Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 48, Issue 3
Displaying 1-17 of 17 articles from this issue
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Contents
  • Pain and drugs for pain management
    YUTAKA TANABE, HARUHIRO MIYAZAKI
    2002 Volume 48 Issue 3 Pages 290-304
    Published: December 12, 2002
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.48.290
    JOURNAL FREE ACCESS
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    Progress in studies about pain and its mechanism have clarified that the mechanism of onset pain is not uniform and that various mechanisms are involved in pain onset. In other words, it has become clear that the treatment of pain is not as simple as giving analgesics. Administration of analgesics in a narrow sense is ineffective for certain kinds of pain such as RSD, causalgia and so on. However, it is not unusual that the administration of anticonvulsants, antidepressants and autonomic nervous system agents are sometimes effective for these types of pain. For this reason, we would like to explain the mechanism of pain simply and introduce drugs available for pain management.
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  • Chronic obstructive pulmonary disease; COPD
    JUN UEKI, KAKU YOSHIMI, YOSHINOSUKE FUKUCHI
    2002 Volume 48 Issue 3 Pages 305-320
    Published: December 12, 2002
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.48.305
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    COPD is a disease state characterized by progressive airflow limitation that is not reversible and by an abnormal inflammatory response of the lungs to noxious particles and gases. There is also a growing realization that COPD is a multi-organ-system disease. To reduce symptoms, improve QOL, and increase physical and emotional participation in everyday activities, comprehensive management including pharmacologic treatment, pulmonary rehabilitation, and oxygen therapy is mandatory. COPD is currently the fourth leading cause of death in the world. To reverse further increase in its prevalence and mortality in the coming decades, continuous improvements in management and prevention strategies are necessary.
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  • Treatment of multicystic dysplastic kidney
    -Comparison between conservative and surgical treatment-
    SHOEI SATAKE, YATAROU HOSODA, YOSHIYUKI OHTOMO, KAZUNARI KANEKO, ATSUY ...
    2002 Volume 48 Issue 3 Pages 348-354
    Published: December 12, 2002
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.48.348
    JOURNAL FREE ACCESS
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    Purpose : Treatment for Multicystic Dysplastic Kidney (MCDK) remains still controversial. There are three types of treatment : conservative therapy (CoG), open nephrectomy (OpG) and laparoscopic nephrectomy (LaG). This study was to examined which type of treatment is the most efficient for MCDK. Materials and Methods : Between 1990 and 2001, the author examined 27 MCDK cases. These were divided into three groups : CoG, OpG, and LaG and a comparative study of the treatment of these three groups were performed retrospectively. Results : There were 11 cases in CoG, 6 cases in OpG and 10 cases in LaG. Cost in LaG was higher than that in CoG, if MCDK disappear within five years. However, corrently if MCDK porsisted for more than five years the cost in CoG was higher. In our series, nearly 50% of MCDK had not disappeared in five years. Thus, we prefer laparoscopic nephrectomy to conservative treatment. Conclusion : There are no complications of MCDK when the patient receives surgery in early stage. Currently, laparoscopic nephrectomy is the most efficient technique for MCDK patients. It is clear that this technique has the merits of a short hospitalization period and smallest scar for the patients.
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  • Effect of Clq gene polymorphism on Clq production and lupus nephritis
    HIDEAKI TOMITA, YUKO MIURA, KAZUHIRO NAKAMURA, HIROSHI TSUDA, HIROSHI ...
    2002 Volume 48 Issue 3 Pages 355-363
    Published: December 12, 2002
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.48.355
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    Objective : SLE is a multigenic disease and the inheritance pattern is extremely complex. Thus, genetic studies in human SLE face many difficulties in identifying susceptibility genes. In this context, spontaneous SLE-prone mouse models are useful tools and have been examined by several investigators around the world. In the present study, we examined lupus nephritis susceptibility genes using SLE-prone (NZB×NZW) F1 mice. Methods and Results : In QTL (quantitative trait loci) analysis of proteinuria in (NZB×NZW) F1×NZW backcross mice, lupus nephritis susceptibility gene was detected in the vicinity of the microsatellite marker D4Mit70 located near C1q gene on NZB chromosome 4. Thus, we examined whether C1q gene polymorphism exists in NZB and NZW strains. Southern blot analysis demonstrated RFLP (restriction length polymorphism) in NZB in comparison with the NZW strain. Hemolytic assay for measurement of C1q molecules demonstrated a significantly lower serum C1q level in disease-free young NZB and (NZB×NZW) F1 mice than in age-matched NZW mice. QTL analysis in the same backcross mice showed that the NZB allele linked to the C1q gene was well associated with low serum C1q levels. Conclusions : These findings suggest that the observed partial reduction of functional C1q in NZB and (NZB×NZW) F1 mice may be due to the NZB-type regulatory region polymorphism, and that not only deleterious mutations of C1q coding regions associated with an absence of detectable C1q, but also NZB-type polymorphism associated with partial reduction of C1q, may appear to confer a disease risk for lupus nephritis.
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  • Fas gene polymorphism affecting Fas expression levels and autoimmune disease
    REIKO AKAKURA, XIANG SHU WEN, MASAAKI ABE, EKI KYO, SACHIKO HIROSE
    2002 Volume 48 Issue 3 Pages 364-374
    Published: December 12, 2002
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.48.364
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    Objective : Based on studies using MRL/lpr mice, deleterious mutation of Fas gene associated with deletion of Fas-mediated apoptosis is associated with autoimmune disease with autoantibody production. We previously found that autoantibody.producing BI cells in SLE-prone (NZB×NZW) F1 mice have a low capacity to express Fas antigen on the cell surface and are resistant to Fas.mediated apoptosis. Although (NZB×NZW) F1 mice have no Fas gene mutation, it is plausible to speculate that Fas gene polymorphism affecting Fas expression levels may be involved in (NZB×NZW) F1 disease. In the present study, we focused on this issue and examined Fas gene polymorphisms in New Zealand mice. Methods and Results : 1) There were nine SNPs (single nucleotide polymorphisms) in the 5' flanking region of Fas gene including the reported promoter region between NZB and NZW strains. 2) Both T and B cells in NZB mice expressed lower Fas levels and were more resistant to Fasmediated apoptosis compared with those in NZW mice. 3) Taking advantage of the NZW-interval congenic mouse strains containing the NZB-type Fas gene polymorphism, the Fas expression level seemed to be controlled by the polymorphic region of Fas gene.4) NZB-type Fas gene polymorphism is significantly associated with B1 cell frequencies and IgG anti-DNA antibody production in (NZB×NZW) F1×NZW　backcross　progeny. Conclusions : These results suggest that the NZB-type Fas gene polymorphism functions as one of the SLE-susceptibility genes in (NZB×NZW) Fl mice.
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  • Changes in drug sensitivity of Helicobacter pylori and serum IgG antibody titers after eradication therapy
    TAKAAKI MATSUMOTO, SHUJI MATSUOKA, HIDEHIRO TSUNEOKA
    2002 Volume 48 Issue 3 Pages 375-383
    Published: December 12, 2002
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.48.375
    JOURNAL FREE ACCESS
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    Objective : To establish an effective eradication therapy for Helicobacter pylori (H. pylori) infection in the stomach and useful methods of evaluating the therapy, in vitro sensitivities of H. pylori to amoxicillin (AMPC) and clarithromycin (CAM) and anti-H. pylori IgG antibodies in sera from patients were examined before and after the eradication therapy in groups of patients with successful and unsuccessful results. Method : Strains of H. pylori were isolated from gastric mucosa and examined using culture, urease, histological and immunohistochemical methods. Drug sensitivities were tested by the minimal inhibitory concentration (MIC) method. Serum anti-H. pylori antibodies were examined using an ELISA-based kit. Results : In an 8-year survey of 872 patients with H. pylori infection, while there were no cases of AMPC-resistant strains, the incidence of patients with CAM-resistant strains gradually increased. In a selected group of patients with successful and unsuccessful eradication therapies, while 8.2 % patients had CAM-resistant strains before therapy, the incidence increased to 73.5 % after therapy, although all were AMPC-sensitive. Such CAM-resistant strains were much more frequent in cases showing unsuccessful results. While titers of serum anti-H. pylori IgG antibodies did not change in unsuccessful cases, a significant decrease was observed in cases showing successful treatment. Conclusion : Tests for drug sensitivity of H. pylori before and after eradication therapy are important to achieve successful results. Measurement of serum IgG antibody titers is useful for evaluation of the results of eradication therapy.
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  • Immunohistochemical characterization of splenic germinal centers in murine lupus
    KOJI MIURA, YAN XIU, HIROMICHI TSURUI, KAZUKO TAKAHASHI, DANQING ZHANG ...
    2002 Volume 48 Issue 3 Pages 384-395
    Published: December 12, 2002
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.48.384
    JOURNAL FREE ACCESS
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    Objective : The germinal center (GC) provides a microenvironment within which affinity maturation of the humoral immune response and memory B cell formation takes place in response to T cell-dependent antigens. Follicular dendritic cells (FDCs) in GC play a role in antigen presentation by retaining immune complexes on their cell surface. Autoantibodies detected in systemic lupus erythematosus (SLE) show affinity maturation in a T cell-dependent fashion ; thus, GCs may play a critical role in the generation of pathogenic autoantibodies. In the present studies, we studied immunohistochemical characteristics of GCs in murine lupus. Methods : Immunohistochemical changes in splenic lymph follicles were examined in SLE-prone (NZB×NZW) F1 and BXSB mice using the three-color immunofluorescence technique. Results : GCs were spontaneously developed in SLE mice even before the onset of SLE, and the number and size of GCs increased with aging. Compared with GCs formed in KLH-immunized BALB / c mice, GCs in aged SLE mice with severe SLE contained larger numbers of T cells intermingled with activated B cells. While FDCs in KLH-immunized BALB / c mice expressed both CR1 and Fc γ RIIB molecules, aged SLE mice lacked Fc γ RIIB expression with aging. Conclusions : The present results of immunohistochemical studies on GCs of lupus mice were consistent with the idea that autoantibody production is highly T cell-dependent. The marked difference in expression levels of CR1 and Fc γ RIIB on FDCs in aged SLE mice may reflect the differential role of these two molecules for generation of high affinity autoantibodies. Further studies are needed to clarify the roles of CR1 and Fc γ RIIB on FDCs in tolerance breakdown and autoantibody production.
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