The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Feb 2007
ReviewCurrent malaria status and distribution of drug resistance in East and Southeast Asia with special focus to Thailand.
Malaria is the world's most important parasitic infection ranking among the major health and developmental challenges. Despite years of continual efforts, malaria is still one of the major causes of morbidity and mortality affecting third-world countries and still a threat to over 2 billion people, representing approximately 40% of the world's population in about 100 countries (Rollback Malaria 2005). During the "eradication era", half a century ago, malaria was eliminated or effectively suppressed in many parts of the world, particularly subtropical regions. ⋯ Pregnant women in Africa (especially primigravidae) are at high risk, and are the major adult risk group in the continent. An increasing number of imported cases of malaria have been reported particularly as a result of increasing worldwide travel to regions where there is ongoing risk of malaria transmission. Nowadays, cases of malaria acquired by international travelers from developed countries probably number 25,000 cases per year, with 10,000 of them reported annually and approximately 150 deaths per year.
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Tohoku J. Exp. Med. · Jun 2006
ReviewAirway remodeling in asthma and its influence on clinical pathophysiology.
Bronchial asthma has been characterized by chronic and allergic airway inflammation, which induces cytological and histological changes in the airway structure over time. These changes have been called airway remodeling, which includes goblet cell hyperplasia, subepithelial fibrosis, and hyperplasia and hypertrophy of airway smooth muscle cells. Airway epithelium in asthma is often occupied with goblet cells, which contain secretory granules. ⋯ Recent studies have demonstrated the molecular and cellular mechanisms of goblet cell hyperplasia, subepithelial fibrosis, and hyperplasia and hypertrophy of airway smooth muscle cells. Several lines of evidence suggest that airway remodeling has been induced by cytokines and mediators produced in chronic allergic airway inflammation. Thus, early intervention with inhaled corticosteroid may prevent progress of airway remodeling by suppressing allergic airway inflammation.
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Tohoku J. Exp. Med. · Mar 2006
ReviewKidney dysfunction and hypertension: role for cadmium, p450 and heme oxygenases?
Cadmium (Cd) is a metal toxin of continuing worldwide concern. Daily intake of Cd, albeit in small quantities, is associated with a number of adverse health effects which are attributable to distinct pathological changes in a variety of tissues and organs. In the present review, we focus on its renal tubular effects in people who have been exposed environmentally to Cd at levels below the provisional tolerable intake level set for the toxin. ⋯ We hypothesize that renal Cd accumulation triggers the host responses mediated by HO-1 and MT in an attempt to protect the kidney against injurious oxidative stress and to resist a rise in blood pressure levels. This hypothesis predicts that individuals with less active HO-1 (caused by the HO-1 genetic polymorphisms) are more likely to have renal injury and express a hypertensive phenotype following chronic ingestion of low-level Cd, compared with those having more active HO-1. Future analytical and molecular epidemiologic research should pave the way to the utility of induction of heme oxygenases together with dietary antioxidants in reducing the risk of kidney injury and hypertension in susceptible people.
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Tohoku J. Exp. Med. · Sep 2005
ReviewPreventive strategies for aspiration pneumonia in elderly disabled persons.
Pneumonia is the fourth leading cause of death despite the availability of potent new antimicrobials in Japan. Aspiration of oropharyngeal bacterial pathogens to the lower respiratory tract is one of the most important risk factors for pneumonia. Impairments in swallowing and cough reflexes among disabled older persons, e.g., related to cerebrovascular disease, increase the risk of pneumonia. ⋯ Similarly, since the production of substance P is regulated by dopaminergic neurons in the cerebral basal ganglia, treatment with dopamine analogs or potentiating drugs such as amantadine can reduce the incidence of pneumonia. Furthermore, since mortality from infections correlates with cutaneous anergy, interventions that reverse these age-associated changes in the immune system are also effective. The main theme of this review is to discuss how pneumonia develops in disabled older people and to suggest preventive strategies that may reduce the incidence of pneumonia among these subjects.
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Tohoku J. Exp. Med. · Feb 2005
Review Case ReportsGorham disease of the spine: a case report and treatment strategies for this enigmatic bone disease.
Gorham disease is an extremely rare condition of unknown etiology characterized by progressive osteolysis. Only 28 cases of its spinal involvement have been reported, and some of those cases showed kyphosis, kyphoscoliosis, subluxation or dislocation. ⋯ In situ posterior fusion with a hook and rod system and iliac bone grafts were performed, but after surgery, he had complete paraplegia and its cause was uncertain. Based on the unfortunate consequence of the present case and the review of the literature, we propose the treatment strategies for spinal Gorham disease.