Yoshikazu Takinami

Hemosuccus pancreaticus successful treatment by double balloon-assisted coil embolization for active bleeding from the main trunk of the superior mesenteric artery

We report a case of a 63-year-old man with hemosuccus pancreaticus due to large pseudoaneurysm originating from the main trunk of the superior mesenteric artery (SMA). The patient was treated successfully with the double balloon-assisted coil embolization technique combined with proximal and distal balloon inflation in the short segment of the SMA. This technique preserved the pancreaticoduodenal arterial arcade and the supply to the distal part of the SMA by embolizing SMA in a short segment.

Association of SNPs in genes encoding zinc transporters on blood zinc levels in humans

Zinc homeostasis in cells depends on zinc transporters, which are divided into 2 families: ZnT (SLC30A) and ZIP (SLC39A). In this study, we examined the effect of 20 single nucleotide polymorphisms (SNPs) in 10 genes encoding zinc transporters on blood zinc concentration in Japanese subjects (n = 102). Blood zinc levels were determined by microwave plasma-atomic emission spectrometry, and SNPs were analyzed by polymerase chain reaction followed by restriction fragment length polymorphism analysis. Among the 20 SNPs examined, 3 SNPs (SLC30A3 rs11126936, SLC39A8 rs233804, and SLC39A14 rs4872479) were significantly associated with blood zinc concentration. Individuals with genotype TT and TG in rs11126936 showed significantly higher blood zinc concentrations than those with GG. As for rs233804, individuals harboring the A allele had significantly higher blood zinc concentrations than those without this allele. Furthermore, the genotype TT and TG in rs4872479 had significantly higher blood zinc concentrations than those with GG. Among these three SNPs, combination of SLC30A3 rs11126936 and SLC39A8 rs233804 may strongly affect blood zinc levels. This study is the first comprehensive investigation of the effect of SNPs in genes encoding zinc transporters on blood zinc concentration. Adverse effects of zinc deficiency are reported and above 3 SNPs may be related to genetic susceptibility to zinc deficiency.

Graft-versus-host disease-Induced esophageal web

Endoscopy revealed a chicken meat impaction in the upper esophagus. On food removal, an esophageal web (thin membranous constriction) was revealed at the site and diagnosed as GVHD‐induced esophageal web by the endoscopist.

The value of CT findings for prognostic prediction of spontaneous superior mesenteric artery dissection

Background Spontaneous superior mesenteric artery (SMA) dissection is rare cause of acute abdomen. Time-dependent change of SMA dissection has not been established. Purpose To determine Sakamoto classification (SC) type of acute and chronic SMA dissection (aSMAD and cSMAD) to predict the treatment methods and outcome. Material and Methods From April 2003 to March 2017, unenhanced and contrast-enhanced CT were used to diagnose acute symptomatic or chronic asymptomatic SMA dissection in 25 consecutive patients without aortic dissection. Correlations between SCs and treatment methods and outcomes were investigated. Results All 13 patients with aSMAD initially received conservative treatment. Initial SCs in aSMAD were type I = 1, type III = 9, and type IV = 3. Three of nine initial type III and two of three initial type IV changed to type I at follow-up. One of nine type III changed to type II at follow-up. Ohers did not change. One with initial type III required vascular repair, so the final SC was not available. Three patients required bowel resection. In cSMAD of 12 patients, the initial/final SC were type I and IV in ten and two patients, respectively, without change during follow-up. cSMAD was significantly older than aSMAD. The initial length of dissection of aSMAD was longer than in the cSMAD group. In aSMAD, the final length of dissection was significantly shorter than in the initial computed tomography scan. Conclusion Initial SC differed significantly between aSMAD and cSMAD. Initial SC types in aSMAD were type III and IV mainly, and changed during the observation period. In cSMAD, SC types were I and IV without change.

Ambulance dispatches to schools during a 5-year period in Fukui Prefecture

To determine the characteristics and trends of medical emergencies during school activities by analyzing information provided by fire departments.

An autopsy case of spontaneous esophageal perforation (Boerhaave syndrome)

A 45-year-old male, an alcohol addict with asthma, was found dead in his home, after several days of continued drinking. A forensic autopsy was performed 3days after the discovery of his death in order to specify the cause of death. A longitudinal perforation penetrating all layers of the esophagus measuring 1.8cm was present on the left wall approximately 2.0cm from the gastroesophageal junction. There were 1900mL of greenish to brownish turbid liquid in the left pleural cavity and 150mL of greenish viscous liquid in the stomach. Histopathologically, an infiltration of numerous neutrophils was evident in the submucosa layer, proper muscular layer, and serous membrane of the esophagus, corresponding to the esophageal laceration. The serum C-reactive protein (CRP) concentration was determined to be 3.1mg/dL. The alcohol concentrations were determined to be 1.49mg/g in the right cardiac blood, 1.31mg/g in the left cardiac blood, and 2.48mg/g in urine. Based upon the autopsy and histopathological findings, as well as the biochemical and toxicological analyses, we concluded that the cause of death was respiratory failure by pleural effusion, resulting from spontaneous esophageal perforation. This was the first report of a spontaneous esophageal perforation eventually causing respiratory failure.

Epidemiological Characteristics of Disaster-related Suicides in the34 Years since the Great East Japan Earthquake

The Great East Japan Earthquake struck Japan with a magnitude of 9.0 at 2:46 PM on March 11, 2011. Five years have passed since the earthquake and subsequent tsunami struck, but the mental and physical care of the victims, the livelihoods of those affected, and the economic impact of the disaster continue to cause social concern (Orui, Harada, & Hayashi, 2014; Tokuzu, Ouchi, Kikuchi & Konno, et al., 2015; Yabuki, Ouchi, Kikuchi & Konno, 2015; Hara, 2015). Over the past few years, research has examined the effects of the disaster on the cognitive function of the elderly (Ishiki et al., 2016), and one study suggested that oxidative stress may be associated with disaster-related hypertension (DRH) in individuals exhibiting effects of the Great East Japan Earthquake (Shiraishi et al., 2016).

A Study of the Relationship between Japans Suicide Rate and the Spring Wage Increase over a Period of 34 Years: Devising Future Suicide Prevention Measures for Various Countries and Examining Numerous Issues Related to Suicide

Japan had around 20,000 suicides in the early 1990s, but the annual number of suicides increased abruptly to over 30,000 in 1998. Devising and implementing suicide prevention measures to reduce the number of suicides has become a societal issue that Japan should promptly address. Over the past few years, suicides in Japan have decreased, but the suicide rate in Japan remains high in comparison to the rest of the world. We believe that clearly identifying factors and issues related to suicide and implementing specific preventive measures to address those factors are crucial to preventing suicide. The current study examines the relationship between suicide and financial issues over a prolonged period. Specifically, it examines the annual suicide rate (per 100,000 populations) during 1980–2013 and the spring wage increase (%) at major companies in Japan during the same period. This study examines suicide rate and spring wage increase statistics in detail. We found the spring wage increase may be related to the overall (both-gender) suicide rate. Closer examination suggested that the spring wage increase is related to the suicide rate among males but not among females. Financial hardships and financial difficulties can lead to mental exhaustion and stress. A key measure to preventing suicide due to financial reasons is providing mental health support to individuals facing financial problems. Suicide prevention measures should be coordinated by relevant bodies and the community. Such efforts in Japan and elsewhere around the world should be based on statistical analysis of the factors involved in suicide.