Juntendo Medical Journal
Online ISSN : 2188-2126
Print ISSN : 2187-9737
ISSN-L : 2187-9737
Volume 59 , Issue 5
Showing 1-18 articles out of 18 articles from the selected issue
Special Reviews
    2013 Volume 59 Issue 5 Pages 398-406
    Published: October 31, 2013
    Released: March 26, 2014
    Glomerular visceral epithelial cells, also known as podocytes, are highly specialized epithelial cells that cover the outer layer of the glomerular basement membrane (GBM). Podocytes serve as the final barrier to urinary protein loss through the special formation and maintenance of foot processes (FPs) and an interposed slit diaphragm (SD). Chronic podocyte injury may cause podocyte detachment from the GBM, which leads to glomerulosclerosis. The elucidation of podocyte biology during the last decade has significantly improved our understanding of the pathophysiologic processes of proteinuria and glomerulosclerosis. This review highlights some of the recent findings for translating podocyte biology into new therapies and examinations for podocyte injury.
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  • Especially for Prevention of Lightning Strike Injury
    2013 Volume 59 Issue 5 Pages 407-410
    Published: October 31, 2013
    Released: March 26, 2014
    We need to pay attention to the risk of lightning strike injury for outdoor sports activities, especially in the Japanese summer, which usually has some thundery days. The most important principle in protecting ourselves from lightning strikes is simply to seek refuge in a safe place during a thunderstorm, and as part of this, to be aware in advance when there is an approaching thundercloud. However, as a second level of protection, if one were unfortunately hit by lightning and subsequent cardiac arrest occurred, an immediate cardiac massage can lead to successful resuscitation.
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original article
    2013 Volume 59 Issue 5 Pages 411-419
    Published: October 31, 2013
    Released: March 26, 2014
    Background & Objective: A poor diet can contribute to a range of illnesses, including obesity, cardiovascular disease, and hypertension among school-age children in Japan. Therefore, the Ministry of Education established the Basic Act for Food Education, which proposed a way of improving the diet of children. Schools are now required to provide health education about a healthy diet for students. However, the formation of children's eating habits is influenced by socio-environmental and psychological factors, such as their family. The aim of this study was to assess the relationship between school-age children's eating behavior and family factors to develop a more comprehensive approach for school health.
    Methods: The conceptual framework of this study was based on the PRECEDE and PROCEED models. Independent variables were set, with family environment as a reinforcing factor, family self-esteem as a predisposing factor, and the dependent variable of eating behavior measurement. The study was conducted among 295 sixth-grade students and 192 fifth-grade students, namely, a total of 487 students in an elementary school in a city near Tsu, Mie, Japan, in 2010. The use of self-administered questionnaires was approved by Mie University IRB. Statistical analysis was performed using paired T-test, chi-square test, and one-way ANOVA.
    Results: Father's presence was significantly related to eating behavior score (t=2.289) in the family environment. High family self-esteem of children was significantly related to higher eating behavior score (t=8.310).
    Conclusions: It is clear that family factors are associated with self-management capacity in schoolchildren. In particular, the presence of the father and high family self-esteem were important sociological and physiological factors for improving children's eating behavior.
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    2013 Volume 59 Issue 5 Pages 420-427
    Published: October 31, 2013
    Released: February 24, 2014
    Purpose: To validate achievement of meaningful linkage between medical knowledge about total hip arthroplasty (THA) approaches and knowledge about nursing support about dislocation prevention in student trained using the computer-assisted instruction (CAI) material,"Preventive support of dislocation after THA"and to clarify the effect of learning.
    Subjects: Sixty five second-year and senior nursing students of a four-year university
    Methods: The subjects were divided into 2 groups at random and the investigation was repeated twice. For group A, the training using the materialwas provided, with test conducted before and after the training in the first investigation, and only the test was conducted in the second investigation carried out 2 weeks later. For group B, only the test was conducted in the first investigation,and in the second investigation conducted 2 weeks later, training was provided using the material, with the test conducted before and after the training. In the analysis, the subjects were divided into groups with high and low scores in respect of the medical knowledge depending on the THA approaches, and the correct-answer rates regarding knowledge about nursing support depending on the THA approach were examined by the χ2 test in each of these groups. The significance level was set at 0. 05. The study was conducted with the approvalof the research ethics committee of the university graduate school.
    Results: Overall, in both groups, when the pre-test and post-test results were compared, meaningful linkage was found between medical knowledge about THA and knowledge/ actions about THA nursing support regarding the posterior approach to THA in the post-test as compared to the pre-test. In addition, when the results of the test 2weeks after the training (post-test) in group A and the result of the test just before the training (pre-test) in group B, linkage was also found between the medical knowledge about THA and knowledge about THA nursing support, including knowledge on"how to wear pants,"in relation to the posterior approach to THA in group A.
    Conclusions: It is suggested that successful linkage between medical knowledge about THA approaches and knowledge about THA nursing support can be achieved in students trained with the newly developed CAI material.
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Lecture Note
    2013 Volume 59 Issue 5 Pages 428-432
    Published: October 31, 2013
    Released: March 26, 2014
    When Professor Jean Berger et al. first reported on “Nephropathy with mesangial IgA-IgG deposits,” namely, IgA nephropathy, in 1968, the prognosis of this disease was generally considered to be benign1). Since then, however, patients with IgA nephropathy have been shown to have microscopic andmacroscopic hematuria and/or proteinuria. Macroscopic hematuria is occasionally observed after upper respiratory infections, including acute tonsillitis and/or pharyngitis. The occurrence of nephrotic syndrome is rare. About 30% of IgA nephropathy patients develop end stage kidney disease (ESKD) within 15-20 years, and 5-10% within 5 years, in Japan. The progression to ESKD in patients with this disease is not as rare as originally thought. Basically, a low-salt diet is usually recommended to control blood pressure, as high salt intake is a major cause of blood pressure increases. Long-term dietary protein restriction is generally considered to reduce the levels of urinary protein excretion and ameliorate glomerular injuries in patients with IgA nephropathy. There are many reports, such as those regarding kidney disease with improving global outcomes (KDIGO) and those from the Japanese guidelines, with respect to medications for IgA nephropathy patients2) 3). KDIGO clinical practice guidelines were published in Kidney International in 20122). Within each recommendation, the strength of recommendation is indicated as Level 1, Level 2, or not graded, and the quality of the support is shown as A, B, C, or D. In this plenary session, I wouldlike to review controversial management strategies for IgA nephropathy patients using several drugs.
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Case Report
    2013 Volume 59 Issue 5 Pages 437-439
    Published: October 31, 2013
    Released: March 26, 2014
    A64-year-old male presented with a painful abscess in the right buttock and fever. He underwent drainage of the abscess and received antibiotics. He had a past history of liver cirrhosis. He demonstrated complications of sepsis, disseminated intravascular coagulopathy, and renal failure, and was thus transferred to our hospital, where he was diagnosed with Fournier gangrene. He underwent resection of the necrotic tissue and colostomy performed by surgeons from multiple departments. Intensive care resulted in improvement of his condition. MRI demonstrated a small residual abscess in his pelvis, so he was given antibiotics for two months until the abscess disappeared. This is a case of successful treatment of Fournier gangrene, which is a severe soft tissue infection, by multidisciplinary co-operation.
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