Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 47, Issue 1
Displaying 1-16 of 16 articles from this issue
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Contents
  • Familial Parkinson's disease based on the single gene defects
    -Akey to the understanding the pathogenesis for nigral degeneration in sporadic Parkinson's disease-
    NOBUTAKA HATTORI, YOSHIKUNI MIZUNO
    2001 Volume 47 Issue 1 Pages 53-70
    Published: July 30, 2001
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.47.53
    JOURNAL FREE ACCESS
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    We review here familial Parkinson's disease (PD) from the clinical and molecular genetic aspects. The contribution of genetic factors to the pathogenesis of PD is supported by the demonstration of the high concordance in twins, increased risk among relatives of PD patients in case control and family studies, and the existence of familial PD and parkinsonism based on single gene defects. Recently, several genes have been mapped and /or identified in patients with familial PD. a -Synuclein is involved in a rare dominant form of familial PD with dopa responsive parkinsonian features and Lewy body positive pathology. In contrast, parkin is responsible for the autosomal recessive form of early-onset PD with Lewy body-negative pathology, which has been identified world-wide among patients with young-onset PD. Furthermore, ubiquitin carboxy terminal hydrolase L1 gene is responsible for an autosomal dominant form of typical PD, although only a single family has so far been identified with mutation of this gene, tau has been identified as a causative gene for frontotemporal dementia and parkinsonism. The presence of different loci or different causative genes indicates that PD is not a single entity but highly heterogeneous. Identification and elucidation of the causative genes should enhance our understanding of the pathogenesis of sporadic PD.
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  • Analysis of Short and Long-term Trends of Stagnation of Tuberculosis Incidence Reduction in Japan
    -with special reference to the variation of the Incidence Reduction Rate-
    HIDEFUMI OGA
    2001 Volume 47 Issue 1 Pages 71-81
    Published: July 30, 2001
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.47.71
    JOURNAL FREE ACCESS
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    Objective : To identify the limitation of the existing method to observe the stagnation of the decline in Tuberculosis (TB) incidence. We adopt edan alternative method deduced from the original concept, i.e. decrease of reduction rates of incidences, and elucidate necessary measures to be taken. Materials : Incidence of total TB based on newly registered patients between 1962 and 1998 in Japan. Methods : Rates of reduction of incidences prior to the previous year's value was named ARR (Annual Rate of Reduction). It was calculated according to the following formula. ARRt=1-Incidencet / Incidencet-1. Detailed ARR movements among 20 and 70 year-old patients, in whom the incidence had markedly dropped in recent years, were observed by their yearly differences as below. ΔARRt=ARRt ARRt-1. Long-term trends were calculated to simplify annual movements as average ARR from the 1960's to the 1990's. They were also plotted in time-series. ARR, ΔARR, and average ARR were plotted in time series and analyzed for variation in short term and long term periods. Results : The ARR among old age groups had suddenly dropped after 1996, however, the reasons for the reduction of the ARR in the long term had not been found. The ARR of groups in their 50's and 20's had large vertical variations after the 1980's. Negative values of ARR were found once in 40-years-old, twice in 30-years-old, and 20-years-old. In long-term observation, the ARR of the younger age groups had sharply stagnated. The ARR of age groups under 19 years showed sizable vertical fluctuations and they had often fallen under 0. In long-term observation, the ARR had declined. Comparison among age groups for average ARR showed old age groups had not stagnated on incidence after the 1970's. Stagnations of incidence reduction were more severe in younger age groups. Conclusion : We consider, observing the long-term trend of ARR and clarifying the reasons for the stagnation of the reduction of TB incidence to be important. Furthermore, human-induced factors such as and-TB measures or random variations seemed to reflect yearly or short-term incidence level movements. Anti-TB measures for patients under 20 years of age should be upgraded, for stagnation of incidence declining was not observed in the older but in the younger.
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  • Usefulness of transesophageal echocardiography for detecting cardiovascular embolic risks in patients with cerebral infarction
    SATOSHI KOJIMA, AKITOSHI SASAKI, TAKAHIKO KOJIMA, SEIICHIRO HOSHI, YOR ...
    2001 Volume 47 Issue 1 Pages 82-90
    Published: July 30, 2001
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.47.82
    JOURNAL FREE ACCESS
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    Objective : Transesophageal echocardiography (TEE) has recently emerged as a very promising tool for identifying cardiovascular sources of embolism. This study was designed to evaluate the utility of TEE for detecting the cardiovascular embolic risks in patients with cerebral infarction. Materials & Methods : TEE was performed in 144 consecutive patients with cerebral infarction who were admitted to our hospital between June 1997 and December 2000. Patients were divided into three groups by cardiac rhythm, and there were 71 patients with chronic atrial fibrillation, 18 patients with paroxysmal atrial fibrillation, and 55 patients with sinus rhythm. The potential cardiovascular sources of embolism were defined into 4 categories : (1) left-sided intracardiac mass (thrombi, vegetation, and tumor); (2) dense left atrial spontaneous echo contrast ; (3) reduced left atrial appendage blood flow velocity (<20cm/sec); and (4) complex aortic plaque. Results : Among 144 patients, at least one potential cardiovascular embolic risks was detected in 104 patients (72.2%) : 57 patients (39.6%) with intracardiac mass, 53 patients (36.8%) with dense left atrial spontaneous echo contrast, 52 patients (36.1%) with complex aortic plaque and 33 patients (22.9%) with reduced left atrial appendage blood flow velocity. The prevalence and number of cardiovascular embolic risks increased with age. Cardiovascular embolic risks were also more prevalent in the chronic and paroxysmal atrial fibrillation groups than in the sinus rhythm group (p<0.001 and p<0.05, respectively). However, the patients in the Chronic atrial fibrillation group had significantly more multi embolic risks than the paroxysmal atrial fibrillation groups (p<0.001). Conclusions : Using TEE, potential sources of embolism were detected in about 70% of patients with cerebral infarction. TEE may be a helpful diagnostic tool for the identification of possible cardiovascular embolic sources.
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