Influence of Underweight on Asthma Control

Background: Although the association between asthma control and body mass index (BMI) has been thoroughly investigated, most of this work has focused on the influence on asthma incidence or the effect of obesity on asthma control. To date, there have been no published studies on the influence of underweight on asthma control.Methods: The aim of this study was to investigate the influence of underweight, as defined by the Japan Society for the Study of Obesity (JASSO), on asthma control in Japanese asthmatic patients. Using data from questionnaire surveys administered by the Niigata Asthma Treatment Study Group, we compared asthma control, as measured by the Asthma Control Test (ACT), between a normal weight group (18.5 kg/m² =< BMI < 25 kg/ m²) and an underweight group (BMI < 18.5 kg/m²).Results: Of the asthmatic patients who completed the 2008 and 2010 surveys, 1464 and 1260 cases were classified as being in the normal weight group, and 174 and 155 cases were classified as being in the underweight group. The ACT score (median, [interquartile range]) in the underweight group in 2008 (22, [19-24]) and 2010 (23, [19-25]) was significantly lower than that in the normal group in 2008 (23, [20-25]) and in 2010 (24, [21-25]).Conclusions: This study is the first, large-scale investigation of the influence of underweight on asthma control, and we have confirmed an adverse influence in a clinical setting. A potential mechanism for this interaction was unknown. Further investigation will be required.     

Occupational Factors and Problem Drinking among a Japanese Working Population

Problem drinking is a serious public health problem in the workplace. However, fewJapanese epidemiological studies have investigated the occupational characteristics ofproblem drinking. The purpose of this study is to clarify the occupational risk factorsfor problem drinking among a Japanese working population. We used data from arandom-sampling survey about mental health and suicide, conducted among Hamamatsu Cityresidents aged 15 to 79 yr old during May and June in 2008. The relation betweenoccupational factors and problem drinking was analyzed with multiple logistic regressionmodels stratified by gender. CAGE questionnaire was used to assess problem drinking. Withregard to employment types, problem drinkers were more prevalent among self-employedwomen. With regard to occupational types, clerical and service professions had moreproblem drinkers of either sex, while administrative/managerial and sales professions hadmore women with such problem. With regard to company size, male problem drinkers were moreprevalent in smaller companies than in larger ones. These results indicate that theprevalence of problem drinkers in the workplace depends on where one works. It isnecessary to consider these characteristics to provide effective measures to addressproblem drinking in the workplace.     

Estimated Glomerular Filtration Rate —A More Stable Indicator than Creatinine Clearance in Peritoneal Dialysis Practice

Objective: The usefulness of estimated glomerular filtration rate may not berestricted to pre-dialysis patients, since we reported that estimated glomerularfiltration rate was well correlated with measured total creatinine clearance in peritonealdialysis patients. To clarify the clinical usefulness of estimated glomerular filtrationrate as a parameter for peritoneal dialysis adequacy, we retrospectively surveyedestimated glomerular filtration rate and total creatinine clearance in peritoneal dialysispatients treated at JA Toride Medical Center.Patients and Methods: A total of 114 data sets of estimated glomerularfiltration rate and total creatinine clearance from 21 PD patients treated at JA TorideMedical Center were collected from November 2010 to October 2011. The patients consistedof 15 men and six women with an average age of 66.6 ± 12.6 years (46–95 years old). Theaverage number of samples was 5.4 ± 1.5 (2 to 7) per patient.Results: The collected data showed less correlation of estimated glomerularfiltration rate and total creatinine clearance (r. = 0.435) than that of a previouscross-sectional study (r. = 0.836). As reported in pre-dialysis patients, the differencesbetween estimated glomerular filtration rate and total creatinine clearance werecorrelated with total creatinine excretion in urine and PD effluent (r. = 0.821). Thedifferences were also correlated with normalized protein catabolic rate, which was one ofthe main determinant factors for total creatinine excretion (r. = 0.636). A similartendency was apparently observed in one patient with poor compliance to diet therapy andfluctuating dietary intake. From the analysis of these data, serum creatinine seemed tofluctuate less possibly due to compensatory capacity of the residual renal function insmall solute clearance.Conclusions: Consequently, estimated glomerular filtration rate was turnedout to be a more stable parameter than total creatinine clearance, which might be adesirable feature in long-term follow-up of peritoneal dialysis patients.     

Echographic detection of diethylnitrosamine-induced liver tumors in rats and the effect of the intratumoral injection of an inhibitor of c-Jun N-terminal kinase

Background and Aim:  There have so far been few reports describing echographic studies of chemically-induced carcinogenesis in rodent livers. Using echography, we observed diethylnitrosamine-induced liver tumors in rats and examined the effect of an intratumoral injection of an inhibitor of c-Jun N-terminal kinase.
Methods:  Male Wistar rats were given 100 ppm of diethylnitrosamine for 6 weeks and their liver nodules were examined by echography weekly. The size of the nodules was measured and they were examined histologically. The effect of SP600125, an inhibitor of c-Jun N-terminal kinase, on the growth of rat hepatoma cell line McA-RH7777 was tested in vitro . Thereafter, SP600125 was injected into the liver nodules under echographic guidance in vivo and the changes in the proliferating cell nuclear antigen expression and size of the nodules were examined.
Results:  The four distinct lobes of rat livers were clearly observed by transabdominal echography. The nodules in the livers were first detected 6 weeks after the treatment began, when they were as small as 1.6 mm in diameter. The nodules thereafter became more malignant histologically as they grew larger than 4 mm. SP600125 decreased the expression of proliferating cell nuclear antigen and the growth of McA-RH7777 cells. After SP600125 was injected in vivo , the proliferating cell nuclear antigen level and the growth rate of the rat liver nodules all significantly decreased.
Conclusions:  Our results indicate that echography is quite useful for follow-up studies of liver carcinogenesis in rats, and c-Jun N-terminal kinase might be another therapeutic target in liver neoplasms.     

Near-fatal cerebral edema associated with adenovirus type 2 infection in a previously healthy infant

We report a near-fatal case of cerebral edema associated with adenovirus type 2 infection in a previously healthy 19-month-old boy. After 3 to 4 d of high fever and a series of seizures, he developed persistent loss of consciousness and irreversible respiratory arrest. Adenovirus type 2 infection was diagnosed by virus isolation from his stool and serology.     

Perioperative management of benign hepatic tumors in patients with glycogen storage disease type Ia

Glycogen storage disease type Ia (GSD-Ia; von Gierke disease) is an inherited disorder caused by glucose-6-phosphatase deficiency, and there have been some reports of hepatic tumors in patients with this disease. We report two patients with benign hepatic tumors with GSD-Ia. One is a 19-year-old man who underwent segmentectomy 4 for a focal nodular hyperplasia, and the other is a 31-year-old woman who underwent segmentectomies 3, 5, and 6 for hepatic adenomas. Two significant perioperative complications, resulting from the carbohydrate metabolic disorders, hypoglycemia and metabolic acidosis, occurred in both patients. We managed the metabolic complications successfully by administering a sufficient volume of glucose intravenously. Close perioperative monitoring of blood glucose and lactate concentrations is essential in the perioperative management of patients with GSD-Ia. The intravenous administration of glucose, starting with a smaller dose and then increasing the dose, is adequate management for lactic acidosis with or without hypoglycemia during the perioperative period.     

Acute retrobulbar optic neuritis with anti-myelin oligodendrocyte glycoprotein antibody-associated disease complicated with microscopic polyangiitis: A case report

Rationale:Anti-myelin oligodendrocyte protein antibody-associated disease (MOGAD) is a new disease entity with various clinical phenotypes. MOGAD often present with recurrent optic neuritis (ON), and it can also develop as a compartment of neuromyelitis optica spectrum disorder (NMOSD). Moreover, multiple autoantibodies such as an anti-myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) had been reported in the serum of patients with NMOSD.Patient concerns:We report an 86-year-old woman with a 2-year history of microscopic polyangiitis (MPA). The patient had a rapid loss of vision in her left eye. No abnormal findings were observed on her left fundus, and she tested negative for MPO-ANCA upon admission. However, anti-MOG antibodies were observed in the patient''s serum and cerebrospinal fluid.Diagnosis:A diagnosis of MOGAD complicated with MPA was made.Interventions:The patient received twice steroid pulse therapy and oral azathioprine as maintenance therapy.Outcomes:Her vision rapidly recovered, and no subsequent relapse was observed during the 8-month observation period.Conclusion:To the best of our knowledge, this is the first case of MOGAD complicated with MPA, and steroid pulse therapy and azathioprine therapy were effective for ON caused by MOGAD.