[in Japanese]

View full abstract

ATP sensitivity potassium (K_ATP) channels exist in not only a pancreas β cell but also the cardiac muscle and the smooth muscle as well. The β cell, cardiac and smooth muscle types of K_ATP channels are involved in Insulin secretion, the cardiac muscle protection at myocardial ischemia and the vascular tone respectively. These sulfonylurea (SU) receptors exist as the subunits of the K_ATP channels and it is expected that the protection by the cardiac K_ATP channel and the tone regulation by the smooth muscle K_ATP channel decline at the closure by SU. Therefore SU receptor occupancy of the β cell, cardiac and smooth muscle was calculated by the pharmacokinetic parameters and the SU receptor affinity with the administration of the usual dose and compared variously with oral hypoglycemic agents to combine with SU receptors. The calculated SU receptor occupancy in the cardiac K_ATP channel by Glibenclamide and Glimepiride isn't very high. This result suggests that the effect of them on the cardiac muscle couldn't be denied completely.
Through investigating 110 diabetic cases to verify the effect of oral hypoglycemic agents occurrence of Ischemic Heart Disease (IHD), we found that the IHD group has more patients who have taken oral hypoglycemic agents compared to non-IHD group, however the difference was not very significant.

View full abstract

Atypical teratoid/rhabdoid tumors (AT/RT) among the central nervous system tumors are highly malignant embryonal tumors. Mutation in the SMARCB1 tumor suppressor gene located in the long arm of chromosome 22 band q11.2 (22q11.2) is regarded as a crucial step of AT/RT in the molecular pathogenesis. Analysis of molecular genetics of the SMARCB1 gene is important in tumor classification of AT/RT, but the identifying of mutations in the SMARCB1 gene is difficult in routine clinical analysis. Therefore commercial probes (DiGeorge/VCFS region probe: CYTOCELL, LSI BCR/ABL probe: VYSIS) were used for the search of the 22q11.2 region included in the SMARCB1 gene, TUPLE1 locus and BCR locus as proximal markers. A telomere probe of chromosome 22 was used as a distal marker. Using frozen specimens, we investigated four central nervous system tumors (three AT/RT, one choroid plexus carcinoma) by FISH (fluorescence in situ hybridization) and did chromosome analyses. The deletions of the 22q11.2 region were observed quickly in all four cases by FISH. Four of two cases were confirmed to have terminal deletions of the 22q11.2, one case was 22 monosomy as the only cytogenetic abnormality by chromosome analyses. The result of FISH suggested that loss of the SMARCB1 gene region. It was concluded that using FISH on frozen specimens was useful as a clinical analysis to quickly search for deletion of the SMARCB1 gene region for diagnosis of AT/RT.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

Introduction: This study investigated the present conditions and problems of the management of percutaneous endoscopic gastrostomy (PEG) for neuromuscular disease in the departments of neurology in the National Hospital Organization.
Methods: In December 2005, we investigated issues related to percutaneous endoscopic gastrostomy (PEG) management in 33 neurology wards by a questionnaire survey of the neurologists in charge. The items surveyed were: 1) physician who constructed the PEG; 2) clinical path of PEG; 3) preoperative meetings for PEG; 4) whom the neurologist consulted about complications of PEG; 5) who informed the patient about PEG; and 6) trouble in the management of PEG. Results: Eight hospitals transferred the patient to another hospital for construction of PEG. Thirteen hospitals scheduled preoperative meetings and two-thirds of institutions have the clinical path of PEG. About half of the neurologists in charge managed complications without consulting a gastrointestinal specialist. Some neurologists were not satisfied with the management of complications.
Conclusion: In the management of PEG, there is poor cooperation between gastrointestinal specialists and neurologists. It is necessary to establish the management system including consultation to the specialists and teamwork between the hospitals.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract