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Volume 58, Issue 2
Displaying 1-6 of 6 articles from this issue
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REVIEWS
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Akihiko Yoshimura2009 Volume 58 Issue 2 Pages 73-83
Published: June 25, 2009
Released on J-STAGE: July 17, 2009
JOURNAL FREE ACCESSVarious cytokines are involved in the regulation of the immune system and of hematopoiesis. Most cytokines utilize the so-called JAK-STAT pathway, but others activate the Ras-ERK pathway, which is more important than the STAT pathway for the proliferation of hematopoietic cells. Dysregulation of cytokine signaling can cause a variety of diseases, including allergy, inflammation, and cancer. We have identified two important regulator families involved in cytokine signaling: the SOCS proteins and the Spred proteins. Suppressors of cytokine signaling (SOCS) proteins bind to JAK and to certain receptors, thereby suppressing further signaling events. Spred family proteins interact with Ras and Raf, thereby suppressing ERK activation. Studies have shown that SOCS and Spred proteins are key physiological regulators of immunity, hematopoiesis, and angiogenesis. Evidence is also emerging for the involvement of these proteins in human diseases.View full abstractDownload PDF (946K) -
7. Observations on Clinical Training at a "US-style" Residency Program at Teine Keijinkai Hospital in Sapporo, JapanR. Harsha Rao2009 Volume 58 Issue 2 Pages 84-94
Published: June 25, 2009
Released on J-STAGE: July 17, 2009
JOURNAL FREE ACCESSThe residency program at Teine Keijinkai Hospital in Sapporo has successfully implemented a training philosophy that is focused on the development of clinical skills and critical thinking in Japanese residents. Several elements contribute to its success. The first and foremost is visionary physician leadership, beginning with the pioneers who implemented the philosophy, and continuing through the current leadership, which has sustained the original vision. A close second is the administrative and financial commitment to invest in producing more clinically accomplished Japanese physicians, long before that need was officially recognized. Third is the program's explicit aim of adhering to international norms by requiring three years of training, promulgating a benevolent, not paternalistic teaching philosophy and encouraging an interactive and interrogatory learning ethic. Fourth is the year-round presence of a US-trained Physician-in-Residence, to sustain the focus on clinical skills and international norms. Fifth is a long-term relationship with the Internal Medicine Training Program at the University of Pittsburgh, providing a conduit for ongoing academic exchange and programmatic advice. Last, but not least, is its avowed intention of being viewed as an "American-style program" with a preference for English fluent applicants, which acts as a magnet for trainees motivated to acquire clinical skills and competencies, with an eye to future training in the US. All these elements contribute to the program's unique focus on teaching clinical skills and critical thinking. Others who are striving with varying degrees of success to implement a similar philosophy in Japan may benefit from studying its example.View full abstractDownload PDF (477K) -
Donald E. Greydanus, Flora Bacopoulou, Emmanuel Tsalamanios2009 Volume 58 Issue 2 Pages 95-102
Published: June 25, 2009
Released on J-STAGE: July 17, 2009
JOURNAL FREE ACCESSThe tragedy of suicide in adolescents is experienced by all countries of the world with as many as 200,000 youth and young adults ending their life in the prime of their life because of self-murder each year. Such a tragedy should be unacceptable to clinicians of the world and this article examines factors leading to such death in our youth with recommendations on how to prevent such a worldwide carnage. A major issue in suicide prevention is to screen all children and adolescents for depression and other factors that may trigger suicide in adolescence.View full abstractDownload PDF (410K)
ORIGINAL ARTICLE
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Yoshiaki Sugiura, Takuya Horio, Satoshi Aiko, Takamitu Ishizuka, Isao ...2009 Volume 58 Issue 2 Pages 103-109
Published: June 25, 2009
Released on J-STAGE: July 17, 2009
JOURNAL FREE ACCESSBetween 1978 and 2007 one hundred and seven patients consecutively underwent resection for primary pancreatic adenocarcinoma. There were 28 pN0 patients, 41 pN1 and 37 pN2 or more (one unknown). Combined resection of the portal vein was performed in 62 out of 107 patients (58%). The hepatic artery in 10 patients, superior mesenteric artery in 8 patients and celiac trunk in 7 patients were also resected additionally to the portal vein. The 5-year survival rate and 10-year survival rate of all 107 cases were 12.1% and 2.8% respectively. The 5-year survival rate of the pN0 group was 37%, significantly better than the 14% 5-year survival rate in the pN1 group (p=0.043). Of 69 patients with pN0 or pN1, 38 patients underwent combined resection of the portal vein. There was not significant difference between the 24% 5-year survival rate in the group without the portal vein resection and the 19% 5-year survival rate in the group with portal vein resection. The 20% 5-year survival rate of the portal vein only group and the 5-year survival rate of both the portal vein and hepatic artery group were the same. The groups of the further resection of the superior mesenteric artery and of the celiac trunk showed no long-term survival. It is concluded that aggressive combined resection of the portal vein or additional resection of the hepatic artery be feasible for a survival benefit in pN0 and pN1 diseases.View full abstractDownload PDF (402K)
LECTURE
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- Considering Spiritual Pain -Alfons Deeken2009 Volume 58 Issue 2 Pages 110-119
Published: June 25, 2009
Released on J-STAGE: July 17, 2009
JOURNAL FREE ACCESSAccording to a paper published by the International Work Group on Death, Dying and Bereavement, "Each person has a spiritual dimension." That means each person has spiritual energy and spiritual needs. In facing death, a patient suffers spiritual pain and needs spiritual care. This paper describes what spirituality and spiritual pain mean. It identifies nine types of fears and anxieties about death which become a source of spiritual pain: 1. Fear of pain; 2. Fear of loneliness; 3. Fear of unpleasant experiences; 4. Fear of becoming a burden to the family and to society; 5. Anxiety towards the unknown; 6. Fear of death resulting from fear of life; 7. Fear of death as a feeling that one's life task is still incomplete; 8. Fear of death as fear of personal extinction; 9. Fear of death as fear of judgment and punishment after death. Five types of spiritual pain that seem to be frequent among patients facing death are discussed: 1. Loss of self-determination; 2. Loss of meaning; 3. Guilt feelings; 4. Loneliness and isolation; 5. Loss of hope. Three ways of preventing or reducing excessive fear of death and of lowering the various types of spiritual pain are suggested: 1. Death education; 2. Presence at the bedside; 3. Humor as an expression of love.View full abstractDownload PDF (360K)
CASE REPORT
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Shusaku Tayama, Etsuo Kunieda, Yohei Oku, Atsushi Takeda, Toshiaki Tak ...2009 Volume 58 Issue 2 Pages 120-123
Published: June 25, 2009
Released on J-STAGE: July 17, 2009
JOURNAL FREE ACCESSA 54-year-old male with partial denture underwent stereotactic radiosurgery with an infrared camera-guided system for a metastatic brain tumor arising from lung cancer. Although this method utilizes a biteplate mounted on the upper jaw to detect head movement, the patient only had four teeth in his upper jaw. In order to stabilize the biteplate, the maxillary denture was fixed to the biteplate with an autopolymerizing resin. In addition, the rest-occlusal position of the lower jaw was impressed on the inferior surface of the biteplate with an autopolymerizing resin. To assess reproducibility and stability, the distance between the left and right incus and left and right markers was measured during pre-planning, as well as before and after stereotactic irradiation. Wearing the biteplate ensures the accuracy of radiotherapy planning for the implementation of radiosurgery in patients who have many maxillary teeth missing. However, a large degree of error was observed when the biteplate was removed.View full abstractDownload PDF (1317K)
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