JOURNAL OF MEDICAL INVESTIGATION最新文献

Allergic rhinitis (AR) is a type I allergic disease characterized by sneezing, watery rhinorrhea, and nasal obstruction. An epidemiological survey found that approximately 50% of Japanese individuals have AR.Histamine is a major chemical mediator that induces AR symptoms through its binding to histamine H1 receptor(H1R). We demonstrated that antihistamines have a blocking effect on histamine signaling of H1R, and the suppressive effect on histamine-induced up-regulation of transcriptional activation, and the suppressive effect on basal transcription of H1R in the absence of histamine which may be part of the inverse agonist action of antihistamine. Sublingual immunotherapy (SLIT) with a standardized Japanese cedar (JC) pollen significantly improved nasal symptoms and AR-related sleep disturbance in patients with JC pollinosis. Dual SLIT with JC pollen and house dust mites (HDM) suppressed both JC pollen-induced seasonal and HDM-induced perennial nasal symptoms in bisensitized patients with AR. Dual SLIT was more effective in suppressing nasal obstruction at the peak JC pollen period than mono SLIT with JC pollen. Posterior nasal neurectomy (PNN) improved nasal symptoms and medication scores in patients with severe perennial AR. Herein, we describe recent advances in the management of AR. J. Med. Invest. 72 : 14-20, February, 2025.

A 75-year-old woman presented with scalp and cranial defects caused by implant exposure, infection,and cranial necrosis following multiple craniotomies. To reduce the risk of complications after cranioplasty, weplanned a two-stage cranial reconstruction. A wide bipedicled scalp flap with a long longitudinal axis above the cranium covered the scalp defect after debridement, and skin grafting was performed on the periosteum after flap harvesting during the first surgery. A custom-made titanium plate was implanted under the bipedicled flap during the second cranioplasty 4 months after the initial surgery. The patient had no complications during the two surgeries, and her clinical course was uneventful for 6 months after the last surgery. Although a two-stage approach, our technique is relatively safe for patients who have previously undergone multiple surgeries and decreases the risk of postoperative complications due to the shorter exposure time of the titanium plate during the second surgery. J. Med. Invest. 72 : 185-188, February, 2025.

Coronavirus disease 2019 (COVID-19) and associated lockdowns affected many people regardless of location, age, or gender. This study aimed to focus on school-aged children studying at a Japanese Language Supplementary School (JLSS) in the southwestern region of the United States and assessed the impact of COVID-19 on their lifestyle and physical activity (PA). An online-based cross-sectional survey was administered to students (age range : 6-18) enrolled in a JLSS as of June 11, 2021. Data were collected from 151 students. The questionnaire consisted of lifestyle and PA questions. A paired and Student t-test was used to test the differences in changes before COVID-19 and during COVID-19 among children. Chi-square tests were used for comparisons with descriptive analyses of frequencies. Level of statistical significance was set at p <.05. Screen time was significantly longer on weekdays (t = 8.71, p<.001) and weekends (t = 5.94, p < .001) than before COVID-19. The number of children who went to bed after 10 pm was significantly higher (χ2 = 4.06, p < 0.05) than before the new coronavirus infection. The frequency of PA per week was significantly higher (χ2 = 4.01, p < 0.05) in the group using digital devices. Findings suggested that the use of digital devices for PA can enhance PA frequency in JLSS students. J. Med. Invest. 72 : 117-123, February, 2025.

Menopausal symptoms can significantly affect the performance of working women. The association between knowledge of symptoms, educational level and better coping with the symptoms has been found. However, no study has been performed about coping with menopausal symptoms among school teachers who have higher educational background in Japan. This cross-sectional study explored coping strategies used by female teachers experiencing menopausal symptoms and the factors influencing their healthcare-seeking behaviors. Data were collected via a self-administered questionnaire between December 5, 2022 and February 28, 2023. Participants included 278 female teachers aged 45-60 years working in public elementary and junior high schools, of whom 156 (56.1%) reported menopausal symptoms. More than 80% of those with symptoms used at least one coping strategy : gathering information (68.6%), self-coping (60.9%), seeking advice (57.1%), and medical consultation (26.3%). Higher somatic menopausal symptom scores were associated with seeking medical consultation or advice. A significant correlation was observed between symptom severity and number of coping strategies used. Additionally, prior knowledge of menopause significantly increased the likelihood of information gathering and self-coping. Our findings underscore the need for support systems that help teachers cope with menopausal symptoms effectively, such as improving access to care and providing educational opportunities about menopause. J. Med. Invest. 72 : 85-92, February, 2025.

Objective: Identified genetic mutation in the patient with unexplained decreased fibrinogen activity.

Methods: We conducted a detailed examination of the patient's fibrinogen activity level, antigen level, and genomic sequence.

Results: The patient's fibrinogen activity level was 80 mg / dL and the antigen level was 131 mg / dL. Upon sequencing of the fibrinogen gene, a novel heterozygous c.Bβ227G > T mutation was detected in Bβ-chain, which results in the cysteine residue at position 76 in exon 3 being converted to a phenylalanine residue.

Conclusions: This mutation reduces fibrinogen activity and antigen levels, but the pathophysiology of this mutation remains unclear. J. Med. Invest. 72 : 182-184, February, 2025.

Nutrition and exercise have effects on the body. The aim of the present study was to assess vitamin D status (serum 25-hydroxyvitamin D [25(OH)D] levels) and investigate its associations with muscle mass and function, as well as the effects of vitamin D supplementation on muscle function in high school athletes. Twenty-one high-school athlete students (6 males and 15 females) participated in this study. The serum 25(OH)D levels of 15 athletes (71.4%) with vitamin D insufficiency (VDI)/vitamin D deficiency (VDD) were and those of six athletes (28.6%) with vitamin D sufficiency (VDS) were 24.2 (22.3-27.0) ng/mL and 35.8 (33.0-38.9) ng/mL, respectively. Serum 25(OH)D concentration was significantly associated with total power in the male, female, and total athlete groups. Daily 1,000 IU vitamin D supplementation for 6 months increased serum vitamin D levels from 27.0 (22.9-32.1) ng/mL to 37.9 (28.9-40.9) ng/mL and improved muscle function in the total athlete group. Our findings suggest that daily 1,000 IU vitamin D supplementation should be recommended to optimize maximal aerobic power in high school athletes. J. Med. Invest. 72 : 167-171, February, 2025.

Background: The proportion of elderly patients within the gastric cancer (GC)-affected population has been increasing. Accordingly, there is a pressing need for reliable methods to stratify surgical risk in geriatric GC cases. Psoas muscle density (PMD), a parameter indicative of sarcopenia, is readily assessable using standard radiological techniques and has been recognized as a prognostic marker in various malignancies. However, its clinical significance in GC, particularly among elderly patients, remains inadequately defined.

Methods: We retrospectively reviewed 110 patients aged ≥75 years who underwent R0 gastrectomy for GC. The prognostic value of preoperative PMD, along with other nutritional indices, was assessed using Cox proportional hazards models.

Results: Lower PMD was significantly associated with diffuse-type histology and higher incidence of postoperative complications. On univariate Cox regression analysis, PMD was significantly associated with overall survival. Multivariate analysis confirmed PMD as an independent predictor of overall survival (hazard ratio:0.57;95% confidence interval:0.35-0.91 per 10-Hounsfield unit increase), along with other nutritional parameters.

Conclusion: Preoperative PMD was significantly associated with postoperative morbidity and independently predicted overall survival in elderly GC patients. Incorporating PMD assessment into preoperative evaluation may enhance risk stratification and guide perioperative management in this vulnerable population. J. Med. Invest. 72 : 396-400, August, 2025.

Fungi are one of the main sources of microbial contamination in food and residential environments. There has been reported that fungi are more resistant to drugs than are viruses and bacteria, so efficient sterilization methods are still required. In this study, we examined the effectiveness of ultraviolet (UV) sterilization against mold by focusing on the wavelength and radiant flux dependence of UV. UVC or UVA irradiation inactivated the mold species Cladosporium sphaerospermum in a dose-dependent manner. The energy required to obtain the same inactivation differed significantly between UVC irradiation and UVA irradiation. UVC irradiation induced the formation of substantial amounts of cyclobutane pyrimidine dimers, whereas UVA irradiation did not show any significant difference from the unirradiated group. Furthermore, UVC irradiation induced morphological changes that could be observed by electron microscopy. On the other hand, UVA irradiation suppressed the growth rate. These results suggest that UVC and UVA irradiation have different effects on fungi. The results suggest that both UVC and UVA irradiation may help control fungal contamination. Since the effect of UV differs depending on the wavelength of irradiation, it will be necessary to understand the wavelength-specific effect and use it to control fungal contamination in the living environment. J. Med. Invest. 72 : 260-265, August, 2025.

Background: Early detection of sarcopenia is critical in countries with rapidly aging populations. In this study, we investigated the diagnostic accuracy of Kihon Checklist (KCL) in screening sarcopenia among older adults.

Methods: This retrospective, cross-sectional study included 442 community-dwelling. A baseline questionnaire and KCL were administered to the participants, and their physical function and body composition were measured. Sarcopenia was defined according to Asian Working Group for Sarcopenia 2019 guidelines. Receiver operating characteristic (ROC) curve analysis was used to examine the diagnostic accuracy of KCL for sarcopenia. In addition, a novel approach using KCL along with patient age was considered.

Results: Among the subjects (72.1% women;average age, 76.7 years), 34 (7.6%) had sarcopenia. The ROC-based diagnostic accuracy for sarcopenia was as follows:Area under the ROC curve (AUC) = 0.805 (95% confidence interval [CI] = 0.735-0.874) for KCL, 0.865 (95% CI = 0.811-0.920) for KCL 5 items model, 0.892 (95% CI = 0.851-0.934) for KCL plus age, and 0.922 (95% CI = 0.886-0.957) for KCL 5 items model plus age.

Conclusion: KCL showed good diagnostic accuracy as a screening tool for predicting sarcopenia, suggesting utility in population-based approaches for sarcopenia detection. J. Med. Invest. 72 : 272-280, August, 2025.

Background: Pneumonia caused by Legionella pneumophila and other Legionella spp. is associated with high hospitalization and mortality rates. We herein report a case of severe cardiogenic shock triggered by Legionella pneumonia that was successfully treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Case presentation: A 59-year-old man was admitted to the emergency department with a fever and consciousness disturbance. He was diagnosed with Legionella pneumonia based on urinary antigen test results. Despite receiving supplemental oxygen, the patient's oxygenation worsened, necessitating immediate tracheal intubation. Mechanical ventilation and vasopressor therapy were initiated;however, tachycardia due to atrial fibrillation, along with a reduced ejection fraction of only 15%, led to the development of cardiogenic shock. On day 1 in the intensive care unit (ICU), VA-ECMO and intra-aortic balloon pumping (IABP) were introduced. By day 3, his tachycardia and myocardial dysfunction had improved, leading to the withdrawal of VA-ECMO on day 4. His respiratory function improved and he was extubated on day 7. He was discharged from the ICU on day 9.

Conclusions: VA-ECMO is a valuable treatment modality for refractory cardiogenic and septic shock. Considering the induction of VA-ECMO as a therapeutic option at an appropriate time is important in such cases. J. Med. Invest. 72 : 434-437, August, 2025.