Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
Search
Advanced search
OR
Browse
Search
Volume 49, Issue 2
Displaying 1-17 of 17 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Contents
  • A new procedure for coronary artery bypass surgery to facilitate early postoperative recovery
    -Conversion from arrested heart to beating heart-
    ATSUSHI AMANO
    2003 Volume 49 Issue 2 Pages 157-162
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.157
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Numerous less invasive surgical procedures have developed since the end of the 20th century and have influenced trends in cardiovascular surgery. Accumulated experience with coronary artery bypass graft (CABG) surgery, which is the most common procedure in adult cardiac surgery, has allowed the procedure to be performed with a smaller incision under a beating heart. We treated 133 CABG cases over an eight-month period beginning in July 2002 with a policy of using arterial graft. Of these 133,109 cases of CABG were performed by a median sternotomy approach with the off-pump beating heart technique. Mean age was 65.6±8.7 years old, the number of distal anastomoses were 3.8±1.2. As a postoperative result, we experienced one hospital death, one perioperative myocardial infarction, and one postoperative bleeding requiring reexploration (0.9%each). There were 5 other postoperative complications (4.6%) involving atrial fibrillation which needed cardioversion, and 2 patients (1.8 %) with postoperative renal failure requiring hemodialysis. At the point of postoperative recovery, when the patient awakened and was weaned from the respirator in the operating room, early recovery is facilitated. We found a tendency for patients who underwent early extubation to show early recovery including shortened ICU stay and over all hospital stay. As indicated above, beating heart CABG was able to facilitate early recovery easily but produces other problems that we must solve in developing young surgeons' training and hospital income, expansion of indications and rehabilitation of very severely complicated cases.
    View full abstract
    Download PDF (865K)
  • Present status of gene therapy for liver diseases
    YOSHIYUKI TAKEI, NOBUHIRO SATO
    2003 Volume 49 Issue 2 Pages 163-175
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.163
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Impaired gene expression is associated with a variety of liver diseases, including hereditary metabolic disorders, viral hepatitis, liver cirrhosis and hepatocellular carcinoma. Gene therapy promises to significantly change the treatment of those intractable liver disorders through the development of new modalities of gene engineering and effective gene delivery systems in combination with better understanding of the biology of the target diseases. This article reviews the present status of gene therapy targeting liver diseases.
    View full abstract
    Download PDF (2905K)
  • Dexamethasone inhibits human peritoneal mesothelial cell proliferation and collagen synthesis
    CHUNG-JEN YEN, CHENG-CHUNG FANG, MING-SHIOU WU, TUN-JUN TSAI, MITSUMIN ...
    2003 Volume 49 Issue 2 Pages 176-184
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.176
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Background : Peritoneal fibrosis is one of the most serious complications of continuous ambulatory peritoneal dialysis (CAPD). Unrestrained proliferation of mesothelial stem cells with overproduction of the extracellular matrix (ECM) precedes the development of peritoneal fibrosis. In the present study, we examined modulation of proliferation and collagen synthesis of human peritoneal mesothelial cells (HPMC) by the anti-inflammatory agent, dexamethasone. Methods : HPMC was cultured from trypsin-digested human omentum. Proliferation of HPMC was assessed by a modified methyltetrazolium assay. Cell cycle analysis was performed by flow cytometry. Expression of collagen α1 (I) mRNA was determined by Northern blotting. Collagen synthesis was measured using H3-proline incorporation into pepsin-resistant, salt-precipitated collagen. Results : Dexamethasone exerted an inhibitory effect on serum-stimulated HPMC growth in a dose-dependent manner (10-6M >10-7M >10-8M). HPMC proliferation was arrested in the G1 phase by dexamethasone. Dexamethasone decreased procollagen α1 (I) mRNA expression of serum-stimulated HPMC, and also consistently suppressed synthesis of collagen protein by HPMC dose-dependently. Conclusion : Judicious use of dexamethasone may be helpful in the prevention or retardation of the development of peritoneal fibrosis in patients under CAPD.
    View full abstract
    Download PDF (1239K)
  • The modulation of auditory evoked responses by intratympanic dexamethasone in an acoustic exposure model
    NAOKO YOKOI, MASAHARU ISHIKAWA, AKIKO KANO, HIROSHI YOSHIKAWA, GINICHI ...
    2003 Volume 49 Issue 2 Pages 185-193
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.185
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : To study changes with time in auditory evoked responses with intratympanic dexamethasone administration after an acoustic exposure. Materials : Guinea pigs with normal Preyer's reflex. Methods : Tracheostomy was performed under general anesthesia, a muscle relaxant was administered and experiments were conducted under artificial ventilation. For acoustic exposure, 105dBSPL, 4kHz pure tone was given for 30 minutes. After exposure, dexamethasone was administered intratympanically and withdrawn 10 minutes later. As the control, a saline solution was administered on the opposite side. Wave I of ABR and CAP were evaluated before exposure, immediately after exposure, immediately after drug administration, and 1 hour and 2 hours after the exposure. Results : In the present experiment, no significant differences in latency or amplitude were found between the dexamathasone administration side and the control side. However, when latency of ABR I wave and that of CAP were studied in each individual, the recovery of latency was seen more frequently on the dexamathasone administration side in many animals.
    View full abstract
    Download PDF (1144K)
  • The function and role of hospice and palliative care facilities in the community
    -Toward establishing a home hospice care system in Japan : A survey of hospice physicians-
    JUNKO TAKAISHI, MASAKO SUGIMOTO, NAOKO ARAGA, MASAKO AKIYAMA, YOSHIKO, ...
    2003 Volume 49 Issue 2 Pages 194-207
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.194
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : The aim of this study was to examine the functions and roles of hospice and palliative care facilities in the community in order to establish home hospice and palliative care. Sample and method : Four (4) out of thirty-six (36) physicians in charge at all Japanese hospice and palliative care facilities were selected from those who answered a survey in November 1999. We chose 2 prefectures, and then 2 physicians from each prefecture. Four physicians were selected in total. The interview method was utilized. Results : Selected facilities were well equipped appropriately staffed and performing unique activities. These facilities have home hospice functions as well. The four (4) facilities' average length of waiting time for admission was 1-2 weeks. It was explained to the patients and their families prior to admission that they could choose either home hospice care or facility care. The doctors all valued the importance of education as an important aspect of community service which consists of the education of private practice physicians, nurses who work at visiting nurses stations and community residents. Each of the four physicians exhibited a desire to serve patients with terminal illness early in their career. The physicians strongly felt that terminally ill patients should have a choice of home or facility care. They highly evaluated the role of nurses in hospice care and expect nurses to play a more important role in the future. Conclusion : Two prefectures (4 facilities) recently showed different types of growth in hospice care. We expect that the growth of hospice care will be determined by community characteristics.
    View full abstract
    Download PDF (1818K)
  • Facilitation by isoproterenol of skeletal L-type Ca2+ channel openings in H9c2 cells derived from rat heart
    TAKESHI NAKAMURA, NAOKI HINO, RIKUO OCHI
    2003 Volume 49 Issue 2 Pages 208-214
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.208
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : The H9c2 clonal cell line derived from embryonic rat ventricle is an in vitro surrogate for both cardiac and skeletal myocytes. We recorded Ca2+ channel currents from cell-attached patches on H9c2 cells in the myotube stage with the aim of better understanding the effect of isoproterenol on skeletal muscle L-type Ca2+ channel currents. Methods : Experiments were carried out using myotubules cultured for 15-50 days. Single L-type Ca2+ channel currents were recorded from cell-attached patches using 100 mM Ba2+ as the charge carrier in the presence of (+) -202-791, a pure dihydropyridine Ca2+ channel agonist. Results : Single L-type Ca2+ channel currents exhibited long open times with small (skeletal muscle) and large (cardiac) unitary amplitudes. Skeletal muscle L-type channel currents appeared more often than the cardiac channels, and the respective mean currents, which were obtained separately from patches containing both channel types, showed the skeletal muscle current rose more slowly than the cardiac current. Application of 1μ M isoproterenol increased the number of openings of both channel types. In a patch that contained numerous skeletal L-type type channels, isoproterenol increased the maximal amplitude in the current-voltage (I-V) relationship of averaged L-type Ba2+ currents and shifted the I-V curve towards more negative potentials. Conclusion : Skeletal L-type Ca2+ channels are more abundant than cardiac-type channels in H9c2 myotubes. Isoproterenola β-adrenergic agonist, increased openings in the skeletal L-type Ca2+ channels and their averaged currents as in the cardiac L-type Ca2+ channels in ventricular myocytes.
    View full abstract
    Download PDF (839K)
  • A report of 1150 cases of renal biopsy over 23 years in Juntendo University Hospital
    SATOKO SAKODA, KYOICHI TASHIRO, KAZUHIKO FUNABIKI, ISAO SHIRATO, SATOS ...
    2003 Volume 49 Issue 2 Pages 215-221
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.215
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : The incidence of glomerular diseases was investigated according to our two indications for renal biopsy in Juntendo University Hospital. Patients and Methods : Renal biopsies were performed on 1,150 patients from1978 to 2000. The indication for renal biopsy differed with time as follows : (1) In the first period (1978-1986), renal biopsy was performed on patients with microscopic or macroscopic hematuria, proteinuria and/or nephrotic syndrome and (2) in the second period (1987-2000), renal biopsy was not performed on patients with only mild microscopic hematuria and patients with nephrotic syndrome without cellular casts and showing therapeutic effects of steroid therapy. The clinical course of those patients was divided into five types according to the WHO clinical classification. Results : The average number of patients undergoing renal biopsies per year in the first period was 75.4 patients and that in the second period was 33.6. Frequent diseases were IgA nephropathy (42%), non-IgA deposited proliferative glomerulonephritis and minor glomerular abnormalities (MGA) (13%), and membranous nephropathy (12%). In a comparison of the patients in the first and the second peroids, IgA nephropathy increased from 38% to 47%. Non-IgA deposited proliferative glomerulonephritis and MGA decreased from 17% to 7%. Membranous nephropathy increased from 10% to 17%. Chronic nephritic syndrome was associated with IgA nephropathy in 53% and nephrotic syndrome was associated with membranous nephropathy in 33% of patients. Conclusions : The most frequent renal disease was IgA nephropathy in spite of a change in the indication for renal biopsy. The decrease of renal biopsy patients in the second period and different frequencies of renal diseases between the first and second periods might be due to different indications for renal biopsy between the first and second periods. In spite of changes in the indication for renal biopsy, renal biopsy is necessary for diagnosis, selection of therapy and assessment of the prognosis of renal diseases.
    View full abstract
    Download PDF (1031K)
  • Left-sided radiofrequency catheter ablation via patent foramen ovale in a patient with concealed WPW syndrome
    YOJI IIDA, YUJI NAKAZATO, AKITOSHI SASAKI, YASUNOBU KAWANO, YORIAKI MI ...
    2003 Volume 49 Issue 2 Pages 222-225
    Published: July 31, 2003
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.49.222
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    We describe a case of concealed WPW syndrome which was successfully treated by radiofrequency catheter ablation via patent foramen ovale. A 52 year-old female was scheduled for radiofrequency catheter ablation due to paroxysmal supraventricular tachycardia. During electrophysiological study, a patent foramen ovale was disclosed. Ventricular pacing demonstrated retrograde atrial activation with earliest activation in the distal coronary sinus, indicating a left lateral accessory pathway. Early ventricular extrastimulation easily induced orthodromic AV reentry utilizing retrograde conduction over the accessory pathway. An ablation catheter was passed to the left atrium through the patent foramen ovale, and the left-sided accessory pathway was successfully ablated at its atrial attachment. An approach from a patent foramen ovale should be attempted for left-sided accessory pathways when it is detected on preoperative echocardiography or during electrophysiological study.
    View full abstract
    Download PDF (1006K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top