Journal of Nihon University Medical Association
Online ISSN : 1884-0779
Print ISSN : 0029-0424
ISSN-L : 0029-0424
Volume 75 , Issue 2
Journal of Nihon University Medical Association
Showing 1-12 articles out of 12 articles from the selected issue
Special Articles:
  • Taro Matsumoto
    2016 Volume 75 Issue 2 Pages 55
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
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  • Noriyoshi Konuma
    2016 Volume 75 Issue 2 Pages 56-60
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    Induced pluripotent stem cells (iPSCs) are generated through the reprograming of somatic cells and exhibit similar characteristics of embryonic stem (ES) cells. The iPSCs have potentially overcome the immune rejection and ethical issues involved in the use of ES cells for clinical applications. However, the iPSCs have several problems including the low efficiency of reprograming and high tumorigenic potential due to the use of potential oncogenes for reprograming. Current studies provide significant progress toward generating safe iPS cells without any genomic modification. This review summarizes current strategies in the generation of iPS cells including variations of reprograming genes and types of somatic cells for reprograming.
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  • Tomohiko Kazama
    2016 Volume 75 Issue 2 Pages 61-66
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    Mesenchymal stem cells (MSCs) are multipotent stromal cells that were originally identified in bone marrow and later detected in the other connective tissues including adipose tissue. MSCs can differentiate not only into mesenchymal lineage cells but also into the other cell types such as neuronal cells and epithelial cells. In addition to their multi-lineage potential, MSCs have the immunomodulatory and anti-inflammatory properties. Therefore, MSCs have profound medicinal effects at body sites of tissue injury, disease, or inflammation as either endogenously or exogenously supplied. The definition of MSCs is becoming increasingly obscure due to the findings of heterogeneous populations with different levels of stemness within MSCs isolated by several different tissues. Recent studies demonstrate that Stro-1, CD271, SSEA4, and CD146 may be good markers to identify multipotent MSCs. The purpose of this review is to provide an update on our knowledge of MSCs in their phenotypic characterization, biological properties and potential for applications in cell therapy and regenerative medicine.
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  • Tomohiko Kazama
    2016 Volume 75 Issue 2 Pages 67-69
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    Cardiovascular regenerative therapy has the potential to improve the treatment of peripheral artery disease (PAD), ischemic heart disease (IHD) and severe heart failure. Autologous implantation of bone marrow-mononuclear cells into ischemic limbs was reported as an effective application by the secretion of various angiogenic factors or cytokines. On the other hand, bone marrow cells and skeletal myoblasts transplantation for cardiac angiogenic therapy, injected directry into cardiac ischemic lesion, was generally insufficient to repair severe myocardial damage. To improve the efficacy of cardiac cell therapy, cell sheet technology was developed to reduce the damage of the transplanted cells. The discovery of iPS cells and cardiac master genes have changed the field of cardiac regenerative medicine. Because cardiomyocytes are terminally differentiated cells with limited regenerative capacity in adult heart, implantation of cardiomyocyte cell-sheet differentiated from iPS cells or the other pluripotent cell types, is expected as a new strategy of cardiac cell therapy. Moreover, direct cardiac reprograming which means cardiac fibroblasts induced converting directry into cardiomyocytes in damaged cardiac tissue, was discovered recentry. Here, this review summarizes recent advances in cardiovascular regenerative therapy and discusses the perspectives and challenges of new technology in basic biology and clinical applications.
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  • Shinsuke Kikuta
    2016 Volume 75 Issue 2 Pages 70-73
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    Cardiovascular regenerative therapy has the potential to improve the treatment of peripheral artery disease (PAD), ischemic heart disease (IHD) and severe heart failure. Autologous implantation of bone marrow-mononuclear cells into ischemic limbs was reported as an effective application by the secretion of various angiogenic factors or cytokines. On the other hand, bone marrow cells and skeletal myoblasts transplantation for cardiac angiogenic therapy, injected directry into cardiac ischemic lesion, was generally insufficient to repair severe myocardial damage. To improve the efficacy of cardiac cell therapy, cell sheet technology was developed to reduce the damage of the transplanted cells. The discovery of iPS cells and cardiac master genes have changed the field of cardiac regenerative medicine. Because cardiomyocytes are terminally differentiated cells with limited regenerative capacity in adult heart, implantation of cardiomyocyte cell-sheet differentiated from iPS cells or the other pluripotent cell types, is expected as a new strategy of cardiac cell therapy. Moreover, direct cardiac reprograming which means cardiac fibroblasts induced converting directry into cardiomyocytes in damaged cardiac tissue, was discovered recentry. Here, this review summarizes recent advances in cardiovascular regenerative therapy and discusses the perspectives and challenges of new technology in basic biology and clinical applications.
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  • Kazutaka Soejima, Tsutomu Kashimura, Toyoharu Jike, Tomohiko Kazama, T ...
    2016 Volume 75 Issue 2 Pages 74-80
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    Skin has been a subject of generative medicine for long time. Technique of culture of human epithelium had been established in 1975 and the use of cultured epithelium is now major treatment option in management of extensive burn patients. However, the grafted cultured epithelium keeps rather fragility for several months after grafting, which is a current unsolved problem. We tested the effects of DFAT (dedifferentiated fat cells) on regeneration of basement membrane after cultured epithelial grafting in porcine experimental model. The result showed that the DFAT enhanced the laminin-5 supply and anchoring fibril formation, which may be beneficial to promote maturity of grafted cultured epithelium. Artificial dermis (AD) is a dermal regeneration template consisting of a spongy, porous collagen dermal replacement layer and a temporary epidermal substitute made of silicone. The advantage using AD to treat skin defects is that tissue quality resembling that with a full-thickness skin graft can be obtained with a thin split-thickness skin graft, which minimizes donor site morbidity. However, this treatment method requires two separate procedures, because the AD must be vascularized before skin grafting. Currently, reducing the time required for dermis-like tissue generation before the secondary skin grafting is desired. We tested the effects of DFAT on vascularization of the AD in rat experimental model. The result showed that the DFAT enhanced the angiogenesis, especially under bFGF treatment. We confirmed that one-step grafting procedure of the artificial dermis and the skin is possible by this method in porcine experimental model.
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Original Article:
  • Chisato Konno, Masahiro Suzuki, Ryuji Furihata, Sakae Takahashi, Yoshi ...
    2016 Volume 75 Issue 2 Pages 81-87
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    In order to elucidate an association between depression and psychological factors, we conducted crosssectional surveys with face-to-face interviews in 2009 as part of the Nihon University Sleep and Mental Health Epidemiology Project (NUSMEP). Data from 2,559 individuals sampled randomly from the general adult Japanese population were analyzed. The Japanese version of the Mini-International Neuropsychiatric Interview was used to assess the presence of depression. Sociodemographic variables, life history, life events, stress-coping strategies, the personality traits of neuroticism, and Melancholic type (Typus melancholicus) were examined in the interview. In relation to depression, multiple logistic regression analyses revealed significant positive odds ratios (OR) for poor perceived mental health (OR 4.61), the personality trait of neuroticism (OR 3.82), perceived lack of parental affection during childhood (OR 2.41), present personal health problems (OR 2.41), the coping strategy of “Bearing without action” (OR 1.88), and a family history of depression (OR 1.79), but a significant negative OR for the coping strategy of “Taking one’s ease” (OR 0.47). The fact that the personality trait associated with depression was neuroticism but not Typus melancholicus suggests that the premorbid personality hypothesis that originated in an anthropologic observation of Typus melancholicus, which has been widely believed in Japan, should be reconsidered based on epidemiological data.
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  • Keiko Takahashi, Ichiro Watanabe, Yasuo Okumura, Kazuki Iso, Rikitake ...
    2016 Volume 75 Issue 2 Pages 88-91
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    Background: Atrial fibrillation (AF) confers a substantial increase in the risk of stroke. While the CHADS2 score is considered a reliable predictor of stroke/thromboembolism risk in patients with AF, thromboembolism can occur even in AF patients with a low CHADS2 score (CHADS2 score = 0 or 1). We retrospectively assessed the relationships between left atrial appendage thrombus (LAAT) and patient characteristics, echocardiographic variables, and surrogate blood markers in patients with unanticoagulated AF, in order to determine whether thrombogenesis can be predicted in this patient population. Methods: The study group was comprised of 31 patients with unanticoagulated persistent non-valvular AF (NVAF) who underwent transthoracic echocardiography (TTE) and transesophageal echocardiography. Patients were divided into those with and without LAAT, and study variables were compared between the 2 groups. Results: LAAT was found in 14 patients. AF duration, left atrial diameter, left ventricular ejection fraction, left atrial appendage flow, β-thromboglobulin, platelet factor 4, prothrombin time, activated prothrombin time, fibrinogen, D-dimer, and antithrombin III levels did not differ between patients with and without LAAT. However, ANP and BNP levels were significantly higher in patients with LAAT (ANP ≥79 pg/ml, P = 0.03, BNP ≥120 pg/ml: P = 0.03). Moreover, patients with BNP ≥120 pg/ml exhibited an increased risk for LAAT (P = 0.03, odds ratio: 6.19), and patients with ANP ≥70 pg/ml in addition to BNP ≥120 pg/ml exhibited a further augmented risk for LAAT (P = 0.055, odds ratio: 8.75). Conclusions: In patients with unanticoagulated NVAF, a BNP level ≥120 pg/ml or an ANP level ≥70 pg/ml and BNP level ≥120 pg/ml could prove useful in predicting LAAT.
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Case Reports:
  • Yuki Takano, Tadataka Sekiyama, Naoki Okamoto, Shu Hashimoto
    2016 Volume 75 Issue 2 Pages 92-94
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    A 36-year-old woman was admitted for severe dyspnea and cough, after inhalation of a waterproofing spray. Chest radiography and computed tomography revealed diffuse ground glass opacities in both lungs. These findings improved after 4 days of steroid therapy. Pulmonary function tests showed a low diffusing capacity. It was believed that the patient had suffered direct pulmonary damage from inhalation of the waterproofing spray.
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  • Shunichiro Ohira, Shunichi Matsuoka, Akinori Tanura, Hiroshi Nakagawar ...
    2016 Volume 75 Issue 2 Pages 95-98
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    A 57-year-old man with hepatitis C cirrhosis experienced sudden hematemesis and was brought to the hospital via ambulance. He underwent endoscopic variceal ligation for ruptured esophageal varices (EV). His platelet count was reduced to 6 X 104 g/dl and splenomegaly was observed. Therefore, partial splenic embolization was performed. However, a complicating portal vein thrombus required thrombolytic therapy with warfarin. His platelet count increased to 15 X 104 g/dl, the EV did not worsen, and there was no complicating hepatocellular carcinoma (HCC). Thus, a planned 24-week course of combined pegylated-interferon (Peg-IFN)-α2a and ribavirin was initiated. Neutropenia occurred during therapy, which led to a reduction in the dose and frequency of Peg-IFN-α2a administration. A sustained viral response (SVR) was obtained after completion of the treatment. The SVR has persisted up to 6 years since the EV rupture. The patient’s platelet count remains 15 X 104 g/dl, the liver function remains normal, the EV have improved, and there is no complicating HCC.
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  • Hiroshi Soeda, Toshio Tabei, Emi Hata, Masahiko Shinohara, Fumi Amano, ...
    2016 Volume 75 Issue 2 Pages 99-103
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    CT and MRI have been used in combination with pathological examination in order to evaluate the efficacy of NAC. We present a case that showed discrepancies between the pathological findings and those of imaging analysis after NAC. We administered NAC to a patient with stage IIIB locally-advanced breast cancer. NAC showed remarkable drug efficacy. Clinical tumor response evaluated by CT and MRI showed a residual tumor. However, the pathological tumor response following NAC was grade 2b according to criteria of the Japanese Breast Cancer Society. Inaccurate determination of a residual tumor by MRI (a residual tumor diagnosed by MRI but a pathological complete response diagnosed by pathological examination) can occur occasionally.
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  • Michiko Yamada, Tetsuji Morimoto, Ryutaro Yamada, Masako Tagawa, Erika ...
    2016 Volume 75 Issue 2 Pages 104-107
    Published: April 01, 2016
    Released: July 20, 2016
    JOURNALS FREE ACCESS
    Intertrigo is a kind of dermatitis that manifests on the intertriginous areas, such as the neck, axilla, groin, genitocrural region, etc., as a result of mechanical irritation and infection. We recently experienced an infant case of streptococcal intertrigo. This disorder is a skin infection triggered by group-A streptococcus that is mainly observed in infants. An otherwise healthy one-month-old girl presented with erythema with clear borders in the intertriginous areas along her neck, axilla, groin, and popliteal space. Since a rapid antigen detection test for group-A streptococcus was positive, we diagnosed her as having streptococcal intertrigo. Furthermore, since the serotype T and protein genotype M of the group-A streptococcus identified from the patient matched one identified from her brother, we concluded that the infection route was intrafamilial transmission. Although this disorder typically presents as a very characteristic rash and has an established treatment method, it is not widely recognized and is often overlooked in the field of pediatrics.
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