Clinical Usefulness of Corticotropin Releasing Hormone Testing in Subclinical Cushing’s Syndrome for Predicting Cortisol Replacement after Adrenalectomy

Masahiro Inoue,Hisamitsu Ide,Koji Kurihara,Tatsuro Koseki,Jingsong Yu,Toshiyuki China,Keisuke Saito,Shuji Isotani,Satoru Muto,Shigeo Horie 대한비뇨의학회 2012 Investigative and Clinical Urology Vol.53 No.6

Purpose: The purpose of this study was to investigate the clinical and hormonal features of patients with incidentally discovered adrenal adenomas in relation to corticotropin releasing hormone (CRH) testing and the clinical outcome of adrenalectomy. Materials and Methods: Twenty-three consecutive patients with incidentally detected adrenal adenomas were included in this retrospective study. All the patients underwent abdominal computed tomography scans and hormonal assays, including assessment of circadian rhythms of plasma cortisol and corticotropin (adrenocorticotropic hormone, ACTH), a corticotropin stimulation test, and low-dose and high-dose dexamethasone tests. The patients were reevaluated at regular intervals (6, 12, and 24 months) for a median period of 24 months. Subclinical Cushing’s syndrome (SCS) was diagnosed in patients with subtle hypercortisolism who did not present clinical signs of Cushing’s syndrome. Results: We calculated the responsive index (peak value of ACTH in CRH test/baseline value of ACTH in CRH test). Of 23 patients, 6 had Cushing’s syndrome, 8 had SCS, and 9 had a non-functioning tumor. All patients underwent laparoscopic adrenalectomy. Several patients (5 of 6 with Cushing’s syndrome and 2 of 8 with SCS) required cortisol replacement therapy after surgery. The remaining patients required no hormonal replacement after surgery. Those who required hormone replacement had a responsive index of less than 1.2. Those who did not need hormone replacement therapy had a responsive index of more than 2.0. Conclusions: In our limited experience, the responsive index of the CRH test might be a valuable tool for predicting the need for cortisol replacement after surgery in patients with SCS. Purpose: The purpose of this study was to investigate the clinical and hormonal features of patients with incidentally discovered adrenal adenomas in relation to corticotropin releasing hormone (CRH) testing and the clinical outcome of adrenalectomy. Materials and Methods: Twenty-three consecutive patients with incidentally detected adrenal adenomas were included in this retrospective study. All the patients underwent abdominal computed tomography scans and hormonal assays, including assessment of circadian rhythms of plasma cortisol and corticotropin (adrenocorticotropic hormone, ACTH), a corticotropin stimulation test, and low-dose and high-dose dexamethasone tests. The patients were reevaluated at regular intervals (6, 12, and 24 months) for a median period of 24 months. Subclinical Cushing’s syndrome (SCS) was diagnosed in patients with subtle hypercortisolism who did not present clinical signs of Cushing’s syndrome. Results: We calculated the responsive index (peak value of ACTH in CRH test/baseline value of ACTH in CRH test). Of 23 patients, 6 had Cushing’s syndrome, 8 had SCS, and 9 had a non-functioning tumor. All patients underwent laparoscopic adrenalectomy. Several patients (5 of 6 with Cushing’s syndrome and 2 of 8 with SCS) required cortisol replacement therapy after surgery. The remaining patients required no hormonal replacement after surgery. Those who required hormone replacement had a responsive index of less than 1.2. Those who did not need hormone replacement therapy had a responsive index of more than 2.0. Conclusions: In our limited experience, the responsive index of the CRH test might be a valuable tool for predicting the need for cortisol replacement after surgery in patients with SCS.

Development of supported iridium catalysts for green synthesis of nitrogen-containing chemicals

( Kenji Wada ),( Keisuke Tateyama ),( Saburo Hosokawa ),( Masashi Inoue ),( Ryu Abe ) 한국공업화학회 2013 한국공업화학회 연구논문 초록집 Vol.2013 No.1

Changes of Glycosidase Activities in Response to Ethylene Production during Avocado Fruit Softening

Akira Tateishi,Fumika Miyohashi,Keisuke Yada,Junko Matsuno,Hiroaki Inoue 한국원예학회 2006 한국원예학회 기타간행물 Vol.- No.-

Effectiveness of music therapy on the activation level of cerebral function

Katsutoshi Tadokoro,Koh Inoue,Keisuke Suzuki 대한인간공학회 2012 대한인간공학회 학술대회논문집 Vol.2012 No.5

The effectiveness of the musical therapy on cerebral function and cerebral blood flow is not clearly investigated. In this research, the relation between how to enjoy the music and activity level of cerebral function when listening to music or singing music was investigated. Based on the investigation results, the optimal presentation method of the music effecting on the activity level of the brain was proposed. In this study, the activity level of cerebral function was quantified in terms of the fluctuation of oxygenated hemoglobin (oxyHb). The fluctuation of the oxyHb and the RRI of heart rate were observed during each experiment. The Cardiac Sympathetic Index (CSI) of the sympathetic nerve and the Cardiac Vagal Index (CVI) of the parasympathetic nerve were used for the investigation. It was observed that making the level of CVI higher by listening to music after making the level of CSI higher by singing music is effective for increasing the level of oxyHb.

Treatment of Thoracolumbar Spinal Fracture Accompanied by Diffuse Idiopathic Skeletal Hyperostosis Using Transdiscal Screws for Diffuse Idiopathic Skeletal Hyperostosis: Preliminary Results

Mehta Gaurav,Hisanori Ikuma,Shinichiro Takao,Yoichi Inoue,Tomohiko Hirose,Keitaro Matsukawa,Keisuke Kawasaki 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.3

Study Design: This retrospective case series enrolled 13 patients who underwent posterior fixation with both transdiscal screws for diffuse idiopathic skeletal hyperostosis (TSDs) and pedicle screws (PSs) to treat spinal injury accompanied by diffuse idiopathic skeletal hyperostosis (DISH). Purpose: To describe the usefulness, feasibility, and biomechanics of TSD. Overview of Literature: Vertebral bodies accompanied by DISH generally have lower bone mineral density than normal vertebral bodies because of the stress shielding effect. This phenomenon tends to makes screw fixation challenging. To our knowledge, solutions for this issue have not previously been reported. Methods: Patients were assessed using the data on surgical time, estimated intraoperative blood loss, mean number of stabilized intervertebral segments, number of screws used, perioperative complications, union rate, and the three-level EuroQol five-dimensional questionnaire (EQ5D-3L) score at the final follow-up. The Hounsfield unit (HU) values of the screw trajectory area, and the actual intraoperative screw insertion torque of TSDs and PSs were also analyzed and compared. Results: The surgical time and estimated intraoperative blood loss were 165.9±45.5 minutes and 71.0±53.4 mL, respectively. The mean number of stabilized intervertebral segments was 4.6±1.0. The number of screws used was 4.9±1.3 for TSDs and 3.0±1.4 for PSs. One death occurred after surgery. The union rate and EQ5D-3L scores were 100% and 0.608±0.128, respectively. The HU value and actual intraoperative screw insertion torque of TSDs were significantly better than those of PSs (p<0.001, p=0.033). Conclusions: We were able to achieve stable surgical outcomes using the combination of TSDs and PSs. The HU value and actual intraoperative screw insertion torque were significantly higher for TSDs than for PSs. Based on these results, when treating thoracolumbar spinal fractures accompanied by DISH in elderly populations, the TSD could be a stronger anchor than the PS.

Biceps-Related Physical Findings Are Useful to Prevent Misdiagnosis of Cervical Spondylotic Amyotrophy as a Rotator Cuff Tear

Eiichiro Iwata,Hideki Shigematsu,Kazuya Inoue,Takuya Egawa,Masato Tanaka,Akinori Okuda,Yasuhiko Morimoto,Keisuke Masuda,Yusuke Yamamoto,Yoshihiro Sakamoto,Munehisa Koizumi,Yasuhito Tanaka 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.1

Study Design: Case–control study. Purpose: The aim of the present study was to identify physical findings useful for differentiating between cervical spondylotic amyotrophy (CSA) and rotator cuff tears to prevent the misdiagnosis of CSA as a rotator cuff tear. Overview of Literature: CSA and rotator cuff tears are often confused among patients presenting with difficulty in shoulder elevation. Methods: Twenty-five patients with CSA and 27 with rotator cuff tears were enrolled. We included five physical findings specific to CSA that were observed in both CSA and rotator cuff tear patients. The findings were as follows: (1) weakness of the deltoid muscle, (2) weakness of the biceps muscle, (3) atrophy of the deltoid muscle, (4) atrophy of the biceps muscle, and (5) swallow-tail sign (assessment of the posterior fibers of the deltoid). Results: Among 25 CSA patients, 10 (40.0%) were misdiagnosed with a rotator cuff tear on initial diagnosis. The sensitivity and specificity of each physical finding were as follows: (1) deltoid weakness (sensitivity, 92.0%; specificity, 55.6%), (2) biceps weakness (sensitivity, 80.0%; specificity, 100%), (3) deltoid atrophy (sensitivity, 96.0%; specificity, 77.8%), (4) biceps atrophy (sensitivity, 88.8%; specificity, 92.6%), and (5) swallow-tail sign (sensitivity, 56.0%; specificity, 74.1%). There were statistically significant differences in each physical finding. Conclusions: CSA is likely to be misdiagnosed as a rotator cuff tear; however, weakness and atrophy of the biceps are useful findings for differentiating between CSA and rotator cuff tears to prevent misdiagnosis.

Evidence of a Rattling Transition in the Caged Compounds LaRu2Zn20 and LaIr2Zn20: 139La NMR Studies

Hideki Tou,Kenji Asaki,Hisashi Kotegawa,Takahiro Onimaru,Keisuke T. Matsumoto,Yukihiro F. Inoue,Toshiro Takabatake 한국물리학회 2013 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.63 No.3

We report a study of 139La(I=7/2) nuclear magnetic resonance (NMR) to investigate the structuralphase transition in the two caged compounds LaIr2Zn20 and LaRu2Zn20 from microscopic viewpoints. The former compound shows a second-order structural phase transition around Ts = 200 Kwhereas the latter one shows a first-order structural phase transition at Ts = 150 K. For both compounds,quite narrow La-NMR lines of less that 10 kHz without any electric field gradient (EFG) atthe La site were observed at temperatures above Ts, indicating that the local symmetry at the Lasite holds a cubic symmetry. On the other hand, an EFG at La site appears at temperatures belowTs, evidencing symmetry lowering occurs at the La site at temperatures below Ts. At temperaturesaround Ts, both the nuclear spin-lattice relaxation rate (1/T1) and the nuclear spin-spin relaxationrate (1/T2) show unusual enhancements associated with the slowing down of the EFG fluctuations. However, the temperature dependences of 1/T1T and 1/T2 are different from the typical slowingdownphenomena of the EFG fluctuations due to the classical motional narrowing. The lowering ofthe local symmetry at the La site is ascribed to a freezing of the rattling motion.

Psychiatric Consultations at an Emergency Department in a Metropolitan University Hospital in Northern Japan

Masaki Shiraishi,Takao Ishii,Yoshiyasu Kigawa,Masaya Tayama,Keisuke Inoue,Kenji Narita,Masaru Tateno,Chiaki Kawanishi 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.7

Many patients with mental disorders visit emergency departments (EDs). However, the majority of these patients do not receive psychiatric assessment. In the present study, we investigated the detailed proportion of patients with mental disorders visiting an urban ED in the largest northern city in Japan. A retrospective chart review study was performed at a University Hospital from January 2012 to December 2015. The reasons for psychiatric consultations made by ED staff, and the primary psychiatric diagnoses were investigated. Among all living patients, 20% of them received consultations. The most common reason for consultation was suicide attempt followed by agitation or insomnia. Of all diagnoses, organic mental disorder was the most frequent and the mean age was significantly higher than the other diagnostic groups. Our study indicated that the frequency of psychiatric consultation was high. This indicates the high demand for mental health services at the ED. A thorough psychiatric assessment can provide adequate psychiatric services to acute patients; thereby possibly preventing suicide attempters from later actually dying by suicide.