JOURNAL OF MEDICAL INVESTIGATION最新文献

Background: Detailed depiction of bony structures on conventional magnetic resonance imaging (MRI) is difficult and the modality is inferior to computerized tomography (CT) for showing bony injuries, ossification and calcification. Novel sequences such as zero-echo time (ZTE) and fast field echo resembling a CT using restricted echo-spacing (FRACTURE) may overcome the weak points of conventional MRI. The objective of this study was to determine the usefulness of these sequences on 3.0-T MRI for imaging the cervical spine.

Methods: ZTE and FRACTURE images were obtained from 3.0-T scans for three representative cases of ossification of the posterior longitudinal ligament, retro-odontoid pseudotumor, and fracture in the cervical spine and compared with CT.

Results: FRACTURE images were superior to ZTE images in both of 2D images and 3D images reconstructed from 2D images. But, both ZTE and FRACTURE images from 3.0-T scans could take the place of CT and fused images reconstructed from 2D images and MR angiography could be used instead of CT angiography.

Conclusion: High-resolution MRI sequences may completely replace CT and appear very useful when surgical strategies are considered for patients with allergies to contrast agents or renal failure for whom use of contrast agents is contraindicated. J. Med. Invest. 72 : 266-271, August, 2025.

Background: Positive-pressure ventilation (PPV) before extubation may improve oxygenation and reduce complications after extubation. However, no study has quantitatively evaluated the effects of extubation on breathing and lung volume.

Methods: A crossover randomized study was performed on 16 patients who received mechanical ventilation and planned to undergo extubation in the intensive-care unit. We used the automatic tube compensation (ATC) mode to simulate extubation. We used electrical impedance tomography and an esophageal balloon catheter to evaluate the work of breathing and lung volume after simulated extubation. We compared the work of breathing and lung volume with and without PPV before simulated extubation.

Result: There were no differences in the changes in end-expiratory lung impedance (-7.4 [-18.2-2.3] vs. -11.2 [-16.6-1.1] arbitrary units, p=0.53), anterior-to-posterior ventilation ratio (0.60 [0.49-0.74] vs. 0.60 [0.52-0.79], p=0.75), esophageal pressure swing (4.9 [2.1-8.7] vs. 5.4 [1.9-6.6] cmH2O, p=0.61), dynamic transpulmonary pressure (7.2 [6.7-9.9] vs. 7.6 [6.6-9.7] cmH2O, p=0.93), and pressure time product (2.4 [1.4-4.2] vs. 3.1 [1.0-4.3] cmH2O*s, p=0.84) with and without PPV before simulated extubation.

Conclusion: PPV before extubation did not affect breathing work or lung volume after extubation. Therefore, it may delay extubation and increase patient stress. J. Med. Invest. 72 : 361-366, August, 2025.

Life support robots in care settings must be able to read a person's emotions from facial expressions to achieve empathic communication. This study aims to determine the degree of agreement between Multi-task Cascaded Convolutional Neural Networks (MTCNN) results and human subjective emotion analysis as a function to be installed in this type of robot. Forty university students talked with PALRO robot for 10 minutes. Thirteen area of interest videos were used to assess the validity identified by MTCNN was facial expression was happy or combination of happy and other emotions. Twenty university students and 20 medical professionals identified which of the 7 emotions (angry, disgust, fear, happy, sad, surprise, neutral) were present. Fleiss' kappa coefficient was calculated. Kappa coefficients of the emotion analysis for seven emotions ranged from 0.21 to 0.28. Kappa coefficient for "Happy" was the highest (0.52 to 0.57) with moderate agreement. Among female university students, only "Surprise" had a moderate agreement with Fleiss' kappa coefficient of 0.48. MTCNN emotion analysis and human emotion analysis were in moderate agreement for the identification of "Happy" emotions. The comparison of the agreement between the results of emotion analysis from facial expressions using non-contact MTCNN and subjective human facial expression analysis suggested that the use of MTCNN may be effective in understanding subjects' happy feelings. J. Med. Invest. 72 : 93-101, February, 2025.

Aging and obesity trigger liver mitochondrial decline, impairing liver function and energy metabolism. Effective hepatic mitochondrial biogenesis helps maintain and restore hepatocyte function. The effects of bergenin, a polyphenol with various pharmacological effects, on hepatic mitochondrial biogenesis remain unclear. Therefore, we aimed to determine its effects on mitochondrial biogenesis in hepatocytes. We measured mitochondrial content in human HepG2 hepatocytes using MitoTracker Green FM ; intracellular ATP content using an ATP assay kit ; and mitochondrial DNA (mtDNA) using the ratio of mtDNA to nuclear DNA by qPCR. Protein levels were analyzed using immunoblotting. Nuclear translocation of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) was assessed by immunofluorescence staining and immunoblotting. In human HepG2 hepatocytes, bergenin increased mitochondrial content, elevated mitochondrial DNA and constituent proteins, and enhanced intracellular ATP levels and PGC-1α nuclear translocation, possibly promoting mitochondrial biosynthesis. SIRT1 expression was induced in bergenin-treated cells and may be responsible for bergenin-inducible mitochondrial biogenesis, which was abolished by the SIRT1 inhibitor EX-527. Furthermore, bergenin activated AMP-activated protein kinase (AMPK). Compound C, an AMPK inhibitor, abolished bergenin-induced SIRT1 expression and mitochondrial biogenesis. Overall, bergenin activates hepatic mitochondrial biogenesis through the AMPK / SIRT1 axis, which could help to prevent and ameliorate serious aging- and obesity-related liver diseases. J. Med. Invest. 72 : 66-75, February, 2025.

Background: The oral and gut microbiomes are linked to prognosis in colorectal cancer patients undergoing surgery, chemotherapy, or radiotherapy. Dysbiosis in the oral microbiome can lead to tooth decay, periodontitis, and gingivitis, resulting in tooth loss. This study examined the relationship between tooth count and chemotherapy outcomes in colorectal cancer patients.

Method: This retrospective cohort study involved 42 patients receiving chemotherapy for unresectable advanced or metastatic colorectal cancer at Tokushima University Hospital between October 2016 and December 2021. Prior to chemotherapy, dental panoramic radiographs were taken to determine tooth count. Patients were grouped based on the number of teeth (≥17 vs. ≤16), and overall survival (OS), progression-free survival (PFS), and adverse events were compared.

Results: Patients with ≤16 teeth had significantly worse OS than those with ≥17 teeth (p = 0.024). PFS tended to be worse in patients with ≤16 teeth, albeit without significance (p = 0.097). The incidence of various adverse events did not differ between the groups. Anemia was the most common adverse event in patients with ≤16 teeth. Conversely, neutropenia was the most common adverse event in patients with ≥17 teeth.

Conclusion: The number of teeth could be easily examined prognostic factor for chemotherapy in colorectal cancer. J. Med. Invest. 72 : 134-138, February, 2025.

The study aimed to investigate the effectiveness of combining a protein and vitamin D-enriched menu with an exercise program to reduce frailty risk and enhance muscle performance. However, current evidence lacks accurate dosage and effectiveness information for this combination. This study involved Japanese men in their 60s who were randomly assigned to two groups : the ExN group, which received a 10-day exercise program along with enriched diet, and the Ex group, which underwent the exercise program alone. The effects of these interventions on muscle mass, strength, and serum vitamin D metabolite levels were assessed. The ExN intervention resulted in a significant increase in skeletal muscle mass and serum 25-hydroxyvitamin D3 (25(OH)D3) levels, while the Ex intervention did not yield the same effects. These results indicate that a combined program of exercise with protein and vitamin D-enriched meal improves serum 25(OH)D3 levels and skeletal muscle mass among older Japanese men. J. Med. Invest. 72 : 76-84, February, 2025.

We report a case of a 14-year-old male sprinter with bilateral fatigue fractures of the proximal phalanges in the great toes. The patient and his guardian wished for an early return to sports; therefore, focused extracorporeal shockwave therapy (FSW) was administered instead of the traditional surgical treatment for bilateral cases. Four weeks after starting treatment, tenderness had disappeared, and he was able to return to sports. Computed tomography at 24 weeks after starting FSW revealed bone healing, and there was no recurrence of the fatigue fractures at the 48-week follow-up. The lesson learned from this case is that FSW offers a novel, less invasive treatment option for athletes with bilateral fatigue fractures of the proximal phalanges in the great toes who wish for an early return to sports without surgery. FSW has analgesic effects and promotes bone healing, resulting in optimal treatment outcomes. FSW should be considered a standard treatment option for this type of fracture. J. Med. Invest. 72 : 207-210, February, 2025.

Background: The COVID-19 pandemic has significantly impacted nursing students in urban settings. Understanding stress and coping in this population is essential for developing effective interventions for future pandemics and post-pandemic nursing education.

Aims: This study assesses the interactions between demographic variables and stress responses, demonstrating these relationships through data sonification.

Methods: A cross-sectional analytical study was conducted at an urban nursing college, with 195 participants completing modified versions of the Perceived Stress Scale, Physio-Psycho-Social Response Scale, and Coping Behavior Inventory. Structural equation modeling and data sonification were employed for analysis.

Results: Nursing students reported moderate stress from academic demands and clinical responsibilities, utilizing coping strategies such as problem-solving and optimism. Structural equation modeling indicated a significant negative relationship between coping skills and physio-psycho-social stress (β = -0.301, p < .0001) and a negative association between age and perceived stress (β = -0.160, p = 0.035). Data sonification revealed synchronization between perceived stress and stress responses, with coping efforts peaking slightly after stress levels.

Discussion: While students employ effective coping strategies, targeted interventions are needed to enhance stress management, especially for younger students.

Conclusion: Stress and coping among nursing students in urban settings are complex, with data sonification providing deeper insights. J. Med. Invest. 72 : 102-116, February, 2025.

AsisTIVA is total intravenous anesthesia support software for syringe pump control. It remains the only automated program to have achieved both practical and commercial viability. AsisTIVA has been certified for use at Tokushima University, Tohoku University, and at its developer institution, Fukui University. We conducted our initial anesthesia management with AsisTIVA at Tokushima University. This initial experience was successful, with no adverse effects. AsisTIVA controls propofol and remifentanil concentrations to maintain a Bispectral index of 45 and adjusts rocuronium concentrations to maintain a Train Of Four value of 1. By managing these anesthetics, AsisTIVA allows anesthesiologists to focus on other aspects of anesthesia management. Its use is expected to expand further. J. Med. Invest. 72 : 211-216, February, 2025.

The aim of this study was to determine the association between total soy product intake and metabolic syndrome (MetS) in Japanese workers. The cross-sectional study included 698 participants aged over 40 years, and the longitudinal study included 527 participants aged over 40 years in 2012 who participated at least once from 2013 to 2018. Dietary intake of total soy products was summed based on the total amount of 12 kinds of soy products assessed using a food frequency questionnaire. Participants were diagnosed as having MetS if they had abdominal obesity and at least one of the following conditions:hypertriglyceridemia, high blood pressure, and hyperglycemia. To calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for MetS according to tertile of total soy product intake, multivariable logistic regression was performed for the cross-sectional analysis, and generalized estimating equations were used for the longitudinal analysis. Cross-sectional analysis showed that there was an inverse association between total soy product intake and MetS, and the OR of tertile 3 was significantly higher than that of tertile 1. However, the inverse association disappeared in the longitudinal analysis. Further long-term studies are needed to determine the association between total soy product intake and MetS. J. Med. Invest. 72 : 343-353, August, 2025.