Impact of Living at the Japanese Antarctic Research Expedition Base on Urinary Status

Objectives

Urinary disorders are generally well understood, but there are few reports on the urinary status of people living in unusual climates such as the polar regions. We studied the impact of living conditions on the urinary status of members of the Japanese Antarctic Research Expedition.

Methods

This prospective study enrolled 12 consenting members of the wintering party stationed at the Syowa Station in Antarctica between November 2012 and March 2014. The subjects completed questionnaires (the International Prostate Symptom Score [IPSS], Overactive Bladder Syndrome Score [OABSS] and Pittsburgh Sleep Quality Index [PSQI]) and kept daily voiding dairies for 3 days consecutively every 2 months.

Results

Compared with baseline values, the mean scores on all the questionnaires decreased during the stay in Antarctica, from 3.42 to 2.31 for the IPSS, 1.25 to 0.986 for the OABSS, and 4.58 to 3.78 on the PSQI. A significant difference was noted in the scores of seven subjects with a 3 point or more decrease in IPSS score and five members with a decrease less than 3 points (?2.22 vs 0.448, P = 0.0416).

Conclusion

This is the first survey of the urinary status of people living in a polar environment. The findings obtained by questionnaires and voiding dairies indicated that urination and sleep status did not worsen during the stay in Antarctica.     

Stent-assisted Coiling for Ruptured Basilar Artery Dissecting Aneurysms: An Initial Experience of Four Cases

No treatment strategy has been established for subarachnoid hemorrhages due to basilar artery (BA) trunk dissecting aneurysms. Our aim was to report our initial experience performing stent-assisted coiling (SAC) for ruptured BA dissecting aneurysms to validate the effectiveness of this treatment. We experienced four consecutive cases of ruptured dissecting BA trunk aneurysm treated with SAC between 2008 and 2014 at three institutions. Aneurysm rebleeding was prevented without causing severe brainstem ischemia in all cases. In our opinion, both the blockage of the inflow to aneurysms and the preservation of the antegrade flow of the BA can be achieved by SAC, although controversies regarding long-term stability and appropriate antiplatelet therapy remain.     

Solitary Epicranial Neurofibroma with Neurofibromatosis Type 1-Related Germline Mutation: Case Report

A 33-year-old male became aware of a painless soft mass in the left occipital region. His medical and family history were unremarkable for neurofibromatosis type 1 (NF1) or other genetic disorders. Physical examination showed no signs of NF1. Neurological and ophthalmological examinations found no abnormality. Cranial computed tomography showed an isodense mass located subcutaneously with irregular deformities in the adjacent occipital bone. Magnetic resonance (MR) imaging demonstrated that the lesion, 7.5 × 5.5 cm in diameter, was hypointense both on T₁- and T₂-weighted images and intensely enhanced after gadolinium infusion. The patient requested to remove the large mass. The subcutaneous tumor was well circumscribed, encapsulated, and less vascular, and resected en bloc. The histological diagnosis was neurofibroma without findings of cell atypia, whereas genomic exploration identified abnormal gains in NF1 gene, and resultant absence of neurofibromin, a protein coded on NF1 gene. Solitary neurofibromas in “clinically” non-NF1 patients may originate from the genomic changes in NF1 gene.     

Effort-reward imbalance and depression among private practice physicians

Purpose  

Current private practice physicians provide medical services in a harsh economic situation. The effort-reward imbalance (ERI) model puts its emphasis on an imbalance between high efforts spent and low rewards received in occupational life. ERI model includes three different reward factors from task to organizational levels. We examined whether ERI in terms of low organizational reward (poor prospective and job insecurity) could be the most relevant and strongly associated with depression among private practice physicians.     

The treatment of neuroleptic malignant syndrome using dantrolene sodium

The use of dantrolene sodium (DS) in the treatment of neuroleptic malignant syndrome (NMS) was studied from the data of 21 cases of NMS, which satisfied the diagnostic criteria of Pope et al. The mean dosage of DS was 0.97 ± 0.52 mg/kg per day and the mean duration of treatment was 8.3 ± 5.3 days. It was confirmed that the mean duration of treatment with DS tended to be longer in the cases involving disturbance of consciousness. However, there were no significant differences in the duration of treatment or the mean daily dosage, in the cases without disturbance of consciousness regardless of any other complications and symptoms. Also, there were no significant differences in the mean duration of treatment using DS and the mean dosage of DS between five cases that were considered to be `typical' and 16 cases that were considered to be `incomplete'. In addition, the prognoses of these cases were good such that not even one death occurred. In 13 cases, the treatment of psychiatric symptoms with thioridazine was started without recurrence of NMS.     

Effects of acetazolamide on the sleep apnea syndrome and its therapeutic mechanism

Abstract Twenty male patients with sleep apnea syndrome were treated with acetazolamide (AZM), a carbonic anhydrase inhibitor. In 14 of the patient a significant decrease was found in the number of apnea, apnea index and % apnea time (percentage of time spent with apnea to the total sleep time) with improvement in sleep structure, clinical symptoms, such as insomnia, daytime excessive sleepiness and snoring. A significant decrease was also observed in arterial blood pH and HCO⁻₃ in the 14 improved patients. On the other hand, no improvement occurred in the parameters of sleep apnea and sleep with AZM in the remaining six patients. Moreover, metabolic acidosis and an improvement in arterial blood gases did not occur with AZM in the six patients.     

Relationship between hepatocellular carcinoma and subtypes of hepatitis C virus: A nationwide analysis

Although hepatitis C virus (HCV) has now been classified into several subtypes, the clinical significance of HCV subtypes is not well known. Typing of HCV is now routinely performed in Japan. In the present study, HCV subtypes in hepatocellular carcinoma (HCC) patients were analysed from nationwide data collected in Japan using a standard questionnaire. Answers to the questionnaire concerning HCV subtypes in patients with chronic hepatitis (CH), liver cirrhosis (LC) and HCC were obtained from 14 hospitals. The prevalence of the 1b-related subtype, which includes the mixed subtype of 1b and 2a or 2b, in patients with LC and HCC in each hospital was higher than in patients with CH, with few exceptions. However, the differences were not statistically significant because of the small number of patients in each hospital. In summarized data from all 14 hospitals, the 1b-related subtype was found in 1370 of 1922 patients with CH (71.2%). In 356 LC and 426 HCC patients, the prevalence of the 1b-related subtype was 79.8 and 80.5%, respectively. The prevalence of the 1b-related subtype in patients with LC and HCC was significantly higher than in patients with CH. There was no significant difference between the prevalence of the 1b-related subtype in patients with HCC and LC. These results indicate that the oncogenic activity of subtype 1b, although not yet clearly characterized, may be stronger than subtypes 2a and 2b.     

IMPAIRED LIPOPROTEIN METABOLISM IN PATIENTS WITH PRIMARY GOUT--INFLUENCE OF ALCOHOL INTAKE AND BODY WEIGHT

Using logistic regression analysh, we investigated whether ornot excessive alcohol intake and increased BMI, both of whichare known causes of lipid metabolism abnormality, are associatedwith increased serum triglyceride, apolipoprotein B concentrationsand decreased high-density lipoprotein cholesterol (HDL-C),high-density lipoprotein 2 cholesterol (HDL₂-C) levels in patientswith gout. Serum triglyceride levels were significantly higherin patients with gout than in normal subjects In contrast, serumlevels of HDL-C and HD₂-C were significantly lower in patientswith gout than in normal subjects. These results were furtheranalysed using stepwise logistic regression. This analysis demonstratedthat both serum triglyceride levels and alcohol consumptiondiscriminated subjects with gout from controls but BMI, HDL-Cand HDL₂-C did not, suggesting that increased serum triglyceridelevels exist intrinsically in gout, while decreased concentrationsof HDL-C and HDL₂-C may be attributed to hypertriglyceridaemia. KEY WORDS: Gout, Triglyceride, Highdensity lipoprotein cholesterol, Alcohol, Body weight     

Effects of ethanol and its metabolites on collagen synthesis by cultured rat liver cells

The effects of ethanol and its metabolites on collagen synthesis in cultured rat Ito cells and hepatocytes were studied. In cultured Ito cells, collagen synthetic ability reached peak values after incubation for 24 h and after 8 h in cultured hepatocytes. The distribution patterns of 14C-activity in each collagen fraction were quite different between the two cell types. About 80% of the activity was found in the degraded collagen fraction in the cultured hepatocytes, indicating a rapid turn-over of collagen protein in this cell type. In the Ito cells, the activity in the intact collagen was about 50%. Ethanol and its metabolites added to the incubation medium did not stimulate collagen synthesis in either cell type; rather, they inhibited it. Collagen metabolism in the cells to which ethanol or its metabolites had been added was slower than in the control medium. These results indicate that the pathogenesis of alcoholic liver fibrosis is not simple and that interaction or modulation of cell function in different types of cells should be considered when examining the mechanisms of fibrogenesis in alcoholic liver fibrosis.