.
  The Kurume Medical Journal 01/2011; 57(4):101-8.
• Article: Successful treatment of T4 renal cell carcinoma after a neoadjuvant targeted therapy using sunitinib: report of a case.

  Kousuke Ueda, Masanori Noguchi, Sigetaka Suekane, Fukuko Moriya, Rikako Nagayoshi, Kazuhisa Ejima, Kousuke Momozono, Kei Matsuoka
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  ABSTRACT: Since the introduction of targeted therapy, treatment of metastatic renal cell carcinoma (RCC) has undergone dramatic changes. Responses to targeted therapy within the primary tumor and metastatic lesions are novel findings not seen with immunotherapeutic-based strategies. We report here a case of T4 RCC in which cytoreductive nephrectomy became possible after a neoadjuvant targeted therapy using sunitinib. Our experience with the present case suggests that targeted therapy in the neoadjuvant setting may have a variety of potential applications. Further investigations should be encouraged.
  The Kurume Medical Journal 01/2011; 58(3):95-8.
• Article: Concurrent lung cancer in non-tuberculous mycobacteriosis: case report.

  Takeharu Koga, Rumi Sato, Tomoko Kamimura, Munetsugu Nishimura, Masayoshi Kage, Kazuhiko Matsuo
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  ABSTRACT: An 82-year-old woman was admitted to our hospital after multiple round opacities were detected in chest X-rays performed during a routine health screening. Mycobacterium avium complex (MAC) was found in sputum cultures, and compatible pathological findings on biopsy confirmed pulmonary MAC infection, whereas biopsies from another opacity revealed adenocarcinoma of the lung.Curative surgery for the lung cancer confirmed a concurrence of lung cancer and pulmonary MAC infection. Since the prevalence of both of these lung diseases is increasing, suspicion of concurrence is critical to provide appropriate care.
  The Kurume Medical Journal 01/2011; 58(3):87-90.
• Article: Transvaginal hydrolaparoscopy by flexible fiberscope - a study of preliminary cases -.

  Akio Kataoka, Shouko Hirakawa, Manami Iwamoto, Yumi Sakumura, Ryouta Yoshinaga
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  ABSTRACT: Transvaginal hydrolaparoscopy (THL) has become a first-line procedure in infertile women, and THL by flexible fiberscope (THLF) is a less traumatic and a more suitable outpatient procedure than diagnostic laparoscopy. We performed THLF on infertile women based on four indications; (i) tubal obstruction and/or peritubal adhesion as suggested by hysterosalpingography (HSG); (ii) serum antibody against Chlamydia (C) positive for trachomatis; (iii) diagnosis of early stage endometriosis; and (iv) unexplained infertility. Seven women with a chief complaint of infertility were the subjects of the present study. Two of the 7 cases had a history of gynecological surgery. Six of 7 cases had a history of C. trachomatis infection. Four cases had abnormal findings of fallopian tubal patency in hysterosalpingography. Parafallopean tubal atresia and tubal obstruction were observed in 4 cases by THLF. In one case the bilateral ovaries were extremely small and atrophic. None of the cases had serious complications after THLF. After the THLF, six women were able to have a baby by assisted reproductive technology (ART) within two years. As THL was developed using a solid scope, indications for THL have been limited, and have excluded cases with retroverted uterus or peritoneal surgical history. In the present study, THL using a fiberscope was carried out in infertile women with retroverted uterus, and in women with a history of peritoneal cavity surgery to examine the feasibility of extending the indications for THL. Findings on the THLF were given precedence in deciding further treatment strategies. We believe that THLF can be useful in helping patients with these indications to successfully achieve early pregnancy. This study is the first trial of THLF.
  The Kurume Medical Journal 01/2011; 58(4):99-103.
• Article: Recurrence of invasive micropapillary carcinoma of the breast with different ultrasound features according to lesion site: case report.

  Yasuko Mizushima, Rin Yamaguchi, Toshiro Yokoyama, Etsuyo Ogo, Osamu Nakashima
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  ABSTRACT: Invasive micropapillary carcinoma (IMPC) of the breast is a distinct variant of breast cancer. Extensive lymphatic penetration, lymph node metastasis, and local recurrence are seen at a relatively high frequency. On ultrasound (US) findings, IMPC has been reported to be an irregular or lobulated mass with hypoechoic internal areas, but as yet there is no consensus regarding typical findings. A 52-year-old female noticed a mass less than 3 cm in diameter in her left upper breast. US findings indicated an irregularly shaped, hypoechoic tumor with indistinct margins. The diagnosis according to fine-needle aspiration cytology was invasive ductal carcinoma. She underwent lymph node dissection with mastectomy of the left breast. Histological examination revealed mixed-type IMPC. Three years and three months after surgery, IMPC recurred under the skin of the surgical scar. US findings indicated a hyperechoic tumor in this region. Eight months after further surgery, a tumor in the anterior chest wall was observed. US findings indicated an oval hypoechoic tumor with posterior acoustic enhancement. US findings differed between primary and recurrent IMPC because of differences in the occupancy and distribution of IMPC. We describe here a comparison between US and histological findings, as well as differences in IMPC between primary, secondary and tertiary sites.
  The Kurume Medical Journal 01/2011; 58(3):81-5.
• Article: A comparative study of treatments for chronic subdural hematoma: burr hole drainage versus burr hole drainage with irrigation.

  Akira Ishibashi, Yoshitake Yokokura, Hisashi Adachi
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  ABSTRACT: Although chronic subdural hematoma (CSDH) is one of the most common entities encountered in neurosurgical practice, optimal surgical treatment for CSDH remains controversial. This study retrospectively compared results for CSDH between burr hole drainage alone and burr hole drainage with irrigation. Ninety-two patients with CSDH underwent surgery at our institution from January 1998 through December 2009. Fifty-eight patients received burr hole drainage alone (Group A), while 34 patients were treated using burr hole drainage with irrigation (Group B). Outcomes, recurrence rates, and death rates for the two groups were analyzed. Age, sex ratio, consciousness level on admission, radiodensity of hematoma on computed tomography before surgery, and duration of hospitalization were nearly the same in both groups. No significant differences were seen in good outcomes or death rates between groups, but poor outcomes were significantly more frequent in Group A (p=0.009). The recurrence rate was higher in Group A compared to Group B (10.3% vs. 2.9%). The authors used logistic regression analysis to identify factors associated with the outcome of CSDH, and found that duration of hospital stay, anti-coagulant therapy, presence of dementia and burr hole drainage alone were significantly associated with poor outcome of CSDH. These results indicate that burr hole drainage with irrigation has a significantly stronger association with good outcomes compared to drainage alone, and could be a reliable and effective operative method for the treatment of CSDH with a lower recurrence rate.
  The Kurume Medical Journal 01/2011; 58(1):35-9.
• Article: Effect of preoperative immunonutrition in patients undergoing hepatectomy; a randomized controlled trial.

  Kazuhiro Mikagi, Ryuichi Kawahara, Hisafumi Kinoshita, Shigeaki Aoyagi
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  ABSTRACT: No consensus has been reached concerning the effects of preoperative immunonutrition in patients undergoing hepatectomy. We evaluated the effects of immunonutrition before hepatectomy on perioperative management. This study was performed as a randomized controlled trial. Patients expected to undergo segmentectomy or more extensive hepatectomy for liver tumors were randomized to immunonutrition (IM) and control (C) groups each consisting of 13 patients. The IM group was given 750 ml of IMPACT in addition to half-size hospital meals orally from 5 days before to the day before surgery, and the C group was given conventional hospital meals. The blood level of eicosapentaenoic acid was elevated preoperatively in all patients of the IM group. The white blood cell count and interleukin 6 levels, which are indices of postoperative inflammation, were significantly lower in the IM group. As regards liver function, postoperative increases in the aspartate aminotransferase and alanine aminotransaminase levels were slightly suppressed in the IM group. No significant difference was noted in postoperative complications or duration of postoperative hospital stay. In patients undergoing hepatectomy, preoperative immunonutrition reduced inflammation and protected against liver dysfunction.
  The Kurume Medical Journal 01/2011; 58(1):1-8.
• Article: Hybrid-training method increases muscle strength and mass in the forearm without adverse effect of hand function in healthy male subjects.

  Hiroo Matsuse, Chikahiro Iwasa, Kisei Imaishi, Takeshi Nago, Yoshihiko Tagawa, Tatsuyuki Kakuma, Naoto Shiba
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  ABSTRACT: Conventional neuromuscular electrical stimulation (NMES) results in surface muscle contraction but high electrical stimulation intensity is required to activate the deep muscles. Therefore, NMES is not useful for training at complicated sites such as the forearm. To make NMES more effective we developed a hybrid training method (HYB), consisting of electrically stimulated antagonists to resist agonist muscle contractions. The purpose of this study was to compare the effects of HYB on the forearm as compared with NMES alone, and to determine whether HYB had any adverse effects on complex hand movements. Thirty subjects were randomly distributed into three groups: a HYB program group, an isometric electrical stimulation group (ES), and a control group (CN). Subjects trained 3 times a week for 6 weeks. Each session consisted of 10 sets of 10 reciprocal 2-sec wrist flexions and extensions separated by 1-min rest intervals. Wrist flexion/extension torques, grip strengths (GS), forearm flexor/extensor cross sectional areas (CSA), and hand dexterity (Purdue Pegboard (PEG) test, finger tapping (Tapping) test were measured. The HYB group demonstrated statistically significant increases in wrist extension torques (22.8%, p<0.01), forearm flexor CSA (9.6%, p<0.01), and in forearm extensor CSA (5.1%, p<0.05) at the end of training. There was no increase in torque or CSA in the ES or CN groups. Hand dexterity showed no significant differences in any of the three groups. HYB had no adverse effect on hand function and was more effective in forearm training than NMES alone.
  The Kurume Medical Journal 01/2011; 57(4):125-32.
• Article: Effects of emotionally affect adult and baby' photographs in healthy controls and schizophrenic patients evaluating by exploratory eye movements.

  Chizuko Kawabe, Kiichiro Morita, Yoshihisa Shoji, Ryo Fujiki, Atsushi Yamamoto, Yasue Asaumi, Naohisa Uchimura
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  ABSTRACT: The relationship between mother and baby is of fundamental importance in the development of cognitive function and emotion. In this study we investigated the effects of affective photographs of a mother and baby (crying or smiling faces) and other stimuli (neutral mother or baby faces) on visual cognitive function in schizophrenic patents. We recorded exploratory eye movements in 22 healthy controls and 22 age-matched schizophrenic patients. Total number of right and left field gaze points (right TNGP, left TNGP) in the visual fields were determined using an eye-mark recorder as subjects viewed affectively charged or neutral photographs (crying, smiling or neutral faces). Left TNGP for all mother photographs (crying, smiling or neutral) were significantly larger in controls than patients, and right TNGP for neutral mother photographs were significantly larger in controls than in patients. Right TNGP for photographs of smiling babies were significantly larger in controls than patients, and left TNGP for photographs of both smiling and crying babies were significantly larger in controls than patients. Within the patient group, right TNGP were significantly larger than left TNGP for all mother photographs (crying, smiling or neutral). Left TNGP for photographs of mothers and babies correlated negatively with negative symptom scores. These results suggest that exploratory eye movements when viewing emotionally laded twin stimuli such as photographs of a mother and baby are a useful marker of visual cognitive function in both healthy controls and schizophrenic patients.
  The Kurume Medical Journal 01/2011; 58(1):27-33.
• Article: Comparison between the gastric cancer cell line MKN-45 and the high-potential peritoneal dissemination gastric cancer cell line MKN-45P.

  Atsuhiko Koga, Keishiro Aoyagi, Takuya Imaizumi, Motoshi Miyagi, Kazuo Shirouzu
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  ABSTRACT: Peritoneal metastasis is the most common form of recurrence in gastric cancer, and is associated with a poor prognosis. It is clear that many agents are involved at the various stages of this process, however, many aspects of the progression remain unclear. In the present study we compared the gastric cancer cell line MKN-45 with the high-potential peritoneal dissemination gastric cancer cell line MKN-45P, established from MKN-45. The supernatant of culture medium of MKN-45 cells or MKN-45P cells was collected, and the concentrations of interleukin-1β (IL-1β), IL-6, IL-8, hepatocyte growth factor (HGF), Transforming growth factor beta-β1 (TGF-β1), vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2), MMP-9, and tissue inhibitor of metalloproteinase-1 (TIMP-1) proteins were measured using an enzyme-linked immuno sorbent assay (ELISA) method. Invasion, wound healing and adhesion assays were performed in vitro to examine interstitial invasion, migration and adhesion in the gastric cancer cell lines. Moreover, Western blotting was performed to determine the expression of cyclooxygenase-1 (COX-1) and COX-2 proteins in the culture media of the cell lines. The concentrations of IL-6, IL-8, VEGF and MMP-2 protein in the culture supernatant of MKN-45P were significantly higher than those of MKN-45. Percent adhesion of MKN-45P was significantly higher than that of MKN-45 in the fibronectin-coated group. There was no significant difference in invasion or migration between MKN-45 and MKN-45P. COX-1 and COX-2 proteins were observed in both cell lines. These results suggested that secretion of IL-6, IL-8, VEGF and MMP-2 from cancer cells, and adhesion of cancer cells to fibronectin, were related to the establishment of peritoneal dissemination.
  The Kurume Medical Journal 01/2011; 58(3):73-9.
• Article: Assessment of physical and mental health in male university students with varying sleep habits.

  Yuuki Matsumoto, Kouji Toyomasu, Naohisa Uchimura
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  ABSTRACT: Healthy sleep habits entail not only sleeping for a sufficient period (quantity) but also regularity of the sleep cycle and getting sound sleep (quality). University students often have erratic schedules that cause irregular sleep patterns even though sleep durations remain relatively constant. This study compared the physical and mental health of 90 male university students with different sleep habits. We created sleep habit scales using the Tokyo Metropolitan Institute for Neuroscience life habits inventory (TMIN-LHI; Miyashita, 1994) by performing a factor analysis and classifying sleeping habits based on regularity, quality, and quantity. Four types of sleep habits were identified by cluster analysis; good sleep was characterized by regular and high quality sleep but of relatively short sleep duration; long sleep was regular and relatively long but of low quality; short sleep was of high quality but short and irregular, while poor sleep was irregular, of low quality, and relatively long. The good sleep group had a significantly lower average waist circumference, and lower systolic and diastolic blood pressure. The long and poor sleep groups, which both had low quality sleep, scored lower than the national standard on the mental component summary (MCS) calculated from the Social Functioning-36 (SF-36) short-form health survey. Furthermore, the average MCS score of the poor sleep group was significantly lower than that of any other sleep habit group. Subjects with poor sleep also scored lowest on the Self-rating Depression Scale (SDS). In addition, the short and poor sleep groups were prone to glucose or lipid metabolism disorders. Maintaining good physical and mental health without sound sleep and a regular sleep cycle is difficult, even if sleeping hours are kept constant. Therefore, we included the assessment of regularity and quality in addition to hours of sleep in order to develop appropriate sleep guidelines for improved physical and mental health.
  The Kurume Medical Journal 01/2011; 58(4):105-15.
• Article: Preoperative Visualization of the Artery of Adamkiewicz by Dual-Phase CT Angiography in Patients with Aortic Aneurysm.

  Mau Amako, Yoshiaki Yamamoto, Katsumi Nakamura, Satoru Tobinaga, Eiji Nakamura, Yukio Hosokawa, Tomokazu Ohno, Hidetoshi Akashi, Shigeaki Aoyagi, Hiroyuki Tanaka
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  ABSTRACT: To improve our ability to visualize the Adamkiewicz artery (AKA), we developed a modified intravenous CT angiography technique, which we refer to as right atrial CT (RA-CT) angiography. In this study, AKA detection rate and visualization of the arterial continuity from the aorta to the anterior spinal cord artery (ASA) was evaluated using RA-CT angiography.We performed RA-CT angiography in 110 patients with abdominal, thoracic descending, or thoracoabdominal aortic aneurysms. In RA-CT angiography, contrast medium with a high iodine concentration (370 mg/dl) was injected twice into the right atrium at a high injection rate (8.0 ml/sec), and two CT scans, starting at 20 sec after the first injection and at 35 sec after the second injection, respectively, were performed. All CT images were obtained using an 8- or 16-detector CT scanner at a slice thickness of 0.625 mm. The AKA was defined as the largest radiculomedullary artery with a characteristic hairpin turn, and with continuity from the aorta to the ASA.The AKA with hairpin turn was detected in all patients (100%), and continuity from the aorta to the ASA was confirmed in 99 of the 110 patients (90.0%). The AKA arose between Th8 and L1 in 86 of these patients (86.8%), and originated from the left side in 71 patients (71.7%).RA-CT angiography may be useful for visualizing the AKA and the arterial continuity from the aorta to the ASA in patients with aortic aneurysm, although the use of more advanced CT machines will provide safe and easy identification of the AKA and arterial continuity with a small amount of contrast medium and a single scan.
  The Kurume Medical Journal 01/2011; 58(4):117-25.
• Article: Can renal infarction occur after renal cyst aspiration? Case report.

  Habib Emre, Yasemin Usul Soyoral, Serhat Tanik, Ilhan Gecit, Huseyin Begenik, Necip Pirincci, Reha Erkoc
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  ABSTRACT: Renal infarction (RI) is a rarely seen disorder, and the diagnosis is often missed. The two major causes of RI are thromboemboli originhating from a thrombus in the heart or aorta, and in-situ thrombosis of a renal artery. We report a case of RI that developed due to renal artery and vein thrombosis, as confirmed by pathological evaluation of the nephrectomy material, three weeks after renal cyst aspiration.
  The Kurume Medical Journal 01/2011; 58(2):59-61.