The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 57, Issue 2
Displaying 1-6 of 6 articles from this issue
REVIEW
  • Mitsuyasu Nakamura, Hidetsugu Saito, Toshifumi Hibi
    2008 Volume 57 Issue 2 Pages 75-83
    Published: June 25, 2008
    Released on J-STAGE: August 08, 2008
    JOURNAL FREE ACCESS
    The research for hepatitis C virus (HCV) has long delayed by missing of in vitro culture system. Since the development of replicon system, a replication system of subgenomic HCV RNAs in a hepatoma cell line, has been reported, many virological and clinical findings have been discovered. Recently, in addition of subgenomic replication system, hepatitis C virus full-length RNA replication has been possible, and a few cell culture systems producing viral particles have been produced. These developments enabled us to investigate the life cycle or intracellular circumstance of HCV production. By screening of newly synthesized drugs with this replicon system, several possible medicines have been established and clinical researches are now running. Among them, VX950 and SCH503034 are nearest to clinical use. Other possible agents for reducing viral replication such as cyclophyllin inhibitors, inhibitors of sphingomyelin synthesis, HMG-CoA reductase inhibitors, or RNA-dependent RNA polymerase inhibitors have been also investigated. Furthermore the mechanism for development of hepatocellular carcinoma in the HCV infected liver has been vigorously studied using the HCV replicon system.
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  • Yoshihisa Masakado, Michiyuki Kawakami, Kanjiro Suzuki, Leon Abe, Tets ...
    2008 Volume 57 Issue 2 Pages 84-89
    Published: June 25, 2008
    Released on J-STAGE: August 08, 2008
    JOURNAL FREE ACCESS
    Peroneal neuropathy is one of the common focal mononeuropathies in the lower extremities occurring in both adults and children. Foot drop due to weakness of ankle dorsiflexion is the most common presentation of a peroneal neuropathy. It may also result from other causes involving the upper or lower motor neurons. Disorders that must be distinguished from peroneal neuropathy include sciatic mononeuropathy, lumbosacral plexopathy, motor neuron disease, polyneuropathy, and an L5 radiculopathy. To establish a diagnosis, electrodiagnostic studies have been used to localize the level of the abnormality and to establish prognosis. The most common site of injury is the fibular head, but focal neuropathies have also been reported at the level of the calf, ankle, and foot. In this article, we overviewed the peroneal nerve palsy, and its diagnosis by neurophysiologic evaluation, conduction study and needle EMG. The neurophysiologic information gives us the underlying pathophysiology and its prognosis. Therefore the neurophysiologic evaluation must be performed not only for the differential diagnosis, but also for planning the treatment strategy.
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ORIGINAL ARTICLE
  • Hayato Shimizu, Naoki Shimada, Yumi Otahara, Hisako Minowa, Yoji Hatto ...
    2008 Volume 57 Issue 2 Pages 90-98
    Published: June 25, 2008
    Released on J-STAGE: August 08, 2008
    JOURNAL FREE ACCESS
    Improvement of an unhealthy lifestyle decreases the risk of incidence and mortality from lifestyle-related disease. One method for the improvement of an unhealthy lifestyle is interviewing for health and consultation regarding a healthy lifestyle to recipients of health checkups by public health nurses. Original articles in occupational health for recipients' evaluation in health checkups as longitudinal studies are rare. The purpose of the present study was to investigate in a longitudinal study the relationship between recipients' evaluation of interviews by public health nurses in a health checkup and variations in health checkup results for one year.
    Data on 750 male white collar workers who underwent a company health checkup in 1999 and 2000 were analyzed. The variation in health checkup results for one year from 1999 to 2000 was studied by computing odds ratios in a conditional logistic analysis of the recipients who set a low value on the interview for health by occupational health nurses in the health checkup in 1999 and those who did not.
    It was found that among the subjects who set a low value on the usefulness of the interview by the occupational health nurses, the numbers of the subjects whose body mass index (BMI) and triglyceride value (TG) were healthy (normal) in 1999 and unhealthy (abnormal) in 2000 were significantly greater than those of the subjects whose values were unhealthy in 1999 and healthy in 2000, while such a finding was not detected in the subjects who set a high value on the interview. The differences for BMI and TG between (i) differences between deterioration and improvement of health checkup results in the subjects who evaluated the interview lowly and (ii) those in the subjects who did not were statistically significant as interactions. It can be supposed that some of the subjects who set a low value on the usefulness of the interview by the occupational health nurses may be indifferent to their health status, indicating that low recipient evaluation of the interview for health in health checkup may be regarded as a risk factor of metabolic syndrome from the viewpoint of prevention.
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  • In-Ho Jeon, Shin-Yoon Kim, Poong-Taek Kim
    2008 Volume 57 Issue 2 Pages 99-104
    Published: June 25, 2008
    Released on J-STAGE: August 08, 2008
    JOURNAL FREE ACCESS
    Few have been reported on the role of early primary ligament repair for acute unstable elbow dislocation. The purpose of this study is to evaluate the clinical outcome of early primary ligament repair for unstable elbow dislocation followed by protected early joint mobilization exercise.
    Thirteen patients who underwent operative treatment due to unstable elbow dislocation without associated fracture were retrospectively reviewed. There were 11 male and 2 female with average age of 37 years (range; 18-72 years). Surgical indications of the unstable elbow were subluxation or non-congruent elbow joint on the radiographs following closed reduction. Elbow dislocation which required extension block splint over 45 degrees to maintain reduction was considered as unstable elbow dislocation.
    In ten patients, full stability was restored only after both medial and lateral structures were re-attached. In two patients, only lateral structure (LCLC and common extensor tendon) was repaired and in one patient, only medial structure (MCL and flexor pronator tendon) was repaired for stability. Overall mean functional Mayo Elbow Performance Score was 93.5 (range; 70-100). No elbow was dislocated or subluxated after operation. All ten patients returned to previous work level in average of 3.5 months. Heterotopic calcification was noted in six patients and three had mild ulnar nerve symptoms after operation.
    In conclusion, primary ligament repair in acute unstable elbow dislocation were successful, because surgery achieved sufficient stability to allow early exercise
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  • Ryoichi Nakagami, Kazuhisa Kohda, Wataru Kakegawa, Tetsuro Kondo, Nobu ...
    2008 Volume 57 Issue 2 Pages 105-110
    Published: June 25, 2008
    Released on J-STAGE: August 08, 2008
    JOURNAL FREE ACCESS
    Long-term depression (LTD) of synaptic transmission at parallel fiber (PF)-Purkinje cell synapses is thought to regulate motor learning and memory formation in the cerebellum. Neuronal activity-evoked protein kinase C (PKC) activation is required for the induction of LTD. In addition, theδ2 glutamate receptor (GluRδ2), which is predominantly expressed at PF-Purkinje cell synapses, is indispensable for the induction of LTD; however, the mechanisms by which GluRδ2 regulates LTD and its relationship with PKC activation remain elusive. Interestingly, GluRδ2 is phosphorylated by PKC on serine 945 (Ser945) near its C-terminus and a postsynaptic protein S-SCAM, which could potentially regulate glutamate receptor trafficking and synaptic plasticity, binds to the extreme C-terminus of GluRδ2 in a phosphorylation-dependent manner on Ser945. Here, using a Sindbis-based virus expression approach, we show that a mutant GluRδ2, in which alanine replaced Ser945 and did not undergo PKC phosphorylation, was normally localized at the postsynaptic sites of PF-Purkinje cell synapses. In addition, like wild-type GluRδ2, the phosphorylation-disrupted GluRδ2 successfully rescued abrogated LTD in GluRδ2-null Purkinje cells. These results indicate that Ser945, a major PKC phosphorylation site of of GluRδ2, may not play a crucial role in induction of LTD in the cerebellum.
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CASE REPORT
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