The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 49, Issue 2
Displaying 1-4 of 4 articles from this issue
  • Elizabeth Helen Blackburn
    2000 Volume 49 Issue 2 Pages 59-65
    Published: 2000
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
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  • Verne S. Caviness, Nikos Makris, Nicholas T. Lange, Martha Herbert, Da ...
    2000 Volume 49 Issue 2 Pages 66-73
    Published: 2000
    Released on J-STAGE: August 24, 2009
    JOURNAL FREE ACCESS
    Magnetic resonance imaging of the brain is now generally indispensable to state of art clinical medicine. Robust, high resolution imaging systems are currently available worldwide. The availability of MRI has, in little more than a decade, revolutionized the certainty and efficiency of clinical diagnosis and management. As a dividend of this revolution, clinicians and radiologists who are expert in the many and varied applications of MRI methods are able to relate this expertise to a confident mastery of the topographic anatomy of the brain as revealed in magnetic resonance images. Whereas the yield to clinical objectives has been massive, the clinician as yet draws upon a relatively limited sampling of the potential informational harvest from this technology which in theory could further enrich both clinical concerns and those of fundamental neuroscience. Here we will review early explorations into these other offerings with the expectation that the coming decade will see them established comfortably with current uses. We will also consider potential offerings of the extended applications of brain MRI to the characterization and insights into biological origins of certain obscure developmental disorders.
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  • Masaru Suzuki, Shingo Hori, Seitaro Fujishima, Seiji Takatsuki, Iwao N ...
    2000 Volume 49 Issue 2 Pages 74-79
    Published: 2000
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Identification of patients with acute chest pain due to acute coronary syndrome is a com-mon and difficult challenge for emergency physicians. A prospective study was conducted to assess the diagnostic value of a bedside test of cardiac troponin T in the emergency room setting. Forty-nine consecutive patients, who visited the emergency room within 6 hours of the onset of acute chest pain, were enrolled. Of the 26 patients who were ultimately diagnosed as having acute coronary syndrome, seven patients (27%) had positive cardiac troponin T assay results, whereas none of the patients with-out acute coronary syndrome had positive results (0%). For patients with acute coronary syndrome who presented later than 3 hours after the onset (n=4), the test was positive in all cases (positive predictive value: 100%, negative predictive value: 100%, p<0.01). However, the positive rate was only 14% for those who presented earlier than 3 hours after the onset (n=22) (positive predictive value: 100%, negative predictive value: 47%, p=0.84). In conclusion, bedside troponin T test results should be evaluated considering the time interval from the onset of chest symptoms.
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  • Ronald Marks
    2000 Volume 49 Issue 2 Pages 80-83
    Published: 2000
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The stratum corneum (SC) provides a vital barrier membrane between the external envi-ronment and the vulnerable internal tissues of the skin. It impedes the flow of water, the penetration of xenobiotics, and invasion of pathogenic micro-organisms. It also has protective capacity against ultra-violet radiation and thermal injury. As routine histopathology provides a misleading picture of a disorganized and shadowy SC, we would recommend the skin surface biopsy technique. This painless technique is easy and reliable in obtaining information from the SC. It demonstrates the geometric patterns of the surface, the openings of the eccrine ducts and hair follicles. The skin surface biopsy technique is also ideal for the investigation of the in situ microbiology of skin. Staining with periodic acid Schiff reagent makes it possible to see ringworm fungi, pityriasis versicolor, candida species, or erythrasma micro-organisms. Scanning electron microscopy can be employed when the higher magni-fication is needed. Histochemical applications include silver staining for melanin particle, potassium ferricyanide staining for blood pigments and lipid staining with Sudan red, for sebum. The rate of movement of topically applied drugs into the skin can be measured using the skin surface biopsy technique. The concentration of radiolabelled drugs can be counted and compared. Comedogenicity and DNA analysis are other applications of this non-invasive technique.
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