The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 50, Issue 2
Displaying 1-8 of 8 articles from this issue
  • Masahiro Kizaki
    2001 Volume 50 Issue 2 Pages 57
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
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  • Isao Okazaki, Tetsu Watanabe, Shigenari Hozawa, Maki Niioka, Masao Ara ...
    2001 Volume 50 Issue 2 Pages 58-65
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
    Since the authors reported the presence of collagenase in the liver as well as its increased activity in the early stage of hepatic fibrosis and its reduced activity in advanced fibrosis in rats induced by chronic CCl4 intoxication, in baboons fed alcohol chronically and in patients with alcoholic fibrosis, other investigators have demonstrated the same tendency of collagenase activity biologically and his-tochemically. Very recently, the authors demonstrated definite gene expression of collagenase during the recovery from experimental hepatic fibrosis using Northern blotting and in situ hybridization. The findings of in situ hybridization not only demonstrated the cells expressing collagenase, but also sug-gested much information on the mechanism of the recovery from fibrosis. Hepatic stellate cells play a key role not only in fibrogenesis but also in fibrolysis. The authors' recent observation revealed that collagenase (matrix metalloproteinase-13 (MMP-13)) gene expression appears very early in the pro-cess of recovery from liver fibrosis, and that both stellate cells and hepatocytes express MMP-13. Recovery from liver cirrhosis requires the gene expression of collagenase, increased production of the collagenase enzyme, and activation of the enzyme balanced with the specific inhibitors of collagenase. The understanding of molecular mechanisms of MMP-1 gene expression which is under investigation in our laboratory may provide us a new strategy for the treatment of liver fibrosis including the possibility of gene therapy.
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  • Makoto Suematsu, Sadakazu Aiso
    2001 Volume 50 Issue 2 Pages 66-71
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
    Ito cells are liver-specific pericytes which were first described as Fett Speicherung Zellen, the fat-storing cells encircling outside sinusoidal endothelial cells, in 1951 by the late professor Toshio Ito. His pioneering approaches for morphological characterization of the cells stimulate investigators to further examine their functional roles in liver homeostasis: a body of evidence has been accumulated in recent years showing that the cells play a crucial role in storage and delivery of vitamin A, regulation of sinusoidal tone and local blood supply, and tissue repair and fibrosis. It is now widely accepted that microvascular pericytes including Ito cells serve as a key player that controls angiogenesis. Further-more, recent studies support a concept that Ito cells constitutes a bridging apparatus mediating bidirec-tional metabolic interactions between sinusoids and hepatocytes, utilizing prostanoids and/or gaseous mediators such as nitric oxide and carbon monoxide as signaling molecules. This article reviews researches on this liver-specific pericyte and its leading roles in recent development of pericyte biology.
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  • Takahiro Amano
    2001 Volume 50 Issue 2 Pages 72-80
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
    Professor Emeritus Fumio Gotoh began and continues his remarkable career in medicine at Keio University. Since his graduation from medical school there in 1951, Dr. Gotoh has devoted him-self to neurology, especially in the enigmatic field of stroke science. He is most renown for his groundbreaking research and leadership in the study of cerebral blood flow and metabolism. Beginning with his doctoral thesis paper in 1959 entitled “Effects of blood pressure on cerebral circulation, ” our article briefly delineates how Prof. Gotoh has paved the path for current and future discoveries in modern medicine. Although wholly difficult to sum up Dr. Gotoh's extensive career in such a short article, we have attempted to chronologically list and furthermore to describe his numerous works. Herein we describe his expansion to the international arena with his contributions at Wayne State University as well as his novel cerebral blood gas monitoring techniques now used in modified fashion throughout the world. From his CO2-based investigations in animals to his study of the autonomic nervous system's role in human cerebrovascular control, we remark on Dr. Gotoh's accomplishments without the use of functional imaging. Yet despite the basic science theme of his research, he has al-ways kept them clinically correlated to entities such as Cheyne-Stokes phenomenon and Shy-Drager syndrome. Prof. Gotoh has been asked to head some of the most influential stroke societies and was the second president of the International Stroke Society. In conjunction with leading authorities, he developed a quantifiable, evidence-based stroke scale which was introduced in the International Jour-nal of Stroke in 2001. Today despite his retirement, Dr. Gotoh continues his work in cerebral blood flow and metabolism.
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  • Celeste R. Wirsig-Wiechmann
    2001 Volume 50 Issue 2 Pages 81-85
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
    Gonadotropin-releasing hormone (GnRH) is present within neurons of the nervus terminalis, the zeroeth cranial nerve. In all vertebrate species, except in sharks where it is a separate nerve, the nervus terminalis consists of a chain of neurons embedded within olfactory or vomeronasal nerves in the nasal cavity. The function of the GnRH component of the nervus terminalis is thought to be neuromodulatory. Our research on GnRH effects on olfaction confirms this hypothesis. The processes of GnRH neural cell bodies located within chemosensory nerves project centrally into the ventral forebrain and peripherally into the lamina propria of the nasal chemosensory mucosa. GnRH receptors are expressed by chemosensory neurons as shown by RT-PCR/Southern blotting and GnRH agonist binding studies. Patch-clamp studies have shown that GnRH alters the responses of isolated chemo-sensory neurons to natural or electrophysiological stimulation through the modulation of voltage-gated and receptor-gated channels. Behavioral experiments demonstrate that interfering with the nasal GnRH system leads to deficits in mating behavior. These studies suggest that the function of the intranasal GnRH system is to modify olfactory information, perhaps at reproductively auspicious times. We speculate that the purpose of this altered olfactory sense is to make pheromones more detectable and salient.
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  • Giorgio Parmiani
    2001 Volume 50 Issue 2 Pages 86-90
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
    During the last 10 years many melanoma antigens recognized by T cells have been molecu-larly characterized. This review summarizes the main features of these antigens, including both classes I and II HLA-restricted peptides, and describes their classification into diverse groups according to the tissue distribution of the antigens. The different in vitro and in vivo immunogenicity of such antigens is then discussed leading to the conclusion that Melan-A/MART-1 is the strongest among those tested being frequently recognized by patients' T cells both in vitro and in vivo. However, no correlation was found between T-cell response of melanoma patients to Melan-A/MART-1 and clinical response when it was used for vaccination. Data are also presented that suggest, through an ex vivo analysis carried out with tetramers staining of melanoma-specific T cells, that only in a limited number of advanced patients does a specific immune response develop. This response, however, appears unable to effec-tively counteract metastatic melanoma growth.
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  • Yoshio Izumi, Kazuo Isozumi
    2001 Volume 50 Issue 2 Pages 91-99
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
    Before the first European visited Japan in 1549, traditional Chinese medicine was mainly employed in Japan. Francisco de Xavier, a missionary of the Society of Jesus, tried to promote the introduction of Christianity by providing a medical service for Japanese citizens. However, Japan implemented a national isolation policy in 1639 and cut off diplomatic relations with the rest of the world, except Holland and China. For over 200 years, until the American admiral Matthew Perry forced Japan to open its doors in 1853, Japan learned about western medicine only from doctors of the Dutch merchants' office or from Dutch medical books. After 1853, Western medicine was rapidly introduced into Japan, and great achievements by Japanese medical doctors soon followed, such as the serum therapy for tetanus, the discovery of the plague and dysentery bacilli, the invention of Salvarsan for the treatment of syphilis, and the demonstration of the neurosyphilis spirochete.
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  • Masahiro Kaminota
    2001 Volume 50 Issue 2 Pages 100-108
    Published: 2001
    Released on J-STAGE: June 16, 2009
    JOURNAL FREE ACCESS
    Although kidney transplantation is considered to be more desirable than dialysis in terms of cost-effectiveness and patients' quality of life, there have been very few cases of kidney transplants in Japan. This study was conducted to compare the cost-effectiveness of dialysis and kidney transplants using Disability-Adjusted Life Years (DALYs) as an indicator of effectiveness. Most data necessary for the DALYs analysis were obtained from publications. The disability weights for dialysis patients and kidney transplant patients were estimated based on a questionnaire emailed to medical officials of the Japanese Government. Expected duration of treatment was estimated from the survival rates of dialysis patients and the graft-survival rates of transplant patients using the Weibull model method. The cost of dialysis and living-related donor (LRD) transplant included only medical expenditures and neglected all other costs, and the cost of cadaveric donor (CAD) transplant included the budget for organ procurement and distribution in addition to medical expenditures. The analysis showed that dialysis averted 138, 019 DALYs/year, living-related donor transplant averted 5, 740 DALYs/year, and CAD transplant averted 1, 892 DALYs/year. The cost-effectiveness ratio (C-E ratio) was 9, 546 thousand yen/DALY for dialysis, 1, 809 thousand yen/DALY for LRD transplant, and 2, 322 thousand yen/ DALY for CAD transplant. These results could be used for the decision making of the Government on what resources should be allocated to the promotion of kidney transplantation. Also, the methodology used in this study can be applied to cost-effectiveness analysis of other organ transplants.
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