Springer Science and Business Media LLCActa Medica Okayama1023-38302021Anti-high mobility group box 1 monoclonal antibody suppressed hyper-permeability and cytokine production in human pulmonary endothelial cells infected with influenza A virusENTakahiroNambaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMitsuruTsugeDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasatoYashiroDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukieSaitoDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKeyueLiuDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasahiroNishiboriDepartment of Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuneoMorishimaDepartment of Pediatrics, Aichi Medical UniversityHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesObjective<br>
High mobility group box-1 (HMGB1) has been reported to be involved in influenza A virus-induced acute respiratory distress syndrome (ARDS). We studied the efficacy of an anti-HMGB1 mAb using an in vitro model of TNF-α stimulation or influenza A virus infection in human pulmonary microvascular endothelial cells (HMVECs).<br>
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Methods<br>
Vascular permeability of HMVECs was quantified using the Boyden chamber assay under tumor necrosis factor-α (TNF-α) stimulation or influenza A virus infection in the presence of anti-HMGB1 mAb or control mAb. The intracellular localization of HMGB1 was assessed by immunostaining. Extracellular cytokine concentrations and intracellular viral mRNA expression were quantified by the enzyme-linked immunosorbent assay and quantitative reverse transcription PCR, respectively.<br>
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Results<br>
Vascular permeability was increased by TNF-α stimulation or influenza A infection; HMVECs became elongated and the intercellular gaps were extended. Anti-HMGB1 mAb suppressed both the increase in permeability and the cell morphology changes. Translocation of HMGB1 to the cytoplasm was observed in the non-infected cells. Although anti-HMGB1 mAb did not suppress viral replication, it did suppress cytokine production in HMVECs.<br>
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Conclusion<br>
Anti-HMGB1 mAb might be an effective therapy for severe influenza ARDS.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812522013マウスインフルエンザ肺炎におけるレドックス制御蛋白チオレドキシン（TRX-1）の治療的効果109112ENMasatoYashiroHirokazuTsukaharaAkihiroMatsukawaMutsukoYamadaYosukeFujiiYoshiharuNagaokaMitsuruTsugeNobukoYamashitaToshihiroItoMasaoYamadaHiroshiMasutaniJunjiYodoiTsuneoMorishimaNo potential conflict of interest relevant to this article was reported.The Editorial Secretariat of JCBNActa Medica Okayama0912-00095212013Thioredoxin-1 and oxidative stress status in pregnant women at early third trimester of pregnancy: relation to maternal and neonatal characteristics2731ENYokoNakatsukasaHirokazuTsukaharaKazuhisaTabuchiMasakoTabuchiTomokoMagamiMutsukoYamadaYosukeFujiiMasatoYashiroMitsuruTsugeTsuneoMorishimaThis study examined the clinical and biological importance of thioredoxin-1, a redox-active defensive protein that controls multiple biological functions, in pregnant women. We measured serum concentrations of thioredoxin-1, total hydroperoxides, and redox potential in 60 pregnant women at the early third trimester: gestational age of 27-29 weeks. The thioredoxin-1 concentration (mean +/- SD) was 90 +/- 42 ng/ml. Total hydroperoxides was 471 +/- 105 U.CARR (1 U.CARR = 0.08 mg/dl H2O2). Redox potential was 2142 +/- 273 mu mol/l. The total hydroperoxides: redox potential ratio (oxidative stress index) was 0.23 +/- 0.08. Thioredoxin-1, total hydroperoxides, and oxidative stress index were higher and redox potential was lower than in blood of healthy adults. Total hydroperoxides and redox potential were mutually correlated significantly and negatively. Thioredoxin-1 correlated significantly and negatively and redox potential correlated significantly and positively with body weight and body mass index. Thioredoxin-1 and redox potential correlated significantly and positively with uric acid and albumin, respectively. Thioredoxin-1 and oxidative stress index correlated significantly and negatively and redox potential significantly and positively with neonatal birth weight. These results suggest that high concentrations of thioredoxin-1 are linked to high oxidative stress status in pregnant women and that neonatal birth weight is affected by the maternal oxidative condition during later pregnancy.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama1522-19468152013Usefulness of balloon angioplasty for the right ventricle-pulmonary artery shunt with the modified norwood procedure837842ENNaokiOhnoShinichiOhtsukiKoichiKataokaKenjiBabaYoshioOkamotoMaikoKondoShunjiSanoShingoKasaharaOsamiHonjoTsuneoMorishimaObjective We sought to evaluate the efficacy of balloon angioplasty (BA) for severely desaturated patients due to a stenotic right ventricle (RV) to pulmonary artery (PA) shunt following modified Norwood procedure. Methods Of 87 patients who underwent a Norwood procedure with the RV-PA shunt between February 1998 through March 2010, 22 (25%) patients underwent BA. The efficacy of BA was assessed by angiographic measurement of the changes in the internal diameters of the stenotic portions of the shunt, changes in arterial saturation and clinical outcomes. Results BA was performed for stenotic RV-PA shunts following stage I palliation (n = 17, 77%), or those placed as an additional blood source (n = 5, 23%, 3 patients awaiting biventricular repair, 2 patients following stage II palliation). The location of the BA was at the distal anastomosis in 12 (54.5%), proximal anastomosis in 21 (95.4%) and in the mid-portion of the shunt in 11 (50%) cases. The diameters of these three shunt portions were measured from the anteriorposterior and lateral angiographic images, increasing significantly after BA (p < 0.0001) in all. Arterial saturation significantly improved after BA in all cases (66.5 +/- 4.3% to 79.4 +/- 3.4%, p < 0.0001). Freedom from reintervention was 100%. All patients underwent subsequent elective planned surgery at an appropriate age with no mortality. Conclusions A BA-alone strategy for a stenotic RV-PA shunt was effective for all three shunt portions, minimizing shunt-related premature surgical intervention.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812322011小児科領域における難治性疾患137139ENTsuneoMorishimaNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6532011A One-Message Question in a Structured Interview: Investigating Psychological Needs of Children and Adolescents with Eating Disorders Directed toward Their Mothers185192ENKumiWatanabeAyumiOkadaNobuyukiOkabeMasaruOnishiTsuneoMorishimaOriginal Article10.18926/AMO/46630The purpose of this study was to investigate the psychological needs of children and adolescents with eating disorders (ED) directed toward their mothers. Patients with ED have low self-assertion and various abnormal eating behaviors. Therefore, mothers face difficulty in understanding their children's psychological needs, and the mother-child relationship is sometimes strained. We developed a One-Message Question (OMQ)-structured interview. The OMQ was easy to answer, and it helped the patients with ED. We examined the relationship between psychological needs and illness phase of the children and adolescents, and we discuss the viability of implementing the OMQ in clinical settings. The subjects were 23 patients and their parents. Their parents were just asked about the patients' background. The mean age of the patients was 15.8 years, and the average age of ED onset was 13.5 years. The EDs were anorexia nervosa (n＝20) and bulimia nervosa (n＝3). The phases of patients' illness were identified as anorexic (n＝5), bulimic (n＝7), chronic (n＝3), and stable (n＝8). All subjects provided specific responses to the OMQ-structured interview. Data analyses revealed the following seven categories of patients' psychological needs directed toward their mothers:attachment, cooperation in meeting their goals, longing for love, changing attitude toward family members, respect for self-reliance, expression of apology, and expression of appreciation. These findings suggested that the OMQ-structured interview may prove useful for mothers to understand their children's psychological needs and may encourage positive interactions as a foundation for future recovery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6152007Self-esteem in Children with Psychosomatic Symptoms: Examination of Low Self-esteem and Prognosis271281ENMizuhoHosogiAyumiOkadaErikoYamanakaKeikoOotyouChiakiTsukamotoTsuneoMorishimaOriginal Article10.18926/AMO/32899Self-esteem is the evaluative feelings one holds for oneself and the sense that one has essential worth. It is evaluated as the difference between the actual self and the ideal self. Healthy self-esteem supports psychological stability and positive social activity and is an essential element in the psychological development of children. The purpose of this study was to evaluate self-esteem in children with psychosomatic symptoms and elucidate a strategy for using such evaluations in therapy. We evaluated self-esteem in 56 patients at the Department of Pediatrics of Okayama University Hospital who were undergoing outpatient therapy for psychosomatic symptoms, using Pope's 5-scale test of self-esteem for children. We examined patient attributes, course of therapy, and social adjustment. Patients with low self-esteem on multiple scales at the first visit were all female, and these patients had a significantly higher frequency of family function problems, such as a family member with a psychiatric disorder, economic hardship, or experience of child abuse. Moreover, the prognosis for these patients was poor regardless of their social adjustment at the first visit.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6152007A Study of Psycho-pathology and Treatment of Children with Phagophobia261269ENAyumiOkadaChiakiTsukamotoMizuhoHosogiErikoYamanakaKumiWatanabeKeikoOotyouTsuneoMorishimaOriginal Article10.18926/AMO/32896Phagophobia is a disorder characterized by a conditioned excessive fear of eating and is initiated by an event such as vomiting or choking. During childhood, vomiting often occurs as a result of infection or overeating, and painful experiences bring about maladaptive eating behavior like food refusal. There have been few reports of phagophobia, and patients have sometimes been misdiagnosed with anorexia nervosa (AN). The objective of this study was to elucidate the psycho-pathology and current treatment of patients with phagophobia by analyzing case studies. We describe 6 cases with phagophobia. Patients with strong obsessions were refractory to treatment, indicating that evaluation of premorbid personality is crucial to the prognosis. It is important to classify this disorder according to psycho-pathology into "post-traumatic type" and "gain-from-illness type" to make a treatment plan. A solution focused approach is also effective for patients and their family. Paying close attention to these conditions and to the diagnostic concept referred as "hagophobia" is useful in achieving these aims.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5932005Usefulness of helical computed tomography in diagnosing pulmonary vein stenosis in infants.9398ENShinnichiOhtsukiKenjiBabaKohichiKataokaNaokiOhnoYoshioOkamotoKozoIshinoMasaakiKawadaShunjiSanoShuheiSatoTsuneoMorishimaArticle10.18926/AMO/31981<p>We investigated the usefulness of helical computed tomography(CT)in the morphological diagnosis of pulmonary vein stenosis, particularly that in infants and small children. In total, 20 helical CT examinations were performed in 10 post-operative cases of Total Anomalous Pulmonary Venous Drainage(TAPVD), 3 cases of single right ventricle, and 1 case of single left ventricle. In all cases, distinct morphological imaging was possible. Pulmonary vein stenosis could be categorized into three types: (1)stenosis from the anastomosis of the common pulmonary vein (CPV)-the left atrium (LA) to the peripheral pulmonary vein; (2) stenosis only at the anastomosis of CPV-LA; and (3) stenosis due to compression by nearby organs. Coronal views by multiplanar reconstruction (MPR) provided morphological information along the up-down direction of the body axis. Morphological diagnosis of pulmonary vein stenosis is important in deciding prognosis and therapeutic regimens, and helical CT was considered useful for such diagnosis in our 14 young patients.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5962005Virological aspects of Epstein-Barr virus infections.239246ENNobukoYamashitaHiroshiKimuraTsuneoMorishimaReview10.18926/AMO/31961<p>Epstein-Barr virus (EBV) is usually maintained in an asymptomatic and latent form by the host immune system, and primarily by EBV-specific cytotoxic T cells (CTLs). However, EBV has been linked to several refractory diseases such as EBV-associated hemophagocytic syndrome(EBV-AHS) and chronic active EBV infection (CAEBV). In these ectopic diseases, EBV infects T/NK cells, causing severe immunodeficiency with a very high EBV load. In recent years, the laboratory procedure to assess these types of EBV infections has been improved. In particular, real-time polymerase chain reaction (PCR) has been used to quantify the EBV load, and the MHC: peptide tetramer assay has been used to quantitate EBV-specific CTLs; these tests have been employed for the management of the illnesses associated with EBV infection. Here, we have reviewed the recent progress in the clinical application of these assays. The pathogenesis of EBV-infected T/NK cells, and the host immune response to infection, including the roles carried out by innate immunity and inflammatory cytokines, are likely to be revealed in the future.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6252008Thrombocytopenia in Preterm Infants with Intrauterine Growth Restriction313317ENHidehikoMaruyamaMasakoShinozukaYo-ichiKondohYo-ichiroAkahoriMiwaMatsudaSeijiInoueYumiSumidaTsuneoMorishimaOriginal Article10.18926/AMO/30973<p>Sick preterm infants often have thrombocytopenia at birth, and this is often associated with intrauterine
growth restriction (IUGR), or birth weights less than the 10th percentile. The pathogenesis of the thrombocytopenia and its importance in IUGR are still unclear. We studied the characteristics of preterm IUGR infants with thrombocytopenia. Twenty-seven singleton Japanese preterm IUGR infants were born between January 2002 and June 2007 at Okayama University Hospital. Infants with malformation, chromosomal abnormalities, alloimmune thrombocytopenia, sepsis, and maternal aspirin ingestion were excluded. The infants were divided into group A (n＝8), which had thrombocytopenia
within 72h after birth, and group B (n＝19), which did not. There were significant differences in birth weight, head circumference, umbilical artery (UA)-pulsatility index (PI), middle cerebral artery-PI, UA-pH, UA-pO2, and UA-pCO2. The infants in group A were smaller, had abnormal blood flow patterns, and were hypoxic at birth. We speculate that the infants with thrombocytopenia were more severely growth-restricted by chronic hypoxia. Thrombocytopenia is an important parameter for chronic hypoxia in the uterine.</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6052006Assessment of Molecular Cytogenetic Methods for the Detection of Chromosomal Abnormalities279287ENTomokaUneYujiYokoyamaShinsukeNinomiyaMasakoShinozukaHidehikoMaruyamaTsuneoMorishimaArticle10.18926/AMO/30740Some marker chromosomes and chromosome rearrangements are difficult to identify using G-bands by Giemsa staining after trypsin treatment (G-banding) alone. Molecular cytogenetic techniques, such as spectral karyotyping (SKY) and fluorescence in situ hybridization (FISH), can help to detect chromosomal aberrations precisely. We analyzed the karyotypes in 6 cases of multiple congenital abnormalities and 1 case of spontaneous abortion (case 2). Three cases (cases 1, 6, and 7) had marker chromosomes, and 4 cases (cases 2-5) had chromosomal rearrangements. The karyotypes in cases 1, 2, and 3 were determined using FISH with probes based on the clinical findings and family histories. Spectral karyotyping (SKY) analysis in cases 4-7 showed that this method is useful and saves time. The combination of SKY and FISH analyses defi ned the range of the ring chromosome in case 7. We demonstrated that a combination of G-banding, FISH, and SKY can be applied effectively to the investigation of chromosomal rearrangement and to the detection of marker chromosome origins. We suggest the use of these methods for prenatal diagnosis, in which the inherent time limitations are particularly important.No potential conflict of interest relevant to this article was reported.