Tokai Journal of Experimental and Clinical Medicine

OBJECTIVE: We aimed to assess whether patients who underwent early palatoplasty have normal speech. METHODS: 19 patients with unilateral cleft lip and palate were enrolled in this study. At 6 months of age, we performed simultaneous lip, maxilla, and palate repair using presurgical orthodontics. Speech development was assessed by evaluating velopharyngeal function (VPF) and development of articulation for 10 years. RESULTS: No articulation disorders were observed after 4 years of age...

OBJECTIVE: This prospective randomized study aimed to assess the usefulness of two videolaryngoscopes with a side channel, the Airtraq DLTM and the AWS-200TM , for intubation with a double-lumen tube (DLT). METHODS: In 60 patients with an American Society of Anesthesiologists physical status of 1-3 who were not expected to have difficult airway, the Airtraq DLTM and the AWS-200TM were randomly used for DLT intubation. The primary outcome was intubation time. The secondary outcomes included exposure time, the glottis view with the Macintosh and study videolaryngoscopes, the number of attempts before successful intubation, the intubation difficulty scale (IDS) score, and the subjectively rated ease of blade insertion and DLT advancement...

OBJECTIVE: Pulmonary vein isolation (PVI) has been widely used for the treatments of paroxysmal atrial fibrillation (PAF); however, AF recurrence remains a significant challenge. We evaluated relation between autonomic nervous activity and AF recurrence using heart rate variability (HRV) and deceleration and acceleration capacity (DC/AC) analyses. METHODS: High-resolution Holter electrocardiogram was performed in 56 PAF patients pre- and 3 and 6 months post-PVI by cryoballoon...

A 63-year-old man was pointed out with a mediastinal tumor on chest computed tomography (CT). On positron emission tomography-CT, fluorodeoxyglucose accumulation with a maximum standardized uptake value of 12.70 was seen in this tumor. Scar-like nodule was found in the apex of the right lung, but no abnormal accumulation was observed in this nodule. The level of carcinoembryonic antigen was abnormally elevated. We performed mediastinal tumorectomy under thoracoscopic surgery. Since arterial oxygen saturation fell during intraoperative one-lung ventilation, we finished the surgery without resection of right apex nodule...

OBJECTIVE: The Universal Adapter for Smartphones® c an record s till images and movies during intubation using the monitor display and recording functions of a smartphone. Here, we describe the successful use of the Airtraq Double Lumen® with the Universal Adapter for Smartphones® for airway management during anesthesia in a patient with intubation difficulty. METHODS: A 78-year-old man required thoracoscopic upper lobectomy for a pulmonary tumor. Preoperative examination revealed micrognathia, mouth opening equivalent to a three-finger width, Mallampati Class II, mentum-hyoid bone distance equal to a 2...

OBJECTIVE: Because of the shape of a double-lumen tube (DLT), it is more difficult to use for intubation than an ordinary endotracheal tube. We prospectively investigated the usefulness of the Airtraq DL® attached to the Universal Adapter for Smartphones® for DLT intubation. METHOD: At Tokai University Hachioji Hospital, anesthesiologists with ≥ 5 years' clinical experience intubated a tracheal intubation training mannequin with DLTs using the Airtraq DL® (Airtraq-alone phase) and the Airtraq DL® attached to the Universal Adapter for Smartphones® (adapter phase), and the time required was measured...

OBJECTIVE: Autologous cultured explants of human oral mucosal epithelial cells (OMEC) are a potential therapeutic modality in patients of bilateral ocular surface disease (OSD) with incapacitating dry eye. Mycophenolate mofetil (MMF) has been found to upregulate the mucin production in conjunctival goblet cells in vitro. The aim of this study was to evaluate the effects of MMF on mucin expression in primary cultures of OMEC. METHODS: With informed consent, oral mucosal epithelial tissue samples were obtained from patients undergoing oral surgery for non-malignant conditions...

OBJECTIVE: Surface plasmon resonance (SPR) has been extensively used to characterize the interactions between molecules in terms of their binding specificity, affinity, and kinetics. Practical procedures, however, for measurement of the protein-DNA association in crude nuclear extract are yet to be defined. METHODS: Crude nuclear extract was obtained from MCF-7 cells or recombinant estrogen receptor alpha (ERα) was used for analysis. To suppress signal from non-specific bindings in SPR assay using Biacore, DNA fragments with minimal protein binding activity were identified in a database for transcription factors and included in the study...

BACKGROUND: Treatment of recurrent chronic obstructive pancreatitis is pancreatic duct decompression with endoscopic drainage (endoscopic pancreatic stenting [EPS] with extracorporeal shockwave lithotripsy [ESWL]) or surgical drainage. Despite the recent popularization of endoscopic drainage, treatment or stent removal is difficult in many patients. We compared the efficacy, safety, and medical cost of endoscopic and surgical treatments. PATIENTS AND METHODS: We retrospectively compared the treatment course and medical cost of hospitalization between 41 patients who had undergone pancreatic stenting between 2006 and 2010 (EPS group) and 10 patients who had undergone surgery for poor control of pancreatitis between 2001 and 2005 (surgical drainage group)...

OBJECTIVE: Ischemic colitis (IC) is a relatively common acute inflammation disorder of the intestine. It was considered to be a disorder of elderly people with risk factors for arteriosclerosis; however, a considerable number of young people with IC have been reported recently. We performed a case-control study to determine the risk factors for IC and compare the risk factors between elderly and non-elderly people. METHODS: The study included 209 consecutive patients diagnosed with IC between December 2004 and March 2017 at Tokai University Hospital...

We report the case of a 62-year-old man who used approximately one can of waterproofing spray in an enclosed room and, then, smoked a cigarette. He developed a fever of 39°C with respiratory distress and was transported by ambulance to his usual doctor. Since his respiratory state was very severe, he was transferred to our hospital. The patient had a smoking habit of 20 cigarettes per day for approximately 42 years. Chest computed tomography (CT) on arrival showed ground glass opacity (GGO) in the bilateral lungs with emphysematous change...

We had a case of Emery-Dreifuss muscular dystrophy (EDMD) in an 18-year-old woman who underwent endovascular therapy for a cardioembolic stroke. At 5 years old, she showed a high creatine kinase level and atrial fibrillation on electrocardiography in our hospital. Finally, she was diagnosed as having EDMD by genetic screening that revealed mutations in the LMNA gene (c.810+1G>T). Before this event, she received no medications. At 18 years old, she was admitted to our hospital>8 hours after the onset of sudden consciousness disturbance...

OBJECTIVE: To determine the relationship between 24-hr blood pressure (BP) fluctuations and autonomic nervous system dysfunction in diabetic patients using non-invasive ambulatory blood-pressure monitoring (ABPM) system. METHODS: The subjects were 39 diabetic patients free of cardiovascular diseases. 24-hr BP was monitored by a non-invasive ABPM system. The relationships among 24-hr BP fluctuations and various clinical parameters relevant to diabetes and hypertension were analyzed...

OBJECTIVE: This study evaluated the effect of cysteine-stabilized peptide fraction (CSPF) of Morinda lucida leaf on selected kidney function indices in mice. METHODS: Sixty mice were assigned into six groups. Group A served as the control while groups B, C, D, E and F received 31.25, 61.5, 125, 250, and 500 mg/kg body weight of CSPF respectively for 7 or 28 days. RESULTS: Administration of CSPF for 7 and 28 days caused no significant (p>0...

PURPOSE: We evaluated whether adding bevacizumab (Bev) to paclitaxel+carboplatin (TC) could improve outcomes, especially progression-free survival (PFS), in patients with platinum-sensitive recurrent ovarian cancer. PATIENTS AND METHODS: Among patients with platinum-sensitive recurrent ovarian cancer treated at our hospital from May 2008 to March 2017, PFS was compared between those receiving platinum-based chemotherapy or TC+Bev therapy by propensity score matching analysis...

We report a patient with recurrent refractory small cell carcinoma of the uterine cervix, in whom combined therapy with paclitaxel, cisplatin, and bevacizumab (TP+Bev) was effective. Small cell cervical carcinoma is a rare malignancy and its outcome is reported to be poor. The patient was a 45-year-old woman who visited a local hospital with the chief complaint of irregular vaginal bleeding and was referred to our department. The results of a smear test and examination of a tissue biopsy specimen suggested small cell carcinoma...

OBJECTIVE: Breath sound parameters have been suggested to be a new biomarker of airway conditions in asthmatic patients. We investigated new breath sound parameters to determine their utility for evaluating asthmatic children. METHODS: Fifty-seven children (mean age, 9.0 years, 6-16 years) were included in the present study. The new breath sound parameters, the area under the curve (AUC)>1,000 Hz (A1000 [dBm·Hz]) and the ratio of the A1000 to the total AUC at 100 Hz to the highest frequency of the dBm power spectrum (AT ) (A1000 /AT [%]) were measured before and after β2 agonist inhalation...

OBJECTIVES: Japanese traditional (Kampo) medicine has its own theories that are quite different from those of Western medicine. For many students and medical doctors, mastering it is a painstaking task. We examined the similarities in clinical reasoning between Western and Kampo medicine, and developed an easy-to-understand method to teach Kampo theories enabling physicians to make accurate diagnoses and choose suitable Kampo formulae. METHODS: We developed a teaching method for Kampo medicine along clinical reasoning for beginners and evaluate its availability and effectiveness in an actual team-based learning class...

We present a 48-year-old man with a history of hypertension, who suddenly noticed dysarthria and right hemiparesis. Diffusion-weighted MRI at 1 day after the onset showed a small high-intensity region in the left corona radiata, indicating the acute phase of lacunar infarction. Fluid attenuation inversion recovery images showed extensive hyperintense lesions predominantly in the white matter of the fronto-temporoparietal lobes and pons, indicating posterior reversible encephalopathy syndrome (PRES). In addition, T2*-weighted gradient-echo images showed multiple small round hypointense lesions in white matter and basal ganglia, indicating cerebral microbleeds...

With the introduction of Highly Active Antiretroviral Therapy (HAART), there has been drastic decline in morbidity and mortality associated with HIV/AIDS. However, many patients experience adverse drug reactions perhaps due to the inherent toxic nature of HAART. The possible toxic effect of HAART (combination ARVs) on reproduction and sexual dysfunction in seropositive HIV patients remains a subject of intense research. This study was designed to investigate the toxic effects of HAART on the reproductive hormones and organs of male and female rats...