Yukio Kanazawa

Alcohol use disorder due to social isolation after a nuclear disaster in Fukushima

It is well-known that a nuclear disaster causes health problems including cancer, however, information on mental disorders linked to a nuclear disaster is limited. On 11 March 2011, there was a serious nuclear power plant accident in Fukushima, Japan. Subsequently, in October 2012, a 78-year-old man living 31 km from the plant was admitted to the hospital with head trauma. This was his third physical trauma since the nuclear accident. A thorough interview revealed that his alcohol intake had increased after the disaster, suggesting that his injuries might be related to alcohol use. The diagnosis of alcohol use disorder was established based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. He had been exposed to social isolation after evacuation of his neighbourhood. Using education and intervention, he was successfully treated. We should recognise that a nuclear disaster might cause social isolation among the elderly, leading to mental disorders and alcohol use disorder. Early diagnosis and intervention might be beneficial for individuals presenting the above symptoms.

Grafting of mitomycin C-treated islet xenograft under the kidney capsule produces a clear bleb.

We have previously shown that mitomycin C (MMC) treatment of donor tissue resulted in significant prolongation of graft survival in allo- and xenotransplantation models. However, the mechanisms involved in this prolongation are not clearly understood. This study aims to shed light on the immune responses to MMC-treated islet xenografting under the kidney capsule. Collagenase-digested WS (RT1k) rat islets incubated for 30 min with MMC and subsequently cultured for 20 h were transplanted into the renal subcapsular space of streptozotocin-induced diabetic C57BL/6 (B6;H-2b) mice. The grafts were harvested on postgrafting day 7 and sections were prepared and stained by hematoxylin and eosin (H&E). Histological study of the grafts in a group not treated with MMC showed marked cellular infiltration and destruction of islet clusters, whereas that of MMC-treated grafts demonstrated a bleb formation under the kidney capsule, in which islet cell clusters were reorganized, creating a layer of cells fixed to the interior of the bleb. Minimal invasion by inflammatory cells was observed only at the edge of the bleb, and most islet cells were protected from these infiltrating cells. In conclusion, MMC treatment induces remodeling of islet structure and forms a bleb under the kidney capsule, where no inflammatory cell infiltration occurs, suggesting that this site is a kind of immunologically privileged environment for xenografted islets.

A need for tetanus vaccination before restoration activities in Fukushima, Japan.

Tetanus is an infectious disease caused by exposure of wounds to spores of Clostridium tetani. The disease is fatal but preventable through vaccination. In Japan, tetanus vaccinations have been included in the routine national immunization program for children only since 1968. Thus, many of those who were born before 1968 are unimmunized against tetanus. Indeed, of 666 tetanus patients reported from 2006 to 2011 in Japan, 89% (596/666) were over 50 years of age according to the National Institute of Infectious Diseases.

Asymptomatic hepatic portal venous gas with gastric emphysema as a chronic complication of gastrostomy tube placement: a case report

BackgroundPercutaneous endoscopic gastrostomy feeding is widely used as a route for enteral feeding for patients with impaired swallowing ability, particularly in older patients. Hepatic portal venous gas is a condition that may arise from several causes. Hepatic portal venous gas that develops after an endoscopic procedure is generally reported to be nonfatal, yet there is little information available concerning the characteristics of hepatic portal venous gas as a chronic complication of percutaneous endoscopic gastrostomy feeding.Case presentationWe experienced a case of hepatic portal venous gas that happened to be detected in an 81-year-old Japanese man with long-term percutaneous endoscopic gastrostomy use who was admitted to our hospital with aspiration pneumonia. While aspiration pneumonia was treated with antibiotics and suspension of tube feedings, he recovered from hepatic portal venous gas without any treatment.ConclusionsThe presence of a percutaneous endoscopic gastrostomy tube may have induced hepatic portal venous gas through a mechanism in which vomiting led to increased abdominal pressure and eventually gastric emphysema. This case suggests that hepatic portal venous gas without any signs of bowel ischemia or emphysematous gastritis can resolve without treatment, which is a finding that could be helpful for clinicians who deal with those supported by percutaneous endoscopic gastrostomy feeding.

Voluntary Medical Support Is Key After Nuclear Disasters

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