Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 50, Issue 4
Displaying 1-20 of 20 articles from this issue
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Contents
  • Life-style related disease and esophago-gastric disorder
    AKIHITO NAGAHARA, NOBUHIRO SATO
    2004 Volume 50 Issue 4 Pages 322-329
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.322
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    QOL score is lower in patients with Gastro-Esophageal Reflux Disease (GERD) than in the normal population or inpatients with many other conditions e. g. hypertension, heart failure and angina pectoris. Obesity is associated with an increased risk of GERD. The presence of hiatal hernia, increased intra-abdominal pressure and higher output of bile and pancreatic enzymes may cause GERD in obese subject. The presence of vertebral fractures associated with hiatal hernia is considered to aggravate GERD in elderly women. NERD (Non-erosive Reflux Disease) is defined as a patient who complains of reflux symptoms without endoscopic erosions. Esophageal sensitivity is likely to be enhanced especially in NERD patients in comparison with that in erosive GERD patients and controls. Therefore, the pathogenesis of NERD may differ from that of erosive GERD. Correlation between H. pylori and gastric carcinoma has been well discussed recently. However, the reason prevalence of H. pylori infection and gastric cancer vary from country to country in Asia is not yet clear. Factors that may influence the etiology of gastric cancer include the genetic diversity of the infecting H. pylori strains and differences in the host genetic background in various ethnic groups, including genetic polymorphisms in proinflammatory cytokines.
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  • Life style and discomfort on defecation
    SEIYA HOSODA
    2004 Volume 50 Issue 4 Pages 330-337
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.330
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    The Japanese life style has greatly changed over the recent several decades, especially with regard to eating habits. The average amount of dietary fiber consumed per day has decreased to almost half, compared to that in the 1950's, while consumption of oily foods has increased. Therefore, many Japanese have problems with defecation such as irritable bowel syndrome (IBS). Although discomfort on defecation such as constipation and diarrhea is not a critical problem, it does deteriorate QOL and has become a social issue. There is no adequate prescription that will cure IBS. Improvement in living style to obtain better defecation is probably the best way to resolve this problem.
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  • Life-style related diseases and colorectal cancer
    YUICHI TOMIKI, KAZUHIRO SAKAMOTO, TOSHIKI KAMANO
    2004 Volume 50 Issue 4 Pages 338-346
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.338
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    The incidence of and mortality from colorectal cancer are increasing in Japan. One factor contributing to this tendency is the recent lifestyle changes in Japan, especially Westernization of eating habits that have led to increased fat intake. Both a high intake of dietary fats and a low intake of fiber increase cholesterol synthesis, thus enhancing its biliary and fecal concentration. The levels of secondary bile acids were found to be higher in the colorectal cancer group as compared to those in the controls. Accompanying this tendency toward increase, elevation of the serum cholesterol level has also been observed. However, several epidemiological studies have suggested an inverse relation between serum cholesterol level and cancer mortality. Therefore, when examining relation of gastrointestinal cancers with serum lipids, not only advanced stage but also early stage cancer patients showed a significant decrease in serum cholesterol level compared with controls. These results suggest that a low serum cholesterol level is not related to cancer stage. Lifestyle factors are important in the etiology of colorectal cancer. Diets high in vegetables and physical activity have been associated with a decreased risk of colorectal cancer. However, it remains very important to develop screening and surveillance programs for colorectal cancer prevention.
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  • Liver disorders in life style-related diseases : non-alcoholic steatohepatitis (NASH)
    KENICHI IKEJIMA, NOBUHIRO SATO
    2004 Volume 50 Issue 4 Pages 347-354
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.347
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    Non-alcoholic steatohepatitis (NASH) is often accompanied with life style-related disorders including central obesity, type-2 diabetes and hypertension. Since alcoholic liver disease (ALD) and NASH demonstrate similar pathological features, it is hypothesized that ALD and NASH share a common patho-physiological basis. Lines of evidence indicate that obesity is an important risk factor for exacerbation of ALD and NASH, suggesting a possibility that cytokines produced from adipose tissues (adipocytokines) play a crucial role in the pathogenesis. Therefore, we have investigated the role of leptin in hepatic inflammation and fibrogenesis. Leptin prevents LPS-induced liver injury, suggesting that leptin is an anti-inflammatory cytokine. However, leptin augments profibrogenic responses in the liver through up-regulation of TGF-β production from sinusoidal endothelial cells and Kupffer cells, and through enhancement of proliferation in hepatic stellate cells. These findings lead to a hypothesis that adipocytokines, especially leptin, most likely modulate immune/inflammatory responses and progression of hepatic fibrosis in a variety of chronic liver diseases including ALD and NASH. Therapeutic standard for NASH has not been established, however, anti-diabetic thiazolidinedione derivatives (TZDs) and biguanides have been reported to demonstrate beneficial effects in short-term studies.
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  • Proteomics, now evolving
    MITSUAKI YANAGIDA, KIMIE MURAYAMA
    2004 Volume 50 Issue 4 Pages 355-363
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.355
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    Proteomics, a simple term, comprises a wide variety of topics and has been in rapid progress. Since it essentially means the field of comprehensive study of proteins, it includes various methodologies such as protein expression profiling, protein-interaction analysis, post-translational modification analysis, quantitative proteomics, and even structure determination. The successive development of new strategies has expanded the proteomics world further. In this review, we focus on the evolving technologies of proteomics, and discuss its application to medical science.
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  • Development of Method for Evaluating Dietary Habits to Identify HighRisk for Colorectal Cancer; Bile Acid Composition in Feces and Diet
    YOSHIHIKO KAWASE, MASAKAZU OUCHI, YUTAKA KOJIMA, ATSUSHI OKUSAWA, TOMO ...
    2004 Volume 50 Issue 4 Pages 364-372
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.364
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    Objective : The feasibility of using bile acid composition in feces as an objective index of improvement in dietary habits by changing to a low fat-high fiber diet was evaluated as a method of primary colorectal cancer prevention. Materials : Seventy-five healthy volunteers participated and 75 specimens were obtained by Juntendo University School of Medicine. Methods : Using the ELISA method, primary bile acid (CA) and secondary bile acid (DCA) were measured in feces collected the morning after intake of a high fat diet or ordinary diet the previous night. The association of bile acid composition, DCA/CA ratio, with several factors was evaluated. Results : 1 : The DCA/CA ratio significantly increased with age. 2 : The DCA/CA ratio in constipated stool was significantly higher than that in normal stool. 3 : The DCA/ CA ratio was significantly higher in the high fat diet group than in the ordinary diet group. Conclusions : This study is the first report that evaluated bile acid in feces from the perspective of primary colorectal cancer prevention. Data suggested the necessity of improving dietary habits in the high DCA/CA ratio population who were considered to have a high risk of developing colorectal cancer.
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  • Examination of Exfoliated Malignant Cells Collected with Intraluminal Lavage in Anterior Resection
    MAKOTO NAKANO, NAOKI NEGAMI, HIRONOBU SENGOKU, SUMITO SUDA, MASANOBU T ...
    2004 Volume 50 Issue 4 Pages 373-379
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.373
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    We examined the relationship between exfoliated malignant cells collected by intraluminal lavage in anterior resection and anastomosis recurrence. In 34 cases of rectal cancer (the lavage group), we washed the distal rectum with 2000ml of normal saline before rectal dissection, and determined cytologically the existence of exfoliated malignant cells in the irrigation fluid, In 18 cases in the lavage group. we also examined exfoliated malignant cells that stuck to oral and anal bowel stumps pierced by the double stapling technique, and their viabilities. Thirty-five in patients whom washing was not performed (the non-lavage group) were examined for contrast regarding the anastomosis recurrence rate. Intraluminal lavage by 2000ml of saline decreased the number of exfoliated malignant cells in the rectum, compared with washout by 100ml of saline (p=0.001). Though there was no significant difference, intraluminal lavage by 2000ml of saline decreased the anastomosis recurrence rate compared with that in the non-lavage group (p=0.614). We detected 33.3% of exfoliated malignant cells in the oral and anal bowel stumps, and these had high viability. It is considered that we must devise a method to wash such cells out.
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  • Current situation of corneal donor action at Juntendo Eye Bank.
    AKIRA MURAKAMI, KOICHI ONO
    2004 Volume 50 Issue 4 Pages 380-382
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.380
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    Objective : To evaluate the current situation of corneal donors and possible ways to improve corneal donation program of Juntendo Eye Bank. Materials : Donors at Juntendo Eye Bank between 1998 and 2003. Methods : A retrospective review of the eye bank charts. Measurement and Results : During that time, 433 corneas were made available for transplantation. Two hundred forty-six corneas (58 %) were used for penetrating corneal transplantations and 153 corneas (35 %) were used for lamellar keratoplasties. Thirty-one percent of the donated corneas were obtained from other domestic eye banks. The shortage of donor corneas for penetrating keratoplasties was not overcome. Conclusion : Further study on corneal donation is necessary.
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  • The contribution of Igh allotype to the development of collagen-induced arthritis
    JINGYUAN ZHAO, DANQING ZHANG, HISASHI KUROSAWA, SACHIKO HIROSE
    2004 Volume 50 Issue 4 Pages 383-391
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.383
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    Objective : Collagen-induced arthritis (CIA) is a widely used experimental model of rheumatoid arthritis (RA). As in the case of human RA, mouse CIA is associated with particular haplotypes of H-2, the mouse MHC (major histocompatibility complex). In addition to H-2-linked gene, non-H-2-linked genes also seem to be involved in the pathogenesis of CIA. In this study, we investigated the possible contribution of immunoglobulin heavy chain (Igh) gene allotype to the development of mouse CIA. Materials and Methods : The B6.Igha- congenic strain (H-2b, Igha) was established by introducing Igha allotype into C57BL/6 (B6) mice bearin the H-2b and Ighb allotype. The IgG Fc receptor γ chain (FcR γ) -deficient B6.Igha. FcR γ-/- strain was established by crossing B6.Igha and B6.FcR γ-/- mice. These mice were immunized with bovine type II collagen, and clinical and histological findings were evaluated to estimate, disease severity. Results : B6 mice did not develop CIA, because of the CIA-resistant H-2b haplotype. In contrast, B6.Igha- congenic mice developed CIA despite the H-2b haplotype. The incidence of CIA was significantly higher in male (54.4%) than in female mice (20%) (P<0.05). Serum levels of IgG1 and IgG2a antibodies to type II collagen were up-regulated in B6.Igha mice, as compared to those in B6 mice. Interestingly, B6.Igha. FcR γ-/- mice showed anti-collagen antibodylevels comparable to those in B6.Igha mice ; however, B6.Igha FcRγ-/- mice did not develop CIA. Conclusions : Our data suggest that Igh allotype contributes to the development of CIA through the up-regulation of anti-collagen antibody production and that FcR γ -mediated signals via immune complexes composed of anti-collagen antibodies and collagen play an important role in the effector phase of inflammation in CIA.
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  • Risk factor of Alzheimer's disease
    --Clinical study in the Medical Care Center for the Demented Elderly in Juntendo University Urayasu Hospital--
    RYO KUMAGAI, MASAKO UDAGAWA, YOSHINO IIZUKA, SHIGEKI TANAKA, YOSUKE IC ...
    2004 Volume 50 Issue 4 Pages 392-398
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.392
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    Objective : To examine risk factors for Alzheimer's disease in Urayasu area, we studied clinical features of patients who consulted the Medical Care Center for the Demented Elderly in Juntendo University Urayasu Hospital retrospectively. Materials : Sixty patients with Alzheimer's disease, who were diagnosed by the DSM-IV criteria and findings on laboratory examinations such as brain CT, MRI and SPECT, were studied. Methods : Clinical features (such as sex, age of onset, medical history and apolipoprotein E genotype) were investigated by retrospective review of the medical records. In addition, the clinical effect of donepezil hydrochloride was also examined. Results : The sex ratio was 21 : 39, and the mean age at onset was 72.3±8.4 years old. The subtypes of apolipoprotein E were divided into the following; 5 cases had ε4/4 (mean age was 72.8± 7.2 years old ; 2 males, 3 females), 29 cases had ε4/3 (73.8 ±7.7years old ; 11 males, 18 females), one case had ε4/2 (77 years old ; female), 24 cases had ε3/3 (69.8 ±8.6 years old ; 9 males, 15 females), and one case had ε3/2 (76 years old ; female). Among E 4 carriers, there were many cases showins onset under 70 years old. Most of the cases had complications such as a hypertension or diabetes mellitus or cholesteremia. The number of cases were increased by a total cholesterol value over 220mg/dl. Education history less than nine years was observed in 33 cases, 29 of these 33 cases were women. Donepezil hydrochloride inhibited the progression of dementia in most cases. However, these effects were reduced in E 4 carriers. Conclusions : In this study, female, aging and ε4 were considered risk factors for Alzheimer's disease. These findings are similar to the previous reports. In addition, it was suggested that living habits, especially cholesteremia contributed to onset. It is important to confirm which examinations are useful for early diagnosis and early treatment of Alzheimer's disease.
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  • The decomposition of hydrogen peroxide
    --On measurements of the rate of reaction--
    MASAO TSUKADA, AKIHIKO SEO, TOMOAKI YOKOKURA
    2004 Volume 50 Issue 4 Pages 515-522
    Published: December 22, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.515
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    Objective : The differences in the experimental methods and the correlations of the results were examined for the decomposition reaction of hydrogen peroxide. A suitable method for practice for students was investigated. Methods : The rate of the reaction was measured using three different methods, the volume measurement, the pressure measurement and the mass measurement. Results : Controlling the temperature was more difficult in the mass measurement than in the other methods. It was proved that room temperature was appropriate for the catalyst. Both the volume measurement and the pressure measurement resulted in data employed to determine the rate constants. The errors were increased with the progress of the reaction in the mass measurement. Almost the same values of activation energy were obtained using all of the methods. Conclusions : The volume measurement method and the pressure measurement method obtained higher reliability than the mass measurement method. It is advisable to give different methods to different groups and compare the results in practice for students.
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