Fukushima Medical University Research Articles

INDOOR-ATMOSPHERIC RADON-RELATED RADIOACTIVITY AFFECTED BY A CHANGE OF VENTILATION STRATEGY

The present author has kept observation for concentrations of atmospheric radon, radon progeny and thoron progeny for several years at the campus of Fukushima Medical University. Accidentally, in the midst of an observation term, i.e., February 2005, the facility management group of the university changed a strategy for the manner of ventilation, probably because of a recession: (I) tidy everyday ventilation of 7:30-24:00 into (II) shortened weekday ventilation of 8: 00-21 : 00 with weekend halts. This change of ventilation manner brought a clear alteration for the concentrations of radon-related natural radioactivity in indoor air. The present paper concerns an investigation of the effect of the ventilation strategy on the indoor-atmospheric radon-related radioactivity.

A case of primary biliary cirrhosis complicated by Behçet’s disease and palmoplantar pustulosis

A 46-year-old woman was diagnosed with palmoplantar pustulosis (PPP) at the Department of Dermatology, Fukushima Medical University Hospital in 2000, and was treated with ointment. However, because liver dysfunction developed in 2003, she was referred to our department, where primary biliary cirrhosis (PBC) was also diagnosed on the basis of clinical findings. One year later, at the age of 49, she developed manifestations of Behçet's disease (BD), including erythema nodosum in the lower extremities. Because she had a history of uveitis, recurrent oral ulceration was present, and the HLA typing was positive for B51, BD was additionally diagnosed. Liver function normalized within three months of the start of treatment with ursodesoxycholic acid (UDCA). This is the first case of PBC associated with BD and PPP.

A Surgical Technique to Protect the Macular Hole in Indocyanine Green-Assisted Vitrectomy

<P>To prevent indocyanine green (ICG) toxicity during macular hole repair, a surgical technique was designed in which the hole is protected by a viscoelastic material before injecting ICG to stain the internal limiting membrane. The area covered by the viscoelastic material was not stained by ICG. The internal limiting membrane was peeled without difficulty by taking advantage of the ICG stain outlining it. After surgery, all holes closed and the postoperative outcomes were favorable. Only a small amount of residual ICG remained in the macular area. This surgical technique does not interfere with internal limiting membrane peeling and reduces the residual ICG postoperatively. [<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2006;37:511-515.]</P> <H4>AUTHORS</H4> <P>From the Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan. </P> <P>Accepted for publication May 18, 2006. </P> <P>Presented in part at the annual meeting of the Vitreoretina Society of Japan, Fukuoka, Japan, December 13, 2003. </P> <P>Address reprint requests to Masaaki Saito, MD, Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan. </P>

Biological characteristics of the sensitive Japanese skin

Biological characteristics of the sensitive Japanese skin

認知行動療法に基づく服薬自己管理モジュールの導入とその評価―退院後の服薬コンプライアンスヘの有用性―

We introduced a medication management module (MMM) for the education of psychiatric inpatients that uses a video (FMV) produced by Fukushima Medical University. We then asked 32 staff members to evaluate the usefulness of FMV by filling out a questionnaire. Nine of the staff (28 %) responded that it greatly improved the patients' comprehension level, 19 (59 %) felt that it had improved, and 4 (13 %) thought that there had been no change. We estimated that the workload of staff had decreased from 10 to 3.7 points. Further, by testing the 37 participants in MMM on their comprehension level before and after it with the same questions, the mean score was significantly higher after MMM (21.4 ± 0.9 points) than before (18.3 ± 3.5 points) (p< 0.001).To assess the effect of MMM on post-hospital self-medication behavior, we mailed another questionnaire to patients who had participated in MMM and those who had not. The sixty-three respondents (34 men and 29 women, aged from 15 to 78 years) consisted of 43 schizophrenia patients and 20 manic-depressive psychosis patients, of whom 33 had participated in MMM and 30 had not. The percentage of MMM-participants who were taking medication regularly was not significantly different from that of non-participants. However, the percentages of MMM participants who understood the necessity of medication and knew how to cope with side effects were significantly higher (p< 0.05 and p< 0.001, respectively).These results indicate that MMM is useful in raising patients' level of comprehension of medication and helping them acquire the proper post-hospital self- medication behavior.

唾液中バルプロ酸（ＶＰＡ）濃度測定による在宅ＴＤＭの試み（１）

In the present study, we examined the clinical significance and utility of measuring salivary valproic acid (VPA) levels in saliva samples taken at patients' homes for therapeutic drug monitoring (TDM). The subjects were 74 patients (33 males and 41 females ; mean age 30.8 ± 1.9 years) under treatment at Outpatient Clinic, Department of Neuropsychiatry, Fukushima Medical University Hospital. For the VPA measurements, saliva samples and blood samples were taken at the Outpatient clinic simultaneously. Salivary VPA levels showed significant correlations with total and free VPA serum concentrations (r=0.71 and r=0.77, respectively) but were not significantly correlated with serum albumin concentration or salivary pH.From a preliminary experiment that we conducted, salivary VPA levels were found to remain stable when saliva samples were kept in home freezers at 4 and -20°C.Based upon the above results, we concluded that TDM based on measurements on saliva samples taken by patients receiving VPA has significant clinical utility because 1) saliva sampling is less invasive than blood sampling and easy to carry out for patients who do not wish their blood to be taken, 2) saliva sampling at home is convenient because either patients or their family members can take the samples and 3) samples taken at home can accurately show VPA levels as they are in everyday life.

Imatinib Mesylate Induced Fatal Hepatitis B Virus (HBV) Reactivation in a Patient with CML.

Imatinib mesylate (Glivec; Novartis, Basel, Switzerland), which is a selective inhibitor of the Bcr/Abl tyrosine kinase, is now widely used for the treatment of Ph-positive leukemia based on the remarkable efficacy. Treatment with imatinib mesylate is generally well tolerated, and the risk for severe adverse effects is low. Hepatic toxicity is less common and usually resolves with interruption of imatinib therapy. On the other hand, although it is well known that HBV reactivations are observed in cancer patients with chronic HBV infection during chemotherapies, imatinib mesylate-induced HBV reactivation has not been reported yet. Here, we report the first case complicated by fatal fulminant HBV reactivation during imatinib mesylate treatment for CML. A 54-year-old man was diagnosed as CML on October 2003. At that time, HBsAg, HBeAb, and HBcAb were positive, whereas HBsAb was negative. HCV Ab and HCV RNA were also positive. However, hepatic examinations revealed normal findings, except slightly elevated levels of AST (50 IU/L). On November 2003, imatinib mesylate was started at the dose of 400mg/day p.o. and continued without any hepatic adverse effects. In contrast, the patient was suffered from neutropenia (grade 2) and lymphocytopenia (grade 2) on December 2003. Although dose of imatinib mesylate was reduced (300mg/day), lymphocytopenia continued. Since May 6, 2004, the patient complained general fatigue. On May 11, AST, ALT, and total bilirubin were 125 IU/L, 95 IU/L, and 0.7 mg/dl, respectively. At that time, bone marrow cytogenetics using a FISH of Bcr/Abl detected 2.0% fusion gene. Then, hepatic function deteriorated despite imatinib mesylate administration was stopped. On May 27, the patient had severe hepatic dysfunction with high AST, ALT, and total bilirubin (2098 IU/L, 1574 IU/L, and 5.6 mg/dl, respectively). In addition, prolonged prothrombin time (13.6%) and deterioration of consciousness were observed. HBV DNA polymerase was extremely increased (> 20000 cpm; normal range: <30). He was diagnosed as a fulminant hepatitis due to HBV reactivation and referred to the Second Department of Internal Medicine (Hepatology) of Fukushima Medical University. Although he received intensive treatments including plasma exchanges, he died from hepatic failure on June 21 2004. This is the first case of a fulminant hepatitis due to HBV reactivation during treatment of imatinib mesylate. Although it is not clear how HBV was reactivated in our case, one of the possible causes may be the lymphocytopenic status by imatinib mesylate. In fact, among the chemotherapeutic agents, the use of steroid is the most significant risk factor of HBV reactivation in cancer patients with chronic HBV infection (Yeo et al, Br J Cancer , 2004). Ph-positive leukemia patients receiving imatinib mesylate often develop transient lymphocytopenia and/or neutropenia (Druker et al, N Engl J Med , 2002). Therefore, in the patients with chronic hepatic viral infections such as HBV and HCV, we should take care of viral reactivation in use of imatinib mesylate. We should also consider prophylaxis of viral reactivation using antiviral drugs or alternative initial therapy with interferon-α for both anti-leukemic and anti-viral effects to treat CML patients with chronic hepatitic viral infection.

CpG immunostimulatory sequences enhance contact hypersensitivity responses in mice.

Bacterial DNA and synthetic cytidine-phosphate-guanosine-oligodeoxynucleotides (CpG ODN) potently activate dendritic cells (DC) and therefore have been proposed as adjuvants for vaccination strategies. Although CpG ODN are considered as safe adjuvants this study shows that CpG ODN are responsible for enhanced antigen-specific skin inflammatory reactions. We used the murine model of contact hypersensitivity (CHS) to 2,4-dinitrofluorobenzene (DNFB) in which hapten-specific CD8+T cytotoxic 1 cells are effector cells. Subcutaneous injection of CpG ODN, 1 d before sensitization enhanced the CHS response to DNFB and resulted in increased recruitment of CD8+ T cells at the challenge sites, whereas control ODN injection did not have any effect. This effect was local and not systemic as it was only observed when DNFB was applied at the same site as the CpG motifs. CpG ODN-induced enhancement of CHS was due to increased antigen-presenting cell functions of DC since: (i) CpG ODN-injected skin revealed upregulated expression of major histocompatibility complex class II, CD80, and CD86 molecules and (ii) CpG ODN treatment of DNFB-derivatized DC enhanced the intensity of CHS responses after in vivo transfer. Taken together, the results show that CpG ODN may be responsible for immune side-effects such as worsening of T cell-mediated skin diseases.

SUPPRESSION OF ADVANCED GLYCATION AND LIPOXIDATION END PRODUCTS BY AN ANGIOTENSIN II TYPE-1 RECEPTOR BLOCKER IN ESSENTIAL HYPERTENSION WITH TYPE-2 DIABETES MELLITUS

Department of Internal Medicine, Miyagi Social Insurance Hospital (Ono) Department of Ecology and Clinical Therapeutics, Fukushima Medical University School of Nursing (Mizuno) (Takahashi) Department of Internal Medicine, Miyagi Social Insurance Hospital (Miura)

Why is otosclerosis of low prevalence in Japanese?

This study aimed to clarify the reasons why clinical otosclerosis, a very common disease among Caucasians, is not prevalent among Japanese. The incidence, site, activity, and volume of otosclerotic foci were examined in 1011 temporal bone sections from 507 Japanese individuals. This study was prepared at the temporal bone laboratory, Fukushima Medical University, Fukushima. Otosclerotic foci were observed in 2.56% of individuals and in 1.48% of the ears. The most common site of involvement was anterior to the oval window region, but this was only in 38.9% of the ears with otosclerotic foci. The otosclerotic foci were not involved in the stapediovestibular articulation or the endosteal layer of the otic capsule in any ears. An active change of the otosclerotic focus was seen in 33.3% of ears with otosclerosis. The volume of otosclerotic foci at the site anterior to the oval window region was less than 0.8 mm3 in 5 out of 7 ears. The incidence of histologic otosclerosis among Japanese seemed to be almost the same as that among Caucasians. Three reasons why clinical otosclerosis was not as prevalent among Japanese as among Caucasians are suggested: low incidence of involvement of foci anterior to the oval window, low activity, and small lesion without involvement of the footplate and/or membranous labyrinth of the inner ear.

The Proceedings of the 17th Annual Meeting of Adolescent Psychiatry, 17 November 1999, Fukushima Medical University School of Medicine, Japan

The Proceedings of the 17th Annual Meeting of Adolescent Psychiatry, 17 November 1999, Fukushima Medical University School of Medicine, Japan

Unusual case of follicular lymphoma with hyaline‐vascular follicles

Pathology InternationalVolume 52, Issue 12 p. 794-795 Unusual case of follicular lymphoma with hyaline-vascular follicles Yoshihiro Nozawa, Corresponding Author Yoshihiro Nozawa Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanYoshihiro Nozawa, MD, Department of Pathology, School of Medicine, Fukushima Medical University, 1-Hikarigaoka, Fukushima 960-1295, Japan. Email:nozawa@fmu.ac.jpSearch for more papers by this authorMieko Hirao, Mieko Hirao Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this authorKatsuhito Kamimura, Katsuhito Kamimura Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this authorYoko Hara, Yoko Hara Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this authorMasafumi Abe, Masafumi Abe Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this author Yoshihiro Nozawa, Corresponding Author Yoshihiro Nozawa Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanYoshihiro Nozawa, MD, Department of Pathology, School of Medicine, Fukushima Medical University, 1-Hikarigaoka, Fukushima 960-1295, Japan. Email:nozawa@fmu.ac.jpSearch for more papers by this authorMieko Hirao, Mieko Hirao Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this authorKatsuhito Kamimura, Katsuhito Kamimura Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this authorYoko Hara, Yoko Hara Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this authorMasafumi Abe, Masafumi Abe Department of Pathology, School of Medicine, Fukushima Medical University, Fukushima, JapanSearch for more papers by this author First published: 05 September 2008 https://doi.org/10.1046/j.1440-1827.2002.01421.xCitations: 9Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume52, Issue12December 2002Pages 794-795 RelatedInformation

Patients with Behcet’s Disease Treated in the Dermatological Clinic of Fukushima Medical University Hospital from 1990 to 1999

Patients with Behcet’s Disease Treated in the Dermatological Clinic of Fukushima Medical University Hospital from 1990 to 1999

Medical education for students in compulsory education: the conception of the preparation of three graded textbooks and preliminary evaluation of lectures using these textbooks

The school pharmacist in our hospital pharmacy used three graded textbooks about medicine for students at the Sukagawa School for the Health-Impaired (Fukushima Medical University Hospital Branch (H. I. school)). A revised textbook for 4th-6th grade elementary school students containing 12 important items of information about medicine, a new picture textbook for 1st-3rd grade elementary school students, and a new textbook containing practical data for junior high school students were prepared by supplementing original information with illustrations, simplified expression and large type face. Additionally, the pronunciation of Chinese characters was included in the textbook for the 1st-3rd grade elementary school students. In this study, 9 students from H. I. school and 37 students from Koyase junior high school took part in a questionnaire and an examination evaluating the usefulness of the lectures, and these textbooks, in regard to the student's recognition and understanding of medicine. Most students answered that the lectures and textbooks helped them to understand medicine. Furthermore, the results of the examination indicated that the students had a general understanding of medicine. In conclusion, we suggest that it is important for students in compulsory education to learn about medicine, and that according to the preliminary result of questionnaires and examinations, both the lectures and textbooks were useful to help the students to understand more about medicine.

Relationship between Hematological Parameters and Incidence of Ischemic Heart Diseases among Japanese White‐Collar Male Workers

Relationship between Hematological Parameters and Incidence of Ischemic Heart Diseases among Japanese White‐Collar Male Workers: Toshio Kobayashi, et al. Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine—The determination whether high hematocrit (Hct) and hemoglobin (Hb) are risk factors for ischemic heart diseases (IHD) remains controversial in Japan. To examine whether hematological parameters are independent risk factors for IHD, we conducted a case control study among 3,924 Japanese male white‐collar workers aged 35‐60 yr. IHD cases were defined as men with a first episode of acute myocardial infarction or angina pectoris during the investigation period (from April 1995 to April 2000). Five controls without a history of IHD were assigned for each case, matching for age and smoking status. Twenty‐two IHD cases were developed during the study period and 110 controls were assigned. Hematological parameters, obtained from periodic health examinations undergone before the onset of the disease, were analyzed with the conditional logistic regression model. Multivariate adjusted odds ratios (OR) with 95% confidence interval (95%CI) were estimated, controlling for Body Mass Index, total cholesterol, alcohol use, hypertension and fasting blood sugar. Crude OR (95%CI) for Hct, Hb, red blood cell count (RBC) and Mean corpuscular volume (MCV) were 1.21 (1.03‐1.42), 2.04 (1.17‐3.56), 1.09 (0.96‐1.24) and 1.09 (0.98‐1.22), respectively. The multivariate adjusted OR (95%CI) for Hct, Hb, RBC and MCV were 1.28 (1.06‐1.54), 2.75 (1.39‐5.46), 1.08 (0.92‐1.28) and 1.09 (0.97‐1.24), respectively. These results suggest that Hct and Hb are independent risk factors for ischemic heart diseases among Japanese middle‐aged male white‐collar workers.

Long-term follow up of traumatic multiple rib fractures

We investigated the prognosis of patients with multiple rib fractures for 2 years after discharge from the hospital, and whether the pain control management during the initial respiratory care influence the respiratory function or neurological findings. The ethical committee in Fukushima Medical University approved this study. 221 patients with chest blunt trauma were admitted in our hospital from 1990 to 1996. We found 61 cases that had more than 4 rib fractures with or without pulmonary contusion. The subjects that were 51 patients who had traffic or some other accidents can be followed by phone and investigated. Forty-one cases were received mechanical ventilation for from 5 to 18 days. All of 51 cases were administrated oxygen and drugs that controlled the chest pain. Nineteen of 51 patients (EPI group) were undergone the epidural anesthesia with xylocain for the first 7 days (5–9 days). The other patients (non-EPI group) were administrated narcotics or non-steroid anti-inflammatory agents. Measurements were arterial blood gasses, respiratory functions, chest X-ray, physical and neurological findings. The subjects were 48 patients who had traffic or some other accidents. Respiratory care was required in 20 cases for 5 to 18 days. PaO2, %VC, PEFR (peak expiratory flow rate) were gradually increased after discharge. The improvement was not associated between both of pain controls. Chest deformities were seen in 12 of 51 cases. Râle sound was audible in three cases. Neurological findings (spontaneous pain, tenderness, hypersthesia, sensory disturbance) were found less frequent in patients who were treated under epidural anesthesia. The epidural anesthesia sometimes induced hypotension, however, fluid resuscitation improved. The epidural anesthesia was better than the other narcotics or anti-inflammatory drugs from the points of neurological prognosis. Sensory disturbance is not associated with chest deformities but pain control. Epidural anesthesia was one of the useful pain management to avoid neurological complications after long-term of multiple rib fractures of chest trauma.

Pre- and postoperative bone metabolism of primary hyperparathyroidism

Primary hyperparathyroidism (PHPT) is a well-known indicator of severe bone loss. However, the recovery process of bone mineral density after surgery in PHPT patients is not sufficiently clear. We examined postoperative bone metabolism in 24 PHPT patients. Subjects were 24 patients with PHPT upon whom we performed parathyroidectomy in the Department of Surgery II, Fukushima Medical University. Mean age was 54.2 years and the male-to-female ratio was 10:14; mean time of follow-up was 27.3 months. Patients were divided histopathologically into 16 adenomas and eight hyperplasias, and classified by heredity into seven familial (six, MEN 1; one, MEN 2) and 17 sporadic types. Bone mineral density was measured by dual energy X-ray absorptometry (DXA) and digital image processing (DIP). Age-matched values of these parameters were obtained. Serum bone metabolic parameters; ionized calcium (CaF), phosphorus, intact PTH (iPTH), c-PTH, ALP, osteocalcin (OC) and PTHrP were measured. PHPT patient preoperative bone mineral densities were significantly lower than those of healthy controls. Those by DIP method were lower than those by DXA. High CaF, iPTH, OC and ALP levels were indicated before surgery, but all parameters immediately became normal. Longitudinal bone mineral density changes of asymptomatic cases increased more than those of patients with renal stone and/or ostitis fibrosa. In adenoma cases, tumor weights were significantly inversely, which correlated with preoperative DIP bone density measurements. Preoperative PHPT patients showed decreased bone density; bone loss in symptomatic cases was especially prominent compared to asymptomatic cases. Most PHPT patients had not completed the BMD recovery after surgery, so even asymptomatic and mild PHPT patients should undergo parathyroidectomy to minimize irreversible bone loss.

108 Extracts from stevia rebaudiana is a potent anti-rotavirus inhibitor in vitro and in vivo : K. Takahashi, S.Mori, N. Sato and S.Shigeta Fukushima Medical University, Fukushimashi, Japan, JBB Stevia Research Institute

108 Extracts from stevia rebaudiana is a potent anti-rotavirus inhibitor in vitro and in vivo : K. Takahashi, S.Mori, N. Sato and S.Shigeta Fukushima Medical University, Fukushimashi, Japan, JBB Stevia Research Institute

56 NMSO3, a potent inhibitor of respiratory syncytial virus (RSV) infection in vitro and in vivo : S Shigeta, S Mori, K Kimura, M Terada, Fukushima Medical University and Nissui Food Product Co. Japan

56 NMSO3, a potent inhibitor of respiratory syncytial virus (RSV) infection in vitro and in vivo : S Shigeta, S Mori, K Kimura, M Terada, Fukushima Medical University and Nissui Food Product Co. Japan

EXPERRIENCE AS A VISITING SCHOLAR IN FUKUSHIMA

In this article, author summarizes the experience as a visiting scholar in Fukushima Medical University. The current status and technical innovations of living related liver transplantation in Japan are comprehensively evaluated. New approaches for islet transplantation in the laboratory of Prof. Gotoh and author's preliminary experience of the experimental islet xenotransplantation are also succinctly reported. In the meantime, the author emphasizes the importance of an "open" department and library in which there is a great difference by comparison with that in China. I had an opportunity to study as a visiting scholar in Fukushima Medical University from July 6th to Sept. 28th, 2000. Here, I summarize what I saw and learnt, which have left a deep impression on my memory in Fukushima.