Juntendo Medical Journal
Online ISSN : 2188-2126
Print ISSN : 2187-9737
ISSN-L : 2187-9737
Volume 61 , Issue 2
Showing 1-31 articles out of 31 articles from the selected issue
Contents
What’s New from Juntendo University, Tokyo
  • AKIRA TSUJIMURA, YOSHIAKI WAKUMOTO, KAZUHIKO FUJITA, YOSHIROU SAKAMOTO ...
    2015 Volume 61 Issue 2 Pages 108-110
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Catholic University of Korea Medical School has the high reputation in both research and clinical, especially in urology, in Korea. We started the collaborative symposium in 2013 and the 2nd symposium was held in Tokyo in 2014. The symposium delivered a stimulating program featuring leaders who presented the latest knowledge regarding construction of clinical databases for urological cancer, clinical and basic research of andrology, antimicrobial resistance monitoring system for urinary tract infections, and surgical technique of endourological operation. All participants were very impressed by the innovative and informative presentation.
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  • An International Student Exchange Event Between Juntendo University and Tokyo Medical and Dental University
    YOKO OKITA
    2015 Volume 61 Issue 2 Pages 111
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Juntendo University international students, faculty and staff participated in the Mochitsuki (Mochi pounding) event 2015, hosted by Tokyo Medical and Dental University on February 10th, 2015 from 11:00-12:00. Mochi is Japanese rice cake and a necessary food at important ceremonial occasions in Japan. Mochi rice is steamed, pounded into paste, and made into various shapes. Pounding Mochi is called Mochitsuki. Even though Japanese these days do not eat Mochi as often as they used to, Mochi is an indispensable traditional food for New Year in Japan. These days Japanese do not pound Mochi at home. However, Mochitsuki is a common event in local gatherings, schools, offices, etc.
    Nineteen international students and 12 faculty and staff of Juntendo University, including Prof. Eiki Kominami, President, Prof. Hajime Arai, Dean of the Medical School, and 79 international students and 25 faculty and staff of Tokyo Medical and Dental University participated in the Mochitsuki event. At the beginning of the event, Prof. Junji Tagami, Vice president of Tokyo Medical and Dental University gave an opening speech, followed by a speech from Prof. Eiki Kominami, President of Juntendo University. Second, Associate Prof. Yoko Okita, International Exchange Center, Tokyo Medical and Dental University explained about Mochitsuki, covering cultural aspects of Mochi in Japan, utensils for Mochitsuki, such as Usu (traditional mortar) and Kine (wooden mallet), how to prepare Mochi, and a similar food, Fufu in the Congo. Third, Prof. Junji Tagami and Prof. Eiki Kominami pounded Mochi together. Forth, international students of the two universities pounded Mochi one by one. Finally, the participants ate four kinds of Mochi, Ankomochi (Mochi with sweet red bean paste), Kinakomochi (Mochi with sweet roasted soybean flour), Isobemochi (Mochi with Nori (seaweed), sugar, and soy sauce) and Karamimochi. (Mochi with smashed radish, red pepper, and soy sauce). All participants enjoyed pounding and tasting Mochi. It was a good experience for international students to experience a traditional Japanese cultural event.
    Since 2012, Juntendo University and Tokyo Medical and Dental University hold 4 international student exchange events a year in order to promote understanding of Japanese culture and friendship of international students between the two universities.
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  • XIANE WANG, SHUNSUKE KATO, KAMI IWANUMA, KENSHI MATSUMOTO
    2015 Volume 61 Issue 2 Pages 112-113
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    For the date of April 2nd and April 16th in 2015, a total of 45 doctors from Henan and Shandong province in China visited Jundendo University in two batch of arrival and attended the symposium with the theme of “the current status of gastric cancer and it’s chemotherapy in Japan”.
    During the symposium, Dr. Kami Iwanuma gave a speech of “gastric cancer operation, laparotomy operation skills and standards of treatment” (Figure-1); Dr. Kenshi Matsumoto made the lecture about “status quo of early gastric cancer and endoscopic treatment” (Table-1); professor Shunsuke Kato added the lecture of “chemotherapy for unresectable or recurrent gastric cancer in Japan” which constituted the whole academic report with the other two (Table-2).
    After the presentation, Japanese and Chinese medical expert initiate a lively discussion, two nations physician group made sufficient communication and enjoyed the seminar,“Thanks Juntendo University for warm and thoughtful arrangements, I am greatly benefited in the communication with Japanese medical experts” said by Sun Peichun-the director of surgery from China Henan Province People’s Hospital. The conference was presided over by Dr. Xiane Wang.
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Special Reviews: Minimally Invasive Hepatobiliary and Pancreatic Surgery
  • TOSHIYASU KAWAHARA
    2015 Volume 61 Issue 2 Pages 114-115
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
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  • KOICHIRO UCHIDA, CADER SONIA, TOSHIYASU KAWAHARA
    2015 Volume 61 Issue 2 Pages 116-120
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Laparoscopic liver resection (LLR) has several advantages over conventional open liver surgery. However, the indications for laparoscopic liver resection remain limited because of technical difficulties, hemorrhagic and embolic risks, and the suspicion of oncological inadequacy. The number of publications on this topic has significantly increased in recent years, and they show that LLR is becoming the standard approach for patients with liver tumors. Although potential good candidates for LLR are patients with peripheral lesions requiring limited hepatectomy or left lateral sectionectomy, the indications for LLR have recently been extended to major hepatectomy in well-experienced centers. We provide a comprehensive review of LLR, focusing on the types of resection, technical approaches, and collective morbidity and mortality according to the literature presently available. LLR, which is a complex procedure requiring experience in both laparoscopic technique and conventional liver surgery, is safe and feasible with careful patient selection.
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  • NICOLAS C. BUCHS, PHILIPPE MOREL, CHRISTIAN TOSO
    2015 Volume 61 Issue 2 Pages 121-125
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Laparoscopic liver surgery is gaining in interest, especially for the management of patients with single lesions, ≤5cm, located in liver segments two to six. Preliminary results of case-control studies have demonstrated at least similar outcomes between the laparoscopic and open approaches. In parallel, robotic liver surgery is also performed more and more often, and in an always-growing number of centers. The robotic approach includes a three-dimensional vision, and the use of instruments with high degrees of freedom. These technical advantages are expected to allow more extreme and safer minimally invasive liver surgery, including the resection of lesions located high and posterior in the liver, a better node dissection, and safer hepatico-jejunostomy. However, more investigations are needed in the field, and the aim of the present study was to review the current literature and the available evidence regarding the use of the robotic approach for liver surgery. We also speculate on the future developments, which might contribute to further establish the robot.
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  • TOSHIYASU KAWAHARA, CHRISTIAN TOSO, HIROYUKI FURUKAWA
    2015 Volume 61 Issue 2 Pages 126-130
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Minimally invasive surgery is drawing interest for the management of patients with pancreatic disease. This is especially the case for patients with benign and low-grade malignant lesions of the pancreatic tail, efficiently treated by laparoscopy. The laparoscopic management of patients with pancreatic head lesions remains technically more challenging, but the use of robot-assisted surgery has the potential to facilitate their resection. This article reviews the recent advances in minimally invasive pancreas surgery.
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  • BORIS GALA-LOPEZ, TOSHIYASU KAWAHARA, ANDREW R. PEPPER, A.M. JAMES SHA ...
    2015 Volume 61 Issue 2 Pages 131-135
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Decades of research have brought islet transplantation from the dream of few to the reality of many. This procedure started as an experimental method to treat type 1 diabetes mellitus, which features β-cell dysfunction due to auto immunity. The burden of complication in these patients is cumulative and has become a major health problem, despite the availability of insulin therapy. The procedure relies on a sequence of finely orchestrated procedures starting in the donor and followed by several steps to isolate high quality islets. Extensive research is nowadays focussed in improving islet engraftment by providing a more beneficial environment to newly transplanted cells, coupled by more effective immunosuppressive drugs to avoid allo and auto immunity. Excellent results are now a reality in the most specialized centers. Yet, further steps are required to transform this low-risk treatment in a widely available and long-lasting therapy for diabetics worldwide.
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Original Articles
  • KIYOKO NISHINA, KAZUHITO YOKOYAMA, TAKEHISA MATSUKAWA, EMIKO NISHIOKA, ...
    2015 Volume 61 Issue 2 Pages 136-141
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Objective: This study aimed to assess sociodemographic factors affecting the employment status of home caregivers of elderly people.
    Participants: Subjects were 98 home caregivers (mean age, 54.9±7.0 years) who had been employed before they started providing care.
    Methods: The employment status and sociodemographic characteristics of caregivers, as well as characteristics of elderly persons receiving care from the caregivers, were surveyed by self-administered questionnaires.
    Results: Among 98 caregivers, 69 (70.4%) were employed and 29 (29.6%) were unemployed. Required care levels of elderly persons who received care were higher with unemployed caregivers than with employed caregivers (p < 0.05). In unemployed caregivers, age was higher, the proportion of females was lower, care time was longer, and support from other family members was less compared with employed caregivers (p < 0.05). Logistic regression analysis showed that care time (OR 0.99, 95% CI 0.98-1.00), age of caregivers (OR 0.80, 95% CI 0.71-0.91), and use of a home-visit nursing service (OR 0.19, 95% CI 0.05-0.75) were negatively related to employment, whereas support from family members was positively related to employment (OR 5.23, 95% CI 1.41-9.34). Required care level was significantly correlated with care time (r=0.37, p < 0.001).
    Conclusions: A higher care level leads to a longer care time, resulting in unemployment. Leave from a job can be moderated by support from family members and a younger age of caregivers. Additionally, unemployment appears to increase the use of home-visit nursing services.
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  • SHIYUE HE, KAZUO KEMPE, YUICHI TOMIKI, MASAKO NISHIZUKA, TSUTOMU SUZUK ...
    2015 Volume 61 Issue 2 Pages 142-148
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Purpose: The present study was conducted to compare students’ entrance examination scores for a school and their grades following admission to discuss the methods for implementing screening tests and advice or guidance for students admitted to the school.
    Subjects and Methods: The subjects were students who took the general entrance examination for the Faculty of Medicine of Juntendo University and were admitted between 2004 and 2006. The entrance examination scores and academic performance were converted using a scale of one to 100, and Pearson’s product-moment correlation coefficient was calculated.
    Results: There were significant correlations between the English test scores for the entrance examination and academic performance in many subjects. On the other hand, there were non-significant negative correlations between the mathematics test scores for the entrance examination and academic performance in many other subjects.
    Conclusion: Students’ English test scores for the entrance examination are important since their academic performance following admission can be predicted from them. Students’ mathematics test scores for the entrance examination were negatively correlated with their academic performance in many subjects. Therefore, when students are provided with guidance for learning following admission, their mathematics scores should be taken into consideration.
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Case Reports
  • YOSHIYUKI IWASE, KOICHI KUSUNOSE, YOSHIMASA TOMITA
    2015 Volume 61 Issue 2 Pages 149-152
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    We report an 11-year-old boy with limitation of flexion in both thumbs due to anomalous tendon slips of the flexor pollicis longus (FPL). The patient had been unaware of inability to flex his thumbs until his teacher noticed difficulty in writing. Since there were no flexion creases at the interphalangeal joint on either of his thumbs, severe congenital anomalies such as the absence of thumb flexion force and other disorders were suspected. However, because his active range of motion was improved with a short-term self-active flexion exercise program, he was diagnosed as having congenital anomalous tendons with FPL insertion sites other than the tendons of his other fingers. Surgical division of the anomalous tendon slips alone yielded a good functional outcome.
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  • MASAYA KAWAI, KAZUHIRO SAKAMOTO, YUICHI TOMIKI, ATSUSHI OKUZAWA, MICHI ...
    2015 Volume 61 Issue 2 Pages 153-157
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    We applied colostomy or ileostomy using single-incision laparoscopic surgery (SILS) in patients with unresectable colorectal cancer, and evaluated SILS based on our experience.
    The subjects were 18 patients who underwent single-incision laparoscopic colostomy or ileostomy. Before surgery, the part of the intestinal tract for the stomal site and the application sites was decided. In the procedure, we used a circular incision for a single port. After the intra-abdominal observation, we could confirm peritoneal metastasis, direct invasion, and make a cytological examination of ascites. Dissection and mobilization were applied if necessary.
    Stoma was applied in 15 colostomies and 3 ileostomies. We could confirm peritoneal or omental metastasis in 6 patients. Another 4 patients were diagnosed with peritoneal metastasis by laparoscopic examination. We also performed examination of ascites in 9 patients. In three of them, carcinoma cells were found. In addition, in 7 patients, an adhesion was dissected and the intestine was mobilized.
    Single-incision laparoscopic colostomy and ileostomy facilitate postoperative stoma management because there is no scarring without a stoma. In addition, they enable accurate colorectal cancer staging and dissection of adhesion and mobilization of the intestine, which are also marked advantages.
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Reports
  • MICHIO MACHIDA, YOSHIAKI KAJIYAMA, KUNIAKI KOJIMA, TOSHIAKI KITABATAKE ...
    2015 Volume 61 Issue 2 Pages 158-165
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    In recent years, laparoscopy-assisted distal gastrectomy (LADG) has become widely used for the treatment of early gastric cancer. In our hospital, LADG has been performed in 53 patients since it was adopted in November 2006. In the present study, we compared 45 of these LADG patients with T1N0M0 stage IA early gastric cancer and 49 patients who underwent open distal gastrectomy (ODG) during the same period for cancer of the same stage. The compared outcomes included operative time, bleeding loss, and number of lymph node dissections, which reflected the surgical outcomes, as well as the times to first water intake, oral intake, flatus, and bowel movement, and blood test results white blood cell (WBC), C-reactive protein (CRP), which reflected the postoperative course. The length of postoperative hospital stay and complications were also compared. There were no significant differences in operative time or number of lymph node dissections between the groups, although blood loss was significantly lesser with LADG (p < 0.05). There were no significant differences in postoperative course between the 2 groups. These findings suggest that LADG can be performed with the same level of safety as conventional ODG in cases of stage IA gastric cancer and that it may be recommended as the standard operative procedure in these patients.
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Communications
  • PAKHAWADEE PALUNGWACHIRA, CATTLEYA BUNDIT, CHUTIRUT VATCHAROTHAYANGUL, ...
    2015 Volume 61 Issue 2 Pages 166-170
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    Three emergency doctors and one family doctor from Thailand joined the clinical elective study at the department of Emergency and Critical Care Medicine in Juntendo University Faculty of Medicine for 4 weeks in August, 2014. We summarize the aim and scope, contents and our experience in this elective study. First, we stayed in Urayasu hospital for 2 weeks, where we could see from walk-in patients to very severe patients by ambulance. Then we moved to Shizuoka hospital and stayed for 1 week, where we could have an unforgettable experience of Dr. Heli. Finally two of us went to main hospital for one week to learn the primary care for walk-in patients. We’ve learned a lot of things in these three hospitals. The emergency doctor teams have different staff components depending on the management and the location of each hospital. All of the information and arrangement in this program were well-prepared and managed. The whole program was educational and enjoyable at the same time. In our opinion if any emergency physicians want to apply in the international elective study, Juntendo University is the first place we would recommend.
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Lecture Notes
  • SATORU OTANI
    2015 Volume 61 Issue 2 Pages 171-174
    Published: 2015
    Released: August 06, 2015
    JOURNALS FREE ACCESS
    The memory system in the brain is conventionally divided into three categories: declarative memory, emotional memory, and procedural memory. We propose yet another type of memory that is one level higher than these normal memories, namely, memory of the “temporal organization of behavior”. This type of memory is thought to be formed and stored in the prefrontal cortex, taking at the cellular level the form of synaptic plasticity. Synaptic plasticity in rat prefrontal cortex is indeed powerfully modulated by dopamine, the critical neuromodulator for the function of this cortex, where abnormalities in the dopamine level lead to abnormalities in prefrontal synaptic plasticity. Abnormal synaptic plasticity is also seen in the prefrontal cortex after injection of the psychoactive drug MK801, which is known to cause schizophrenia-like cognitive dysfunction in humans. MK801 spontaneously induces in rats synaptic potentiation in hippocampus-prefrontal cortex projection, and this abnormal plasticity is indeed accompanied by deficits of hippocampus-prefrontal cortex projection-dependent cognition that involves memory of the temporal organization of behavior. These results show that synaptic plasticity in the prefrontal cortex correlates with cognitive processes that involve this cortex.
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